Low-Level Visual Features of Window Views Contribute to Perceived Naturalness and Mental Health Outcomes.

Previous studies have shown that natural window views are beneficial for mental health, but it is still unclear which specific features constitute a 'natural' window view. On the other hand, studies on image analysis found that low-level visual features (LLVFs) are associated with perceived naturalness, but mainly conducted experiments with brief stimulus presentations. In this study, research on the effects of window views on mental health was combined with the detailed analysis of LLVFs. Healthy adults rated window views from their home and sent in photographs of those views for analysis. Content validity of the 'ecological' view assessment was evaluated by checking correlations of LLVFs with window view ratings. Afterwards, it was explored which of the LLVFs best explained variance in perceived percentage of nature and man-made elements, and in ratings of view quality. Criterion validity was tested by investigating which variables were associated with negative affect and impulsive decision-making. The objective and subjective assessments of nature/sky in the view were aligned but objective brightness was unreliable. The perceived percentage of nature was significantly explained by green pixel ratio, while view quality was associated with fractals, saturation, sky pixel ratio and straight edge density. The higher subjective brightness of rooms was associated with a lower negative affect, whereas results for impulsive decision-making were inconsistent. The research highlights the validity to apply LLVFs analysis to ecological window views. For affect, subjective brightness seemed to be more relevant than LLVFs. For impulsive decision-making, performance context needs to be controlled in future studies.

How emotional contexts modulate item memory in individuals with high and low negative affect and worry.

Emotional stimuli are usually remembered with high confidence. Yet, it remains unknown whether-in addition to memory for the emotional stimulus itself-memory for a neutral stimulus encountered just after an emotional one can be enhanced. Further, little is known about the interplay between emotion elicited by a stimulus and emotion relating to affective dispositions. To address these questions, we examined (1) how emotional valence and arousal of a context image preceding a neutral item image affect memory of the item, and (2) how such memory modulation is affected by two hallmark features of emotional disorders: trait negative affect and tendency to worry. In two experiments, participants encoded a series of trials in which an emotional (negative, neutral, or positive) context image was followed by a neutral item image. In experiment 1 (n = 42), items presented seconds after negative context images were remembered better and with greater confidence compared to those presented after neutral and positive ones. Arousal ratings of negative context images were higher compared to neutral and positive ones and the likelihood of correctly recognizing an item image was related to higher arousal of the context image. In experiment 2 (n = 59), better item memory was related to lower trait negative affect. Participants with lower trait negative affect or tendency to worry displayed higher confidence compared to those with high negative affect or tendency to worry. Our findings describe an emotional "carry-over" effect elicited by a context image that enhances subsequent item memory on a trial-by-trial basis, however, not in individuals with high trait negative affect who seem to have a general memory disadvantage.

Randomized Controlled Trial on Imaginal Retraining for Problematic Alcohol Use: A Dismantling Study.

Imaginal retraining (IR) is an approach-avoidance procedure that has shown promising results in previous studies. The aim of the present study was to dismantle the efficacy of IR's components in a randomized controlled trial (RCT). We conducted a RCT with nine conditions comprising eight intervention groups and a waitlist control group (WLC). Alcohol craving (primary outcome), consumption, depressive symptoms, quality of life, subjective appraisal, and side effects were assessed online at baseline, post intervention (6 weeks), and follow-up (12 weeks). The sample consisted of 426 participants (age: M = 47.22, SD = 11.82, women: 50.5%). The intervention groups received instructions for four different components of IR (mood induction, mental avoidance of unhealthy stimuli, motor avoidance of unhealthy stimuli, approach to healthy stimuli) that were each conveyed with or without prior psychoeducation (PE). The intervention was delivered online. At total of 163 individuals (42.9%) used the intervention at least once. No group differences were found for any primary or secondary outcome after Sidák correction. Uncorrected statistics showed effects of significantly decreased alcohol consumption for the approach + PE group in the intention-to-treat and the merged motor avoidance group in the per-protocol analyses at post assessment compared with the WLC. Exploratory moderation analyses revealed that individuals with high visualization skills benefited most. The authors conclude that visualization training and motivational components may increase the efficacy and adherence of IR.

Videogame training increases clinical well-being, attention and hippocampal-prefrontal functional connectivity in patients with schizophrenia.

Recent research shows that videogame training enhances neuronal plasticity and cognitive improvements in healthy individuals. As patients with schizophrenia exhibit reduced neuronal plasticity linked to cognitive deficits and symptoms, we investigated whether videogame-related cognitive improvements and plasticity changes extend to this population. In a training study, patients with schizophrenia and healthy controls were randomly assigned to 3D or 2D platformer videogame training or E-book reading (active control) for 8 weeks, 30 min daily. After training, both videogame conditions showed significant increases in sustained attention compared to the control condition, correlated with increased functional connectivity in a hippocampal-prefrontal network. Notably, patients trained with videogames mostly improved in negative symptoms, general psychopathology, and perceived mental health recovery. Videogames, incorporating initiative, goal setting and gratification, offer a training approach closer to real life than current psychiatric treatments. Our results provide initial evidence that they may represent a possible adjunct therapeutic intervention for complex mental disorders.

Spatial characteristics of non-communicable diseases and their associations to social conditions in a large urban cohort in Germany-Results from the Hamburg City Health Study.

BACKGROUND: Non-communicable diseases (NCDs) are responsible for many deaths. They are associated with several modifiable and metabolic risk factors and are therefore prone to significant regional variations on different scales. However, only few intra-urban studies examined spatial variation in NCDs and its association with social circumstances, especially in Germany. Thus, the present study aimed to identify associations of personal risk factors and local social conditions with NCDs in a large German city. METHODS: This study is based on a population-based cohort of the Hamburg City Health Study including 10,000 probands. Six NCDs were analyzed (chronic obstructive pulmonary disease [COPD], coronary heart disease [CHD], diabetes mellitus, heart failure, depression, and hypertension) in 68 city district clusters. As risk factors, we considered socio-demographic variables (age, sex, education) and risk behaviour variables (smoking, alcohol consumption). Logistic regression analyses identified associations between the district clusters and the prevalence rates for each NCD. Regional variation was detected by Gini coefficients and spatial cluster analyses. Local social condition indexes were correlated with prevalence rates of NCDs on city district level and hot-spot analyses were performed for significant high or low values. RESULTS: The analyses included 7,308 participants with a mean age of 63.1 years (51.5% female). The prevalence of hypertension (67.6%) was the highest. Risk factor associations were identified between smoking, alcohol consumption and education and the prevalence of NCDs (hypertension, diabetes, and COPD). Significant regional variations were detected and persisted after adjusting for personal risk factors. Correlations for prevalence rates with the local social conditions were significant for hypertension (r = 0.294, p < 0.02), diabetes (r = 0.259, p = 0.03), and COPD (r = 0.360, p < 0.01). CONCLUSIONS: The study shows that regional differences in NCD prevalence persist even after adjusting for personal risk factors. This highlights the central role of both personal socio-economic status and behaviors such as alcohol and tobacco consumption. It also highlights the importance of other potential regional factors (e.g. the environment) in shaping NCD prevalence. This knowledge helps policy- and decision-makers to develop intervention strategies.

Deficits in memory metacognitive efficiency in late adulthood are related to distinct brain profile.

The tendency of falsely remembering events that did not happen in the past increases with age. This is particularly evident in cases in which features presented at study are re-presented at test in a recombined constellation (termed rearranged pairs). Interestingly, older adults also express high confidence in such false memories, a tendency that may indicate reduced metacognitive efficiency. Within an existing cohort study, we aimed at investigating age-related differences in memory metacognitive efficiency (as measured by meta d' ratio) in a sample of 1522 older adults and 397 young adults. The analysis showed an age-related deficit in metacognition which was more pronounced for rearranged pairs than for new pairs. We then explored associations between cortical thickness and memory metacognitive efficiency for rearranged pairs in a subsample of 231 older adults. By using partial least square analysis, we found that a multivariate profile composed by ventromedial prefrontal cortex, insula, and parahippocampal cortex was uniquely associated with between-person differences in memory metacognitive efficiency. These results suggest that the impairment in memory metacognitive efficiency for false alarms is a distinct age-related deficit, above and beyond a general age-related decline in memory discrimination, and that it is associated with brain regions involved in metacognitive processes.

A latent clinical-anatomical dimension relating metabolic syndrome to brain structure and cognition.

The link between metabolic syndrome (MetS) and neurodegenerative as well as cerebrovascular conditions holds substantial implications for brain health in at-risk populations. This study elucidates the complex relationship between MetS and brain health by conducting a comprehensive examination of cardiometabolic risk factors, brain morphology, and cognitive function in 40,087 individuals. Multivariate, data-driven statistics identified a latent dimension linking more severe MetS to widespread brain morphological abnormalities, accounting for up to 71% of shared variance in the data. This dimension was replicable across sub-samples. In a mediation analysis, we could demonstrate that MetS-related brain morphological abnormalities mediated the link between MetS severity and cognitive performance in multiple domains. Employing imaging transcriptomics and connectomics, our results also suggest that MetS-related morphological abnormalities are linked to the regional cellular composition and macroscopic brain network organization. By leveraging extensive, multi-domain data combined with a dimensional stratification approach, our analysis provides profound insights into the association of MetS and brain health. These findings can inform effective therapeutic and risk mitigation strategies aimed at maintaining brain integrity.

Neural correlates of an illusionary sense of agency caused by virtual reality.

Sense of agency (SoA) is the sensation that self-actions lead to ensuing perceptual consequences. The prospective mechanism emphasizes that SoA arises from motor prediction and its comparison with actual action outcomes, while the reconstructive mechanism stresses that SoA emerges from retrospective causal processing about the action outcomes. Consistent with the prospective mechanism, motor planning regions were identified by neuroimaging studies using the temporal binding (TB) effect, a behavioral measure often linked to implicit SoA. Yet, TB also occurs during passive observation of another's action, lending support to the reconstructive mechanism, but its neural correlates remain unexplored. Here, we employed virtual reality (VR) to modulate such observation-based SoA and examined it with functional magnetic resonance imaging (fMRI). After manipulating an avatar hand in VR, participants passively observed an avatar's "action" and showed a significant increase in TB. The binding effect was associated with the right angular gyrus and inferior parietal lobule, which are critical nodes for inferential and agency processing. These results suggest that the experience of controlling an avatar may potentiate inferential processing within the right inferior parietal cortex and give rise to the illusionary SoA without voluntary action.

Subjective evaluation of home environment and levels of self-reported depression in middle to old age: Results from the HCHS study.

OBJECTIVES: The immediate living environment might, like other lifestyle factors, be significantly related to mental well-being. The current study addresses the question whether five relevant subjective home environment variables (i.e., protection from disturbing nightlight, daylight entering the home, safety at home, quality of window views, and noise disturbance) are associated with levels of self-reported depression over and above well-known sociodemographic and common lifestyle variables. METHODS: Data from the Hamburg City Health Study (HCHS) were analyzed. In N = 8757 with available PHQ-9 depression data, multiple linear regression models were computed, with demographic data, lifestyle variables, and variables describing the subjective evaluation of the home environment. RESULTS: The model explained 15% of variance in depression levels, with ratings for the subjective evaluation of home environment accounting for 6%. Better protection from disturbing light at night, more daylight entering the home, feeling safer, and perceived quality of the window views, were all significantly associated with lower, while more annoyance by noise was associated with higher levels of self-reported depression. Results did not differ if examining a sample of the youngest (middle-aged participants: 46-50 years) versus oldest (70-78 years) participants within HCHS. CONCLUSION: Beyond studying the role of lifestyle factors related to self-reported depression, people's homes may be important for subclinical levels of depression in middle and older age, albeit the direction of effects or causality cannot be inferred from the present study. The development of a consensus and tools for a standardized home environment assessment is needed.

Grey-matter structure in cortical and limbic regions correlates with general cognitive ability in old age.

According to the maintenance hypothesis (Nyberg et al., 2012), structural integrity of the brain's grey matter helps to preserve cognitive functioning into old age. A corollary of this hypothesis that can be tested in cross-sectional data is that grey-matter structural integrity and general cognitive ability are positively associated in old age. Building on Köhncke et al. (2021), who found that region-specific latent factors of grey-matter integrity are positively associated with episodic memory ability among older adults, we examine associations between general factors of grey-matter integrity and a general factor of cognitive ability in a cross-sectional sample of 1466 participants aged 60-88 years, 319 of whom contributed imaging data. Indicator variables based on T1-weighted images (voxel-based morphometry, VBM), magnetization-transfer imaging (MT), and diffusion tensor imaging-derived mean diffusivity (MD) had sufficient portions of variance in common to establish latent factors of grey-matter structure for a comprehensive set of regions of interest (ROI). Individual differences in grey-matter factors were positively correlated across neocortical and limbic areas, allowing for the definition of second-order, general factors for neocortical and limbic ROI, respectively. Both general grey-matter factors were positively correlated with general cognitive ability. For the basal ganglia, the three modality-specific indicators showed heterogenous loading patterns, and no reliable associations of the general grey-matter factor to general cognitive ability were found. To provide more direct tests of the maintenance hypothesis, we recommend applying the present structural modeling approach to longitudinal data, thereby enhancing the physiological validity of latent constructs of brain structure.

Impact of exposure to natural versus urban soundscapes on brain functional connectivity, BOLD entropy and behavior.

BACKGROUND: Humans have been moving from rural to urban environments for decades. This process may have important consequences for our health and well-being. Most previous studies have focused on visual input, and the auditory domain has been understudied so far. Therefore, we set out to investigate the influence of exposure to natural vs urban soundscapes on brain activity and behavior. METHODS: Resting-state fMRI data was acquired while participants (N = 35) listened to natural and urban soundscapes. Two affective questionnaires (the Positive and Negative Affect Schedule (PANAS) and the Perceived Stress Scale) and two cognitive tasks (dual n-back (DNB) and the backward digit-span (BDS)) were assessed before and after each soundscape condition. To quantify brain function we used complexity and network measures, namely brain entropy (BEN) and whole brain functional connectivity (FC). To study the link between brain and behavior, changes in BEN and whole brain FC were correlated to changes in cognitive performance and self-reported affect. RESULTS: We found higher BEN when listening to urban sounds in posterior cingulate gyrus, cuneus and precuneus, occipital lobe/calcarine as compared to nature sounds, which was negatively correlated to (post-pre) differences in positive affect (PANAS) in the urban soundscape condition. In addition, we found higher FC between areas in the auditory, cinguloopercular, somatomotor hand and mouth networks when listening to nature as compared to urban sounds which was positively correlated to (post-pre) differences of the of the composite score of Digit span and N-back for nature soundscape. CONCLUSIONS: This study provides a framework for the neural underpinnings of how natural versus urban soundscapes affect both whole brain FC and BEN and bear implications for the understanding of how the physical auditory environment affects brain function and subsequently observed behavior. Moreover, correlations with cognition and affect reveal the meaning that exposure to soundscapes may have on the human brain. To the best of our knowledge this is the first study to analyze BEN and whole brain FC at rest during exposure to nature and urban soundscapes and to explore their relationship to behavior.

Resting-state functional connectivity in an auditory network differs between aspiring professional and amateur musicians and correlates with performance.

Auditory experience-dependent plasticity is often studied in the domain of musical expertise. Available evidence suggests that years of musical practice are associated with structural and functional changes in auditory cortex and related brain regions. Resting-state functional magnetic resonance imaging (MRI) can be used to investigate neural correlates of musical training and expertise beyond specific task influences. Here, we compared two groups of musicians with varying expertise: 24 aspiring professional musicians preparing for their entrance exam at Universities of Arts versus 17 amateur musicians without any such aspirations but who also performed music on a regular basis. We used an interval recognition task to define task-relevant brain regions and computed functional connectivity and graph-theoretical measures in this network on separately acquired resting-state data. Aspiring professionals performed significantly better on all behavioral indicators including interval recognition and also showed significantly greater network strength and global efficiency than amateur musicians. Critically, both average network strength and global efficiency were correlated with interval recognition task performance assessed in the scanner, and with an additional measure of interval identification ability. These findings demonstrate that task-informed resting-state fMRI can capture connectivity differences that correspond to expertise-related differences in behavior.

Cognitive Deficits in Executive and Language Functions Predict Postoperative Delirium.

OBJECTIVES: Postoperative delirium (POD) remains the most common complication in older adults, with cognitive impairment being the main risk factor. Patients with mild cognitive impairment, in particular, have much to lose from delirium; despite this, their cognitive impairment might be clinically overlooked. Understanding which cognitive domains are particularly predictive in this regard may improve the sensitivity of preoperative testing and allow for a more targeted application of resource-intensive measures to prevent delirium in the perioperative period. The authors conducted this study with the aim of identifying the most indicative cognitive domains. DESIGN: A secondary analysis of a randomized controlled trial. SETTING: At a single center, the University Medical Centre Hamburg in Hamburg, Germany. PARTICIPANTS: Patients ≥60 years without major neurocognitive disorders (dementia, Mini-Mental State Examination score ≤23) scheduled for cardiovascular surgery. MEASUREMENTS AND MAIN RESULTS: Preoperative neuropsychologic testing and delirium screening were performed twice daily until postoperative day 5. A multiple logistic regression model was applied to determine the predictive ability of test performances for the development of delirium. RESULTS: A total of 541 patients were included in the analysis; the delirium rate was 15.6%. After controlling for confounders, only low performance within the Trail Making Test B/A (odds ratio [OR] = 1.32; 95% CI: 1.05-1.66) and letter fluency (OR = 0.66; 95% CI: 0.45-0.96) predicted a particularly high risk for delirium development. The discriminative ability of the final multiple logistic regression model to predict POD had an area under the curve of 0.786. CONCLUSIONS: Impairment in the cognitive domains of executive function and language skills associated with memory, inhibition, and access speed seem to be particularly associated with the development of delirium after surgery in adults ≥65 years of age without apparent preoperative neurocognitive impairment.

Association between periodontitis and depression severity - A cross-sectional study of the older population in Hamburg.

The aim of the current study is to investigate the association between periodontitis (exposure variable) and depression severity (outcome variable) in an older German population. We evaluated data from 6,209 participants (median age 62 years) of the Hamburg City Health Study (HCHS). The HCHS is a prospective cohort study and is registered at ClinicalTrial.gov (NCT03934957). Depression severity were assessed with the 9-item Patient Health Questionnaire (PHQ-9). Periodontal examination included probing depth, gingival recession, plaque index, and bleeding on probing. Descriptive analyses were stratified by periodontitis severity. Multiple linear regression models were adjusted for age, sex, diabetes, education, smoking, and antidepressant medication. Linear regression analyses revealed a significant association between log-transformed depression severity and periodontitis when including the interaction term for periodontitis * age, even after adjusting for age, sex, diabetes, education, smoking and antidepressant medication. We identified a significant association between severe periodontitis and elevated depression severity, which interacts with age. Additionally, we performed a linear regression model for biomarker analyses, which revealed significant associations between depression severity and severe periodontitis with log-transformed inflammatory biomarkers interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hsCRP). In order to identify new therapeutic strategies for patients with depression and periodontal disease, future prospective studies are needed to assess the physiological and psychosocial mechanisms behind this relationship and the causal directionality.

No phenotypic or genotypic evidence for a link between sleep duration and brain atrophy.

Short sleep is held to cause poorer brain health, but is short sleep associated with higher rates of brain structural decline? Analysing 8,153 longitudinal MRIs from 3,893 healthy adults, we found no evidence for an association between sleep duration and brain atrophy. In contrast, cross-sectional analyses (51,295 observations) showed inverse U-shaped relationships, where a duration of 6.5 (95% confidence interval, (5.7, 7.3)) hours was associated with the thickest cortex and largest volumes relative to intracranial volume. This fits converging evidence from research on mortality, health and cognition that points to roughly seven hours being associated with good health. Genome-wide association analyses suggested that genes associated with longer sleep for below-average sleepers were linked to shorter sleep for above-average sleepers. Mendelian randomization did not yield evidence for causal impacts of sleep on brain structure. The combined results challenge the notion that habitual short sleep causes brain atrophy, suggesting that normal brains promote adequate sleep duration-which is shorter than current recommendations.

Transferring the approach avoidance task into virtual reality: a study in patients with alcohol use disorder versus healthy controls.

Study aims were to (I) transfer the measurement of the approach bias (Apb) related to alcoholic stimuli via the Approach Avoidance Task (AAT) into Virtual Reality (VR), (II) check whether measuring Apb in VR leads to similar or different results compared to the classical PC-based version, (III) check the validity of VR versus PC-based bias scores in terms of relatedness to clinical variables. Different 'grasping-conditions' were tested and contrasted in VR concerning (Ia) feasibility (performance): (1) never grasp, (2) always grasp, (3) grasp when PULLing stimuli towards oneself. (Ib) Differences in the bias scores between patients with alcohol use disorder (AUD) and healthy controls (HC) were examined for each grasping-condition. (II) PC-based bias scores were computed and contrasted for AUD versus HC. (III) Correlations of the different VR- versus PC-based bias scores with AUD symptom severity and impulsivity were checked to evaluate validity. (Ia) Grasping-condition 1, followed by 3, showed acceptable (> 50%) and good (> 80%) rates of correct performances allowing for robust median estimation. (Ib) Significant differences in the resulting bias scores emerged between AUD and HC only for grasping-condition 1 (p = 0.034) and 3 at trend-level (p = 0.093). For grasping-condition 1 the Apb Median for AUD was different from zero at a non-significant trend-level (p = 0.064). (II) The PC-based bias scores did not discriminate between AUD versus HC groups. (III) Grasping-condition 1 and 3 VR-based bias scores correlated significantly with impulsivity. In sum, transferring the AAT into VR is feasible, valid, and best implemented without an additional grasping-component when using the VR-controller. This way of Apb assessment represents a viable, perhaps even superior, alternative to PC-based assessments. Trial registration The trial was pre-registered at AsPredicted #76854: 'Transferring the approach avoidance task into virtual reality', 10/13/2021; prior to any analyses being undertaken.

The effects of assessing character strengths vs. psychopathology on mood, hope, perceived stigma and cognitive performance in individuals with psychosis.

OBJECTIVES: The main objective of the present study was to investigate whether assessments of psychopathology vs. character strengths were associated with systematic differences concerning transient psychological states (i.e., cognitive performance, state mood, optimism, therapy motivation, perceived stigma) in individuals with psychotic disorders. An additional goal was to evaluate the acceptance and appraisal of a subsequent online character-strength intervention, consisting of top-two strengths feedback, and to explore associations between character strengths and psychotic symptoms. The study thus aimed to contribute to the discussion on the extension of current treatment approaches for schizophrenia through positive psychological interventions. METHODS: The study was implemented online applying a randomized within-subject cross-over design in N = 39 patients with self-reported psychosis. After a baseline assessment, briefly capturing psychological states (including cognition: TMT A/B, positive and negative affect, motivation for change/ therapy, optimism, and self-stigma) participants were randomly assigned to a first questionnaire block, which addressed either individual character strengths (VIA-IS) or psychopathology (CAPE & BSI). This was followed by a second, brief assessment of transient psychological states, whereafter the second questionnaire block was conducted, this time with the respective opposite (strengths or psychopathology) assessment. A final psychological states assessment was conducted. Afterwards, participants received feedback on their top-two strengths and a brief psycho-education, followed by a qualitative assessment. RESULTS: Contrary to expectations, there were no differences between the psychological states after the pathology vs. character strengths assessment blocks. Character strengths mainly correlated negatively with negative symptoms, with medium to large effect sizes. Participants were generally satisfied with the intervention and rated a focus on personal strengths in psychotherapy as highly important. CONCLUSION: Our main hypothesis stating that the assessment of character strengths (vs. psychopathology) is associated with differences in subsequent psychological states could not be confirmed. Qualitative findings indicate that the emphasis on individual character strengths interventions is well accepted and viewed as important. The associations of character strengths with negative symptoms are important from the background of the cognitive model or defeatist beliefs (e.g., amotivation due to perceiving the self as 'incapable'), which could be addressed in experimental or intervention studies targeting character strengths.

The integrity of dopaminergic and noradrenergic brain regions is associated with different aspects of late-life memory performance.

Changes in dopaminergic neuromodulation play a key role in adult memory decline. Recent research has also implicated noradrenaline in shaping late-life memory. However, it is unclear whether these two neuromodulators have distinct roles in age-related cognitive changes. Here, combining longitudinal MRI of the dopaminergic substantia nigra-ventral tegmental area (SN-VTA) and noradrenergic locus coeruleus (LC) in younger (n = 69) and older (n = 251) adults, we found that dopaminergic and noradrenergic integrity are differentially associated with memory performance. While LC integrity was related to better episodic memory across several tasks, SN-VTA integrity was linked to working memory. Longitudinally, we found that older age was associated with more negative change in SN-VTA and LC integrity. Notably, changes in LC integrity reliably predicted future episodic memory. These differential associations of dopaminergic and noradrenergic nuclei with late-life cognitive decline have potential clinical utility, given their degeneration in several age-associated diseases.

Association between periodontal disease and microstructural brain alterations in the Hamburg City Health Study.

AIM: The aim of the PAROBRAIN study was to examine the association of periodontal health with microstructural white matter integrity and cerebral small vessel disease (CSVD) in the Hamburg City Health Study, a large population-based cohort with dental examination and brain magnetic resonance imaging (MRI). MATERIALS AND METHODS: Periodontal health was determined by measuring clinical attachment loss (CAL) and plaque index. Additionally, the decayed/missing/filled teeth (DMFT) index was quantified. 3D-FLAIR and 3D-T1-weighted images were used for white matter hyperintensity (WMH) segmentation. Diffusion-weighted MRI was used to quantify peak width of skeletonized mean diffusivity (PSMD). RESULTS: Data from 2030 participants were included in the analysis. Median age was 65 years, with 43% female participants. After adjusting for age and sex, an increase in WMH load was significantly associated with more CAL, higher plaque index and higher DMFT index. PSMD was significantly associated with the plaque index and DMFT. Additional adjustment for education and cardiovascular risk factors revealed a significant association of PSMD with plaque index (p < .001) and DMFT (p < .01), whereas effects of WMH load were attenuated (p > .05). CONCLUSIONS: These findings suggest an adverse effect of periodontal health on CSVD and white matter integrity. Further research is necessary to examine whether early treatment of periodontal disease can prevent microstructural brain damage.