1
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Scheltens NME, van der Weijden K, Adriaanse SM, van Assema D, Oomen PP, Krudop WA, Lammertsma AA, Barkhof F, Koene T, Teunissen CE, Scheltens P, van der Flier WM, Pijnenburg YAL, Yaqub M, Ossenkoppele R, van Berckel BNM. Hypometabolism of the posterior cingulate cortex is not restricted to Alzheimer's disease. Neuroimage Clin 2018; 19:625-632. [PMID: 29984170 PMCID: PMC6030576 DOI: 10.1016/j.nicl.2018.05.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 04/18/2018] [Accepted: 05/19/2018] [Indexed: 11/15/2022]
Abstract
When differential diagnosis of dementia includes both Alzheimer's disease (AD) and the behavioural variant of frontotemporal dementia (bvFTD), distribution of cerebral glucose metabolism as measured using [18F]‑2‑fluoro‑2‑deoxy‑d‑glucose positron emission tomography ([18F]FDG-PET) may be helpful. One important clue for differentiation is the presence of hypometabolism in the posterior cingulate cortex (PCC), usually associated with AD. PCC hypometabolism however, could also be present in bvFTD. Therefore, the specificity of PCC hypometabolism was examined. Based on visual reading PCC hypometabolism was present in 69–73/81 probable AD patients, in 10–16/33 probable bvFTD patients, and in 0–1/22 cognitive normal (CN) subjects. Findings were validated using a PCC to reference tissue [18F]FDG standard uptake value ratio (SUVr) cut-off, which was derived from the receiver operating characteristic (ROC) separating probable AD from CN, resulting in 9–14/33 bvFTD patients having PCC hypometabolism, depending on the reference tissue used. In conclusion, PCC hypometabolism is not restricted to AD.
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Affiliation(s)
- Nienke M E Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
| | - Kars van der Weijden
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Sofie M Adriaanse
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Danielle van Assema
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Priscilla P Oomen
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Welmoed A Krudop
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Institutes of Neurology and Healthcare Engineering, UCL, London, UK
| | - Teddy Koene
- Alzheimer Center and Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Maqsood Yaqub
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Rik Ossenkoppele
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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2
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Tolonen A, Rhodius-Meester HFM, Bruun M, Koikkalainen J, Barkhof F, Lemstra AW, Koene T, Scheltens P, Teunissen CE, Tong T, Guerrero R, Schuh A, Ledig C, Baroni M, Rueckert D, Soininen H, Remes AM, Waldemar G, Hasselbalch SG, Mecocci P, van der Flier WM, Lötjönen J. Data-Driven Differential Diagnosis of Dementia Using Multiclass Disease State Index Classifier. Front Aging Neurosci 2018; 10:111. [PMID: 29922145 PMCID: PMC5996907 DOI: 10.3389/fnagi.2018.00111] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 04/03/2018] [Indexed: 01/18/2023] Open
Abstract
Clinical decision support systems (CDSSs) hold potential for the differential diagnosis of neurodegenerative diseases. We developed a novel CDSS, the PredictND tool, designed for differential diagnosis of different types of dementia. It combines information obtained from multiple diagnostic tests such as neuropsychological tests, MRI and cerebrospinal fluid samples. Here we evaluated how the classifier used in it performs in differentiating between controls with subjective cognitive decline, dementia due to Alzheimer's disease, vascular dementia, frontotemporal lobar degeneration and dementia with Lewy bodies. We used the multiclass Disease State Index classifier, which is the classifier used by the PredictND tool, to differentiate between controls and patients with the four different types of dementia. The multiclass Disease State Index classifier is an extension of a previously developed two-class Disease State Index classifier. As the two-class Disease State Index classifier, the multiclass Disease State Index classifier also offers a visualization of its decision making process, which makes it especially suitable for medical decision support where interpretability of the results is highly important. A subset of the Amsterdam Dementia cohort, consisting of 504 patients (age 65 ± 8 years, 44% females) with data from neuropsychological tests, cerebrospinal fluid samples and both automatic and visual MRI quantifications, was used for the evaluation. The Disease State Index classifier was highly accurate in separating the five classes from each other (balanced accuracy 82.3%). Accuracy was highest for vascular dementia and lowest for dementia with Lewy bodies. For the 50% of patients for which the classifier was most confident on the classification the balanced accuracy was 93.6%. Data-driven CDSSs can be of aid in differential diagnosis in clinical practice. The decision support system tested in this study was highly accurate in separating the different dementias and controls from each other. In addition to the predicted class, it also provides a confidence measure for the classification.
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Affiliation(s)
- Antti Tolonen
- VTT Technical Research Centre of Finland, Tampere, Finland
| | - Hanneke F M Rhodius-Meester
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Marie Bruun
- Danish Dementia Research Centre, Rigshospitalet, Copenhagen, Denmark
| | | | - Frederik Barkhof
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands.,Institutes of Neurology and Healthcare Engineering, University College London, London, United Kingdom
| | - Afina W Lemstra
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Teddy Koene
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Philip Scheltens
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Charlotte E Teunissen
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Tong Tong
- Imperial College London, London, United Kingdom
| | | | | | | | - Marta Baroni
- Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | | | - Hilkka Soininen
- Institute of Clinical Medicine and Department of Neurology, University of Eastern Finland, Kuopio, Finland.,Neurology, Neurocenter, Kuopio University Hospital, Kuopio, Finland
| | - Anne M Remes
- Institute of Clinical Medicine and Department of Neurology, University of Eastern Finland, Kuopio, Finland.,Neurology, Neurocenter, Kuopio University Hospital, Kuopio, Finland
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Rigshospitalet, Copenhagen, Denmark
| | | | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Wiesje M van der Flier
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands.,Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, Netherlands
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3
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Louwersheimer E, Cohn-Hokke PE, Pijnenburg YAL, Weiss MM, Sistermans EA, Rozemuller AJ, Hulsman M, van Swieten JC, van Duijn CM, Barkhof F, Koene T, Scheltens P, Van der Flier WM, Holstege H. Rare Genetic Variant in SORL1 May Increase Penetrance of Alzheimer's Disease in a Family with Several Generations of APOE-ɛ4 Homozygosity. J Alzheimers Dis 2018; 56:63-74. [PMID: 27911290 PMCID: PMC5240543 DOI: 10.3233/jad-160091] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: The major genetic risk factor for late onset Alzheimer’s disease (AD) is the APOE-ɛ4 allele. However, APOE-ɛ4 homozygosity is not fully penetrant, suggesting co-occurrence of additional genetic variants. Objective: To identify genetic factors that, next to APOE-ɛ4 homozygosity, contribute to the development of AD. Methods: We identified a family with nine AD patients spanning four generations, with an inheritance pattern suggestive of autosomal dominant AD, with no variants in PSEN1, PSEN2, or APP. We collected DNA from four affected and seven unaffected family members and performed exome sequencing on DNA from three affected and one unaffected family members. Results: All affected family members were homozygous for the APOE-ɛ4 allele. Statistical analysis revealed that AD onset in this family was significantly earlier than could be expected based on APOE genotype and gender. Next to APOE-ɛ4 homozygosity, we found that all four affected family members carried a rare variant in the VPS10 domain of the SORL1 gene, associated with AβPP processing and AD risk. Furthermore, three of four affected family members carried a rare variant in the TSHZ3 gene, also associated with AβPP processing. Affected family members presented between 61 and 74 years, with variable presence of microbleeds/cerebral amyloid angiopathy and electroencephalographic abnormalities. Conclusion: We hypothesize that next to APOE-ɛ4 homozygosity, impaired SORL1 protein function, and possibly impaired TSHZ3 function, further disturbed Aβ processing. The convergence of these genetic factors over several generations might clarify the increased AD penetrance and the autosomal dominant-like inheritance pattern of AD as observed in this family.
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Affiliation(s)
- Eva Louwersheimer
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Petra E Cohn-Hokke
- Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Marjan M Weiss
- Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands
| | - Erik A Sistermans
- Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Marc Hulsman
- Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands.,Delft Bioinformatics Laboratory, Delft University of Technology, Delft, The Netherlands
| | - John C van Swieten
- Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands.,Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Cock M van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Institutes of Neurology and Healthcare Engineering, UCL, London, UK
| | - Teddy Koene
- Alzheimer Center & Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M Van der Flier
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.,Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Henne Holstege
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.,Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands
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4
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Van Mierlo LD, Wouters H, Sikkes SAM, Van der Flier WM, Prins ND, Bremer JAE, Koene T, Van Hout HPJ. Screening for Mild Cognitive Impairment and Dementia with Automated, Anonymous Online and Telephone Cognitive Self-Tests. J Alzheimers Dis 2018; 56:249-259. [PMID: 27911296 PMCID: PMC5389042 DOI: 10.3233/jad-160566] [Citation(s) in RCA: 11] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: Many older people worry about cognitive decline. Early cognitive screening in an anonymous and easily accessible manner may reassure older people who are unnecessarily worried about normal cognitive aging while it may also expedite help seeking in case of suspicious cognitive decline. Objective: To develop and validate online and telephone-based automated self-tests of cognitive function. Methods: We examined the feasibility and validity of the self-tests in a prospective study of 117 participants of whom 34 had subjective cognitive decline (SCD), 30 had mild cognitive impairment (MCI), and 53 had dementia. The ability of these self-tests to accurately distinguish MCI and dementia from SCD was examined with ROC curves. Convergent validity was examined by calculating rank correlations between the self-tests and neuropsychological tests. Results: Both the online and telephone cognitive self-tests were feasible, because the majority of participants (86% and 80%, respectively) were able to complete them. The online self-test had adequate diagnostic accuracy in the screening for MCI and dementia versus SCD with an Area under the Curve (AUC) of 0.86 (95% CI: 0.78–0.93). The AUC of the MMSE was 0.82 (95% CI: 0.74–0.89). By contrast, the telephone self-test had lower diagnostic accuracy (AUC = 0.75, 95% CI: 0.64–0.86). Both self-tests had good convergent validity as demonstrated by moderate to strong rank correlations with neuropsychological tests. Conclusion: We demonstrated good diagnostic accuracy and convergent validity for the online self-test of cognitive function. It is therefore a promising tool in the screening for MCI and dementia.
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Affiliation(s)
- Lisa D Van Mierlo
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Hans Wouters
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,Department of Pharmacy, Unit of Pharmacotherapy and Pharmaceutical Care, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Sietske A M Sikkes
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.,Neuroscience Campus Amsterdam, VU University, Amsterdam, The Netherlands
| | - Wiesje M Van der Flier
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.,Neuroscience Campus Amsterdam, VU University, Amsterdam, The Netherlands
| | - Niels D Prins
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.,Neuroscience Campus Amsterdam, VU University, Amsterdam, The Netherlands
| | - Jonne A E Bremer
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - Teddy Koene
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - Hein P J Van Hout
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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5
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Groot C, van Loenhoud AC, Barkhof F, van Berckel BN, Koene T, Teunissen CC, Scheltens P, van der Flier WM, Ossenkoppele R. Differential effects of cognitive reserve and brain reserve on cognition in Alzheimer disease. Neurology 2017; 90:e149-e156. [DOI: 10.1212/wnl.0000000000004802] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 09/27/2017] [Indexed: 01/02/2023] Open
Abstract
ObjectiveTo examine cross-sectional effects of cognitive reserve (CR) and brain reserve (BR) on cognition across the spectrum of Alzheimer disease (AD).MethodsWe included 663 AD biomarker–positive participants with dementia (probable AD, n = 462) or in the predementia stages (preclinical/prodromal AD, n = 201). Education was used as a proxy of CR and intracranial volume as a proxy of BR. Cognition was assessed across 5 domains (memory, attention, language, visuospatial, and executive functions). We performed multiple linear regression models to examine effects of CR and BR on cognitive domain Z scores, adjusted for cerebral atrophy. Furthermore, we assessed differences in effects according to disease stage and across degrees of total reserve using a 4-level variable (high CR/high BR, high CR/low BR, low CR/high BR, and low CR/low BR).ResultsWe found positive, independent effects of both CR and BR across multiple cognitive domains. Stratification for disease stage showed that effects of CR on attention and executive functioning were greater in predementia than in dementia (β = 0.39 vs β = 0.21 [Welch t = 2.40, p < 0.01] and β = 0.46 vs β = 0.26 [t = 2.83, p < 0.01]). Furthermore, we found a linear trend for better cognitive performance in all domains in the high CR/high BR group, followed by high CR/low BR, low CR/high BR, and then low CR/low BR (p for trend <0.05).ConclusionsCR and BR both independently mitigate cognitive symptoms in AD. The positive effect of CR is most strongly expressed in the predementia stages and the additive effects of high CR and BR are most beneficial.
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6
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Groot C, Weijden CW, Flier WM, Loenhoud AC, Berckel BN, Barkhof F, Koene T, Teunissen CE, Scheltens P, Ossenkoppele R. [IC‐P‐055]: EFFECT OF APOE‐ε2 ON REGIONAL GRAY MATTER ATROPHY AND CLINICAL PHENOTYPE IN ALZHEIMER's DISEASE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2328] [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)
- Colin Groot
- Department of Radiology and Nuclear Medicine, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Chris W.J. Weijden
- Department of Radiology and Nuclear Medicine, Neuroscience Campus AmsterdamVU University Medical CenterAmsterdamNetherlands
- Alzheimer Center, Department of Neurology, Neuroscience Campus AmsterdamVU University Medical CenterAmsterdamNetherlands
| | - Wiesje M. Flier
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
- Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdamNetherlands
| | - Anita C. Loenhoud
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Bart N.M. Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Frederik Barkhof
- Radiology and Nuclear MedicineVU University Medical CenterAmsterdamNetherlands
- Institutes of Neurology and Healthcare Engineering, UCLLondonUnited Kingdom
| | - Teddy Koene
- Department of Medical Psychology, Neuroscience Campus AmsterdamVU University Medical CenterAmsterdamNetherlands
| | - Charlotte E. Teunissen
- Department of BiochemistryVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Rik Ossenkoppele
- Department of Radiology and Nuclear Medicine, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
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7
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Scheltens NME, Tijms BM, Koene T, Barkhof F, Teunissen CE, Wolfsgruber S, Wagner M, Kornhuber J, Peters O, Cohn-Sheehy BI, Rabinovici GD, Miller BL, Kramer JH, Scheltens P, van der Flier WM. Cognitive subtypes of probable Alzheimer's disease robustly identified in four cohorts. Alzheimers Dement 2017; 13:1226-1236. [PMID: 28427934 DOI: 10.1016/j.jalz.2017.03.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 03/09/2017] [Accepted: 03/09/2017] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Patients with Alzheimer's disease (AD) show heterogeneity in profile of cognitive impairment. We aimed to identify cognitive subtypes in four large AD cohorts using a data-driven clustering approach. METHODS We included probable AD dementia patients from the Amsterdam Dementia Cohort (n = 496), Alzheimer's Disease Neuroimaging Initiative (n = 376), German Dementia Competence Network (n = 521), and University of California, San Francisco (n = 589). Neuropsychological data were clustered using nonnegative matrix factorization. We explored clinical and neurobiological characteristics of identified clusters. RESULTS In each cohort, a two-clusters solution best fitted the data (cophenetic correlation >0.9): one cluster was memory-impaired and the other relatively memory spared. Pooled analyses showed that the memory-spared clusters (29%-52% of patients) were younger, more often apolipoprotein E (APOE) ɛ4 negative, and had more severe posterior atrophy compared with the memory-impaired clusters (all P < .05). CONCLUSIONS We could identify two robust cognitive clusters in four independent large cohorts with distinct clinical characteristics.
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Affiliation(s)
- Nienke M E Scheltens
- Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
| | - Betty M Tijms
- Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Teddy Koene
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands; Institute of Neurology, University College London, London, UK; Institute of Healthcare Engineering, University College London, London, UK
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Centre, Amsterdam, The Netherlands
| | - Steffen Wolfsgruber
- Department of Psychiatry, University of Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Michael Wagner
- Department of Psychiatry, University of Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Johannes Kornhuber
- Department of Psychiatry, Friedrich-Alexander-University Erlangen, Erlangen, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Brendan I Cohn-Sheehy
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
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8
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Leeuwis AE, Benedictus MR, Kuijer JPA, Binnewijzend MAA, Hooghiemstra AM, Verfaillie SCJ, Koene T, Scheltens P, Barkhof F, Prins ND, van der Flier WM. Lower cerebral blood flow is associated with impairment in multiple cognitive domains in Alzheimer's disease. Alzheimers Dement 2016; 13:531-540. [PMID: 27693109 DOI: 10.1016/j.jalz.2016.08.013] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/26/2016] [Accepted: 08/18/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION We examined the association between decreased cerebral blood flow (CBF) and cognitive impairment in Alzheimer's disease (AD), mild cognitive impairment (MCI), and subjective cognitive decline (SCD). METHODS We included 161 AD, 95 MCI, and 143 SCD patients from the Amsterdam Dementia Cohort. We used 3-T pseudo-continuous arterial spin labeling to estimate whole-brain and regional partial volume-corrected CBF. Neuropsychological tests covered global cognition and five cognitive domains. Associations were investigated using linear regression analyses. RESULTS In the whole sample, reduced overall and regional CBF was associated with impairment in all cognitive domains. We found significant interactions between diagnosis and CBF for language and between diagnosis and parietal CBF for global cognition and executive functioning. Stratification showed that decreased CBF was associated with worse performance in AD patients but not in MCI or SCD. DISCUSSION Our results suggest that CBF may have potential as a functional marker of disease severity.
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Affiliation(s)
- Anna E Leeuwis
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
| | - Marije R Benedictus
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Joost P A Kuijer
- Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
| | - Maja A A Binnewijzend
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands; Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Astrid M Hooghiemstra
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands; Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Sander C J Verfaillie
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands; Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Teddy Koene
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands; Institutes of Neurology and Healthcare Engineering, UCL, London, United Kingdom
| | - Niels D Prins
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
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9
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Verfaillie SC, Slot RE, Tijms BM, Bouwman FH, Benedictus M, Overbeek J, Koene T, Vrenken H, Scheltens P, Barkhof F, van der Flier WM. IC‐P‐153: Thinner Cortical Thickness in Patients With Subjective Cognitive Decline is Related to Poor Memory Performance and Faster Decline of Executive Function. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.184] [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: 11/28/2022]
Affiliation(s)
- Sander C.J. Verfaillie
- Alzheimer Center, VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | | | - Betty M. Tijms
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam VU University Medical CenterAmsterdamNetherlands
| | - Femke H. Bouwman
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- Alzheimer Center and Department of Neurology VU University Medical CenterAmsterdamNetherlands
| | | | | | - Teddy Koene
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Hugo Vrenken
- VU University Medical CenterAmsterdamNetherlands
| | - Philip Scheltens
- Alzheimer Center, VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Frederik Barkhof
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam VU University Medical CenterAmsterdamNetherlands
| | - Wiesje M. van der Flier
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
- Alzheimer Center and Neurology Department Neuroscience Campus Amsterdam, VU University Medical CenterAmsterdamNetherlands
- Department of Epidemiology and Biostatistics VU University Medical CenterAmsterdamNetherlands
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10
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Groot C, Loenhoud AC, Berckel BN, Barkhof F, Koene T, Teunissen CE, Scheltens P, van der Flier WM, Ossenkoppele R. O1‐01‐01: Active and Passive Reserve Differentially Mitigate Cognitive Symptoms in Demented and Non‐Demented Stages of Alzheimer’s Disease. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.292] [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)
- Colin Groot
- Department of Radiology & Nuclear Medicine Neuroscience Campus Amsterdam VU University Medical CenterAmsterdamNetherlands
| | | | - Bart N.M. Berckel
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Frederik Barkhof
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- Department of Radiology and Nuclear Medicine Neuroscience Campus Amsterdam VU University Medical CenterAmsterdamNetherlands
| | - Teddy Koene
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Charlotte E. Teunissen
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Philip Scheltens
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Wiesje M. van der Flier
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Rik Ossenkoppele
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University AmsterdamAmsterdamNetherlands
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11
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Scheltens NME, Galindo-Garre F, Pijnenburg YAL, van der Vlies AE, Smits LL, Koene T, Teunissen CE, Barkhof F, Wattjes MP, Scheltens P, van der Flier WM. The identification of cognitive subtypes in Alzheimer's disease dementia using latent class analysis. J Neurol Neurosurg Psychiatry 2016; 87:235-43. [PMID: 25783437 DOI: 10.1136/jnnp-2014-309582] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [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: 09/29/2014] [Accepted: 02/26/2015] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Alzheimer's disease (AD) is a heterogeneous disorder with complex underlying neuropathology that is still not completely understood. For better understanding of this heterogeneity, we aimed to identify cognitive subtypes using latent class analysis (LCA) in a large sample of patients with AD dementia. In addition, we explored the relationship between the identified cognitive subtypes, and their demographical and neurobiological characteristics. METHODS We performed LCA based on neuropsychological test results of 938 consecutive probable patients with AD dementia using Mini-Mental State Examination as the covariate. Subsequently, we performed multinomial logistic regression analysis with cluster membership as dependent variable and dichotomised demographics, APOE genotype, cerebrospinal fluid biomarkers and MRI characteristics as independent variables. RESULTS LCA revealed eight clusters characterised by distinct cognitive profile and disease severity. Memory-impaired clusters-mild-memory (MILD-MEM) and moderate-memory (MOD-MEM)-included 43% of patients. Memory-spared clusters mild-visuospatial-language (MILD-VILA), mild-executive (MILD-EXE) and moderate-visuospatial (MOD-VISP) -included 29% of patients. Memory-indifferent clusters mild-diffuse (MILD-DIFF), moderate-language (MOD-LAN) and severe-diffuse (SEV-DIFF) -included 28% of patients. Cognitive clusters were associated with distinct demographical and neurobiological characteristics. In particular, the memory-spared MOD-VISP cluster was associated with younger age, APOE e4 negative genotype and prominent atrophy of the posterior cortex. CONCLUSIONS Using LCA, we identified eight distinct cognitive subtypes in a large sample of patients with AD dementia. Cognitive clusters were associated with distinct demographical and neurobiological characteristics.
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Affiliation(s)
- Nienke M E Scheltens
- Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Francisca Galindo-Garre
- Department of Epidemiology and Biostatistics, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Annelies E van der Vlies
- Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Lieke L Smits
- Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Teddy Koene
- Department of Medical Psychology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Mike P Wattjes
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands Department of Epidemiology and Biostatistics, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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12
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Benedictus MR, van Harten AC, Leeuwis AE, Koene T, Scheltens P, Barkhof F, Prins ND, van der Flier WM. White Matter Hyperintensities Relate to Clinical Progression in Subjective Cognitive Decline. Stroke 2015; 46:2661-4. [PMID: 26173729 DOI: 10.1161/strokeaha.115.009475] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 06/08/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE In patients with subjective cognitive decline, we assessed whether small vessel disease was associated with clinical progression and cognitive decline. METHODS We included 334 patients with subjective cognitive decline. Follow-up was 3±2 years. RESULTS Fifty-three (16%) patients progressed clinically to mild cognitive impairment or dementia. White matter hyperintensities were associated with clinical progression and with annual decline on memory, attention, executive functioning, and global cognition. Microbleeds and lacunes were not associated with clinical progression or cognitive decline. CONCLUSIONS In patients with subjective cognitive decline, patients with white matter hyperintensities are at increased risk of clinical progression and cognitive decline.
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Affiliation(s)
- Marije R Benedictus
- From the Alzheimer Center and Department of Neurology (M.R.B., A.C.v.H., A.E.L., P.S., N.D.P., W.M.v.d.F.), Department of Radiology and Nuclear Medicine (F.B.), Department of Medical Psychology (T.K.), and Department of Epidemiology and Biostatistics (W.M.v.d.F.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
| | - Argonde C van Harten
- From the Alzheimer Center and Department of Neurology (M.R.B., A.C.v.H., A.E.L., P.S., N.D.P., W.M.v.d.F.), Department of Radiology and Nuclear Medicine (F.B.), Department of Medical Psychology (T.K.), and Department of Epidemiology and Biostatistics (W.M.v.d.F.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Annebet E Leeuwis
- From the Alzheimer Center and Department of Neurology (M.R.B., A.C.v.H., A.E.L., P.S., N.D.P., W.M.v.d.F.), Department of Radiology and Nuclear Medicine (F.B.), Department of Medical Psychology (T.K.), and Department of Epidemiology and Biostatistics (W.M.v.d.F.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Teddy Koene
- From the Alzheimer Center and Department of Neurology (M.R.B., A.C.v.H., A.E.L., P.S., N.D.P., W.M.v.d.F.), Department of Radiology and Nuclear Medicine (F.B.), Department of Medical Psychology (T.K.), and Department of Epidemiology and Biostatistics (W.M.v.d.F.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- From the Alzheimer Center and Department of Neurology (M.R.B., A.C.v.H., A.E.L., P.S., N.D.P., W.M.v.d.F.), Department of Radiology and Nuclear Medicine (F.B.), Department of Medical Psychology (T.K.), and Department of Epidemiology and Biostatistics (W.M.v.d.F.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- From the Alzheimer Center and Department of Neurology (M.R.B., A.C.v.H., A.E.L., P.S., N.D.P., W.M.v.d.F.), Department of Radiology and Nuclear Medicine (F.B.), Department of Medical Psychology (T.K.), and Department of Epidemiology and Biostatistics (W.M.v.d.F.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Niels D Prins
- From the Alzheimer Center and Department of Neurology (M.R.B., A.C.v.H., A.E.L., P.S., N.D.P., W.M.v.d.F.), Department of Radiology and Nuclear Medicine (F.B.), Department of Medical Psychology (T.K.), and Department of Epidemiology and Biostatistics (W.M.v.d.F.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- From the Alzheimer Center and Department of Neurology (M.R.B., A.C.v.H., A.E.L., P.S., N.D.P., W.M.v.d.F.), Department of Radiology and Nuclear Medicine (F.B.), Department of Medical Psychology (T.K.), and Department of Epidemiology and Biostatistics (W.M.v.d.F.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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13
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Scheltens NM, Adriaanse S, Oomen PP, Ossenkoppele R, Krudop WA, Lammertsma AA, Barkhof F, Koene T, Teunissen CE, Scheltens P, Flier WM, Pijnenburg YA, Berckel BN. IC‐02‐03: Hypometabolism of the posterior cingulate cortex is not restricted to Alzheimer's disease. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.009] [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)
- Nienke M.E. Scheltens
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Sofie Adriaanse
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Priscilla P. Oomen
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Rik Ossenkoppele
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
- University of California San FranciscoSan FranciscoCAUSA
| | - Welmoed A. Krudop
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Adriaan A. Lammertsma
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Frederik Barkhof
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Teddy Koene
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Charlotte E. Teunissen
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Philip Scheltens
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Wiesje M. Flier
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Yolande A.L. Pijnenburg
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
| | - Bart N.M. Berckel
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- VU University Medical CenterAmsterdamNetherlands
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14
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Scheltens NM, Adriaanse S, Oomen PP, Ossenkoppele R, Krudop WA, Lammertsma AA, Barkhof F, Koene T, Teunissen CE, Scheltens P, Flier WM, Pijnenburg YA, Berckel BN. P1‐180: Hypometabolism of the posterior cingulate cortex is not restricted to Alzheimer's disease. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.379] [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: 10/22/2022]
Affiliation(s)
- Nienke M.E. Scheltens
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Sofie Adriaanse
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Priscilla P. Oomen
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Rik Ossenkoppele
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- University of California San FranciscoSan FranciscoCAUSA
| | - Welmoed A. Krudop
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Adriaan A. Lammertsma
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Frederik Barkhof
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Teddy Koene
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Charlotte E. Teunissen
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Philip Scheltens
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Wiesje M. Flier
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Yolande A.L. Pijnenburg
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Bart N.M. Berckel
- VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
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15
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Hamel R, Köhler S, Sistermans N, Koene T, Pijnenburg Y, van der Flier W, Scheltens P, Aalten P, Verhey F, Visser PJ, Ramakers I. The trajectory of cognitive decline in the pre-dementia phase in memory clinic visitors: findings from the 4C-MCI study. Psychol Med 2015; 45:1509-1519. [PMID: 25407094 DOI: 10.1017/s0033291714002645] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [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] [Indexed: 12/31/2022]
Abstract
BACKGROUND We investigated the course of decline in multiple cognitive domains in non-demented subjects from a memory clinic setting, and compared pattern, onset and magnitude of decline between subjects who progressed to Alzheimer's disease (AD) dementia at follow-up and subjects who did not progress. METHOD In this retrospective cohort study 819 consecutive non-demented patients who visited the memory clinics in Maastricht or Amsterdam between 1987 and 2010 were followed until they became demented or for a maximum of 10 years (range 0.5-10 years). Differences in trajectories of episodic memory, executive functioning, verbal fluency, and information processing speed/attention between converters to AD dementia and subjects remaining non-demented were compared by means of random effects modelling. RESULTS The cognitive performance of converters and non-converters could already be differentiated seven (episodic memory) to three (verbal fluency and executive functioning) years prior to dementia diagnosis. Converters declined in these three domains, while non-converters remained stable on episodic memory and executive functioning and showed modest decline in verbal fluency. There was no evidence of decline in information processing speed/attention in either group. CONCLUSIONS Differences in cognitive performance between converters to AD dementia and subjects remaining non-demented could be established 7 years prior to diagnosis for episodic memory, with verbal fluency and executive functioning following several years later. Therefore, in addition to early episodic memory decline, decline in executive functions may also flag incident AD dementia. By contrast, change in information processing speed/attention seems less informative.
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Affiliation(s)
- R Hamel
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Centre,Maastricht,The Netherlands
| | - S Köhler
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Centre,Maastricht,The Netherlands
| | - N Sistermans
- Department of Neurology and Neuroscience Campus Amsterdam,VUmc Alzheimer Centre, VUmc Medical Centre,Amsterdam,The Netherlands
| | - T Koene
- Department of Medical Psychology and Neuroscience Campus Amsterdam,VUmc Alzheimer Centre, VUmc Medical Centre,Amsterdam,The Netherlands
| | - Y Pijnenburg
- Department of Neurology and Neuroscience Campus Amsterdam,VUmc Alzheimer Centre, VUmc Medical Centre,Amsterdam,The Netherlands
| | - W van der Flier
- Department of Neurology and Neuroscience Campus Amsterdam,VUmc Alzheimer Centre, VUmc Medical Centre,Amsterdam,The Netherlands
| | - P Scheltens
- Department of Neurology and Neuroscience Campus Amsterdam,VUmc Alzheimer Centre, VUmc Medical Centre,Amsterdam,The Netherlands
| | - P Aalten
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Centre,Maastricht,The Netherlands
| | - F Verhey
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Centre,Maastricht,The Netherlands
| | - P J Visser
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Centre,Maastricht,The Netherlands
| | - I Ramakers
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Centre,Maastricht,The Netherlands
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16
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Adriaanse SM, Binnewijzend MAA, Ossenkoppele R, Tijms BM, van der Flier WM, Koene T, Smits LL, Wink AM, Scheltens P, van Berckel BNM, Barkhof F. Widespread disruption of functional brain organization in early-onset Alzheimer's disease. PLoS One 2014; 9:e102995. [PMID: 25080229 PMCID: PMC4117463 DOI: 10.1371/journal.pone.0102995] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 06/25/2014] [Indexed: 11/25/2022] Open
Abstract
Early-onset Alzheimer's disease (AD) patients present a different clinical profile than late-onset AD patients. This can be partially explained by cortical atrophy, although brain organization might provide more insight. The aim of this study was to examine functional connectivity in early-onset and late-onset AD patients. Resting-state fMRI scans of 20 early-onset (<65 years old), 28 late-onset (≥65 years old) AD patients and 15 "young" (<65 years old) and 31 "old" (≥65 years old) age-matched controls were available. Resting-state network-masks were used to create subject-specific maps. Group differences were examined using a non-parametric permutation test, accounting for gray-matter. Performance on five cognitive domains were used in a correlation analysis with functional connectivity in AD patients. Functional connectivity was not different in any of the RSNs when comparing the two control groups (young vs. old controls), which implies that there is no general effect of aging on functional connectivity. Functional connectivity in early-onset AD was lower in all networks compared to age-matched controls, where late-onset AD showed lower functional connectivity in the default-mode network. Functional connectivity was lower in early-onset compared to late-onset AD in auditory-, sensory-motor, dorsal-visual systems and the default mode network. Across patients, an association of functional connectivity of the default mode network was found with visuoconstruction. Functional connectivity of the right dorsal visual system was associated with attention across patients. In late-onset AD patients alone, higher functional connectivity of the sensory-motor system was associated with poorer memory performance. Functional brain organization was more widely disrupted in early-onset AD when compared to late-onset AD. This could possibly explain different clinical profiles, although more research into the relationship of functional connectivity and cognitive performance is needed.
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Affiliation(s)
- Sofie M. Adriaanse
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Maja A. A. Binnewijzend
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Department of Neurology/Alzheimercenter Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Rik Ossenkoppele
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Betty M. Tijms
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Department of Neurology/Alzheimercenter Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Wiesje M. van der Flier
- Department of Neurology/Alzheimercenter Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
- Department of Epidemiology and biostatistics, VU University Medical Center, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Teddy Koene
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Lieke L. Smits
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Alle Meije Wink
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology/Alzheimercenter Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Bart N. M. van Berckel
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
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17
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Smits LL, Tijms BM, Benedictus MR, Koedam ELE, Koene T, Reuling IE, Barkhof F, Scheltens P, Pijnenburg YA, Wattjes MP, Flier WM. Regional atrophy is associated with impairment in distinct cognitive domains in Alzheimer's disease. Alzheimers Dement 2013; 10:S299-305. [DOI: 10.1016/j.jalz.2013.06.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 06/13/2013] [Accepted: 06/28/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Lieke L. Smits
- Alzheimer Center and Department of NeurologyVU University Medical CenterAmsterdamThe Netherlands
| | - Betty M. Tijms
- Alzheimer Center and Department of NeurologyVU University Medical CenterAmsterdamThe Netherlands
| | - Marije R. Benedictus
- Alzheimer Center and Department of NeurologyVU University Medical CenterAmsterdamThe Netherlands
| | - Esther L.G. E. Koedam
- Alzheimer Center and Department of NeurologyVU University Medical CenterAmsterdamThe Netherlands
| | - Teddy Koene
- Alzheimer Center and Department of Medical PsychologyVU University Medical CenterAmsterdamThe Netherlands
| | - Ilona E.W. Reuling
- Alzheimer Center and Department of Medical PsychologyVU University Medical CenterAmsterdamThe Netherlands
| | - Frederik Barkhof
- Alzheimer Center and Department of RadiologyVU University Medical CenterAmsterdamThe Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of NeurologyVU University Medical CenterAmsterdamThe Netherlands
| | - Yolande A.L. Pijnenburg
- Alzheimer Center and Department of NeurologyVU University Medical CenterAmsterdamThe Netherlands
| | - Mike P. Wattjes
- Alzheimer Center and Department of RadiologyVU University Medical CenterAmsterdamThe Netherlands
| | - Wiesje M. Flier
- Alzheimer Center and Department of NeurologyVU University Medical CenterAmsterdamThe Netherlands
- Alzheimer Center and Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdamThe Netherlands
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18
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van Harten AC, Smits LL, Teunissen CE, Visser PJ, Koene T, Blankenstein MA, Scheltens P, van der Flier WM. Preclinical AD predicts decline in memory and executive functions in subjective complaints. Neurology 2013; 81:1409-16. [PMID: 24049134 DOI: 10.1212/wnl.0b013e3182a8418b] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [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 We assessed whether preclinical Alzheimer disease (AD) based on CSF biomarkers at baseline predicts decline in cognitive functioning as measured by repeated neuropsychological tests for 4 cognitive domains in patients with subjective complaints. METHODS We included 132 patients with subjective complaints from our memory clinic-based Amsterdam Dementia Cohort, who underwent lumbar puncture and had repeated (range 2-7) neuropsychological evaluations. Follow-up was 2 ± 1 years. CSF biomarkers amyloid-β (Aβ42), total tau (Tau), and hyperphosphorylated tau-181 were used to define National Institute on Aging-Alzheimer's Association (NIA-AA) preclinical AD stages. Predictive value of preclinical AD stages as defined by CSF biomarkers, individual biomarkers, and Aβ42/tau ratio was assessed using linear mixed models. Outcome measures were compound z scores for memory, attention, executive functioning, language, and global cognition. Analyses were adjusted for age, sex, and education. RESULTS Patients were 61 ± 8 years old; 56 (42%) were women. Average baseline Mini-Mental State Examination score was 28.3 ± 1.5. Patients who fulfilled criteria for preclinical AD (stage 1: n = 11 + stage 2: n = 10) showed decline over time in memory (β ± SE -0.41 ± 0.14, p < 0.01), executive functions (-0.21 ± 0.08, p < 0.01), and global cognition (-0.29 ± 0.10, p < 0.01). There were no differences in cognitive decline between NIA-AA preclinical AD stages 1 and 2. In patients with normal CSF biomarkers, we observed memory improvement (0.19 ± 0.07, p < 0.01) and stable performance in all other domains. CONCLUSIONS CSF evidence of preclinical AD in patients with subjective complaints predicted cognitive decline over time, encompassing more than memory alone. Executive functioning and global cognitive functioning also deteriorated. On the other hand, 2-year prognosis for patients without evidence of AD pathophysiology was good.
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Affiliation(s)
- Argonde C van Harten
- From the Alzheimer Center (A.C.v.H., L.L.S., P.J.V., T.K., P.S., W.M.v.d.F.), Department of Neurology (A.C.v.H., L.L.S., P.S., W.M.v.d.F.), Neuroscience Campus Amsterdam (A.C.v.H., L.L.S., C.E.T., P.J.V., P.S., W.M.v.d.F.), Department of Clinical Chemistry (C.E.T., M.A.B.), Department of Medical Psychology (T.K.), and Department of Epidemiology/Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam; and the Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neurosciences, Maastricht University Medical Center, Maastricht, the Netherlands
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Hepp D, da Hora C, Koene T, Uitdehaag B, van den Heuvel O, Klein M, van de Berg W, Berendse H, Foncke E. Cognitive correlates of visual hallucinations in non-demented Parkinson's disease patients. Parkinsonism Relat Disord 2013; 19:795-9. [DOI: 10.1016/j.parkreldis.2013.04.026] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 04/23/2013] [Accepted: 04/30/2013] [Indexed: 12/01/2022]
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Kohler S, Hamel R, Sistermans N, Koene T, Pijnenburg YAL, van der Flier WM, Scheltens P, Visser PJ, Aalten P, Verhey FRJ, Ramakers I. Progression to dementia in memory clinic patients without dementia: A latent profile analysis. Neurology 2013; 81:1342-9. [DOI: 10.1212/wnl.0b013e3182a82536] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Pleizier CM, van der Vlies AE, Koedam E, Koene T, Barkhof F, van der Flier WM, Scheltens P, Pijnenburg Y. Episodic memory and the medial temporal lobe: not all it seems. Evidence from the temporal variants of frontotemporal dementia. J Neurol Neurosurg Psychiatry 2012; 83:1145-8. [PMID: 22933816 DOI: 10.1136/jnnp-2012-302437] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [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: 11/03/2022]
Abstract
BACKGROUND Disproportionate medial temporal lobe atrophy (MTA) is an early finding in Alzheimer's disease (AD). Episodic memory impairment in AD is associated with the degree of MTA. Episodic memory impairment and MTA are also found in semantic dementia (SD) and in right temporal lobe atrophy (RTLA), the temporal variants of frontotemporal dementia, but their relationship is unclear. OBJECTIVE To compare episodic memory impairment among patients with these temporal variants of frontotemporal dementia with that of patients with AD with the same degree of MTA. METHODS Episodic memory was tested with the visual association test, and semantic memory (SM) with animal fluency and the visual association naming test. MTA was measured using a visual rating scale. Each patient with SD or RTLA was matched for MTA with two patients with AD. Comparisons of episodic memory and SM were made for patients with SD versus matched patients with AD; patients with RTLA versus matched patients with AD and for SD, RTLA and all patients with AD. RESULTS 27 patients with SD and 11 with RTLA were matched with 54 and 22 patients with AD, respectively. Episodic memory was less impaired in patients with SD than in those with AD (8 versus 2; p<0.001) and in patients with RTLA than in those with AD (10 versus 4.5; p=0.009). Semantic memory was more affected in patients with SD than in those with AD, and the Mini Mental State Examination score was higher in patients with RTLA than in those with AD. Comparison of the three diagnostic groups showed that episodic memory was most impaired in AD, whereas SM was most impaired in SD. CONCLUSION Since episodic memory impairment is more severe in AD than in SD and RTLA, despite a comparable degree of MTA, atrophy of the medial temporal lobe alone cannot account for episodic memory dysfunction.
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Affiliation(s)
- C Machiel Pleizier
- Department of Neurology, Diakonessenhuis, PO Box 80250, 3508 TG, Utrecht, The Netherlands.
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22
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Smits LL, Pijnenburg YAL, Koedam ELGE, van der Vlies AE, Reuling IEW, Koene T, Teunissen CE, Scheltens P, van der Flier WM. Early onset Alzheimer's disease is associated with a distinct neuropsychological profile. J Alzheimers Dis 2012; 30:101-8. [PMID: 22366769 DOI: 10.3233/jad-2012-111934] [Citation(s) in RCA: 127] [Impact Index Per Article: 10.6] [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]
Abstract
Alzheimer's disease (AD) in younger patients is associated with a higher prevalence of atypical symptoms. We examined neuropsychological performance according to age-at-onset. We assessed cognition in 172 patients with AD (81 early and 91 late onset) in five cognitive domains (memory, language, visuo-spatial functioning, executive functioning, attention). Dementia severity was assessed using the Mini-Mental State Examination (MMSE) and global cognitive decline using Cambridge Cognitive Examination (CAMCOG). Analyses of variance were performed with age-at-onset as between-subjects factor, and gender and education as covariates. Analysis was repeated after stratification for dementia severity (based on median MMSE). In early onset AD, age (mean ± SD) was 60 ± 4 years; 44 (54%) were female. In late onset AD, age was 72 ± 5 years; 47 (52%) were female. Dementia severity and global cognitive decline did not differ between groups (early onset: MMSE: 20 ± 5, CAMCOG: 69 ± 15, late onset: MMSE: 21 ± 5, CAMCOG: 70 ± 15; p > 0.05). Early onset patients performed worse than late onset patients on visuo-spatial functioning (p < 0.01), executive functioning (p < 0.001), and attention (p < 0.01). Late onset patients performed worse on memory, although not significantly (p = 0.11). Stratification for dementia severity showed that in mildly demented early onset patients, memory function was remarkably preserved compared to late onset patients (p < 0.01). In moderate AD, differences in memory function disappeared, but early onset patients performed worse on visuo-spatial functioning (p < 0.01), executive functioning (p < 0.001), and attention (p < 0.01) than late onset patients. Adjustment for APOE left results unchanged. In conclusion, early onset AD presents with a different cognitive profile and the disease course seems different. Relative sparing of memory function in early stages stresses the need to adequately test other cognitive domains.
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Affiliation(s)
- Lieke L Smits
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands.
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Smits L, Benedictus M, Koedam E, Koene T, Roos‐Reuling I, Barkhof F, Scheltens P, Wattjes M, Van der Flier W. P3‐252: Patterns of atrophy in Alzheimer's disease: Does cognition follow structure? Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.1475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Lieke Smits
- VUMC Alzheimer Centre AmsterdamAmsterdamNetherlands
| | | | | | - Teddy Koene
- VUMC Alzheimer Centre AmsterdamAmsterdamNetherlands
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van Dijk K, Jongbloed W, Teunissen C, Koene T, Groenewegen H, Berendse H, van de Berg W, Veerhuis R. 2.131 CSF CLUSTERIN IS ASSOCIATED WITH COGNITIVE IMPAIRMENT AND ALZHEIMER'S DISEASE BIOMARKERS IN PARKINSON'S DISEASE PATIENTS. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70503-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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de Haan W, van der Flier WM, Koene T, Smits LL, Scheltens P, Stam CJ. Disrupted modular brain dynamics reflect cognitive dysfunction in Alzheimer's disease. Neuroimage 2011; 59:3085-93. [PMID: 22154957 DOI: 10.1016/j.neuroimage.2011.11.055] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 11/09/2011] [Accepted: 11/14/2011] [Indexed: 11/19/2022] Open
Abstract
The relation between pathology and cognitive dysfunction in dementia is still poorly understood, although disturbed communication between different brain regions is almost certainly involved. In this study we combine magneto-encephalography (MEG) and network analysis to investigate the role of functional sub-networks (modules) in the brain with regard to cognitive failure in Alzheimer's disease. Whole-head resting-state (MEG) was performed in 18 Alzheimer patients (age 67 ± 9, 6 females, MMSE 23 ± 5) and 18 healthy controls (age 66 ± 9, 11 females, MMSE 29 ± 1). We constructed functional brain networks based on interregional synchronization measurements, and performed graph theoretical analysis with a focus on modular organization. The overall modular strength and the number of modules changed significantly in Alzheimer patients. The parietal cortex was the most highly connected network area, but showed the strongest intramodular losses. Nonetheless, weakening of intermodular connectivity was even more outspoken, and more strongly related to cognitive impairment. The results of this study demonstrate that particularly the loss of communication between different functional brain regions reflects cognitive decline in Alzheimer's disease. These findings imply the relevance of regarding dementia as a functional network disorder.
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Affiliation(s)
- W de Haan
- Department of Clinical Neurophysiology and MEG, VU University Medical Center, Amsterdam, The Netherlands.
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Smits L, Pijnenburg Y, Koedam E, Vlies A, Roos‐Reuling I, Koene T, Scheltens P, Flier W. P1‐477: Early‐onset Alzheimer's disease is associated with a distinct neuropsychological profile. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.760] [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)
- Lieke Smits
- VU University Medical CenterAmsterdamNetherlands
| | | | | | | | | | - Teddy Koene
- VU University Medical CenterAmsterdamNetherlands
| | | | - Wiesje Flier
- VU University Medical CenterAmsterdamNetherlands
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Smits LL, Liedorp M, Koene T, Roos-Reuling IEW, Lemstra AW, Scheltens P, Stam CJ, van der Flier WM. EEG abnormalities are associated with different cognitive profiles in Alzheimer's disease. Dement Geriatr Cogn Disord 2011; 31:1-6. [PMID: 21109738 DOI: 10.1159/000322202] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2010] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Our purpose was to investigate associations between different cognitive profiles and their underlying functional brain changes as measured by electroencephalogram (EEG) in Alzheimer's disease (AD). METHODS EEG was obtained and neuropsychological performance assessed in 254 patients with AD. The EEGs were visually assessed for the presence of focal and/or diffuse abnormalities. Multivariate analysis of variance for repeated measures was performed with presence of focal and/or diffuse abnormalities as between-subjects factor and neuropsychological tests as within-subject factor. Age, sex and education were entered as covariates. RESULTS Twenty-eight percent of the patients had a normal EEG, 32% had focal abnormalities, 14% diffuse abnormalities and 26% had both focal and diffuse abnormalities. Patients with a normal EEG presented with a cognitive profile in which memory was mostly impaired. Patients with focal and diffuse EEG abnormalities presented with a nonmemory profile. CONCLUSION These results illustrate that specific types of EEG abnormalities are associated with different cognitive profiles in AD, providing biological support in terms of brain functioning for variability in cognitive impairment.
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Affiliation(s)
- Lieke L Smits
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
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Van Der Werf YD, Altena E, Vis JC, Koene T, Van Someren EJ. Reduction of nocturnal slow-wave activity affects daytime vigilance lapses and memory encoding but not reaction time or implicit learning. Slow Brain Oscillations of Sleep, Resting State and Vigilance 2011; 193:245-55. [DOI: 10.1016/b978-0-444-53839-0.00016-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Tolboom N, van der Flier WM, Yaqub M, Koene T, Boellaard R, Windhorst AD, Scheltens P, Lammertsma AA, van Berckel B. Differential association of [11C]PIB and [18F]FDDNP binding with cognitive impairment. Neurology 2009; 73:2079-85. [DOI: 10.1212/wnl.0b013e3181c679cc] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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van der Vlies AE, Pijnenburg YAL, Koene T, Klein M, Kok A, Scheltens P, van der Flier WM. Cognitive impairment in Alzheimer's disease is modified by APOE genotype. Dement Geriatr Cogn Disord 2007; 24:98-103. [PMID: 17596691 DOI: 10.1159/000104467] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2007] [Indexed: 11/19/2022] Open
Abstract
AIM We examined whether impairment in specific cognitive domains in Alzheimer's disease (AD) differed according to APOE genotype and age at onset. METHODS Cognitive functions of 229 consecutive AD patients were assessed using Visual Association Test (VAT), Memory Impairment Screen+ (MIS+), VAT object naming, fluency test and Trail Making Test (TMT). Dementia severity was assessed using MMSE. ANOVAs were performed with APOE genotype and age at onset as independent variables and sex, education and MMSE as covariates. RESULTS 28% of patients were APOE epsilon4-negative, 58% heterozygous and 14% homozygous. A significant association between APOE genotype and VAT and MIS+ was found when correcting for sex and education. An interaction effect between APOE genotype and age at onset on VAT and VAT object naming was found, with young carriers performing worse than young noncarriers. By contrast, when additionally correcting for MMSE, a significant association between APOE genotype and VAT object naming, TMT-A and TMT-B was found, with noncarriers performing worse than carriers. CONCLUSION Memory was more impaired among APOE epsilon4 carriers than among noncarriers. By contrast, naming, executive functions and mental speed were more impaired among APOE epsilon4 noncarriers. This suggests that the APOE genotype modifies the clinical phenotype in terms of cognitive impairment in AD.
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Affiliation(s)
- Annelies E van der Vlies
- Department of Neurology, Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands.
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31
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Vlies AE, Flier WM, Kok A, Pijnenburg YA, Koene T, Klein M, Scheltens P. P3–029: Pattern of cognitive impairment in AD is modified by APOE genotype. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.1296] [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)
| | | | - Astrid Kok
- Alzheimer Centrum VUmcAmsterdamThe Netherlands
| | | | - Teddy Koene
- Alzheimer Centrum VUmcAmsterdamThe Netherlands
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Schmand B, Lindeboom J, Schagen S, Heijt R, Koene T, Hamburger HL. Cognitive complaints in patients after whiplash injury: the impact of malingering. J Neurol Neurosurg Psychiatry 1998; 64:339-43. [PMID: 9527145 PMCID: PMC2169999 DOI: 10.1136/jnnp.64.3.339] [Citation(s) in RCA: 128] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The validity of memory and concentration complaints that are often reported after a whiplash trauma is controversial. The prevalence of malingering or underperformance in post-whiplash patients, and its impact on their cognitive test results were studied. METHODS The Amsterdam short term memory (ASTM) test, a recently developed malingering test, was used as well as a series of conventional memory and concentration tests. The study sample was a highly selected group of patients, who were examined either as part of a litigation procedure (n=36) or in the normal routine of an outpatient clinic (n=72). RESULTS The prevalence of underperformance, as defined by a positive score on the malingering test, was 61% (95% CI: 45-77) in the context of litigation, and 29% (95% CI: 18-40) in the outpatient clinic (p=0.003). Furthermore, the scores on the memory and concentration test of malingering post-whiplash patients (n=43) and non-malingering post-whiplash patients (n=65) were compared with the scores of patients with closed head injury (n=20) and normal controls (n=46). The malingering post-whiplash patients scored as low as the patients with closed head injury on most tests. CONCLUSIONS The prevalence of malingering or cognitive underperformance in late post-whiplash patients is substantial, particularly in litigation contexts. It is not warranted to explain the mild cognitive disorders of whiplash patients in terms of brain damage, as some authors have done. The cognitive complaints of non-malingering post-whiplash patients are more likely a result of chronic pain, chronic fatigue, or depression.
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Affiliation(s)
- B Schmand
- Department of Psychology, Slotervaartziekenhuis, Amsterdam, The Netherlands.
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Lindeboom J, Koene T, Matto D. [The diagnostic value of tests for mental control]. Tijdschr Gerontol Geriatr 1993; 24:105-109. [PMID: 8328004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Designated as Mental Control, the recitation of word lists and arithmetic progressions is often used for a cursory examination of attention and concentration in elderly patients. We studied the psychometric properties of the EMCT (Expanded Mental Control Test), which consists of 12 mental control tasks. The test was given to 174 residents of rest homes and semi-independent housing projects (aged 68 to 94) and 74 neurologic patients (aged 65 to 87) who had been referred for neuropsychological assessment. The reliability of the EMCT was satisfactory. Performance was related to education level but not to sex or age. In healthy subjects the EMCT score was associated with the backward digit span score. The correlations between the EMCT and subtests of the Amsterdam Dementia Screening (Ads6) in patients appeared to depend on the complexity of the target behavior. Performance on the EMCT may reflect the functioning of the Supervisory Attentional System postulated by Shallice.
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Affiliation(s)
- J Lindeboom
- Afdeling Medische Psychologie, Academisch Ziekenhuis Vrije Universiteit Amsterdam
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