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Jaén C, Maute C, Mackin S, Camacho MR, Truran D, Nosheny R, Weiner MW, Dalton P. Remote olfactory assessment using the NIH Toolbox Odor Identification test and the brain health registry. PLoS One 2024; 19:e0301264. [PMID: 38635771 PMCID: PMC11025917 DOI: 10.1371/journal.pone.0301264] [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: 07/07/2022] [Accepted: 03/13/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Early identification of deficits in our ability to perceive odors is important as many normal (i.e., aging) and pathological (i.e., sinusitis, viral, neurodegeneration) processes can result in diminished olfactory function. To realistically enable population-level measurements of olfaction, validated olfaction tests must be capable of being administered outside the research laboratory and clinical setting. AIM The purpose of this study was to determine the feasibility of remotely testing olfactory performance using a test that was developed with funding from the National Institutes of Health as part of a ready-to-use, non-proprietary set of measurements useful for epidemiologic studies (NIH Toolbox Odor ID Test). MATERIALS AND METHODS Eligible participants older than 39 years and active (within 6 months) in the Brain Health Registry (BHR), an online cognitive assessment platform which connects participants with researchers, were recruited for this study. Interested participants were mailed the NIH Toolbox Odor ID Test along with instructions on accessing a website to record their responses. Data obtained from subjects who performed the test at home was compared to the normative data collected when the NIH Toolbox Odor ID Test was administered by a tester in a research setting and validated against the Smell Identification Test. The age-range and composition of the population ensured we had the ability to observe both age-related decline and gender-related deficits in olfactory ability, as shown in the experimental setting. RESULTS We observed that age-associated olfactory decline and gender-associated performance was comparable to performance on the administered test. Self-administration of this test showed the age-related loss in olfactory acuity, F(4, 1156)=14.564, p<.0001 as well as higher accuracy for women compared to men after controlling for participants' age, F(1, 1160) = 22.953, p <.0001. The effect size calculated as Hedge's g, was 0.41. CONCLUSION These results indicate that the NIH Toolbox Odor ID Test is an appropriate instrument for self-administered assessment of olfactory performance. The ability to self-administer an inexpensive olfactory test increases its utility for inclusion in longitudinal epidemiological studies and when in-person testing is not feasible.
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Affiliation(s)
- Cristina Jaén
- Monell Chemical Senses Center, Philadelphia, Pennsylvania, United States of America
| | - Christopher Maute
- Monell Chemical Senses Center, Philadelphia, Pennsylvania, United States of America
| | - Scott Mackin
- University of California San Francisco, San Francisco, California, United States of America
- Department of Veteran Affairs Medical Center, San Francisco, California, United States of America
| | - Monica R. Camacho
- Department of Veteran Affairs Medical Center, San Francisco, California, United States of America
- Department of Veterans Affairs Medical Center, Northern California Institute for Research and Education (NCIRE), San Francisco, California, United States of America
| | - Diana Truran
- Department of Veteran Affairs Medical Center, San Francisco, California, United States of America
- Department of Veterans Affairs Medical Center, Northern California Institute for Research and Education (NCIRE), San Francisco, California, United States of America
| | - Rachel Nosheny
- University of California San Francisco, San Francisco, California, United States of America
- Department of Veteran Affairs Medical Center, San Francisco, California, United States of America
| | - Michael W. Weiner
- University of California San Francisco, San Francisco, California, United States of America
- Department of Veteran Affairs Medical Center, San Francisco, California, United States of America
| | - Pamela Dalton
- Monell Chemical Senses Center, Philadelphia, Pennsylvania, United States of America
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Fortel I, Zhan L, Ajilore O, Wu Y, Mackin S, Leow A. Disrupted excitation-inhibition balance in cognitively normal individuals at risk of Alzheimer's disease. bioRxiv 2023:2023.08.21.554061. [PMID: 37662359 PMCID: PMC10473582 DOI: 10.1101/2023.08.21.554061] [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: 09/05/2023]
Abstract
Background Sex differences impact Alzheimer's disease (AD) neuropathology, but cell-to-network level dysfunctions in the prodromal phase are unclear. Alterations in hippocampal excitation-inhibition balance (EIB) have recently been linked to early AD pathology. Objective Examine how AD risk factors (age, APOE-ɛ4, amyloid-β) relate to hippocampal EIB in cognitively normal males and females using connectome-level measures. Methods Individuals from the OASIS-3 cohort (age 42-95) were studied (N = 437), with a subset aged 65+ undergoing neuropsychological testing (N = 231). Results In absence of AD risk factors (APOE-ɛ4/Aβ+), whole-brain EIB decreases with age more significantly in males than females (p = 0.021, β = -0.007). Regression modeling including APOE-ɛ4 allele carriers (Aβ-) yielded a significant positive AGE-by-APOE interaction in the right hippocampus for females only (p = 0.013, β = 0.014), persisting with inclusion of Aβ+ individuals (p = 0.012, β = 0.014). Partial correlation analyses of neuropsychological testing showed significant associations with EIB in females: positive correlations between right hippocampal EIB with categorical fluency and whole-brain EIB with the trail-making test (p < 0.05). Conclusion Sex differences in EIB emerge during normal aging and progresses differently with AD risk. Results suggest APOE-ɛ4 disrupts hippocampal balance more than amyloid in females. Increased excitation correlates positively with neuropsychological performance in the female group, suggesting a duality in terms of potential beneficial effects prior to cognitive impairment. This underscores the translational relevance of APOE-ɛ4 related hyperexcitation in females, potentially informing therapeutic targets or early interventions to mitigate AD progression in this vulnerable population.
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Affiliation(s)
- Igor Fortel
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL
| | - Liang Zhan
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA
| | - Olusola Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL
| | - Yichao Wu
- Department of Math, Statistics and Computer Science, University of Illinois at Chicago, Chicago, IL
| | - Scott Mackin
- Department of Psychiatry, University of California - San Francisco, San Francisco, CA
| | - Alex Leow
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL
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Jakary A, Lupo JM, Mackin S, Yin A, Murray D, Yang T, Mukherjee P, Larson P, Xu D, Eisendrath S, Luks T, Li Y. Evaluation of major depressive disorder using 7 Tesla phase sensitive neuroimaging before and after mindfulness-based cognitive therapy. J Affect Disord 2023; 335:383-391. [PMID: 37192691 DOI: 10.1016/j.jad.2023.05.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 04/21/2023] [Accepted: 05/12/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVE We applied 7 Tesla phase sensitive imaging to evaluate the impact of brain iron levels on depression severity and cognitive function in individuals with major depressive disorder (MDD) treated with mindfulness-based cognitive therapy (MBCT). METHODS Seventeen unmedicated MDD participants underwent MRI, evaluation of depression severity, and cognitive testing before and after receiving MBCT, compared to fourteen healthy controls (HC). Local field shift (LFS) values, measures of brain iron levels, were derived from phase images in the putamen, caudate, globus pallidus (GP), anterior cingulate cortex (ACC) and thalamus. RESULTS Compared to the HC group, the MDD group had significantly lower baseline LFS (indicative of higher iron) in the left GP and left putamen and had a higher number of subjects with impairment in a test of information processing speed. In the MDD group, lower LFS values in the left and right ACC, right putamen, right GP, and right thalamus were significantly associated with depression severity; and lower LFS in the right GP was correlated with worse performance on measures of attention. All MBCT participants experienced depression relief. MBCT treatment also significantly improved executive function and attention. MBCT participants with lower baseline LFS values in the right caudate experienced significantly greater improvement in depression severity with treatment; and those with lower LFS values in the right ACC, right caudate, and right GB at baseline performed better on measures of verbal learning and memory after MBCT. CONCLUSIONS Our study highlights the potential contribution of subtle differences in brain iron to MDD symptoms and their successful treatment.
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Affiliation(s)
- Angela Jakary
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Janine M Lupo
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Scott Mackin
- Department of Psychiatry and Behavioral Sciences, UCSF, San Francisco, CA, United States of America
| | - Audrey Yin
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Donna Murray
- Department of Psychiatry and Behavioral Sciences, UCSF, San Francisco, CA, United States of America
| | - Tony Yang
- Department of Psychiatry and Behavioral Sciences, UCSF, San Francisco, CA, United States of America
| | - Pratik Mukherjee
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Peder Larson
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Stuart Eisendrath
- Department of Psychiatry and Behavioral Sciences, UCSF, San Francisco, CA, United States of America
| | - Tracy Luks
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Yan Li
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America.
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Kryza-Lacombe M, Kassel M, Insel PS, Butters MA, Tosun-Turgut D, Aisen P, Raman R, Landau S, Saykin A, Toga A, Jack CR, Koeppe R, Weiner MW, Nelson C, Mackin S. Anxiety in Late Life Depression: Associations with Brain Structure and Functional Impairment. The American Journal of Geriatric Psychiatry 2023. [DOI: 10.1016/j.jagp.2022.12.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Mah L, Mackin S, Gatchel JR, Mulsant BH. Is late-life depression associated with Alzheimer's disease? Evidence from epidemiological, neuropsychological, and neuroimaging perspectives. The American Journal of Geriatric Psychiatry 2023. [DOI: 10.1016/j.jagp.2022.12.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Morrissey ZD, Gao J, Zhan L, Li W, Fortel I, Saido T, Saito T, Bakker A, Mackin S, Ajilore O, Lazarov O, Leow AD. Hippocampal functional connectivity across age in an App knock-in mouse model of Alzheimer's disease. Front Aging Neurosci 2023; 14:1085989. [PMID: 36711209 PMCID: PMC9878347 DOI: 10.3389/fnagi.2022.1085989] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 10/31/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
Introduction Alzheimer's disease (AD) is a progressive neurodegenerative disease. The early processes of AD, however, are not fully understood and likely begin years before symptoms manifest. Importantly, disruption of the default mode network, including the hippocampus, has been implicated in AD. Methods To examine the role of functional network connectivity changes in the early stages of AD, we performed resting-state functional magnetic resonance imaging (rs-fMRI) using a mouse model harboring three familial AD mutations (App NL-G-F/NL-G-F knock-in, APPKI) in female mice in early, middle, and late age groups. The interhemispheric and intrahemispheric functional connectivity (FC) of the hippocampus was modeled across age. Results We observed higher interhemispheric functional connectivity (FC) in the hippocampus across age. This was reduced, however, in APPKI mice in later age. Further, we observed loss of hemispheric asymmetry in FC in APPKI mice. Discussion Together, this suggests that there are early changes in hippocampal FC prior to heavy onset of amyloid β plaques, and which may be clinically relevant as an early biomarker of AD.
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Affiliation(s)
- Zachery D. Morrissey
- Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL, United States
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
- Department of Anatomy & Cell Biology, University of Illinois at Chicago, Chicago, IL, United States
| | - Jin Gao
- Department of Electrical and Computer Engineering, University of Illinois at Chicago, Chicago, IL, United States
- Preclinical Imaging Core, University of Illinois at Chicago, Chicago, IL, United States
| | - Liang Zhan
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Weiguo Li
- Preclinical Imaging Core, University of Illinois at Chicago, Chicago, IL, United States
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, United States
- Department of Radiology, Northwestern University, Chicago, IL, United States
| | - Igor Fortel
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, United States
| | - Takaomi Saido
- Laboratory for Proteolytic Neuroscience, RIKEN Center for Brain Science, Wako, Japan
| | - Takashi Saito
- Department of Neurocognitive Science, Institute of Brain Science, Nagoya City University, Nagoya, Japan
| | - Arnold Bakker
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, United States
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Scott Mackin
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Olusola Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Orly Lazarov
- Department of Anatomy & Cell Biology, University of Illinois at Chicago, Chicago, IL, United States
| | - Alex D. Leow
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, United States
- Department of Computer Science, University of Illinois at Chicago, Chicago, IL, United States
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7
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Fortel I, Zhan L, Ajilore O, Wu Y, Mackin S, Leow A. Disrupted Excitation-Inhibition Balance in Cognitively Normal Individuals at Risk of Alzheimer's Disease. J Alzheimers Dis 2023; 95:1449-1467. [PMID: 37718795 DOI: 10.3233/jad-230035] [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: 09/19/2023]
Abstract
BACKGROUND Sex differences impact Alzheimer's disease (AD) neuropathology, but cell-to-network level dysfunctions in the prodromal phase are unclear. Alterations in hippocampal excitation-inhibition balance (EIB) have recently been linked to early AD pathology. OBJECTIVE Examine how AD risk factors (age, APOEɛ4, amyloid-β) relate to hippocampal EIB in cognitively normal males and females using connectome-level measures. METHODS Individuals from the OASIS-3 cohort (age 42-95) were studied (N = 437), with a subset aged 65+ undergoing neuropsychological testing (N = 231). RESULTS In absence of AD risk factors (APOEɛ4/Aβ+), whole-brain EIB decreases with age more significantly in males than females (p = 0.021, β= -0.007). Regression modeling including APOEɛ4 allele carriers (Aβ-) yielded a significant positive AGE-by-APOE interaction in the right hippocampus for females only (p = 0.013, β= 0.014), persisting with inclusion of Aβ+ individuals (p = 0.012, β= 0.014). Partial correlation analyses of neuropsychological testing showed significant associations with EIB in females: positive correlations between right hippocampal EIB with categorical fluency and whole-brain EIB with the Trail Making Test (p < 0.05). CONCLUSIONS Sex differences in EIB emerge during normal aging and progresses differently with AD risk. Results suggest APOEɛ4 disrupts hippocampal balance more than amyloid in females. Increased excitation correlates positively with neuropsychological performance in the female group, suggesting a duality in terms of potential beneficial effects prior to cognitive impairment. This underscores the translational relevance of APOEɛ4 related hyperexcitation in females, potentially informing therapeutic targets or early interventions to mitigate AD progression in this vulnerable population.
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Affiliation(s)
- Igor Fortel
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Liang Zhan
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Olusola Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Yichao Wu
- Department of Math, Statistics and Computer Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Scott Mackin
- Department of Psychiatry, University of California - San Francisco, San Francisco, CA, USA
| | - Alex Leow
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
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8
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Tang H, Guo L, Fu X, Wang Y, Mackin S, Ajilore O, Leow AD, Thompson PM, Huang H, Zhan L. Signed graph representation learning for functional-to-structural brain network mapping. Med Image Anal 2023; 83:102674. [PMID: 36442294 PMCID: PMC9904311 DOI: 10.1016/j.media.2022.102674] [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: 06/20/2022] [Revised: 10/04/2022] [Accepted: 10/27/2022] [Indexed: 11/18/2022]
Abstract
MRI-derived brain networks have been widely used to understand functional and structural interactions among brain regions, and factors that affect them, such as brain development and diseases. Graph mining on brain networks can facilitate the discovery of novel biomarkers for clinical phenotypes and neurodegenerative diseases. Since brain functional and structural networks describe the brain topology from different perspectives, exploring a representation that combines these cross-modality brain networks has significant clinical implications. Most current studies aim to extract a fused representation by projecting the structural network to the functional counterpart. Since the functional network is dynamic and the structural network is static, mapping a static object to a dynamic object may not be optimal. However, mapping in the opposite direction (i.e., from functional to structural networks) are suffered from the challenges introduced by negative links within signed graphs. Here, we propose a novel graph learning framework, named as Deep Signed Brain Graph Mining or DSBGM, with a signed graph encoder that, from an opposite perspective, learns the cross-modality representations by projecting the functional network to the structural counterpart. We validate our framework on clinical phenotype and neurodegenerative disease prediction tasks using two independent, publicly available datasets (HCP and OASIS). Our experimental results clearly demonstrate the advantages of our model compared to several state-of-the-art methods.
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Affiliation(s)
- Haoteng Tang
- University of Pittsburgh, 3700 O'Hara St., Pittsburgh, 15261, PA, USA.
| | - Lei Guo
- University of Pittsburgh, 3700 O'Hara St., Pittsburgh, 15261, PA, USA
| | - Xiyao Fu
- University of Pittsburgh, 3700 O'Hara St., Pittsburgh, 15261, PA, USA
| | - Yalin Wang
- Arizona State University, 699 S Mill Ave., Tempe, 85281, AZ, USA
| | - Scott Mackin
- University of California San Francisco, 505 Parnassus Ave., San Francisco, 94143, CA, USA
| | - Olusola Ajilore
- University of Illinois Chicago, 1601 W. Taylor St., Chicago, 60612, IL, USA
| | - Alex D Leow
- University of Illinois Chicago, 1601 W. Taylor St., Chicago, 60612, IL, USA
| | - Paul M Thompson
- University of Southern California, 2001 N. Soto St., Los Angeles, 90032, CA, USA
| | - Heng Huang
- University of Pittsburgh, 3700 O'Hara St., Pittsburgh, 15261, PA, USA
| | - Liang Zhan
- University of Pittsburgh, 3700 O'Hara St., Pittsburgh, 15261, PA, USA.
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Howell T, Gummadi S, Bui C, Santhakumar J, Knight K, Roberson ED, Marson D, Chambless C, Gersteneker A, Martin R, Kennedy R, Zhang Y, Morris JC, Moulder KL, Mayo C, Carroll M, Li Y, Petersen RC, Stricker NH, Nosheny RL, Mackin S, Weiner MW. Development and implementation of an electronic Clinical Dementia Rating and Financial Capacity Instrument-Short Form. Alzheimers Dement (Amst) 2022; 14:e12331. [PMID: 35898521 PMCID: PMC9309008 DOI: 10.1002/dad2.12331] [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: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION To address the need for remote assessments of cognitive decline and dementia, we developed and administered electronic versions of the Clinical Dementia Rating (CDR®) and the Financial Capacity Instrument-Short Form (FCI-SF) (F-CAP®), called the eCDR and eFCI, respectively. METHODS The CDR and FCI-SF were adapted for remote, unsupervised, online use based on item response analysis of the standard instruments. Participants completed the eCDR and eFCI first in clinic, and then at home within 2 weeks. RESULTS Of the 243 enrolled participants, 179 (73%) cognitively unimpaired (CU), 50 (21%) with mild cognitive impairment (MCI) or dementia, and 14 (6%) with an unknown diagnosis, 84% and 85% of them successfully completed the eCDR and eFCI, respectively, at home. DISCUSSION These results show initial feasibility in developing and administering online instruments to remotely assess and monitor cognitive decline along the CU to MCI/very mild dementia continuum. Validation is an important next step.
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Affiliation(s)
- Taylor Howell
- San Francisco Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
- VA Advanced Imaging Research CenterSan Francisco Veteran's Administration Medical CenterSan FranciscoCaliforniaUSA
| | - Shilpa Gummadi
- San Francisco Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
- VA Advanced Imaging Research CenterSan Francisco Veteran's Administration Medical CenterSan FranciscoCaliforniaUSA
| | - Chau Bui
- San Francisco Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
- VA Advanced Imaging Research CenterSan Francisco Veteran's Administration Medical CenterSan FranciscoCaliforniaUSA
| | - Jessica Santhakumar
- San Francisco Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
- VA Advanced Imaging Research CenterSan Francisco Veteran's Administration Medical CenterSan FranciscoCaliforniaUSA
| | - Kristen Knight
- San Francisco Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
- VA Advanced Imaging Research CenterSan Francisco Veteran's Administration Medical CenterSan FranciscoCaliforniaUSA
| | - Erik D. Roberson
- Alzheimer's Disease CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of NeurologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Daniel Marson
- Alzheimer's Disease CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of NeurologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Carol Chambless
- Alzheimer's Disease CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of NeurologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Adam Gersteneker
- Department of NeurologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Roy Martin
- Department of NeurologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Richard Kennedy
- Alzheimer's Disease CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Division of Gerontology, Geriatrics, and Palliative CareDepartment of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Yue Zhang
- Division of Gerontology, Geriatrics, and Palliative CareDepartment of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - John C. Morris
- Department of NeurologyWashington University in St. LouisSt. LouisMissouriUSA
| | - Krista L. Moulder
- Department of NeurologyWashington University in St. LouisSt. LouisMissouriUSA
| | - Connie Mayo
- Department of NeurologyWashington University in St. LouisSt. LouisMissouriUSA
| | - Maria Carroll
- Department of NeurologyWashington University in St. LouisSt. LouisMissouriUSA
| | - Yan Li
- Department of NeurologyWashington University in St. LouisSt. LouisMissouriUSA
| | | | - Nikki H. Stricker
- Mayo ClinicDepartment of Psychiatry and PsychologyRochesterMinnesotaUSA
| | - Rachel L. Nosheny
- VA Advanced Imaging Research CenterSan Francisco Veteran's Administration Medical CenterSan FranciscoCaliforniaUSA
- San Francisco Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Scott Mackin
- VA Advanced Imaging Research CenterSan Francisco Veteran's Administration Medical CenterSan FranciscoCaliforniaUSA
- San Francisco Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Michael W. Weiner
- San Francisco Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
- VA Advanced Imaging Research CenterSan Francisco Veteran's Administration Medical CenterSan FranciscoCaliforniaUSA
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10
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Zakrzewski JJ, Henderson R, Archer C, Vigil OR, Mackin S, Mathews CA. Subjective cognitive complaints and objective cognitive impairment in hoarding disorder. Psychiatry Res 2022; 307:114331. [PMID: 34920395 DOI: 10.1016/j.psychres.2021.114331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/03/2021] [Accepted: 12/05/2021] [Indexed: 11/24/2022]
Abstract
Individuals with Hoarding Disorder (HD) frequently complain of problems with attention and memory. These self-identified difficulties are often used as justification for saving and acquiring behaviors. Research using neuropsychological measures to examine verbal and visual memory performance and sustained attention have reported contradictory findings. Here we aim to determine the relationship between self-reported problems with memory and attention, objective memory and attention performance, and self-reported depression and anxiety symptoms in HD. Data was available for 319 individuals who participated in a treatment study of HD. Multiple regression was used to assess the relationship between self-reported complaints and objective measures, with age, education, and measures of depression and anxiety included as covariates. We found no association between self-reported memory difficulties and objective verbal or visual memory performance. Self-reported problems with attention were associated with objective attentional performance, although this relationship was partially accounted for by anxiety symptom severity. There was a small association between visual memory performance at baseline and improvements in hoardingrelated functional abilities following treatment. Improvements in subjective memory complaints pre-to-post treatment were associated with improvements in hoarding symptom severity and hoarding-related functioning. These results demonstrate a dissociation between perceived and objective functioning in HD.
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Affiliation(s)
- Jessica J Zakrzewski
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, College of Medicine, University of Florida, FL, United States of America.
| | - Rebecca Henderson
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, College of Medicine, University of Florida, FL, United States of America
| | - Christian Archer
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, College of Medicine, University of Florida, FL, United States of America
| | - Ofilio R Vigil
- Department of Psychiatry, University of California, San Francisco and San Francisco VA Medical Center, San Francisco, CA, United States of America
| | - Scott Mackin
- Department of Psychiatry, University of California, San Francisco and San Francisco VA Medical Center, San Francisco, CA, United States of America
| | - Carol A Mathews
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, College of Medicine, University of Florida, FL, United States of America
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Alosco ML, Tripodis Y, Baucom ZH, Mez J, Stein TD, Martin B, Haller O, Conneely S, McClean M, Nosheny R, Mackin S, McKee AC, Weiner MW, Stern RA. Late contributions of repetitive head impacts and TBI to depression symptoms and cognition. Neurology 2020; 95:e793-e804. [PMID: 32591472 DOI: 10.1212/wnl.0000000000010040] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/13/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To test the hypothesis that repetitive head impacts (RHIs), like those from contact sport play and traumatic brain injury (TBI) have long-term neuropsychiatric and cognitive consequences, we compared middle-age and older adult participants who reported a history of RHI and/or TBI with those without this history on measures of depression and cognition. METHODS This cross-sectional study included 13,323 individuals (mean age, 61.95; 72.5% female) from the Brain Health Registry who completed online assessments, including the Ohio State University TBI Identification Method, the Geriatric Depression Scale (GDS-15), and the CogState Brief Battery and Lumos Labs NeuroCognitive Performance Tests. Inverse propensity-weighted linear regressions accounting for age, sex, race/ethnicity, and education tested the effects of RHI and TBI compared to a non-RHI/TBI group. RESULTS A total of 725 participants reported RHI exposure (mostly contact sport play and abuse) and 7,277 reported TBI (n = 2,604 with loss of consciousness [LOC]). RHI (β, 1.24; 95% CI, 0.36-2.12), TBI without LOC (β, 0.43; 95% CI, 0.31-0.54), and TBI with LOC (β, 0.75; 95% CI, 0.59-0.91) corresponded to higher GDS-15 scores. While TBI with LOC had the most neuropsychological associations, TBI without LOC had a negative effect on CogState Identification (β, 0.004; 95% CI, 0.001-0.01) and CogState One Back Test (β, 0.004; 95% CI, 0.0002-0.01). RHI predicted worse CogState One Back Test scores (β, 0.02; 95% CI, -0.01 to 0.05). There were RHI × TBI interaction effects on several neuropsychological subtests, and participants who had a history of both RHI and TBI with LOC had the greatest depression symptoms and worse cognition. CONCLUSIONS RHI and TBI independently contributed to worse mid- to later-life neuropsychiatric and cognitive functioning.
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Affiliation(s)
- Michael L Alosco
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA.
| | - Yorghos Tripodis
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
| | - Zachary H Baucom
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
| | - Jesse Mez
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
| | - Thor D Stein
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
| | - Brett Martin
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
| | - Olivia Haller
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
| | - Shannon Conneely
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
| | - Michael McClean
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
| | - Rachel Nosheny
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
| | - Scott Mackin
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
| | - Ann C McKee
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
| | - Michael W Weiner
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
| | - Robert A Stern
- From the Departments of Neurology (M.L.A., J.M., O.H., S.C., A.C.M., R.A.S.), Pathology & Laboratory Medicine (T.D.S., A.C.M.), Boston University Alzheimer's Disease Center and CTE Center (Y.T., B.M.), and Departments of Neurosurgery (R.A.S.) and Anatomy and Neurobiology (R.A.S.), Boston University School of Medicine; Department of Biostatistics (Y.T., Z.H.B.), Biostatistics and Epidemiology Data Analytics Center (B.M.), and Department of Environmental Health (M.M.), Boston University School of Public Health, MA; VA Boston Healthcare System (T.D.S., A.C.M.); Department of Veterans Affairs Medical Center (T.D.S., A.C.M.), Bedford, MA; Departments of Psychiatry (R.N., S.M., M.W.W.), Radiology (M.W.W.), Biomedical Imaging (M.W.W.), Medicine (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (R.N., S.M., M.W.W.), Center for Imaging and Neurodegenerative Diseases, San Francisco, CA
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Lutz J, Beaudreau S, Morin R, Bickford D, Nelson JC, Mackin S. CHANGES IN FUNCTIONAL DISABILITY AND SUICIDAL IDEATION ASSOCIATED WITH PSYCHOTHERAPY FOR DEPRESSION. Innov Aging 2019. [PMCID: PMC6846430 DOI: 10.1093/geroni/igz038.3041] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Given the association between functional disability and suicidal ideation (SI) in late life (Lutz & Fiske, 2017), this study examined associations between functional disability and SI among older adults receiving problem solving therapy (PST) for depression. PST is a promising intervention for SI (e.g., Gustavson et al., 2016) and has been shown to be effective in reducing functional disability among older adults with depression (e.g., Choi et al., 2014). Regression analyses with adults age 65-91 (n=65) found that level of SI (Geriatric Suicide Ideation Scale) at baseline was not significantly associated with change in SI from pre- to post-treatment. However, lower baseline disability (WHODAS-II; ΔR2=.08, p=.022) and greater reduction in disability (ΔR2=.12, p=.004) were significantly associated with greater reduction in SI after controlling for age and baseline SI. These results suggest that treatments that decrease disability may be particularly advantageous for reducing SI in older depressed adults.
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Affiliation(s)
- Julie Lutz
- West Virginia University, Morgantown, West Virginia, United States
| | - Sherry Beaudreau
- Sierra Pacific Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California, United States
| | - Ruth Morin
- San Francisco VA Medical Center, San Francisco, California, United States
| | - David Bickford
- University of California, San Francisco Department of Psychiatry, San Francisco, California, United States
| | - J Craig Nelson
- University of California, San Francisco Department of Psychiatry, San Francisco, California, United States
| | - Scott Mackin
- University of California, San Francisco Department of Psychiatry, San Francisco, California, United States
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Jain FA, Connolly CG, Reus VI, Meyerhoff DJ, Yang TT, Mellon SH, Mackin S, Hough CM, Morford A, Wolkowitz OM. Cortisol, moderated by age, is associated with antidepressant treatment outcome and memory improvement in Major Depressive Disorder: A retrospective analysis. Psychoneuroendocrinology 2019; 109:104386. [PMID: 31382170 PMCID: PMC6842706 DOI: 10.1016/j.psyneuen.2019.104386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Studies testing the relationship between cortisol levels, depression, and antidepressant treatment response have yielded divergent results suggesting the possibility of moderators of a cortisol effect. Several studies indicate that age may moderate the relationship between cortisol and depression. In patients with Major Depressive Disorder (MDD), we studied the interactive effects of age and cortisol in association with MDD diagnostic status and mood and memory response to antidepressant treatment. METHODS Serum cortisol levels in 66 unmedicated patients with MDD and 75 matched healthy controls (HC) were measured at baseline and retrospectively analyzed. Logistic regression was used to determine an association of age, cortisol and their interaction with MDD diagnosis in the pooled sample of MDD and HC participants. Thirty-four of the MDD participants (age range: 19-65 years; median: 36) underwent treatment with a selective serotonin reuptake inhibitor (SSRl) for 8 weeks. Clinician and self-ratings of depression symptoms, as well as tests of verbal and visual delayed recall were obtained at baseline and post treatment. Moderation analyses determined the effect of age on the relationship between baseline cortisol and treatment outcome. RESULTS Cortisol, moderated by age, was associated with MDD diagnosis (p < .05), treatment-associated reduction of depression symptoms (p < .001) and improvement of delayed recall (p < .001). Modeling the Cortisol × Age interaction suggested that for participants below the median age of our sample, lower cortisol levels were associated with a lower rate of MDD diagnosis and higher antidepressant effects. On the contrary, in those above the median sample age, lower cortisol was associated with a higher rate of MDD and less improvement in depression symptoms and memory performance. CONCLUSIONS Our results add to the body of literature suggesting that age might be an important factor in moderating the relationship between peripheral cortisol levels, depression, cognition, and prognosis. These results indicate that previous disparities in the literature linking peripheral cortisol levels with depression characteristics and treatment response may critically relate, at least in part, to the age of the participants studied.
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Affiliation(s)
- Felipe A. Jain
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA,Corresponding Author: Felipe A. Jain, M.D, Present Address Depression Clinical and Research Program, Massachusetts General Hospital, One Bowdoin Square, 6 Floor, Boston, MA 02114, Phone: 617-643-4682, Fax: 617-724-3028,
| | - Colm G. Connolly
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Victor I. Reus
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Dieter J. Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA,Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, 4150 Clement St, San Francisco, CA 94121, USA
| | - Tony T. Yang
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Synthia H. Mellon
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Scott Mackin
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | - Christina M. Hough
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Alexandra Morford
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | - Owen M. Wolkowitz
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
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Nosheny RL, Camacho MR, Mackin S, Truran-Sacrey D, Flenniken D, Ulbricht A, Fockler J, Maruff P, Rabinovici GD, Fargo K, Carrillo MC, Weiner MW. F1‐01‐03: ONLINE STUDY‐PARTNER‐REPORTED SUBJECTIVE DECLINE IS ASSOCIATED WITH β‐AMYLOID AND CLINICAL DIAGNOSIS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Rachel L. Nosheny
- University of California San Francisco Department of Psychiatry San Francisco CA USA
- Center for Imaging of Neurodegenerative Diseases San Francisco Veterans Affairs Medical Center San Francisco CA USA
| | - Monica R. Camacho
- Center for Imaging of Neurodegenerative Diseases San Francisco Veterans Affairs Medical Center San Francisco CA USA
| | - Scott Mackin
- Center for Imaging of Neurodegenerative Diseases San Francisco Veterans Administration Medical Center San Francisco CA USA
- University of California, San Francisco San Francisco CA USA
- Mental Health Service Department of Veterans Affairs Medical Center San Francisco CA USA
| | - Diana Truran-Sacrey
- Center for Imaging of Neurodegenerative Diseases San Francisco Veterans Administration Medical Center San Francisco CA USA
- NCIRE San Francisco CA USA
| | - Derek Flenniken
- Center for Imaging of Neurodegenerative Diseases San Francisco Veterans Affairs Medical Center San Francisco CA USA
- NCIRE San Francisco CA USA
| | - Aaron Ulbricht
- Center for Imaging of Neurodegenerative Diseases San Francisco Veterans Administration Medical Center San Francisco CA USA
- NCIRE San Francisco CA USA
| | - Juliet Fockler
- Center for Imaging of Neurodegenerative Diseases San Francisco Veterans Affairs Medical Center San Francisco CA USA
| | | | - Gil D. Rabinovici
- Memory and Aging Center, UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
- University of California San Francisco San Francisco CA USA
| | | | | | - Michael W. Weiner
- Center for Imaging of Neurodegenerative Diseases San Francisco Veterans Affairs Medical Center San Francisco CA USA
- UCSF Department of Radiology and Biomedical Imaging San Francisco CA USA
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Howell T, Weiner MW, Truran-Sacrey D, Nosheny RL, Mackin S, Fockler J, Camacho MR. P3-099: BRAIN HEALTH REGISTRY PARTICIPANT SUPPORT AND COMMUNICATION: WHAT DOES IT TAKE TO SUPPORT AN ONLINE STUDY? Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Michael W. Weiner
- UCSF Department of Radiology and Biomedical Imaging; San Francisco CA USA
| | - Diana Truran-Sacrey
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Affairs Medical Center; San Francisco CA USA
| | - Rachel L. Nosheny
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Affairs Medical Center; San Francisco CA USA
- University of California; San Francisco Department of Psychiatry; San Francisco CA USA
| | - Scott Mackin
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Administration Medical Center; San Francisco CA USA
- University of California, San Francisco; San Francisco CA USA
| | - Juliet Fockler
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Affairs Medical Center; San Francisco CA USA
| | - Monica R. Camacho
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Affairs Medical Center; San Francisco CA USA
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Nosheny RL, Camacho MR, Flenniken D, Ulbricht A, Fockler J, Mackin S, Truran-Sacrey D, Maruff P, Rabinovici GD, Fargo K, Carrillo MC, Weiner MW. F4-01-02: INCREASING THE IMPACT OF THE IDEAS STUDY USING BRAIN HEALTH REGISTRY ONLINE DATA COLLECTION. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Rachel L. Nosheny
- University of California; San Francisco Department of Psychiatry; San Francisco CA USA
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Affairs Medical Center; San Francisco CA USA
| | - Monica R. Camacho
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Affairs Medical Center; San Francisco CA USA
- NCIRE; San Francisco CA USA
| | - Derek Flenniken
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Affairs Medical Center; San Francisco CA USA
- NCIRE; San Francisco CA USA
| | - Aaron Ulbricht
- NCIRE; San Francisco CA USA
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Administration Medical Center; San Francisco CA USA
| | - Juliet Fockler
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Affairs Medical Center; San Francisco CA USA
| | - Scott Mackin
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Administration Medical Center; San Francisco CA USA
- University of California, San Francisco; San Francisco CA USA
| | - Diana Truran-Sacrey
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Affairs Medical Center; San Francisco CA USA
- NCIRE; San Francisco CA USA
| | | | - Gil D. Rabinovici
- Memory and Aging Center, UCSF Weill Institute for Neurosciences; University of California, San Francisco; San Francisco CA USA
- University of California San Francisco; San Francisco CA USA
| | | | | | - Michael W. Weiner
- Center for Imaging of Neurodegenerative Diseases; San Francisco Veterans Affairs Medical Center; San Francisco CA USA
- UCSF Department of Radiology and Biomedical Imaging; San Francisco CA USA
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Nosheny R, Insel P, Camacho MR, Flenniken D, Ulbricht A, Fockler J, Truran-Sacrey D, Finley S, Maruff P, Rabinovici GD, Hendrix J, Carrillo MC, Mackin S, Weiner M. O1‐04‐04: VALIDATION OF ONLINE DATA FROM IDEAS PARTICIPANTS WITH MCI AND AD USING THE BRAIN HEALTH REGISTRY. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Rachel Nosheny
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | - Philip Insel
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | - Monica R. Camacho
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | - Derek Flenniken
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | - Aaron Ulbricht
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | - Juliet Fockler
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | - Diana Truran-Sacrey
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | - Shannon Finley
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental HealthMelbourneAustralia
| | | | | | | | - Scott Mackin
- University of California, San FranciscoSan FranciscoCAUSA
| | - Michael Weiner
- University of California, San FranciscoSan FranciscoCAUSA
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Insel P, Weiner M, Mackin S, Mormino EC, Lim Y, Stomrud E, Palmqvist S, Masters CL, Maruff P, Hansson O, Mattsson N. DT‐01‐06: COGNITIVE DECLINE IN PRECLINICAL ALZHEIMER'S DISEASE: A COMPARISON AND SYNTHESIS OF LARGE INTERNATIONAL COHORTS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Philip Insel
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
| | - Michael Weiner
- University of California, San FranciscoSan FranciscoCAUSA
| | - Scott Mackin
- University of California, San FranciscoSan FranciscoCAUSA
| | | | - Yen Lim
- Washington University in St. LouisSt. LouisMOUSA
| | - Erik Stomrud
- Clinical Memory Research UnitLund UniversityLundSweden
| | | | - Colin L. Masters
- The Florey Institute of Neuroscience and Mental HealthMelbourneAustralia
| | - Paul Maruff
- The Florey Institute of Neuroscience and Mental HealthMelbourneAustralia
| | - Oskar Hansson
- Clinical Memory Research UnitLund UniversityMalmöSweden
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Mackin S, Morrison R, Insel P, Mosca K, Finley S, Truran‐Sacrey D, Flenniken D, Nosheny R, Li H, Seabrook G, Narayan V, Weiner M. [O2–16–05]: VALIDATION OF A COMPUTERIZED NEUROPSYCHOLOGICAL TEST BATTERY INCLUDING VERBAL MEMORY USING SPEECH RECOGNITION SOFTWARE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.07.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Scott Mackin
- University of California, San FranciscoSan FranciscoCAUSA
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
- Mental Health ServiceDepartment of Veterans Affairs Medical CenterSan FranciscoCAUSA
- Janssen Research and Development LLCTitusvilleNJUSA
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco Veterans Affairs Medical CenterSan FranciscoCAUSA
| | | | - Philip Insel
- University of California, San FranciscoSan FranciscoCAUSA
| | - Kenneth Mosca
- University of California, San FranciscoSan FranciscoCAUSA
| | - Shannon Finley
- University of California, San FranciscoSan FranciscoCAUSA
| | | | | | - Rachel Nosheny
- University of California, San FranciscoSan FranciscoCAUSA
| | - Han Li
- University of California, San FranciscoSan FranciscoCAUSA
| | - Guy Seabrook
- University of California, San FranciscoSan FranciscoCAUSA
| | | | - Michael Weiner
- University of California, San FranciscoSan FranciscoCAUSA
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Nosheny R, Camacho MR, Flenniken D, Ulbricht A, Fockler J, Insel P, Mackin S, Truran‐Sacrey D, Finley S, McKenzie K, Maruff P, Weiner M. [O3–06–06]: VALIDATION OF STUDY PARTNER‐REPORTED OUTCOMES COLLECTED ONLINE USING THE BRAIN HEALTH REGISTRY. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.07.337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Rachel Nosheny
- University of California, San FranciscoSan FranciscoCAUSA
- Center for Imaging of Neurodegenerative DiseasesSan Francisco Veterans Administration Medical CenterSan FranciscoCAUSA
- NCIRESan FranciscoCAUSA
- Clinical Memory Research UnitLund UniversityMalmöSweden
- The Florey Institute of Neuroscience and Mental HealthParkvilleAustralia
| | | | | | - Aaron Ulbricht
- University of California, San FranciscoSan FranciscoCAUSA
| | - Juliet Fockler
- University of California, San FranciscoSan FranciscoCAUSA
| | - Philip Insel
- University of California, San FranciscoSan FranciscoCAUSA
| | - Scott Mackin
- University of California, San FranciscoSan FranciscoCAUSA
| | | | - Shannon Finley
- University of California, San FranciscoSan FranciscoCAUSA
| | | | - Paul Maruff
- University of California, San FranciscoSan FranciscoCAUSA
| | - Michael Weiner
- University of California, San FranciscoSan FranciscoCAUSA
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Camacho MR, Nosheny RL, Truran-Sacrey D, Finley S, Flenniken D, Ulbricht A, Mackin S, Sperling RA, Aisen PS, McKenzie K, Weiner MW. P4‐396: Using an Internet Registry to Supplement Recruitment Efforts for Clinical Research. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.07.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Monica R. Camacho
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
- University of California San FranciscoSan FranciscoCA USA
- NCIRESan FranciscoCA USA
| | - Rachel L. Nosheny
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
- University of California San FranciscoSan FranciscoCA USA
| | - Diana Truran-Sacrey
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
- NCIRESan FranciscoCA USA
| | - Shannon Finley
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
- NCIRESan FranciscoCA USA
| | - Derek Flenniken
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
- University of California San FranciscoSan FranciscoCA USA
- NCIRESan FranciscoCA USA
| | - Aaron Ulbricht
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
- NCIRESan FranciscoCA USA
| | - Scott Mackin
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
- University of California San FranciscoSan FranciscoCA USA
| | - Reisa A. Sperling
- Harvard Medical SchoolBostonMA USA
- Brigham and Women's HospitalBostonMA USA
| | - Paul S. Aisen
- Alzheimer's Therapeutic Research InstituteSan DiegoCA USA
- University of Southern CaliforniaSan DiegoCA USA
| | - Kirsten McKenzie
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
- University of California San FranciscoSan FranciscoCA USA
| | - Michael W. Weiner
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
- University of California San FranciscoSan FranciscoCA USA
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Nosheny RL, Flenniken D, Insel PS, Mackin S, Finley S, Camacho MR, Truran-Sacrey D, Ulbricht A. P4‐005: SELF‐REPORTED APOE GENOTYPE IN THE BRAIN HEALTH REGISTRY: ASSOCIATIONS WITH MEMORY AND ASSESSMENT OF APOE 4+ PARTICIPANTS ELIGIBLE FOR ALZHEIMER'S DISEASE CLINICAL TRIALS. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.2094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Derek Flenniken
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
| | - Philip S. Insel
- San Francisco Veteran's Administration Medical CenterSan FranciscoCA USA
| | - Scott Mackin
- University of California, San FranciscoSan FranciscoCA USA
| | - Shannon Finley
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
| | - Monica R. Camacho
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
| | - Diana Truran-Sacrey
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
| | - Aaron Ulbricht
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
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24
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Insel PS, Palmqvist S, Mackin S, Nosheny RL, Gessert D, Hansson O, Weiner MW, Mattsson N. P1‐338: Assessing Risk for Preclinical β‐Amyloid Pathology with
APOE
, Cognitive and Demographic Information. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Philip S. Insel
- Center for Imaging of Neurodegenerative DiseasesSan FranciscoCA USA
| | | | - Scott Mackin
- University of California, San FranciscoSan FranciscoCA USA
| | - Rachel L. Nosheny
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Administration Medical CenterSan FranciscoCA USA
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Lund UniversityLundSweden
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25
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Jack CR, Barnes J, Bernstein MA, Borowski BJ, Brewer J, Clegg S, Dale AM, Carmichael O, Ching C, DeCarli C, Desikan RS, Fennema-Notestine C, Fjell AM, Fletcher E, Fox NC, Gunter J, Gutman BA, Holland D, Hua X, Insel P, Kantarci K, Killiany RJ, Krueger G, Leung KK, Mackin S, Maillard P, Malone IB, Mattsson N, McEvoy L, Modat M, Mueller S, Nosheny R, Ourselin S, Schuff N, Senjem ML, Simonson A, Thompson PM, Rettmann D, Vemuri P, Walhovd K, Zhao Y, Zuk S, Weiner M. Magnetic resonance imaging in Alzheimer's Disease Neuroimaging Initiative 2. Alzheimers Dement 2016; 11:740-56. [PMID: 26194310 DOI: 10.1016/j.jalz.2015.05.002] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [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: 03/03/2015] [Revised: 04/28/2015] [Accepted: 05/05/2015] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Alzheimer's Disease Neuroimaging Initiative (ADNI) is now in its 10th year. The primary objective of the magnetic resonance imaging (MRI) core of ADNI has been to improve methods for clinical trials in Alzheimer's disease (AD) and related disorders. METHODS We review the contributions of the MRI core from present and past cycles of ADNI (ADNI-1, -Grand Opportunity and -2). We also review plans for the future-ADNI-3. RESULTS Contributions of the MRI core include creating standardized acquisition protocols and quality control methods; examining the effect of technical features of image acquisition and analysis on outcome metrics; deriving sample size estimates for future trials based on those outcomes; and piloting the potential utility of MR perfusion, diffusion, and functional connectivity measures in multicenter clinical trials. DISCUSSION Over the past decade the MRI core of ADNI has fulfilled its mandate of improving methods for clinical trials in AD and will continue to do so in the future.
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Affiliation(s)
| | - Josephine Barnes
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | | | | | - James Brewer
- Department of Neuroscience, University of California at San Diego, La Jolla, CA, USA
| | - Shona Clegg
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Anders M Dale
- Department of Neuroscience, University of California at San Diego, La Jolla, CA, USA
| | - Owen Carmichael
- Department of Neurology, University of California at Davis, Davis, CA, USA
| | - Christopher Ching
- Department of Neurology, Imaging Genetics Center, Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, Davis, CA, USA; Center for Neuroscience, University of California at Davis, Davis, CA, USA
| | - Rahul S Desikan
- Department of Radiology, University of California at San Diego, La Jolla, CA, USA
| | - Christine Fennema-Notestine
- Department of Radiology, University of California at San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California at San Diego, La Jolla, CA, USA
| | - Anders M Fjell
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Evan Fletcher
- Department of Neurology, University of California at Davis, Davis, CA, USA; Center for Neuroscience, University of California at Davis, Davis, CA, USA
| | - Nick C Fox
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Jeff Gunter
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Boris A Gutman
- Department of Neurology, Imaging Genetics Center, Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - Dominic Holland
- Department of Neuroscience, University of California at San Diego, La Jolla, CA, USA
| | - Xue Hua
- Department of Neurology, Imaging Genetics Center, Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - Philip Insel
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Ron J Killiany
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | | | - Kelvin K Leung
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Scott Mackin
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Pauline Maillard
- Department of Neurology, University of California at Davis, Davis, CA, USA; Center for Neuroscience, University of California at Davis, Davis, CA, USA
| | - Ian B Malone
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Niklas Mattsson
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
| | - Linda McEvoy
- Department of Radiology, University of California at San Diego, La Jolla, CA, USA
| | - Marc Modat
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, UK; Translational Imaging Group, Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Susanne Mueller
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Radiology, University of California at San Francisco, San Francisco, CA, USA
| | - Rachel Nosheny
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Radiology, University of California at San Francisco, San Francisco, CA, USA
| | - Sebastien Ourselin
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, UK; Translational Imaging Group, Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Norbert Schuff
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Radiology, University of California at San Francisco, San Francisco, CA, USA
| | | | - Alix Simonson
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Paul M Thompson
- Department of Neurology, Imaging Genetics Center, Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - Dan Rettmann
- MR Applications and Workflow, GE Healthcare, Rochester, MN, USA
| | | | | | | | - Samantha Zuk
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Michael Weiner
- Department of Radiology and Biomedical Imaging, Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA; Department of Radiology, University of California at San Francisco, San Francisco, CA, USA; Department of Medicine, University of California at San Francisco, San Francisco, CA, USA; Department of Neurology, University of California at San Francisco, San Francisco, CA, USA
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Mueller SG, Ng P, Neylan T, Mackin S, Wolkowitz O, Mellon S, Yan X, Flory J, Yehuda R, Marmar CR, Weiner MW. Evidence for disrupted gray matter structural connectivity in posttraumatic stress disorder. Psychiatry Res 2015; 234:194-201. [PMID: 26419357 DOI: 10.1016/j.pscychresns.2015.09.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 08/30/2015] [Accepted: 09/02/2015] [Indexed: 12/20/2022]
Abstract
Posttraumatic stress disorder (PTSD) is characterized by atrophy within the prefrontal-limbic network. Graph analysis was used to investigate to what degree atrophy in PTSD is associated with impaired structural connectivity within prefrontal limbic network (restricted) and how this affects the integration of the prefrontal limbic network with the rest of the brain (whole-brain). 85 male veterans (45 PTSD neg, 40 PTSD pos) underwent volumetric MRI on a 3T MR. Subfield volumes were obtained using a manual labeling scheme and cortical thickness measurements and subcortical volumes from FreeSurfer. Regression analysis was used to identify regions with volume loss. Graph analytical Toolbox (GAT) was used for graph-analysis. PTSD pos had a thinner rostral anterior cingulate and insular cortex but no hippocampal volume loss. PTSD was characterized by decreased nodal degree (orbitofrontal, anterior cingulate) and clustering coefficients (thalamus) but increased nodal betweenness (insula, orbitofrontal) and a reduced small world index in the whole brain analysis and by orbitofrontal and insular nodes with increased nodal degree, clustering coefficient and nodal betweenness in the restricted analysis. PTSD associated atrophy in the prefrontal-limbic network results in an increased structural connectivity within that network that negatively affected its integration with the rest of the brain.
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Affiliation(s)
- Susanne G Mueller
- Center for Imaging of Neurodegenerative Diseases, VAMC San Francisco, Clement Street 4150, San Francisco, CA 94121, USA.
| | - Peter Ng
- Center for Imaging of Neurodegenerative Diseases, VAMC San Francisco, Clement Street 4150, San Francisco, CA 94121, USA
| | - Thomas Neylan
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Scott Mackin
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Owen Wolkowitz
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Synthia Mellon
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Xiaodan Yan
- Department of Psychiatry, NYU School of Medicine, New York, NY, USA
| | - Janine Flory
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel Yehuda
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Charles R Marmar
- Department of Psychiatry, NYU School of Medicine, New York, NY, USA
| | - Michael W Weiner
- Center for Imaging of Neurodegenerative Diseases, VAMC San Francisco, Clement Street 4150, San Francisco, CA 94121, USA
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27
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Insel PS, Mattsson N, Mackin S, Kornak J, Nosheny RL, Tosun D, Donohue MC, Aisen PS, Weiner MW. P4‐135: Inclusion criteria and cognitive responses to optimize trials in Alzheimer's disease. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.1841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Philip S. Insel
- Department of Veterans Affairs Medical CenterSan FranciscoCAUSA
| | | | | | | | - Rachel L. Nosheny
- San Francisco Veteran's Administration Medical CenterSan FranciscoCAUSA
| | - Duygu Tosun
- University of California San FranciscoSan FranciscoCAUSA
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28
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Weiner MW, Nosheny RL, Flennkiken D, Insel PS, Finley S, Mackin S, Camacho M, Truran-Sacrey D. P1‐318: Internet‐based recruitment and screening of subjects for ad trials using longitudinal data from the brain health registry. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Rachel L. Nosheny
- San Francisco Veteran's Administration Medical CenterSan FranciscoCAUSA
| | - Derek Flennkiken
- San Francisco Veteran's Administration Medical CenterSan FranciscoCAUSA
| | - Philip S. Insel
- San Francisco Veteran's Administration Medical CenterSan FranciscoCAUSA
| | - Shannon Finley
- San Francisco Veteran's Administration Medical CenterSan FranciscoCAUSA
| | | | - Monica Camacho
- San Francisco Veteran's Administration Medical CenterSan FranciscoCAUSA
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29
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Wolkowitz OM, Mellon SH, Lindqvist D, Epel ES, Blackburn EH, Lin J, Reus VI, Burke H, Rosser R, Mahan L, Mackin S, Yang T, Weiner M, Mueller S. PBMC telomerase activity, but not leukocyte telomere length, correlates with hippocampal volume in major depression. Psychiatry Res 2015; 232:58-64. [PMID: 25773002 PMCID: PMC4404215 DOI: 10.1016/j.pscychresns.2015.01.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 12/02/2014] [Accepted: 01/09/2015] [Indexed: 11/29/2022]
Abstract
Accelerated cell aging, indexed in peripheral leukocytes by telomere shortness and in peripheral blood mononuclear cells (PBMCs) by telomerase activity, has been reported in several studies of major depressive disorder (MDD). However, the relevance of these peripheral measures for brain indices that are presumably more directly related to MDD pathophysiology is unknown. In this study, we explored the relationship between PBMC telomerase activity and leukocyte telomere length and magnetic resonance imaging-estimated hippocampal volume in un-medicated depressed individuals and healthy controls. We predicted that, to the extent peripheral and central telomerase activity are directly related, PBMC telomerase activity would be positively correlated with hippocampal volume, perhaps due to hippocampal telomerase-associated neurogenesis, neuroprotection or neurotrophic facilitation, and that this effect would be clearer in individuals with increased PBMC telomerase activity, as previously reported in un-medicated MDD. We did not have specific hypotheses regarding the relationship between leukocyte telomere length and hippocampal volume, due to conflicting reports in the published literature. We found, in 25 un-medicated MDD subjects, that PBMC telomerase activity was significantly positively correlated with hippocampal volume; this relationship was not observed in 18 healthy controls. Leukocyte telomere length was not significantly related to hippocampal volume in either group (19 unmedicated MDD subjects and 17 healthy controls). Although the nature of the relationship between peripheral telomerase activity and telomere length and the hippocampus is unclear, these preliminary data are consistent with the possibility that PBMC telomerase activity indexes, and may provide a novel window into, hippocampal neuroprotection and/or neurogenesis in MDD.
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Affiliation(s)
- Owen M. Wolkowitz
- Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
,Corresponding author: Dept. of Psychiatry, UCSF School of Medicine, 401 Parnassus Ave., San Francisco, CA 94143-0983, USA. Tel.: +1 (415) 476-7433; Fax: +1 (415) 502-2661;
| | - Synthia H. Mellon
- Department of OBGYN and Reproductive Endocrinology, UCSF School of Medicine, San Francisco, CA, USA
| | - Daniel Lindqvist
- Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden
| | - Elissa S. Epel
- Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Elizabeth H. Blackburn
- Department of Physiology and Biochemistry, UCSF School of Medicine, San Francisco, CA, USA
| | - Jue Lin
- Department of Physiology and Biochemistry, UCSF School of Medicine, San Francisco, CA, USA
| | - Victor I. Reus
- Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Heather Burke
- Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Rebecca Rosser
- Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Laura Mahan
- Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Scott Mackin
- Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Tony Yang
- Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Michael Weiner
- Department of Radiology, UCSF School of Medicine, and San Francisco Veterans Administration Medical Center, San Francisco, CA, USA
| | - Susanne Mueller
- Department of Radiology, UCSF School of Medicine, and San Francisco Veterans Administration Medical Center, San Francisco, CA, USA
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30
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Mattsson N, Insel PS, Aisen PS, Jagust W, Mackin S, Weiner M. Brain structure and function as mediators of the effects of amyloid on memory. Neurology 2015; 84:1136-44. [PMID: 25681451 DOI: 10.1212/wnl.0000000000001375] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The objective of this study was to test whether effects of β-amyloid (Aβ) pathology on episodic memory were mediated by metabolism and gray matter volume in the early stages of Alzheimer disease. METHODS This was a prospective cohort study. We measured baseline Aβ (using florbetapir-PET), brain function (using fluorodeoxyglucose-PET), and brain structure (using MRI). A mediation analysis was performed to test whether statistical effects of Aβ positivity on cross-sectional and longitudinal episodic memory were mediated by hypometabolism or regional gray matter volume in cognitively healthy controls (CN, n = 280) and mild cognitive impairment (MCI, n = 463). RESULTS Lower memory scores were associated with Aβ positivity (CN, mildly; MCI, strongly), smaller gray matter volumes (CN, few regions, including hippocampus; MCI, widespread), and hypometabolism. Smaller volumes and hypometabolism mediated effects of Aβ in MCI but not in CN. The strongest individual regions mediated up to approximately 25%. A combination of brain structure and function mediated up to approximately 40%. In several regions, gray matter atrophy and hypometabolism predicted episodic memory without being associated (at p < 0.05) with Aβ positivity. CONCLUSIONS Changes in brain structure and function appear to be, in part, downstream events from Aβ pathology, ultimately resulting in episodic memory deficits. However, Aβ pathology is also strongly related to memory deficits through mechanisms that are not quantified by these imaging measurements, and episodic memory decline is partly caused by Alzheimer disease-like brain changes independently of Aβ pathology.
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Affiliation(s)
- Niklas Mattsson
- From the Department of Veterans Affairs Medical Center (N.M., P.S.I., S.M., M.W.), Center for Imaging of Neurodegenerative Diseases, San Francisco, CA; Clinical Neurochemistry Laboratory (N.M.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Radiology and Biomedical Imaging (N.M., P.S.I., M.W.), University of California, San Francisco; Alzheimer's Disease Cooperative Study (P.S.A.), Department of Neurosciences, University of California, San Diego, La Jolla; Helen Wills Neuroscience Institute and School of Public Health (W.J.), University of California, Berkeley; and Department of Psychiatry (S.M.), University of California, San Francisco.
| | - Philip S Insel
- From the Department of Veterans Affairs Medical Center (N.M., P.S.I., S.M., M.W.), Center for Imaging of Neurodegenerative Diseases, San Francisco, CA; Clinical Neurochemistry Laboratory (N.M.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Radiology and Biomedical Imaging (N.M., P.S.I., M.W.), University of California, San Francisco; Alzheimer's Disease Cooperative Study (P.S.A.), Department of Neurosciences, University of California, San Diego, La Jolla; Helen Wills Neuroscience Institute and School of Public Health (W.J.), University of California, Berkeley; and Department of Psychiatry (S.M.), University of California, San Francisco
| | - Paul S Aisen
- From the Department of Veterans Affairs Medical Center (N.M., P.S.I., S.M., M.W.), Center for Imaging of Neurodegenerative Diseases, San Francisco, CA; Clinical Neurochemistry Laboratory (N.M.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Radiology and Biomedical Imaging (N.M., P.S.I., M.W.), University of California, San Francisco; Alzheimer's Disease Cooperative Study (P.S.A.), Department of Neurosciences, University of California, San Diego, La Jolla; Helen Wills Neuroscience Institute and School of Public Health (W.J.), University of California, Berkeley; and Department of Psychiatry (S.M.), University of California, San Francisco
| | - William Jagust
- From the Department of Veterans Affairs Medical Center (N.M., P.S.I., S.M., M.W.), Center for Imaging of Neurodegenerative Diseases, San Francisco, CA; Clinical Neurochemistry Laboratory (N.M.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Radiology and Biomedical Imaging (N.M., P.S.I., M.W.), University of California, San Francisco; Alzheimer's Disease Cooperative Study (P.S.A.), Department of Neurosciences, University of California, San Diego, La Jolla; Helen Wills Neuroscience Institute and School of Public Health (W.J.), University of California, Berkeley; and Department of Psychiatry (S.M.), University of California, San Francisco
| | - Scott Mackin
- From the Department of Veterans Affairs Medical Center (N.M., P.S.I., S.M., M.W.), Center for Imaging of Neurodegenerative Diseases, San Francisco, CA; Clinical Neurochemistry Laboratory (N.M.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Radiology and Biomedical Imaging (N.M., P.S.I., M.W.), University of California, San Francisco; Alzheimer's Disease Cooperative Study (P.S.A.), Department of Neurosciences, University of California, San Diego, La Jolla; Helen Wills Neuroscience Institute and School of Public Health (W.J.), University of California, Berkeley; and Department of Psychiatry (S.M.), University of California, San Francisco
| | - Michael Weiner
- From the Department of Veterans Affairs Medical Center (N.M., P.S.I., S.M., M.W.), Center for Imaging of Neurodegenerative Diseases, San Francisco, CA; Clinical Neurochemistry Laboratory (N.M.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Radiology and Biomedical Imaging (N.M., P.S.I., M.W.), University of California, San Francisco; Alzheimer's Disease Cooperative Study (P.S.A.), Department of Neurosciences, University of California, San Diego, La Jolla; Helen Wills Neuroscience Institute and School of Public Health (W.J.), University of California, Berkeley; and Department of Psychiatry (S.M.), University of California, San Francisco
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31
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Geyer J, Weiner M, Insel P, Farzin F, Sternberg D, Hardy J, Scanlon M, Mungas D, Kramer JH, Mackin S. P4‐318: EVIDENCE FOR AGE‐ASSOCIATED COGNITIVE DECLINE IN A LARGE DATABASE OF LUMOSITY INTERNET GAME SCORES. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.07.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Jason Geyer
- University of California San FranciscoSan FranciscoCaliforniaUnited States
| | - Michael Weiner
- University of California San FranciscoSan FranciscoCaliforniaUnited States
| | - Philip Insel
- University of California San FranciscoSan FranciscoCaliforniaUnited States
| | - Faraz Farzin
- Lumos Labs, Inc.San FranciscoCaliforniaUnited States
| | | | - Joe Hardy
- Lumos Labs, Inc.San FranciscoCaliforniaUnited States
| | | | - Dan Mungas
- University of California DavisSacramentoCaliforniaUnited States
| | | | - Scott Mackin
- University of California San FranciscoSan FranciscoCaliforniaUnited States
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Weiner M, Mackin S, Insel P, Truran D, Nosheny RL, Flenniken D, Kramer JH, Mungas D, Maruff P, Chenhall T, Schembri A, Harel B. P4‐317: BRAINHEALTHREGISTRY.ORG: AN ONLINE REGISTRY FOR NEUROSCIENCE CLINICAL TRIALS–PRELIMINARY RESULTS OF UNSUPERVISED ONLINE NEUROPSYCHOLOGICAL TESTING. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.07.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Michael Weiner
- University of California San FranciscoSan FranciscoCaliforniaUnited States
| | | | | | - Diana Truran
- Center for Imaging of Neurodegenerative DiseasesSan FranciscoCaliforniaUnited States
| | - Rachel L. Nosheny
- Center for the Imaging of Neurodegnerative DiseasesSan FranciscoCaliforniaUnited States
| | | | | | - Dan Mungas
- UC DavisSacramentoCaliforniaUnited States
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Rog LA, Park LQ, Harvey DJ, Huang CJ, Mackin S, Farias ST. The independent contributions of cognitive impairment and neuropsychiatric symptoms to everyday function in older adults. Clin Neuropsychol 2014; 28:215-36. [PMID: 24502686 DOI: 10.1080/13854046.2013.876101] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The everyday functional capacities of older adults are determined by multiple factors. The primary goal of the present study was to evaluate whether apathy and depression have unique influences on degree of functional impairment, independent of the effects of specific cognitive impairments. Participants included 344 older adults (199 normal, 87 with MCI, 58 with dementia). The Everyday Cognition (ECog) scales were used to measure both global and domain-specific functional abilities. Neuropsychiatric symptoms of depression and apathy were measured by the Neuropsychiatric Inventory (NPI), and specific neuropsychological domains measured included episodic memory and executive functioning. Results indicated that worse memory and executive function, as well as greater depression and apathy, were all independent and additive determinants of poorer functional abilities. Apathy had a slightly more restricted effect than the other variables across the specific functional domains assessed. Secondary analysis suggested that neuropsychiatric symptoms may be more strongly associated with everyday function within cognitively normal and MCI groups, while cognitive impairment is more strongly associated with everyday function in dementia. Thus, a somewhat different set of factors may be associated with functional status across various clinical groups.
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Affiliation(s)
- Lauren A Rog
- a VeteransAffairs Northern California Health Care System , Martinez , CA , USA
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Lee JY, Park S, Mackin S, Ewers M, Chui H, Jagust W, Insel PS, Weiner MW. Differences in prefrontal, limbic, and white matter lesion volumes according to cognitive status in elderly patients with first-onset subsyndromal depression. PLoS One 2014; 9:e87747. [PMID: 24498184 PMCID: PMC3909227 DOI: 10.1371/journal.pone.0087747] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 12/30/2013] [Indexed: 12/04/2022] Open
Abstract
The purpose of this preliminary study was to test the hypothesis that subsyndromal depression is associated with the volume of medial prefrontal regional gray matter and that of white matter lesions (WMLs) in the brains of cognitively normal older people. We also explored the relationships between subsyndromal depression and medial prefrontal regional gray matter volume, limbic regional gray matter volume, and lobar WMLs in the brains of patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). We performed a cross-sectional study comparing patients with subsyndromal depression and nondepressed controls with normal cognition (n = 59), MCI (n = 27), and AD (n = 27), adjusting for sex, age, years of education, and results of the Mini-Mental State Examination. Frontal WML volume was greater, and right medial orbitofrontal cortical volume was smaller in cognitively normal participants with subsyndromal depression than in those without subsyndromal depression. No volume differences were observed in medial prefrontal, limbic, or WML volumes according to the presence of subsyndromal depression in cognitively impaired patients. The absence of these changes in patients with MCI and AD suggests that brain changes associated with AD pathology may override the changes associated with subsyndromal depression.
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Affiliation(s)
- Jun-Young Lee
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
- Center for Imaging of Neurodegenerative Diseases, Veterans Affairs Medical Center, San Francisco, California, United States of America
- * E-mail:
| | - Soowon Park
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Scott Mackin
- Department of Psychiatry, University of California San Francisco, San Francisco, California, United States of America
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Ludwig Maximilian University, München, Germany
| | - Helena Chui
- Department of Neurology, University of Southern California, Los Angeles, California, United States of America
| | - William Jagust
- School of Public Health and Helen Wills Neuroscience Institute, University of California, Berkeley, California, United States of America
| | - Philip S. Insel
- Center for Imaging of Neurodegenerative Diseases, Veterans Affairs Medical Center, San Francisco, California, United States of America
| | - Michael W. Weiner
- Center for Imaging of Neurodegenerative Diseases, Veterans Affairs Medical Center, San Francisco, California, United States of America
- Department of Radiology, Psychiatry, Neurology, and Medicine, University of California San Francisco, San Francisco, California, United States of America
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Gibbons L, Carle A, Insel P, Mackin S, Mukherjee S, McKay Curtis S, Harvey D, Mungas D, Weiner M, Crane P. P1‐415: Composite scores for memory outperformed other approaches to the neuropsychological data collected by the Alzheimer's Disease Neuroimaging Initiative (ADNI). Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Laura Gibbons
- University of WashingtonSeattleWashingtonUnited States
| | - Adam Carle
- Cincinnati Children's Hospital Medical CenterCincinnatiOhioUnited States
| | - Philip Insel
- University of California, San Francisco; Center for Imaging of Neurodegenerative DiseasesSan FranciscoCaliforniaUnited States
| | - Scott Mackin
- University of California San FranciscoSan FranciscoCaliforniaUnited States
| | | | | | | | - Dan Mungas
- UC DavisSacramentoCaliforniaUnited States
| | - Michael Weiner
- University of California San FranciscoSan FranciscoCaliforniaUnited States
| | - Paul Crane
- University of WashingtonSeattleWashingtonUnited States
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Arnold S, Xie SX, Leung Y, Kim E, Kling M, Wilson R, Bennett D, Hu W, Mackin S, Grossman M, Chen‐Plotkin A, Wolk D, Lee V, Trojanowski J, Shaw L. P2‐017: Biochemical Biomarkers of Depressive Symptoms in ADNI. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Steven Arnold
- University of PennsylvaniaPhiladelphiaPennsylvaniaUnited States
| | | | - Yuk‐Yee Leung
- University of PennsylvaniaPhiladelphiaPennsylvaniaUnited States
| | - Eun‐Ji Kim
- University of PennsylvaniaPhiladelphiaPennsylvaniaUnited States
| | - Mitchel Kling
- University of PennsylvaniaPhiladelphiaPennsylvaniaUnited States
| | - Robert Wilson
- Rush University Medical CenterChicagoIllinoisUnited States
| | - David Bennett
- Rush University Medical CenterChicagoIllinoisUnited States
| | - William Hu
- Emory UniversityAtlantaGeorgiaUnited States
| | | | - Murray Grossman
- University of PennsylvaniaPhiladelphiaPennsylvaniaUnited States
| | | | - David Wolk
- University of PennsylvaniaPhiladelphiaPennsylvaniaUnited States
| | - Virginia Lee
- University of PennsylvaniaPhiladelphiaPennsylvaniaUnited States
| | - John Trojanowski
- University of School of MedicinePhiladelphiaPennsylvaniaUnited States
| | - Leslie Shaw
- University of PennsylvaniaPhiladelphiaPennsylvaniaUnited States
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Areán PA, Mackin S, Vargas-Dwyer E, Raue P, Sirey JA, Kanellopoulos D, Alexopoulos GS. Treating depression in disabled, low-income elderly: a conceptual model and recommendations for care. Int J Geriatr Psychiatry 2010; 25:765-9. [PMID: 20602424 PMCID: PMC3025862 DOI: 10.1002/gps.2556] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The treatment of depression in low-income older adults who live in poverty is complicated by several factors. Poor access to resources, disability, and mild cognitive impairment are the main factors that moderate treatment effects in this population. Interventions that not only address the depressive syndrome but also manage social adversity are sorely needed to help this patient population recover from depression. METHODS This paper is a literature review of correlates of depression in late life. In the review we propose a treatment model that combines case management (CM) to address social adversity with problem solving treatment (PST) to address the depressive syndrome. RESULTS We present the case of Mr Z, an older gentleman living in poverty who is also depressed and physically disabled. In this case we illustrate how the combination of CM and PST can work together to ameliorate depression. CONCLUSIONS The combination of age, disability, and social adversity complicates the management and treatment of depression. CM and PST are interventions that work synergistically to overcome depression and manage social problems.
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Affiliation(s)
| | | | | | - Patrick Raue
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medical College
| | - Jo Anne Sirey
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medical College
| | - Dora Kanellopoulos
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medical College
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Alexopoulos GS, Raue PJ, Kanellopoulos D, Mackin S, Arean PA. Problem solving therapy for the depression-executive dysfunction syndrome of late life. Int J Geriatr Psychiatry 2008; 23:782-8. [PMID: 18213605 DOI: 10.1002/gps.1988] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The 'depression executive dysfunction syndrome' afflicts a considerable number of depressed elderly patients and may be resistant to conventional pharmacotherapy. Non-pharmacological approaches addressing their behavioral deficits may reduce disability and experienced stress and improve depression. METHODS This paper focuses on problem solving therapy (PST) because it targets concrete problems that can be understood by patients with executive dysfunction and trains patients to address them using an easy to comprehend structured approach. RESULTS We suggest that PST is a suitable treatment for patients with the depression-executive dysfunction syndrome because it has been found effective in uncomplicated geriatric major depression and in other psychiatric disorders accompanied by severe executive dysfunction. Furthermore, PST can address specific clinical features of depressed patients with executive dysfunction, especially when modified to address difficulties with affect regulation, initiation and perseveration. CONCLUSIONS A preliminary study suggests that appropriately modified PST improves problem solving skills, depression and disability in elderly patients with the depression-executive dysfunction syndrome of late life. If these findings are confirmed, PST may become a therapeutic option for a large group of depressed elderly patients likely to be drug resistant.
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Affiliation(s)
- George S Alexopoulos
- Department of Psychiatry, Weill Cornell Medical College, White Plains, NY 10605, USA.
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Abstract
OBJECTIVES To evaluate the role of cognitive functioning and other clinical and demographic characteristics as potential predictors of suicidal ideation in older primary care patients. DESIGN Cross-sectional. SETTING Primary care clinics at three Department of Veterans Affairs Medical Centers, three community health centers, and two hospital networks. PARTICIPANTS Fifteen thousand five hundred ninety older adults without dementia who were receiving primary care (mean age+/-standard deviation 74.0+/-6.4; 62.8% men). MEASUREMENTS Hierarchical logistic regressions were conducted with passive (e.g., thoughts of being better off dead) and active (e.g., thoughts of hurting one self) suicidal ideation as outcome variables. All demographic variables (age, sex, marital status, and ethnicity) were entered in the first block. All clinical variables (distress, cognitive functioning, alcohol consumption, and perceived health) were entered in the second block. RESULTS In addition to the typical demographic predictors of late-life suicide (age, martial status, and ethnicity), having poorer cognitive functioning, poorer health, and greater mental distress were associated with passive suicidal ideation (chi-square (chi2) (14, n=14,618)=1,192.12, P<.001). Younger age, female sex, poorer cognitive functioning, and greater mental distress were associated with active suicidal ideation (chi2(14, n=14,605)=205.35, P<.001). CONCLUSION Distress and cognitive impairment are the only two variables that consistently predicted passive and active suicidal ideation. Primary care providers who work with older adults need to take both into consideration when evaluating suicidal ideation.
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Affiliation(s)
- Liat Ayalon
- School of Social Work, Bar Ilan University, Ramat Gan, Israel.
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Abstract
OBJECTIVE The main objective of this study was to prospectively examine the acute effects of heading in soccer on cognitive function. DESIGN This was a prospective cross-over study using a brief neuropsychological battery to assess cognitive function. The tests were performed before and after two separate practice sessions, with athletes serving as their own controls. SETTING Male and female Division I college athletes. PARTICIPANTS Members of the men's and women's varsity collegiate Penn State University soccer teams. Forty-four males and 56 females entered and finished the study. All athletes had a normal physical examination. INTERVENTIONS Before and after both practice sessions, all athletes had a brief battery of neuropsychological tests and a symptom checklist. MAIN OUTCOME MEASURES Neuropsychological tests symptom checklist compared at baseline with those after the practice sessions. RESULTS There were no significant differences in pretest scores between groups and no difference on posttest scores between heading and nonheading groups. A significant difference was detected using MANOVA (p = < 0.001) between pre- and posttest scores for measures of attention and concentration, indicating a practice effect. A gender-specific effect in one test measuring attention and concentration was found. There was no difference in symptoms before and after heading as compared with exertional controls. CONCLUSIONS In this study, soccer players heading the ball does not appear to lead to acute changes in cognitive function as assessed by a brief neuropsychological battery. There are practice effects that occur with repetitive neuropsychological testing and gender differences with certain tests.
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Affiliation(s)
- M Putukian
- Department of Internal Medicine, Penn State Geisinger Health System, University Park, Pennsylvania, USA
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Tan V, Cheatle MD, Mackin S, Moberg PJ, Esterhai JL. Goal setting as a predictor of return to work in a population of chronic musculoskeletal pain patients. Int J Neurosci 1997; 92:161-70. [PMID: 9522264 DOI: 10.3109/00207459708986399] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
To assess prospectively the association between personal attributes, vocational factors, and the return to work outcome for patients with chronic, nonmalignant, musculoskeletal pain, we assessed return to work (RTW) motivation though an open-format listing of treatment goals in 59 chronic pain patients admitted to a university pain management program. Patients were then followed (average of 17.9 months) in the posttreatment period to determine whether they had in fact returned to employment. Results indicated that a number of pretreatment factors predicted future employment status in this patient population. Age, marital status, education and decreased length of unemployment were predictive of RTW outcome. Overall, RTW goal was the single best predictor of return to work outcome. In contrast, increased number of premorbid jobs, compensation status, patient's race and sex were not predictive. The present study suggests that the assessment of an individual's motivation as defined by goal-setting may be a key factor in predicting a favorable outcome in this typically refractory population of patients.
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Affiliation(s)
- V Tan
- Department of Orthopedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, USA
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Zhang L, Yu Y, Mackin S, Weight FF, Uhl GR, Wang JB. Differential mu opiate receptor phosphorylation and desensitization induced by agonists and phorbol esters. J Biol Chem 1996; 271:11449-54. [PMID: 8626702 DOI: 10.1074/jbc.271.19.11449] [Citation(s) in RCA: 132] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
mu opiate receptors, the principal sites for opiate analgesia and reward, can display compensatory responses to opiate agonist drug administration. Agonist-induced K+ channel responses mediated by these receptors desensitize when examined in Xenopus oocyte expression systems. Mechanisms underlying such processes could include phosphorylation events similar to those reported to desensitize other G-protein-linked receptors. We used C-terminally directed anti-mu receptor antibodies to immunoprecipitate a phosphoprotein with size appropriate for the mu receptor from stably expressing Chinese hamster ovary cells. Phosphorylation of this mu opiate receptor protein was enhanced approximately 5-fold by treatment with the mu agonist morphine. The time course and dose-response relationships between mu receptor phosphorylation and agonist-induced desensitization display interesting parallels. Phosphorylation of mu opiate receptor protein is also enhanced approximately 5-fold by treatment with the protein kinase C activator phorbol 12-myristate 13-acetate. The protein kinase inhibitor staurosporine blocked the effect of phorbol 12-myristate 13-acetate on mu receptor phosphorylation. However, staurosporine failed to block morphine-induced phosphorylation. These observations suggest that several biochemical pathways can lead to mu receptor phosphorylation events that may include mechanisms involved in mu receptor desensitization.
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Affiliation(s)
- L Zhang
- Laboratory of Molecular and Cellular Neurobiology, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland 20892-8205, USA
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