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Kim M, Yi D, Byun MS, Ahn H, Jung JH, Kong N, Chang Y, Choi H, Choi J, Kim K, Jung G, Lee DY. Development of a Cognitive Composite for Preclinical Alzheimer's Disease in Korean Older Adults. J Alzheimers Dis 2023; 96:633-641. [PMID: 37807780 PMCID: PMC10657668 DOI: 10.3233/jad-230263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND As tracking subtle cognitive declines in the preclinical stage of Alzheimer's disease (AD) is difficult with traditional individual outcome measures, need for cognitive composite for preclinical AD is widely recognized. OBJECTIVE We aimed to develop culturally appropriate cognitive composite that sensitively identifies subtle cognitive decline of preclinical AD in Korean older adults. METHODS A total 225 cognitively normal elderly individuals from the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease, were included. Tests of episodic memory, orientation, and executive function were carefully selected through review of previously established composites. Three candidate composites including Consortium to Establish a Registry for Alzheimer's Disease Word list recall (WLR), Logical memory (LM) II, and Mini-Mental status examination (MMSE) in common, and Letter fluency test (LF), category fluency test, or Stroop color and word test, were selected. RESULTS Student t-tests demonstrated that only the composite composed of WLR, LM II, MMSE, and LF (Composite 1) showed a significant difference in score decline over two-year follow-up period between Aβ positive and negative group (p = 0.03). Linear mixed model analyses also showed that the Aβ x time interaction effect was significant only for Composite 1 (p = 0.025). Based on the results, Composite 1 was chosen as the final cognitive composite for preclinical Alzheimer's disease (CPAD). CONCLUSIONS CPAD can be used to assess subtle cognitive decline of preclinical AD in clinical research settings, especially in Korean older adults. It also may be used for monitoring progression or treatment benefits in clinical practices.
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Affiliation(s)
- Minjae Kim
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Dahyun Yi
- Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, Korea
| | - Min Soo Byun
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Hyejin Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Joon Hyung Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Nayeong Kong
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Yoonyoung Chang
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Hyeji Choi
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Jungmin Choi
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Kyungtae Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Gijung Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Dong Young Lee
- Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - for the KBASE Research Group
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, Seoul, Korea
- Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
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Kang KM, Byun MS, Yi D, Lee KH, Kim M, Ahn H, Jung G, Lee J, Kim YK, Lee Y, Sohn C, Lee DY. Enlarged perivascular spaces are associated with decreased brain tau deposition. CNS Neurosci Ther 2022; 29:577-586. [PMID: 36468423 PMCID: PMC9873511 DOI: 10.1111/cns.14040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 12/10/2022] Open
Abstract
AIMS The aim of this study was to investigate the associations of enlarged perivascular spaces (EPVS) in the basal ganglia (BG) and centrum semiovale (CSO) with beta-amyloid (Aβ) and tau deposition in older adults with a diverse cognitive spectrum. METHODS A total of 163 (68 cognitively normal and 95 cognitively impaired) older participants underwent [11 C] Pittsburgh compound B and [18 F] AV-1451 PET, and MRI. EPVS in the BG and CSO and other small vessel disease markers, such as white matter hyperintensities, lacunes, and deep and lobar microbleeds, were assessed. RESULTS Increased EPVS in the BG showed a significant association with lower cerebral tau deposition, even after controlling for other small vessel disease markers. Further exploratory analyses showed that this association was significant in cognitively impaired, Aβ-positive, or APOE4-positive individuals, but not significant in the cognitively normal, Aβ-negative, or APOE4-negative participants. In contrast to EPVS in the BG, EPVS in the CSO did not have any relationship with cerebral tau deposition. In addition, none of the two types of EPVS were associated with cerebral Aβ deposition. CONCLUSION Brain tau deposition appears to be reduced with increased EPVS in the BG, especially in individuals with cognitive impairment, pathological amyloid burden, or genetic Alzheimer's disease risk.
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Affiliation(s)
- Koung Mi Kang
- Department of RadiologySeoul National University HospitalSeoulKorea,Department of RadiologySeoul National University College of MedicineSeoulKorea
| | - Min Soo Byun
- Department of NeuropsychiatrySeoul National University College of MedicineSeoulKorea,Department of NeuropsychiatrySeoul National University HospitalSeoulKorea
| | - Dahyun Yi
- Biomedical Research Institute, Seoul National University HospitalSeoulKorea
| | - Kyung Hoon Lee
- Department of RadiologySeoul National University HospitalSeoulKorea
| | - Min Jung Kim
- Department of NeuropsychiatrySeoul National University HospitalSeoulKorea
| | - Hyejin Ahn
- Department of NeuropsychiatrySeoul National University HospitalSeoulKorea
| | - Gijung Jung
- Department of NeuropsychiatrySeoul National University HospitalSeoulKorea
| | - Jun‐Young Lee
- Department of NeuropsychiatrySeoul National University College of MedicineSeoulKorea,Department of NeuropsychiatrySMG‐SNU Boramae Medical CenterSeoulKorea
| | - Yu Kyeong Kim
- Department of Nuclear MedicineSMG‐SNU Boramae Medical CenterSeoulKorea
| | - Yun‐Sang Lee
- Department of Nuclear MedicineSeoul National University College of MedicineSeoulKorea
| | - Chul‐Ho Sohn
- Department of RadiologySeoul National University HospitalSeoulKorea,Department of RadiologySeoul National University College of MedicineSeoulKorea
| | - Dong Young Lee
- Department of NeuropsychiatrySeoul National University College of MedicineSeoulKorea,Department of NeuropsychiatrySeoul National University HospitalSeoulKorea,Institute of Human Behavioral MedicineMedical Research Center Seoul National UniversitySeoulKorea
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Abstract
BACKGROUND Although some human studies have reported gut microbiome changes in individuals with Alzheimer's disease (AD) dementia or mild cognitive impairment (MCI), gut microbiome alterations in preclinical AD, i.e., cerebral amyloidosis without cognitive impairment, is largely unknown. OBJECTIVE We aimed to identify gut microbial alterations associated with preclinical AD by comparing cognitively normal (CN) older adults with cerebral Aβ deposition (Aβ+ CN) and those without cerebral Aβ deposition (Aβ- CN). METHODS Seventy-eight CN older participants (18 Aβ+ CN and 60 Aβ- CN) were included, and all participants underwent clinical assessment and Pittsburg compound B-positron emission tomography. The V3-V4 region of the 16S rRNA gene of genomic DNA extracted from feces was amplified and sequenced to establish the microbial community. RESULTS Generalized linear model analysis revealed that the genera Megamonas (B = 3.399, q<0.001), Serratia (B = 3.044, q = 0.005), Leptotrichia (B = 5.862, q = 0.024) and Clostridium (family Clostridiaceae) (B = 0.788, q = 0.034) were more abundant in the Aβ+ CN group than the Aβ- CN group. In contrast, genera CF231 (B = -3.237, q< 0.001), Victivallis (B = -3.447, q = 0.004) Enterococcus (B = -2.044, q = 0.042), Mitsuokella (B = -2.119, q = 0.042) and Clostridium (family Erysipelotrichaceae) (B = -2.222, q = 0.043) were decreased in Aβ+ CN compared to Aβ- CN. Notably, the classification model including the differently abundant genera could effectively distinguish Aβ+ CN from Aβ- CN (AUC = 0.823). CONCLUSION Our findings suggest that specific alterations of gut bacterial taxa are related to preclinical AD, which means these changes may precede cognitive decline. Therefore, examining changes in the microbiome may be helpful in preclinical AD screening.
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Affiliation(s)
- Joon Hyung Jung
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Gihyeon Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
| | - Min Soo Byun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, Republic of Korea
| | - Hansoo Park
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
- Genome and Company, Seongnam, Republic of Korea
- * E-mail: (DYL); (HP)
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, Republic of Korea
- * E-mail: (DYL); (HP)
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Kim JW, Byun MS, Yi D, Lee JH, Ko K, Jeon SY, Sohn BK, Lee JY, Kim YK, Shin SA, Sohn CH, Lee DY. Association of moderate alcohol intake with in vivo amyloid-beta deposition in human brain: A cross-sectional study. PLoS Med 2020; 17:e1003022. [PMID: 32097439 PMCID: PMC7041799 DOI: 10.1371/journal.pmed.1003022] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 01/17/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND An emerging body of literature has indicated that moderate alcohol intake may be protective against Alzheimer disease (AD) dementia. However, little information is available regarding whether moderate alcohol intake is related to reductions in amyloid-beta (Aβ) deposition, or is protective via amyloid-independent mechanisms in the living human brain. Here we examined the associations of moderate alcohol intake with in vivo AD pathologies, including cerebral Aβ deposition, neurodegeneration of AD-signature regions, and cerebral white matter hyperintensities (WMHs) in the living human brain. METHODS AND FINDINGS The present study was part of the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer's Disease (KBASE), an ongoing prospective cohort study that started in 2014. As of November 2016, 414 community-dwelling individuals with neither dementia nor alcohol-related disorders (280 cognitively normal [CN] individuals and 134 individuals with mild cognitive impairment [MCI]) between 56 and 90 years of age (mean age 70.9 years ± standard deviation 7.8; male, n [%] = 180 [43.5]) were recruited from 4 sites (i.e., 2 university hospitals and 2 public centers for dementia prevention and management) around Seoul, South Korea. All the participants underwent comprehensive clinical assessments comprising lifetime and current histories of alcohol intake and multimodal brain imaging, including [11C] Pittsburgh compound B positron emission tomography (PET), [18F] fluorodeoxyglucose (FDG) PET, and magnetic resonance imaging (MRI) scans. Lifetime and current alcohol intake were categorized as follows: no drinking, <1 standard drink (SD)/week, 1-13 SDs/week, and 14+ SDs/week. A moderate lifetime alcohol intake (1-13 SDs/week) was significantly associated with a lower Aβ positivity rate compared to the no drinking group, even after controlling for potential confounders (odds ratio 0.341, 95% confidence interval 0.163-0.714, p = 0.004). In contrast, current alcohol intake was not associated with amyloid deposition. Additionally, alcohol intake was not related to neurodegeneration of AD-signature regions or cerebral WMH volume. The present study had some limitations in that it had a cross-sectional design and depended on retrospective recall for alcohol drinking history. CONCLUSIONS In this study, we observed in middle- and old-aged individuals with neither dementia nor alcohol-related disorders that moderate lifetime alcohol intake was associated with lower cerebral Aβ deposition compared to a lifetime history of not drinking. Moderate lifetime alcohol intake may have a beneficial influence on AD by reducing pathological amyloid deposition rather than amyloid-independent neurodegeneration or cerebrovascular injury.
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Affiliation(s)
- Jee Wook Kim
- Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
- Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Min Soo Byun
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kang Ko
- Department of Geriatric Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - So Yeon Jeon
- Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Bo Kyung Sohn
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Jun-Young Lee
- Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Seong A Shin
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Young Lee
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- * E-mail:
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Kim JW, Byun MS, Yi D, Lee JH, Jeon SY, Jung G, Lee HN, Sohn BK, Lee JY, Kim YK, Shin SA, Sohn CH, Lee DY. Coffee intake and decreased amyloid pathology in human brain. Transl Psychiatry 2019; 9:270. [PMID: 31641100 PMCID: PMC6805864 DOI: 10.1038/s41398-019-0604-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/22/2019] [Accepted: 07/30/2019] [Indexed: 12/17/2022] Open
Abstract
Several epidemiological and preclinical studies supported the protective effect of coffee on Alzheimer's disease (AD). However, it is still unknown whether coffee is specifically related with reduced brain AD pathologies in human. Hence, this study aims to investigate relationships between coffee intake and in vivo AD pathologies, including cerebral beta-amyloid (Aβ) deposition, the neurodegeneration of AD-signature regions, and cerebral white matter hyperintensities (WMH). A total of 411 non-demented older adults were included. Participants underwent comprehensive clinical assessment and multimodal neuroimaging including [11C] Pittsburgh compound B-positron emission tomography (PET), [18F] fluorodeoxyglucose PET, and magnetic resonance imaging scans. Lifetime and current coffee intake were categorized as follows: no coffee or <2 cups/day (reference category) and ≥2 cups/day (higher coffee intake). Lifetime coffee intake of ≥2 cups/day was significantly associated with a lower Aβ positivity compared to coffee intake of <2 cups/day, even after controlling for potential confounders. In contrast, neither lifetime nor current coffee intake was not related to hypometabolism, atrophy of AD-signature region, and WMH volume. The findings suggest that higher lifetime coffee intake may contribute to lowering the risk of AD or related cognitive decline by reducing pathological cerebral amyloid deposition.
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Affiliation(s)
- Jee Wook Kim
- 0000 0004 1790 2596grid.488450.5Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, 7 Keunjaebong-Gil, Hwaseong, Gyeonggi 18450 Republic of Korea ,0000 0004 0470 5964grid.256753.0Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Gangwon 24252 Republic of Korea
| | - Min Soo Byun
- 0000 0004 0470 5905grid.31501.36Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, 03080 Republic of Korea
| | - Dahyun Yi
- 0000 0004 0470 5905grid.31501.36Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, 03080 Republic of Korea
| | - Jun Ho Lee
- 0000 0001 0302 820Xgrid.412484.fDepartment of Neuropsychiatry, Seoul National University Hospital, Seoul, 03080 Republic of Korea
| | - So Yeon Jeon
- 0000 0001 0302 820Xgrid.412484.fDepartment of Neuropsychiatry, Seoul National University Hospital, Seoul, 03080 Republic of Korea
| | - Gijung Jung
- 0000 0001 0302 820Xgrid.412484.fDepartment of Neuropsychiatry, Seoul National University Hospital, Seoul, 03080 Republic of Korea
| | - Han Na Lee
- 0000 0001 0302 820Xgrid.412484.fDepartment of Neuropsychiatry, Seoul National University Hospital, Seoul, 03080 Republic of Korea
| | - Bo Kyung Sohn
- 0000 0004 0470 5112grid.411612.1Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, 01757 Republic of Korea
| | - Jun-Young Lee
- grid.412479.dDepartment of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, 07061 Republic of Korea ,0000 0004 0470 5905grid.31501.36Department of Psychiatry, Seoul National University College of Medicine, Seoul, 03080 Republic of Korea
| | - Yu Kyeong Kim
- grid.412479.dDepartment of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, 07061 Republic of Korea
| | - Seong A Shin
- grid.412479.dDepartment of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, 07061 Republic of Korea
| | - Chul-Ho Sohn
- 0000 0004 0470 5905grid.31501.36Department of Radiology, Seoul National University College of Medicine, Seoul, 03080 Republic of Korea
| | - Dong Young Lee
- Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, 03080, Republic of Korea. .,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, 03080, Republic of Korea. .,Department of Psychiatry, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea.
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