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Clinical and Neuropathological Correlates of Substance Use in American Football Players. 美式橄榄球运动员使用药物的临床和神经病理学相关性。
IF 4 3区 医学 Q2 NEUROSCIENCES Pub Date : 2024-09-07 DOI: 10.3233/jad-240300
Michael Walsh,Madeline Uretsky,Yorghos Tripodis,Christopher J Nowinski,Abigail Rasch,Hannah Bruce,Megan Ryder,Brett M Martin,Joseph N Palmisano,Douglas I Katz,Brigid Dwyer,Daniel H Daneshvar,Alexander Y Walley,Theresa W Kim,Lee E Goldstein,Robert A Stern,Victor E Alvarez,Bertrand Russell Huber,Ann C McKee,Thor D Stein,Jesse Mez,Michael L Alosco
BackgroundChronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy more frequently found in deceased former football players. CTE has heterogeneous clinical presentations with multifactorial causes. Previous literature has shown substance use (alcohol/drug) can contribute to Alzheimer's disease and related tauopathies pathologically and clinically.ObjectiveTo examine the association between substance use and clinical and neuropathological endpoints of CTE.MethodsOur sample included 429 deceased male football players. CTE was neuropathologically diagnosed. Informant interviews assessed features of substance use and history of treatment for substance use to define indicators: history of substance use treatment (yes vs no, primary variable), alcohol severity, and drug severity. Outcomes included scales that were completed by informants to assess cognition (Cognitive Difficulties Scale, BRIEF-A Metacognition Index), mood (Geriatric Depression Scale-15), behavioral regulation (BRIEF-A Behavioral Regulation Index, Barratt Impulsiveness Scale-11), functional ability (Functional Activities Questionnaire), as well as CTE status and cumulative p-tau burden. Regression models tested associations between substance use indicators and outcomes.ResultsOf the 429 football players (mean age = 62.07), 313 (73%) had autopsy confirmed CTE and 100 (23%) had substance use treatment history. Substance use treatment and alcohol/drug severity were associated with measures of behavioral regulation (FDR-p-values<0.05, ΔR2 = 0.04-0.18) and depression (FDR-p-values<0.05, ΔR2 = 0.02-0.05). Substance use indicators had minimal associations with cognitive scales, whereas p-tau burden was associated with all cognitive scales (p-values <0.05). Substance use treatment had no associations with neuropathological endpoints (FDR-p-values>0.05).ConclusionsAmong deceased football players, substance use was common and associated with clinical symptoms.
背景 慢性创伤性脑病(CTE)是一种神经退行性牛磺酸病,多见于已故的前橄榄球运动员。CTE 的临床表现多种多样,其病因是多因素的。以前的文献表明,使用药物(酒精/毒品)在病理和临床上可能会导致阿尔茨海默病和相关的牛磺酸病。目的 研究使用药物与 CTE 的临床和神经病理学终点之间的关系。我们的样本包括 429 名已故的男性足球运动员,他们均经神经病理学诊断为 CTE。知情者访谈评估了药物使用特征和药物使用治疗史,以确定指标:药物使用治疗史(是与否,主要变量)、酒精严重程度和药物严重程度。结果包括由信息提供者完成的量表,用于评估认知(认知困难量表、BRIEF-A 元认知指数)、情绪(老年抑郁量表-15)、行为调节(BRIEF-A 行为调节指数、Barratt 冲动量表-11)、功能能力(功能活动问卷)以及 CTE 状态和累积 p-tau 负担。回归模型检验了药物使用指标与结果之间的关联。结果 在 429 名足球运动员(平均年龄 = 62.07 岁)中,313 人(73%)经尸检证实患有 CTE,100 人(23%)有药物使用治疗史。药物使用治疗和酒精/毒品严重程度与行为调节指标相关(FDR-p 值为 0.05)。
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引用次数: 0
Alzheimer's Disease: An Attempt of Total Recall. 阿尔茨海默病:全面回忆的尝试
IF 4 3区 医学 Q2 NEUROSCIENCES Pub Date : 2024-09-07 DOI: 10.3233/jad-240620
Alexey P Bolshakov,Konstantin Gerasimov,Yulia V Dobryakova
This review is an attempt to compile existing hypotheses on the mechanisms underlying the initiation and progression of Alzheimer's disease (AD), starting from sensory impairments observed in AD and concluding with molecular events that are typically associated with the disease. These events include spreading of amyloid plaques and tangles of hyperphosphorylated tau and formation of Hirano and Biondi bodies as well as the development of oxidative stress. We have detailed the degenerative changes that occur in several neuronal populations, including the cholinergic neurons in the nucleus basalis of Meynert, the histaminergic neurons in the tuberomammillary nucleus, the serotonergic neurons in the raphe nuclei, and the noradrenergic neurons in the locus coeruleus. Furthermore, we discuss the potential role of iron accumulation in the brains of subjects with AD in the disease progression which served as a basis for the idea that iron chelation in the brain may mitigate oxidative stress and decelerate disease development. We also draw attention to possible role of sympathetic system and, more specifically, noradrenergic neurons of the superior cervical ganglion in triggering of the disease. We also explore the alternative possibility of compensatory protective changes that may occur in these neurons to support cholinergic function in the forebrain of subjects with AD.
这篇综述试图从阿尔茨海默病(AD)中观察到的感官障碍入手,以与该疾病相关的典型分子事件为结论,对阿尔茨海默病(AD)发病和进展机制的现有假说进行梳理。这些事件包括淀粉样蛋白斑块的扩散、高磷酸化 tau 的缠结、平野体和比昂迪体的形成以及氧化应激的发展。我们详细介绍了发生在几个神经元群中的退行性变化,包括麦氏基底核中的胆碱能神经元、结节乳突核中的组胺能神经元、剑突核中的5-羟色胺能神经元和脑室中的去甲肾上腺素能神经元。此外,我们还讨论了 AD 患者大脑中铁的积累在疾病进展中的潜在作用,这也是大脑中铁螯合作用可减轻氧化应激和减缓疾病发展的观点的基础。我们还提请注意交感系统,更具体地说是颈上神经节的去甲肾上腺素能神经元在诱发疾病中可能扮演的角色。我们还探讨了另一种可能性,即这些神经元可能发生代偿性保护变化,以支持注意力缺失症患者前脑的胆碱能功能。
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引用次数: 0
A Data-Driven Cognitive Composite Sensitive to Amyloid-β for Preclinical Alzheimer's Disease. 对淀粉样蛋白-β敏感的数据驱动认知复合体,用于临床前阿尔茨海默病
IF 4 3区 医学 Q2 NEUROSCIENCES Pub Date : 2024-09-06 DOI: 10.3233/jad-231319
Shu Liu,Paul Maruff,Victor Fedyashov,Colin L Masters,Benjamin Goudey
BackgroundIntegrating scores from multiple cognitive tests into a single cognitive composite has been shown to improve sensitivity to detect AD-related cognitive impairment. However, existing composites have little sensitivity to amyloid-β status (Aβ +/-) in preclinical AD.ObjectiveEvaluate whether a data-driven approach for deriving cognitive composites can improve the sensitivity to detect Aβ status among cognitively unimpaired (CU) individuals compared to existing cognitive composites.MethodsBased on the data from the Anti-Amyloid Treatment in the Asymptomatic Alzheimer's Disease (A4) study, a novel composite, the Data-driven Preclinical Alzheimer's Cognitive Composite (D-PACC), was developed based on test scores and response durations selected using a machine learning algorithm from the Cogstate Brief Battery (CBB). The D-PACC was then compared with conventional composites in the follow-up A4 visits and in individuals from the Alzheimer's Disease Neuroimaging Initiative (ADNI).ResultThe D-PACC showed a comparable or significantly higher ability to discriminate Aβ status [median Cohen's d = 0.172] than existing composites at the A4 baseline visit, with similar results at the second visit. The D-PACC demonstrated the most consistent sensitivity to Aβ status in both A4 and ADNI datasets.ConclusionsThe D-PACC showed similar or improved sensitivity when screening for Aβ+ in CU populations compared to existing composites but with higher consistency across studies.
背景将多个认知测试的得分整合到一个认知复合测试中,已被证明能提高检测与急性损伤相关的认知障碍的灵敏度。目的与现有的认知复合测试相比,评估用数据驱动的方法得出认知复合测试是否能提高检测认知功能未受损(CU)个体的淀粉样β状态的灵敏度。方法以无症状阿尔茨海默病(A4)抗淀粉样蛋白治疗研究的数据为基础,使用机器学习算法从 Cogstate Brief Battery (CBB) 中选择测试得分和反应持续时间,开发出一种新型复合方法--数据驱动的临床前阿尔茨海默氏症认知复合方法(D-PACC)。结果D-PACC对Aβ状态的判别能力[中位数Cohen's d = 0.172]与A4基线随访时的现有复合量表相当或明显更高,第二次随访时的结果与之相似。结论D-PACC在CU人群中筛查Aβ+的灵敏度与现有复合样本相似或更高,但在不同研究中具有更高的一致性。
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引用次数: 0
Adverse Events as a Cause of Unblinding of Allocated Arms in Anti-Amyloid Therapy Trials: A Meta-Analysis of the Predictive Value. 不良事件是导致抗淀粉样变性治疗试验中分配臂取消盲法的原因之一:预测价值的 Meta 分析。
IF 4 3区 医学 Q2 NEUROSCIENCES Pub Date : 2024-09-06 DOI: 10.3233/jad-240623
Kenichiro Sato,Yoshiki Niimi,Ryoko Ihara,Atsushi Iwata,Takeshi Iwatsubo
Anti-amyloid drugs for early Alzheimer's disease, including lecanemab, are associated with adverse events (AEs), such as amyloid-related imaging abnormalities (ARIA)-edema/effusion (E), ARIA-hemorrhage, and infusion-related reactions, which can indicate allocated arms in clinical trials. Herein, we evaluated the predictive value of AEs using a meta-analysis to estimate their incidence and simulated positive predictive value (PPV). The PPV for ARIA-E was high (0.915), but that for ARIA hemorrhage was low (0.630). Infusion-related reactions had a high PPV of 0.910, but with a wide confidence interval. Our results suggest the need to ameliorate the unblinding effects of AEs, particularly ARIA-E in trials.
包括莱卡奈单抗在内的治疗早期阿尔茨海默病的抗淀粉样蛋白药物与不良事件(AEs)有关,如淀粉样蛋白相关成像异常(ARIA)-水肿/渗出(E)、ARIA-出血和输液相关反应,这些不良事件可能预示着临床试验中被分配的臂。在此,我们通过荟萃分析评估了AEs的预测价值,以估计其发生率和模拟阳性预测值(PPV)。ARIA-E的预测值较高(0.915),但ARIA出血的预测值较低(0.630)。输液相关反应的 PPV 高达 0.910,但置信区间较宽。我们的研究结果表明,有必要在试验中改善AE(尤其是ARIA-E)的非绑定效应。
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引用次数: 0
Interpersonal Synchrony in Dance/Movement Therapy: Neural Underpinnings for Individuals with Dementia. 舞蹈/运动疗法中的人际同步:痴呆症患者的神经基础。
IF 3.4 3区 医学 Q2 NEUROSCIENCES Pub Date : 2024-07-30 DOI: 10.3233/JAD-240239
Rebekka Dieterich-Hartwell

Rising global levels of dementia including Alzheimer's disease call for the treatment of both cognitive and psychosocial deficits of this population. While there is no cure for dementia, the progression can be slowed, and symptoms eased. The positive effects of exercise and dance have been documented as has interpersonal synchrony. Dance/movement therapy uses kinesthetic empathy, attunement, and mirroring to communicate, synchronize, and connect with clients, salient for a population that often struggles with loneliness and isolation. Here I offer a perspective on how dance/movement therapy promotes the social functions and neural underpinning of interpersonal synchrony, possibly providing neuroprotection for this population.

包括阿尔茨海默病在内的痴呆症在全球的发病率不断上升,这就要求对这一人群的认知和社会心理缺陷进行治疗。虽然痴呆症无法治愈,但可以延缓病情发展,缓解症状。运动和舞蹈的积极作用以及人际间的同步性已被证实。舞蹈/运动疗法利用动觉共鸣、调适和镜像来与客户沟通、同步和联系,这对于经常在孤独和孤立中挣扎的人群来说非常重要。在此,我将从舞蹈/运动疗法如何促进人际同步的社会功能和神经基础的角度,为这一人群提供可能的神经保护。
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引用次数: 0
Moving Towards a Medicine of Dance: A Scoping Review of Characteristics of Dance Interventions Targeting Older Adults and a Theoretical Framework. 迈向舞蹈医学:以老年人为对象的舞蹈干预措施的特点范围综述和理论框架。
IF 3.4 3区 医学 Q2 NEUROSCIENCES Pub Date : 2024-07-12 DOI: 10.3233/JAD-230741
Paige E Rice, Deepthi Thumuluri, Rebecca Barnstaple, Jason Fanning, Jessie Laurita-Spanglet, Christina T Soriano, Christina E Hugenschmidt

Background: Dance combines cultural and aesthetic elements with behaviors important for brain health, including physical activity, social engagement, and cognitive challenge. Therefore, dance could positively impact public health given the rapidly aging population, increasing incidence of Alzheimer's disease and related dementias, and lack of uptake of exercise in many older adults. Despite a high volume of literature, existing literature does not support evidence-based guidelines for dance to support healthy aging.

Objective: To conduct a scoping review of the dance intervention literature in older adults and provide information to facilitate a more consistent approach among scientists in designing dance interventions for older adults that stimulate physical and neurocognitive health adaptations.

Methods: Study characteristics (sample size, population, study design, outcomes, intervention details) were ascertained from 112 separate studies of dance reported in 127 papers that reported outcomes important for brain health (cardiorespiratory fitness, balance and mobility, cognition, mood, and quality of life).

Results: High heterogeneity across studies was evident. Class frequency ranged from < 1 to 5 classes per week, class length from 30-120 minutes, and intervention duration from 2 weeks to 18 months. Studies often did not randomize participants, had small (< 30) sample sizes, and used varied comparator conditions. Over 50 tests of cognition, 40 dance forms, and 30 tests of mobility were identified.

Conclusions: Based on these results, important future directions are establishing common data elements, developing intervention mapping and mechanistic modeling, and testing dosing parameters to strengthen and focus trial design of future studies and generate evidence-based guidelines for dance.

背景:舞蹈将文化和美学元素与对大脑健康非常重要的行为相结合,包括体育活动、社交参与和认知挑战。因此,鉴于人口迅速老龄化、阿尔茨海默病和相关痴呆症的发病率不断上升以及许多老年人缺乏锻炼,舞蹈可以对公众健康产生积极影响。尽管有大量文献,但现有文献并不支持以证据为基础的舞蹈支持健康老龄化的指导方针:目的:对有关老年人舞蹈干预的文献进行概括性回顾,并提供相关信息,以促进科学家在为老年人设计舞蹈干预时采用更加一致的方法,从而激发老年人的身体和神经认知健康适应能力:从127篇论文中报告的112项独立的舞蹈研究中确定了研究特征(样本大小、人群、研究设计、结果、干预细节),这些研究报告了对大脑健康非常重要的结果(心肺功能、平衡和活动能力、认知、情绪和生活质量):结果:各研究之间存在明显的高度异质性。结论基于这些结果,未来的重要方向是建立通用数据元素、开发干预映射和机理建模,以及测试剂量参数,以加强和关注未来研究的试验设计,并为舞蹈制定循证指南。
{"title":"Moving Towards a Medicine of Dance: A Scoping Review of Characteristics of Dance Interventions Targeting Older Adults and a Theoretical Framework.","authors":"Paige E Rice, Deepthi Thumuluri, Rebecca Barnstaple, Jason Fanning, Jessie Laurita-Spanglet, Christina T Soriano, Christina E Hugenschmidt","doi":"10.3233/JAD-230741","DOIUrl":"https://doi.org/10.3233/JAD-230741","url":null,"abstract":"<p><strong>Background: </strong>Dance combines cultural and aesthetic elements with behaviors important for brain health, including physical activity, social engagement, and cognitive challenge. Therefore, dance could positively impact public health given the rapidly aging population, increasing incidence of Alzheimer's disease and related dementias, and lack of uptake of exercise in many older adults. Despite a high volume of literature, existing literature does not support evidence-based guidelines for dance to support healthy aging.</p><p><strong>Objective: </strong>To conduct a scoping review of the dance intervention literature in older adults and provide information to facilitate a more consistent approach among scientists in designing dance interventions for older adults that stimulate physical and neurocognitive health adaptations.</p><p><strong>Methods: </strong>Study characteristics (sample size, population, study design, outcomes, intervention details) were ascertained from 112 separate studies of dance reported in 127 papers that reported outcomes important for brain health (cardiorespiratory fitness, balance and mobility, cognition, mood, and quality of life).</p><p><strong>Results: </strong>High heterogeneity across studies was evident. Class frequency ranged from < 1 to 5 classes per week, class length from 30-120 minutes, and intervention duration from 2 weeks to 18 months. Studies often did not randomize participants, had small (< 30) sample sizes, and used varied comparator conditions. Over 50 tests of cognition, 40 dance forms, and 30 tests of mobility were identified.</p><p><strong>Conclusions: </strong>Based on these results, important future directions are establishing common data elements, developing intervention mapping and mechanistic modeling, and testing dosing parameters to strengthen and focus trial design of future studies and generate evidence-based guidelines for dance.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Associations Between Music and Dance Relationships, Rhythmic Proficiency, and Spatiotemporal Movement Modulation Ability in Adults with and without Mild Cognitive Impairment. 有轻度认知障碍和无轻度认知障碍成人的音乐与舞蹈关系、节奏熟练程度和时空运动调节能力之间的关联。
IF 3.4 3区 医学 Q2 NEUROSCIENCES Pub Date : 2024-07-06 DOI: 10.3233/JAD-231453
Alexandra Slusarenko, Michael C Rosenberg, Meghan E Kazanski, J Lucas McKay, Laura Emmery, Trisha M Kesar, Madeleine E Hackney

Background: Personalized dance-based movement therapies may improve cognitive and motor function in individuals with mild cognitive impairment (MCI), a precursor to Alzheimer's disease. While age- and MCI-related deficits reduce individuals' abilities to perform dance-like rhythmic movement sequences (RMS)-spatial and temporal modifications to movement-it remains unclear how individuals' relationships to dance and music affect their ability to perform RMS.

Objective: Characterize associations between RMS performance and music or dance relationships, as well as the ability to perceive rhythm and meter (rhythmic proficiency) in adults with and without MCI.

Methods: We used wearable inertial sensors to evaluate the ability of 12 young adults (YA; age = 23.9±4.2 years; 9F), 26 older adults without MCI (OA; age = 68.1±8.5 years; 16F), and 18 adults with MCI (MCI; age = 70.8±6.2 years; 10F) to accurately perform spatial, temporal, and spatiotemporal RMS. To quantify self-reported music and dance relationships and rhythmic proficiency, we developed Music (MRQ) and Dance Relationship Questionnaires (DRQ), and a rhythm assessment (RA), respectively. We correlated MRQ, DRQ, and RA scores against RMS performance for each group separately.

Results: The OA and YA groups exhibited better MRQ and RA scores than the MCI group (p < 0.006). Better MRQ and RA scores were associated with better temporal RMS performance for only the YA and OA groups (r2 = 0.18-0.41; p < 0.045). DRQ scores were not associated with RMS performance in any group.

Conclusions: Cognitive deficits in adults with MCI likely limit the extent to which music relationships or rhythmic proficiency improve the ability to perform temporal aspects of movements performed during dance-based therapies.

背景:基于舞蹈的个性化运动疗法可改善轻度认知障碍(MCI)患者的认知和运动功能,而轻度认知障碍是阿尔茨海默病的前兆。虽然与年龄和 MCI 相关的缺陷会降低患者进行类似舞蹈的节奏性动作序列(RMS)--对动作进行空间和时间上的调整--的能力,但目前仍不清楚患者与舞蹈和音乐的关系会如何影响他们进行 RMS 的能力:描述患有和未患有 MCI 的成年人的 RMS 表演与音乐或舞蹈关系以及感知节奏和节拍能力(节奏熟练度)之间的关联:我们使用可穿戴惯性传感器评估了 12 名年轻成人(YA;年龄 = 23.9±4.2岁;9F)、26 名未患有 MCI 的老年人(OA;年龄 = 68.1±8.5岁;16F)和 18 名患有 MCI 的成人(MCI;年龄 = 70.8±6.2岁;10F)准确执行空间、时间和时空 RMS 的能力。为了量化自我报告的音乐和舞蹈关系以及节奏能力,我们分别编制了音乐(MRQ)和舞蹈关系问卷(DRQ)以及节奏评估(RA)。我们分别将各组的 MRQ、DRQ 和 RA 分数与 RMS 成绩进行了关联:结果:OA 组和 YA 组的 MRQ 和 RA 得分均优于 MCI 组(p 结论:OA 组和 YA 组的 MRQ 和 RA 得分均优于 MCI 组:成人 MCI 患者的认知缺陷可能会限制音乐关系或节奏熟练程度在多大程度上提高舞蹈疗法中动作的时间性能力。
{"title":"Associations Between Music and Dance Relationships, Rhythmic Proficiency, and Spatiotemporal Movement Modulation Ability in Adults with and without Mild Cognitive Impairment.","authors":"Alexandra Slusarenko, Michael C Rosenberg, Meghan E Kazanski, J Lucas McKay, Laura Emmery, Trisha M Kesar, Madeleine E Hackney","doi":"10.3233/JAD-231453","DOIUrl":"10.3233/JAD-231453","url":null,"abstract":"<p><strong>Background: </strong>Personalized dance-based movement therapies may improve cognitive and motor function in individuals with mild cognitive impairment (MCI), a precursor to Alzheimer's disease. While age- and MCI-related deficits reduce individuals' abilities to perform dance-like rhythmic movement sequences (RMS)-spatial and temporal modifications to movement-it remains unclear how individuals' relationships to dance and music affect their ability to perform RMS.</p><p><strong>Objective: </strong>Characterize associations between RMS performance and music or dance relationships, as well as the ability to perceive rhythm and meter (rhythmic proficiency) in adults with and without MCI.</p><p><strong>Methods: </strong>We used wearable inertial sensors to evaluate the ability of 12 young adults (YA; age = 23.9±4.2 years; 9F), 26 older adults without MCI (OA; age = 68.1±8.5 years; 16F), and 18 adults with MCI (MCI; age = 70.8±6.2 years; 10F) to accurately perform spatial, temporal, and spatiotemporal RMS. To quantify self-reported music and dance relationships and rhythmic proficiency, we developed Music (MRQ) and Dance Relationship Questionnaires (DRQ), and a rhythm assessment (RA), respectively. We correlated MRQ, DRQ, and RA scores against RMS performance for each group separately.</p><p><strong>Results: </strong>The OA and YA groups exhibited better MRQ and RA scores than the MCI group (p < 0.006). Better MRQ and RA scores were associated with better temporal RMS performance for only the YA and OA groups (r2 = 0.18-0.41; p < 0.045). DRQ scores were not associated with RMS performance in any group.</p><p><strong>Conclusions: </strong>Cognitive deficits in adults with MCI likely limit the extent to which music relationships or rhythmic proficiency improve the ability to perform temporal aspects of movements performed during dance-based therapies.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141599847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incident Dementia After Spontaneous Intracerebral Hemorrhage 自发性脑内出血后的痴呆事件
IF 4 3区 医学 Q2 NEUROSCIENCES Pub Date : 2024-04-30 DOI: 10.3233/jad-240111
Zheting Zhang, Mervyn Jun Rui Lim
Post-stroke cognitive impairment and dementia (PSCID) is a complication that affects long-term functional outcomes after stroke. Studies on dementia after long-term follow-up in stroke have focused predominantly on ischemic stroke, which may be different from the development of dementia after spontaneous intracerebral hemorrhage (ICH). In this review, we summarize the existing data and hypotheses on the development of dementia after spontaneous ICH, review the management of post-ICH dementia, and suggest areas for future research. Dementia after spontaneous ICH has a cumulative incidence of up to 32.0–37.4% at 5 years post-ICH. Although the pathophysiology of post-ICH dementia has not been fully understood, two main theoretical frameworks can be considered: 1) the triggering role of ICH (both primary and secondary brain injury) in precipitating cognitive decline and dementia; and 2) the contributory role of pre-existing brain pathology (including small vessel disease and neurodegenerative pathology), reduced cognitive reserve, and genetic factors predisposing to cognitive dysfunction. These pathophysiological pathways may have synergistic effects that converge on dysfunction of the neurovascular unit and disruptions in functional connectivity leading to dementia post-ICH. Management of post-ICH dementia may include screening and monitoring, cognitive therapy, and pharmacotherapy. Non-invasive brain stimulation is an emerging therapeutic modality under investigation for safety and efficacy. Our review highlights that there remains a paucity of data and standardized reporting on incident dementia after spontaneous ICH. Further research is imperative for determining the incidence, risk factors, and pathophysiology of post-ICH dementia, in order to identify new therapies for the treatment of this debilitating condition.
卒中后认知障碍和痴呆(PSCID)是影响卒中后长期功能预后的一种并发症。有关脑卒中长期随访后痴呆的研究主要集中在缺血性脑卒中,这可能与自发性脑内出血(ICH)后痴呆的发生有所不同。在本综述中,我们总结了有关自发性 ICH 后痴呆发展的现有数据和假设,回顾了 ICH 后痴呆的处理方法,并提出了未来的研究领域。自发性 ICH 后痴呆症在 ICH 后 5 年的累积发病率高达 32.0-37.4%。虽然 ICH 后痴呆症的病理生理学尚未完全清楚,但有两个主要的理论框架可供选择:1)ICH(原发性和继发性脑损伤)在诱发认知功能下降和痴呆症方面的触发作用;2)先前存在的脑部病变(包括小血管疾病和神经退行性病变)、认知储备减少以及易导致认知功能障碍的遗传因素的促成作用。这些病理生理途径可能会产生协同效应,导致神经血管单元功能障碍和功能连接中断,从而导致重度脑缺血后痴呆症。ICH 后痴呆症的治疗可包括筛查和监测、认知疗法和药物疗法。非侵入性脑刺激是一种新兴的治疗方式,其安全性和有效性正在研究之中。我们的综述强调,关于自发性 ICH 后发生痴呆的数据和标准化报告仍然很少。进一步的研究对于确定 ICH 后痴呆症的发病率、风险因素和病理生理学至关重要,以便确定治疗这种衰弱病症的新疗法。
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引用次数: 0
Psychosis in Neurodegenerative Dementias: A Systematic Comparative Review 神经退行性痴呆症中的精神病:系统性比较综述
IF 4 3区 医学 Q2 NEUROSCIENCES Pub Date : 2024-04-30 DOI: 10.3233/jad-231363
Coralie Cressot, Agathe Vrillon, Matthieu Lilamand, Hélène Francisque, Aurélie Méauzoone, Claire Hourregue, Julien Dumurgier, Emeline Marlinge, Claire Paquet, Emmanuel Cognat
Background:Psychosis, characterized by delusions and/or hallucinations, is frequently observed during the progression of Alzheimer’s disease (AD) and other neurodegenerative dementias (ND) (i.e., dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD)) and cause diagnostic and managementdifficulties. Objective:This review aims at presenting a concise and up-to-date overview of psychotic symptoms that occur in patients with ND with a comparative approach. Methods:A systematic review was conducted following the PRISMA guidelines. 98 original studies investigating psychosis phenotypes in neurodegenerative dementias were identified (40 cohort studies, 57 case reports). Results:Psychosis is a frequently observed phenomenon during the course of ND, with reported prevalence ranging from 22.5% to 54.1% in AD, 55.9% to 73.9% in DLB, and 18% to 42% in FTD. Throughout all stages of these diseases, noticeable patterns emerge depending on their underlying causes. Misidentification delusions (16.6–78.3%) and visual hallucinations (50–69.6%) are frequently observed in DLB, while paranoid ideas and somatic preoccupations seem to be particularly common in AD and FTD, (respectively 9.1–60.3% and 3.10–41.5%). Limited data were found regarding psychosis in the early stages of these disorders. Conclusions:Literature data suggest that different ND are associated with noticeable variations in psychotic phenotypes, reflecting disease-specific tendencies. Further studies focusing on the early stages of these disorders are necessary to enhance our understanding of early psychotic manifestations associated with ND and help in differential diagnosis issues.
背景:以妄想和/或幻觉为特征的精神病在阿尔茨海默病(AD)和其他神经退行性痴呆(ND)(即路易体痴呆(DLB)和额颞叶痴呆(FTD))的进展过程中经常出现,给诊断和管理带来困难。目的:本综述旨在以比较的方法对 ND 患者出现的精神病性症状进行简明扼要的最新概述。方法:按照 PRISMA 指南进行了系统性综述。确定了 98 项调查神经退行性痴呆症患者精神病表型的原始研究(40 项队列研究,57 项病例报告)。结果:精神病是神经退行性痴呆症病程中经常出现的现象,据报道,发病率在AD中为22.5%至54.1%,在DLB中为55.9%至73.9%,在FTD中为18%至42%。在这些疾病的各个阶段,都会出现明显的模式,这取决于其根本原因。错认妄想(16.6%-78.3%)和视幻觉(50%-69.6%)经常出现在 DLB 中,而偏执想法和躯体妄想似乎在 AD 和 FTD 中尤为常见(分别为 9.1%-60.3%和 3.10%-41.5%)。有关这些疾病早期精神病的数据有限。结论:文献数据表明,不同的ND与精神病表型的明显差异有关,反映了疾病的特异性倾向。有必要对这些疾病的早期阶段进行进一步研究,以加深我们对与 ND 相关的早期精神病表现的了解,并帮助解决鉴别诊断问题。
{"title":"Psychosis in Neurodegenerative Dementias: A Systematic Comparative Review","authors":"Coralie Cressot, Agathe Vrillon, Matthieu Lilamand, Hélène Francisque, Aurélie Méauzoone, Claire Hourregue, Julien Dumurgier, Emeline Marlinge, Claire Paquet, Emmanuel Cognat","doi":"10.3233/jad-231363","DOIUrl":"https://doi.org/10.3233/jad-231363","url":null,"abstract":"Background:Psychosis, characterized by delusions and/or hallucinations, is frequently observed during the progression of Alzheimer’s disease (AD) and other neurodegenerative dementias (ND) (i.e., dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD)) and cause diagnostic and managementdifficulties. Objective:This review aims at presenting a concise and up-to-date overview of psychotic symptoms that occur in patients with ND with a comparative approach. Methods:A systematic review was conducted following the PRISMA guidelines. 98 original studies investigating psychosis phenotypes in neurodegenerative dementias were identified (40 cohort studies, 57 case reports). Results:Psychosis is a frequently observed phenomenon during the course of ND, with reported prevalence ranging from 22.5% to 54.1% in AD, 55.9% to 73.9% in DLB, and 18% to 42% in FTD. Throughout all stages of these diseases, noticeable patterns emerge depending on their underlying causes. Misidentification delusions (16.6–78.3%) and visual hallucinations (50–69.6%) are frequently observed in DLB, while paranoid ideas and somatic preoccupations seem to be particularly common in AD and FTD, (respectively 9.1–60.3% and 3.10–41.5%). Limited data were found regarding psychosis in the early stages of these disorders. Conclusions:Literature data suggest that different ND are associated with noticeable variations in psychotic phenotypes, reflecting disease-specific tendencies. Further studies focusing on the early stages of these disorders are necessary to enhance our understanding of early psychotic manifestations associated with ND and help in differential diagnosis issues.","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":"32 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140839054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Could the Historical Transition from Segmented to Monophasic Sleep Explain the Modern Insurgence of Alzheimer’s Disease and Related Dementias? 从分段睡眠到单相睡眠的历史性转变能否解释现代阿尔茨海默病和相关痴呆症的肆虐?
IF 4 3区 医学 Q2 NEUROSCIENCES Pub Date : 2024-04-16 DOI: 10.3233/jad-240154
Nicola Luigi Bragazzi, Ayoub Boulares, Sergio Garbarino
In their article, Finch and Burstein explore the hypothesis that Alzheimer’s disease and related dementias (ADRD) may predominantly be phenomena of the modern era. Through a review of classical Greek and Latin literature, they found minimal reference to conditions akin to ADRD, suggesting a historical rarity of severe cognitive decline. Instead, ancient texts focused on physical aspects of aging, with cognitive changes, when noted, not resembling modern-day dementia. Finch and Burstein further extend their analysis by drawing parallels with the Tsimane people of Bolivia, known for their low prevalence of dementia and cardiovascular diseases, attributed to lifestyle factors such as diet and physical activity. By comparing historical sleep patterns transitioning from segmented to monophasic sleep with those of the Tsimane community, we enriched Finch and Burstein’s research, highlighting the need to take into account a range of diverse factors, including sleep, in understanding the etiopathogenesis of ADRD in today’s society.
芬奇和伯斯汀在文章中探讨了阿尔茨海默病和相关痴呆症(ADRD)可能主要是现代现象的假设。通过对古典希腊语和拉丁语文献的回顾,他们发现与 ADRD 类似的病症极少被提及,这表明严重认知功能衰退在历史上是罕见的。相反,古代文献侧重于衰老的生理方面,即使提到认知变化,也与现代痴呆症并不相似。芬奇和伯斯汀进一步扩展了他们的分析,将其与玻利维亚的齐玛尼人相提并论,齐玛尼人以痴呆症和心血管疾病发病率低而闻名,这归因于饮食和体育锻炼等生活方式因素。通过将历史上从分段睡眠过渡到单相睡眠的睡眠模式与Tsimane社区的睡眠模式进行比较,我们丰富了Finch和Burstein的研究,强调在理解当今社会ADRD的发病机制时,需要考虑包括睡眠在内的一系列不同因素。
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引用次数: 0
期刊
Journal of Alzheimer's Disease
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