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Huang S, Zhou X, Liu Y, Luo J, Lv Z, Shang P, Zhang W, Lin B, Huang Q, Feng Y, Wang W, Tao S, Wang Y, Zhang C, Chen L, Shi L, Luo Y, Mok VCT, Pan S, Xie H. High Fall Risk Associated With Memory Deficit and Brain Lobes Atrophy Among Elderly With Amnestic Mild Cognitive Impairment and Mild Alzheimer's Disease. Front Neurosci 2022; 16:896437. [PMID: 35757554 PMCID: PMC9213689 DOI: 10.3389/fnins.2022.896437] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives This study aimed to primarily examine the association between memory deficit and increased fall risk, second, explore the underlying neuroanatomical linkage of this association in the elderly with aMCI and mild AD. Methods In this cross-sectional study, a total of 103 older adults were included (55 cognitively normal, CN; 48 cognitive impairment, CI, elderly with aMCI, and mild AD). Memory was assessed by the Auditory Verbal Learning Test (AVLT). Fall risk was evaluated by the Timed Up and Go (TUG) Test, heel strike angles, and stride speed, which were collected by an inertial-sensor-based wearable instrument (the JiBuEn™ gait analysis system). Brain volumes were full-automatic segmented and quantified using AccuBrain® v1.2 from three-dimensional T1-weighted (3D T1W) MR images. Multivariable regression analysis was used to examine the extent of the association between memory deficit and fall risk, the association of brain volumes with memory, and fall risk. Age, sex, education, BMI, and HAMD scores were adjusted. Sensitivity analysis was conducted. Results Compared to CN, participants with aMCI and mild AD had poorer cognitive performance (p < 0.001), longer TUG time (p = 0.018), and smaller hippocampus and medial temporal volumes (p = 0.037 and 0.029). In the CI group, compared to good short delayed memory (SDM) performance (AVLT > 5), the elderly with bad SDM performance (AVLT ≤ 3) had longer TUG time, smaller heel strike angles, and slower stride speed. Multivariable regression analysis showed that elderly with poor memory had higher fall risk than relative good memory performance among cognitive impairment elderly. The TUG time increased by 2.1 s, 95% CI, 0.54∼3.67; left heel strike angle reduced by 3.22°, 95% CI, −6.05 to −0.39; and stride speed reduced by 0.09 m/s, 95% CI, −0.19 to −0.00 for the poor memory elderly among the CI group, but not found the association in CN group. In addition, serious medial temporal atrophy (MTA), small volumes of the frontal lobe and occipital lobe were associated with long TUG time and small heel strike angles; small volumes of the temporal lobe, frontal lobe, and parietal lobe were associated with slow stride speed. Conclusion Our findings suggested that memory deficit was associated with increased fall risk in the elderly with aMCI and mild AD. The association might be mediated by the atrophy of medial temporal, frontal, and parietal lobes. Additionally, increased fall risk, tested by TUG time, heel stride angles, and stride speed, might be objective and convenient kinematics markers for dynamic monitoring of both memory function and fall risk.
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Affiliation(s)
- Shuyun Huang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China.,Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xinhan Zhou
- Department of Imaging, First People's Hospital of Foshan, Foshan, China
| | - Yajing Liu
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Jiali Luo
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Zeping Lv
- National Research Center for Rehabilitation Technical Aids, Rehabilitation Hospital, Beijing, China
| | - Pan Shang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Weiping Zhang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Biqing Lin
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Qiulan Huang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - YanYun Feng
- Department of Imaging, First People's Hospital of Foshan, Foshan, China
| | - Wei Wang
- Department of Imaging, First People's Hospital of Foshan, Foshan, China
| | - Shuai Tao
- Dalian Key Laboratory of Smart Medical and Health, Dalian University, Dalian, China
| | - Yukai Wang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Chengguo Zhang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Lushi Chen
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,BrainNow Research Institute, Shenzhen, China
| | - Yishan Luo
- BrainNow Research Institute, Shenzhen, China
| | - Vincent C T Mok
- Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Suyue Pan
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Haiqun Xie
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
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Wang Y, Li L, Zhao X, Sui S, Wang Q, Shi G, Xu H, Zhang X, He Y, Gu J. Intestinal Microflora Changes in Patients with Mild Alzheimer's Disease in a Chinese Cohort. J Alzheimers Dis 2022; 88:563-575. [PMID: 35662119 DOI: 10.3233/jad-220076] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Understanding the relationship between Alzheimer's disease (AD) and intestinal flora is still a major scientific topic that continues to advance. OBJECTIVE To determine characterized changes in the intestinal microbe community of patients with mild AD. METHODS Comparison of the 16S ribosomal RNA (rRNA) high-throughput sequencing data was obtained from the Illumina MiSeq platform of fecal microorganisms of the patients and healthy controls (HC) which were selected from cohabiting caregivers of AD patients to exclude environmental and dietary factors. RESULTS We found that the abundance of several bacteria taxa in AD patients was different from that in HC at the genus level, such as Anaerostipes, Mitsuokella, Prevotella, Bosea, Fusobacterium, Anaerotruncus, Clostridium, and Coprobacillus. Interestingly, the abundance of Akkermansia, an emerging probiotic, increased significantly in the AD group compared with that in the HC group. Meanwhile, the quantity of traditional probiotic Bifidobacteria of the AD group also rose. CONCLUSION These alterations in fecal microbiome of the AD group indicate that patients with mild AD have unique gut microbial characteristics. These specific AD-associated intestinal microbes could serve as novel potential targets for early intervention of AD.
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Affiliation(s)
- Yilin Wang
- College of Biological Science and Technology, University of Jinan, Jinan, China
| | - Lei Li
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, China
| | - Xiaodong Zhao
- College of Biological Science and Technology, University of Jinan, Jinan, China
| | - Shaomei Sui
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, China
| | - Qi Wang
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, China
| | - Guizhi Shi
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Huilian Xu
- College of Biological Science and Technology, University of Jinan, Jinan, China
| | - Xiujun Zhang
- College of Biological Science and Technology, University of Jinan, Jinan, China
| | - Yan He
- Department of Neurology, Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, China
| | - Jinsong Gu
- College of Biological Science and Technology, University of Jinan, Jinan, China
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Itaguchi Y, Castro-Chavira SA, Waterloo K, Johnsen SH, Rodríguez-Aranda C. Evaluation of Error Production in Animal Fluency and Its Relationship to Frontal Tracts in Normal Aging and Mild Alzheimer's Disease: A Combined LDA and Time-Course Analysis Investigation. Front Aging Neurosci 2022; 13:710938. [PMID: 35095462 PMCID: PMC8790484 DOI: 10.3389/fnagi.2021.710938] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Semantic verbal fluency (VF), assessed by animal category, is a task widely used for early detection of dementia. A feature not regularly assessed is the occurrence of errors such as perseverations and intrusions. So far, no investigation has analyzed the how and when of error occurrence during semantic VF in aging populations, together with their possible neural correlates. The present study aims to address the issue using a combined methodology based on latent Dirichlet allocation (LDA) analysis for word classification together with a time-course analysis identifying exact time of errors' occurrence. LDA is a modeling technique that discloses hidden semantic structures based on a given corpus of documents. We evaluated a sample of 66 participants divided into a healthy young group (n = 24), healthy older adult group (n = 23), and group of patients with mild Alzheimer's disease (AD) (n = 19). We performed DTI analyses to evaluate the white matter integrity of three frontal tracts purportedly underlying error commission: anterior thalamic radiation, frontal aslant tract, and uncinate fasciculus. Contrasts of DTI metrics were performed on the older groups who were further classified into high-error rate and low-error rate subgroups. Results demonstrated a unique deployment of error commission in the patient group characterized by high incidence of intrusions in the first 15 s and higher rate of perseverations toward the end of the trial. Healthy groups predominantly showed very low incidence of perseverations. The DTI analyses revealed that the patients with AD committing high-error rate presented significantly more degenerated frontal tracts in the left hemisphere. Thus, our findings demonstrated that the appearance of intrusions, together with left hemisphere degeneration of frontal tracts, is a pathognomic trait of mild AD. Furthermore, our data suggest that the error commission of patients with AD arises from executive and working memory impairments related partly to deteriorated left frontal tracts.
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Affiliation(s)
| | | | - Knut Waterloo
- Department of Psychology, UiT The Artic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital North Norway, Tromsø, Norway
| | - Stein Harald Johnsen
- Department of Neurology, University Hospital North Norway, Tromsø, Norway
- Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Artic University of Norway, Tromsø, Norway
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Smirni D, Oliveri M, Misuraca E, Catania A, Vernuccio L, Picciolo V, Inzerillo F, Barbagallo M, Cipolotti L, Turriziani P. Verbal Fluency in Mild Alzheimer's Disease: Transcranial Direct Current Stimulation over the Dorsolateral Prefrontal Cortex. J Alzheimers Dis 2021; 81:1273-1283. [PMID: 33935089 DOI: 10.3233/jad-210003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recent studies showed that in healthy controls and in aphasic patients, inhibitory trains of repetitive transcranial magnetic stimulation (rTMS) over the right prefrontal cortex can improve phonemic fluency performance, while anodal transcranial direct current stimulation (tDCS) over the left prefrontal cortex can improve performance in naming and semantic fluency tasks. OBJECTIVE This study aimed at investigating the effects of cathodal tDCS over the left or the right dorsolateral prefrontal cortex (DLPFC) on verbal fluency tasks (VFT) in patients with mild Alzheimer's disease (AD). METHODS Forty mild AD patients participated in the study (mean age 73.17±5.61 years). All participants underwent cognitive baseline tasks and a VFT twice. Twenty patients randomly received cathodal tDCS to the left or the right DLPFC, and twenty patients were assigned to a control group in which only the two measures of VFT were taken, without the administration of the tDCS. RESULTS A significant improvement of performance on the VFT in AD patients was present after tDCS over the right DLPFC (p = 0.001). Instead, no difference was detected between the two VFTs sessions after tDCS over the left DLPFC (p = 0.42). Furthermore, these results cannot be related to task learning effects, since no significant difference was found between the two VFT sessions in the control group (p = 0.73). CONCLUSION These data suggest that tDCS over DLPFC can improve VFT performance in AD patients. A hypothesis is that tDCS enhances adaptive patterns of brain activity between functionally connected areas.
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Affiliation(s)
- Daniela Smirni
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.,NeuroTeam Life and Science, Palermo, Italy
| | - Massimiliano Oliveri
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.,NeuroTeam Life and Science, Palermo, Italy
| | | | | | - Laura Vernuccio
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Valentina Picciolo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Flora Inzerillo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Lisa Cipolotti
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Patrizia Turriziani
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.,NeuroTeam Life and Science, Palermo, Italy
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Abstract
This study aims to explore a little investigated topic, i.e., whether the presence of the APOE eɛ4 allele in patients with a diagnosis of mild Alzheimer’s disease (AD) can influence financial capacity. Twenty-eight elders with mild AD carrying the APOEɛ4 allele and 28 matched non-carrier patients were examined with an extensive battery of neuropsychological tests, and a specific test measuring financial capacity: Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). The presence of the APOEɛ4 allele does not differentiate the group of mild AD patients regarding a number of cognitive domains necessary for financial capacity scores as measured by LCPLTAS.
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Affiliation(s)
- Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Epelbaum S, Paquet C, Hugon J, Dumurgier J, Wallon D, Hannequin D, Jonveaux T, Besozzi A, Pouponneau S, Hommet C, Blanc F, Berly L, Julian A, Paccalin M, Pasquier F, Bellet J, Boutoleau-Bretonniere C, Charriau T, Rouaud O, Madec O, Mouton A, David R, Bekadar S, Fabre R, Liegey E, Deberdt W, Robert P, Dubois B. How many patients are eligible for disease-modifying treatment in Alzheimer's disease? A French national observational study over 5 years. BMJ Open 2019; 9:e029663. [PMID: 31239309 PMCID: PMC6597622 DOI: 10.1136/bmjopen-2019-029663] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE We aimed to study the epidemiology of the prodromal and mild stages of Alzheimer's disease (AD) patients who are eligible for clinical trials with disease-modifying therapies. SETTINGS We analysed two large complementary databases to study the incidence and characteristics of this population on a nationwide scope in France from 2014 to 2018. The National Alzheimer Database contains data from 357 memory centres and 90 private neurologists. Data from 2014 to 2018 have been analysed. PARTICIPANTS Patients, 50-85 years old, diagnosed with AD who had an Mini-Mental State Exam (MMSE) score of ≥20 were included. We excluded patients with mixed and non-AD neurocognitive disorders. PRIMARY OUTCOME MEASURE Descriptive statistics of the population of interest was the primary measure. RESULTS In the National Alzheimer Database, 550 198 patients were assessed. Among them, 72 174 (13.1%) were diagnosed with AD and had an MMSE ≥20. Using corrections for specificity of clinical diagnosis of AD, we estimated that about 50 000 (9.1%) had a prodromal or mild AD. In the combined electronic clinical records database of 11 French expert memory centres, a diagnosis of prodromal or mild AD, certified by the use of cerebrospinal fluid AD biomarkers, could be established in 195 (1.3%) out of 14 596 patients. CONCLUSIONS AD was not frequently diagnosed at a prodromal or mild dementia stage in France in 2014 to 2018. Diagnosis rarely relied on a pathophysiological marker even in expert memory centres. National databases will be valuable to monitor early stage AD diagnosis efficacy in memory centres when a disease-modifying treatment becomes available.
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Affiliation(s)
- Stéphane Epelbaum
- Institute of Memoryand Alzheimer’s Disease (IM2A) and Brain and Spine Institute(ICM) UMR S 1127, Inria, Aramis-Project Team, Department of Neurology, AP-HP, Pitié-Salpêtrière University Hospital, Sorbonne Universities, Pierre et Marie Curie University, Paris 06 and National Reference Center for Rare or Early Dementias and Center of Excellence of Neurodegenerative Disease (CoEN), Paris, France
| | - Claire Paquet
- Neurology Memory Center, Lariboisière FW Saint Louis University Hospital, Paris, France
| | - Jacques Hugon
- Center of Cognitive Neurology, Groupe hospitalier Lariboisiere Fernand-Widal, Paris, France
- Cognitive Neurology Center, CMRR Paris-Nord Ile-de-France, Groupe hospitalier Lariboisiere Fernand-Widal, Paris, France
| | - Julien Dumurgier
- Cognitive Neurology Center, CMRR Paris-Nord Ile-de-France, Groupe hospitalier Lariboisiere Fernand-Widal, Paris, France
- U942 Team Biomarkers and Neurocognition, INSERM/Université Paris Diderot, Paris, France
| | - David Wallon
- Department of Neurology, Rouen University Hospital, Rouen, France
| | | | | | | | | | | | - Frederic Blanc
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | | | | | - Marc Paccalin
- Geriatrics Department University Hospital La Milétrie, Poitiers, France
| | - Florence Pasquier
- Neurology, Centre Hospitalier Regional et Universitaire de Lille (CHRU- LILLE), Lille, France
| | - Julie Bellet
- Neurology, Centre Hospitalier Regional Universitaire de Lille Pole Neurosciences et Appareil Locomoteur, Lille, France
| | | | | | | | | | - Aurélie Mouton
- Department of Neuropsychiatry, CHU de nice, Nice, France
| | - Renaud David
- Centre Mémoire de Ressources et de Recherche, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Samir Bekadar
- Department of Clinical Research, Institut du cerveau et de la moelle epiniere, Paris, France
| | - Roxane Fabre
- Department of Neuropsychiatry, CHU de nice, Nice, France
| | - Emmanuelle Liegey
- Délégation à la Recherche Clinique et à l’Innovation, Assistance publique–Hôpitaux de Paris, Paris, France
| | - Walter Deberdt
- Medical Department, Eli Lilly and Co, Indianapolis, Indiana, USA
| | | | - Bruno Dubois
- Neurology, CHU de la Pitiè Salpêtrière-AP-HP, Paris, France
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Valotassiou V, Papatriantafyllou J, Sifakis N, Tzavara C, Tsougos I, Psimadas D, Fezoulidis I, Kapsalaki E, Hadjigeorgiou G, Georgoulias P. Clinical Evaluation of Brain Perfusion SPECT with Brodmann Areas Mapping in Early Diagnosis of Alzheimer's Disease. J Alzheimers Dis 2016; 47:773-85. [PMID: 26401711 DOI: 10.3233/jad-150068] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Early diagnosis of Alzheimer's disease (AD) based on clinical criteria alone may be problematic, while current and future treatments should be administered earlier in order to be more effective. Thus, various disease biomarkers could be used for early detection of AD. We evaluated brain perfusion with 99mTc-HMPAO single photon emission computed tomography (SPECT) and Brodmann areas (BAs) mapping in mild AD using an automated software (NeuroGam) for the semi-quantitative evaluation of perfusion in BAs and the comparison with the software's normal database. We studied 34 consecutive patients with mild AD: 9 men, 25 women, mean age 70.9 ± 8.1 years, mean Mini-Mental State Examination 22.6 ± 2.5. BAs 25L, 25R, 38L, 38R, 28L, 28R, 36L, and 36R had the lower mean perfusion values, while BAs 31L, 31R, 19R, 18L, 18R, 17L, and 17R had the higher mean values. Compared with healthy subjects of the same age, perfusion values in BAs 25L, 25R, 28R, 28L, 36L, and 36R had the greatest deviations from the healthy sample, while the lowest deviations were found in BAs 32L, 32R, 19R, 24L, 17L, 17R, 18L, and 18R. A percentage of ≥94% of patients had perfusion values more than -2SDs below the mean of healthy subjects in BAs 38R, 38L, 36L, 36R, 23L, 23R, 22L, 44L, 28L, 28R, 25L, and 25R. The corresponding proportion was less than 38% for BAs 11L, 19R, 32L, 32R, 18L, 18R, 24L, and 17R. In conclusion, brain SPECT studies with automated perfusion mapping could be useful as an ancillary tool in daily practice, revealing perfusion impairments in early AD.
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Affiliation(s)
- Varvara Valotassiou
- Department of Nuclear Medicine, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - John Papatriantafyllou
- Memory & Cognitive Disorders Clinic, Department of Neurology, "G.Gennimatas" Hospital, Athens, Greece
| | - Nikolaos Sifakis
- Department of Nuclear Medicine, "Alexandra" University Hospital, Athens, Greece
| | - Chara Tzavara
- Department of Nuclear Medicine, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Ioannis Tsougos
- Department of Nuclear Medicine, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Dimitrios Psimadas
- Department of Nuclear Medicine, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Ioannis Fezoulidis
- Department of Radiology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Eftychia Kapsalaki
- Department of Radiology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - George Hadjigeorgiou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Panagiotis Georgoulias
- Department of Nuclear Medicine, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
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