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1.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 40: e20240008, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38952174

RESUMO

The numerous and varied forms of neurodegenerative illnesses provide a considerable challenge to contemporary healthcare. The emergence of artificial intelligence has fundamentally changed the diagnostic picture by providing effective and early means of identifying these crippling illnesses. As a subset of computational intelligence, machine-learning algorithms have become very effective tools for the analysis of large datasets that include genetic, imaging, and clinical data. Moreover, multi-modal data integration, which includes information from brain imaging (MRI, PET scans), genetic profiles, and clinical evaluations, is made easier by computational intelligence. A thorough knowledge of the course of the illness is made possible by this consolidative method, which also facilitates the creation of predictive models for early medical evaluation and outcome prediction. Furthermore, there has been a great deal of promise shown by the use of artificial intelligence to neuroimaging analysis. Sophisticated image processing methods combined with machine learning algorithms make it possible to identify functional and structural anomalies in the brain, which often act as early indicators of neurodegenerative diseases. This chapter examines how computational intelligence plays a critical role in improving the diagnosis of neurodegenerative diseases such as Parkinson's, Alzheimer's, etc. To sum up, computational intelligence provides a revolutionary approach for improving the identification of neurodegenerative illnesses. In the battle against these difficult disorders, embracing and improving these computational techniques will surely pave the path for more individualized therapy and more therapies that are successful.


Assuntos
Biologia Computacional , Aprendizado de Máquina , Doenças Neurodegenerativas , Neuroimagem , Humanos , Doenças Neurodegenerativas/diagnóstico , Doenças Neurodegenerativas/diagnóstico por imagem , Biologia Computacional/métodos , Neuroimagem/métodos , Algoritmos , Inteligência Artificial , Encéfalo/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos
2.
CNS Neurosci Ther ; 30(7): e14828, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38946709

RESUMO

OBJECTIVE: Wallerian degeneration (WD) of the middle cerebellar peduncles (MCPs) following pontine infarction is a rare secondary degenerative neurological condition. Due to its infrequency, there is limited research on its characteristics. METHODS: This study aims to present three cases of WD of MCPs following pontine infarction and to analyze the prognosis, clinical manifestations, and neuroimaging features by amalgamating our cases with previously reported ones. RESULTS: The cohort consisted of 25 cases, comprising 18 men and 7 women aged 29 to 77 years (mean age: 66.2 years). The majority of patients (94%) exhibit risk factors for cerebrovascular disease, with hypertension being the primary risk factor. Magnetic resonance imaging (MRI) can detect WD of MCPs within a range of 21 days to 12 months following pontine infarction. This degeneration is characterized by bilateral symmetric hyperintensities on T2/FLAIR-weighted images (WI) lesions in the MCPs. Moreover, restricted diffusion, with hyperintensity on diffusion-weighted imaging (DWI) and low apparent diffusion coefficient (ADC) signal intensity may be observed as early as 21 days after the infarction. Upon detection of WD, it was observed that 20 patients (80%) remained asymptomatic during subsequent clinic visits, while four (16%) experienced a worsening of pre-existing symptoms. CONCLUSIONS: These findings underscore the importance of neurologists enhancing their understanding of this condition by gaining fresh insights into the neuroimaging characteristics, clinical manifestations, and prognosis of individuals with WD of bilateral MCPs.


Assuntos
Infartos do Tronco Encefálico , Pedúnculo Cerebelar Médio , Ponte , Degeneração Walleriana , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Adulto , Degeneração Walleriana/diagnóstico por imagem , Degeneração Walleriana/patologia , Ponte/diagnóstico por imagem , Ponte/patologia , Infartos do Tronco Encefálico/diagnóstico por imagem , Pedúnculo Cerebelar Médio/diagnóstico por imagem , Pedúnculo Cerebelar Médio/patologia , Imageamento por Ressonância Magnética , Neuroimagem/métodos
3.
Hum Brain Mapp ; 45(10): e26768, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-38949537

RESUMO

Structural neuroimaging data have been used to compute an estimate of the biological age of the brain (brain-age) which has been associated with other biologically and behaviorally meaningful measures of brain development and aging. The ongoing research interest in brain-age has highlighted the need for robust and publicly available brain-age models pre-trained on data from large samples of healthy individuals. To address this need we have previously released a developmental brain-age model. Here we expand this work to develop, empirically validate, and disseminate a pre-trained brain-age model to cover most of the human lifespan. To achieve this, we selected the best-performing model after systematically examining the impact of seven site harmonization strategies, age range, and sample size on brain-age prediction in a discovery sample of brain morphometric measures from 35,683 healthy individuals (age range: 5-90 years; 53.59% female). The pre-trained models were tested for cross-dataset generalizability in an independent sample comprising 2101 healthy individuals (age range: 8-80 years; 55.35% female) and for longitudinal consistency in a further sample comprising 377 healthy individuals (age range: 9-25 years; 49.87% female). This empirical examination yielded the following findings: (1) the accuracy of age prediction from morphometry data was higher when no site harmonization was applied; (2) dividing the discovery sample into two age-bins (5-40 and 40-90 years) provided a better balance between model accuracy and explained age variance than other alternatives; (3) model accuracy for brain-age prediction plateaued at a sample size exceeding 1600 participants. These findings have been incorporated into CentileBrain (https://centilebrain.org/#/brainAGE2), an open-science, web-based platform for individualized neuroimaging metrics.


Assuntos
Envelhecimento , Encéfalo , Imageamento por Ressonância Magnética , Humanos , Adolescente , Feminino , Idoso , Adulto , Criança , Adulto Jovem , Masculino , Encéfalo/diagnóstico por imagem , Encéfalo/anatomia & histologia , Encéfalo/crescimento & desenvolvimento , Idoso de 80 Anos ou mais , Pré-Escolar , Pessoa de Meia-Idade , Envelhecimento/fisiologia , Imageamento por Ressonância Magnética/métodos , Neuroimagem/métodos , Neuroimagem/normas , Tamanho da Amostra
4.
BMC Med ; 22(1): 266, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38951846

RESUMO

BACKGROUND: Benzodiazepine use is common, particularly in older adults. Benzodiazepines have well-established acute adverse effects on cognition, but long-term effects on neurodegeneration and dementia risk remain uncertain. METHODS: We included 5443 cognitively healthy (MMSE ≥ 26) participants from the population-based Rotterdam Study (57.4% women, mean age 70.6 years). Benzodiazepine use from 1991 until baseline (2005-2008) was derived from pharmacy dispensing records, from which we determined drug type and cumulative dose. Benzodiazepine use was defined as prescription of anxiolytics (ATC-code: N05BA) or sedative-hypnotics (ATC-code: N05CD) between inception of pharmacy records and study baseline. Cumulative dose was calculated as the sum of the defined daily doses for all prescriptions. We determined the association with dementia risk until 2020 using Cox regression. Among 4836 participants with repeated brain MRI, we further determined the association of benzodiazepine use with changes in neuroimaging markers using linear mixed models. RESULTS: Of all 5443 participants, 2697 (49.5%) had used benzodiazepines at any time in the 15 years preceding baseline, of whom 1263 (46.8%) used anxiolytics, 530 (19.7%) sedative-hypnotics, and 904 (33.5%) used both; 345 (12.8%) participants were still using at baseline assessment. During a mean follow-up of 11.2 years, 726 participants (13.3%) developed dementia. Overall, use of benzodiazepines was not associated with dementia risk compared to never use (HR [95% CI]: 1.06 [0.90-1.25]), irrespective of cumulative dose. Risk estimates were somewhat higher for any use of anxiolytics than for sedative-hypnotics (HR 1.17 [0.96-1.41] vs 0.92 [0.70-1.21]), with strongest associations for high cumulative dose of anxiolytics (HR [95% CI] 1.33 [1.04-1.71]). In imaging analyses, current use of benzodiazepine was associated cross-sectionally with lower brain volumes of the hippocampus, amygdala, and thalamus and longitudinally with accelerated volume loss of the hippocampus and to a lesser extent amygdala. However, imaging findings did not differ by type of benzodiazepines or cumulative dose. CONCLUSIONS: In this population-based sample of cognitively healthy adults, overall use of benzodiazepines was not associated with increased dementia risk, but potential class-dependent adverse effects and associations with subclinical markers of neurodegeneration may warrant further investigation.


Assuntos
Benzodiazepinas , Demência , Humanos , Feminino , Demência/epidemiologia , Demência/induzido quimicamente , Masculino , Idoso , Benzodiazepinas/efeitos adversos , Benzodiazepinas/administração & dosagem , Pessoa de Meia-Idade , Imageamento por Ressonância Magnética , Países Baixos/epidemiologia , Idoso de 80 Anos ou mais , Neuroimagem , Encéfalo/diagnóstico por imagem , Encéfalo/efeitos dos fármacos , Encéfalo/patologia , Estudos Prospectivos , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/induzido quimicamente , Hipnóticos e Sedativos/efeitos adversos , Fatores de Risco
6.
Semin Pediatr Neurol ; 50: 101140, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38964816

RESUMO

This focused review on abusive head trauma describes the injuries to the head, brain and/or spine of an infant or young child from inflicted trauma and their neuroimaging correlates. Accurate recognition and diagnosis of abusive head trauma is paramount to prevent repeated injury, provide timely treatment, and ensure that accidental or underlying medical contributors have been considered. In this article, we aim to discuss the various findings on neuroimaging that have been associated with AHT, compared to those that are more consistent with accidental injuries or with underlying medical causes that may also be on the differential.


Assuntos
Maus-Tratos Infantis , Traumatismos Craniocerebrais , Neuroimagem , Humanos , Maus-Tratos Infantis/diagnóstico , Traumatismos Craniocerebrais/diagnóstico por imagem , Neuroimagem/métodos , Lactente , Pré-Escolar , Criança
7.
Alzheimers Res Ther ; 16(1): 149, 2024 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-38961406

RESUMO

BACKGROUND: Enlarged choroid plexus (ChP) volume has been reported in patients with Alzheimer's disease (AD) and inversely correlated with cognitive performance. However, its clinical diagnostic and predictive value, and mechanisms by which ChP impacts the AD continuum remain unclear. METHODS: This prospective cohort study enrolled 607 participants [healthy control (HC): 110, mild cognitive impairment (MCI): 269, AD dementia: 228] from the Chinese Imaging, Biomarkers, and Lifestyle study between January 1, 2021, and December 31, 2022. Of the 497 patients on the AD continuum, 138 underwent lumbar puncture for cerebrospinal fluid (CSF) hallmark testing. The relationships between ChP volume and CSF pathological hallmarks (Aß42, Aß40, Aß42/40, tTau, and pTau181), neuropsychological tests [Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Neuropsychiatric Inventory (NPI), and Activities of Daily Living (ADL) scores], and multimodal neuroimaging measures [gray matter volume, cortical thickness, and corrected cerebral blood flow (cCBF)] were analyzed using partial Spearman's correlation. The mediating effects of four neuroimaging measures [ChP volume, hippocampal volume, lateral ventricular volume (LVV), and entorhinal cortical thickness (ECT)] on the relationship between CSF hallmarks and neuropsychological tests were examined. The ability of the four neuroimaging measures to identify cerebral Aß42 changes or differentiate among patients with AD dementia, MCI and HCs was determined using receiver operating characteristic analysis, and their associations with neuropsychological test scores at baseline were evaluated by linear regression. Longitudinal associations between the rate of change in the four neuroimaging measures and neuropsychological tests scores were evaluated on the AD continuum using generalized linear mixed-effects models. RESULTS: The participants' mean age was 65.99 ± 8.79 years. Patients with AD dementia exhibited the largest baseline ChP volume than the other groups (P < 0.05). ChP volume enlargement correlated with decreased Aß42 and Aß40 levels; lower MMSE and MoCA and higher NPI and ADL scores; and lower volume, cortical thickness, and cCBF in other cognition-related regions (all P < 0.05). ChP volume mediated the association of Aß42 and Aß40 levels with MMSE scores (19.08% and 36.57%), and Aß42 levels mediated the association of ChP volume and MMSE or MoCA scores (39.49% and 34.36%). ChP volume alone better identified cerebral Aß42 changes than LVV alone (AUC = 0.81 vs. 0.67, P = 0.04) and EC thickness alone (AUC = 0.81 vs.0.63, P = 0.01) and better differentiated patients with MCI from HCs than hippocampal volume alone (AUC = 0.85 vs. 0.81, P = 0.01), and LVV alone (AUC = 0.85 vs.0.82, P = 0.03). Combined ChP and hippocampal volumes significantly increased the ability to differentiate cerebral Aß42 changes and patients among AD dementia, MCI, and HCs groups compared with hippocampal volume alone (all P < 0.05). After correcting for age, sex, years of education, APOE ε4 status, eTIV, and hippocampal volume, ChP volume was associated with MMSE, MoCA, NPI, and ADL score at baseline, and rapid ChP volume enlargement was associated with faster deterioration in NPI scores with an average follow-up of 10.03 ± 4.45 months (all P < 0.05). CONCLUSIONS: ChP volume may be a novel neuroimaging marker associated with neurodegenerative changes and clinical AD manifestations. It could better detect the early stages of the AD and predict prognosis, and significantly enhance the differential diagnostic ability of hippocampus on the AD continuum.


Assuntos
Doença de Alzheimer , Peptídeos beta-Amiloides , Biomarcadores , Plexo Corióideo , Disfunção Cognitiva , Neuroimagem , Humanos , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/líquido cefalorraquidiano , Doença de Alzheimer/patologia , Feminino , Masculino , Idoso , Plexo Corióideo/diagnóstico por imagem , Plexo Corióideo/patologia , Estudos Prospectivos , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/líquido cefalorraquidiano , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Neuroimagem/métodos , Biomarcadores/líquido cefalorraquidiano , Pessoa de Meia-Idade , Testes Neuropsicológicos , Imageamento por Ressonância Magnética/métodos , Proteínas tau/líquido cefalorraquidiano , Fragmentos de Peptídeos/líquido cefalorraquidiano
8.
Alzheimers Res Ther ; 16(1): 148, 2024 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-38961512

RESUMO

BACKGROUND: Leveraging Alzheimer's disease (AD) imaging biomarkers and longitudinal cognitive data may allow us to establish evidence of cognitive resilience (CR) to AD pathology in-vivo. Here, we applied latent class mixture modeling, adjusting for sex, baseline age, and neuroimaging biomarkers of amyloid, tau and neurodegeneration, to a sample of cognitively unimpaired older adults to identify longitudinal trajectories of CR. METHODS: We identified 200 Harvard Aging Brain Study (HABS) participants (mean age = 71.89 years, SD = 9.41 years, 59% women) who were cognitively unimpaired at baseline with 2 or more timepoints of cognitive assessment following a single amyloid-PET, tau-PET and structural MRI. We examined latent class mixture models with longitudinal cognition as the dependent variable and time from baseline, baseline age, sex, neocortical Aß, entorhinal tau, and adjusted hippocampal volume as independent variables. We then examined group differences in CR-related factors across the identified subgroups from a favored model. Finally, we applied our favored model to a dataset from the Alzheimer's Disease Neuroimaging Initiative (ADNI; n = 160, mean age = 73.9 years, SD = 7.6 years, 60% women). RESULTS: The favored model identified 3 latent subgroups, which we labelled as Normal (71% of HABS sample), Resilient (22.5%) and Declining (6.5%) subgroups. The Resilient subgroup exhibited higher baseline cognitive performance and a stable cognitive slope. They were differentiated from other groups by higher levels of verbal intelligence and past cognitive activity. In ADNI, this model identified a larger Normal subgroup (88.1%), a smaller Resilient subgroup (6.3%) and a Declining group (5.6%) with a lower cognitive baseline. CONCLUSION: These findings demonstrate the value of data-driven approaches to identify longitudinal CR groups in preclinical AD. With such an approach, we identified a CR subgroup who reflected expected characteristics based on previous literature, higher levels of verbal intelligence and past cognitive activity.


Assuntos
Imageamento por Ressonância Magnética , Tomografia por Emissão de Pósitrons , Proteínas tau , Humanos , Feminino , Masculino , Idoso , Proteínas tau/metabolismo , Estudos Longitudinais , Estudos Transversais , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/patologia , Doença de Alzheimer/psicologia , Doença de Alzheimer/metabolismo , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Encéfalo/metabolismo , Peptídeos beta-Amiloides/metabolismo , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/metabolismo , Cognição/fisiologia , Pessoa de Meia-Idade , Reserva Cognitiva/fisiologia , Biomarcadores , Neuroimagem/métodos
10.
Mycoses ; 67(7): e13767, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39004801

RESUMO

BACKGROUND: The radiological manifestations of central nervous system (CNS) cryptococcosis are diverse and often subtle. There is heterogeneity on how different neuroimaging patterns impact prognosis. This study aims to assess the association between the neuroimaging and clinical outcomes of CNS cryptococcosis. METHODS: All patients with CNS cryptococcosis between July 2017 and April 2023 who underwent brain magnetic resonance imaging (MRI) were included. The primary outcome was mortality during hospitalisation. Secondary outcomes were readmission, ventricular shunting, duration of hospitalisation and time to the first negative cerebrospinal fluid culture. We compared the outcomes for each of the five main radiological findings on the brain MRI scan. RESULTS: We included 46 proven CNS cryptococcosis cases. The two main comorbidity groups were HIV infection (20, 43%) and solid organ transplantation (10, 22%), respectively. Thirty-nine patients exhibited at least one radiological abnormality (85%), with the most common being meningeal enhancement (34, 74%). The mortality rates occurred at 11% (5/46) during hospitalisation. We found no significant disparities in mortality related to distinct radiological patterns. The presence of pseudocysts was significantly associated with the need for readmission (p = .027). The ventricular shunting was significantly associated with the presence of pseudocysts (p = .005) and hydrocephalus (p = .044). CONCLUSION: In this study, there is no association between brain MRI findings and mortality. Larger studies are needed to evaluate this important issue.


Assuntos
Criptococose , Imageamento por Ressonância Magnética , Neuroimagem , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neuroimagem/métodos , Criptococose/diagnóstico por imagem , Criptococose/mortalidade , Criptococose/microbiologia , Adulto , Idoso , Estudos Retrospectivos , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Infecções Fúngicas do Sistema Nervoso Central/diagnóstico por imagem , Infecções Fúngicas do Sistema Nervoso Central/mortalidade , Infecções Fúngicas do Sistema Nervoso Central/microbiologia , Prognóstico , Hidrocefalia/diagnóstico por imagem , Hidrocefalia/mortalidade , Hospitalização , Infecções por HIV/complicações
11.
Ecotoxicol Environ Saf ; 281: 116664, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38954909

RESUMO

BACKGROUND: Observational studies have reported associations between air pollutants and brain imaging-derived phenotypes (IDPs); however, whether this relationship is causal remains uncertain. METHODS: We conducted bidirectional two-sample Mendelian randomization (MR) analyses to explore the causal relationships between 5 types of air pollutants (N=423,796 to 456,380 individuals) and 587 reliable IDPs (N=33,224 individuals). Two-step MR was also conducted to assess whether the identified effects are mediated through the modulation of circulating cytokines (N=8293). RESULTS: We found genetic evidence supporting the association of nitrogen oxides (NOx) with mean intra-cellular volume fraction (ICVF) in the left uncinate fasciculus (IVW ß=-0.42, 95 % CI -0.62 to -0.23, P=1.51×10-5) and mean fractional anisotropy (FA) in the left uncinate fasciculus (IVW ß=-0.42, 95 % CI -0.62 to -0.21, P=4.89×10-5). In further two-step MR analyses, we did not find evidence that genetic predictions of any circulating cytokines mediated the association between NOx and IDPs. CONCLUSION: This study provides evidence for the association between air pollutants and brain IDPs, emphasizing the importance of controlling air pollution to improve brain health.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Encéfalo , Fenótipo , Humanos , Poluição do Ar/efeitos adversos , Poluentes Atmosféricos/toxicidade , Encéfalo/diagnóstico por imagem , Análise da Randomização Mendeliana , Óxidos de Nitrogênio , Citocinas/genética , Citocinas/sangue , Neuroimagem
12.
Nat Commun ; 15(1): 5996, 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39013848

RESUMO

Machine learning can be used to define subtypes of psychiatric conditions based on shared biological foundations of mental disorders. Here we analyzed cross-sectional brain images from 4,222 individuals with schizophrenia and 7038 healthy subjects pooled across 41 international cohorts from the ENIGMA, non-ENIGMA cohorts and public datasets. Using the Subtype and Stage Inference (SuStaIn) algorithm, we identify two distinct neurostructural subgroups by mapping the spatial and temporal 'trajectory' of gray matter change in schizophrenia. Subgroup 1 was characterized by an early cortical-predominant loss with enlarged striatum, whereas subgroup 2 displayed an early subcortical-predominant loss in the hippocampus, striatum and other subcortical regions. We confirmed the reproducibility of the two neurostructural subtypes across various sample sites, including Europe, North America and East Asia. This imaging-based taxonomy holds the potential to identify individuals with shared neurobiological attributes, thereby suggesting the viability of redefining existing disorder constructs based on biological factors.


Assuntos
Algoritmos , Substância Cinzenta , Imageamento por Ressonância Magnética , Esquizofrenia , Humanos , Esquizofrenia/diagnóstico por imagem , Esquizofrenia/patologia , Masculino , Feminino , Adulto , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/patologia , Aprendizado de Máquina , Pessoa de Meia-Idade , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Estudos Transversais , Europa (Continente) , Neuroimagem , Reprodutibilidade dos Testes , América do Norte , Hipocampo/diagnóstico por imagem , Hipocampo/patologia
13.
J Prev Alzheimers Dis ; 11(4): 889-894, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39044498

RESUMO

BACKGROUND: The Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) and Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) studies were conducted between 2014 and 2023, with enrollment completed in 2017 and final study results reported in 2023. The study screening process involved the collection of initial clinical, cognitive, neuroimaging, and genetic measures to determine eligibility. Once randomized, enrolled participants were assessed every four weeks over a 4.5-year follow-up period during which longitudinal clinical, cognitive, and neuroimaging measures were collected. A large number of longitudinal fluid biospecimens were also collected and banked. Consistent with the NIH data sharing policy and the principles of Open Science, the A4/LEARN investigators aimed to share data as broadly and early as possible while still protecting participant privacy and confidentiality and the scientific integrity of the studies. OBJECTIVES: We describe the approach, methods, and platforms used to share the A4 and LEARN pre-randomization study data for secondary research use. Preliminary results measuring the impact of these efforts are also summarized. We conclude with a discussion of lessons learned and next steps. DESIGN: The materials shared included de-identified quantitative and image data, analysis software, instruments, and documentation. SETTING: The A4 and LEARN Studies were conducted at 67 clinical trial sites in the United States, Canada, Japan, and Australia. PARTICIPANTS: The A4 study screened (n=6763), enrolled, and randomized (n=1169) participants between the ages of 65 and 85 with a blinded follow-up period of 240 weeks followed by an open-label period of variable length. The LEARN study screened and enrolled individuals (n=538) who were ineligible for the A4 study based on nonelevated measures of amyloid accumulation using positron emission tomography imaging (amyloid PET). MEASUREMENTS: We provide descriptive measures of the data shared and summarize the frequency, characteristics, and status of all data access requests submitted to date. We evaluate the scientific impact of the data-sharing effort by conducting a literature search to identify related publications. RESULTS: The A4 and LEARN pre-randomization study data were released in December 2018. As of May 8, 2024, 1506 requests have been submitted by investigators and citizen scientists from more than 50 countries. We identified 49 peer-reviewed publications that acknowledge the A4/LEARN study. CONCLUSIONS: Our initial results provide evidence supporting the feasibility and scientific utility of broad and timely sharing of Alzheimer's disease trial data.


Assuntos
Doença de Alzheimer , Disseminação de Informação , Humanos , Estudos Longitudinais , Idoso , Neuroimagem , Masculino , Feminino , Ensaios Clínicos Controlados Aleatórios como Assunto , Anticorpos Monoclonais Humanizados
14.
J Prev Alzheimers Dis ; 11(4): 1087-1092, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39044521

RESUMO

OBJECTIVE: Previous studies demonstrated a significant protective effect of elevated cerebrospinal fluid (CSF) sTREM2 levels on brain structure and cognitive decline. Nonetheless, the role of sTREM2 in the depression progression remains unclear. This study aimed to investigate the association between CSF sTREM2 levels and longitudinal trajectories of depression. METHODS: Data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) Study were used. CSF sTREM2 levels and depression were measured using an ELISA-based assay and the Geriatric Depression Scale (GDS-15), respectively. Linear mixed-effect models were employed to assess the relationships between CSF sTREM2 levels and GDS scores. RESULTS: A total of 1,017 participants were enrolled at baseline, with a mean follow-up time of 4.65 years. Baseline CSF sTREM2 levels were negatively correlated with GDS scores (ß=-0.21, P=0.022) after adjustment for age, gender, race/ethnicity, education, APOE ε4 carrier status, TREM2 rare variant carrier status, marital status, smoking, and clinical cognitive status. CONCLUSION: Our findings suggested that a higher level of CSF sTREM2 was associated with a lower risk of depression.


Assuntos
Doença de Alzheimer , Depressão , Glicoproteínas de Membrana , Receptores Imunológicos , Humanos , Feminino , Doença de Alzheimer/líquido cefalorraquidiano , Doença de Alzheimer/diagnóstico , Glicoproteínas de Membrana/líquido cefalorraquidiano , Masculino , Idoso , Depressão/líquido cefalorraquidiano , Neuroimagem , Biomarcadores/líquido cefalorraquidiano , Disfunção Cognitiva/líquido cefalorraquidiano , Idoso de 80 Anos ou mais
15.
J Prev Alzheimers Dis ; 11(4): 1140-1147, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39044526

RESUMO

BACKGROUND: Resting heart rate (RHR), has been related to increased risk of dementia, but the relationship between RHR and brain age is unclear. OBJECTIVE: We aimed to investigate the association of RHR with brain age and brain age gap (BAG, the difference between predicted brain age and chronological age) assessed by multimodal Magnetic Resonance Imaging (MRI) in mid- and old-aged adults. DESIGN: A longitudinal study from the UK Biobank neuroimaging project where participants underwent brain MRI scans 9+ years after baseline. SETTING: A population-based study. PARTICIPANTS: A total of 33,381 individuals (mean age 54.74 ± 7.49 years; 53.44% female). MEASUREMENTS: Baseline RHR was assessed by blood pressure monitor and categorized as <60, 60-69 (reference), 70-79, or ≥80 beats per minute (bpm). Brain age was predicted using LASSO through 1,079 phenotypes in six MRI modalities (including T1-weighted MRI, T2-FLAIR, T2*, diffusion-MRI, task fMRI, and resting-state fMRI). Data were analyzed using linear regression models. RESULTS: As a continuous variable, higher RHR was associated with older brain age (ß for per 1-SD increase: 0.331, 95% [95% confidence interval, CI]: 0.265, 0.398) and larger BAG (ß: 0.263, 95% CI: 0.202, 0.324). As a categorical variable, RHR 70-79 bpm and RHR ≥80 bpm were associated with older brain age (ß [95% CI]: 0.361 [0.196, 0.526] / 0.737 [0.517, 0.957]) and larger BAG (0.256 [0.105, 0.407] / 0.638 [0.436, 0.839]), but RHR< 60 bpm with younger brain age (-0.324 [-0.500, -0.147]) and smaller BAG (-0.230 [-0.392, -0.067]), compared to the reference group. These associations between elevated RHR and brain age were similar in both middle-aged (<60) and older (≥60) adults, whereas the association of RHR< 60 bpm with younger brain age and larger BAG was only significant among middle-aged adults. In stratification analysis, the association between RHR ≥80 bpm and older brain age was present in people with and without CVDs, while the relation of RHR 70-79 bpm to brain age present only in people with CVD. CONCLUSION: Higher RHR (>80 bpm) is associated with older brain age, even among middle-aged adults, but RHR< 60 bpm is associated with younger brain age. Greater RHR could be an indicator for accelerated brain aging.


Assuntos
Encéfalo , Frequência Cardíaca , Aprendizado de Máquina , Imageamento por Ressonância Magnética , Humanos , Pessoa de Meia-Idade , Feminino , Masculino , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Idoso , Frequência Cardíaca/fisiologia , Estudos Longitudinais , Envelhecimento/fisiologia , Reino Unido , Neuroimagem , Descanso/fisiologia
16.
J Prev Alzheimers Dis ; 11(4): 1093-1105, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39044522

RESUMO

BACKGROUND: The focus of medicine is shifting from treatment to preventive care. The expression of biomarkers of dementia and Alzheimer's disease (AD) appear decades before the onset of observable symptoms, and evidence has emerged supporting pharmacological and non-pharmacological interventions to treat modifiable risk factors of dementia. However, there is limited research on the epidemiology, clinical phenotypes, and underlying pathobiology of cognitive diseases in Asian populations. OBJECTIVES: The objectives of the Biomarkers and Cognition Study, Singapore(BIOCIS) are to characterize the underlying pathobiology of Cognitive Impairment through a longitudinal study incorporating fluid biomarker profiles, neuroimaging, neuropsychological and clinical outcomes in a multi-ethnic Southeast Asian population. DESIGN, SETTING, PARTICIPANTS: BIOCIS is a 5-year longitudinal study where participants are assessed annually. 2500 participants aged 30 to 95 will be recruited from the community in Singapore. To investigate how pathology presents with or without minimal clinical symptoms and vice versa, CI and unimpaired individuals will be recruited. Participants will undergo assessments to characterise biomarkers of dementia through neuroimaging, fluid biomarkers, cognitive assessments, behavioural and lifestyle profiles, retinal scans and microbiome indicators. RESULTS: Since commencement of recruitment in February 2022, 1148 participants have been enrolled, comprising 1012 Chinese, 62 Indian, and 35 Malay individuals. Mean age and education is 61.32 years and 14.34 years respectively with 39.8% males. 47.9 % of the cohort are employed and 32.06% have a family history of dementia. The prevalence of cerebral small vessel disease is 90.2% with a mean modified Fazekas white matter hyperintensity score of 4.1. CONCLUSION: The BIOCIS cohort will help identify novel biomarkers, pathological trajectories, epidemiology of dementia, and reversible risk factors in a Southeast Asian population. Completion of BIOCIS longitudinal data could provide insights into risk-stratification of Asians populations, and potentially inform public healthcare and precision medicine for better patient outcomes in the prevention of Alzheimer's disease and dementia.


Assuntos
Biomarcadores , Disfunção Cognitiva , Humanos , Singapura/epidemiologia , Estudos Longitudinais , Masculino , Idoso , Pessoa de Meia-Idade , Feminino , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Adulto , Idoso de 80 Anos ou mais , Testes Neuropsicológicos , Cognição/fisiologia , Neuroimagem , Demência/epidemiologia , Demência/diagnóstico , Projetos de Pesquisa
17.
CNS Neurosci Ther ; 30(7): e14841, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39045778

RESUMO

Cerebral small vessel disease (CSVD) is an important cause of stroke, cognitive impairment, and other diseases, and its early quantitative evaluation can significantly improve patient prognosis. Magnetic resonance imaging (MRI) is an important method to evaluate the occurrence, development, and severity of CSVD. However, the diagnostic process lacks quantitative evaluation criteria and is limited by experience, which may easily lead to missed diagnoses and misdiagnoses. With the development of artificial intelligence technology based on deep learning, the extraction of high-dimensional features in imaging can assist doctors in clinical decision-making, and it has been widely used in brain function and mental disorders, and cardiovascular and cerebrovascular diseases. This paper summarizes the global research results in recent years and briefly describes the application of deep learning in evaluating CSVD signs in MRI imaging, including recent small subcortical infarcts, lacunes of presumed vascular origin, vascular white matter hyperintensity, enlarged perivascular spaces, cerebral microbleeds, brain atrophy, cortical superficial siderosis, and cortical cerebral microinfarct.


Assuntos
Inteligência Artificial , Doenças de Pequenos Vasos Cerebrais , Imageamento por Ressonância Magnética , Humanos , Doenças de Pequenos Vasos Cerebrais/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Aprendizado Profundo , Neuroimagem/métodos
18.
PLoS Comput Biol ; 20(7): e1012241, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38985831

RESUMO

Dimension reduction tools preserving similarity and graph structure such as t-SNE and UMAP can capture complex biological patterns in high-dimensional data. However, these tools typically are not designed to separate effects of interest from unwanted effects due to confounders. We introduce the partial embedding (PARE) framework, which enables removal of confounders from any distance-based dimension reduction method. We then develop partial t-SNE and partial UMAP and apply these methods to genomic and neuroimaging data. For lower-dimensional visualization, our results show that the PARE framework can remove batch effects in single-cell sequencing data as well as separate clinical and technical variability in neuroimaging measures. We demonstrate that the PARE framework extends dimension reduction methods to highlight biological patterns of interest while effectively removing confounding effects.


Assuntos
Algoritmos , Biologia Computacional , Neuroimagem , Humanos , Neuroimagem/métodos , Biologia Computacional/métodos , Genômica/métodos , Genômica/estatística & dados numéricos , Análise de Célula Única/métodos , Análise de Célula Única/estatística & dados numéricos
19.
Cereb Cortex ; 34(7)2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-39042033

RESUMO

We aimed to evaluate the potential causal relationship between brain imaging-derived phenotypes and cognitive functions via Mendelian randomization analyses. Genetic instruments for 470 brain imaging-derived phenotypes were selected from a genome-wide association study based on the UK Biobank (n = 33,224). Statistics for cognitive functions were obtained from the genome-wide association study based on the UK Biobank. We used the inverse variance weighted Mendelian randomization method to investigate the associations between brain imaging-derived phenotypes and cognitive functions, and reverse Mendelian randomization analyses were performed for significant brain imaging-derived phenotypes to examine the reverse causation for the identified associations. We identified three brain imaging-derived phenotypes to be associated with verbal-numerical reasoning, including cortical surface area of the left fusiform gyrus (beta, 0.18 [95% confidence interval, 0.11 to 0.25], P = 4.74 × 10-7), cortical surface area of the right superior temporal gyrus (beta, 0.25 [95% confidence interval, 0.15 to 0.35], P = 6.30 × 10-7), and orientation dispersion in the left superior longitudinal fasciculus (beta, 0.14 [95% confidence interval, 0.09 to 0.20], P = 8.37 × 10-7). The reverse Mendelian randomization analysis indicated that verbal-numerical reasoning had no effect on these three brain imaging-derived phenotypes. This Mendelian randomization study identified cortical surface area of the left fusiform gyrus, cortical surface area of the right superior temporal gyrus, and orientation dispersion in the left superior longitudinal fasciculus as predictors of verbal-numerical reasoning.


Assuntos
Encéfalo , Cognição , Estudo de Associação Genômica Ampla , Análise da Randomização Mendeliana , Fenótipo , Humanos , Cognição/fisiologia , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Masculino , Feminino , Neuroimagem/métodos , Pessoa de Meia-Idade , Imageamento por Ressonância Magnética/métodos , Idoso
20.
Epilepsy Res ; 204: 107400, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38954950

RESUMO

OBJECTIVE: Approximately 20-30 % of epilepsy patients exhibit negative findings on routine magnetic resonance imaging, and this condition is known as nonlesional epilepsy. Absence epilepsy (AE) is a prevalent form of nonlesional epilepsy. This study aimed to investigate the clinical diagnostic utility of regional homogeneity (ReHo) assessed through the support vector machine (SVM) approach for identifying AE. METHODS: This research involved 102 healthy individuals and 93 AE patients. Resting-state functional magnetic resonance imaging was employed for data acquisition in all participants. ReHo analysis, coupled with SVM methodology, was utilized for data processing. RESULTS: Compared to healthy control individuals, AE patients demonstrated significantly elevated ReHo values in the bilateral putamen, accompanied by decreased ReHo in the bilateral thalamus. SVM was used to differentiate patients with AE from healthy control individuals based on rs-fMRI data. A composite assessment of altered ReHo in the left putamen and left thalamus yielded the highest accuracy at 81.64 %, with a sensitivity of 95.41 % and a specificity of 69.23 %. SIGNIFICANCE: According to the results, altered ReHo values in the bilateral putamen and thalamus could serve as neuroimaging markers for AE, offering objective guidance for its diagnosis.


Assuntos
Epilepsia Tipo Ausência , Imageamento por Ressonância Magnética , Máquina de Vetores de Suporte , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Feminino , Adulto , Epilepsia Tipo Ausência/diagnóstico por imagem , Adulto Jovem , Tálamo/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Neuroimagem/métodos , Putamen/diagnóstico por imagem , Mapeamento Encefálico/métodos , Sensibilidade e Especificidade
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