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Armstrong MJ, Dai Y, Sovich K, LaBarre B, Paulson HL, Maixner SM, Fields JA, Lunde AM, Forsberg LK, Boeve BF, Manning CA, Galvin JE, Taylor AS, Li Z. Caregiver Experiences and Burden in Moderate-Advanced Dementia With Lewy Bodies. Neurol Clin Pract 2024; 14:e200292. [PMID: 38617555 PMCID: PMC11014644 DOI: 10.1212/cpj.0000000000200292] [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] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/23/2024] [Indexed: 04/16/2024]
Abstract
Background and Objectives Dementia with Lewy bodies (DLB) is a common degenerative dementia, but research on caregiver experiences in late stages is lacking. This study aimed to investigate the caregiving experience in moderate-advanced DLB to identify opportunities for improving care and support. Methods Dyads of individuals with moderate-advanced DLB and their primary informal caregivers were recruited from specialty clinics, advocacy organizations, and research registries. The study collected demographics, disease-related measures, and measures of the caregiver experience relating to caregiver support, burden, grief, self-efficacy, depression, quality of life, and coping. Spearman correlation coefficients and Wilcoxon rank-sum tests evaluated the relationships of caregiver measures with patient and caregiver variables with adjustments for multiple testing. Results Caregivers (n = 143) were mostly women (83.5%) and spouses (84.7%) (mean age 68 years; range 37-85). Almost 40% reported high burden and/or depression. Caregiver measures correlated with fluctuation and behavioral symptom severity, sleepiness, and autonomic symptoms of the person with DLB. Higher burden correlated with worse caregiver quality of life, higher depression, and grief. Greater self-efficacy, social support, and resilience correlated with lower caregiver burden. The most frequently reported caregiver concerns were being unable to plan for the future, having to put the needs of the person with DLB ahead of the caregiver's own needs, and worry that the person with DLB would become too dependent on the caregiver, but many additional concerns were endorsed. Caregivers were generally satisfied with medical team support. The lowest reported satisfaction related to information regarding disease progression and how well medical teams shared information with each other. Discussion Various patient-related and caregiver-related factors influence caregiver experiences in moderate-advanced DLB. Clinicians can target caregiver needs by providing support resources and DLB education and treating bothersome patient symptoms. Future research should investigate what interventions can modify and improve caregiver experiences in advanced DLB and identify therapeutics for patient symptoms currently without adequate treatments (e.g., fluctuations, daytime sleepiness). Trial Registration Information NCT04829656.
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Affiliation(s)
- Melissa J Armstrong
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - Yunfeng Dai
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - Kaitlin Sovich
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - Brian LaBarre
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - Henry L Paulson
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - Susan M Maixner
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - Julie A Fields
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - Angela M Lunde
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - Leah K Forsberg
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - Bradley F Boeve
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - Carol A Manning
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - James E Galvin
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - Angela S Taylor
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
| | - Zhigang Li
- Department of Neurology (MJA, KS), University of Florida College of Medicine; Norman Fixel Institute for Neurological Diseases (MJA); Department of Biostatistics (YD, BL, ZL), University of Florida College of Medicine, Gainesville; Departments of Neurology (HLP) and Psychiatry (SMM), University of Michigan, Ann Arbor; Departments of Psychiatry and Psychology (JAF) and Neurology (AML, LKF, BFB), Mayo Clinic Rochester, MN; Department of Neurology (CAM), University of Virginia, Charlottesville; Comprehensive Center for Brain Health (JEG), Department of Neurology, University of Miami Miller School of Medicine, FL; and Lewy Body Dementia Association (AST), Lilburn, GA
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Karstens AJ, Christianson TJ, Lundt ES, Machulda MM, Mielke MM, Fields JA, Kremers WK, Graff-Radford J, Vemuri P, Jack CR, Knopman DS, Petersen RC, Stricker NH. Mayo normative studies: regression-based normative data for ages 30-91 years with a focus on the Boston Naming Test, Trail Making Test and Category Fluency. J Int Neuropsychol Soc 2024; 30:389-401. [PMID: 38014536 PMCID: PMC11014770 DOI: 10.1017/s1355617723000760] [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: 11/29/2023]
Abstract
OBJECTIVE Normative neuropsychological data are essential for interpretation of test performance in the context of demographic factors. The Mayo Normative Studies (MNS) aim to provide updated normative data for neuropsychological measures administered in the Mayo Clinic Study of Aging (MCSA), a population-based study of aging that randomly samples residents of Olmsted County, Minnesota, from age- and sex-stratified groups. We examined demographic effects on neuropsychological measures and validated the regression-based norms in comparison to existing normative data developed in a similar sample. METHOD The MNS includes cognitively unimpaired adults ≥30 years of age (n = 4,428) participating in the MCSA. Multivariable linear regressions were used to determine demographic effects on test performance. Regression-based normative formulas were developed by first converting raw scores to normalized scaled scores and then regressing on age, age2, sex, and education. Total and sex-stratified base rates of low scores (T < 40) were examined in an older adult validation sample and compared with Mayo's Older Americans Normative Studies (MOANS) norms. RESULTS Independent linear regressions revealed variable patterns of linear and/or quadratic effects of age (r2 = 6-27% variance explained), sex (0-13%), and education (2-10%) across measures. MNS norms improved base rates of low performance in the older adult validation sample overall and in sex-specific patterns relative to MOANS. CONCLUSIONS Our results demonstrate the need for updated norms that consider complex demographic associations on test performance and that specifically exclude participants with mild cognitive impairment from the normative sample.
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Affiliation(s)
- Aimee J. Karstens
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Teresa J. Christianson
- Division of Biomedical Statistics and Informatics,
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Emily S. Lundt
- Division of Biomedical Statistics and Informatics,
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Mary M. Machulda
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle M. Mielke
- Department of Epidemiology and Prevention, Wake Forest
University School of Medicine, Winston-Salem, NC, USA
- Department of Gerontology and Geriatric Medicine, Wake
Forest University School of Medicine, Winston-Salem, NC, USA
| | - Julie A. Fields
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Walter K. Kremers
- Division of Biomedical Statistics and Informatics,
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | | | | | | | - Nikki H. Stricker
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
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Kouri N, Frankenhauser I, Peng Z, Labuzan SA, Boon BDC, Moloney CM, Pottier C, Wickland DP, Caetano-Anolles K, Corriveau-Lecavalier N, Tranovich JF, Wood AC, Hinkle KM, Lincoln SJ, Spychalla AJ, Senjem ML, Przybelski SA, Engelberg-Cook E, Schwarz CG, Kwan RS, Lesser ER, Crook JE, Carter RE, Ross OA, Lachner C, Ertekin-Taner N, Ferman TJ, Fields JA, Machulda MM, Ramanan VK, Nguyen AT, Reichard RR, Jones DT, Graff-Radford J, Boeve BF, Knopman DS, Petersen RC, Jack CR, Kantarci K, Day GS, Duara R, Graff-Radford NR, Dickson DW, Lowe VJ, Vemuri P, Murray ME. Clinicopathologic Heterogeneity and Glial Activation Patterns in Alzheimer Disease. JAMA Neurol 2024:2817289. [PMID: 38619853 PMCID: PMC11019448 DOI: 10.1001/jamaneurol.2024.0784] [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] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/05/2024] [Indexed: 04/16/2024]
Abstract
Importance Factors associated with clinical heterogeneity in Alzheimer disease (AD) lay along a continuum hypothesized to associate with tangle distribution and are relevant for understanding glial activation considerations in therapeutic advancement. Objectives To examine clinicopathologic and neuroimaging characteristics of disease heterogeneity in AD along a quantitative continuum using the corticolimbic index (CLix) to account for individuality of spatially distributed tangles found at autopsy. Design, Setting, and Participants This cross-sectional study was a retrospective medical record review performed on the Florida Autopsied Multiethnic (FLAME) cohort accessioned from 1991 to 2020. Data were analyzed from December 2022 to December 2023. Structural magnetic resonance imaging (MRI) and tau positron emission tomography (PET) were evaluated in an independent neuroimaging group. The FLAME cohort includes 2809 autopsied individuals; included in this study were neuropathologically diagnosed AD cases (FLAME-AD). A digital pathology subgroup of FLAME-AD cases was derived for glial activation analyses. Main Outcomes and Measures Clinicopathologic factors of heterogeneity that inform patient history and neuropathologic evaluation of AD; CLix score (lower, relative cortical predominance/hippocampal sparing vs higher, relative cortical sparing/limbic predominant cases); neuroimaging measures (ie, structural MRI and tau-PET). Results Of the 2809 autopsied individuals in the FLAME cohort, 1361 neuropathologically diagnosed AD cases were evaluated. A digital pathology subgroup included 60 FLAME-AD cases. The independent neuroimaging group included 93 cases. Among the 1361 FLAME-AD cases, 633 were male (47%; median [range] age at death, 81 [54-96] years) and 728 were female (53%; median [range] age at death, 81 [53-102] years). A younger symptomatic onset (Spearman ρ = 0.39, P < .001) and faster decline on the Mini-Mental State Examination (Spearman ρ = 0.27; P < .001) correlated with a lower CLix score in FLAME-AD series. Cases with a nonamnestic syndrome had lower CLix scores (median [IQR], 13 [9-18]) vs not (median [IQR], 21 [15-27]; P < .001). Hippocampal MRI volume (Spearman ρ = -0.45; P < .001) and flortaucipir tau-PET uptake in posterior cingulate and precuneus cortex (Spearman ρ = -0.74; P < .001) inversely correlated with CLix score. Although AD cases with a CLix score less than 10 had higher cortical tangle count, we found lower percentage of CD68-activated microglia/macrophage burden (median [IQR], 0.46% [0.32%-0.75%]) compared with cases with a CLix score of 10 to 30 (median [IQR], 0.75% [0.51%-0.98%]) and on par with a CLix score of 30 or greater (median [IQR], 0.40% [0.32%-0.57%]; P = .02). Conclusions and Relevance Findings show that AD heterogeneity exists along a continuum of corticolimbic tangle distribution. Reduced CD68 burden may signify an underappreciated association between tau accumulation and microglia/macrophages activation that should be considered in personalized therapy for immune dysregulation.
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Affiliation(s)
- Naomi Kouri
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | - Isabelle Frankenhauser
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
- Paracelsus Medical Private University, Salzburg, Austria
| | - Zhongwei Peng
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | | | | | | | - Cyril Pottier
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | - Daniel P. Wickland
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | | | - Nick Corriveau-Lecavalier
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | | | - Ashley C. Wood
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | - Kelly M. Hinkle
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | | | | | | | - Scott A. Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | | | | | - Rain S. Kwan
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | - Elizabeth R. Lesser
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | - Julia E. Crook
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | - Rickey E. Carter
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | - Owen A. Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | - Christian Lachner
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida
| | - Nilüfer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
- Department of Neurology, Mayo Clinic, Jacksonville, Florida
| | - Tanis J. Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Mary M. Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | | | - Aivi T. Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - R. Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - David T. Jones
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | | | | | | | | | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Gregory S. Day
- Department of Neurology, Mayo Clinic, Jacksonville, Florida
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, Florida
| | | | | | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Vandebergh M, Ramos EM, Corriveau-Lecavalier N, Ramanan VK, Kornak J, Mester C, Kolander T, Brushaber D, Staffaroni AM, Geschwind D, Wolf A, Kantarci K, Gendron TF, Petrucelli L, Van den Broeck M, Wynants S, Baker MC, Borrego – Écija S, Appleby B, Barmada S, Bozoki A, Clark D, Darby RR, Dickerson BC, Domoto-Reilly K, Fields JA, Galasko DR, Ghoshal N, Graff-Radford N, Grant IM, Honig LS, Hsiung GYR, Huey ED, Irwin D, Knopman DS, Kwan JY, Léger GC, Litvan I, Masdeu JC, Mendez MF, Onyike C, Pascual B, Pressman P, Ritter A, Roberson ED, Snyder A, Sullivan AC, Tartaglia MC, Wint D, Heuer HW, Forsberg LK, Boxer AL, Rosen HJ, Boeve BF, Rademakers R. Gene specific effects on brain volume and cognition of TMEM106B in frontotemporal lobar degeneration. medRxiv 2024:2024.04.05.24305253. [PMID: 38633784 PMCID: PMC11023674 DOI: 10.1101/2024.04.05.24305253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Background and Objectives TMEM106B has been proposed as a modifier of disease risk in FTLD-TDP, particularly in GRN mutation carriers. Furthermore, TMEM106B has been investigated as a disease modifier in the context of healthy aging and across multiple neurodegenerative diseases. The objective of this study is to evaluate and compare the effect of TMEM106B on gray matter volume and cognition in each of the common genetic FTD groups and in sporadic FTD patients. Methods Participants were enrolled through the ARTFL/LEFFTDS Longitudinal Frontotemporal Lobar Degeneration (ALLFTD) study, which includes symptomatic and presymptomatic individuals with a pathogenic mutation in C9orf72, GRN, MAPT, VCP, TBK1, TARDBP, symptomatic non-mutation carriers, and non-carrier family controls. All participants were genotyped for the TMEM106B rs1990622 SNP. Cross-sectionally, linear mixed-effects models were fitted to assess an association between TMEM106B and genetic group interaction with each outcome measure (gray matter volume and UDS3-EF for cognition), adjusting for education, age, sex and CDR®+NACC-FTLD sum of boxes. Subsequently, associations between TMEM106B and each outcome measure were investigated within the genetic group. For longitudinal modeling, linear mixed-effects models with time by TMEM106B predictor interactions were fitted. Results The minor allele of TMEM106B rs1990622, linked to a decreased risk of FTD, associated with greater gray matter volume in GRN mutation carriers under the recessive dosage model. This was most pronounced in the thalamus in the left hemisphere, with a retained association when considering presymptomatic GRN mutation carriers only. The minor allele of TMEM106B rs1990622 also associated with greater cognitive scores among all C9orf72 mutation carriers and in presymptomatic C9orf72 mutation carriers, under the recessive dosage model. Discussion We identified associations of TMEM106B with gray matter volume and cognition in the presence of GRN and C9orf72 mutations. This further supports TMEM106B as modifier of TDP-43 pathology. The association of TMEM106B with outcomes of interest in presymptomatic GRN and C9orf72 mutation carriers could additionally reflect TMEM106B's impact on divergent pathophysiological changes before the appearance of clinical symptoms.
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Affiliation(s)
- Marijne Vandebergh
- VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Eliana Marisa Ramos
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Nick Corriveau-Lecavalier
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Carly Mester
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Tyler Kolander
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Danielle Brushaber
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Daniel Geschwind
- Institute for Precision Health, Departments of Neurology, Psychiatry and Human Genetics at David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Amy Wolf
- Department of Neurology, Memory and Aging Center, University of California, San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Kejal Kantarci
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Tania F Gendron
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | - Marleen Van den Broeck
- VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Sarah Wynants
- VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Matthew C Baker
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Sergi Borrego – Écija
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca Biomèdica, Universitat de Barcelona, Barcelona, Spain
| | - Brian Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Sami Barmada
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Andrea Bozoki
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - David Clark
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - R Ryan Darby
- Department of Neurology, Vanderbilt University, Nashville, TN, USA
| | | | | | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Douglas R. Galasko
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Nupur Ghoshal
- Departments of Neurology and Psychiatry, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | | | - Ian M Grant
- Department of Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Lawrence S Honig
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, Columbia University, New York, NY, USA
| | - Ging-Yuek Robin Hsiung
- Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edward D Huey
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - David Irwin
- Department of Neurology and Penn Frontotemporal Degeneration Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David S Knopman
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Justin Y Kwan
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Gabriel C Léger
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Irene Litvan
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Joseph C Masdeu
- Department of Neurology, Houston Methodist, Houston, TX, USA
| | - Mario F Mendez
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chiadi Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Belen Pascual
- Department of Neurology, Houston Methodist, Houston, TX, USA
| | - Peter Pressman
- Department of Neurology, University of Colorado, Aurora, CO, USA
| | - Aaron Ritter
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, 89106, USA
| | - Erik D Roberson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allison Snyder
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Anna Campbell Sullivan
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, UT Health San Antonio
| | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Dylan Wint
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, 89106, USA
| | - Hilary W Heuer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Leah K Forsberg
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
| | | | - Rosa Rademakers
- VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
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5
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Corriveau-Lecavalier N, Barnard LR, Botha H, Graff-Radford J, Ramanan VK, Lee J, Dicks E, Rademakers R, Boeve BF, Machulda MM, Fields JA, Dickson DW, Graff-Radford N, Knopman DS, Lowe VJ, Petersen RC, Jack CR, Jones DT. Uncovering the distinct macro-scale anatomy of dysexecutive and behavioural degenerative diseases. Brain 2024; 147:1483-1496. [PMID: 37831661 PMCID: PMC10994526 DOI: 10.1093/brain/awad356] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/28/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
There is a longstanding ambiguity regarding the clinical diagnosis of dementia syndromes predominantly targeting executive functions versus behaviour and personality. This is due to an incomplete understanding of the macro-scale anatomy underlying these symptomatologies, a partial overlap in clinical features and the fact that both phenotypes can emerge from the same pathology and vice versa. We collected data from a patient cohort of which 52 had dysexecutive Alzheimer's disease, 30 had behavioural variant frontotemporal dementia (bvFTD), seven met clinical criteria for bvFTD but had Alzheimer's disease pathology (behavioural Alzheimer's disease) and 28 had amnestic Alzheimer's disease. We first assessed group-wise differences in clinical and cognitive features and patterns of fluorodeoxyglucose (FDG) PET hypometabolism. We then performed a spectral decomposition of covariance between FDG-PET images to yield latent patterns of relative hypometabolism unbiased by diagnostic classification, which are referred to as 'eigenbrains'. These eigenbrains were subsequently linked to clinical and cognitive data and meta-analytic topics from a large external database of neuroimaging studies reflecting a wide range of mental functions. Finally, we performed a data-driven exploratory linear discriminant analysis to perform eigenbrain-based multiclass diagnostic predictions. Dysexecutive Alzheimer's disease and bvFTD patients were the youngest at symptom onset, followed by behavioural Alzheimer's disease, then amnestic Alzheimer's disease. Dysexecutive Alzheimer's disease patients had worse cognitive performance on nearly all cognitive domains compared with other groups, except verbal fluency which was equally impaired in dysexecutive Alzheimer's disease and bvFTD. Hypometabolism was observed in heteromodal cortices in dysexecutive Alzheimer's disease, temporo-parietal areas in amnestic Alzheimer's disease and frontotemporal areas in bvFTD and behavioural Alzheimer's disease. The unbiased spectral decomposition analysis revealed that relative hypometabolism in heteromodal cortices was associated with worse dysexecutive symptomatology and a lower likelihood of presenting with behaviour/personality problems, whereas relative hypometabolism in frontotemporal areas was associated with a higher likelihood of presenting with behaviour/personality problems but did not correlate with most cognitive measures. The linear discriminant analysis yielded an accuracy of 82.1% in predicting diagnostic category and did not misclassify any dysexecutive Alzheimer's disease patient for behavioural Alzheimer's disease and vice versa. Our results strongly suggest a double dissociation in that distinct macro-scale underpinnings underlie predominant dysexecutive versus personality/behavioural symptomatology in dementia syndromes. This has important implications for the implementation of criteria to diagnose and distinguish these diseases and supports the use of data-driven techniques to inform the classification of neurodegenerative diseases.
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Affiliation(s)
| | | | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Vijay K Ramanan
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Jeyeon Lee
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - Ellen Dicks
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
- Center for Molecular Neurology, Antwerp University, Antwerp, Belgium
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | - David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
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6
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Mak E, Reid RI, Przybelski SA, Lesnick TG, Schwarz CG, Senjem ML, Raghavan S, Vemuri P, Jack CR, Min HK, Jain MK, Miyagawa T, Forsberg LK, Fields JA, Savica R, Graff-Radford J, Jones DT, Botha H, St Louis EK, Knopman DS, Ramanan VK, Dickson DW, Graff-Radford NR, Ferman TJ, Petersen RC, Lowe VJ, Boeve BF, O'Brien JT, Kantarci K. Influences of amyloid-β and tau on white matter neurite alterations in dementia with Lewy bodies. NPJ Parkinsons Dis 2024; 10:76. [PMID: 38570511 PMCID: PMC10991290 DOI: 10.1038/s41531-024-00684-4] [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: 07/19/2023] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
Dementia with Lewy bodies (DLB) is a neurodegenerative condition often co-occurring with Alzheimer's disease (AD) pathology. Characterizing white matter tissue microstructure using Neurite Orientation Dispersion and Density Imaging (NODDI) may help elucidate the biological underpinnings of white matter injury in individuals with DLB. In this study, diffusion tensor imaging (DTI) and NODDI metrics were compared in 45 patients within the dementia with Lewy bodies spectrum (mild cognitive impairment with Lewy bodies (n = 13) and probable dementia with Lewy bodies (n = 32)) against 45 matched controls using conditional logistic models. We evaluated the associations of tau and amyloid-β with DTI and NODDI parameters and examined the correlations of AD-related white matter injury with Clinical Dementia Rating (CDR). Structural equation models (SEM) explored relationships among age, APOE ε4, amyloid-β, tau, and white matter injury. The DLB spectrum group exhibited widespread white matter abnormalities, including reduced fractional anisotropy, increased mean diffusivity, and decreased neurite density index. Tau was significantly associated with limbic and temporal white matter injury, which was, in turn, associated with worse CDR. SEM revealed that amyloid-β exerted indirect effects on white matter injury through tau. We observed widespread disruptions in white matter tracts in DLB that were not attributed to AD pathologies, likely due to α-synuclein-related injury. However, a fraction of the white matter injury could be attributed to AD pathology. Our findings underscore the impact of AD pathology on white matter integrity in DLB and highlight the utility of NODDI in elucidating the biological basis of white matter injury in DLB.
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Affiliation(s)
- Elijah Mak
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Robert I Reid
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Scott A Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Timothy G Lesnick
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Hoon Ki Min
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Manoj K Jain
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Erik K St Louis
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
- Center for Sleep Medicine, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Dennis W Dickson
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Tanis J Ferman
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Ronald C Petersen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
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7
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Staffaroni AM, Clark AL, Taylor JC, Heuer HW, Sanderson-Cimino M, Wise AB, Dhanam S, Cobigo Y, Wolf A, Manoochehri M, Forsberg L, Mester C, Rankin KP, Appleby BS, Bayram E, Bozoki A, Clark D, Darby RR, Domoto-Reilly K, Fields JA, Galasko D, Geschwind D, Ghoshal N, Graff-Radford N, Grossman M, Hsiung GY, Huey ED, Jones DT, Lapid MI, Litvan I, Masdeu JC, Massimo L, Mendez MF, Miyagawa T, Pascual B, Pressman P, Ramanan VK, Ramos EM, Rascovsky K, Roberson ED, Tartaglia MC, Wong B, Miller BL, Kornak J, Kremers W, Hassenstab J, Kramer JH, Boeve BF, Rosen HJ, Boxer AL. Reliability and Validity of Smartphone Cognitive Testing for Frontotemporal Lobar Degeneration. JAMA Netw Open 2024; 7:e244266. [PMID: 38558141 PMCID: PMC10985553 DOI: 10.1001/jamanetworkopen.2024.4266] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Importance Frontotemporal lobar degeneration (FTLD) is relatively rare, behavioral and motor symptoms increase travel burden, and standard neuropsychological tests are not sensitive to early-stage disease. Remote smartphone-based cognitive assessments could mitigate these barriers to trial recruitment and success, but no such tools are validated for FTLD. Objective To evaluate the reliability and validity of smartphone-based cognitive measures for remote FTLD evaluations. Design, Setting, and Participants In this cohort study conducted from January 10, 2019, to July 31, 2023, controls and participants with FTLD performed smartphone application (app)-based executive functioning tasks and an associative memory task 3 times over 2 weeks. Observational research participants were enrolled through 18 centers of a North American FTLD research consortium (ALLFTD) and were asked to complete the tests remotely using their own smartphones. Of 1163 eligible individuals (enrolled in parent studies), 360 were enrolled in the present study; 364 refused and 439 were excluded. Participants were divided into discovery (n = 258) and validation (n = 102) cohorts. Among 329 participants with data available on disease stage, 195 were asymptomatic or had preclinical FTLD (59.3%), 66 had prodromal FTLD (20.1%), and 68 had symptomatic FTLD (20.7%) with a range of clinical syndromes. Exposure Participants completed standard in-clinic measures and remotely administered ALLFTD mobile app (app) smartphone tests. Main Outcomes and Measures Internal consistency, test-retest reliability, association of smartphone tests with criterion standard clinical measures, and diagnostic accuracy. Results In the 360 participants (mean [SD] age, 54.0 [15.4] years; 209 [58.1%] women), smartphone tests showed moderate-to-excellent reliability (intraclass correlation coefficients, 0.77-0.95). Validity was supported by association of smartphones tests with disease severity (r range, 0.38-0.59), criterion-standard neuropsychological tests (r range, 0.40-0.66), and brain volume (standardized β range, 0.34-0.50). Smartphone tests accurately differentiated individuals with dementia from controls (area under the curve [AUC], 0.93 [95% CI, 0.90-0.96]) and were more sensitive to early symptoms (AUC, 0.82 [95% CI, 0.76-0.88]) than the Montreal Cognitive Assessment (AUC, 0.68 [95% CI, 0.59-0.78]) (z of comparison, -2.49 [95% CI, -0.19 to -0.02]; P = .01). Reliability and validity findings were highly similar in the discovery and validation cohorts. Preclinical participants who carried pathogenic variants performed significantly worse than noncarrier family controls on 3 app tasks (eg, 2-back β = -0.49 [95% CI, -0.72 to -0.25]; P < .001) but not a composite of traditional neuropsychological measures (β = -0.14 [95% CI, -0.42 to 0.14]; P = .32). Conclusions and Relevance The findings of this cohort study suggest that smartphones could offer a feasible, reliable, valid, and scalable solution for remote evaluations of FTLD and may improve early detection. Smartphone assessments should be considered as a complementary approach to traditional in-person trial designs. Future research should validate these results in diverse populations and evaluate the utility of these tests for longitudinal monitoring.
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Affiliation(s)
- Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Annie L Clark
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Jack C Taylor
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Hilary W Heuer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Mark Sanderson-Cimino
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Amy B Wise
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Sreya Dhanam
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Amy Wolf
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | | | - Leah Forsberg
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Carly Mester
- Department of Quantitative Health Sciences, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Katherine P Rankin
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Brian S Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, Ohio
| | - Ece Bayram
- Department of Neurosciences, University of California, San Diego, La Jolla
| | - Andrea Bozoki
- Department of Radiology, University of North Carolina, Chapel Hill
| | - David Clark
- Department of Neurology, Indiana University, Indianapolis
| | - R Ryan Darby
- Department of Neurology, Vanderbilt University, Nashville, Tennessee
| | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Douglas Galasko
- Department of Neurosciences, University of California, San Diego, La Jolla
| | - Daniel Geschwind
- Department of Neurology, Institute for Precision Health, University of California, Los Angeles
| | - Nupur Ghoshal
- Department of Neurology, Knight Alzheimer Disease Research Center, Washington University, Saint Louis, Missouri
- Department of Psychiatry, Knight Alzheimer Disease Research Center, Washington University, Saint Louis, Missouri
| | | | - Murray Grossman
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Ging-Yuek Hsiung
- Division of Neurology, University of British Columbia, Musqueam, Squamish & Tsleil-Waututh Traditional Territory, Vancouver, Canada
| | - Edward D Huey
- Department of Neurology, Columbia University, New York, New York
| | - David T Jones
- Department of Quantitative Health Sciences, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Irene Litvan
- Department of Neurosciences, University of California, San Diego, La Jolla
| | - Joseph C Masdeu
- Department of Neurology, Nantz National Alzheimer Center, Houston Methodist and Weill Cornell Medicine, Houston Methodist, Houston, Texas
| | - Lauren Massimo
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Mario F Mendez
- Department of Neurology, UCLA (University of California, Los Angeles)
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Belen Pascual
- Department of Neurology, Nantz National Alzheimer Center, Houston Methodist and Weill Cornell Medicine, Houston Methodist, Houston, Texas
| | | | | | | | - Katya Rascovsky
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | | | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Bonnie Wong
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Walter Kremers
- Department of Quantitative Health Sciences, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Jason Hassenstab
- Department of Neurology, Knight Alzheimer Disease Research Center, Washington University, Saint Louis, Missouri
- Department of Psychological & Brain Sciences, Washington University, Saint Louis, Missouri
| | - Joel H Kramer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | | | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
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8
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Diaz‐Galvan P, Przybelski SA, Algeciras‐Schimnich A, Figdore DJ, Lesnick TG, Schwarz CG, Senjem ML, Gunter JL, Jack CR, Min PH, Jain MK, Miyagawa T, Forsberg LK, Fields JA, Savica R, Graff‐Radford J, Ramanan VK, Jones DT, Botha H, St Louis EK, Knopman DS, Graff‐Radford NR, Ferman TJ, Petersen RC, Lowe VJ, Boeve BF, Kantarci K. Plasma biomarkers of Alzheimer's disease in the continuum of dementia with Lewy bodies. Alzheimers Dement 2024; 20:2485-2496. [PMID: 38329197 PMCID: PMC11032523 DOI: 10.1002/alz.13653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Patients with dementia with Lewy bodies (DLB) may have Alzheimers disease (AD) pathology that can be detected by plasma biomarkers. Our objective was to evaluate plasma biomarkers of AD and their association with positron emission tomography (PET) biomarkers of amyloid and tau deposition in the continuum of DLB, starting from prodromal stages of the disease. METHODS The cohort included patients with isolated rapid eye movement (REM) sleep behavior disorder (iRBD), mild cognitive impairment with Lewy bodies (MCI-LB), or DLB, with a concurrent blood draw and PET scans. RESULTS Abnormal levels of plasma glial fibrillary acidic protein (GFAP) were found at the prodromal stage of MCI-LB in association with increased amyloid PET. Abnormal levels of plasma phosphorylated tau (p-tau)-181 and neurofilament light (NfL) were found at the DLB stage. Plasma p-tau-181 showed the highest accuracy in detecting abnormal amyloid and tau PET in patients with DLB. DISCUSSION The range of AD co-pathology can be detected with plasma biomarkers in the DLB continuum, particularly with plasma p-tau-181 and GFAP.
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Affiliation(s)
| | | | | | - Dan J. Figdore
- Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Timothy G. Lesnick
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | | | | | | | | | - Paul H Min
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
| | - Manoj K. Jain
- Department of RadiologyMayo ClinicJacksonvilleFloridaUSA
| | - Toji Miyagawa
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | | | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | | | | | | | | | - Hugo Botha
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Erik K. St Louis
- Mayo Center for Sleep MedicineMayo ClinicRochesterMinnesotaUSA
- Departments of Neurology and Clinical and Translational ResearchMayo Clinic Southwest WisconsinLa CrosseWisconsinUSA
| | | | | | - Tanis J. Ferman
- Department of Psychiatry & PsychologyMayo ClinicJacksonvilleFloridaUSA
| | - Ronald C. Petersen
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Val J. Lowe
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
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9
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Armstrong MJ, LaBarre B, Sovich K, Maixner SM, Paulson HL, Manning C, Fields JA, Lunde A, Forsberg L, Boeve BF, Galvin JE, Taylor AS, Li Z. Patient- and proxy-reported quality of life in advanced dementia with Lewy bodies. Alzheimers Dement 2024; 20:2719-2730. [PMID: 38400528 PMCID: PMC11032544 DOI: 10.1002/alz.13745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Little is known regarding quality of life (QoL) in dementia with Lewy bodies (DLB), particularly in advanced stages. METHODS Dyads of individuals with moderate-advanced DLB and their primary caregivers were recruited from specialty clinics, advocacy organizations, and research registries. The study collected demographics, disease-related measures, and measures of patient/caregiver experiences. RESULTS The Quality of Life in Alzheimer's Disease (QoL-AD) was completed by the person with DLB and the caregiver (proxy) in 61 dyads; 85 dyads had only a proxy-completed QoL-AD. Patient- and proxy-reported scores were moderately correlated (r = 0.57, P < 0.0001). Worse patient-reported QoL correlated with daytime sleepiness, autonomic symptom burden, and behavioral symptoms. Proxy ratings correlated with dementia severity, daytime sleepiness, behavioral symptoms, dependence in activities of daily living, and caregiver experience measures. DISCUSSION Patient- and proxy-reported quality of life (QoL) should be assessed separately in advanced DLB. Some symptoms associated with QoL have available therapeutic options. Research is needed regarding strategies to optimally improve QoL in DLB. HIGHLIGHTS Patient and proxy quality of life (QoL) ratings had moderate correlation in advanced dementia with Lewy bodies. Daytime sleepiness affected patient- and proxy-reported QoL. Behavioral symptoms affected patient- and proxy-reported QoL. Autonomic symptom burden affected patient-reported QoL. Dementia severity, dependence, and caregiver experiences affected proxy ratings.
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Affiliation(s)
- Melissa J. Armstrong
- Department of NeurologyUniversity of Florida College of MedicineGainesvilleFloridaUSA
- Norman Fixel Institute for Neurological DiseasesGainesvilleFloridaUSA
| | - Brian LaBarre
- Department of BiostatisticsUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Kaitlin Sovich
- Department of NeurologyUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Susan M. Maixner
- Department of PsychiatryUniversity of MichiganAnn ArborMichiganUSA
| | - Henry L. Paulson
- Department of NeurologyUniversity of MichiganAnn ArborMichiganUSA
| | - Carol Manning
- Department of NeurologyUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Angela Lunde
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Leah Forsberg
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | | | - James E. Galvin
- Comprehensive Center for Brain HealthDepartment of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | | | - Zhigang Li
- Department of BiostatisticsUniversity of Florida College of MedicineGainesvilleFloridaUSA
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10
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Shir D, Corriveau-Lecavalier N, Bermudez Noguera C, Barnard L, Pham NTT, Botha H, Duffy JR, Clark HM, Utianski RL, Knopman DS, Petersen RC, Boeve BF, Murray ME, Nguyen AT, Reichard RR, Dickson DW, Day GS, Kremers WK, Graff-Radford NR, Jones DT, Machulda MM, Fields JA, Whitwell JL, Josephs KA, Graff-Radford J. Clinicoradiological and neuropathological evaluation of primary progressive aphasia. J Neurol Neurosurg Psychiatry 2024:jnnp-2023-332862. [PMID: 38514176 DOI: 10.1136/jnnp-2023-332862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Primary progressive aphasia (PPA) defines a group of neurodegenerative disorders characterised by language decline. Three PPA variants correlate with distinct underlying pathologies: semantic variant PPA (svPPA) with transactive response DNA-binding protein of 43 kD (TDP-43) proteinopathy, agrammatic variant PPA (agPPA) with tau deposition and logopenic variant PPA (lvPPA) with Alzheimer's disease (AD). Our objectives were to differentiate PPA variants using clinical and neuroimaging features, assess progression and evaluate structural MRI and a novel 18-F fluorodeoxyglucose positron emission tomography (FDG-PET) image decomposition machine learning algorithm for neuropathology prediction. METHODS We analysed 82 autopsied patients diagnosed with PPA from 1998 to 2022. Clinical histories, language characteristics, neuropsychological results and brain imaging were reviewed. A machine learning framework using a k-nearest neighbours classifier assessed FDG-PET scans from 45 patients compared with a large reference database. RESULTS PPA variant distribution: 35 lvPPA (80% AD), 28 agPPA (89% tauopathy) and 18 svPPA (72% frontotemporal lobar degeneration-TAR DNA-binding protein (FTLD-TDP)). Apraxia of speech was associated with 4R-tauopathy in agPPA, while pure agrammatic PPA without apraxia was linked to 3R-tauopathy. Longitudinal data revealed language dysfunction remained the predominant deficit for patients with lvPPA, agPPA evolved to corticobasal or progressive supranuclear palsy syndrome (64%) and svPPA progressed to behavioural variant frontotemporal dementia (44%). agPPA-4R-tauopathy exhibited limited pre-supplementary motor area atrophy, lvPPA-AD displayed temporal atrophy extending to the superior temporal sulcus and svPPA-FTLD-TDP had severe temporal pole atrophy. The FDG-PET-based machine learning algorithm accurately predicted clinical diagnoses and underlying pathologies. CONCLUSIONS Distinguishing 3R-taupathy and 4R-tauopathy in agPPA may rely on apraxia of speech presence. Additional linguistic and clinical features can aid neuropathology prediction. Our data-driven brain metabolism decomposition approach effectively predicts underlying neuropathology.
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Affiliation(s)
- Dror Shir
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Leland Barnard
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph R Duffy
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Heather M Clark
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Rene L Utianski
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ronald C Petersen
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Quantitative Health Sciences, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Melissa E Murray
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Aivi T Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - R Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Gregory S Day
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - Walter K Kremers
- Department of Quantitative Health Sciences, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | | | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Mary M Machulda
- Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Julie A Fields
- Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Keith A Josephs
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
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11
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Chiu SY, Chen R, Wang WE, Armstrong MJ, Boeve BF, Savica R, Ramanan V, Fields JA, Graff-Radford N, Ferman TJ, Kantarci K, Vaillancourt DE. Longitudinal Free-Water Changes in Dementia with Lewy Bodies. Mov Disord 2024. [PMID: 38477399 DOI: 10.1002/mds.29763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/06/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Diffusion-weighted magnetic resonance imaging (dMRI) examines tissue microstructure integrity in vivo. Prior dementia with Lewy bodies (DLB) diffusion tensor imaging studies yielded mixed results. OBJECTIVE We employed free-water (FW) imaging to assess DLB progression and correlate with clinical decline in DLB. METHODS Baseline and follow-up MRIs were obtained at 12 and/or 24 months for 27 individuals with DLB or mild cognitive impairment with Lewy bodies (MCI-LB). FW was analyzed using the Mayo Clinic Adult Lifespan Template. Primary outcomes were FW differences between baseline and 12 or 24 months. To compare FW change longitudinally, we included 20 cognitively unimpaired individuals from the Alzheimer's Disease Neuroimaging Initiative. RESULTS We followed 23 participants to 12 months and 16 participants to 24 months. Both groups had worsening in Montreal Cognitive Assessment (MoCA) and Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scores. We found significant FW increases at both time points compared to baseline in the insula, amygdala, posterior cingulum, parahippocampal, entorhinal, supramarginal, fusiform, retrosplenial, and Rolandic operculum regions. At 24 months, we found more widespread microstructural changes in regions implicated in visuospatial processing, motor, and cholinergic functions. Between-group analyses (DLB vs. controls) confirmed significant FW changes over 24 months in most of these regions. FW changes were associated with longitudinal worsening of MDS-UPDRS and MoCA scores. CONCLUSIONS FW increased in gray and white matter regions in DLB, likely due to neurodegenerative pathology associated with disease progression. FW change was associated with clinical decline. The findings support dMRI as a promising tool to track disease progression in DLB. © 2024 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Shannon Y Chiu
- Department of Neurology, University of Florida, Gainesville, Florida, USA
- Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Robin Chen
- Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, Florida, USA
| | - Wei-En Wang
- Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, Florida, USA
| | | | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Vijay Ramanan
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Tanis J Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA
| | - Kejal Kantarci
- Department of Neuroradiology, Mayo Clinic, Rochester, Minnesota, USA
| | - David E Vaillancourt
- Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, Florida, USA
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12
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Walton RL, Koga S, Beasley AI, White LJ, Griesacker T, Murray ME, Kasanuki K, Hou X, Fiesel FC, Springer W, Uitti RJ, Fields JA, Botha H, Ramanan VK, Kantarci K, Lowe VJ, Jack CR, Ertekin-Taner N, Savica R, Graff-Radford J, Petersen RC, Parisi JE, Reichard RR, Graff-Radford NR, Ferman TJ, Boeve BF, Wszolek ZK, Dickson DW, Ross OA, Heckman MG. Role of GBA variants in Lewy body disease neuropathology. Acta Neuropathol 2024; 147:54. [PMID: 38472443 PMCID: PMC11049671 DOI: 10.1007/s00401-024-02699-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/26/2024] [Accepted: 01/27/2024] [Indexed: 03/14/2024]
Abstract
Rare and common GBA variants are risk factors for both Parkinson's disease (PD) and dementia with Lewy bodies (DLB). However, the degree to which GBA variants are associated with neuropathological features in Lewy body disease (LBD) is unknown. Herein, we assessed 943 LBD cases and examined associations of 15 different neuropathological outcomes with common and rare GBA variants. Neuropathological outcomes included LBD subtype, presence of a high likelihood of clinical DLB (per consensus guidelines), LB counts in five cortical regions, tyrosine hydroxylase immunoreactivity in the dorsolateral and ventromedial putamen, ventrolateral substantia nigra neuronal loss, Braak neurofibrillary tangle (NFT) stage, Thal amyloid phase, phospho-ubiquitin (pS65-Ub) level, TDP-43 pathology, and vascular disease. Sequencing of GBA exons revealed a total of 42 different variants (4 common [MAF > 0.5%], 38 rare [MAF < 0.5%]) in our series, and 165 cases (17.5%) had a copy of the minor allele for ≥ 1 variant. In analysis of common variants, p.L483P was associated with a lower Braak NFT stage (OR = 0.10, P < 0.001). In gene-burden analysis, presence of the minor allele for any GBA variant was associated with increased odds of a high likelihood of DLB (OR = 2.00, P < 0.001), a lower Braak NFT stage (OR = 0.48, P < 0.001), a lower Thal amyloid phase (OR = 0.55, P < 0.001), and a lower pS65-Ub level (β: -0.37, P < 0.001). Subgroup analysis revealed that GBA variants were most common in LBD cases with a combination of transitional/diffuse LBD and Braak NFT stage 0-II or Thal amyloid phase 0-1, and correspondingly that the aforementioned associations of GBA gene-burden with a decreased Braak NFT stage and Thal amyloid phase were observed only in transitional or diffuse LBD cases. Our results indicate that in LBD, GBA variants occur most frequently in cases with greater LB pathology and low AD pathology, further informing disease-risk associations of GBA in PD, PD dementia, and DLB.
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Affiliation(s)
- Ronald L Walton
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Shunsuke Koga
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | - Launia J White
- Division of Clinical Trials and Biostatistics, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, USA
| | | | | | - Koji Kasanuki
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Xu Hou
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - Ryan J Uitti
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Julie A Fields
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Kejal Kantarci
- Department of Neuroradiology, Mayo Clinic, Rochester, MN, USA
| | - Val J Lowe
- Department of Nuclear Medicine, Mayo Clinic, Rochester, MN, USA
| | - Clifford R Jack
- Department of Neuroradiology, Mayo Clinic, Rochester, MN, USA
| | - Nilufer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Joseph E Parisi
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - R Ross Reichard
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Tanis J Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | | | | | | | - Owen A Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL, USA
| | - Michael G Heckman
- Division of Clinical Trials and Biostatistics, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, USA.
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13
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Robinson CG, Lee J, Min PH, Przybelski SA, Josephs KA, Jones DT, Graff‐Radford J, Boeve BF, Knopman DS, Jack CR, Petersen RC, Machulda MM, Fields JA, Lowe VJ. Significance of a positive tau PET scan with a negative amyloid PET scan. Alzheimers Dement 2024; 20:1923-1932. [PMID: 38159060 PMCID: PMC10947949 DOI: 10.1002/alz.13608] [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: 07/10/2023] [Revised: 10/24/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION The implications of positive tau positron emission tomography (T) with negative beta amyloid positron emission tomography (A) are not well understood. We investigated cognitive performance in participants who were T+ but A-. METHODS We evaluated 98 participants from the Mayo Clinic who were T+ and A-. Participants were matched 2:1 to A- and T- cognitively unimpaired (CU) controls. Cognitive test scores were compared between different groups. RESULTS The A-T+ group demonstrated lower performance than the A-T- group on the Mini-Mental Status Exam (MMSE) (p < 0.001), Wechsler Memory Scale-Revised Logical Memory I (p < 0.001) and Logical Memory II (p < 0.001), Auditory Verbal Learning Test (AVLT) delayed recall (p = 0.004), category fluency (animals p = 0.005; vegetables p = 0.021), Trail Making Test A and B (p < 0.001), and others. There were no significant differences in demographic features or apolipoprotein E (APOE) e4 genotype between CU A-T+ and CI A-T+. DISCUSSION A-T+ participants show an association with lower cognitive performance.
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Affiliation(s)
| | - Jeyeon Lee
- College of MedicineHanyang UniversitySeoulSouth Korea
| | - Paul H. Min
- Departments of RadiologyMayo ClinicRochesterMinnesotaUSA
| | | | | | - David T. Jones
- Departments of NeurologyMayo ClinicRochesterMinnesotaUSA
| | | | | | | | | | | | - Mary M. Machulda
- Departments of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Julie A. Fields
- Departments of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Val J. Lowe
- Departments of RadiologyMayo ClinicRochesterMinnesotaUSA
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14
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Choudhury P, Lee-Iannotti JK, Busicescu AO, Rangan P, Fantini ML, Avidan AY, Bliwise DL, Criswell SR, During EH, Elliott JE, Fields JA, Gagnon JF, Howell MJ, Huddleston DE, McLeland J, Mignot E, Miglis MG, Lim MM, Pelletier A, Schenck CH, Shprecher D, St Louis EK, Videnovic A, Ju YES, Boeve BF, Postuma R. Validation of the RBD Symptom Severity Scale in the North American Prodromal Synucleinopathy Consortium. Neurology 2024; 102:e208008. [PMID: 38181331 DOI: 10.1212/wnl.0000000000208008] [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] [Received: 03/17/2023] [Accepted: 10/13/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND AND OBJECTIVES REM sleep behavior disorder (RBD) is a parasomnia characterized by dream enactment. The International RBD Study Group developed the RBD Symptom Severity Scale (RBDSSS) to assess symptom severity for clinical or research use. We assessed the psychometric and clinimetric properties of the RBDSSS in participants enrolled in the North American Prodromal Synucleinopathy (NAPS) Consortium for RBD. METHODS NAPS participants, who have polysomnogram-confirmed RBD, and their bedpartners completed the RBDSSS (participant and bedpartner versions). The RBDSSS contains 8 questions to assess the frequency and severity/impact of (1) dream content, (2) vocalizations, (3) movements, and (4) injuries associated with RBD. Total scores for participant (maximum score = 54) and bedpartner (maximum score = 38) questionnaires were derived by multiplying frequency and severity scores for each question. The Clinical Global Impression Scale of Severity (CGI-S) and RBD symptom frequency were assessed by a physician during a semistructured clinical interview with participants and, if available, bedpartners. Descriptive analyses, correlations between overall scores, and subitems were assessed, and item response analysis was performed to determine the scale's validity. RESULTS Among 261 study participants, the median (interquartile range) score for the RBDSSS-PT (participant) was 10 (4-18) and that for the RBDSSS-BP (bedpartner) was 8 (4-15). The median CGI-S was 3 (3-4), indicating moderate severity. RBDSSS-BP scores were significantly lower in women with RBD (6 vs 9, p = 0.02), while there were no sex differences in RBDSSS-PT scores (8 vs 10.5, p = 0.615). Positive correlations were found between RBDSSS-PT vs RBDSSS-BP (Spearman rs = 0.561), RBDSSS-PT vs CGI-S (rs = 0.556), and RBDSSS-BP vs CGI-S (rs = 0.491, all p < 0.0001). Item response analysis showed a high discriminatory value (range 1.40-2.12) for the RBDSSS-PT and RBDSSS-BP (1.29-3.47). DISCUSSION We describe the RBDSSS with adequate psychometric and clinimetric properties to quantify RBD symptom severity and good concordance between participant and bedpartner questionnaires and between RBDSSS scores and clinician-assessed global severity.
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Affiliation(s)
- Parichita Choudhury
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Joyce K Lee-Iannotti
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Andrea O Busicescu
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Pooja Rangan
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Maria Livia Fantini
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Alon Y Avidan
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Donald L Bliwise
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Susan R Criswell
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Emmanuel H During
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Jonathan E Elliott
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Julie A Fields
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Jean-Francois Gagnon
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Michael J Howell
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Daniel E Huddleston
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Jennifer McLeland
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Emmanuel Mignot
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Mitchell G Miglis
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Miranda M Lim
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Amélie Pelletier
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Carlos H Schenck
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - David Shprecher
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Erik K St Louis
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Aleksandar Videnovic
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Yo-El S Ju
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Bradley F Boeve
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Ronald Postuma
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
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15
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Corriveau-Lecavalier N, Tosakulwong N, Lesnick TG, Fought AJ, Reid RI, Schwarz CG, Senjem ML, Jack CR, Jones DT, Vemuri P, Rademakers R, Ramos EM, Geschwind DH, Knopman DS, Botha H, Savica R, Graff-Radford J, Ramanan VK, Fields JA, Graff-Radford N, Wszolek Z, Forsberg LK, Petersen RC, Heuer HW, Boxer AL, Rosen HJ, Boeve BF, Kantarci K. Neurite-based white matter alterations in MAPT mutation carriers: A multi-shell diffusion MRI study in the ALLFTD consortium. Neurobiol Aging 2024; 134:135-145. [PMID: 38091751 PMCID: PMC10872472 DOI: 10.1016/j.neurobiolaging.2023.12.001] [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: 07/05/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
We assessed white matter (WM) integrity in MAPT mutation carriers (16 asymptomatic, 5 symptomatic) compared to 31 non-carrier family controls using diffusion tensor imaging (DTI) (fractional anisotropy; FA, mean diffusivity; MD) and neurite orientation dispersion and density imaging (NODDI) (neurite density index; NDI, orientation and dispersion index; ODI). Linear mixed-effects models accounting for age and family relatedness revealed alterations across DTI and NODDI metrics in all mutation carriers and in symptomatic carriers, with the most significant differences involving fronto-temporal WM tracts. Asymptomatic carriers showed higher entorhinal MD and lower cingulum FA and patterns of higher ODI mostly involving temporal areas and long association and projections fibers. Regression models between estimated time to or time from disease and DTI and NODDI metrics in key regions (amygdala, cingulum, entorhinal, inferior temporal, uncinate fasciculus) in all carriers showed increasing abnormalities with estimated time to or time from disease onset, with FA and NDI showing the strongest relationships. Neurite-based metrics, particularly ODI, appear to be particularly sensitive to early WM involvement in asymptomatic carriers.
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Affiliation(s)
- Nick Corriveau-Lecavalier
- Department of Neurology, Mayo Clinic, Rochester, MN, USA; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Timothy G Lesnick
- Departmenf of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Angela J Fought
- Departmenf of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Robert I Reid
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic Jacksonville, FL, USA; Center for Molecular Neurology, Antwerp University, Belgium
| | | | | | | | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | - Hilary W Heuer
- Department of Neurology, University of California San Francisco, CA, USA
| | - Adam L Boxer
- Department of Neurology, University of California San Francisco, CA, USA
| | - Howard J Rosen
- Department of Neurology, University of California San Francisco, CA, USA
| | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
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16
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Stricker NH, Stricker JL, Frank RD, Fan WZ, Christianson TJ, Patel JS, Karstens AJ, Kremers WK, Machulda MM, Fields JA, Graff-Radford J, Jack CR, Knopman DS, Mielke MM, Petersen RC. Stricker Learning Span criterion validity: a remote self-administered multi-device compatible digital word list memory measure shows similar ability to differentiate amyloid and tau PET-defined biomarker groups as in-person Auditory Verbal Learning Test. J Int Neuropsychol Soc 2024; 30:138-151. [PMID: 37385974 PMCID: PMC10756923 DOI: 10.1017/s1355617723000322] [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: 07/01/2023]
Abstract
OBJECTIVE The Stricker Learning Span (SLS) is a computer-adaptive digital word list memory test specifically designed for remote assessment and self-administration on a web-based multi-device platform (Mayo Test Drive). We aimed to establish criterion validity of the SLS by comparing its ability to differentiate biomarker-defined groups to the person-administered Rey's Auditory Verbal Learning Test (AVLT). METHOD Participants (N = 353; mean age = 71, SD = 11; 93% cognitively unimpaired [CU]) completed the AVLT during an in-person visit, the SLS remotely (within 3 months) and had brain amyloid and tau PET scans available (within 3 years). Overlapping groups were formed for 1) those on the Alzheimer's disease (AD) continuum (amyloid PET positive, A+, n = 125) or not (A-, n = 228), and those with biological AD (amyloid and tau PET positive, A+T+, n = 55) vs no evidence of AD pathology (A-T-, n = 195). Analyses were repeated among CU participants only. RESULTS The SLS and AVLT showed similar ability to differentiate biomarker-defined groups when comparing AUROCs (p's > .05). In logistic regression models, SLS contributed significantly to predicting biomarker group beyond age, education, and sex, including when limited to CU participants. Medium (A- vs A+) to large (A-T- vs A+T+) unadjusted effect sizes were observed for both SLS and AVLT. Learning and delay variables were similar in terms of ability to separate biomarker groups. CONCLUSIONS Remotely administered SLS performed similarly to in-person-administered AVLT in its ability to separate biomarker-defined groups, providing evidence of criterion validity. Results suggest the SLS may be sensitive to detecting subtle objective cognitive decline in preclinical AD.
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Affiliation(s)
- Nikki H Stricker
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - John L Stricker
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Ryan D Frank
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Winnie Z Fan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Jay S Patel
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Aimee J Karstens
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Walter K Kremers
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Michelle M Mielke
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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17
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Elliott JE, Ligman BR, Bryant-Ekstrand MD, Keil AT, Powers K, Olivo C, Neilson L, Postuma RB, Pelletier A, Gagnon JF, Gan-Or Z, Yu E, Liu L, St Louis EK, Forsberg LK, Fields JA, Ross OA, Huddleston DE, Bliwise DL, Avidan AY, Howell MJ, Schenck CH, McLeland J, Criswell SR, Videnovic A, During EH, Miglis MG, Shprecher DR, Lee-Iannotti JK, Boeve BF, Ju YES, Lim MM. Comorbid neurotrauma increases neurodegenerative-relevant cognitive, motor, and autonomic dysfunction in patients with REM sleep behavior disorder: A substudy of the North American Prodromal Synucleinopathy Consortium. Sleep 2024:zsae007. [PMID: 38181205 DOI: 10.1093/sleep/zsae007] [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: 10/11/2023] [Indexed: 01/07/2024] Open
Abstract
STUDY OBJECTIVES Rapid eye movement (REM) sleep behavior disorder (RBD) is strongly associated with phenoconversion to an overt synucleinopathy, e.g., Parkinson's disease (PD), Lewy Body Dementia (LBD), and related disorders. Comorbid traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) - henceforth "neurotrauma" (NT) - increase the odds of RBD by ~2.5-fold and is associated with an increased rate of service-connected PD in Veterans. Thus, RBD and NT are both independently associated with PD; however, it is unclear how NT influences neurological function in patients with RBD. METHODS Participants ≥18 years with overnight-polysomnogram-confirmed RBD were enrolled between 8/2018 to 4/2021 through the North American Prodromal Synucleinopathy (NAPS) Consortium. Standardized assessments for RBD, TBI, and PTSD history, as well as cognitive, motor, sensory and autonomic function were completed. This cross-sectional analysis compared cases (n=24; RBD+NT) to controls (n=96; RBD), matched for age (~60 years), sex (15% female), and years of education (~15 years). RESULTS RBD+NT reported earlier RBD symptom onset (37.5±11.9 vs. 52.2±15.1 years of age) and a more severe RBD phenotype. Similarly, RBD+NT reported more severe anxiety and depression, greater frequency of hypertension, and significantly worse cognitive, motor, and autonomic function compared to RBD. No differences in olfaction or color vision were observed. CONCLUSION This cross-sectional, matched case:control study shows individuals with RBD+NT have significantly worse neurological measures related to common features of an overt synucleinopathy. Confirmatory longitudinal studies are ongoing; however, these results suggest RBD+NT may be associated with more advanced neurological symptoms related to an evolving neurodegenerative process.
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Affiliation(s)
- Jonathan E Elliott
- VA Portland Health Care System, Research Service, Portland, OR, USA
- Oregon Health & Science University, Department of Neurology, Portland, OR, USA
| | | | | | - Allison T Keil
- VA Portland Health Care System, Research Service, Portland, OR, USA
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, Québec, Canada
| | - Katherine Powers
- VA Portland Health Care System, Research Service, Portland, OR, USA
| | - Cosette Olivo
- VA Portland Health Care System, Research Service, Portland, OR, USA
| | - Lee Neilson
- VA Portland Health Care System, Research Service, Portland, OR, USA
- Oregon Health & Science University, Department of Neurology, Portland, OR, USA
| | - Ronald B Postuma
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, Québec, Canada
- Université du Québec à Montréal, Département of Psychology, Montréal, Québec, Canada
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine, Montréal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Amélie Pelletier
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine, Montréal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Jean-François Gagnon
- Université du Québec à Montréal, Département of Psychology, Montréal, Québec, Canada
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine, Montréal, Quebec, Canada
| | - Ziv Gan-Or
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, Québec, Canada
- McGill University, Department of Human Genetics, Montréal, Québec, Canada
| | - Eric Yu
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, Québec, Canada
- McGill University, Department of Human Genetics, Montréal, Québec, Canada
| | - Lang Liu
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, Québec, Canada
- McGill University, Department of Human Genetics, Montréal, Québec, Canada
| | | | | | | | - Owen A Ross
- Mayo Clinic, Neurology and Medicine, Rochester, MN, USA
| | | | | | - Alon Y Avidan
- University of California Los Angeles, Neurology, Sleep Disorders Center, Los Angeles, CA, USA
| | - Michael J Howell
- University of Minnesota Medical Center, Neurology, Minneapolis, MN, USA
- Hennepin County Medical Center, Minnesota Regional Sleep Disorders Center, Minneapolis, MN, USA
| | - Carlos H Schenck
- University of Minnesota Medical Center, Neurology, Minneapolis, MN, USA
| | | | | | - Aleksandar Videnovic
- Massachusetts General Hospital, Movement Disorders Unit, Division of Sleep Medicine, Boston, MA, USA
- Harvard Medical School, Neurological Clinical Research Institute, Boston, MA, USA
| | - Emmanuel H During
- Stanford University, Psychiatry and Behavioral Sciences, Redwood City, CA, USA
- Stanford University, Neurology & Neurological Sciences, Palo Alto, CA, USA
- Mt Sinai School of Medicine, Neurology, New York, NY, USA
| | - Mitchell G Miglis
- Stanford University, Psychiatry and Behavioral Sciences, Redwood City, CA, USA
- Stanford University, Neurology & Neurological Sciences, Palo Alto, CA, USA
| | | | | | | | - Yo-El S Ju
- Washington University School of Medicine, Saint Louis, MO, USA
| | - Miranda M Lim
- Oregon Health & Science University, Department of Neurology, Portland, OR, USA
- Oregon Health & Science University, Department of Behavioral Neuroscience; Department of Pulmonary and Critical Care Medicine; Oregon Institute of Occupational Health Sciences, Portland, OR, USA
- VA Portland Health Care System, Mental Illness Research Education and Clinical Center; Neurology; National Center for Rehabilitative Auditory Research, Portland, OR, USA
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18
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Kantarci K, Tosakulwong N, Lesnick TG, Kara F, Kendall-Thomas J, Kapoor E, Fields JA, James TT, Lobo RA, Manson JE, Pal L, Hammers DB, Malek-Ahmadi M, Cedars MI, Naftolin FN, Santoro N, Miller VM, Harman SM, Dowling NM, Gleason CE. Cardiometabolic outcomes in Kronos Early Estrogen Prevention Study continuation: 14-year follow-up of a hormone therapy trial. Menopause 2024; 31:10-17. [PMID: 37989141 PMCID: PMC10756493 DOI: 10.1097/gme.0000000000002278] [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: 11/23/2023]
Abstract
OBJECTIVE This study aimed to determine long-term cardiometabolic effects of hormone therapies initiated within 3 years of onset of menopause after a 14-year follow-up study of participants of the Kronos Early Estrogen Prevention Study (KEEPS). METHODS KEEPS was a multisite clinical trial that recruited recently menopausal women with good cardiovascular health for randomization to oral conjugated equine estrogens (Premarin, 0.45 mg/d) or transdermal 17β-estradiol (Climara, 50 μg/d) both with micronized progesterone (Prometrium, 200 mg/d) for 12 d/mo, or placebo pills and patch for 4 years. KEEPS continuation recontacted KEEPS participants 14 years after randomization and 10 years after the completion of the 4-year clinical trial to attend in-person clinic visits. RESULTS Participants of KEEPS continuation (n = 299 of the 727 KEEPS participants; 41%) had an average age of 67 years (range, 58-73 y). Measurements of systolic and diastolic blood pressures, waist-to-hip ratio, fasting levels of glucose, insulin, lipid profiles, and homeostasis model assessment of insulin resistance were not different among the treatment groups at either KEEPS baseline or at KEEPS continuation visits, or for change between these two visits. The frequency of self-reported diabetes ( P = 0.007) and use of diabetes medications was higher in the placebo than the oral conjugated equine estrogens ( P = 0.045) or transdermal 17β-estradiol ( P = 0.02) groups, but these differences were not supported by the laboratory measurements of glycemia or insulin resistance. CONCLUSIONS There was no evidence of cardiovascular and/or metabolic benefits or adverse effects associated with 4 years use of oral or transdermal forms of hormone therapy by recently menopausal women with good cardiovascular health after 10 years.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - JoAnn E. Manson
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | | | | | | | | | | | | | - Sherman M. Harman
- Phoenix VA Health University of Arizona College of Medicine, Phoenix, AZ
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19
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Lee JK, Frank RD, Christenson LR, Fields JA, Rocca WA, Mielke MM. Associations of reproductive factors and exogenous estrogens with global and domain-specific cognition in later life. Alzheimers Dement 2024; 20:63-73. [PMID: 37450421 PMCID: PMC10787812 DOI: 10.1002/alz.13394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Few studies have comprehensively examined the impact of reproductive factors (i.e., reproductive window, parity, hormonal contraception [HC], and menopausal hormone therapy [MHT]) on global and domain-specific cognition in later life. METHODS We studied a population-based sample of 2458 women (median age 74.2 years) residing in Olmsted County, Minnesota; participants underwent a clinical evaluation and comprehensive cognitive testing. RESULTS The length of a woman's reproductive window was not associated with cognition. Higher parity was associated with greater cognitive decline in all domains. Ever HC use was associated with less decline in all domains. Ever MHT use was associated with greater decline in global cognition and all domain-specific z-scores except visuospatial; results were driven by women who initiated MHT 5 or more years after menopause. Additional adjustments for APOE and vascular-related covariates did not attenuate the results. DISCUSSION Multiple reproductive risk factors are associated with cognitive decline in later life. HIGHLIGHTS The length of a woman's reproductive window was not associated with cognition longitudinally. Greater parity was associated with greater cognitive decline longitudinally. Ever HC use was associated with less decline in global cognition and all domain-specific z-scores longitudinally (all p < 0.01). Ever MHT use was associated with greater decline in global cognition and all domain-specific z-scores except visuospatial longitudinally (all p < 0.01). The greatest cognitive decline was among women who initiated MHT more than 5 years after menopause.
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Affiliation(s)
- Jillian K. Lee
- Department of Epidemiology and PreventionWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Ryan D. Frank
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | | | - Julie A. Fields
- Division of Neurocognitive DisordersDepartment of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Walter A. Rocca
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
- Women's Health Research CenterMayo ClinicRochesterMinnesotaUSA
| | - Michelle M. Mielke
- Department of Epidemiology and PreventionWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
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20
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Miyagawa T, Vernon C, Przybelski SA, Min HK, Fields JA, Kantarci K, Lowe VJ, Boeve BF. Marked Decreased Tracer Binding in 123 I-FP-CIT SPECT Scans From Lisdexafetamine Dismesylate Interaction: A Case Report. Clin Neuropharmacol 2024; 47:26-28. [PMID: 38193851 PMCID: PMC10872469 DOI: 10.1097/wnf.0000000000000579] [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: 01/10/2024]
Abstract
OBJECTIVES The objective of this case study is to raise awareness of potential 123 I-FP-CIT SPECT interference by lisdexafetamine dimesylate, a prodrug of d -amphetamine. METHODS A 69-year-old man with Rapid Eye Movement sleep behavior disorder and mild cognitive impairment had been treated with lisdexafetamine dimesylate for attention-deficit/hyperactivity disorder. The patient had annual or biennial 123 I-FP-CIT SPECT evaluations after their baseline visit at 69 years old. Nigrostriatal dopamine transporter uptake was semiquantitatively evaluated with 123 I-FP-CIT SPECT using DaTQUANT 2.0 software. Lisdexafetamine dimesylate was discontinued 3 months before the sixth-year visit (76 years old) by his primary care provider. RESULTS The patient had 4 123 I-FP-CIT SPECT scans with lisdexafetamine dimesylate and 2 scans after the discontinuation of lisdexafetamine dimesylate. The DaTQUANT z -scores of the putamen declined from -1.36 at the baseline visit to -3.02 at the fifth-year visit. After the discontinuation of lisdexafetamine dimesylate, DaTQUANT z -scores of the putamen increased to -0.63 at the sixth-year visit and remained in the normal range of -0.71 at the seventh-year visit. CONCLUSIONS This case suggests that lisdexafetamine dimesylate may have a strong interference with 123 I-FP-CIT SPECT, decreasing the tracer binding to the dopamine transporter and presenting false positive results.
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Affiliation(s)
- Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Cynthia Vernon
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Hoon-Ki Min
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Corriveau-Lecavalier N, Barnard LR, Przybelski SA, Gogineni V, Botha H, Graff-Radford J, Ramanan VK, Forsberg LK, Fields JA, Machulda MM, Rademakers R, Gavrilova RH, Lapid MI, Boeve BF, Knopman DS, Lowe VJ, Petersen RC, Jack CR, Kantarci K, Jones DT. Assessing network degeneration and phenotypic heterogeneity in genetic frontotemporal lobar degeneration by decoding FDG-PET. Neuroimage Clin 2023; 41:103559. [PMID: 38147792 PMCID: PMC10944211 DOI: 10.1016/j.nicl.2023.103559] [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: 10/16/2023] [Revised: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 12/28/2023]
Abstract
Genetic mutations causative of frontotemporal lobar degeneration (FTLD) are highly predictive of a specific proteinopathy, but there exists substantial inter-individual variability in their patterns of network degeneration and clinical manifestations. We collected clinical and 18Fluorodeoxyglucose-positron emission tomography (FDG-PET) data from 39 patients with genetic FTLD, including 11 carrying the C9orf72 hexanucleotide expansion, 16 carrying a MAPT mutation and 12 carrying a GRN mutation. We performed a spectral covariance decomposition analysis between FDG-PET images to yield unbiased latent patterns reflective of whole brain patterns of metabolism ("eigenbrains" or EBs). We then conducted linear discriminant analyses (LDAs) to perform EB-based predictions of genetic mutation and predominant clinical phenotype (i.e., behavior/personality, language, asymptomatic). Five EBs were significant and explained 58.52 % of the covariance between FDG-PET images. EBs indicative of hypometabolism in left frontotemporal and temporo-parietal areas distinguished GRN mutation carriers from other genetic mutations and were associated with predominant language phenotypes. EBs indicative of hypometabolism in prefrontal and temporopolar areas with a right hemispheric predominance were mostly associated with predominant behavioral phenotypes and distinguished MAPT mutation carriers from other genetic mutations. The LDAs yielded accuracies of 79.5 % and 76.9 % in predicting genetic status and predominant clinical phenotype, respectively. A small number of EBs explained a high proportion of covariance in patterns of network degeneration across FTLD-related genetic mutations. These EBs contained biological information relevant to the variability in the pathophysiological and clinical aspects of genetic FTLD, and for offering valuable guidance in complex clinical decision-making, such as decisions related to genetic testing.
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Affiliation(s)
- Nick Corriveau-Lecavalier
- Department of Neurology, Mayo Clinic Rochester, USA; Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | | | | | | | - Hugo Botha
- Department of Neurology, Mayo Clinic Rochester, USA
| | | | | | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic Jacksonville, USA; VIB-UA Center for Molecular Neurology, VIB, University of Antwerp, Belgium
| | | | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | | | | | - Val J Lowe
- Department of Radiology, Mayo Clinic Rochester, USA
| | | | | | | | - David T Jones
- Department of Neurology, Mayo Clinic Rochester, USA; Department of Radiology, Mayo Clinic Rochester, USA.
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22
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Elliott JE, Bryant-Ekstrand MD, Keil AT, Ligman BR, Lim MM, Zitser J, During EH, Gagnon JF, St Louis EK, Fields JA, Huddleston DE, Bliwise DL, Avidan AY, Schenck CH, McLeland J, Criswell SR, Davis AA, Videnovic A, Lee-Iannotti JK, Postuma R, Boeve BF, Ju YES, Miglis MG. Frequency of Orthostatic Hypotension in Isolated REM Sleep Behavior Disorder. Neurology 2023; 101:e2545-e2559. [PMID: 37857496 PMCID: PMC10791057 DOI: 10.1212/wnl.0000000000207883] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/11/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Although orthostatic hypotension (OH) can be an early feature of autonomic dysfunction in isolated REM sleep behavior disorder (iRBD), no large-scale studies have examined the frequency of OH in iRBD. In this study, we prospectively evaluated the frequency of OH in a large multicenter iRBD cohort. METHODS Participants 18 years or older with video polysomnogram-confirmed iRBD were enrolled through the North American Prodromal Synucleinopathy consortium. All participants underwent 3-minute orthostatic stand testing to assess the frequency of OH, and a Δ heart rate/Δ systolic blood pressure (ΔHR/ΔSBP) ratio <0.5 was used to define reduced HR augmentation, suggestive of neurogenic OH. All participants completed a battery of assessments, including the Scales for Outcomes in Parkinson Disease-Autonomic Dysfunction (SCOPA-AUT) and others assessing cognitive, motor, psychiatric, and sensory domains. RESULTS Of 340 iRBD participants (65 ± 10 years, 82% male), 93 (27%) met criteria for OH (ΔHR/ΔSBP 0.37 ± 0.28; range 0.0-1.57), and of these, 72 (77%) met criteria for OH with reduced HR augmentation (ΔHR/ΔSBP 0.28 ± 0.21; range 0.0-0.5). Supine hypertension (sHTN) was present in 72% of those with OH. Compared with iRBD participants without OH, those with OH were older, reported older age of RBD symptom onset, and had worse olfaction. There was no difference in autonomic symptom scores as measured by SCOPA-AUT. DISCUSSION OH and sHTN are common in iRBD. However, as patients may have reduced autonomic symptom awareness, orthostatic stand testing should be considered in clinical evaluations. Longitudinal studies are needed to clarify the relationship between OH and phenoconversion risk in iRBD. TRIAL REGISTRATION INFORMATION ClinicalTrials.gov: NCT03623672; North American Prodromal Synucleinopathy Consortium.
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Affiliation(s)
- Jonathan E Elliott
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Mohini D Bryant-Ekstrand
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Allison T Keil
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Brittany R Ligman
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Miranda M Lim
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Jennifer Zitser
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Emmanuel H During
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Jean-Francois Gagnon
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Erik K St Louis
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Julie A Fields
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Daniel E Huddleston
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Donald L Bliwise
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Alon Y Avidan
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Carlos H Schenck
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Jennifer McLeland
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Susan R Criswell
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Albert A Davis
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Aleksandar Videnovic
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Joyce K Lee-Iannotti
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Ronald Postuma
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Bradley F Boeve
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Yo-El S Ju
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Mitchell G Miglis
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
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Corriveau-Lecavalier N, Botha H, Graff-Radford J, Switzer AR, Przybelski SA, Wiste HJ, Murray ME, Reichard RR, Dickson DW, Nguyen AT, Ramanan VK, McCarter SJ, Boeve BF, Machulda MM, Fields JA, Stricker NH, Nelson PT, Grothe MJ, Knopman DS, Lowe VJ, Petersen RC, Jack CR, Jones DT. A limbic-predominant amnestic neurodegenerative syndrome associated with TDP-43 pathology. medRxiv 2023:2023.11.19.23298314. [PMID: 38045300 PMCID: PMC10690340 DOI: 10.1101/2023.11.19.23298314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Limbic-predominant age-related TDP-43 encephalopathy (LATE) is a neuropathologically-defined disease that affects 40% of persons in advanced age, but its associated neurological syndrome is not defined. LATE neuropathological changes (LATE-NC) are frequently comorbid with Alzheimer's disease neuropathologic changes (ADNC). When seen in isolation, LATE-NC have been associated with a predominantly amnestic profile and slow clinical progression. We propose a set of clinical criteria for a limbic-predominant amnestic neurodegenerative syndrome (LANS) that is highly associated with LATE-NC but also other pathologic entities. The LANS criteria incorporate core, standard and advanced features that are measurable in vivo, including older age at evaluation, mild clinical syndrome, disproportionate hippocampal atrophy, impaired semantic memory, limbic hypometabolism, absence of neocortical degenerative patterns and low likelihood of neocortical tau, with degrees of certainty (highest, high, moderate, low). We operationalized this set of criteria using clinical, imaging and biomarker data to validate its associations with clinical and pathologic outcomes. We screened autopsied patients from Mayo Clinic (n = 922) and ADNI (n = 93) cohorts and applied the LANS criteria to those with an antemortem predominant amnestic syndrome (Mayo, n = 165; ADNI, n = 53). ADNC, ADNC/LATE-NC and LATE-NC accounted for 35%, 37% and 4% of cases in the Mayo cohort, respectively, and 30%, 22%, and 9% of cases in the ADNI cohort, respectively. The LANS criteria effectively categorized these cases, with ADNC having the lowest LANS likelihoods, LATE-NC patients having the highest likelihoods, and ADNC/LATE-NC patients having intermediate likelihoods. A logistic regression model using the LANS features as predictors of LATE-NC achieved a balanced accuracy of 74.6% in the Mayo cohort, and out-of-sample predictions in the ADNI cohort achieved a balanced accuracy of 73.3%. Patients with high LANS likelihoods had a milder and slower clinical course and more severe temporo-limbic degeneration compared to those with low likelihoods. Stratifying ADNC/LATE-NC patients from the Mayo cohort according to their LANS likelihood revealed that those with higher likelihoods had more temporo-limbic degeneration and a slower rate of cognitive decline, and those with lower likelihoods had more lateral temporo-parietal degeneration and a faster rate of cognitive decline. The implementation of LANS criteria has implications to disambiguate the different driving etiologies of progressive amnestic presentations in older age and guide prognosis, treatment, and clinical trials. The development of in vivo biomarkers specific to TDP-43 pathology are needed to refine molecular associations between LANS and LATE-NC and precise antemortem diagnoses of LATE.
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Affiliation(s)
- Nick Corriveau-Lecavalier
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Heather J. Wiste
- Department of Quantitative Health Sciences, Mayo Clinic Rochester, MN, USA
| | | | - R. Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, MN, USA
| | | | - Aivi T. Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, MN, USA
| | | | | | | | - Mary M. Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Nikki H. Stricker
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Peter T. Nelson
- Department of Pathology, University of Kentucky, Lexington, KY, USA
| | - Michel J. Grothe
- CIEN Foundation/Queen Sofia Foundation Alzheimer Center, Madrid, Spain
- Wallenberg Center for Molecular and Translational Medicine and Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | | | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Clifford R. Jack
- Department of Neuroscience, Mayo Clinic Jacksonville, FL, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - David T. Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Vassilaki M, Syrjanen JA, Krell-Roesch J, Graff-Radford J, Vemuri P, Scharf EL, Machulda MM, Fields JA, Kremers WK, Lowe VJ, Jack CR, Knopman DS, Petersen RC, Geda YE. Association of Cerebrovascular Imaging Biomarkers, Depression, and Anxiety, with Mild Cognitive Impairment. J Alzheimers Dis Rep 2023; 7:1237-1246. [PMID: 38025797 PMCID: PMC10657723 DOI: 10.3233/adr-230073] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
The study included 1,738 Mayo Clinic Study of Aging participants (≥50 years old; 1,460 cognitively unimpaired and 278 with mild cognitive impairment (MCI)) and examined the cross-sectional association between cerebrovascular (CVD) imaging biomarkers (e.g., white matter hyperintensities (WMH), infarctions) and Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI) scores, as well as their association with MCI. High (abnormal) WMH burden was significantly associated with having BDI-II>13 and BAI > 7 scores, and both (CVD imaging biomarkers and depression/anxiety) were significantly associated with MCI when included simultaneously in the model, suggesting that both were independently associated with the odds of MCI.
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Affiliation(s)
- Maria Vassilaki
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Jeremy A. Syrjanen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Janina Krell-Roesch
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | | | | | | | - Mary M. Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Walter K. Kremers
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Ronald C. Petersen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Yonas E. Geda
- Department of Neurology, and the Franke Barrow Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix, AZ, USA
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Mielke MM, Kapoor E, Geske JR, Fields JA, LeBrasseur NK, Morrow MM, Winham SJ, Faubion LL, Castillo AM, Hofrenning EI, Bailey KR, Rocca WA, Kantarci K. Long-term effects of premenopausal bilateral oophorectomy with or without hysterectomy on physical aging and chronic medical conditions. Menopause 2023; 30:1090-1097. [PMID: 37699239 PMCID: PMC10615715 DOI: 10.1097/gme.0000000000002254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
OBJECTIVE We examined the long-term effects of premenopausal bilateral oophorectomy (PBO) with or without concurrent or preceding hysterectomy on physical and cognitive function and on odds of chronic conditions. METHODS We enrolled 274 women with PBO with or without concurrent or preceding hysterectomy and 240 referents aged 55 years and older who were residents of Olmsted County, MN as of the PBO or index date. Chronic conditions were assessed via medical record abstraction. Cognitive diagnoses were based on neurocognitive testing. A physical function assessment included measures of strength and mobility. Multivariable regression models compared characteristics for women with PBO <46 years, PBO 46-49 years, and referent women with adjustments for age and other confounders. RESULTS The clinical visits (median age, 67 years) were a median of 22 years after the PBO or index date. Of 274 women with PBO, 161 (59%) were <46 years at PBO and 113 (41%) were 46-49 years. Compared with referents, women with a history of PBO <46 years had increased odds of arthritis (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.06-2.55), asthma (OR, 1.74; 95% CI, 1.03-2.93), obstructive sleep apnea (OR, 2.00; 95% CI, 1.23-3.26), and bone fractures (OR, 2.86; 95% CI, 1.17-6.98), and walked a shorter mean distance on a 6-minute walk test ( b = -18.43; P = 0.034). Compared with referents, women with a history of PBO at age 46-49 years had increased odds of arthritis (OR, 1.92; 95% CI, 1.16-3.18) and obstructive sleep apnea (OR, 2.21; 95% CI, 1.33-3.66). There were no significant differences in cognitive status in women with PBO compared with referents. CONCLUSIONS Women with a history of PBO with or without concurrent or preceding hysterectomy, especially at age <46 years, have more chronic conditions in late mid-life compared with referents.
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Affiliation(s)
- Michelle M. Mielke
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Ekta Kapoor
- Mayo Clinic Center for Women’s Health, Mayo Clinic, Rochester, MN
- Women’s Health Research Center, Mayo Clinic, Rochester, MN
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN
| | - Jennifer R. Geske
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Nathan K. LeBrasseur
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Melissa M. Morrow
- University of Texas Medical Branch, Department of Nutrition, Metabolism & Rehabilitation Sciences, Galveston, TX
| | - Stacey J. Winham
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | | | - Anna M. Castillo
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | | | - Kent R. Bailey
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Walter A. Rocca
- Women’s Health Research Center, Mayo Clinic, Rochester, MN
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
- Department of Neurology, Mayo Clinic, Rochester, MN
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26
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Diaz-Galvan P, Przybelski SA, Lesnick TG, Schwarz CG, Senjem ML, Gunter JL, Jack CR, Min HKP, Jain M, Miyagawa T, Forsberg LK, Fields JA, Savica R, Graff-Radford J, Jones DT, Botha H, St Louis EK, Knopman DS, Ramanan VK, Ross O, Graff-Radford N, Day GS, Dickson DW, Ferman TJ, Petersen RC, Lowe VJ, Boeve BF, Kantarci K. β-Amyloid Load on PET Along the Continuum of Dementia With Lewy Bodies. Neurology 2023; 101:e178-e188. [PMID: 37202168 PMCID: PMC10351554 DOI: 10.1212/wnl.0000000000207393] [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] [Received: 08/08/2022] [Accepted: 03/23/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES β-Amyloid (Aβ) plaques can co-occur with Lewy-related pathology in patients with dementia with Lewy bodies (DLB), but Aβ load at prodromal stages of DLB still needs to be elucidated. We investigated Aβ load on PET throughout the DLB continuum, from an early prodromal stage of isolated REM sleep behavior disorder (iRBD) to a stage of mild cognitive impairment with Lewy bodies (MCI-LB), and finally DLB. METHODS We performed a cross-sectional study in patients with a diagnosis of iRBD, MCI-LB, or DLB from the Mayo Clinic Alzheimer Disease Research Center. Aβ levels were measured by Pittsburgh compound B (PiB) PET, and global cortical standardized uptake value ratio (SUVR) was calculated. Global cortical PiB SUVR values from each clinical group were compared with each other and with those of cognitively unimpaired (CU) individuals (n = 100) balanced on age and sex using analysis of covariance. We used multiple linear regression testing for interaction to study the influences of sex and APOE ε4 status on PiB SUVR along the DLB continuum. RESULTS Of the 162 patients, 16 had iRBD, 64 had MCI-LB, and 82 had DLB. Compared with CU individuals, global cortical PiB SUVR was higher in those with DLB (p < 0.001) and MCI-LB (p = 0.012). The DLB group included the highest proportion of Aβ-positive patients (60%), followed by MCI-LB (41%), iRBD (25%), and finally CU (19%). Global cortical PiB SUVR was higher in APOE ε4 carriers compared with that in APOE ε4 noncarriers in MCI-LB (p < 0.001) and DLB groups (p = 0.049). Women had higher PiB SUVR with older age compared with men across the DLB continuum (β estimate = 0.014, p = 0.02). DISCUSSION In this cross-sectional study, levels of Aβ load was higher further along the DLB continuum. Whereas Aβ levels were comparable with those in CU individuals in iRBD, a significant elevation in Aβ levels was observed in the predementia stage of MCI-LB and in DLB. Specifically, APOE ε4 carriers had higher Aβ levels than APOE ε4 noncarriers, and women tended to have higher Aβ levels than men as they got older. These findings have important implications in targeting patients within the DLB continuum for clinical trials of disease-modifying therapies.
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Affiliation(s)
- Patricia Diaz-Galvan
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Scott A Przybelski
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Timothy G Lesnick
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Christopher G Schwarz
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Matthew L Senjem
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Jeffrey L Gunter
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Clifford R Jack
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Hoon-Ki Paul Min
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Manoj Jain
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Toji Miyagawa
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Leah K Forsberg
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Julie A Fields
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Rodolfo Savica
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Jonathan Graff-Radford
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - David T Jones
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Hugo Botha
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Erik K St Louis
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - David S Knopman
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Vijay K Ramanan
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Owen Ross
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Neill Graff-Radford
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Gregory S Day
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Dennis W Dickson
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Tanis J Ferman
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Ronald C Petersen
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Val J Lowe
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Brad F Boeve
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Kejal Kantarci
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL.
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Krell‐Roesch J, Zaniletti I, Syrjanen JA, Kremers WK, Algeciras‐Schimnich A, Dage JL, van Harten AC, Fields JA, Knopman DS, Jack CR, Petersen RC, Vassilaki M, Geda YE. Plasma-derived biomarkers of Alzheimer's disease and neuropsychiatric symptoms: A community-based study. Alzheimers Dement (Amst) 2023; 15:e12461. [PMID: 37529120 PMCID: PMC10387518 DOI: 10.1002/dad2.12461] [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] [Received: 10/31/2022] [Revised: 05/31/2023] [Accepted: 06/21/2023] [Indexed: 08/03/2023]
Abstract
INTRODUCTION We examined associations between plasma-derived biomarkers of Alzheimer's disease (AD) and neuropsychiatric symptoms (NPS) in community-dwelling older adults. METHODS Cross-sectional study involving 1005 persons ≥50 years of age (mean 74 years, 564 male, 118 cognitively impaired), who completed plasma-derived biomarker (amyloid beta 42 [Aβ42]/Aβ40, phosphorylated tau 181 [p-tau181], p-tau217, total tau [t-tau], neurofilament light [NfL]), and NPS assessment. RESULTS P-tau181 (odds ratio [OR] 2.06, 95% confidence interval [CI] 1.41-3.00, p < 0.001), p-tau217 (OR 1.70, 95% CI 1.10-2.61, p = 0.016), and t-tau (OR 1.44, 95% CI 1.08-1.92, p = 0.012) were associated with appetite change. We also found that p-tau181 and p-tau217 were associated with increased symptoms of agitation (OR 1.93, 95% CI 1.20-3.11, p = 0.007 and OR 2.04, 95% CI 1.21-3.42, p = 0.007, respectively), and disinhibition (OR 2.39, 95% CI 1.45-3.93, p = 0.001 and OR 2.30, 95% CI 1.33-3.98, p = 0.003, respectively). Aβ42/Aβ40 and NfL were not associated with NPS. CONCLUSION Higher plasma-derived p-tau181 and p-tau217 levels are associated with increased symptoms of appetite change, agitation, and disinhibition. These findings may support the validity of plasma tau biomarkers for predicting behavioral symptoms that often accompany cognitive impairment. HIGHLIGHTS We studied 1005 community-dwelling persons aged ≥ 50 yearsHigher plasma tau levels are associated with increased neuropsychiatric symptomsAβ42/Aβ40 and NfL are not associated with neuropsychiatric symptomsClinicians should treat neuropsychiatric symptoms in persons with high plasma-derived tau.
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Affiliation(s)
- Janina Krell‐Roesch
- Institute of Sports and Sports ScienceKarlsruhe Institute of TechnologyKarlsruheGermany
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Isabella Zaniletti
- Department of Quantitative Health SciencesMayo ClinicScottsdaleArizonaUSA
| | - Jeremy A. Syrjanen
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Walter K. Kremers
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | | | - Jeffrey L. Dage
- Department of Neurology and Stark Neurosciences Research InstituteIndiana University School of MedicineIndianapolisIndianaUSA
| | - Argonde C. van Harten
- Alzheimer Center, Department of NeurologyVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | | | | | - Ronald C. Petersen
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Maria Vassilaki
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Yonas E. Geda
- Department of Neurology and the Franke Barrow Global Neuroscience Education CenterBarrow Neurological InstitutePhoenixArizonaUSA
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Mielke MM, Frank RD, Christenson LR, Fields JA, Rocca WA, Garovic VD. Association of Hypertensive Disorders of Pregnancy With Cognition in Later Life. Neurology 2023; 100:e2017-e2026. [PMID: 36859405 PMCID: PMC10186223 DOI: 10.1212/wnl.0000000000207134] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/17/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Studies of hypertensive disorders of pregnancy (HDP), including gestational or chronic hypertension (GH/CH) and preeclampsia/eclampsia (PE/E), suggest associations with early-life and mid-life cognition but have been limited by self-report or use of diagnostic codes, exclusion of nulliparous women, and lack of measurement of cognition in later life. We examined the effects of any HDP, GH/CH, PE/E, and nulliparity on cognition in later life. METHODS Participants included 2,239 women (median age 73) enrolled in the Mayo Clinic Study of Aging with medical record-abstracted pregnancy information. A cognitive battery of 9 tests was conducted every 15 months. Global cognitive and domain-specific z scores (memory, executive/attention, visuospatial, and language) were outcomes. Linear mixed-effect models evaluated associations between pregnancy history (all normotensive, any HPD, HPD subtype [GH/CH, PE/E], or nulliparous) and cognitive decline, adjusting for age and education. Additional models adjusted for APOE, smoking, hypertension, dyslipidemia, body mass index (BMI), diabetes, stroke, and heart disease. Interactions between pregnancy history and age or education on cognitive performance were examined. RESULTS Of the 2,239 women, 1,854 (82.8%) had at least 1 pregnancy (1,607 all normotensive, 100 GH/CH, and 147 PE/E); 385 (17.2%) were nulliparous. Cognitive performance did not cross-sectionally differ for women with a history of any HDP, GH/CH, or PE/E vs women with a history of all normotensive pregnancies; women who were nulliparous had lower global and domain-specific cognition (all p < 0.05) in age- and education-adjusted models. There was an interaction (p = 0.015) between nulliparity and education such that the lower cognitive performance was most pronounced among nulliparous women with ≤12 years of education (beta = -0.42, p < 0.001) vs 12 + years (b = -0.11, p = 0.049). Longitudinally, women with any HDP had greater declines in global cognition and attention/executive z scores compared with women with all normotensive pregnancies. When stratified by HDP type, only women with PE/E had greater declines in global cognition (beta = -0.04, p < 0.001), language (beta = -0.03, p = 0.001), and attention (beta = -0.04, p < 0.001) z scores. Adjustment for vascular risk factors, BMI, smoking, and APOE did not attenuate results. DISCUSSION Women with a history of HDP, especially PE/E, are at greater risk of cognitive decline in later life.
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Affiliation(s)
- Michelle M Mielke
- From the Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Quantitative Health Sciences (R.D.F., L.R.C., W.A.R.), Mayo Clinic, Rochester, MN; Division of Neurocognitive Disorders, Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Neurology and Women's Health Research Center (W.A.R.), Mayo Clinic, Rochester, MN; Division of Nephrology and Hypertension and Department of Obstetrics and Gynecology (V.D.G.), Mayo Clinic, Rochester, MN
| | - Ryan D Frank
- From the Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Quantitative Health Sciences (R.D.F., L.R.C., W.A.R.), Mayo Clinic, Rochester, MN; Division of Neurocognitive Disorders, Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Neurology and Women's Health Research Center (W.A.R.), Mayo Clinic, Rochester, MN; Division of Nephrology and Hypertension and Department of Obstetrics and Gynecology (V.D.G.), Mayo Clinic, Rochester, MN
| | - Luke R Christenson
- From the Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Quantitative Health Sciences (R.D.F., L.R.C., W.A.R.), Mayo Clinic, Rochester, MN; Division of Neurocognitive Disorders, Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Neurology and Women's Health Research Center (W.A.R.), Mayo Clinic, Rochester, MN; Division of Nephrology and Hypertension and Department of Obstetrics and Gynecology (V.D.G.), Mayo Clinic, Rochester, MN
| | - Julie A Fields
- From the Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Quantitative Health Sciences (R.D.F., L.R.C., W.A.R.), Mayo Clinic, Rochester, MN; Division of Neurocognitive Disorders, Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Neurology and Women's Health Research Center (W.A.R.), Mayo Clinic, Rochester, MN; Division of Nephrology and Hypertension and Department of Obstetrics and Gynecology (V.D.G.), Mayo Clinic, Rochester, MN
| | - Walter A Rocca
- From the Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Quantitative Health Sciences (R.D.F., L.R.C., W.A.R.), Mayo Clinic, Rochester, MN; Division of Neurocognitive Disorders, Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Neurology and Women's Health Research Center (W.A.R.), Mayo Clinic, Rochester, MN; Division of Nephrology and Hypertension and Department of Obstetrics and Gynecology (V.D.G.), Mayo Clinic, Rochester, MN
| | - Vesna D Garovic
- From the Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Quantitative Health Sciences (R.D.F., L.R.C., W.A.R.), Mayo Clinic, Rochester, MN; Division of Neurocognitive Disorders, Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Neurology and Women's Health Research Center (W.A.R.), Mayo Clinic, Rochester, MN; Division of Nephrology and Hypertension and Department of Obstetrics and Gynecology (V.D.G.), Mayo Clinic, Rochester, MN
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Taylor JC, Heuer HW, Clark AL, Wise AB, Manoochehri M, Forsberg L, Mester C, Rao M, Brushaber D, Kramer J, Welch AE, Kornak J, Kremers W, Appleby B, Dickerson BC, Domoto‐Reilly K, Fields JA, Ghoshal N, Graff‐Radford N, Grossman M, Hall MGH, Huey ED, Irwin D, Lapid MI, Litvan I, Mackenzie IR, Masdeu JC, Mendez MF, Nevler N, Onyike CU, Pascual B, Pressman P, Rankin KP, Ratnasiri B, Rojas JC, Tartaglia MC, Wong B, Gorno‐Tempini ML, Boeve BF, Rosen HJ, Boxer AL, Staffaroni AM. Feasibility and acceptability of remote smartphone cognitive testing in frontotemporal dementia research. Alzheimers Dement (Amst) 2023; 15:e12423. [PMID: 37180971 PMCID: PMC10170087 DOI: 10.1002/dad2.12423] [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] [Received: 09/02/2022] [Revised: 12/27/2022] [Accepted: 03/01/2023] [Indexed: 05/16/2023]
Abstract
Introduction Remote smartphone assessments of cognition, speech/language, and motor functioning in frontotemporal dementia (FTD) could enable decentralized clinical trials and improve access to research. We studied the feasibility and acceptability of remote smartphone data collection in FTD research using the ALLFTD Mobile App (ALLFTD-mApp). Methods A diagnostically mixed sample of 214 participants with FTD or from familial FTD kindreds (asymptomatic: CDR®+NACC-FTLD = 0 [N = 101]; prodromal: 0.5 [N = 49]; symptomatic ≥1 [N = 51]; not measured [N = 13]) were asked to complete ALLFTD-mApp tests on their smartphone three times within 12 days. They completed smartphone familiarity and participation experience surveys. Results It was feasible for participants to complete the ALLFTD-mApp on their own smartphones. Participants reported high smartphone familiarity, completed ∼ 70% of tasks, and considered the time commitment acceptable (98% of respondents). Greater disease severity was associated with poorer performance across several tests. Discussion These findings suggest that the ALLFTD-mApp study protocol is feasible and acceptable for remote FTD research. HIGHLIGHTS The ALLFTD Mobile App is a smartphone-based platform for remote, self-administered data collection.The ALLFTD Mobile App consists of a comprehensive battery of surveys and tests of executive functioning, memory, speech and language, and motor abilities.Remote digital data collection using the ALLFTD Mobile App was feasible in a multicenter research consortium that studies FTD. Data was collected in healthy controls and participants with a range of diagnoses, particularly FTD spectrum disorders.Remote digital data collection was well accepted by participants with a variety of diagnoses.
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Affiliation(s)
- Jack Carson Taylor
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | - Hilary W. Heuer
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | - Annie L. Clark
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | - Amy B. Wise
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | | | - Leah Forsberg
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Carly Mester
- Department of Quantitative Health SciencesDivision of Biomedical Statistics and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Meghana Rao
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Daniell Brushaber
- Department of Quantitative Health SciencesDivision of Biomedical Statistics and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Joel Kramer
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | - Ariane E. Welch
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | - John Kornak
- Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Walter Kremers
- Department of Quantitative Health SciencesDivision of Biomedical Statistics and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Brian Appleby
- Department of NeurologyCase Western Reserve UniversityClevelandOhioUSA
| | - Bradford C. Dickerson
- Department of NeurologyMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | | | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Nupur Ghoshal
- Center for Advanced Medicine Memory Diagnostic CenterWashington UniversitySaint LouisMissouriUSA
| | | | - Murray Grossman
- Department of NeurologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Matthew GH Hall
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | - Edward D. Huey
- Department of NeurologyColumbia UniversityNew YorkNew YorkUSA
| | - David Irwin
- Department of NeurologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Maria I. Lapid
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Irene Litvan
- Department of NeurosciencesUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Ian R. Mackenzie
- Department of PathologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Mario F. Mendez
- Department of NeurologyUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Naomi Nevler
- Department of NeurologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Chiadi U. Onyike
- Department of Psychiatry and Behavioral SciencesJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Belen Pascual
- Department of NeurologyHouston MethodistHoustonTexasUSA
| | - Peter Pressman
- Department of NeurologyUniversity of ColoradoAuroraColoradoUSA
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | - Buddhika Ratnasiri
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | - Julio C. Rojas
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, Division of NeurologyUniversity of TorontoTorontoOntarioCanada
| | - Bonnie Wong
- Department of NeurologyMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Maria Luisa Gorno‐Tempini
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | | | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | - Adam L. Boxer
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
| | - Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San FranciscoWeill Institute for NeurosciencesSan FranciscoCaliforniaUSA
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Ferreira D, Przybelski SA, Lesnick TG, Schwarz CG, Diaz-Galvan P, Graff-Radford J, Senjem ML, Fields JA, Knopman DS, Jones DT, Savica R, Ferman TJ, Graff-Radford N, Lowe VJ, Jack CR, Petersen RC, Westman E, Boeve BF, Kantarci K. Cross-sectional Associations of β-Amyloid, Tau, and Cerebrovascular Biomarkers With Neurodegeneration in Probable Dementia With Lewy Bodies. Neurology 2023; 100:e846-e859. [PMID: 36443011 PMCID: PMC9984215 DOI: 10.1212/wnl.0000000000201579] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/06/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although alpha-synuclein-related pathology is the hallmark of dementia with Lewy bodies (DLB), cerebrovascular and Alzheimer disease pathologies are common in patients with DLB. Little is known about the contribution of these pathologies to neurodegeneration in DLB. We investigated associations of cerebrovascular, β-amyloid, and tau biomarkers with gray matter (GM) volume in patients with probable DLB. METHODS We assessed patients with probable DLB and cognitively unimpaired (CU) controls with 11C-Pittsburgh compound B (PiB) and 18F-flortaucipir PET as markers of β-amyloid and tau, respectively. MRI was used to assess white matter hyperintensity (WMH) volume (a marker of cerebrovascular lesion load) and regional GM volume (a marker of neurodegeneration). We used correlations and analysis of covariance (ANCOVA) in the entire cohort and structural equation models (SEMs) in patients with DLB to investigate associations of WMH volume and regional β-amyloid and tau PET standardized uptake value ratios (SUVrs) with regional GM volume. RESULTS We included 30 patients with DLB (69.3 ± 10.2 years, 87% men) and 100 CU controls balanced on age and sex. Compared with CU controls, patients with DLB showed a lower GM volume across all cortical and subcortical regions except for the cuneus, putamen, and pallidum. A larger WMH volume was associated with a lower volume in the medial and orbital frontal cortices, insula, fusiform cortex, and thalamus in patients with DLB. A higher PiB SUVr was associated with a lower volume in the inferior temporal cortex, while flortaucipir SUVr did not correlate with GM volume. SEMs showed that a higher age and absence of the APOE ε4 allele were significant predictors of higher WMH volume, and WMH volume in turn was a significant predictor of GM volume in medial and orbital frontal cortices, insula, and inferior temporal cortex. By contrast, we observed 2 distinct paths for the fusiform cortex, with age having an effect through PiB and flortaucipir SUVr on one path and through WMH volume on the other path. DISCUSSION Patients with probable DLB have widespread cortical atrophy, most of which is likely influenced by alpha-synuclein-related pathology. Although cerebrovascular, β-amyloid, and tau pathologies often coexist in probable DLB, their contributions to neurodegeneration seem to be region specific.
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Affiliation(s)
- Daniel Ferreira
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Scott A Przybelski
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Timothy G Lesnick
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Christopher G Schwarz
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Patricia Diaz-Galvan
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Jonathan Graff-Radford
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Matthew L Senjem
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Julie A Fields
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - David S Knopman
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - David T Jones
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Rodolfo Savica
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Tanis J Ferman
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Neill Graff-Radford
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Val J Lowe
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Clifford R Jack
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Ronald C Petersen
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Eric Westman
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Brad F Boeve
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Kejal Kantarci
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
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Elliott JE, Lim MM, Keil AT, Postuma RB, Pelletier A, Gagnon JF, St Louis EK, Forsberg LK, Fields JA, Huddleston DE, Bliwise DL, Avidan AY, Howell MJ, Schenck CH, McLeland J, Criswell SR, Videnovic A, During EH, Miglis MG, Shprecher DR, Lee-Iannotti JK, Boeve BF, Ju YES. Baseline characteristics of the North American prodromal Synucleinopathy cohort. Ann Clin Transl Neurol 2023; 10:520-535. [PMID: 36751940 PMCID: PMC10109527 DOI: 10.1002/acn3.51738] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVE Rapid eye movement (REM) sleep behavior disorder (RBD) is widely considered a prodromal synucleinopathy, as most with RBD develop overt synucleinopathy within ~10 years. Accordingly, RBD offers an opportunity to test potential treatments at the earliest stages of synucleinopathy. The North American Prodromal Synucleinopathy (NAPS) Consortium has created a multisite RBD participant, primarily clinic-based cohort to better understand characteristics at diagnosis, and in future work, identify predictors of phenoconversion, develop synucleinopathy biomarkers, and enable early stage clinical trial enrollment. METHODS Participants ≥18 years of age with overnight polysomnogram-confirmed RBD without Parkinson's disease, dementia, multiple system atrophy, or narcolepsy were enrolled from nine sites across North America (8/2018 to 4/2021). Data collection included family/personal history of RBD and standardized assessments of cognitive, motor, sensory, and autonomic function. RESULTS Outcomes are primarily reported based on sex (361 total: n = 295 male, n = 66 female), and secondarily based on history of antidepressant use (n = 200 with, n = 154 without; with correction for sex differences) and based on extent of synucleinopathy burden (n = 56 defined as isolated RBD, n = 305 defined as RBD+ [i.e., exhibiting ≥1 abnormality]). Overall, these participants commonly demonstrated abnormalities in global cognition (MoCA; 38%), motor function (alternate tap test; 48%), sensory (BSIT; 57%), autonomic function (orthostatic hypotension, 38.8%), and anxiety/depression (BAI and PHQ-9; 39.3% and 31%, respectively). INTERPRETATION These RBD participants, assessed with extensive history, demographic, cognitive, motor, sensory, and autonomic function demonstrated a lack of sex differences and high frequency of concomitant neurological abnormalities. These participants will be valuable for future longitudinal study and neuroprotective clinical trials.
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Affiliation(s)
- Jonathan E Elliott
- VA Portland Health Care System, Research Service, Portland, Oregon, USA.,Oregon Health & Science University, Neurology, Portland, Oregon, USA
| | - Miranda M Lim
- Oregon Health & Science University, Neurology, Portland, Oregon, USA.,Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA.,Department of Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, Oregon, USA.,Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon, USA.,Neurology, VA Portland Health Care System, Portland, Oregon, USA.,Mental Illness Research Education and Clinical Center, VA Portland Health Care System, Portland, Oregon, USA.,National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA
| | - Allison T Keil
- VA Portland Health Care System, Research Service, Portland, Oregon, USA
| | - Ronald B Postuma
- Montreal Neurological Institute, McGill University, Montreal, Québec, Canada.,Psychology, Université du Québec à Montréal, Montreal, Québec, Canada
| | - Amelie Pelletier
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine, Montreal, Québec, Canada
| | - Jean-François Gagnon
- Psychology, Université du Québec à Montréal, Montreal, Québec, Canada.,Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine, Montreal, Québec, Canada
| | - Erik K St Louis
- Mayo Clinic, Neurology and Medicine, Rochester, Minnesota, USA
| | - Leah K Forsberg
- Mayo Clinic, Neurology and Medicine, Rochester, Minnesota, USA
| | - Julie A Fields
- Mayo Clinic, Neurology and Medicine, Rochester, Minnesota, USA
| | | | | | - Alon Y Avidan
- Neurology, Sleep Disorders Center, University of California Los Angeles, Los Angeles, California, USA
| | - Michael J Howell
- Neurology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA.,Hennepin County Medical Center, Minnesota Regional Sleep Disorders Center, Minneapolis, Minnesota, USA
| | - Carlos H Schenck
- Neurology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
| | | | - Susan R Criswell
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Aleksandar Videnovic
- Movement Disorders Unit, Division of Sleep Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Neurological Clinical Research Institute, Boston, Massachusetts, USA
| | - Emmanuel H During
- Psychiatry and Behavioral Sciences, Stanford University, Redwood City, California, USA.,Neurology & Neurological Sciences, Stanford University, Palo Alto, California, USA
| | - Mitchell G Miglis
- Psychiatry and Behavioral Sciences, Stanford University, Redwood City, California, USA.,Neurology & Neurological Sciences, Stanford University, Palo Alto, California, USA
| | - David R Shprecher
- Neurology, Banner Sun Health Research Institute, Phoenix, Arizona, USA
| | | | - Bradley F Boeve
- Mayo Clinic, Neurology and Medicine, Rochester, Minnesota, USA
| | - Yo-El S Ju
- Washington University School of Medicine, St. Louis, Missouri, USA
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Diaz-Galvan P, Miyagawa T, Przybelski SA, Lesnick TG, Senjem ML, Jack CR, Forsberg LK, Min HK, St. Louis EK, Savica R, Fields JA, Benarroch EE, Lowe V, Petersen RC, Boeve BF, Kantarci K. Brain glucose metabolism and nigrostriatal degeneration in isolated rapid eye movement sleep behaviour disorder. Brain Commun 2023; 5:fcad021. [PMID: 36844148 PMCID: PMC9945851 DOI: 10.1093/braincomms/fcad021] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 11/14/2022] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
Alterations of cerebral glucose metabolism can be detected in patients with isolated rapid eye movement sleep behaviour disorder, a prodromal feature of neurodegenerative diseases with α-synuclein pathology. However, metabolic characteristics that determine clinical progression in isolated rapid eye movement sleep behaviour disorder and their association with other biomarkers need to be elucidated. We investigated the pattern of cerebral glucose metabolism on 18F-fluorodeoxyglucose PET in patients with isolated rapid eye movement sleep behaviour disorder, differentiating between those who clinically progressed and those who remained stable over time. Second, we studied the association between 18F-fluorodeoxyglucose PET and lower dopamine transporter availability in the putamen, another hallmark of synucleinopathies. Patients with isolated rapid eye movement sleep behaviour disorder from the Mayo Clinic Alzheimer's Disease Research Center and Center for Sleep Medicine (n = 22) and age-and sex-matched clinically unimpaired controls (clinically unimpaired; n = 44) from the Mayo Clinic Study of Aging were included. All participants underwent 18F-fluorodeoxyglucose PET and dopamine transporter imaging with iodine 123-radiolabeled 2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane on single-photon emission computerized tomography. A subset of patients with isolated rapid eye movement sleep behaviour disorder with follow-up evaluations (n = 17) was classified as isolated rapid eye movement sleep behaviour disorder progressors (n = 7) if they developed mild cognitive impairment or Parkinson's disease; or isolated rapid eye movement sleep behaviour disorder stables (n = 10) if they remained with a diagnosis of isolated rapid eye movement sleep behaviour disorder with no cognitive impairment. Glucose metabolic abnormalities in isolated rapid eye movement sleep behaviour disorder were determined by comparing atlas-based regional 18F-fluorodeoxyglucose PET uptake between isolated rapid eye movement sleep behaviour disorder and clinically unimpaired. Associations between 18F-fluorodeoxyglucose PET and dopamine transporter availability in the putamen were analyzed with Pearson's correlation within the nigrostriatal pathway structures and with voxel-based analysis in the cortex. Patients with isolated rapid eye movement sleep behaviour disorder had lower glucose metabolism in the substantia nigra, retrosplenial cortex, angular cortex, and thalamus, and higher metabolism in the amygdala and entorhinal cortex compared with clinically unimpaired. Patients with isolated rapid eye movement sleep behaviour disorder who clinically progressed over time were characterized by higher glucose metabolism in the amygdala and entorhinal cortex, and lower glucose metabolism in the cerebellum compared with clinically unimpaired. Lower dopamine transporter availability in the putamen was associated with higher glucose metabolism in the pallidum within the nigrostriatal pathway; and with higher 18F-fluorodeoxyglucose uptake in the amygdala, insula, and temporal pole on a voxel-based analysis, although these associations did not survive after correcting for multiple comparisons. Our findings suggest that cerebral glucose metabolism in isolated rapid eye movement sleep behaviour disorder is characterized by hypometabolism in regions frequently affected during the prodromal stage of synucleinopathies, potentially reflecting synaptic dysfunction. Hypermetabolism is also seen in isolated rapid eye movement sleep behaviour disorder, suggesting that synaptic metabolic disruptions may be leading to a lack of inhibition, compensatory mechanisms, or microglial activation, especially in regions associated with nigrostriatal degeneration.
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Affiliation(s)
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Scott A Przybelski
- Department of Quantitative Health Science, Mayo Clinic, Rochester, MN 55905, USA
| | - Timothy G Lesnick
- Department of Quantitative Health Science, Mayo Clinic, Rochester, MN 55905, USA
| | - Matthew L Senjem
- Department of Information Technology, Mayo Clinic, Rochester, MN 55905, USA
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - Leah K Forsberg
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Hoon-Ki Min
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Val Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
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Pink A, Krell‐Roesch J, Syrjanen JA, Christenson LR, Lowe VJ, Vemuri P, Fields JA, Stokin GB, Kremers WK, Scharf EL, Jack CR, Knopman DS, Petersen RC, Vassilaki M, Geda YE. Interactions Between Neuropsychiatric Symptoms and Alzheimer's Disease Neuroimaging Biomarkers in Predicting Longitudinal Cognitive Decline. Psychiatr Res Clin Pract 2023; 5:4-15. [PMID: 36909142 PMCID: PMC9997077 DOI: 10.1176/appi.prcp.20220036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 01/22/2023] Open
Abstract
Objective To examine interactions between Neuropsychiatric symptoms (NPS) with Pittsburgh Compound B (PiB) and fluorodeoxyglucose positron emission tomography (FDG-PET) in predicting cognitive trajectories. Methods We conducted a longitudinal study in the setting of the population-based Mayo Clinic Study of Aging in Olmsted County, MN, involving 1581 cognitively unimpaired (CU) persons aged ≥50 years (median age 71.83 years, 54.0% males, 27.5% APOE ɛ4 carriers). NPS at baseline were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Brain glucose hypometabolism was defined as a SUVR ≤ 1.47 (measured by FDG-PET) in regions typically affected in Alzheimer's disease. Abnormal cortical amyloid deposition was measured using PiB-PET (SUVR ≥ 1.48). Neuropsychological testing was done approximately every 15 months, and we calculated global and domain-specific (memory, language, attention, and visuospatial skills) cognitive z-scores. We ran linear mixed-effect models to examine the associations and interactions between NPS at baseline and z-scored PiB- and FDG-PET SUVRs in predicting cognitive z-scores adjusted for age, sex, education, and previous cognitive testing. Results Individuals at the average PiB and without NPS at baseline declined over time on cognitive z-scores. Those with increased PiB at baseline declined faster (two-way interaction), and those with increased PiB and NPS declined even faster (three-way interaction). We observed interactions between time, increased PiB and anxiety or irritability indicating accelerated decline on global z-scores, and between time, increased PiB and several NPS (e.g., agitation) showing faster domain-specific decline, especially on the attention domain. Conclusions NPS and increased brain amyloid deposition synergistically interact in accelerating global and domain-specific cognitive decline among CU persons at baseline.
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Affiliation(s)
- Anna Pink
- First Department of MedicineParacelsus Medical UniversitySalzburgAustria
| | - Janina Krell‐Roesch
- Department of Quantitative Health SciencesMayo Clinic RochesterRochesterMinnesotaUSA
- Institute of Sports and Sports ScienceKarlsruhe Institute of TechnologyKarlsruheGermany
| | - Jeremy A. Syrjanen
- Department of Quantitative Health SciencesMayo Clinic RochesterRochesterMinnesotaUSA
| | - Luke R. Christenson
- Department of Quantitative Health SciencesMayo Clinic RochesterRochesterMinnesotaUSA
| | - Val J. Lowe
- Department of RadiologyMayo Clinic RochesterRochesterMinnesotaUSA
| | | | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo Clinic RochesterRochesterMinnesotaUSA
| | - Gorazd B. Stokin
- International Clinical Research Center/St. Anne HospitalBrnoCzech Republic
| | - Walter K. Kremers
- Department of Quantitative Health SciencesMayo Clinic RochesterRochesterMinnesotaUSA
| | - Eugene L. Scharf
- Department of NeurologyMayo Clinic RochesterRochesterMinnesotaUSA
| | - Clifford R. Jack
- Department of RadiologyMayo Clinic RochesterRochesterMinnesotaUSA
| | - David S. Knopman
- Department of NeurologyMayo Clinic RochesterRochesterMinnesotaUSA
| | - Ronald C. Petersen
- Department of Quantitative Health SciencesMayo Clinic RochesterRochesterMinnesotaUSA
- Department of NeurologyMayo Clinic RochesterRochesterMinnesotaUSA
| | - Maria Vassilaki
- Department of Quantitative Health SciencesMayo Clinic RochesterRochesterMinnesotaUSA
| | - Yonas E. Geda
- Department of NeurologyFranke Global Neuroscience Education CenterBarrow Neurological InstitutePhoenixArizonaUSA
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Stricker NH, Twohy EL, Albertson SM, Karstens AJ, Kremers WK, Machulda MM, Fields JA, Jack CR, Knopman DS, Mielke MM, Petersen RC. Mayo-PACC: A parsimonious preclinical Alzheimer's disease cognitive composite comprised of public-domain measures to facilitate clinical translation. Alzheimers Dement 2022. [PMID: 36565459 DOI: 10.1002/alz.12895] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION We aimed to define a Mayo Preclinical Alzheimer's disease Cognitive Composite (Mayo-PACC) that prioritizes parsimony and use of public domain measures to facilitate clinical translation. METHODS Cognitively unimpaired participants aged 65 to 85 at baseline with amyloid PET imaging were included, yielding 428 amyloid negative (A-) and 186 amyloid positive (A+) individuals with 7 years mean follow-up. Sensitivity to amyloid-related cognitive decline was examined using slope estimates derived from linear mixed models (difference in annualized change across A+ and A- groups). We compared differences in rates of change between Mayo-PACC and other composites (A+ > A- indicating more significant decline in A+). RESULTS All composites showed sensitivity to amyloid-related longitudinal cognitive decline (A+ > A- annualized change p < 0.05). Comparisons revealed that Mayo-PACC (AVLT sum of trials 1-5+6+delay, Trails B, animal fluency) showed comparable longitudinal sensitivity to other composites. DISCUSSION Mayo-PACC performs similarly to other composites and can be directly translated to the clinic.
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Affiliation(s)
- Nikki H Stricker
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Erin L Twohy
- Division of Biomedical Statistics and Informatics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Sabrina M Albertson
- Division of Biomedical Statistics and Informatics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Aimee J Karstens
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Walter K Kremers
- Division of Biomedical Statistics and Informatics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Mary M Machulda
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Julie A Fields
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle M Mielke
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.,Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
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Krell-Roesch J, Syrjanen JA, Bezold J, Trautwein S, Barisch-Fritz B, Kremers WK, Fields JA, Scharf EL, Knopman DS, Stokin GB, Petersen RC, Jekauc D, Woll A, Vassilaki M, Geda YE. Mid- and Late-Life Physical Activity and Neuropsychiatric Symptoms in Dementia-Free Older Adults: Mayo Clinic Study of Aging. J Neuropsychiatry Clin Neurosci 2022; 35:133-140. [PMID: 36464975 DOI: 10.1176/appi.neuropsych.20220068] [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: 12/12/2022]
Abstract
OBJECTIVE This study examined associations between physical activity (PA) and neuropsychiatric symptoms (NPS) in older adults free of dementia. METHODS This cross-sectional study included 3,222 individuals ≥70 years of age (1,655 men; mean±SD age=79.2±5.6; cognitively unimpaired, N=2,723; mild cognitive impairment, N=499) from the population-based Mayo Clinic Study of Aging. PA (taken as a presumed predictor) in midlife (i.e., when participants were 50-65 years of age) and late life (i.e., the year prior to assessment) was assessed with a self-reported, validated questionnaire; PA intensity and frequency were used to calculate composite scores. NPS (taken as presumed outcomes) were assessed with the Neuropsychiatric Inventory Questionnaire, Beck Depression Inventory (BDI-II), and Beck Anxiety Inventory (BAI). Regression analyses included midlife and late-life PA in each model, which were adjusted for age, sex, education, apolipoprotein E ɛ4 status, and medical comorbidity. RESULTS Higher late-life PA was associated with lower odds of having apathy (OR=0.89, 95% CI=0.84-0.93), appetite changes (OR=0.92, 95% CI=0.87-0.98), nighttime disturbances (OR=0.95, 95% CI=0.91-0.99), depression (OR=0.94, 95% CI=0.90-0.97), irritability (OR=0.93, 95% CI=0.89-0.97), clinical depression (OR=0.92, 95% CI=0.88-0.97), and clinical anxiety (OR=0.90, 95% CI=0.86-0.94), as well as lower BDI-II (β estimate=-0.042, 95% CI=-0.051 to -0.033) and BAI (β estimate=-0.030, 95% CI=-0.040 to -0.021) scores. Higher midlife PA was associated only with higher BDI-II scores (β estimate=0.011, 95% CI=0.004 to 0.019). Sex modified the associations between PA and NPS. CONCLUSIONS Late-life PA was associated with a lower likelihood of clinical depression or anxiety and subclinical NPS. These findings need to be confirmed in a cohort study.
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Affiliation(s)
- Janina Krell-Roesch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Jeremy A Syrjanen
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Jelena Bezold
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Sandra Trautwein
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Bettina Barisch-Fritz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Walter K Kremers
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Julie A Fields
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Eugene L Scharf
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - David S Knopman
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Gorazd B Stokin
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Ronald C Petersen
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Darko Jekauc
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Maria Vassilaki
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
| | - Yonas E Geda
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch, Bezold, Trautwein, Barisch-Fritz, Jekauc, Woll); Department of Quantitative Health Sciences (Krell-Roesch, Syrjanen, Kremers, Vassilaki), Department of Psychiatry and Psychology (Fields), and Department of Neurology (Scharf, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; International Clinical Research Center, St. Anne University Hospital, Brno, Czech Republic (Stokin); Department of Neurology, Barrow Neurological Institute, Phoenix (Geda)
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Miyagawa T, Brushaber D, Syrjanen JA, Kremers WK, Fields JA, Forsberg LK, Heuer HW, Huey ED, Knopman DS, Kornak J, Boxer AL, Rosen HJ, Boeve BF, Consortium ALLFTD. Characterization of CDR® plus NACC FTLD at Phenoconversion from Asymptomatic to Mild Behavioral and/or Cognitive Impairment in Familial Frontotemporal Lobar Degeneration: Data from the ALLFTD Consortium. Alzheimers Dement 2022. [DOI: 10.1002/alz.063438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | | | | | | | - Hilary W. Heuer
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco San Francisco CA USA
| | | | | | - John Kornak
- University of California, San Francisco San Francisco CA USA
| | - Adam L. Boxer
- University of California, San Francisco San Francisco CA USA
| | - Howard J. Rosen
- University of California, San Francisco San Francisco CA USA
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Krell‐Roesch J, Syrjanen JA, Bezold J, Barisch‐Fritz B, Trautwein S, Woll A, Stokin GB, Vemuri P, Eugene SL, Fields JA, Kremers WK, Lowe VJ, Jack CR, Knopman DS, Petersen RC, Vassilaki M, Geda YE. A longitudinal investigation of physical and cognitive activities and the outcome of trajectories of AD neuroimaging biomarkers: The Mayo Clinic Study of Aging. Alzheimers Dement 2022. [DOI: 10.1002/alz.063663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Janina Krell‐Roesch
- Karlsruhe Institute of Technology Karlsruhe Germany
- Mayo Clinic Rochester MN USA
| | | | | | | | | | | | - Gorazd B. Stokin
- International Clinical Research Center, St. Anne’s University Hospital Brno (ICRC‐FNUSA) Brno Czech Republic
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Boeve BF, Miyagawa T, Przybelski SA, Min PH, Jordan L, Lesnick T, Savica R, Graff‐Radford J, Jones DT, Botha H, Ramanan VK, Knopman DS, Petersen RC, Graff‐Radford NR, Day GS, Fields JA, Machulda MM, Ferman TJ, Forsberg LK, Diaz‐Galvan P, Li W, Christine CBJ, Jack CR, Jain MK, Kantarci K, Lowe VJ. Baseline and Longitudinal Ioflupane SPECT Findings in DLB and MCI‐LB. Alzheimers Dement 2022. [DOI: 10.1002/alz.067066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Josephs KA, Tosakulwong N, Gatto RG, Weigand SD, Ali F, Botha H, Graff‐Radford J, Machulda MM, Savica R, Schwarz CG, Senjem ML, Boeve BF, Kantarci K, Jones DT, Ramanan VK, Fields JA, Reichard RR, Dickson DW, Petersen RC, Jack CR, Lowe VJ, Whitwell JL. Optimum Differentiation of Frontotemporal Lobar Degeneration from Alzheimer Disease Achieved with Cross-Sectional Tau Positron Emission Tomography. Ann Neurol 2022; 92:1016-1029. [PMID: 36054427 PMCID: PMC9804568 DOI: 10.1002/ana.26479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE This study was undertaken to assess cross-sectional and longitudinal [18 F]-flortaucipir positron emission tomography (PET) uptake in pathologically confirmed frontotemporal lobar degeneration (FTLD) and to compare FTLD to cases with high and low levels of Alzheimer disease (AD) neuropathologic changes (ADNC). METHODS One hundred forty-three participants who had completed at least one flortaucipir PET and had autopsy-confirmed FTLD (n = 52) or high (n = 58) or low ADNC (n = 33) based on Braak neurofibrillary tangle stages 0-IV versus V-VI were included. Flortaucipir standard uptake value ratios (SUVRs) were calculated for 9 regions of interest (ROIs): an FTLD meta-ROI, midbrain, globus pallidum, an AD meta-ROI, entorhinal, inferior temporal, orbitofrontal, precentral, and medial parietal. Linear mixed effects models were used to compare mean baseline SUVRs and annual rate of change in SUVR by group. Sensitivity and specificity to distinguish FTLD from high and low ADNC were calculated. RESULTS Baseline uptake in the FTLD meta-ROI, midbrain, and globus pallidus was greater in FTLD than high and low ADNC. No region showed a greater rate of flortaucipir accumulation in FTLD. Baseline uptake in the AD-related regions and orbitofrontal and precentral cortices was greater in high ADNC, and all showed greater rates of accumulation compared to FTLD. Baseline differences were superior to longitudinal rates in differentiating FTLD from high and low ADNC. A simple baseline metric of midbrain/inferior temporal ratio of flortaucipir uptake provided good to excellent differentiation between FTLD and high and low ADNC (sensitivities/specificities = 94%/95% and 71%/70%). INTERPRETATION There are cross-sectional and longitudinal differences in flortaucipir uptake between FTLD and high and low ADNC. However, optimum differentiation between FTLD and ADNC was achieved with baseline uptake rather than longitudinal rates. ANN NEUROL 2022;92:1016-1029.
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Affiliation(s)
| | | | | | | | - Farwa Ali
- Department of NeurologyMayo ClinicRochesterMNUSA
| | - Hugo Botha
- Department of NeurologyMayo ClinicRochesterMNUSA
| | | | - Mary M. Machulda
- Department of Psychiatry and PsychologyMayo ClinicRochesterMNUSA
| | | | | | - Matthew L. Senjem
- Department of RadiologyMayo ClinicRochesterMNUSA,Department of Information TechnologyMayo ClinicRochesterMNUSA
| | | | | | | | | | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo ClinicRochesterMNUSA
| | - Ross R. Reichard
- Department of Laboratory Medicine and PathologyMayo ClinicRochesterMNUSA
| | - Dennis W. Dickson
- Department of Neuroscience (Neurogenetics)Mayo ClinicJacksonvilleFLUSA
| | | | | | - Val J. Lowe
- Department of RadiologyMayo ClinicRochesterMNUSA
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Diaz‐Galvan P, Przybelski SA, Lesnick TG, Schwarz CG, Senjem ML, Gunter JL, Jack CR, Min PH, Jain MK, Miyagawa T, Forsberg LK, Fields JA, Savica R, Graff‐Radford J, St EK, Knopman DS, Graff‐Radford NR, Ferman TJ, Petersen RC, Lowe VJ, Boeve BF, Kantarci K. Amyloid PET in the Lewy Body disease continuum. Alzheimers Dement 2022. [DOI: 10.1002/alz.067319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Tipton PW, Ali F, Syrjanen JA, Graff‐Radford NR, Machulda MM, Fields JA, Vemuri P, Jack CR, Mielke MM, Boeve BF, Jones DT, Graff‐Radford J, Knopman DS, Petersen RC, Savica R. Gait Correlates of Cognitive Function and Future Decline. Alzheimers Dement 2022. [DOI: 10.1002/alz.061291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Fields JA, Forsberg LK, Knutson M, Seifert SJ, Melius JL, Kramer KM, Lunde A. Feasibility of Intentional Technology Pairing in Fostering Connections Among Dementia Caregivers. Alzheimers Dement 2022; 18 Suppl 2:e067871. [DOI: 10.1002/alz.067871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Staffaroni AM, Quintana M, Wendelberger B, Heuer HW, Russell LL, Cobigo Y, Wolf A, Goh SYM, Petrucelli L, Gendron TF, Heller C, Clark AL, Taylor JC, Wise A, Ong E, Forsberg L, Brushaber D, Rojas JC, VandeVrede L, Ljubenkov P, Kramer J, Casaletto KB, Appleby B, Bordelon Y, Botha H, Dickerson BC, Domoto-Reilly K, Fields JA, Foroud T, Gavrilova R, Geschwind D, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford N, Grossman M, Hall MGH, Hsiung GY, Huey ED, Irwin D, Jones DT, Kantarci K, Kaufer D, Knopman D, Kremers W, Lago AL, Lapid MI, Litvan I, Lucente D, Mackenzie IR, Mendez MF, Mester C, Miller BL, Onyike CU, Rademakers R, Ramanan VK, Ramos EM, Rao M, Rascovsky K, Rankin KP, Roberson ED, Savica R, Tartaglia MC, Weintraub S, Wong B, Cash DM, Bouzigues A, Swift IJ, Peakman G, Bocchetta M, Todd EG, Convery RS, Rowe JB, Borroni B, Galimberti D, Tiraboschi P, Masellis M, Finger E, van Swieten JC, Seelaar H, Jiskoot LC, Sorbi S, Butler CR, Graff C, Gerhard A, Langheinrich T, Laforce R, Sanchez-Valle R, de Mendonça A, Moreno F, Synofzik M, Vandenberghe R, Ducharme S, Le Ber I, Levin J, Danek A, Otto M, Pasquier F, Santana I, Kornak J, Boeve BF, Rosen HJ, Rohrer JD, Boxer AL. Temporal order of clinical and biomarker changes in familial frontotemporal dementia. Nat Med 2022; 28:2194-2206. [PMID: 36138153 PMCID: PMC9951811 DOI: 10.1038/s41591-022-01942-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [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: 12/11/2021] [Accepted: 07/08/2022] [Indexed: 01/17/2023]
Abstract
Unlike familial Alzheimer's disease, we have been unable to accurately predict symptom onset in presymptomatic familial frontotemporal dementia (f-FTD) mutation carriers, which is a major hurdle to designing disease prevention trials. We developed multimodal models for f-FTD disease progression and estimated clinical trial sample sizes in C9orf72, GRN and MAPT mutation carriers. Models included longitudinal clinical and neuropsychological scores, regional brain volumes and plasma neurofilament light chain (NfL) in 796 carriers and 412 noncarrier controls. We found that the temporal ordering of clinical and biomarker progression differed by genotype. In prevention-trial simulations using model-based patient selection, atrophy and NfL were the best endpoints, whereas clinical measures were potential endpoints in early symptomatic trials. f-FTD prevention trials are feasible but will likely require global recruitment efforts. These disease progression models will facilitate the planning of f-FTD clinical trials, including the selection of optimal endpoints and enrollment criteria to maximize power to detect treatment effects.
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Affiliation(s)
- Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
| | | | | | - Hilary W Heuer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Amy Wolf
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sheng-Yang Matt Goh
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | | | - Tania F Gendron
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Carolin Heller
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Annie L Clark
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jack Carson Taylor
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Amy Wise
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Elise Ong
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Leah Forsberg
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Danielle Brushaber
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Julio C Rojas
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lawren VandeVrede
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Peter Ljubenkov
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Joel Kramer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Kaitlin B Casaletto
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Brian Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Yvette Bordelon
- Department of Neurology, University of California, Los Angeles, Los Angeles, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Tatiana Foroud
- Indiana University School of Medicine, National Centralized Repository for Alzheimer's, Indianapolis, IN, USA
| | | | - Daniel Geschwind
- Department of Neurology, University of California, Los Angeles, Los Angeles, USA
- Institute for Precision Health, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Nupur Ghoshal
- Departments of Neurology and Psychiatry, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Jill Goldman
- Department of Neurology, Columbia University, New York, NY, USA
| | | | | | - Murray Grossman
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Matthew G H Hall
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Ging-Yuek Hsiung
- Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edward D Huey
- Department of Neurology, Columbia University, New York, NY, USA
| | - David Irwin
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Kejal Kantarci
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Daniel Kaufer
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - David Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Walter Kremers
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Argentina Lario Lago
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Irene Litvan
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Diane Lucente
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ian R Mackenzie
- Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mario F Mendez
- Department of Neurology, University of California, Los Angeles, Los Angeles, USA
| | - Carly Mester
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Chiadi U Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Applied and Translational Neurogenomics Group, VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | | | - Eliana Marisa Ramos
- Department of Neurology, University of California, Los Angeles, Los Angeles, USA
| | - Meghana Rao
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Katya Rascovsky
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Katherine P Rankin
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Erik D Roberson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Sandra Weintraub
- Department of Neurology, Northwestern University, Chicago, IL, USA
| | - Bonnie Wong
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Arabella Bouzigues
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Imogen J Swift
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Georgia Peakman
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Emily G Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Rhian S Convery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - James B Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust and Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Mario Masellis
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
| | | | - Harro Seelaar
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Lize C Jiskoot
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Sandro Sorbi
- Department of Neurofarba, University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Chris R Butler
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Caroline Graff
- Center for Alzheimer Research, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Bioclinicum, Karolinska Institutet, Solna, Sweden
- Unit for Hereditary Dementias, Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK
- Departments of Geriatric Medicine and Nuclear Medicine, Center for Translational Neuro- and Behavioral Sciences, University Medicine Essen, Essen, Germany
| | - Tobias Langheinrich
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK
- Cerebral Function Unit, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, and Faculté de Médecine, Université Laval, Québec City, Québec, Canada
| | - Raquel Sanchez-Valle
- Alzheimer's disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | | | - Fermin Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia University Hospital, San Sebastian, Gipuzkoa, Spain
- Neuroscience Area, Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Neurology Service, University Hospitals Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Simon Ducharme
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Department of Neurology & Neurosurgery, McGill University, Montreal, Québec, Canada
| | - Isabelle Le Ber
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau - ICM, Inserm U1127, CNRS UMR 7225, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France
- Centre de référence des démences rares ou précoces, IM2A, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France
- Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France
| | - Johannes Levin
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Munich, Germany
- Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster of Systems Neurology, Munich, Germany
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Florence Pasquier
- University of Lille, Lille, France
- Inserm, Lille, France
- CHU, CNR-MAJ, Labex Distalz, LiCEND Lille, Lille, France
| | - Isabel Santana
- Neurology Service, Faculty of Medicine, University Hospital of Coimbra (HUC), University of Coimbra, Coimbra, Portugal
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | | | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
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Silverman HE, Ake JM, Manoochehri M, Appleby BS, Brushaber D, Devick KL, Dickerson BC, Fields JA, Forsberg LK, Ghoshal N, Graff‐Radford NR, Grossman M, Heuer HW, Kornak J, Lapid MI, Litvan I, Mackenzie IR, Mendez MF, Onyike CU, Pascual B, Tartaglia MC, Boeve BF, Boxer AL, Rosen HJ, Cosentino S, Huey ED, Barker MS, Goldman JS. The contribution of behavioral features to caregiver burden in FTLD spectrum disorders. Alzheimers Dement 2022; 18:1635-1649. [PMID: 34854532 PMCID: PMC9160199 DOI: 10.1002/alz.12494] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/09/2021] [Accepted: 09/07/2021] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Caregivers of patients with frontotemporal lobar degeneration (FTLD) spectrum disorders experience tremendous burden, which has been associated with the neuropsychiatric and behavioral features of the disorders. METHODS In a sample of 558 participants with FTLD spectrum disorders, we performed multiple-variable regressions to identify the behavioral features that were most strongly associated with caregiver burden, as measured by the Zarit Burden Interview, at each stage of disease. RESULTS Apathy and disinhibition, as rated by both clinicians and caregivers, as well as clinician-rated psychosis, showed the strongest associations with caregiver burden, a pattern that was consistent when participants were separated cross-sectionally by disease stage. In addition, behavioral features appeared to contribute most to caregiver burden in patients with early dementia. DISCUSSION Caregivers should be provided with early education on the management of the behavioral features of FTLD spectrum disorders. Interventions targeting apathy, disinhibition, and psychosis may be most useful to reduce caregiver burden.
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Affiliation(s)
- Hannah E. Silverman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Gertrude H. Sergievsky CenterDepartment of NeurologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Jeannie M. Ake
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Gertrude H. Sergievsky CenterDepartment of NeurologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Masood Manoochehri
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Gertrude H. Sergievsky CenterDepartment of NeurologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Brian S. Appleby
- Department of NeurologyCase Western Reserve UniversityClevelandOhioUSA
| | - Danielle Brushaber
- Division of Clinical Trials and BiostatisticsDepartment of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Katrina L. Devick
- Division of Clinical Trials and BiostatisticsDepartment of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Bradford C. Dickerson
- Department of NeurologyFrontotemporal Disorders UnitMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Julie A. Fields
- Division of Neurocognitive DisordersDepartment of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | | | - Nupur Ghoshal
- Department of NeurologyWashington UniversitySt. LouisMissouriUSA
| | | | - Murray Grossman
- Penn Frontotemporal Degeneration CenterDepartment of NeurologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Hilary W. Heuer
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - John Kornak
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Maria I. Lapid
- Division of Neurocognitive DisordersDepartment of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Irene Litvan
- Department of NeuroscienceUniversity of California, San DiegoSan DiegoCaliforniaUSA
| | - Ian R. Mackenzie
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Mario F. Mendez
- Department of NeurologyUniversity of CaliforniaLos AngelesCaliforniaUSA
- Department of Psychiatry and Biobehavioral SciencesUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | - Chiadi U. Onyike
- Division of Geriatric Psychiatry and NeuropsychiatryDepartment of Psychiatry and Behavioral SciencesJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Belen Pascual
- Stanley H. Appel Department of NeurologyHouston Methodist HospitalWeill Cornell MedicineHouston Methodist Neurological and Research InstituteHoustonTexasUSA
| | | | | | - Adam L. Boxer
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Howard J. Rosen
- Department of NeurologyMemory and Aging CenterUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Stephanie Cosentino
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Gertrude H. Sergievsky CenterDepartment of NeurologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Edward D. Huey
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Gertrude H. Sergievsky CenterDepartment of NeurologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
- Department of Psychiatry and New York Psychiatric InstituteColumbia University Medical CenterNew YorkUSA
| | - Megan S. Barker
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Gertrude H. Sergievsky CenterDepartment of NeurologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Jill S. Goldman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Gertrude H. Sergievsky CenterDepartment of NeurologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
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Valentino RR, Ramnarine C, Heckman MG, Johnson PW, Soto-Beasley AI, Walton RL, Koga S, Kasanuki K, Murray ME, Uitti RJ, Fields JA, Botha H, Ramanan VK, Kantarci K, Lowe VJ, Jack CR, Ertekin-Taner N, Savica R, Graff-Radford J, Petersen RC, Parisi JE, Reichard RR, Graff-Radford NR, Ferman TJ, Boeve BF, Wszolek ZK, Dickson DW, Ross OA. Mitochondrial genomic variation in dementia with Lewy bodies: association with disease risk and neuropathological measures. Acta Neuropathol Commun 2022; 10:103. [PMID: 35836284 PMCID: PMC9281088 DOI: 10.1186/s40478-022-01399-4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/18/2022] [Indexed: 11/29/2022] Open
Abstract
Dementia with Lewy bodies (DLB) is clinically diagnosed when patients develop dementia less than a year after parkinsonism onset. Age is the primary risk factor for DLB and mitochondrial health influences ageing through effective oxidative phosphorylation (OXPHOS). Patterns of stable polymorphisms in the mitochondrial genome (mtDNA) alter OXPHOS efficiency and define individuals to specific mtDNA haplogroups. This study investigates if mtDNA haplogroup background affects clinical DLB risk and neuropathological disease severity. 360 clinical DLB cases, 446 neuropathologically confirmed Lewy body disease (LBD) cases with a high likelihood of having DLB (LBD-hDLB), and 910 neurologically normal controls had European mtDNA haplogroups defined using Agena Biosciences MassARRAY iPlex technology. 39 unique mtDNA variants were genotyped and mtDNA haplogroups were assigned to mitochondrial phylogeny. Striatal dopaminergic degeneration, neuronal loss, and Lewy body counts were also assessed in different brain regions in LBD-hDLB cases. Logistic regression models adjusted for age and sex were used to assess associations between mtDNA haplogroups and risk of DLB or LBD-hDLB versus controls in a case-control analysis. Additional appropriate regression models, adjusted for age at death and sex, assessed associations of haplogroups with each different neuropathological outcome measure. No mtDNA haplogroups were significantly associated with DLB or LBD-hDLB risk after Bonferroni correction.Haplogroup H suggests a nominally significant reduced risk of DLB (OR=0.61, P=0.006) but no association of LBD-hDLB (OR=0.87, P=0.34). The haplogroup H observation in DLB was consistent after additionally adjusting for the number of APOE ε4 alleles (OR=0.59, P=0.004). Haplogroup H also showed a suggestive association with reduced ventrolateral substantia nigra neuronal loss (OR=0.44, P=0.033). Mitochondrial haplogroup H may be protective against DLB risk and neuronal loss in substantia nigra regions in LBD-hDLB cases but further validation is warranted.
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Affiliation(s)
- Rebecca R Valentino
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Chloe Ramnarine
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Michael G Heckman
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Patrick W Johnson
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, 32224, USA
| | | | - Ronald L Walton
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Shunsuke Koga
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Koji Kasanuki
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
- Department of Neuropsychiatry, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Melissa E Murray
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Ryan J Uitti
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Vijay K Ramanan
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Nilufer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA
| | | | | | - Joseph E Parisi
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - R Ross Reichard
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | | | - Tanis J Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA
| | | | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Owen A Ross
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
- Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL, 32224, USA.
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46
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Chen Q, Przybelski SA, Senjem ML, Schwarz CG, Lesnick TG, Botha H, Knopman DS, Graff‐Radford J, Savica R, Jones DT, Fields JA, Jain MK, Graff‐Radford NR, Ferman TJ, Kremers WK, Jack CR, Petersen RC, Boeve BF, Lowe VJ, Kantarci K. Longitudinal Tau Positron Emission Tomography in Dementia with Lewy Bodies. Mov Disord 2022; 37:1256-1264. [PMID: 35261094 PMCID: PMC9232920 DOI: 10.1002/mds.28973] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/03/2022] [Accepted: 02/09/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Patients with dementia with Lewy bodies (DLB) may have overlapping Alzheimer's disease pathology. We investigated the longitudinal rate of tau accumulation and its association with neurodegeneration and clinical disease progression in DLB. METHODS Consecutive patients with probable DLB (n = 22) from the Mayo Clinic Alzheimer's Disease Research Center and age-matched and sex-matched cognitively unimpaired controls (CU; n = 22) with serial magnetic resonance imaging and flortaucipir positron emission tomography scans within an average of 1.6 years were included. Regional annualized rates of flortaucipir uptake standardized uptake value ratios (SUVr) were calculated. Regional annualized rates of cortical volume change were measured with the Tensor Based Morphometry-Syn algorithm. RESULTS The annual increase of flortaucipir SUVr was greater in the middle and superior occipital, fusiform, and inferior parietal cortices in DLB (mean: 0.017, 0.019, 0.019, and 0.015, respectively) compared with the CU (mean: -0.006, -0.009, -0.003, and - 0.005, respectively; P < 0.05). In patients with DLB (but not the CU), a longitudinal increase in flortaucipir SUVr was associated with longitudinal cortical atrophy rates in the lateral occipital and inferior temporoparietal cortices, hippocampus, and the temporal pole as well as a concurrent decline on Mini-Mental State Examination and Clinical Dementia Rating-Sum of Boxes in the lateral occipital and the fusiform cortices. CONCLUSIONS Tau accumulation was faster in DLB compared with the CU, with increased accumulation rates in the lateral occipital and temporoparietal cortices. These increased rates of tau accumulation were associated with neurodegeneration and faster disease progression in DLB. Tau may be a potential treatment target in a subset of patients with DLB. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Qin Chen
- Department of NeurologyWest China Hospital of Sichuan UniversityChengduChina
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
| | | | | | | | - Timothy G. Lesnick
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Hugo Botha
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | | | | | | | | | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Manoj K. Jain
- Department of RadiologyMayo ClinicJacksonvilleFloridaUSA
| | | | - Tanis J. Ferman
- Department of Psychology and PsychiatryMayo ClinicJacksonvilleFloridaUSA
| | - Walter K. Kremers
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | | | | | | | - Val J. Lowe
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
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47
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Barker MS, Gottesman RT, Manoochehri M, Chapman S, Appleby BS, Brushaber D, Devick KL, Dickerson BC, Domoto-Reilly K, Fields JA, Forsberg LK, Galasko DR, Ghoshal N, Goldman J, Graff-Radford NR, Grossman M, Heuer HW, Hsiung GY, Knopman DS, Kornak J, Litvan I, Mackenzie IR, Masdeu JC, Mendez MF, Pascual B, Staffaroni AM, Tartaglia MC, Boeve BF, Boxer AL, Rosen HJ, Rankin KP, Cosentino S, Rascovsky K, Huey ED. Proposed research criteria for prodromal behavioural variant frontotemporal dementia. Brain 2022; 145:1079-1097. [PMID: 35349636 PMCID: PMC9050566 DOI: 10.1093/brain/awab365] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/30/2021] [Accepted: 08/24/2021] [Indexed: 01/17/2023] Open
Abstract
At present, no research criteria exist for the diagnosis of prodromal behavioural variant frontotemporal dementia (bvFTD), though early detection is of high research importance. Thus, we sought to develop and validate a proposed set of research criteria for prodromal bvFTD, termed 'mild behavioural and/or cognitive impairment in bvFTD' (MBCI-FTD). Participants included 72 participants deemed to have prodromal bvFTD; this comprised 55 carriers of a pathogenic mutation known to cause frontotemporal lobar degeneration, and 17 individuals with autopsy-confirmed frontotemporal lobar degeneration. All had mild behavioural and/or cognitive changes, as judged by an evaluating clinician. Based on extensive clinical workup, the prodromal bvFTD group was divided into a Development Group (n = 22) and a Validation Group (n = 50). The Development Group was selected to be the subset of the prodromal bvFTD group for whom we had the strongest longitudinal evidence of conversion to bvFTD, and was used to develop the MBCI-FTD criteria. The Validation Group was the remainder of the prodromal bvFTD group and was used as a separate sample on which to validate the criteria. Familial non-carriers were included as healthy controls (n = 165). The frequencies of behavioural and neuropsychiatric features, neuropsychological deficits, and social cognitive dysfunction in the prodromal bvFTD Development Group and healthy controls were assessed. Based on sensitivity and specificity analyses, seven core features were identified: apathy without moderate-severe dysphoria, behavioural disinhibition, irritability/agitation, reduced empathy/sympathy, repetitive behaviours (simple and/or complex), joviality/gregariousness, and appetite changes/hyperorality. Supportive features include a neuropsychological profile of impaired executive function or naming with intact orientation and visuospatial skills, reduced insight for cognitive or behavioural changes, and poor social cognition. Three core features or two core features plus one supportive feature are required for the diagnosis of possible MBCI-FTD; probable MBCI-FTD requires imaging or biomarker evidence, or a pathogenic genetic mutation. The proposed MBCI-FTD criteria correctly classified 95% of the prodromal bvFTD Development Group, and 74% of the prodromal bvFTD Validation Group, with a false positive rate of <10% in healthy controls. Finally, the MBCI-FTD criteria were tested on a cohort of individuals with prodromal Alzheimer's disease, and the false positive rate of diagnosis was 11-16%. Future research will need to refine the sensitivity and specificity of these criteria, and incorporate emerging biomarker evidence.
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Affiliation(s)
- Megan S Barker
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Reena T Gottesman
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Masood Manoochehri
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Silvia Chapman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Brian S Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Danielle Brushaber
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Katrina L Devick
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Bradford C Dickerson
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Julie A Fields
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Douglas R Galasko
- Department of Neuroscience, University of California, San Diego, San Diego, CA, USA
| | - Nupur Ghoshal
- Department of Neurology, Washington University, St. Louis, MO, USA
| | - Jill Goldman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | | | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hilary W Heuer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Ging-Yuek Hsiung
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Irene Litvan
- Department of Neuroscience, University of California, San Diego, San Diego, CA, USA
| | - Ian R Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joseph C Masdeu
- Nantz National Alzheimer Center, Houston Methodist Neurological Institute, Houston, TX, USA and Weill Cornell Medicine, NY, USA
| | - Mario F Mendez
- Department of Neurology, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Belen Pascual
- Nantz National Alzheimer Center, Houston Methodist Neurological Institute, Houston, TX, USA and Weill Cornell Medicine, NY, USA
| | - Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Maria Carmela Tartaglia
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Katherine P Rankin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Stephanie Cosentino
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Edward D Huey
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
- Department of Psychiatry and New York Psychiatric Institute, Columbia University Medical Center, New York, USA
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48
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Stricker NH, Stricker JL, Karstens AJ, Geske JR, Fields JA, Hassenstab J, Schwarz CG, Tosakulwong N, Wiste HJ, Jack CR, Kantarci K, Mielke MM. A novel computer adaptive word list memory test optimized for remote assessment: Psychometric properties and associations with neurodegenerative biomarkers in older women without dementia. Alzheimers Dement (Amst) 2022; 14:e12299. [PMID: 35280963 PMCID: PMC8905660 DOI: 10.1002/dad2.12299] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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] [Received: 09/13/2021] [Revised: 02/04/2022] [Accepted: 02/08/2022] [Indexed: 11/18/2022]
Abstract
Introduction This study established the psychometric properties and preliminary validity of the Stricker Learning Span (SLS), a novel computer adaptive word list memory test designed for remote assessment and optimized for smartphone use. Methods Women enrolled in the Mayo Clinic Specialized Center of Research Excellence (SCORE) were recruited via e-mail or phone to complete two remote cognitive testing sessions. Convergent validity was assessed through correlation with previously administered in-person neuropsychological tests (n = 96, ages 55-79) and criterion validity through associations with magnetic resonance imaging measures of neurodegeneration sensitive to Alzheimer's disease (n = 47). Results SLS performance significantly correlated with the Auditory Verbal Learning Test and measures of neurodegeneration (temporal meta-regions of interest and entorhinal cortical thickness, adjusting for age and education). Test-retest reliabilities across two sessions were 0.71-0.76 (two-way mixed intraclass correlation coefficients). Discussion The SLS is a valid and reliable self-administered memory test that shows promise for remote assessment of aging and neurodegenerative disorders.
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Affiliation(s)
- Nikki H. Stricker
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - John L. Stricker
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
- Department of Information TechnologyMayo ClinicRochesterMinnesotaUSA
| | - Aimee J. Karstens
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Jennifer R. Geske
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Jason Hassenstab
- Department of Neurology and Psychological & Brain SciencesWashington University in St. LouisSt. LouisMissouriUSA
| | | | | | - Heather J. Wiste
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | | | | | - Michelle M. Mielke
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
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49
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Kantarci K, Nedelska Z, Chen Q, Senjem ML, Schwarz CG, Gunter JL, Przybelski SA, Lesnick TG, Kremers WK, Fields JA, Graff-Radford J, Savica R, Jones D, Botha H, Knopman DS, Lowe V, Graff-Radford NR, Murray MM, Dickson DW, Reichard RR, Jack CR, Petersen RC, Ferman TJ, Boeve BF. OUP accepted manuscript. Brain Commun 2022; 4:fcac013. [PMID: 35415608 PMCID: PMC8994111 DOI: 10.1093/braincomms/fcac013] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 11/10/2021] [Accepted: 02/02/2022] [Indexed: 12/02/2022] Open
Abstract
Mild cognitive impairment with the core clinical features of dementia with Lewy bodies is recognized as a prodromal stage of dementia with Lewy bodies. Although grey matter atrophy has been demonstrated in prodromal dementia with Lewy bodies, longitudinal rates of atrophy during progression to probable dementia with Lewy bodies are unknown. We investigated the regional patterns of cross-sectional and longitudinal rates of grey matter atrophy in prodromal dementia with Lewy bodies, including those who progressed to probable dementia with Lewy bodies. Patients with mild cognitive impairment with at least one core clinical feature of dementia with Lewy bodies (mean age = 70.5; 95% male), who were enrolled in the Mayo Clinic Alzheimer’s Disease Research Center and followed for at least two clinical evaluations and MRI examinations, were included (n = 56). A cognitively unimpaired control group (n = 112) was matched 2:1 to the patients with mild cognitive impairment by age and sex. Patients either remained stable (n = 28) or progressed to probable dementia with Lewy bodies (n = 28) during a similar follow-up period and pathologic confirmation was available in a subset of cases (n = 18). Cross-sectional and longitudinal rates of grey matter atrophy were assessed using voxel-based and atlas-based region of interest analyses. At baseline, prodromal dementia with Lewy bodies was characterized by atrophy in the nucleus basalis of Meynert both in those who remained stable and those who progressed to probable dementia with Lewy bodies (P < 0.05 false discovery rate corrected). Increase in longitudinal grey matter atrophy rates were widespread, with greatest rates of atrophy observed in the enthorhinal and parahippocampal cortices, temporoparietal association cortices, thalamus and the basal ganglia, in mild cognitive impairment patients who progressed to probable dementia with Lewy bodies at follow-up (P < 0.05 false discovery rate corrected). Rates of inferior temporal atrophy were associated with greater rates of worsening on the clinical dementia rating–sum of boxes. Seventeen of the 18 (94%) autopsied cases had Lewy body disease. Results show that atrophy in the nucleus basalis of Meynert is a feature of prodromal dementia with Lewy bodies regardless of proximity to progression to probable dementia with Lewy bodies. Longitudinally, grey matter atrophy progresses in regions with significant cholinergic innervation, in alignment with clinical disease progression, with widespread and accelerated rates of atrophy in patients who progress to probable dementia with Lewy bodies. Given the prominent neurodegeneration in the cholinergic system, patients with prodromal dementia with Lewy bodies may be candidates for cholinesterase inhibitor treatment.
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Affiliation(s)
- Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Correspondence to: Kejal Kantarci, MD, MS Department of Radiology Mayo Clinic 200 First Street SW Rochester, MN 55905, USA E-mail:
| | - Zuzana Nedelska
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Charles University, Prague, Czech Republic
| | - Qin Chen
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | | | | | | | | | | | - Walter K. Kremers
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Julie A. Fields
- Department of Psychology and Psychiatry, Mayo Clinic, Rochester, MN, USA
| | | | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - David Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Val Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Melissa M. Murray
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Dennis W. Dickson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - R. Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - Tanis J. Ferman
- Department of Psychology and Psychiatry, Mayo Clinic, Jacksonville, FL, USA
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50
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Fields JA, Forsberg LK, Knutson M, Seifert SJ, Farah-Milller EA, Melius JL, Miller JK, Knopman DS, Boeve BF, Petersen RC, Kramer KM, Lunde AM. Assessing the needs of Black/African American dementia caregivers seeking emotional support. Alzheimers Dement 2022. [PMID: 34971251 DOI: 10.1002/alz.056579] [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] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Black/African Americans (B/AA) are nearly twice as likely as White/European Americans (W/EA) to have Alzheimer's or other dementias and are more likely to provide care for persons with dementia (PwD). Evidence indicates that B/AA desire having someone to talk with who understands their caregiving challenges, yet are less likely than W/EA to ask for support. Further, community resources supporting caregivers' ability to maintain health and well-being developed with input from B/AA are lacking. We aimed to determine how a technology-assisted caregiver matching service designed with user input could address diverse caregiver needs. METHODS For this Phase I project, 32 caregivers of PwD (31% B/AA) participated in semi-structured focus groups and completed surveys to provide input regarding characteristics deemed valuable in someone they would choose to be connected with for emotional support. Through an iterative process as new information emerged, a web-based prototype and matching algorithm were developed. RESULTS Age and sex distribution were similar between B/AA and W/EA (71 and 68 yrs; 90% and 86%, respectively). W/EA were most likely caring for a spouse/significant other (73%) whereas B/AA were caring for spouse/significant other (30%), a parent (30%;18% W/EA), a sibling (10%; 0% W/EA), or other (30%; 9%W/EA). Level of emotional support was rated "poor" (50% B/AA, 18% W/EA); "average" (0% B/AA, 14% W/EA); "good" (40% B/AA, 41% W/EA); and "excellent" (10%, 27% W/EA). Characteristics B/AA deemed "very important" or "absolutely essential" for a supportive match included living in close proximity, same ethnicity, similar lifestyle, and common values. Alternatively, W/EA selected similar age, living in close proximity, same sex, similar lifestyle, common values and interests, having the same caregiving relationship, and having the same diagnosis in their PwD (see chart). CONCLUSION In this cohort, B/AA reported poorer levels of emotional support than W/EA. B/AA were equally likely to be supporting a spouse/significant other as a parent or other acquaintance, whereas W/EA provided support primarily for a spouse/significant other. Characteristics B/AA and W/EA consider important in a supportive caregiver match show important differences that should be considered when optimizing caregiving resources. Phase II will explore further in a much larger sample.
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