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1.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1096-1099, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018177

RESUMO

Simultaneously resting brain glucose metabolism and intrinsic functional activity, by integrated PET/MRI scans, both reflect nerve actions. Studies showed that there existed relevance between two phenotypes of neuros in normal human brains. However, whether the relevance will change in cognitive dysfunction (CD) brains is still unknown. The aim of this study therefore is to explore the relevance between voxel-wise glucose metabolism and functional connectivity in Chinese CD people. The dataset in this study included two imaging modalities and clinical information of 21 healthy control (HC) individuals and 15 CD patients, from Xuanwu hospital, Beijing, China. Firstly, we calculated the standardized uptake value rate (SUVR) from positron emission tomography (PET), and three parameters for intrinsic functional activity from functional magnetic resonance imaging (fMRI), including amplitude of low frequency fluctuations (ALFF), fractional amplitude of low frequency fluctuations (fALFF) and regional homogeneity (ReHo). Second, the two sample t-test was used to compare each parameter between HC and CD groups respectively. Third, the relevance between SUVR and the three fMRI parameters were measured by Spearman's rank correlation. The results of t-test showed that glucose metabolism consumption decreased in Default Mode Network (DMN) (p < 0.01), and the damage of functional connection also happened DMN area in CD group. The correlation between glucose metabolism and functional activity in CD group was lower than that in HC group in DMN. Especially, the correlation between SUVR and ReHo was significantly reduced (p < 0.05). Above results promoted a deeper understanding on the pathogenesis of cognitive impairment, and providing new biomarkers to discriminate CD and HC subjects.


Assuntos
Disfunção Cognitiva , Tomografia por Emissão de Pósitrons , Encéfalo/diagnóstico por imagem , China , Disfunção Cognitiva/diagnóstico por imagem , Glucose , Humanos , Imagem por Ressonância Magnética
2.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1775-1778, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018342

RESUMO

Subjective cognitive decline (SCD) is the preclinical stage of Alzheimer's disease (AD). Abnormal brain glucose metabolism and Aß depositions can be observed in SCD subjects. Nevertheless, there was not cognitive impaired performance in standardized neuropsychological in these subjects. Cognitive reserve (CR) could be the reason to explain this phenomenon. However, correspondence between CR and SCD was still uncleared. In this study, we attained 74 subjects underwent 18FFDG PET scans (SCD1 group) and 38 patients underwent 18FAV45 PET scans (SCD2 group) from Xuanwu Hospital, Beijing, China. First, SCD1 group was divided into SCD1H (high CR, n=33, educational years>12) and SCD1L (low CR, n=41, educational years<=12) groups. The SCD2 group was divided into SCD2H (high CR, n=17, educational years>12) and SCD2L (low CR, n=21, educational years<=12) groups. Second, we calculated standardized uptake value rate (SUVR) values of 18FFDG PET and 18F-AV45 PET images in voxel-wise level. Third, the two-sample t-test between low and high CR groups was used to investigate the effects of CR. As a result, the SUVR values of FDG-PET images in SCD1H (0.89±0.11) were significant lower than SCD1L (0.96±0.13, p=0.017). The SUVR values of AV45PET images in SCD2H (0.63±0.11) were significant lower than SCD2L (0.78±0.15, p=0.001). In addition, the frontal lobe was found as the main area of hypometabolism and reduced AB depositions. As a conclusion, there are differential glucose metabolism and Aß deposition patterns in SCD subjects between low and high CR groups.


Assuntos
Disfunção Cognitiva , Reserva Cognitiva , Encéfalo/diagnóstico por imagem , China , Disfunção Cognitiva/diagnóstico por imagem , Glucose , Humanos
3.
Artigo em Russo | MEDLINE | ID: mdl-33081441

RESUMO

OBJECTIVE: To study the relationship between cognitive deficits and retinal neuroarchitectonics in Alzheimer's disease, vascular dementia, and glaucoma based on optical coherence tomography. MATERIAL AND METHODS: A comprehensive examination of 90 patients with Alzheimer's disease, vascular dementia and glaucoma was conducted. The patients were divided into three groups of 30 people each. The groups were comparable by gender and age and initial socio-economic status. All patients underwent a comprehensive neurological and neuropsychological study as well as optical coherence tomography. RESULTS AND CONCLUSION: The results of optical coherence tomography in Alzheimer's disease and glaucoma reveal retinal changes in the perifocal region in the upper and lower quadrants. In patients with vascular dementia, the process is observed in the foveal (central) region of the retina, which can be considered as a potential biomarker of the neurodegenerative damage. The severity of cognitive deficit in the Alzheimer's disease group correlates with the degree of degeneration in the layers of the peripapillary layer of the nerve fibers of the retina of the temporal region, the perifocal region of the lower quadrant of the retina, ganglion cells, and the inner plexiform layers of the retina. In the vascular dementia group, the severity of cognitive deficit positively correlates with the degree of cell degeneration in the foveal region of the inner plexiform retinal layer.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Doença de Alzheimer/complicações , Doença de Alzheimer/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Humanos , Fibras Nervosas , Retina/diagnóstico por imagem , Tomografia de Coerência Óptica
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5486-5489, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019221

RESUMO

The ability to accurately detect onset of dementia is important in the treatment of the disease. Clinically, the diagnosis of Alzheimer Disease (AD) and Mild Cognitive Impairment (MCI) patients are based on an integrated assessment of psychological tests and brain imaging such as positron emission tomography (PET) and anatomical magnetic resonance imaging (MRI). In this work using two different datasets, we propose a behavior score-embedded encoder network (BSEN) that integrates regularly adminstrated psychological tests information into the encoding procedure of representing subject's resting-state fMRI data for automatic classification tasks. BSEN is based on a 3D convolutional autoencoder structure with contrastive loss jointly optimized using behavior scores from Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). Our proposed classification framework of using BSEN achieved an overall recognition accuracy of 59.44% (3-class classification: AD, MCI and Healthy Control), and we further extracted the most discriminative regions between healthy control (HC) and AD patients.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Doença de Alzheimer/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X
5.
Lancet Neurol ; 19(10): 860-871, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32949546

RESUMO

Multiple sclerosis is a chronic, demyelinating disease of the CNS. Cognitive impairment is a sometimes neglected, yet common, sign and symptom with a profound effect on instrumental activities of daily living. The prevalence of cognitive impairment in multiple sclerosis varies across the lifespan and might be difficult to distinguish from other causes in older age. MRI studies show that widespread changes to brain networks contribute to cognitive dysfunction, and grey matter atrophy is an early sign of potential future cognitive decline. Neuropsychological research suggests that cognitive processing speed and episodic memory are the most frequently affected cognitive domains. Narrowing evaluation to these core areas permits brief, routine assessment in the clinical setting. Owing to its brevity, reliability, and sensitivity, the Symbol Digit Modalities Test, or its computer-based analogues, can be used to monitor episodes of acute disease activity. The Symbol Digit Modalities Test can also be used in clinical trials, and data increasingly show that cognitive processing speed and memory are amenable to cognitive training interventions.


Assuntos
Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/psicologia , Gerenciamento Clínico , Imagem por Ressonância Magnética/métodos , Esclerose Múltipla/diagnóstico por imagem , Esclerose Múltipla/psicologia , Adolescente , Idoso de 80 Anos ou mais , Disfunção Cognitiva/terapia , Feminino , Humanos , Esclerose Múltipla/terapia
6.
PLoS Comput Biol ; 16(9): e1008186, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32941425

RESUMO

Identifying heterogeneous cognitive impairment markers at an early stage is vital for Alzheimer's disease diagnosis. However, due to complex and uncertain brain connectivity features in the cognitive domains, it remains challenging to quantify functional brain connectomic changes during non-pharmacological interventions for amnestic mild cognitive impairment (aMCI) patients. We present a quantitative method for functional brain network analysis of fMRI data based on the multi-graph unsupervised Gaussian embedding method (MG2G). This neural network-based model can effectively learn low-dimensional Gaussian distributions from the original high-dimensional sparse functional brain networks, quantify uncertainties in link prediction, and discover the intrinsic dimensionality of brain networks. Using the Wasserstein distance to measure probabilistic changes, we discovered that brain regions in the default mode network and somatosensory/somatomotor hand, fronto-parietal task control, memory retrieval, and visual and dorsal attention systems had relatively large variations during non-pharmacological training, which might provide distinct biomarkers for fine-grained monitoring of aMCI cognitive alteration. An important finding of our study is the ability of the new method to capture subtle changes for individual patients before and after short-term intervention. More broadly, the MG2G method can be used in studying multiple brain disorders and injuries, e.g., in Parkinson's disease or traumatic brain injury (TBI), and hence it will be useful to the wider neuroscience community.


Assuntos
Encéfalo , Disfunção Cognitiva , Diagnóstico por Computador/métodos , Distribuição Normal , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/terapia , Conectoma , Humanos , Imagem por Ressonância Magnética , Memória/fisiologia , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Aprendizado de Máquina não Supervisionado
7.
Neurology ; 95(14): e1918-e1931, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-32887784

RESUMO

OBJECTIVE: To characterize lesion evolution and neurodegeneration in retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCL-S) using multimodal MRI. METHODS: We prospectively performed MRI and cognitive testing in RVCL-S and healthy control cohorts. Gray and white matter volume and disruption of white matter microstructure were quantified. Asymmetric spin echo acquisition permitted voxel-wise oxygen extraction fraction (OEF) calculation as an in vivo marker of microvascular ischemia. The RVCL-S cohort was included in a longitudinal analysis of lesion subtypes in which hyperintense lesions on fluid-attenuated inversion recovery (FLAIR), T1-postgadolinium, and diffusion-weighted imaging were delineated and quantified volumetrically. RESULTS: Twenty individuals with RVCL-S and 26 controls were enrolled. White matter volume and microstructure declined faster in those with RVCL-S compared to controls. White matter atrophy in RVCL-S was highly linear (ρ = -0.908, p < 0.0001). Normalized OEF was elevated in RVCL-S and increased with disease duration. Multiple cognitive domains, specifically those measuring working memory and processing speed, were impaired in RVCL-S. Lesion volumes, regardless of subtype, progressed/regressed with high variability as a function of age, while FLAIR lesion burden increased near time to death (p < 0.001). CONCLUSION: RVCL-S is a monogenic microvasculopathy affecting predominantly the white matter with regard to atrophy and cognitive impairment. White matter volumes in RVCL-S declined linearly, providing a potential metric against which to test the efficacy of future therapies. Progressive elevation of white matter OEF suggests that microvascular ischemia may underlie neurodegeneration in RVCL-S.


Assuntos
Disfunção Cognitiva/patologia , Doenças Desmielinizantes Hereditárias do Sistema Nervoso Central/patologia , Degeneração Neural/patologia , Doenças Retinianas/patologia , Doenças Vasculares/patologia , Substância Branca/patologia , Adulto , Disfunção Cognitiva/diagnóstico por imagem , Feminino , Doenças Desmielinizantes Hereditárias do Sistema Nervoso Central/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Degeneração Neural/diagnóstico por imagem , Neuroimagem/métodos , Doenças Retinianas/diagnóstico por imagem , Doenças Vasculares/diagnóstico por imagem , Substância Branca/diagnóstico por imagem
8.
Stroke ; 51(10): 2901-2909, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32951537

RESUMO

BACKGROUND AND PURPOSE: Covert brain infarcts are associated with cognitive decline. It is not known whether therapies that prevent symptomatic stroke prevent covert infarcts. COMPASS compared rivaroxaban with and without aspirin with aspirin for the prevention of stroke, myocardial infarction, and vascular death in participants with stable vascular disease and was terminated early because of benefits of rivaroxaban 2.5 mg twice daily plus aspirin over aspirin. We obtained serial magnetic resonance imagings and cognitive tests in a consenting subgroup of COMPASS patients to examine treatment effects on infarcts, cerebral microbleeds, and white matter hyperintensities. METHODS: Baseline and follow-up magnetic resonance imagings were completed in 1445 participants with a mean (SD) interval of 2.0 (0.7) years. Whole-brain T1, T2 fluid-attenuated inversion recovery, T2* sequences were centrally interpreted by blinded, trained readers. Participants had serial measurements of cognition and function. The primary end point was the proportion of participants with incident covert infarcts. Secondary end points were the composite of clinical stroke and covert brain infarcts, cerebral microbleeds, and white matter hyperintensities. RESULTS: At baseline, 493 (34.1%) participants had infarcts. Incident covert infarcts occurred in 55 (3.8%) participants. In the overall trial rivaroxaban plus aspirin reduced ischemic stroke by 49% (0.7% versus 1.4%; hazard ratio [95% CI], 0.51 [0.38-0.68]). In the magnetic resonance imaging substudy the effects of rivaroxaban+aspirin versus aspirin were: covert infarcts: 2.7% versus 3.5% (odds ratio [95% CI], 0.77 [0.37-1.60]); Covert infarcts or ischemic stroke: 2.9% versus 5.3% (odds ratio [95% CI], 0.53 [0.27-1.03]). Incident microbleeds occurred in 6.6% of participants and 65.7% of participants had an increase in white matter hyperintensities volume with no effect of treatment for either end point. There was no effect on cognitive tests. CONCLUSIONS: Covert infarcts were not significantly reduced by treatment with rivaroxaban and aspirin but estimates for the combination of ischemic stroke and covert infarcts were consistent with the effect on ischemic stroke in the overall trial. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01776424.


Assuntos
Aspirina/uso terapêutico , Infarto Encefálico/prevenção & controle , Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/prevenção & controle , Inibidores do Fator Xa/uso terapêutico , Inibidores da Agregação de Plaquetas/uso terapêutico , Rivaroxabana/uso terapêutico , Acidente Vascular Cerebral/prevenção & controle , Idoso , Infarto Encefálico/complicações , Infarto Encefálico/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/etiologia , Quimioterapia Combinada , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico por imagem , Resultado do Tratamento
9.
PLoS One ; 15(9): e0239577, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32986743

RESUMO

Mild Cognitive Impairment (MCI) is a border or precursor state of dementia. To optimize implemented interventions for MCI, it is essential to clarify the underlying neural mechanisms. However, knowledge regarding the brain regions responsible for MCI is still limited. Here, we implemented the Montreal Cognitive Assessment (MoCA) test, a screening tool for MCI, in 20 healthy elderly participants (mean age, 67.5 years), and then recorded magnetoencephalograms (MEG) while they performed a visual sequential memory task. In the task, each participant memorized the four possible directions of seven sequentially presented arrow images. Recall accuracy for beginning items of the memory sequence was significantly positively related with MoCA score. Meanwhile, MEG revealed stronger alpha-band (8-13 Hz) rhythm desynchronization bilaterally in the precuneus (PCu) for higher MoCA (normal) participants. Most importantly, this PCu desynchronization response weakened in correspondence with lower MoCA score during the beginning of sequential memory encoding, a time period that should rely on working memory and be affected by declined cognitive function. Our results suggest that deactivation of the PCu is associated with early MCI, and corroborate pathophysiological findings based on post-mortem tissue which have implicated hypoperfusion of the PCu in early stages of Alzheimer disease. Our results indicate the possibility that cognitive decline can be detected early and non-invasively by monitoring PCu activity with electrophysiological methods.


Assuntos
Doença de Alzheimer/patologia , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/fisiopatologia , Magnetoencefalografia , Lobo Parietal/diagnóstico por imagem , Lobo Parietal/patologia , Idoso , Doença de Alzheimer/diagnóstico por imagem , Humanos , Masculino , Memória de Curto Prazo/fisiologia , Rememoração Mental/fisiologia , Testes de Estado Mental e Demência , Testes Neuropsicológicos , Psicometria/métodos
10.
PLoS One ; 15(9): e0239484, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32956392

RESUMO

OBJECTIVE: To assess and compare the involvement of choroidal thickness (CT) in patients with mild cognitive impairment (MCI) and dementia due to Alzheimer's disease (AD) defined by amyloid PET and healthy controls (HC). METHODS: Sixty-three eyes from 34 AD patients [12 eyes (19.0%) with dementia and 51 eyes (80.9%) with MCI], positive to 11C-labelled Pittsburgh Compound-B with positron emission tomography (11C-PiB PET/CT), and the same number of sex- and age-paired HC were recruited. All participants underwent enhanced depth imaging optical coherence tomography (EDI-OCT) assessing CT at 14 measurements from 2 B-scans. Paired Student t-test was used to compare CT measurements between MCI, dementia and sex- and age-paired HC. A univariate generalized estimating equations model (GEE) test was performed to compare MCI and dementia individually with all HC included. RESULTS: Compared with HC, eyes from patients with positive 11C-PiB PET/CT showed a significant CT thinning in 5 selected locations (in foveal thickness in vertical scan, in temporal scan at 1500µm, in superior scan at 500µm and in inferior scan at 1000µm and 1500µm, p = 0.020-0.045) whilst few significant CT reduction data was reported in MCI or dementia individually versus HC. However, the GEE test identified significant CT thinning in AD compared with all HC included (p = 0.015-0.046). CONCLUSIONS: To our knowledge, the present study is the first measuring CT in eyes from MCI and dementia eyes positive to 11C-PiB PET/CT reporting a significant trend towards CT thinning in MCI patients which became more pronounced in dementia stage. We support further investigation involving larger and prospective OCT studies in AD population characterized with available biomarkers to describe whether choroidal vascular damage occurs specifically in prodromal stages of AD.


Assuntos
Doença de Alzheimer/patologia , Amiloide/análise , Corioide/ultraestrutura , Disfunção Cognitiva/patologia , Sintomas Prodrômicos , Tomografia de Coerência Óptica , Idoso , Doença de Alzheimer/diagnóstico por imagem , Compostos de Anilina , Antropometria , Área Sob a Curva , Radioisótopos de Carbono , Estudos de Casos e Controles , Disfunção Cognitiva/diagnóstico por imagem , Estudos Transversais , Progressão da Doença , Diagnóstico Precoce , Feminino , Humanos , Masculino , Neuroimagem , Variações Dependentes do Observador , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Reprodutibilidade dos Testes , Tiazóis
11.
PLoS One ; 15(8): e0238283, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32857796

RESUMO

AIMS: Non-Coeliac Gluten Sensitivity (NCGS) is poorly understood, particularly in terms of its neurological outcomes. We initially conducted a prospective postal survey to investigate its neurological presentation and symptom course. Results from this then motivated a follow-up pilot study utilising brain MRI to characterise potential diagnostic biomarkers for future research. METHODS: Patients with NCGS were recruited from a specialist centre and completed a prospective postal questionnaire (N = 125). This summarised symptoms experienced, their severity and their course. Onset time was compared by Chi-squared analysis to data from the same centre concerning coeliac disease patients (N = 224). Five respondents on a strict gluten-free diet who self-reported brain fog then attended a pilot study, completing MR brain imaging/questionnaires before/after a gluten challenge. "Baseline" data were assessed for abnormalities, while symptom severity and cerebral blood flow (CBF) were compared before/after challenge. RESULTS: Survey participants were aged 47 (85% female). Prevalence of neurological symptoms were: headaches (51%), brain fog (48%), balance issues (31%), tingling (19%). Median symptom resolution time was 48 hours, while onset was 90 minutes; onset pattern was not significantly different compared to CD patients (p = 0.322). Extra-intestinal symptoms worsened by 37%(±28) during a typical reaction. Predominantly non-statistical observations from the brain imaging study are discussed. CONCLUSIONS: Neurological symptoms in NCGS are common, and onset time is comparable to that in CD. Brain imaging may be a useful future means of investigating physiological injury and responses to gluten in further study.


Assuntos
Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Imagem por Ressonância Magnética , Síndromes de Malabsorção/diagnóstico por imagem , Adolescente , Adulto , Idoso , Disfunção Cognitiva/etiologia , Dieta Livre de Glúten , Feminino , Seguimentos , Glutens/metabolismo , Humanos , Síndromes de Malabsorção/dietoterapia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudo de Prova de Conceito , Estudos Prospectivos , Autorrelato , Índice de Gravidade de Doença , Adulto Jovem
12.
Psychogeriatrics ; 20(5): 726-736, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32767414

RESUMO

AIM: Many researchers argue that Alzheimer's disease is at least partly caused by deposition of amyloid beta (Aß) in the brain. Ferulic acid (FA) and Angelica archangelica (AA) are candidate agents for reducing Aß and improving cognitive function. Feru-guard 100M is a supplement containing FA and AA extract. Using this supplement, we planned to assess the effect of FA and AA on Aß deposition in the human brain. METHODS: This was an open-label, interventional multi-institutional joint study of Kobe University and the Institute of Biomedical Research and Innovation (Kobe, Japan). Seventeen subjects diagnosed with mild cognitive impairment were divided into two groups: the intervention group (n = 10) and the control group (n = 7). The subjects in the intervention group used Feru-guard 100M every day for 48 weeks, whereas the subjects in the control group did not use the supplement. We assessed the differences between the two groups by examining Aß deposition and brain atrophy at 48 weeks and cognitive function every 24 weeks. We used carbon-11-labelled Pittsburgh compound B (PiB) positron emission tomography to evaluate Aß deposition. RESULTS: There were no significant differences in Aß deposition, brain atrophy, and cognitive function between the two groups. Specifically, differences in Aß deposition change in seven regions of interest examined with PiB positron emission tomography, brain atrophy change in four indicators of voxel-based morphometry, and cognitive impairment measured by five psychological tests were not significantly between the two groups. CONCLUSION: Treatment with Feru-guard 100M, a supplement containing FA and AA extract, for 48 weeks did not reduce cortical PiB retention, which reflects Aß deposition. It also did not suppress the aggravation of brain atrophy or decline in cognitive function.


Assuntos
Peptídeos beta-Amiloides/efeitos dos fármacos , Angelica archangelica/química , Encéfalo/patologia , Disfunção Cognitiva/diagnóstico , Ácidos Cumáricos/uso terapêutico , Idoso , Doença de Alzheimer/etiologia , Doença de Alzheimer/psicologia , Peptídeos beta-Amiloides/metabolismo , Compostos de Anilina , Atrofia , Encéfalo/diagnóstico por imagem , Radioisótopos de Carbono , Disfunção Cognitiva/diagnóstico por imagem , Progressão da Doença , Feminino , Humanos , Japão , Masculino , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Tiazóis
13.
BMC Neurol ; 20(1): 302, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32799829

RESUMO

BACKGROUND: Ischemic Moyamoya disease is one of the important causes of stroke, which leads to severe impairment in cognitive functions. This cognitive impairment occurs prior to stroke. However, the cognitive functions that are impaired and the mechanisms of these impairments have not been determined. METHODS: We analyzed 12 patients with Moyamoya disease and 12 controls. All participants underwent cognitive tests and magnetic resonance imaging (MRI) scans. The diffusion tensor imaging (DTI) data was processed using Tract-Based Spatial Statistics (TBSS). Significantly different white matter areas were correlated with different cognitive functions. RESULTS: There were significant differences in intelligence and subtraction between the patients and controls (p < 0.05). The parameters of DTI such as fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) have different changes in anterior thalamic radiation, inferior fronto-occipital fasciculus (IFO), superior longitudinal fasciculus (SLF), uncinate fasciculus (UF), inferior longitudinal fasciculus, forceps minor, and other regions between the two groups. CONCLUSION: Left UF and IFO may be the key brain regions affecting arithmetic function, while bilateral IFO has an effect on intelligence. RD and AD may be better indicators for early prediction of chronic white matter damage than FA, while MD tends to have a comprehensive indirect change. There is cognitive impairment in ischemic MMD, which is closely related to white matter impairment. TRIAL REGISTRATION: Clinical Trial Registration, Unique identifier: ChiCTR1900023610 . Registered 4 June 2019 - Prospective study registered.


Assuntos
Disfunção Cognitiva , Doença de Moyamoya , Substância Branca , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Imagem de Tensor de Difusão , Humanos , Doença de Moyamoya/complicações , Doença de Moyamoya/diagnóstico por imagem , Doença de Moyamoya/epidemiologia , Doença de Moyamoya/fisiopatologia , Substância Branca/diagnóstico por imagem , Substância Branca/fisiopatologia
14.
J Stroke Cerebrovasc Dis ; 29(9): 105019, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807434

RESUMO

BACKGROUND AND AIMS: Occupational status may influence physical and mental post-stroke outcomes. We aimed to evaluate the association between occupational status and type, or engagement in social and family activities, neuroimaging measures and cognitive decline (CD) in a prospective cohort of stroke patients. METHODS: We included 273 first-ever stroke survivors at working age. All patients underwent 3T MRI at admission, as well as clinical and cognitive assessments at admission, 6, 12 and 24 months thereafter. RESULTS: Ninty nine (36.3%) of the participants were unemployed prior to the stroke. Age, sex, work type, other comorbidities, stroke severity or location were not associated with return to work. Patients who returned to work (87.4%) had better cognitive results and less depressive symptoms than those who retired after the event. Pre-stroke unemployment was associated with diabetes mellitus, hypertension, dyslipidemia, depression, poorer cognitive scores and brain atrophy. During the follow-up, 11% developed CD. CD was more common among previously unemployed than employed participants (19.2% vs. 6.3%, p = 0.001). Multiple regression adjusted for risk factors, revealed that pre-stroke unemployment was an independent predictor of CD (HR, 3.0; 95% CI: 1.06-8.44). Furthermore, engagement in mentally stimulating jobs decreased the risk for CD. CONCLUSIONS: Pre-stroke unemployment and post-stroke work disruption were each associated with depression and poorer cognitive performance up to two years post-stroke, as well as with brain atrophy at admission. Retirement after the stroke may increase the risk of developing CD. These results highlight the importance of continued employment in preserving cognitive abilities among stroke survivors.


Assuntos
Cognição , Disfunção Cognitiva/etiologia , Ataque Isquêmico Transitório/complicações , Aposentadoria , Retorno ao Trabalho , Acidente Vascular Cerebral/complicações , Desemprego , Idoso , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/psicologia , Depressão/etiologia , Depressão/fisiopatologia , Depressão/psicologia , Relações Familiares , Feminino , Nível de Saúde , Humanos , Ataque Isquêmico Transitório/diagnóstico por imagem , Ataque Isquêmico Transitório/fisiopatologia , Ataque Isquêmico Transitório/psicologia , Imagem por Ressonância Magnética , Masculino , Saúde Mental , Pessoa de Meia-Idade , Neuroimagem , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Comportamento Social , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Fatores de Tempo
15.
Neurology ; 95(6): e662-e670, 2020 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-32636325

RESUMO

OBJECTIVE: Early biomarkers for dementia with Lewy bodies (DLB) are lacking. To determine whether EEG differentiates the prodromal phase of DLB from other causes of mild cognitive impairment (MCI) and whether EEG is predictive for time to conversion from MCI to DLB, we compared EEGs and clinical follow-up of patients with MCI due to DLB with those of patients with MCI due to Alzheimer disease (MCI-AD). METHODS: We compared 37 patients with MCI who developed DLB during follow-up or had an abnormal 123I-PF-CIT SPECT scan (MCI-DLB) with 67 age-matched patients with MCI-AD. EEGs were assessed visually with a score of increasing abnormality (range 1-5). We performed fast Fourier transform to analyze the power spectrum. With survival analyses, EEG characteristics were related to time to progression to dementia. RESULTS: The visual EEG score was higher in MCI-DLB (score >2 in 60%) compared to MCI-AD (score >2 in 8%, p < 0.001). We found frontal intermittent delta activity in 22% of MCI-DLB, not in MCI-AD. Patients with MCI-DLB had a lower peak frequency (7.5 [6.0-9.9] Hz vs 8.8 [6.8-10.2] in MCI-AD, p < 0.001) and more slow-wave activity. Several individual EEG measures showed good performance to discriminate MCI-DLB from MCI-AD (areas under the curve up to 0.94). In MCI-DLB, high visual EEG score, diffuse abnormalities, and low α2 power were related to time to progression to dementia (hazard ratios 4.1, 9.9, 5.1, respectively). CONCLUSIONS: Profound EEG abnormalities are already present in the prodromal stage of DLB and have diagnostic and prognostic value. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that EEG abnormalities are more common in MCI-DLB than MCI-AD.


Assuntos
Eletroencefalografia , Doença por Corpos de Lewy/diagnóstico , Idoso , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/fisiopatologia , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Disfunção Cognitiva/líquido cefalorraquidiano , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/fisiopatologia , Diagnóstico Diferencial , Progressão da Doença , Diagnóstico Precoce , Feminino , Seguimentos , Análise de Fourier , Humanos , Radioisótopos do Iodo , Doença por Corpos de Lewy/líquido cefalorraquidiano , Doença por Corpos de Lewy/diagnóstico por imagem , Doença por Corpos de Lewy/fisiopatologia , Masculino , Pessoa de Meia-Idade , Países Baixos , Fragmentos de Peptídeos/líquido cefalorraquidiano , Estudos Prospectivos , Compostos Radiofarmacêuticos , Avaliação de Sintomas , Fatores de Tempo , Tomografia Computadorizada de Emissão de Fóton Único , Tropanos , Proteínas tau/líquido cefalorraquidiano
16.
PLoS One ; 15(7): e0235039, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32707574

RESUMO

Functional brain network (FBN), estimated with functional magnetic resonance imaging (fMRI), has become a potentially useful way of diagnosing neurological disorders in their early stages by comparing the connectivity patterns between different brain regions across subjects. However, this depends, to a great extent, on the quality of the estimated FBNs, indicating that FBN estimation is a key step for the subsequent task of disorder identification. In the past decades, researchers have developed many methods to estimate FBNs, including Pearson's correlation and (regularized) partial correlation, etc. Despite their widespread applications in current studies, most of the existing methods estimate FBNs only based on the dependency between the measured blood oxygen level dependent (BOLD) signals, which ignores spatial relationship of signals associated with different brain regions. Due to the space and material parsimony principle of our brain, we believe that the spatial distance between brain regions has an important influence on FBN topology. Therefore, in this paper, we assume that spatially neighboring brain regions tend to have stronger connections and/or share similar connections with others; based on this assumption, we propose two novel methods to estimate FBNs by incorporating the information of brain region distance into the estimation model. To validate the effectiveness of the proposed methods, we use the estimated FBNs to identify subjects with mild cognitive impairment (MCI) from normal controls (NCs). Experimental results show that the proposed methods are better than the baseline methods in the sense of MCI identification accuracy.


Assuntos
Disfunção Cognitiva/diagnóstico , Conectoma/métodos , Imagem por Ressonância Magnética/métodos , Rede Nervosa , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Mapeamento Encefálico/métodos , Disfunção Cognitiva/diagnóstico por imagem , Feminino , Humanos , Masculino , Modelos Teóricos , Rede Nervosa/diagnóstico por imagem , Análise Espacial
17.
Neurology ; 95(11): e1538-e1553, 2020 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-32675080

RESUMO

OBJECTIVE: To develop and evaluate a model for staging cortical amyloid deposition using PET with high generalizability. METHODS: Three thousand twenty-seven individuals (1,763 cognitively unimpaired [CU], 658 impaired, 467 with Alzheimer disease [AD] dementia, 111 with non-AD dementia, and 28 with missing diagnosis) from 6 cohorts (European Medical Information Framework for AD, Alzheimer's and Family, Alzheimer's Biomarkers in Daily Practice, Amsterdam Dementia Cohort, Open Access Series of Imaging Studies [OASIS]-3, Alzheimer's Disease Neuroimaging Initiative [ADNI]) who underwent amyloid PET were retrospectively included; 1,049 individuals had follow-up scans. With application of dataset-specific cutoffs to global standard uptake value ratio (SUVr) values from 27 regions, single-tracer and pooled multitracer regional rankings were constructed from the frequency of abnormality across 400 CU individuals (100 per tracer). The pooled multitracer ranking was used to create a staging model consisting of 4 clusters of regions because it displayed a high and consistent correlation with each single-tracer ranking. Relationships between amyloid stage, clinical variables, and longitudinal cognitive decline were investigated. RESULTS: SUVr abnormality was most frequently observed in cingulate, followed by orbitofrontal, precuneal, and insular cortices and then the associative, temporal, and occipital regions. Abnormal amyloid levels based on binary global SUVr classification were observed in 1.0%, 5.5%, 17.9%, 90.0%, and 100.0% of individuals in stage 0 to 4, respectively. Baseline stage predicted decline in Mini-Mental State Examination (MMSE) score (ADNI: n = 867, F = 67.37, p < 0.001; OASIS: n = 475, F = 9.12, p < 0.001) and faster progression toward an MMSE score ≤25 (ADNI: n = 787, hazard ratio [HR]stage1 2.00, HRstage2 3.53, HRstage3 4.55, HRstage4 9.91, p < 0.001; OASIS: n = 469, HRstage4 4.80, p < 0.001). CONCLUSION: The pooled multitracer staging model successfully classified the level of amyloid burden in >3,000 individuals across cohorts and radiotracers and detects preglobal amyloid burden and distinct risk profiles of cognitive decline within globally amyloid-positive individuals.


Assuntos
Amiloidose/diagnóstico por imagem , Radioisótopos de Carbono , Córtex Cerebral/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Radioisótopos de Flúor , Tomografia por Emissão de Pósitrons/métodos , Idoso , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/metabolismo , Amiloidose/metabolismo , Córtex Cerebral/metabolismo , Disfunção Cognitiva/metabolismo , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
18.
World Neurosurg ; 138: 672-679, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32545020

RESUMO

OBJECTIVE: In this study, we considered the treatment of cognitive characteristics of Parkinson's subtypes under resting magnetic resonance imaging scans, and used magnetic resonance imaging to analyze brain activity characteristics of patients with Parkinson's subtypes at rest. METHODS: In this study, patients with neurological Parkinson's disease subtypes were selected: 27 patients in the tremor group, 33 patients in the orthostatic gastric instability group, and 3 patients with mild cognitive impairment and neuropathic Parkinson's disease. Scientific treatment was adopted. RESULTS: Nineteen patients had mild cognitive dysfunction tremor and unstable posture, and 23 of them had mild cognitive dysfunction. Fifteen healthy controls were subjected to resting state functional magnetic resonance imaging by plane echo imaging sequence scanning. Neurological diseases-Regional consistency analysis of brain regions in patients with Parkinson's disease increased, including the right lower lobe, while regional consistency analysis of brain regions decreased, including the right frontal gyrus, right middle anterior gyrus, and lateral cerebellum. CONCLUSIONS: The experimental results show that the local consistency analysis method based on resting magnetic resonance imaging scan can effectively detect the differences in early neural activity in patients with Parkinson's disease subtype cognitive impairment, and can effectively reflect the brain characteristics of Parkinson's disease.


Assuntos
Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Doença de Parkinson/diagnóstico por imagem , Idoso , Estudos de Casos e Controles , Cognição , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/psicologia , Feminino , Neuroimagem Funcional , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Doença de Parkinson/psicologia , Descanso , Tremor/fisiopatologia
19.
Am J Cardiol ; 129: 102-108, 2020 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-32576368

RESUMO

Evidence on the relations between heart rate, brain morphology, and cognition is limited. We examined the associations of resting heart rate (RHR), visit-to-visit heart rate variation (VVHRV), brain volumes and cognitive impairment. The study sample consisted of postmenopausal women enrolled in the Women's Health Initiative Memory Study and its ancillary MRI sub-studies (WHIMS-MRI 1 and WHIMS-MRI 2) without a history of cardiovascular disease, including 493 with one and 299 women with 2 brain magnetic resonance imaging (MRI) scans. HR readings were acquired annually starting from baseline visit (1996-1998). RHR was calculated as the mean and VVHRV as standard deviation of all available HR readings. Brain MRI scans were performed between 2005 and 2006 (WHIMS-MRI 1), and approximately 5 years later (WHIMS-MRI 2). Cognitive impairment was defined as incident mild cognitive impairment or probable dementia until December 30, 2017. An elevated RHR was associated with greater brain lesion volumes at the first MRI exam (7.86 cm3 [6.48, 9.24] vs 4.78 cm3 [3.39, 6.17], p-value <0.0001) and with significant increases in lesion volumes between brain MRI exams (6.20 cm3 [4.81, 7.59] vs 4.28 cm3 [2.84, 5.73], p-value = 0.0168). Larger ischemic lesion volumes were associated with a higher risk for cognitive impairment (Hazard Ratio [95% confidence interval], 2.02 [1.18, 3.47], p-value = 0.0109). Neither RHR nor VVHRV were related to cognitive impairment. In sensitivity analyses, we additionally included women with a history of cardiovascular disease to the study sample. The main results were consistent to those without a history of cardiovascular disease. In conclusion, these findings show an association between elevated RHR and ischemic brain lesions, probably due to underlying subclinical disease processes.


Assuntos
Isquemia Encefálica/epidemiologia , Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/epidemiologia , Demência/epidemiologia , Frequência Cardíaca/fisiologia , Idoso , Encéfalo/patologia , Isquemia Encefálica/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Demência/diagnóstico por imagem , Terapia de Reposição de Estrogênios , Feminino , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/patologia , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Tamanho do Órgão , Pós-Menopausa , Modelos de Riscos Proporcionais , Substância Branca/diagnóstico por imagem , Substância Branca/patologia
20.
Neurology ; 95(3): e256-e267, 2020 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-32591471

RESUMO

OBJECTIVE: We studied interrelationships between CSF biomarkers and associations with APOE ε4 genotype, demographic variables, vascular variables, and clinical diagnosis in Olmsted County, Minnesota. METHODS: We included 774 Mayo Clinic Study of Aging participants (693 cognitively unimpaired [CU]; 71 with mild cognitive impairment [MCI]). CSF ß-amyloid 42 (Aß42), total tau (t-tau), and hyperphosphorylated tau (p-tau) were analyzed using Aß42 CSF, t-tau CSF, and p-tau (181P) CSF electrochemiluminescence immunoassays. Bivariate mixture models were used to evaluate latent classes. We used linear regression models to evaluate independent associations of APOE ε4, demographic factors, cardiovascular risk, and diagnosis with CSF biomarker levels. Results were weighted back to the Olmsted County population. RESULTS: Interrelationships between CSF Aß42 and p-tau/t-tau were consistent with 2 latent classes in the general population. In subgroup 1 (n = 547 [71%]), we found a strong positive correlation between Aß42 and p-tau (ρ = 0.81), while the correlation was much smaller in group 2 (ρ = 0.26, n = 227 [29%]). Group 2 was associated with older age, APOE ε4 genotype, a diagnosis of MCI, and elevated amyloid PET. Overall, APOE ε4 genotype and MCI were associated with Aß42, while age was associated with p-tau/t-tau. There were no associations with sex, education, or vascular risk. CONCLUSION: We hypothesize the population without dementia can be subdivided into participants with and without biological Alzheimer disease (AD) based on the combination of CSF Aß42 and p-tau/t-tau (represented also by the p-tau/t-tau/Aß42 ratio). In those without biological AD, common factors such as CSF dynamics may cause a positive correlation between CSF Aß42 and p-tau/t-tau, while AD leads to dissociation of these proteins.


Assuntos
Envelhecimento/líquido cefalorraquidiano , Disfunção Cognitiva/líquido cefalorraquidiano , Disfunção Cognitiva/diagnóstico por imagem , Medicina Baseada em Evidências/métodos , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/patologia , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Biomarcadores/líquido cefalorraquidiano , Disfunção Cognitiva/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Minnesota/epidemiologia , Fragmentos de Peptídeos/líquido cefalorraquidiano , Tomografia por Emissão de Pósitrons/métodos , Punção Espinal/métodos , Proteínas tau/líquido cefalorraquidiano
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