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Statin use and risk of Parkinson’s disease among older adults in Japan: a nested case-control study using the longevity improvement and fair evidence study 他汀类药物的使用与日本老年人患帕金森病的风险:利用长寿改善和公平证据研究进行的巢式病例对照研究
Pub Date : 2024-06-04 DOI: 10.1093/braincomms/fcae195
Sanyu Ge, Ling Zha, Yasuyoshi Kimura, Yoshimitsu Shimomura, Masayo Komatsu, Y. Gon, S. Komukai, Fumiko Murata, M. Maeda, K. Kiyohara, Tomotaka Sobue, T. Kitamura, Haruhisa Fukuda
The association between statin use and the risk of Parkinson’s disease remains inconclusive, particularly in Japan’s super-aging society. This study aimed to investigate the potential association between statin use and the risk of Parkinson’s disease among Japanese participants aged ≥65 years. We used data from the Longevity Improvement and Fair Evidence Study, which included medical and long-term care claims data from April 2014 to December 2020 across 17 municipalities. Using a nested case-control design, we matched one case to five controls based on age, sex, municipality, and cohort entry year. A conditional logistic regression model was used to estimate the odds ratios with 95% confidence intervals. Among the 56,186 participants (9,397 cases and 46, 789 controls), 53.6% were women. The inverse association between statin use and Parkinson’s disease risk was significant after adjusting for multiple variables (odds ratio: 0.61; 95% confidence interval: 0.56–0.66). Compared with non-users, the dose analysis revealed varying odds ratios: 1.30 (1.12–1.52) for 1–30 total standard daily doses, 0.77 (0.64–0.92) for 31-90 total standard daily doses, 0.62 (0.52–0.75) for 91–180 total standard daily doses, and 0.30 (0.25–0.35) for >180 total standard daily doses. Statin use among older Japanese adults was associated with a decreased risk of Parkinson’s disease. Notably, lower cumulative statin doses were associated with an elevated risk of Parkinson’s disease, whereas higher cumulative doses exhibited protective effects against Parkinson’s disease development.
他汀类药物的使用与帕金森病风险之间的关系仍无定论,尤其是在日本这个超老龄化社会中。本研究旨在调查年龄≥65 岁的日本参与者中他汀类药物的使用与帕金森病风险之间的潜在关联。我们使用了 "长寿改善和公平证据研究 "的数据,其中包括 17 个市在 2014 年 4 月至 2020 年 12 月期间的医疗和长期护理索赔数据。我们采用嵌套病例对照设计,根据年龄、性别、城市和队列进入年份将一个病例与五个对照匹配。我们使用条件逻辑回归模型估算了几率比,并得出了 95% 的置信区间。在 56186 名参与者(9397 例病例和 46789 例对照)中,53.6% 为女性。在对多种变量进行调整后,他汀类药物的使用与帕金森病风险之间的反向关系非常显著(几率比:0.61;95% 置信区间:0.56-0.66)。与不使用他汀类药物者相比,剂量分析显示出不同的几率:1-30 个标准日总剂量的几率比为 1.30(1.12-1.52),31-90 个标准日总剂量的几率比为 0.77(0.64-0.92),91-180 个标准日总剂量的几率比为 0.62(0.52-0.75),大于 180 个标准日总剂量的几率比为 0.30(0.25-0.35)。日本老年人使用他汀类药物与帕金森病风险的降低有关。值得注意的是,较低的他汀类药物累积剂量与帕金森病风险的升高有关,而较高的累积剂量则对帕金森病的发展具有保护作用。
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引用次数: 0
Dose-dependent LSD effects on cortical/thalamic and cerebellar activity: brain oxygen level-dependent fMRI study in awake rats 剂量依赖性 LSD 对大脑皮层/丘脑和小脑活动的影响:清醒大鼠脑氧水平依赖性 fMRI 研究
Pub Date : 2024-06-04 DOI: 10.1093/braincomms/fcae194
Ashley Ghaw, Alisha Chunduri, Arnold Chang, Richard Ortiz, Milena Kozlowska, P. Kulkarni, Craig F Ferris
LSD (lysergic acid diethylamide) is a hallucinogen with complex neurobiological and behavioral effects. This is the first study to use MRI to follow functional changes in brain activity in response to different doses of LSD in fully awake, drug naive rats. We hypothesized that LSD would show a dose-dependent increase in activity in the prefrontal cortex and thalamus, while decreasing hippocampal activity. Female and male rats were given intraperitoneal injections of vehicle or LSD in doses of 10 µg/kg or 100 µg/kg while fully awake during the imaging session. Changes in blood oxygen level dependent (BOLD) signal were recorded over a 30 min window. Approximately 45 min post injection data for resting state functional connectivity were collected All data were registered to rat 3D MRI atlas with 173 brain regions providing site-specific increases and decreases in global brain activity and changes in functional connectivity. Treatment with LSD resulted in a significant dose-dependent increase in negative BOLD signal. The areas most affected were the primary olfactory system, prefrontal cortex, thalamus and hippocampus. This was observed in both the number of voxels affected in these brains regions and the changes in BOLD signal over time. However, there was a significant increases in functional connectivity between the thalamus and somatosensory cortex, and the cerebellar nuclei and the surrounding brainstem areas. Contrary to our hypothesis, there was an acute dose-dependent increase in negative BOLD which can be interpreted as a decrease in brain activity, a finding that agrees with much of the behavioral data from preclinical studies. The enhanced connectivity between thalamus and sensory motor cortices is consistent with the human literature looking at LSD treatments in healthy human volunteers. The unexpected finding that LSD enhances connectivity to the cerebellar nuclei raises an interesting question concerning the role of this brain region in the psychotomimetic effects of hallucinogens.
LSD(麦角酰二乙胺)是一种致幻剂,具有复杂的神经生物学和行为学效应。这是首次使用核磁共振成像技术跟踪完全清醒、未服药的大鼠在不同剂量 LSD 作用下大脑活动的功能变化。我们假设 LSD 会导致前额叶皮层和丘脑的活动呈剂量依赖性增加,同时降低海马的活动。在成像过程中,我们给完全清醒的雌性和雄性大鼠腹腔注射 10 µg/kg 或 100 µg/kg 剂量的载体或迷幻剂。在 30 分钟内记录血氧水平依赖性(BOLD)信号的变化。注射后约 45 分钟,收集静息状态功能连接数据。所有数据均登记到大鼠三维核磁共振成像图谱中,该图谱有 173 个脑区,可提供特定部位的全脑活动增减和功能连接变化。使用 LSD 会导致负 BOLD 信号的显著剂量依赖性增加。受影响最大的区域是初级嗅觉系统、前额叶皮层、丘脑和海马。从这些脑区受影响的体素数量和 BOLD 信号随时间的变化都可以观察到这一点。然而,丘脑与躯体感觉皮层之间、小脑核与周围脑干区域之间的功能连接性却明显增加。与我们的假设相反,负BOLD出现了急性剂量依赖性增加,这可以解释为大脑活动的减少,这一发现与临床前研究的大部分行为数据一致。丘脑和感觉运动皮层之间的连通性增强,这与人类文献中研究 LSD 治疗健康人类志愿者的结果一致。迷幻剂会增强小脑核的连接性,这一意想不到的发现提出了一个有趣的问题,即这个脑区在迷幻剂的拟精神效应中扮演什么角色。
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引用次数: 0
Altered functional connectivity of the default mode network in non-arteritic anterior ischemic optic neuropathy 非动脉炎性前部缺血性视神经病变中默认模式网络功能连接的改变
Pub Date : 2024-06-03 DOI: 10.1093/braincomms/fcae186
Pengde Guo, Jian Zhou, Yan Su, Weixin Wang, Haiqin Hua, Pengbo Zhao, Yan Wang, Shaohong Kang, Ming Liu
The functional connectivity of the default mode network is important in understanding the neuro-pathophysiological abnormalities in patients with non-arteritic anterior ischemic optic neuropathy. Independent component analysis can effectively determine within and between network connectivity of different brain components. Therefore, in order to explore the association between the default mode network and other brain regions, we utilized independent component analysis to investigate the alteration of functional connectivity of the default mode network. Thirty-one patients with non-arteritic anterior ischemic optic neuropathy and 31 healthy controls, matched for age, sex, and years of education, were recruited. For patients and healthy controls, functional connectivity within and between the default mode network and other brain regions were evaluated by independent component analysis. Compared with healthy controls, patients with non-arteritic anterior ischemic optic neuropathy showed reduced functional connectivity within the default mode network in the right cerebellar tonsil and left cerebellum posterior lobe and increased functional connectivity in the left inferior temporal and right middle frontal gyri. Furthermore, patients with non-arteritic anterior ischemic optic neuropathy showed reduced functional connectivity between the default mode network and other brain regions in the left cerebellar tonsil and increased functional connectivity in the right putamen, left thalamus, right middle temporal, and left middle frontal gyri. In conclusion, negative correlations between several clinical parameters and functional connectivity of the default mode network were observed. The study contributes to understanding the mechanism of functional reorganization in non-arteritic anterior ischemic optic neuropathy.
默认模式网络的功能连接对于了解非动脉炎性前部缺血性视神经病变患者的神经病理生理异常非常重要。独立成分分析能有效确定不同大脑成分内部和之间的网络连接。因此,为了探讨默认模式网络与其他脑区之间的关联,我们利用独立成分分析法研究了默认模式网络功能连接的改变。我们招募了 31 名非动脉炎性前部缺血性视神经病变患者和 31 名健康对照者,他们的年龄、性别和受教育年限均匹配。通过独立成分分析评估了患者和健康对照组默认模式网络内部以及默认模式网络与其他脑区之间的功能连接性。与健康对照组相比,非动脉炎性前部缺血性视神经病变患者右侧小脑扁桃体和左侧小脑后叶默认模式网络内的功能连接性降低,而左侧下颞叶和右侧额叶中部的功能连接性增加。此外,非动脉炎性前部缺血性视神经病变患者左侧小脑扁桃体的默认模式网络与其他脑区之间的功能连接性降低,而右侧丘脑、左侧丘脑、右侧颞叶中部和左侧额叶中部的功能连接性增加。总之,多项临床参数与默认模式网络的功能连通性呈负相关。该研究有助于理解非动脉炎性前部缺血性视神经病变的功能重组机制。
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引用次数: 0
Leveraging sex-genetic interactions to understand brain disorders: recent advances and current gaps 利用性别基因的相互作用来了解脑部疾病:最新进展和当前差距
Pub Date : 2024-06-03 DOI: 10.1093/braincomms/fcae192
Nikita Neale, Frida Lona-Durazo, Mina Ryten, S. G. Gagliano Taliun
It is established that there are sex differences in terms of prevalence, age of onset, clinical manifestations, and response to treatment for a variety of brain disorders, including neurodevelopmental, psychiatric, and neurodegenerative disorders. Cohorts of increasing sample sizes with diverse data types collected, including genetic, transcriptomic and/or phenotypic data, are providing the building blocks to permit analytical designs to test for sex-biased genetic variant-trait associations, and for sex-biased transcriptional regulation. Such molecular assessments can contribute to our understanding of the manifested phenotypic differences between the sexes for brain disorders, offering the future possibility of delivering personalised therapy for females and males. With the intention of raising the profile of this field as a research priority, this review aims to shed light on the importance of investigating sex-genetic interactions for brain disorders, focusing on two areas: (i) variant-trait associations and (ii) transcriptomics (i.e., gene expression, transcript usage and regulation). We specifically discuss recent advances in the field, current gaps and provide considerations for future studies.
现已证实,包括神经发育性疾病、精神疾病和神经退行性疾病在内的各种脑部疾病在发病率、发病年龄、临床表现和治疗反应方面存在性别差异。样本规模不断扩大的队列收集了多种类型的数据,包括基因、转录组和/或表型数据,这些数据为分析设计提供了基础,可用于测试性别遗传变异与性状的关联以及性别转录调控。这种分子评估有助于我们了解脑部疾病的性别表型差异,为将来为女性和男性提供个性化治疗提供了可能。为了提高该领域作为优先研究领域的地位,本综述旨在阐明研究性基因相互作用对脑部疾病的重要性,重点关注两个领域:(i) 变体与性状的关联;(ii) 转录组学(即基因表达、转录本使用和调控)。我们将具体讨论该领域的最新进展、目前存在的差距,并为未来的研究提供参考。
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引用次数: 0
Propionic acid promotes neurite recovery in damaged multiple sclerosis neurons 丙酸促进受损多发性硬化神经元的神经元恢复
Pub Date : 2024-06-03 DOI: 10.1093/braincomms/fcae182
Barbara Gisevius, Alexander Duscha, G. Poschmann, Kai Stühler, J. Motte, A. L. Fisse, Sanja Augustyniak, Adriana Rehm, P. Renk, Celina Böse, Diana Hubert, Kathrin Peters, Michelle Jagst, André Gömer, D. Todt, V. Bader, M. Tokic, Sarah Hirschberg, Christos Krogias, Nadine Trampe, Charlotta Coutourier, Carmen Winnesberg, E. Steinmann, K. Winklhofer, Ralf Gold, Aiden Haghikia
Neurodegeneration in the autoimmune disease multiple sclerosis still poses a major therapeutic challenge. Effective drugs that target the inflammation can only partially reduce accumulation of neurological deficits and conversion to progressive disease forms. Diet and the associated gut microbiome are currently being discussed as crucial environmental risk factors that determine disease onset and subsequent progression. In people with multiple sclerosis (pwMS), supplementation of the short-chain fatty acid (SCFA) propionic acid (PA), as microbial metabolite derived from the fermentation of a high-fiber diet, has previously been shown to regulate inflammation accompanied by neuroprotective properties. We set out to determine, whether the neuroprotective impact of PA is a direct mode of action of SCFAs on CNS neurons. We analyzed neurite recovery in the presence of the SCFAs propionic acid (PA) and butyric acid (BA) in a reverse translational disease-in-a-dish model of human induced primary neurons (iPNs) differentiated from pwMS-derived induced pluripotent stem cells (iPSCs). We found that recovery of damaged neurites is induced by PA and BA, respectively. We could also show that administration of BA is able to enhance PA-associated neurite recovery. Whole cell proteome analysis of iPNs following recovery in the presence of PA revealed abundance changes of protein groups that are associated with the chromatin assembly, translational-, and metabolic processes. We further present evidence that these alterations in the chromatin assembly were associated with inhibition of histone deacetylases (HDAC) class I/II following both PA and BA treatment, mediated by free fatty acid receptor (FFAR) signaling. While neurite recovery in the presence of PA is promoted by activation of the anti-oxidative response, administration of BA increases neuronal ATP synthesis in pwMS-specific iPNs.
自身免疫性疾病多发性硬化症的神经变性仍然是一项重大的治疗挑战。针对炎症的有效药物只能部分缓解神经功能缺损的累积和疾病进展的转化。饮食和相关的肠道微生物组目前被认为是决定疾病发病和后续发展的关键环境风险因素。在多发性硬化症患者(pwMS)中,补充短链脂肪酸(SCFA)丙酸(PA)作为高纤维饮食发酵产生的微生物代谢产物,已被证明可以调节炎症,同时具有神经保护特性。我们试图确定 PA 的神经保护作用是否是 SCFAs 对中枢神经系统神经元的直接作用模式。我们分析了由 pwMS 衍生的诱导多能干细胞(iPSCs)分化而来的人类诱导原发性神经元(iPNs)的反向转化疾病模型中,在存在 SCFAs 丙酸(PA)和丁酸(BA)的情况下神经元的恢复情况。我们发现 PA 和 BA 可分别诱导受损神经元的恢复。我们还发现,给予 BA 能够增强 PA 相关神经元的恢复。在 PA 的存在下,iPNs 恢复后的全细胞蛋白质组分析揭示了与染色质组装、翻译和代谢过程相关的蛋白质组的丰度变化。我们还进一步提出证据表明,染色质组装的这些变化与 PA 和 BA 处理后组蛋白去乙酰化酶(HDAC)I/II 类的抑制有关,这种抑制是由游离脂肪酸受体(FFAR)信号传导介导的。在存在 PA 的情况下,神经元的恢复是通过激活抗氧化反应来促进的,而在 pwMS 特异性 iPNs 中,给予 BA 会增加神经元的 ATP 合成。
{"title":"Propionic acid promotes neurite recovery in damaged multiple sclerosis neurons","authors":"Barbara Gisevius, Alexander Duscha, G. Poschmann, Kai Stühler, J. Motte, A. L. Fisse, Sanja Augustyniak, Adriana Rehm, P. Renk, Celina Böse, Diana Hubert, Kathrin Peters, Michelle Jagst, André Gömer, D. Todt, V. Bader, M. Tokic, Sarah Hirschberg, Christos Krogias, Nadine Trampe, Charlotta Coutourier, Carmen Winnesberg, E. Steinmann, K. Winklhofer, Ralf Gold, Aiden Haghikia","doi":"10.1093/braincomms/fcae182","DOIUrl":"https://doi.org/10.1093/braincomms/fcae182","url":null,"abstract":"\u0000 Neurodegeneration in the autoimmune disease multiple sclerosis still poses a major therapeutic challenge. Effective drugs that target the inflammation can only partially reduce accumulation of neurological deficits and conversion to progressive disease forms. Diet and the associated gut microbiome are currently being discussed as crucial environmental risk factors that determine disease onset and subsequent progression. In people with multiple sclerosis (pwMS), supplementation of the short-chain fatty acid (SCFA) propionic acid (PA), as microbial metabolite derived from the fermentation of a high-fiber diet, has previously been shown to regulate inflammation accompanied by neuroprotective properties. We set out to determine, whether the neuroprotective impact of PA is a direct mode of action of SCFAs on CNS neurons. We analyzed neurite recovery in the presence of the SCFAs propionic acid (PA) and butyric acid (BA) in a reverse translational disease-in-a-dish model of human induced primary neurons (iPNs) differentiated from pwMS-derived induced pluripotent stem cells (iPSCs). We found that recovery of damaged neurites is induced by PA and BA, respectively. We could also show that administration of BA is able to enhance PA-associated neurite recovery. Whole cell proteome analysis of iPNs following recovery in the presence of PA revealed abundance changes of protein groups that are associated with the chromatin assembly, translational-, and metabolic processes. We further present evidence that these alterations in the chromatin assembly were associated with inhibition of histone deacetylases (HDAC) class I/II following both PA and BA treatment, mediated by free fatty acid receptor (FFAR) signaling. While neurite recovery in the presence of PA is promoted by activation of the anti-oxidative response, administration of BA increases neuronal ATP synthesis in pwMS-specific iPNs.","PeriodicalId":9318,"journal":{"name":"Brain Communications","volume":"29 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141270505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spinal cord neurone loss and foot placement changes in a rat knock-in model of amyotrophic lateral sclerosis type 8 8 型肌萎缩性脊髓侧索硬化症基因敲入模型大鼠的脊髓神经元缺失和足部位置变化
Pub Date : 2024-05-24 DOI: 10.1093/braincomms/fcae184
Brenda Murage, Han Tan, Tomoji Mashimo, Mandy Jackson, Paul A Skehel
Amyotrophic Lateral Sclerosis is an age-dependent cell type-selective degenerative disease. Genetic studies indicate that Amyotrophic Lateral Sclerosis is part of a spectrum of disorders ranging from spinal muscular atrophy to frontotemporal dementia that share common pathological mechanisms. Amyotrophic Lateral Sclerosis type 8 is a familial disease caused by mis-sense mutations in VAPB. VAPB is localised to the cytoplasmic surface of the endoplasmic reticulum where it serves as a docking point for cytoplasmic proteins and mediates inter-organelle interactions with the endoplasmic reticulum membrane. A gene knock-in model of Amyotrophic Lateral Sclerosis type 8 based on the VapBP56S mutation and VapB gene deletion have been generated in the rat. These animals display a range of age-dependent phenotypes distinct from those previously reported in mouse models of Amyotrophic Lateral Sclerosis type 8. A loss of motor neurones in VapBP56S/+ and VapBP56S/P56Sanimals is indicated by a reduction in the number of large choline acetyl transferase-staining cells in the spinal cord. VapB-/-animals exhibit a relative increase in cytoplasmic TDP-43 levels compared to the nucleus, but no large protein aggregates. Concomitant with these spinal cord pathologies VapBP56S/+, VapBP56S/P56S and VapB-/-animals exhibit age-dependent changes in paw placement and exerted pressures when traversing a CatWalk apparatus, consistent with a somatosensory dysfunction. Extra motor dysfunction is reported in half the cases of motor neurone disease, and this is the first indication of an associated sensory dysfunction in a rodent model of Amyotrophic Lateral Sclerosis. Different rodent models may offer complementary experimental platforms with which to understand the human disease.
肌萎缩侧索硬化症是一种与年龄有关的细胞类型选择性变性疾病。遗传学研究表明,肌萎缩侧索硬化症是脊髓性肌肉萎缩症和额颞叶痴呆症等一系列疾病的一部分,这些疾病具有共同的病理机制。肌萎缩侧索硬化症 8 型是一种由 VAPB 的错义突变引起的家族性疾病。VAPB 定位于内质网的细胞质表面,是细胞质蛋白的对接点,并介导细胞器间与内质网膜的相互作用。基于 VapBP56S 突变和 VapB 基因缺失的肌萎缩侧索硬化症 8 型基因敲入模型已在大鼠体内产生。这些动物表现出一系列年龄依赖性表型,与之前报道的肌萎缩侧索硬化症 8 型小鼠模型的表型截然不同。VapBP56S/+和VapBP56S/P56S动物运动神经元的缺失表现为脊髓中大的胆碱乙酰转移酶染色细胞数量的减少。与细胞核相比,VapB-/-动物的细胞质 TDP-43 含量相对增加,但没有大的蛋白质聚集。伴随着这些脊髓病变,VapBP56S/+、VapBP56S/P56S 和 VapB-/- 动物在穿越 CatWalk 装置时,爪子的位置和施加的压力会出现与年龄相关的变化,这与躯体感觉功能障碍是一致的。据报道,一半的运动神经元病例都存在运动功能障碍,而这是肌萎缩侧索硬化症啮齿动物模型中首次出现相关感觉功能障碍的迹象。不同的啮齿类动物模型可以为了解人类疾病提供互补的实验平台。
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引用次数: 0
Personality and quality-of-life improvement after apomorphine infusion in Parkinson’s disease 帕金森病患者输注阿朴吗啡后性格和生活质量的改善
Pub Date : 2024-05-24 DOI: 10.1093/braincomms/fcae181
M. Boussac, Estelle Harroch, Christel Barthelemy, F. Ory-Magne, Clémence Leung, Margherita Fabbri, Christophe Arbus, Christine Brefel-Courbon
People with Parkinson’s disease with motor fluctuations can be treated by Continuous Subcutaneous Apomorphine Infusion (CSAI) to reduce their symptoms. Nonetheless, factors are lacking to predict patients’ quality-of-life amelioration after CSAI. This pilot study aimed to evaluate associations between personality dimensions and quality-of-life improvement after six months of CSAI. Thirty-nine people with Parkinson’s disease awaiting CSAI were included. Linear regression models between “Temperament and Character Inventory” personality dimensions at baseline and percentage of change in PDQ-39 (Parkinson’s Disease Questionnaire-39) scores after six months of CSAI were realized (n = 35). Temperament and Character Inventory was also compared between patients awaiting CSAI and patients awaiting deep brain stimulation of the sub-thalamic nucleus (n = 39 from the PREDI-STIM study). Higher Reward Dependence scores were associated with a better quality-of-life outcome after six months of CSAI, while Self-Directedness scores were associated with a better quality of life before CSAI (as opposed to Harm Avoidance, Reward Dependence, and Self-Transcendence scores associated with a worse quality of life). Moreover, people with Parkinson’s disease awaiting deep brain stimulation of the sub-thalamic nucleus had similar Temperament and Character Inventory dimensions compared to patients awaiting CSAI. People with Parkinson’s disease with higher Reward Dependence scores at baseline had the best quality-of-life improvement after six months of CSAI. This finding could be used to better prepare and accompany people with Parkinson’s disease during CSAI establishment. Moreover, this result could serve as an orientation factor to second-line treatments.
帕金森病患者如果出现运动波动,可以通过持续皮下注射阿朴吗啡(CSAI)来减轻症状。然而,目前还缺乏能预测患者在 CSAI 治疗后生活质量改善情况的因素。本试验研究旨在评估人格维度与 CSAI 六个月后生活质量改善之间的关联。研究纳入了 39 名等待 CSAI 的帕金森病患者。基线时的 "气质和性格量表 "人格维度与 CSAI 六个月后 PDQ-39(帕金森病问卷-39)得分变化百分比之间的线性回归模型得以实现(n = 35)。还对等待 CSAI 的患者和等待丘脑下核深部脑刺激的患者(PREDI-STIM 研究中的 39 人)的气质和性格量表进行了比较。较高的奖赏依赖性得分与CSAI六个月后较好的生活质量结果相关,而自我导向性得分与CSAI前较好的生活质量相关(相反,避免伤害、奖赏依赖性和自我超越性得分与较差的生活质量相关)。此外,等待丘脑下核深部脑刺激的帕金森病患者与等待CSAI的患者相比,具有相似的气质和性格量表维度。基线奖励依赖评分较高的帕金森病患者在接受CSAI治疗6个月后,生活质量改善得最好。这一发现可用于帕金森病患者在 CSAI 建立期间做好更好的准备和陪伴。此外,这一结果还可作为二线治疗的导向因素。
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引用次数: 0
Brain network changes and cognitive function after cardiac arrest 心脏骤停后的脑网络变化和认知功能
Pub Date : 2024-05-23 DOI: 10.1093/braincomms/fcae174
Pardis Zarifkar, M. Wagner, Patrick MacDonald Fisher, Dea Siggaard Stenbæk, Selina Kikkenborg Berg, Gitte Moos Knudsen, Michael E Benros, Daniel Kondziella, Christian Hassager
Survival rates after out-of-hospital cardiac arrest (OHCA) have improved over the past two decades. Despite this progress, long-term cognitive impairment remains prevalent even in those with early recovery of consciousness after OHCA; however, little is known about the determinants and underlying mechanisms. We utilized the REcovery after cardiac arrest surVIVAL (REVIVAL) cohort of OHCA survivors who fully regained consciousness to correlate cognition measurements with brain network changes using resting state functional MRI and the Montreal Cognitive Assessment (MoCA) at hospital discharge and a comprehensive neuropsychological assessment at three-month follow-up. About half of OHCA survivors displayed cognitive impairments at discharge, and in most, cognitive deficits persisted at three-month follow-up, particularly in the executive and visuospatial functions. Compared to healthy controls, OHCA survivors exhibited increased connectivity between resting-state networks, particularly involving the frontoparietal network. The increased connectivity between the frontoparietal and visual network was associated with less favorable cognitive outcomes (β=14.0, p=0.01), while higher education seemed to confer some cognitive protection (β=-2.06, p=0.03). In sum, the data highlight the importance of subtle cognitive impairment, also in OHCA survivors who are eligible for home discharge, and the potential of fMRI to identify alterations in brain networks correlating with cognitive outcomes.
过去二十年来,院外心脏骤停(OHCA)后的存活率有所提高。尽管取得了这一进步,但即使在 OHCA 后意识早期恢复的患者中,长期认知功能障碍仍然普遍存在;然而,人们对其决定因素和潜在机制知之甚少。我们利用完全恢复意识的心脏骤停幸存者REcovery after cardiac arrest surVIVAL(REVIVAL)队列,在出院时使用静息状态功能磁共振成像和蒙特利尔认知评估(MoCA)以及三个月随访时的综合神经心理学评估,将认知测量与脑网络变化联系起来。约有一半的 OHCA 幸存者在出院时表现出认知障碍,其中大多数人的认知障碍在三个月的随访中仍然存在,尤其是在执行功能和视觉空间功能方面。与健康对照组相比,OHCA幸存者表现出静息态网络之间的连接性增强,尤其是涉及额顶叶网络。额顶叶和视觉网络之间连接性的增加与较差的认知结果有关(β=14.0,p=0.01),而较高的教育程度似乎能提供一些认知保护(β=-2.06,p=0.03)。总之,这些数据强调了细微认知障碍的重要性,同样适用于符合出院条件的 OHCA 幸存者,以及 fMRI 识别与认知结果相关的大脑网络改变的潜力。
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引用次数: 0
Plasma pTau181 and pTau217 predict asymptomatic amyloid accumulation equally well as amyloid-PET 血浆 pTau181 和 pTau217 预测无症状淀粉样蛋白积聚的能力与淀粉样蛋白-PET 预测能力相当
Pub Date : 2024-05-23 DOI: 10.1093/braincomms/fcae162
Steffi De Meyer, Jolien M Schaeverbeke, Emma S Luckett, Mariska Reinartz, Elena R Blujdea, Isabelle Cleynen, Patrick Dupont, Koen Van Laere, Jeroen Vanbrabant, Erik Stoops, Eugeen Vanmechelen, Guglielmo di Molfetta, Henrik Zetterberg, Nicholas J Ashton, Charlotte E Teunissen, Koen Poesen, Rik Vandenberghe
The dynamic phase of preclinical Alzheimer’s disease, as characterised by accumulating cortical amyloid-β (Aβ), is a window of opportunity for Aβ lowering therapies to have greater efficacy. Biomarkers that accurately predict Aβ accumulation may be of critical importance for participant inclusion in secondary prevention trials and thus enhance development of early Alzheimer’s disease therapies. We compared the ability of baseline plasma phosphorylated tau at threonine181 (pTau181), pTau217 and Aβ-PET load to predict future Aβ accumulation in asymptomatic elderly. In this longitudinal cohort study, baseline plasma pTau181 and pTau217 were quantified using single molecule array (Simoa) assays in cognitively unimpaired elderly selected from the community-recruited Flemish Prevent Alzheimer’s disease Cohort KU Leuven (F-PACK) based on the availability of baseline plasma samples and longitudinal Aβ-PET data (average time interval = 5 years, range 2 - 10 years). The predictive abilities of pTau181, pTau217 and PET-based Aβ measures for PET-based Aβ accumulation were investigated using receiver operating characteristic analyses, correlations and stepwise regression analyses. We included 75 F-PACK subjects (mean age = 70 years, 48% female), of which 16 were classified as Aβ accumulators (median [IQR] Centiloid rate of change = 3.42 [1.60] Centiloids/year). Plasma pTau181 (area under the curve (AUC) [95% CI] = 0.72 [0.59–0.86]) distinguished Aβ accumulators from non-accumulators with similar accuracy as pTau217 (AUC [95% CI] = 0.75 [0.62–0.88] and Aβ-PET (AUC [95% CI] = 0.72 [0.56–0.87]). Plasma pTau181 and pTau217 strongly correlated with each other (r = 0.93, PFDR < 0.001) and, together with Aβ-PET, similarly correlated with Aβ rate of change (rpTau181 = 0.33, rpTau217 = 0.36, rAβ-PET = 0.35, all PFDR ≤ 0.01). Addition of either plasma pTau181, plasma pTau217, or Aβ-PET to a linear demographic model including age, sex and APOE-ε4 carriership similarly improved the prediction of Aβ accumulation (ΔAkaike Information Criterion ≤ 4.1). In a multimodal biomarker model including all three biomarkers, each biomarker lost their individual predictive ability. These findings indicate that plasma pTau181, plasma pTau217 and Aβ-PET convey overlapping information and therefore predict the dynamic phase of asymptomatic amyloid-β accumulation with comparable performances. In clinical trial recruitment, confirmatory PET scans following blood-based prescreening might thus not provide additional value for detecting participants in these early disease stages who are destined to accumulate cortical Aβ. Given the moderate performances, future studies should investigate whether integrating plasma pTau species with other factors can improve performance and thus enhance clinical and research utility.
临床前阿尔茨海默病的动态阶段以皮质淀粉样蛋白-β(Aβ)的积累为特征,是降低 Aβ 的疗法发挥更大疗效的机会之窗。能准确预测 Aβ 积累的生物标志物可能对将参与者纳入二级预防试验至关重要,从而促进早期阿尔茨海默病疗法的开发。我们比较了血浆中苏氨酸181磷酸化 tau(pTau181)、pTau217 和 Aβ-PET 负荷基线预测无症状老年人未来 Aβ 累积的能力。在这项纵向队列研究中,根据基线血浆样本和纵向 Aβ-PET 数据(平均时间间隔 = 5 年,范围为 2 - 10 年)的可用性,从社区招募的弗拉芒预防阿尔茨海默病队列鲁汶大学(F-PACK)中挑选了认知功能未受损的老年人,使用单分子阵列(Simoa)测定法对他们的基线血浆 pTau181 和 pTau217 进行了量化。我们使用接收器操作特征分析、相关性分析和逐步回归分析研究了 pTau181、pTau217 和基于 PET 的 Aβ 测量对基于 PET 的 Aβ 累积的预测能力。我们纳入了 75 名 F-PACK 受试者(平均年龄 = 70 岁,48% 为女性),其中 16 人被归类为 Aβ 累积者(中位数 [IQR] 百分位数变化率 = 3.42 [1.60] 百分位数/年)。血浆pTau181(曲线下面积(AUC)[95% CI] = 0.72 [0.59-0.86])可区分Aβ蓄积者和非蓄积者,其准确性与pTau217(AUC [95% CI] = 0.75 [0.62-0.88])和Aβ-PET(AUC [95% CI] = 0.72 [0.56-0.87])相似。血浆 pTau181 和 pTau217 之间存在密切的相关性(r = 0.93,PFDR < 0.001),并且与 Aβ-PET 一起与 Aβ 变化率存在类似的相关性(rpTau181 = 0.33,rpTau217 = 0.36,rAβ-PET = 0.35,所有 PFDR 均小于 0.01)。将血浆 pTau181、血浆 pTau217 或 Aβ-PET 添加到包括年龄、性别和 APOE-ε4 血型的线性人口统计学模型中,同样可以提高对 Aβ 累积的预测(ΔAkaike 信息标准≤ 4.1)。在包括所有三种生物标志物的多模态生物标志物模型中,每种生物标志物都失去了各自的预测能力。这些研究结果表明,血浆 pTau181、血浆 pTau217 和 Aβ-PET 可传递重叠的信息,因此可预测无症状淀粉样蛋白-β积聚的动态阶段,而且性能相当。因此,在临床试验招募中,基于血液的预筛选后的 PET 扫描确认可能无法为检测处于这些疾病早期阶段、注定会积累皮质 Aβ 的参与者提供额外价值。鉴于其性能一般,未来的研究应探讨将血浆 pTau 种类与其他因素结合是否能改善性能,从而提高临床和研究效用。
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引用次数: 0
Potential for in vivo visualization of intracellular pH gradient in brain using PET imaging 利用 PET 成像在体内观察脑细胞内 pH 梯度的潜力
Pub Date : 2024-05-22 DOI: 10.1093/braincomms/fcae172
Tomoteru Yamasaki, Wakana Mori, Takayuki Ohkubo, Atsuto Hiraishi, Yiding Zhang, Yusuke Kurihara, N. Nengaki, Hideaki Tashima, Masayuki Fujinaga, Ming-Rong Zhang
Intracellular pH is a valuable index for predicting neuronal damage and injury. However, no PET probe is currently available for monitoring intracellular pH in vivo. In this study, we developed a new approach for visualizing the hydrolysis rate of monoacylglycerol lipase, which is widely distributed in neurons and astrocytes throughout the brain. This approach uses PET with the new radioprobe [11C]QST-0837 (1,1,1,3,3,3-hexafluoropropan-2-yl-3-(1-phenyl-1H-pyrazol-3-yl)azetidine-1-[11C]carboxylate), a covalent inhibitor containing an azetidine carbamate skeleton for monoacylglycerol lipase. The uptake and residence of this new radioprobe depends on the intracellular pH gradient, and we evaluated this with in silico, in vitro, and in vivo assessments. Molecular dynamics simulations predicted that because the azetidine carbamate moiety is close to that of water molecules, the compound containing azetidine carbamate would be more easily hydrolyzed following binding to monoacylglycerol lipase than would its analog containing a piperidine carbamate skeleton. Interestingly, it was difficult for monoacylglycerol lipase to hydrolyze the azetidine carbamate compound under weak-acidic (pH 6) conditions because of a change in the interactions with water molecules on the carbamate moiety of their complex. Subsequently, an in vitro assessment using rat brain homogenate to confirm the molecular dynamics simulation-predicted behavior of the azetidine carbamate compound showed that [11C]QST-0837 reacted with monoacylglycerol lipase to yield an [11C]complex, which was hydrolyzed to liberate 11CO2 as a final product. Additionally, the 11CO2 liberation rate was slower at lower pH. Finally, to indicate the feasibility of estimating how the hydrolysis rate depends on intracellular pH in vivo, we performed a PET study with [11C]QST-0837 using ischemic rats. In our proposed in vivo compartment model, the clearance rate of radioactivity from the brain reflected the rate of [11C]QST-0837 hydrolysis (clearance through the production of 11CO2) in the brain, which was lower in a remarkably hypoxic area than in the contralateral region. In conclusion, we indicated the potential for visualization of the intracellular pH gradient in the brain using PET imaging, although some limitations remain. This approach should permit further elucidation of the pathological mechanisms involved under acidic conditions in multiple CNS disorders.
细胞内 pH 值是预测神经元损伤的重要指标。然而,目前还没有 PET 探针可用于监测体内细胞内 pH 值。在这项研究中,我们开发了一种新方法来观察单酰基甘油脂肪酶的水解率,这种酶广泛分布于整个大脑的神经元和星形胶质细胞中。这种方法使用 PET 和新型放射性探针 [11C]QST-0837(1,1,1,3,3,3-六氟丙烷-2-基-3-(1-苯基-1H-吡唑-3-基)氮杂环丁烷-1-[11C]羧酸盐),这是一种含有氮杂环丁烷氨基甲酸酯骨架的单酰基甘油脂肪酶共价抑制剂。这种新型放射性探针的吸收和驻留取决于细胞内的 pH 梯度,我们通过硅学、体外和体内评估对此进行了评估。分子动力学模拟预测,由于氮杂环丁烷氨基甲酸酯分子接近于水分子的分子,与含有哌啶氨基甲酸酯骨架的类似物相比,含有氮杂环丁烷氨基甲酸酯的化合物在与单酰甘油脂肪酶结合后更容易水解。有趣的是,在弱酸性(pH 值为 6)条件下,单酰基甘油脂肪酶很难水解氮杂环丁烷氨基甲酸酯化合物,这是因为它们的复合物氨基甲酸酯分子与水分子的相互作用发生了变化。随后,为了证实分子动力学模拟预测的氮杂环丁烷氨基甲酸酯化合物的行为,使用大鼠脑匀浆进行了体外评估,结果显示[11C]QST-0837 与单酰基甘油脂肪酶反应生成了[11C]复合物,该复合物水解后的最终产物是 11CO2。此外,pH 值较低时,11CO2 的释放速度较慢。最后,为了说明在体内估计水解率如何取决于细胞内 pH 值的可行性,我们利用缺血大鼠进行了[11C]QST-0837 的 PET 研究。在我们提出的体内分区模型中,脑内放射性清除率反映了脑内[11C]QST-0837的水解率(通过产生11CO2清除),明显缺氧区域的水解率低于对侧区域。总之,我们指出了利用 PET 成像观察大脑细胞内 pH 梯度的潜力,尽管还存在一些局限性。这种方法应能进一步阐明多种中枢神经系统疾病在酸性条件下的病理机制。
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引用次数: 0
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Brain Communications
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