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Beyond group classification: Probabilistic differential diagnosis of frontotemporal dementia and Alzheimer’s disease with MRI and CSF biomarkers 超越群体分类:利用核磁共振成像和脑脊液生物标记物对额颞叶痴呆症和阿尔茨海默病进行概率鉴别诊断
IF 3.7 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-30 DOI: 10.1016/j.neurobiolaging.2024.08.008
Agnès Pérez-Millan , Bertrand Thirion , Neus Falgàs , Sergi Borrego-Écija , Beatriz Bosch , Jordi Juncà-Parella , Adrià Tort-Merino , Jordi Sarto , Josep Maria Augé , Anna Antonell , Nuria Bargalló , Mircea Balasa , Albert Lladó , Raquel Sánchez-Valle , Roser Sala-Llonch

Neuroimaging and fluid biomarkers are used to differentiate frontotemporal dementia (FTD) from Alzheimer’s disease (AD). We implemented a machine learning algorithm that provides individual probabilistic scores based on magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) data. We investigated whether combining MRI and CSF levels could improve the diagnosis confidence. 215 AD patients, 103 FTD patients, and 173 healthy controls (CTR) were studied. With MRI data, we obtained an accuracy of 82 % for AD vs. FTD. A total of 74 % of FTD and 73 % of AD participants have a high probability of accurate diagnosis. Adding CSF-NfL and 14–3–3 levels improved the accuracy and the number of patients in the confidence group for differentiating FTD from AD. We obtain individual diagnostic probabilities with high precision to address the problem of confidence in the diagnosis. We suggest when MRI, CSF, or the combination are necessary to improve the FTD and AD diagnosis. This algorithm holds promise towards clinical applications as support to clinical findings or in settings with limited access to expert diagnoses.

神经影像和脑脊液生物标记物被用于区分额颞叶痴呆(FTD)和阿尔茨海默病(AD)。我们采用了一种机器学习算法,根据磁共振成像(MRI)和脑脊液(CSF)数据提供个体概率评分。我们研究了结合磁共振成像和脑脊液水平是否能提高诊断可信度。我们对 215 名 AD 患者、103 名 FTD 患者和 173 名健康对照者(CTR)进行了研究。通过核磁共振成像数据,我们获得了82%的AD与FTD诊断准确率。共有 74% 的 FTD 患者和 73% 的 AD 患者有很高的准确诊断概率。加入 CSF-NfL 和 14-3-3 水平提高了区分 FTD 和 AD 的准确性,并增加了置信组患者的数量。我们获得了高精度的个体诊断概率,从而解决了诊断中的置信度问题。我们建议何时需要核磁共振成像、脑脊液或两者结合来提高 FTD 和 AD 的诊断率。该算法有望应用于临床,为临床发现提供支持,或用于专家诊断有限的情况。
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引用次数: 0
Editorial Advisory Board 编辑顾问委员会
IF 3.7 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-29 DOI: 10.1016/S0197-4580(24)00140-4
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引用次数: 0
Predicting brain atrophy and cognitive aging trajectories with baseline subjective cognitive concerns in cognitively normal older adults 用认知正常老年人的基线主观认知问题预测脑萎缩和认知老化轨迹
IF 3.7 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-23 DOI: 10.1016/j.neurobiolaging.2024.08.006
Michelle You , Cutter A. Lindbergh , Renaud La Joie , Emily W. Paolillo , Rowan Saloner , Valentina Diaz , Devyn L. Cotter , Samantha Walters , Marie Altendahl , Adam M. Staffaroni , Joel H. Kramer , Leslie S. Gaynor , Kaitlin B. Casaletto

Subjective cognitive concerns (SCC) are common even in cognitively normal older adults who lack objectively-detectable deficits on standard neuropsychological evaluation. The clinical relevance of these concerns, particularly considering the nature of concerns (e.g., memory versus non-memory), remains unclear. Thus, we examined whether baseline memory and non-memory SCC relate to longitudinal change in brain volume and neuropsychological test performance in 476 functionally-intact, objectively unimpaired older adults (Mage = 72y, 56 % female, follow-up time = 1 – 9 years). Mixed-effects models revealed that both higher baseline memory and non-memory SCC predicted greater atrophy in total gray matter and dorsolateral prefrontal cortex atrophy over time, while only memory SCC predicted steeper medial temporal lobe atrophy. Regarding neuropsychological performance, higher non-memory SCC predicted decline in processing speed performance, while memory SCC did not predict neuropsychological trajectories. SCC are a risk factor for more adverse brain and cognitive aging trajectories, even in functionally-intact, seemingly cognitively normal older adults.

主观认知障碍(SCC)即使在认知正常的老年人中也很常见,这些老年人在标准神经心理学评估中没有客观上可检测到的缺陷。这些问题的临床意义,尤其是考虑到问题的性质(如记忆与非记忆),仍不清楚。因此,我们研究了基线记忆和非记忆 SCC 是否与 476 名功能完好、客观上未受损的老年人(年龄 = 72 岁,56% 为女性,随访时间 = 1 - 9 年)的脑容量和神经心理学测试成绩的纵向变化有关。混合效应模型显示,较高的基线记忆和非记忆SCC可预测随着时间的推移,总灰质和背外侧前额叶皮质的萎缩程度加重,而只有记忆SCC可预测内侧颞叶的萎缩程度加重。在神经心理学表现方面,较高的非记忆性 SCC 预测了处理速度表现的下降,而记忆性 SCC 并未预测神经心理学轨迹。即使是功能完好、认知能力看似正常的老年人,SCC 也是导致大脑和认知能力衰老轨迹更加不利的风险因素。
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引用次数: 0
Plasma p-tau181 and amyloid markers in Alzheimer’s disease: A comparison between Lumipulse and SIMOA 阿尔茨海默病的血浆 p-tau181 和淀粉样蛋白标记物:Lumipulse 和 SIMOA 的比较
IF 3.7 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-22 DOI: 10.1016/j.neurobiolaging.2024.08.007
Virginia Quaresima , Andrea Pilotto , Chiara Trasciatti , Chiara Tolassi , Marta Parigi , Diego Bertoli , Cristina Mordenti , Alice Galli , Andrea Rizzardi , Salvatore Caratozzolo , Alberto Benussi , Nicholas J. Ashton , Kaj Blennow , Henrik Zetterberg , Silvia Giliani , Duilio Brugnoni , Alessandro Padovani

Aim of the project was to evaluate the technical and clinical validity of plasma Lumipulse p-tau, Aβ42 and Aβ40 species and their correlation with CSF core Alzheimer’s Disease (AD) markers; a method comparison with SIMOA was also performed. One-hundred-thirthy-three participants, namely 55 A+T+N+ AD, 28 Neurodegenerative disorders (NDD) and 50 controls were enrolled for the study. Lumipulse technical validity showed high stability for p-tau181, Aβ42, and Aβ40, with higher stability of p-tau to repeated freezing thaw cycles. p-tau181 levels detected by both techniques were higher in AD compared to both NDD/controls and exhibited a similar correlation with CSF p-tau levels, whereas Aβ42 levels were slightly lower in AD with both methods. In the comparison between SIMOA and Lumipulse plasma markers, both techniques exhibited similar diagnostic accuracy for AD for p-tau181 (0.87; 95 %CI 0.81–0.94, vs 0.85; 95 %CI 0.78–0.93), whereas the best performance was reached by p-tau181/ Aβ42 Lumipulse ratio (ROC AUC 0.915, 95 %CI 0.86–0.97). The study thus confirmed the construct validity of both Lumipulse and SIMOA techniques for the identification of CSF AD pattern in clinical settings.

该项目的目的是评估血浆 Lumipulse p-tau、Aβ42 和 Aβ40 物种的技术和临床有效性及其与脑脊液阿尔茨海默病(AD)核心标志物的相关性;还进行了与 SIMOA 方法的比较。研究共招募了 133 名参与者,即 55 名 A+T+N+ AD、28 名神经退行性疾病(NDD)和 50 名对照组。两种技术检测到的p-tau181水平在AD中均高于NDD/对照组,且与CSF p-tau水平具有相似的相关性,而两种方法检测到的Aβ42水平在AD中均略低。在 SIMOA 和 Lumipulse 血浆标记物的比较中,两种技术对 p-tau181 的 AD 诊断准确性相似(0.87;95 %CI 0.81-0.94 vs 0.85;95 %CI 0.78-0.93),而 p-tau181/ Aβ42 Lumipulse 比值的表现最佳(ROC AUC 0.915,95 %CI 0.86-0.97)。因此,该研究证实了 Lumipulse 和 SIMOA 技术在临床环境中识别 CSF AD 模式的构建有效性。
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引用次数: 0
Contrasting association pattern of plasma low-density lipoprotein with white matter integrity in APOE4 carriers versus non-carriers APOE4 携带者与非携带者血浆低密度脂蛋白与白质完整性的关联模式截然不同
IF 3.7 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-22 DOI: 10.1016/j.neurobiolaging.2024.08.005
Zhenyao Ye , Yezhi Pan , Rozalina G. McCoy , Chuan Bi , Chen Mo , Li Feng , Jiaao Yu , Tong Lu , Song Liu , J. Carson Smith , Minxi Duan , Si Gao , Yizhou Ma , Chixiang Chen , Braxton D. Mitchell , Paul M. Thompson , L. Elliot Hong , Peter Kochunov , Tianzhou Ma , Shuo Chen

Apolipoprotein E ε4 (APOE4) is a strong genetic risk factor of Alzheimer’s disease and metabolic dysfunction. However, whether APOE4 and markers of metabolic dysfunction synergistically impact the deterioration of white matter (WM) integrity in older adults remains unknown. In the UK Biobank data, we conducted a multivariate analysis to investigate the interactions between APOE4 and 249 plasma metabolites (measured using nuclear magnetic resonance spectroscopy) with whole-brain WM integrity (measured by diffusion-weighted magnetic resonance imaging) in a cohort of 1917 older adults (aged 65.0–81.0 years; 52.4 % female). Although no main association was observed between either APOE4 or metabolites with WM integrity (adjusted P > 0.05), significant interactions between APOE4 and metabolites with WM integrity were identified. Among the examined metabolites, higher concentrations of low-density lipoprotein and very low-density lipoprotein were associated with a lower level of WM integrity (b=0.12, CI=0.14,0.10) among APOE4 carriers. Conversely, among non-carriers, they were associated with a higher level of WM integrity (b=0.05, CI=0.04,0.07), demonstrating a significant moderation role of APOE4 (b =0.18, CI=0.20,0.15, P<0.00001).

载脂蛋白 E ε4(APOE4)是阿尔茨海默病和代谢功能障碍的一个重要遗传风险因素。然而,载脂蛋白 E ε4 和代谢功能障碍标志物是否会协同影响老年人白质(WM)完整性的恶化仍是未知数。在英国生物库数据中,我们进行了一项多变量分析,以 1917 名老年人(年龄 65.0-81.0 岁;52.4% 为女性)为研究对象,调查 APOE4 和 249 种血浆代谢物(使用核磁共振波谱测量)与全脑白质完整性(使用扩散加权磁共振成像测量)之间的相互作用。虽然未观察到 APOE4 或代谢物与 WM 完整性之间存在主要关联(调整后 P > 0.05),但发现 APOE4 和代谢物与 WM 完整性之间存在显著的交互作用。在所研究的代谢物中,低密度脂蛋白和极低密度脂蛋白浓度较高与 APOE4 携带者较低的 WM 完整性水平相关(b=-0.12,CI=-0.14,-0.10)。相反,在非携带者中,它们与较高的WM完整性水平相关(b=0.05,CI=0.04,0.07),表明APOE4具有显著的调节作用(b=-0.18,CI=-0.20,-0.15,P<0.00001)。
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引用次数: 0
Associations between brain structure and dual decline in gait and cognition 大脑结构与步态和认知能力双重衰退之间的关系
IF 3.7 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-20 DOI: 10.1016/j.neurobiolaging.2024.08.004
Sadhani Karunarathna , Monique Breslin , Jane Alty , Richard Beare , Taya A. Collyer , Velandai K. Srikanth , James Scott McDonald , Michele L. Callisaya

Dual decline in gait and cognition is associated with an increased risk of dementia, with combined gait and memory decline exhibiting the strongest association. To better understand the underlying pathology, we investigated the associations of baseline brain structure with dual decliners using three serial gait speed and cognitive assessments in memory, processing speed-attention, and verbal fluency. Participants (n=267) were categorized based on annual decline in gait speed and cognitive measures. Lower gray and white matter volume and higher white matter hyperintensity volume increased the risk of being a dual decliner in gait and both the memory and processing speed-attention groups (all p < 0.05). Lower hippocampal volume (p = 0.047) was only associated with dual decline in gait and memory group. No brain structures were correlated with dual decline in gait and verbal fluency. These results suggest that neurodegenerative pathology and white matter hyperintensities are involved in dual decline in gait and both memory and processing speed-attention. Smaller hippocampal volume may only contribute to dual decline in gait and memory.

步态和认知能力的双重衰退与痴呆症风险的增加有关,其中步态和记忆力的综合衰退表现出最强的关联性。为了更好地了解潜在的病理,我们使用三个序列的步速和记忆力、处理速度-注意力和语言流畅性的认知评估,研究了基线大脑结构与双重衰退者的关联。根据步速和认知测量的年下降率对参与者(n=267)进行了分类。较低的灰质和白质体积以及较高的白质高密度体积会增加步态以及记忆和处理速度-注意力两组双重下降的风险(所有 p < 0.05)。海马体积较小(p = 0.047)仅与步态和记忆组的双重衰退有关。没有大脑结构与步态和语言流畅性的双重下降相关。这些结果表明,神经退行性病变和白质高密度与步态、记忆力和处理速度-注意力的双重下降有关。海马体积较小可能只导致步态和记忆力的双重下降。
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引用次数: 0
Older adults do not show enhanced benefits from multisensory information on speeded perceptual discrimination tasks 在快速感知辨别任务中,老年人并没有从多感官信息中获得更多益处
IF 3.7 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-15 DOI: 10.1016/j.neurobiolaging.2024.08.003
Christopher Atkin , Jemaine E. Stacey , Harriet A. Allen , Helen Henshaw , Katherine L. Roberts , Stephen P. Badham

Some research has shown that older adults benefit more from multisensory information than do young adults. However, more recent evidence has shown that the multisensory age benefit varies considerably across tasks. In the current study, older (65 – 80) and young (18 – 30) adults (N = 191) completed a speeded perceptual discrimination task either online or face-to-face to assess task response speed. We examined whether presenting stimuli in multiple sensory modalities (audio-visual) instead of one (audio-only or visual-only) benefits older adults more than young adults. Across all three experiments, a consistent speeding of response was found in the multisensory condition compared to the unisensory conditions for both young and older adults. Furthermore, race model analysis showed a significant multisensory benefit across a broad temporal interval. Critically, there were no significant differences between young and older adults. Taken together, these findings provide strong evidence in favour of a multisensory benefit that does not differ across age groups, contrasting with prior research.

一些研究表明,与年轻人相比,老年人从多感官信息中获益更多。然而,最近的证据表明,不同年龄段的人从不同任务中获得的多感官益处差别很大。在本研究中,老年人(65 - 80 岁)和年轻人(18 - 30 岁)(N = 191)通过在线或面对面的方式完成了一项加速知觉辨别任务,以评估任务反应速度。我们研究了以多种感官模式(视听模式)而非一种感官模式(纯视听模式或纯视听模式)呈现刺激是否会使老年人比年轻人更受益。在所有三项实验中,我们都发现,与单感官条件相比,多感官条件下年轻人和老年人的反应速度一致加快。此外,竞赛模型分析表明,在广泛的时间间隔内,多感官条件下的反应速度明显更快。重要的是,年轻人和老年人之间没有明显差异。综上所述,这些研究结果提供了强有力的证据,证明多感官益处在不同年龄组之间没有差异,这与之前的研究结果形成了鲜明对比。
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引用次数: 0
Age-related differences in how the shape of alpha and beta oscillations change during reaction time tasks 反应时间任务中阿尔法和贝塔振荡形状变化的年龄差异
IF 3.7 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-13 DOI: 10.1016/j.neurobiolaging.2024.08.001
George M. Opie , James M. Hughes , Rohan Puri

While the shape of cortical oscillations is increasingly recognised to be physiologically and functionally informative, its relevance to the aging motor system has not been established. We therefore examined the shape of alpha and beta band oscillations recorded at rest, as well as during performance of simple and go/no-go reaction time tasks, in 33 young (23.3 ± 2.9 years, 27 females) and 27 older (60.0 ± 5.2 years, 23 females) adults. The shape of individual oscillatory cycles was characterised using a recently developed pipeline involving empirical mode decomposition, before being decomposed into waveform motifs using principal component analysis. This revealed four principal components that were uniquely influenced by task and/or age. These described specific dimensions of shape and tended to be modulated during the reaction phase of each task. Our results suggest that although oscillation shape is task-dependent, the nature of this effect is altered by advancing age, possibly reflecting alterations in cortical activity. These outcomes demonstrate the utility of this approach for understanding the neurophysiological effects of ageing.

尽管人们越来越认识到皮层振荡的形状在生理和功能上具有信息价值,但其与老化运动系统的相关性尚未得到证实。因此,我们研究了 33 名年轻人(23.3 ± 2.9 岁,27 名女性)和 27 名老年人(60.0 ± 5.2 岁,23 名女性)在静息状态下以及在完成简单和去/不去反应时间任务时记录到的α和β波段振荡的形状。在使用主成分分析法将单个振荡周期分解为波形图案之前,先使用最近开发的经验模式分解流水线对振荡周期的形状进行了表征。结果显示,有四个主成分受到任务和/或年龄的独特影响。这些主成分描述了形状的特定维度,并倾向于在每个任务的反应阶段进行调节。我们的结果表明,虽然振荡形状与任务有关,但这种影响的性质会随着年龄的增长而改变,这可能反映了大脑皮层活动的变化。这些结果证明了这种方法在理解老化的神经生理学影响方面的实用性。
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引用次数: 0
Explainable artificial intelligence identifies an AQP4 polymorphism-based risk score associated with brain amyloid burden 可解释人工智能确定了与脑淀粉样蛋白负荷相关的基于AQP4多态性的风险评分
IF 3.7 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-10 DOI: 10.1016/j.neurobiolaging.2024.08.002
Simone Beer , David Elmenhorst , Gerard N. Bischof , Alfredo Ramirez , Andreas Bauer , Alexander Drzezga , for the Alzheimer’s Disease Neuroimaging Initiative

Aquaporin-4 (AQP4) is hypothesized to be a component of the glymphatic system, a pathway for removing brain interstitial solutes like amyloid-β (Aβ). Evidence exists that genetic variation of AQP4 impacts Aβ clearance, clinical outcome in Alzheimer’s disease as well as sleep measures. We examined whether a risk score calculated from several AQP4 single-nucleotide polymorphisms (SNPs) is related to Aβ neuropathology in older cognitively unimpaired white individuals. We used a machine learning approach and explainable artificial intelligence to extract information on synergistic effects of AQP4 SNPs on brain amyloid burden from the ADNI cohort. From this information, we formulated a sex-specific AQP4 SNP-based risk score and evaluated it using data from the screening process of the A4 study. We found in both cohorts significant associations of the risk score with brain amyloid burden. The results support the hypothesis of an involvement of the glymphatic system, and particularly AQP4, in brain amyloid aggregation pathology. They suggest also that different AQP4 SNPs exert a synergistic effect on the build-up of brain amyloid burden.

据推测,水蒸发素-4(AQP4)是glymphatic系统的一个组成部分,而glymphatic系统是清除淀粉样蛋白-β(Aβ)等脑间质溶质的一个途径。有证据表明,AQP4 的遗传变异会影响 Aβ 的清除、阿尔茨海默病的临床结果以及睡眠质量。我们研究了根据几个 AQP4 单核苷酸多态性(SNPs)计算出的风险评分是否与认知功能未受损的老年白人的 Aβ 神经病理学有关。我们使用机器学习方法和可解释人工智能从ADNI队列中提取了AQP4 SNPs对大脑淀粉样蛋白负荷协同效应的信息。根据这些信息,我们制定了基于 AQP4 SNP 的性别特异性风险评分,并利用 A4 研究筛选过程中的数据对其进行了评估。我们在两个队列中都发现了风险评分与脑淀粉样蛋白负荷的显著关联。这些结果支持了甘液系统,尤其是 AQP4 参与大脑淀粉样蛋白聚集病理学的假设。这些结果还表明,不同的 AQP4 SNPs 对大脑淀粉样蛋白负荷的积累具有协同作用。
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引用次数: 0
Editorial Advisory Board 编辑顾问委员会
IF 3.7 3区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-14 DOI: 10.1016/S0197-4580(24)00127-1
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引用次数: 0
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Neurobiology of Aging
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