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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
Robert Rissman, PhD, is the recipient of the 2024 Alzheimer Award 罗伯特-里斯曼(Robert Rissman)博士荣获 2024 年阿尔茨海默奖
IF 3.4 3区 医学 Q2 NEUROSCIENCES Pub Date : 2024-07-16 DOI: 10.3233/jad-249013
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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。
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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。
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引用次数: 0
BACE1 Inhibitors for Alzheimer's Disease: Current Challenges and Future Perspectives. 治疗阿尔茨海默病的 BACE1 抑制剂:当前挑战与未来展望》。
IF 3.4 3区 医学 Q2 NEUROSCIENCES Pub Date : 2024-06-22 DOI: 10.3233/JAD-240146
Judite R M Coimbra, Rosa Resende, José B A Custódio, Jorge A R Salvador, Armanda E Santos

Disease-modifying therapies (DMT) for Alzheimer's disease (AD) are highly longed-for. In this quest, anti-amyloid therapies take center stage supported by genetic facts that highlight an imbalance between production and clearance of amyloid-β peptide (Aβ) in AD patients. Indeed, evidence from basic research, human genetic and biomarker studies, suggests the accumulation of Aβ as a driver of AD pathogenesis and progression. The aspartic protease β-site AβPP cleaving enzyme (BACE1) is the initiator for Aβ production. Underpinning a critical role for BACE1 in AD pathophysiology are the elevated BACE1 concentration and activity observed in the brain and body fluids of AD patients. Therefore, BACE1 is a prime drug target for reducing Aβ levels in early AD. Small-molecule BACE1 inhibitors have been extensively developed for the last 20 years. However, clinical trials with these molecules have been discontinued for futility or safety reasons. Most of the observed adverse side effects were due to other aspartic proteases cross-inhibition, including the homologue BACE2, and to mechanism-based toxicity since BACE1 has substrates with important roles for synaptic plasticity and synaptic homeostasis besides amyloid-β protein precursor (AβPP). Despite these setbacks, BACE1 persists as a well-validated therapeutic target for which a specific inhibitor with high substrate selectivity may yet to be found. In this review we provide an overview of the evolution in BACE1 inhibitors design pinpointing the molecules that reached advanced phases of clinical trials and the liabilities that precluded adequate trial effects. Finally, we ponder on the challenges that anti-amyloid therapies must overcome to achieve clinical success.

针对阿尔茨海默病(AD)的疾病改变疗法(DMT)是人们翘首以盼的。在这一探索过程中,抗淀粉样蛋白疗法占据了中心位置,因为遗传学事实表明,阿尔茨海默病患者体内淀粉样蛋白-β肽(Aβ)的产生和清除之间存在失衡。事实上,基础研究、人类遗传学和生物标志物研究的证据表明,Aβ的积累是AD发病和发展的驱动因素。天冬氨酸蛋白酶β位点AβPP裂解酶(BACE1)是Aβ生成的启动器。在 AD 患者的大脑和体液中观察到 BACE1 的浓度和活性升高,这是 BACE1 在 AD 病理生理学中发挥关键作用的基础。因此,BACE1 是降低 AD 早期 Aβ 水平的主要药物靶点。在过去的 20 年中,小分子 BACE1 抑制剂得到了广泛的开发。然而,由于无效或安全原因,这些分子的临床试验已经停止。大多数观察到的不良副作用是由于其他天冬氨酸蛋白酶的交叉抑制(包括同源物 BACE2)和机制毒性造成的,因为 BACE1 的底物除了淀粉样蛋白-β 蛋白前体(AβPP)外,还对突触可塑性和突触稳态具有重要作用。尽管遇到了这些挫折,BACE1 仍然是一个有价值的治疗靶点,而具有高底物选择性的特异性抑制剂可能尚未找到。在这篇综述中,我们概述了 BACE1 抑制剂设计的演变过程,指出了已进入临床试验高级阶段的分子以及阻碍充分试验效果的缺陷。最后,我们将探讨抗淀粉样蛋白疗法要取得临床成功必须克服的挑战。
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引用次数: 0
Polyphenols and Diets as Current and Potential Nutrition Senotherapeutics in Alzheimer's Disease: Findings from Clinical Trials. 多酚和饮食作为阿尔茨海默病当前和潜在的营养治疗药物:临床试验结果。
IF 4 3区 医学 Q1 Psychology Pub Date : 2024-06-12 DOI: 10.3233/JAD-231222
Xi Chen, Karen Walton, Henry Brodaty, Karen Chalton

Cellular senescence, a hallmark of aging, plays an important role in age-related conditions among older adults. Targeting senescent cells and its phenotype may provide a promising strategy to delay the onset or progression of Alzheimer's disease (AD). In this review article, we investigated efficacy and safety of nutrition senotherapy in AD, with a focus on the role of polyphenols as current and potential nutrition senotherapeutic agents, as well as relevant dietary patterns. Promising results with neuroprotective effects of senotherapeutic agents such as quercetin, resveratrol, Epigallocatechin-gallate, curcumin and fisetin were reported from preclinical studies. However, in-human trials remain limited, and findings were inconclusive. In future, nutrition senotherapeutic agents should be studied both individually and within dietary patterns, through the perspective of cellular senescence and AD. Further studies are warranted to investigate bioavailability, dosing regimen, long term effects of nutrition senotherapy and provide better understanding of the underlying mechanisms. Collaboration between researchers needs to be established, and methodological limitations of current studies should be addressed.

细胞衰老是衰老的标志之一,在老年人与年龄有关的疾病中扮演着重要角色。针对衰老细胞及其表型可能是延缓阿尔茨海默病(AD)发病或进展的一种有前景的策略。在这篇综述文章中,我们研究了营养衰老疗法对阿尔茨海默病的疗效和安全性,重点关注多酚作为当前和潜在营养衰老治疗药物的作用,以及相关的饮食模式。临床前研究显示,槲皮素、白藜芦醇、表儿茶素-棓酸盐、姜黄素和菲赛汀等营养治疗剂具有良好的神经保护作用。然而,人体试验仍然有限,研究结果尚无定论。今后,应从细胞衰老和注意力缺失的角度,对营养衰老治疗药物进行单独研究和饮食模式研究。有必要进一步研究营养衰老疗法的生物利用度、剂量方案和长期效果,并更好地了解其潜在机制。需要建立研究人员之间的合作,并解决当前研究在方法上的局限性。
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引用次数: 0
Effects of 6-Month Combined Physical Exercise and Cognitive Training on Neuropsychological and Neurophysiological Function in Older Adults with Subjective Cognitive Decline: A Randomized Controlled Trial 为期 6 个月的体育锻炼和认知训练相结合对主观认知能力下降的老年人的神经心理和神经电生理功能的影响:随机对照试验
IF 4 3区 医学 Q1 Psychology Pub Date : 2024-06-04 DOI: 10.3233/jad-231257
Chia-Hsiung Cheng, Yu-Wei Hsieh, Chiung-Chih Chang, Fu-Jung Hsiao, Li-Fen Chen, Pei-Ning Wang
Background: Multidomain intervention may delay or ameliorate cognitive decline in older adults at risk of Alzheimer’s disease, particularly in the memory and inhibitory functions. However, no study systematically investigates the changes of brain function in cognitively-normal elderly with subjective cognitive decline (SCD) when they receive multidomain intervention. Objective: We aimed to examine whether a multidomain intervention could improve neuropsychological function and neurophysiological activities related to memory and inhibitory function in SCD subjects. Methods: Eight clusters with a total of 50 community-dwelling SCD older adults were single-blind, randomized into intervention group, which received physical and cognitive training, or control group, which received treatment as usual. For the neuropsychological function, a composite Z score from six cognitive tests was calculated and compared between two groups. For the neurophysiological activities, event-related potentials (ERPs) of memory function, including mismatch negativity (MMN) and memory-P3, as well as ERPs of inhibitory function, including sensory gating (SG) and inhibition-P3, were measured. Assessments were performed at baseline (T1), end of the intervention (T2), and 6 months after T2 (T3). Results: For the neuropsychological function, the effect was not observed after the intervention. For the neurophysiological activities, improved MMN responses of ΔT2–T1 were observed in the intervention group versus the control group. The multidomain intervention produced a sustained effect on memory-P3 latencies of ΔT3–T1. However, there were no significant differences in changes of SG and inhibition-P3 between intervention and control groups. Conclusions: While not impactful on neuropsychological function, multidomain intervention enhances specific neurophysiological activities associated with memory function.
背景:多领域干预可延缓或改善有阿尔茨海默病风险的老年人的认知功能衰退,尤其是记忆和抑制功能。然而,还没有研究系统地调查了认知正常但有主观认知衰退(SCD)的老年人在接受多领域干预后大脑功能的变化。研究目的我们旨在研究多领域干预能否改善 SCD 受试者的神经心理功能以及与记忆和抑制功能相关的神经生理活动。方法:对 8 个群组共 50 名居住在社区的 SCD 老年人进行单盲随机分组,分为干预组(接受体能和认知训练)和对照组(接受常规治疗)。在神经心理功能方面,计算六项认知测试的综合 Z 值,并在两组之间进行比较。在神经生理学活动方面,测量了记忆功能的事件相关电位(ERP),包括错配负性(MMN)和记忆-P3,以及抑制功能的事件相关电位(ERP),包括感觉门控(SG)和抑制-P3。评估分别在基线(T1)、干预结束(T2)和 T2 结束后 6 个月(T3)进行。结果显示在神经心理功能方面,干预后未观察到效果。在神经生理活动方面,干预组与对照组相比,MMN反应ΔT2-T1有所改善。多领域干预对ΔT3-T1的记忆-P3潜伏期产生了持续影响。然而,干预组和对照组在 SG 和抑制-P3 的变化上没有明显差异。结论:多领域干预虽然对神经心理功能没有影响,但能增强与记忆功能相关的特定神经生理活动。
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引用次数: 0
Lung Function and Brain MRI Outcomes in the Atherosclerosis Risk in Communities Neurocognitive Study 社区动脉粥样硬化风险神经认知研究中的肺功能和脑磁共振成像结果
IF 4 3区 医学 Q1 Psychology Pub Date : 2024-06-04 DOI: 10.3233/jad-240162
Srishti Shrestha, Xiaoqian Zhu, Kevin J. Sullivan, J. Simino, P. Lutsey, Rebecca F. Gottesman, Stephanie London, Michael E. Griswold, Thomas H Mosley
Background: Brain imaging studies may provide etiologic insight into observed links between lung function and dementia and stroke. Objective: We evaluated associations of lung function measures with brain MRI markers of vascular and neurodegenerative disease in the ARIC Neurocognitive Study, as few studies have examined the associations. Methods: Lung function was measured at participants’ midlife in 1990–1992 (mean age = 56±5 years) and later-life in 2011–2013 (mean age = 76±5 years), and brain MRI was performed in 2011–2013. Linear regression models were used to examine the associations of lung function with brain and white matter hyperintensity (WMH) volumes, and logistic regression models were used for cerebral infarcts and microbleeds, adjusting for potential confounders. Results: In cross-sectional analysis (i.e., examining later-life lung function and MRI markers, n = 1,223), higher forced-expiratory volume in one second (FEV1) and forced vital capacity (FVC) were associated with larger brain and lower WMH volumes [e.g., 8.62 (95% CI:2.54–14.71) cm3 greater total brain volume per one-liter higher FEV1]. No association was seen with microbleeds in the overall sample, but higher FVC was associated with lower odds of microbleeds in never-smokers and higher odds in ever-smokers. In the cross-temporal analysis (i.e., associations with midlife lung function, n = 1,787), higher FVC levels were significantly associated with lower later-life brain volumes. Conclusions: Our results support modest associations of better lung function with less neurodegenerative and cerebrovascular pathology, although findings for microbleeds were unexpected in ever-smokers.
背景:脑成像研究可为观察到的肺功能与痴呆和中风之间的联系提供病因学见解。研究目的在 ARIC 神经认知研究中,我们评估了肺功能指标与脑磁共振成像血管和神经退行性疾病标志物之间的关联,因为很少有研究对这种关联进行研究。研究方法在1990-1992年参与者的中年(平均年龄=56±5岁)和2011-2013年参与者的晚年(平均年龄=76±5岁)测量肺功能,在2011-2013年进行脑磁共振成像。采用线性回归模型检验肺功能与脑和白质高密度(WMH)体积的关系,并采用逻辑回归模型检验脑梗塞和微出血,同时调整潜在的混杂因素。结果在横断面分析中(即检查晚年肺功能和磁共振成像标记物,n = 1,223 人),一秒钟内用力呼气容积(FEV1)和用力呼吸容量(FVC)越大,脑容量越大,WMH 容积越小[例如,FEV1 每增加一升,脑总容量增加 8.62 (95% CI:2.54-14.71) cm3]。在总体样本中,未发现微出血的相关性,但在从不吸烟者中,较高的 FVC 与较低的微出血几率相关,而在曾经吸烟者中,较高的 FVC 与较高的几率相关。在跨时空分析中(即与中年肺功能的关联,n = 1,787 人),较高的 FVC 水平与较低的晚年脑容量有显著关联。结论:我们的研究结果表明,肺功能越好,神经退行性病变和脑血管病变就越少,尽管微出血的研究结果出乎曾经吸烟者的意料。
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引用次数: 0
Diagnostic Sensitivity and Symptomatic Relevance of Dopamine Transporter Imaging and Myocardial Sympathetic Scintigraphy in Patients with Dementia with Lewy Bodies 多巴胺转运体成像和心肌交感闪烁成像对路易体痴呆患者的诊断敏感性和症状相关性
IF 4 3区 医学 Q1 Psychology Pub Date : 2024-06-04 DOI: 10.3233/jad-231395
Zhihui Tang, S. Hirano, Yume Koizumi, Michiko Izumi, Yoshihisa Kitayama, Kosuke Yamagishi, Mitsuyoshi Tamura, A. Ishikawa, Kouichi Kashiwado, Takashi Iimori, H. Mukai, Hajime Yokota, T. Horikoshi, Takashi Uno, Satoshi Kuwabara
Background: Dementia with Lewy bodies (DLB) presents with various symptoms, posing challenges for early diagnosis challenging. Dopamine transporter (123I-FP-CIT) single-photon emission tomography (SPECT) and 123I-meta-iodobenzylguanidine (123I-MIBG) imaging are crucial diagnostic biomarkers. Hypothesis about body- and brain-first subtypes of DLB indicate that some DLB may show normal 123I-FP-CIT or 123I-MIBG results; but the characteristic expression of these two subtypes remains unclear. Objective: This study aimed to evaluate the diagnostic sensitivity of 123I-FP-CIT and 123I-MIBG imaging alone, combined in patients with DLB and explore symptoms associated with the abnormal imaging results. Methods: Demographic data, clinical status, and imaging results were retrospectively collected from patients diagnosed with possible DLB. Both images were quantified using semi-automated software, and the sensitivity of each imaging modality and their combination was calculated. Demographic data, cognition, and motor and non-motor symptoms were compared among the subgroups based on the imaging results. Symptoms related to each imaging abnormality were examined using binomial logistic regression analyses. Results: Among 114 patients with DLB, 80 underwent 123I-FP-CIT SPECT (sensitivity: 80.3%), 83 underwent 123I-MIBG imaging (68.2%), and 66 both (sensitivity of either abnormal result: 93.9%). Visual hallucinations differed among the four subgroups based on imaging results. Additionally, nocturia and orthostatic hypotension differed between abnormal and normal 123I-MIBG images. Conclusions: Overall, 123I-FP-CIT SPECT was slightly higher sensitivity than 123I-MIBG imaging, with combined imaging increasing diagnostic sensitivity. Normal results of a single imaging test may not refute DLB. Autonomic symptoms may lead to abnormal 123I-MIBG scintigraphy findings indicating body-first subtype of patients with DLB.
背景:路易体痴呆(DLB)症状多样,给早期诊断带来挑战。多巴胺转运体(123I-FP-CIT)单光子发射断层扫描(SPECT)和123I-甲基碘苄胍(123I-MIBG)成像是重要的诊断生物标志物。关于DLB的身体亚型和大脑亚型的假设表明,一些DLB可能显示正常的123I-FP-CIT或123I-MIBG结果;但这两种亚型的特征性表达仍不清楚。研究目的本研究旨在评估123I-FP-CIT和123I-MIBG单独或联合成像对DLB患者的诊断敏感性,并探讨与异常成像结果相关的症状。研究方法回顾性收集被诊断为可能患有 DLB 的患者的人口统计学数据、临床状态和成像结果。使用半自动软件对两种图像进行量化,并计算每种成像方式及其组合的灵敏度。根据成像结果对各分组的人口统计学数据、认知能力、运动和非运动症状进行比较。使用二项式逻辑回归分析研究了与每种成像异常相关的症状。结果显示在114名DLB患者中,80人接受了123I-FP-CIT SPECT检查(灵敏度:80.3%),83人接受了123I-MIBG成像检查(68.2%),66人同时接受了这两种检查(任一异常结果的灵敏度:93.9%)。根据成像结果,视幻觉在四个分组中有所不同。此外,夜尿和正性低血压在 123I-MIBG 图像异常和正常之间也存在差异。结论:总体而言,123I-FP-CIT SPECT 的灵敏度略高于 123I-MIBG造影,联合造影可提高诊断灵敏度。单一成像检查的正常结果可能无法反驳 DLB。自主神经症状可能会导致123I-MIBG闪烁扫描结果异常,表明DLB患者属于身体优先亚型。
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引用次数: 0
Machine Learning Approaches for Dementia Detection Through Speech and Gait Analysis: A Systematic Literature Review 通过语音和步态分析检测痴呆症的机器学习方法:系统性文献综述
IF 4 3区 医学 Q1 Psychology Pub Date : 2024-06-03 DOI: 10.3233/jad-231459
Mustafa Al-Hammadi, Hasan Fleyeh, Anna Cristina Åberg, Kjartan Halvorsen, Ilias Thomas
Background: Dementia is a general term for several progressive neurodegenerative disorders including Alzheimer’s disease. Timely and accurate detection is crucial for early intervention. Advancements in artificial intelligence present significant potential for using machine learning to aid in early detection. Objective: Summarize the state-of-the-art machine learning-based approaches for dementia prediction, focusing on non-invasive methods, as the burden on the patients is lower. Specifically, the analysis of gait and speech performance can offer insights into cognitive health through clinically cost-effective screening methods. Methods: A systematic literature review was conducted following the PRISMA protocol (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The search was performed on three electronic databases (Scopus, Web of Science, and PubMed) to identify the relevant studies published between 2017 to 2022. A total of 40 papers were selected for review. Results: The most common machine learning methods employed were support vector machine followed by deep learning. Studies suggested the use of multimodal approaches as they can provide comprehensive and better prediction performance. Deep learning application in gait studies is still in the early stages as few studies have applied it. Moreover, including features of whole body movement contribute to better classification accuracy. Regarding speech studies, the combination of different parameters (acoustic, linguistic, cognitive testing) produced better results. Conclusions: The review highlights the potential of machine learning, particularly non-invasive approaches, in the early prediction of dementia. The comparable prediction accuracies of manual and automatic speech analysis indicate an imminent fully automated approach for dementia detection.
背景:痴呆症是包括阿尔茨海默病在内的几种进行性神经退行性疾病的统称。及时准确的检测对于早期干预至关重要。人工智能的进步为利用机器学习帮助早期检测提供了巨大的潜力。目标:总结最先进的基于机器学习的痴呆症预测方法,重点关注非侵入性方法,因为这些方法对患者造成的负担较小。具体来说,步态和言语表现分析可通过具有临床成本效益的筛查方法来深入了解认知健康状况。研究方法按照 PRISMA 协议(系统综述和元分析首选报告项目)进行了系统性文献综述。在三个电子数据库(Scopus、Web of Science 和 PubMed)中进行了检索,以确定 2017 年至 2022 年间发表的相关研究。共选取了 40 篇论文进行审查。研究结果最常用的机器学习方法是支持向量机,其次是深度学习。研究建议使用多模态方法,因为它们可以提供全面和更好的预测性能。深度学习在步态研究中的应用仍处于早期阶段,因为应用这种方法的研究很少。此外,包含全身运动特征有助于提高分类准确性。在语音研究方面,不同参数(声学、语言学、认知测试)的结合产生了更好的结果。结论:综述强调了机器学习,特别是非侵入式方法在早期预测痴呆症方面的潜力。人工和自动语音分析的预测准确率相当,这表明即将出现一种全自动痴呆症检测方法。
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Journal of Alzheimer's Disease
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