Brain imaging of cognitively normal individuals with 2 parents affected by late-onset AD

Objective:This observational multimodality brain imaging study investigates emergence of endophenotypes of late-onset Alzheimer disease (AD) risk during endocrine transition states in a cohort of clinically and cognitively normal women and age-matched men.Methods:Forty-two 40- to 60-year-old cognitively normal women (15 asymptomatic perimenopausal by age [CNT], 13 perimenopausal [PERI], and 14 postmenopausal [MENO]) and 18 age- and education-matched men were examined. All patients had volumetric MRI, 18F-fluoro-2-deoxyglucose (FDG)–PET (glucose metabolism), and Pittsburgh compound B–PET scans (β-amyloid [Aβ] deposition, a hallmark of AD pathology).Results:As expected, the MENO group was older than the PERI and CNT groups. Otherwise, groups were comparable on clinical and neuropsychological measures and APOE4 distribution. Compared to CNT women and to men, and controlling for age, PERI and MENO groups exhibited increased indicators of AD endophenotype, including hypometabolism, increased Aβ deposition, and reduced gray and white matter volumes in AD-vulnerable regions (p < 0.001). AD biomarker abnormalities were greatest in MENO, intermediate in PERI, and lowest in CNT women (p < 0.001). Aβ deposition was exacerbated in APOE4-positive MENO women relative to the other groups (p < 0.001).Conclusions:Multimodality brain imaging indicates sex differences in development of the AD endophenotype, suggesting that the preclinical AD phase is early in the female aging process and coincides with the endocrine transition of perimenopause. These data indicate that the optimal window of opportunity for therapeutic intervention in women is early in the endocrine aging process.

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CROSS-SECTIONAL AND LONGITUDINAL COMPARISONS OF COGNITION AND BIOMARKERS AMONG COGNITIVELY NORMAL INDIVIDUALS AGED 42 TO 65 YEARS WITH A FAMILY HISTORY OF EITHER AUTOSOMAL DOMINANT AD (ADAD) OR LATE-ONSET AD (LOAD)

Alzheimer s & Dementia ◽

10.1016/j.jalz.2017.07.357 ◽

2017 ◽

Vol 13 (7) ◽

pp. P923

Author(s):

Chengjie Xiong ◽

Lena McCue ◽

Elizabeth A. Grant ◽

Randall J. Bateman ◽

Anne M. Fagan ◽

...

Keyword(s):

Family History ◽

Autosomal Dominant ◽

Late Onset ◽

Cross Sectional ◽

Cognitively Normal ◽

Normal Individuals ◽

History Of

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Lower functional hippocampal redundancy in mild cognitive impairment

Translational Psychiatry ◽

10.1038/s41398-020-01166-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Stephanie Langella ◽

◽

Muhammad Usman Sadiq ◽

Peter J. Mucha ◽

Kelly S. Giovanello ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Resting State ◽

Memory Performance ◽

Potential Mechanism ◽

Network Efficiency ◽

Cognitively Normal ◽

Normal Individuals ◽

The Relationship

AbstractWith an increasing prevalence of mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in response to an aging population, it is critical to identify and understand neuroprotective mechanisms against cognitive decline. One potential mechanism is redundancy: the existence of duplicate elements within a system that provide alternative functionality in case of failure. As the hippocampus is one of the earliest sites affected by AD pathology, we hypothesized that functional hippocampal redundancy is protective against cognitive decline. We compared hippocampal functional redundancy derived from resting-state functional MRI networks in cognitively normal older adults, with individuals with early and late MCI, as well as the relationship between redundancy and cognition. Posterior hippocampal redundancy was reduced between cognitively normal and MCI groups, plateauing across early and late MCI. Higher hippocampal redundancy was related to better memory performance only for cognitively normal individuals. Critically, functional hippocampal redundancy did not come at the expense of network efficiency. Our results provide support that hippocampal redundancy protects against cognitive decline in aging.

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Spontaneous Resolution of Late-Onset, Symptomatic Fluid Collection Localized in the Meningioma Resection Cavity: A Case Report and Suggestion of Possible Pathogenesis

Brain Sciences ◽

10.3390/brainsci11030299 ◽

2021 ◽

Vol 11 (3) ◽

pp. 299

Author(s):

Yeong Jin Kim ◽

Tae-Young Jung ◽

In-Young Kim ◽

Shin Jung ◽

Kyung-Sub Moon

Keyword(s):

Brain Imaging ◽

Late Onset ◽

Fluid Collection ◽

Good Condition ◽

Treatment Strategies ◽

Imaging Studies ◽

Resection Cavity ◽

Perilesional Edema ◽

Posterior Neck ◽

The Right

Postoperative complications after brain tumor surgery occur occasionally and it is important for clinicians to know how to properly manage each complication. Here, we described a rare case of late-onset, subdural fluid collection localized at the resection cavity that caused motor weakness after convexity meningioma resection, requiring differentiation from an abscess, to help clinicians determine treatment strategies. A 58-year-old right-handed female was admitted to the hospital with a headache and posterior neck pain. Brain computed tomography (CT) scans and magnetic resonance (MR) images showed a homogeneously enhanced, calcified, and multi-lobulated mass adjacent to the right motor strip without perilesional edema. The patient underwent surgery without incident or residual deficit and was discharged from the hospital in good condition. Six weeks after surgery, the patient complained of left arm monoparesis without infection-related symptoms. Brain imaging studies showed a localized fluid collection in the resection cavity with an enhanced margin and perilesional edema. Diffusion restriction was not detected. After three months of conservative treatment without surgery or antibiotics, she recovered from the neurologic deficits, and brain imaging studies showed the spontaneous regression of the fluid collection and perilesional edema. Late-onset, localized fluid collection at the resection cavity, which is similar to an abscess, could occur three to eight weeks after meningioma resection. When there are predisposing factors, including blood components and hemostatic materials in the surgical cavity, it is important for clinicians to understand this type of complication and choose conservative management as a feasible strategy.

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An overview of psychological and social factors in Charles Bonnet syndrome

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211034715 ◽

2021 ◽

Vol 13 ◽

pp. 251584142110347

Author(s):

Lee Jones ◽

Lara Ditzel-Finn ◽

Jamie Enoch ◽

Mariya Moosajee

Keyword(s):

Emotional Response ◽

Causal Mechanism ◽

Visual Hallucinations ◽

Cognitively Normal ◽

Charles Bonnet Syndrome ◽

Raising Awareness ◽

Normal Individuals ◽

The Social ◽

Recent Developments ◽

Insight Into

Charles Bonnet syndrome (CBS) is a condition where cognitively normal individuals with sight impairment experience simple and/or complex visual hallucinations. The exact pathogenesis of CBS is unknown; however, deafferentation is often recognised as a causal mechanism. Studies have provided insight into the multifaceted impact of CBS on wellbeing. Onset of CBS may cause distress among those believing visual hallucinations are indicative of a neurological condition. Hallucinatory content is often congruent with the emotional response. For example, hallucinations of a macabre nature typically result in a fearful response. Visual hallucinations may be highly disruptive, causing everyday tasks to become challenging. Clinical management relies on forewarning and pre-emptive questioning. Yet, knowledge and awareness of CBS is typically low. In this review, we provide a summary of the social and psychological implications of CBS and explore recent developments aimed at raising awareness and improving patient management.

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Increased midlife triglycerides predict brain β-amyloid and tau pathology 20 years later

Neurology ◽

10.1212/wnl.0000000000004749 ◽

2017 ◽

Vol 90 (1) ◽

pp. e73-e81 ◽

Cited By ~ 27

Author(s):

Katarina Nägga ◽

Anna-Märta Gustavsson ◽

Erik Stomrud ◽

Daniel Lindqvist ◽

Danielle van Westen ◽

...

Keyword(s):

Risk Factors ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Healthy Population ◽

Lipid Levels ◽

Tau Pathology ◽

Lipoprotein Subfractions ◽

Cognitively Normal ◽

Normal Individuals ◽

Β Amyloid

ObjectiveTo evaluate the effect of midlife lipid levels on Alzheimer brain pathology 20 years later in cognitively normal elderly individuals.MethodsThis is a longitudinal cohort study of 318 cognitively normal individuals with data on fasting lipid levels at midlife (mean age 54 years). Presence of β-amyloid (Aβ) and tau pathologies 20 years later (mean age 73 years) were detected by quantifying Alzheimer disease (AD) biomarkers in CSF. In a subset (n = 134), Aβ (18F-flutemetamol) PET was also performed.ResultsCSF Aβ42 and Aβ PET revealed Aβ pathology in approximately 20% of the cognitively healthy population and CSF Aβ42/phosphorylated tau (p-tau) ratio indicated both Aβ and tau pathology in 16%. Higher levels of triglycerides in midlife were independently associated with abnormal CSF Aβ42 (odds ratio [OR] 1.34, 95% confidence interval [CI] 1.03–1.75, p = 0.029) and abnormal Aβ42/p-tau ratio (OR 1.46, 95% CI 1.10–1.93; p = 0.009) adjusting for age, sex, APOE ε4, education, and multiple vascular risk factors. Triglycerides were also associated with abnormal Aβ PET in multivariable regression models, but the association was attenuated in the fully adjusted model. Increased levels of medium and large low-density lipoprotein subfractions were significantly associated with abnormal Aβ PET and large high-density lipoprotein particles were associated with decreased risk of abnormal Aβ PET.ConclusionsIncreased levels of triglycerides at midlife predict brain Aβ and tau pathology 20 years later in cognitively healthy individuals. Certain lipoprotein subfractions may also be risk factors for Aβ pathology. These findings further support an involvement of lipids in the very early stages of AD development.

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