BACKGROUND: Although neuromelanin-sensitive magnetic resonance imaging (NM-MRI) has been used to evaluate early neurodegeneration in Parkinson's disease, studies concentrating on the locus coeruleus (LC) in pre-dementia stages of dementia with Lewy bodies (DLB) are lacking. OBJECTIVES: The aims were to evaluate NM-MRI signal changes in the LC in patients with mild cognitive impairment with Lewy bodies (MCI-LB) compared to healthy controls (HC) and to identify the cognitive correlates of the changes. We also aimed to test the hypothesis of a caudal-rostral α-synuclein pathology spread using NM-MRI of the different LC subparts. METHODS: A total of 38 MCI-LB patients and 59 HCs underwent clinical and cognitive testing and NM-MRI of the LC. We calculated the contrast ratio of NM-MRI signal (LC-CR) in the whole LC as well as in its caudal, middle, and rostral MRI slices, and we compared the LC-CR values between the MCI-LB and HC groups. Linear regression analyses were performed to assess the relationship between the LC-CR and cognitive outcomes. RESULTS: The MCI-LB group exhibited a significant reduction in the right LC-CR compared to HCs (P = 0.021). The right LC-CR decrease was associated with impaired visuospatial memory in the MCI-LB group. Only the caudal part of the LC exhibited significant LC-CR decreases in MCI-LB patients compared to HCs on both sides (P < 0.0001). CONCLUSIONS: This is the first study that focuses on LC-CRs in MCI-LB patients and analyzes the LC subparts, offering new insights into the LC integrity alterations in the initial stages of DLB and their clinical correlates. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
- MeSH
- alpha-Synuclein metabolism MeSH
- Lewy Body Disease * diagnostic imaging pathology MeSH
- Cognitive Dysfunction * diagnostic imaging pathology physiopathology etiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Locus Coeruleus * diagnostic imaging pathology MeSH
- Magnetic Resonance Imaging * MeSH
- Neuropsychological Tests MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Cíl: Montrealský kognitivní test (MoCA) je jednou z nejpoužívanějších screeningových zkoušek kognice u dospělých osob, pro něž existují normy pro českou populaci. Varianta MoCA-22, která je určena pro osoby s poruchami zraku či imobilitou horních končetin, se dá administrovat i po telefonu. Tato studie přináší české normy MoCA-22. Materiál a metodika: Soubor (n = 1 049) se skládá z účastníků čtyř studií provedených v ČR. Zařazeny byly osoby ve věku 19–98 let, bez neurodegenerativního, psychiatrického či jiného závažného onemocnění. Data pro MoCA-22 byla odvozena z dat získaných vyšetřením standardní verzí MoCA. V souladu se zavedenou klinickou praxí i statistickou analýzou jsou soubor a odvozené normy rozděleny na tři věkové kategorie: 19–50 let, 51–74 let, 75 a více let. Výsledky: Pro výše uvedené věkové kategorie dále rozdělené dle dosaženého vzdělání (nižší, vyšší) předkládáme průměrné skóry i odhadované percentilové hranice. Výkon v MoCA-22 je ovlivněn dosaženým vzděláním a věkem, ale nikoli pohlavím. Pro úpravu výsledků dle demografických faktorů proto poskytujeme i regresní rovnici. Závěr: Normativní údaje pro MoCA-22 rozšíří klinické instrumentárium v Česku a umožní adekvátní screening kognice u osob, jež jsou zdravotním stavem limitovány při využití standardních metod.
Aim: The Montreal Cognitive Assessment (MoCA) is one of the most widely used cognitive screening tests in adults with reference standards for the Czech population. The MoCA-22 variant is designed for individuals with visual impairment or upper limb immobility and can be administered over the telephone. This study presents the Czech MoCA-22 normative standards. Materials and methods: The sample (N = 1,049) consists of participants from four studies conducted in the Czech Republic. The subjects included were aged 19–98 years, and were without neurodegenerative, psychiatric, or other serious illness. Data for the MoCA-22 were derived from data obtained by the standard version of MoCA. Following established clinical practice and statistical analysis, the population and derived norms are divided into three age categories: 19–50 years, 51–74 years, and 75 years and older. Results: For these age categories above, which were further subdivided by educational status (lower, higher), we present mean scores and estimated percentile thresholds. Performance in the MoCA-22 is affected by demoraphic factors, such as educational status and age but not sex, as reflected by the regression equation. Conclusions: Normative data for MoCA-22 will complement the clinical armamentarium in Czechia and allow adequate cognitive screening in people whose health status limits them when using standard methods.
- Keywords
- Montrealský kognitivní test (MoCA),
- MeSH
- Clinical Studies as Topic MeSH
- Cognition Disorders diagnosis MeSH
- Humans MeSH
- Neuropsychological Tests * standards MeSH
- Bedridden Persons MeSH
- Telephone MeSH
- Telemedicine MeSH
- Persons with Visual Disabilities MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: Cardiometabolic risk factors - including diabetes, hypertension, and obesity - have long been linked with adverse health outcomes such as strokes, but more subtle brain changes in regional brain volumes and cortical thickness associated with these risk factors are less understood. Computer models can now be used to estimate brain age based on structural magnetic resonance imaging data, and subtle brain changes related to cardiometabolic risk factors may manifest as an older-appearing brain in prediction models; thus, we sought to investigate the relationship between cardiometabolic risk factors and machine learning-predicted brain age. METHODS: We performed a systematic search of PubMed and Scopus. We used the brain age gap, which represents the difference between one's predicted and chronological age, as an index of brain structural integrity. We calculated the Cohen d statistic for mean differences in the brain age gap of people with and without diabetes, hypertension, or obesity and performed random effects meta-analyses. RESULTS: We identified 185 studies, of which 14 met inclusion criteria. Among the 3 cardiometabolic risk factors, diabetes had the highest effect size (12 study samples; d = 0.275, 95% confidence interval [CI] 0.198-0.352; n = 47 436), followed by hypertension (10 study samples; d = 0.113, 95% CI 0.063-0.162; n = 45 102) and obesity (5 study samples; d = 0.112, 95% CI 0.037-0.187; n = 15 678). These effects remained significant in sensitivity analyses that included only studies that controlled for confounding effects of the other cardiometabolic risk factors. LIMITATIONS: Our study tested effect sizes of only categorically defined cardiometabolic risk factors and is limited by inconsistencies in diabetes classification, a smaller pooled sample in the obesity analysis, and limited age range reporting. CONCLUSION: Our findings show that each of the cardiometabolic risk factors uniquely contributes to brain structure, as captured by brain age. The effect size for diabetes was more than 2 times greater than the independent effects of hypertension and obesity. We therefore highlight diabetes as a primary target for the prevention of brain structural changes that may lead to cognitive decline and dementia.
- MeSH
- Diabetes Mellitus * epidemiology pathology MeSH
- Hypertension * epidemiology pathology MeSH
- Cardiometabolic Risk Factors * MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Brain * diagnostic imaging pathology MeSH
- Obesity * epidemiology pathology MeSH
- Aging pathology MeSH
- Machine Learning MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Meta-Analysis MeSH
- Systematic Review MeSH
IMPORTANCE: Depressive symptoms are associated with cognitive decline in older individuals. Uncertainty about underlying mechanisms hampers diagnostic and therapeutic efforts. This large-scale study aimed to elucidate the association between depressive symptoms and amyloid pathology. OBJECTIVE: To examine the association between depressive symptoms and amyloid pathology and its dependency on age, sex, education, and APOE genotype in older individuals without dementia. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analyses were performed using data from the Amyloid Biomarker Study data pooling initiative. Data from 49 research, population-based, and memory clinic studies were pooled and harmonized. The Amyloid Biomarker Study has been collecting data since 2012 and data collection is ongoing. At the time of analysis, 95 centers were included in the Amyloid Biomarker Study. The study included 9746 individuals with normal cognition (NC) and 3023 participants with mild cognitive impairment (MCI) aged between 34 and 100 years for whom data on amyloid biomarkers, presence of depressive symptoms, and age were available. Data were analyzed from December 2022 to February 2024. MAIN OUTCOMES AND MEASURES: Amyloid-β1-42 levels in cerebrospinal fluid or amyloid positron emission tomography scans were used to determine presence or absence of amyloid pathology. Presence of depressive symptoms was determined on the basis of validated depression rating scale scores, evidence of a current clinical diagnosis of depression, or self-reported depressive symptoms. RESULTS: In individuals with NC (mean [SD] age, 68.6 [8.9] years; 5664 [58.2%] female; 3002 [34.0%] APOE ε4 carriers; 937 [9.6%] had depressive symptoms; 2648 [27.2%] had amyloid pathology), the presence of depressive symptoms was not associated with amyloid pathology (odds ratio [OR], 1.13; 95% CI, 0.90-1.40; P = .29). In individuals with MCI (mean [SD] age, 70.2 [8.7] years; 1481 [49.0%] female; 1046 [44.8%] APOE ε4 carriers; 824 [27.3%] had depressive symptoms; 1668 [55.8%] had amyloid pathology), the presence of depressive symptoms was associated with a lower likelihood of amyloid pathology (OR, 0.73; 95% CI 0.61-0.89; P = .001). When considering subgroup effects, in individuals with NC, the presence of depressive symptoms was associated with a higher frequency of amyloid pathology in APOE ε4 noncarriers (mean difference, 5.0%; 95% CI 1.0-9.0; P = .02) but not in APOE ε4 carriers. This was not the case in individuals with MCI. CONCLUSIONS AND RELEVANCE: Depressive symptoms were not consistently associated with a higher frequency of amyloid pathology in participants with NC and were associated with a lower likelihood of amyloid pathology in participants with MCI. These findings were not influenced by age, sex, or education level. Mechanisms other than amyloid accumulation may commonly underlie depressive symptoms in late life.
- MeSH
- Amyloid beta-Peptides * cerebrospinal fluid metabolism MeSH
- Apolipoprotein E4 genetics MeSH
- Biomarkers cerebrospinal fluid MeSH
- Depression * MeSH
- Adult MeSH
- Cognitive Dysfunction * MeSH
- Middle Aged MeSH
- Humans MeSH
- Peptide Fragments cerebrospinal fluid MeSH
- Positron-Emission Tomography * MeSH
- Cross-Sectional Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Age Factors MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Research has shown that external focus (EF) instructions-directing attention to intended movement effects (e.g., ball's or dart's path)-are more effective for enhancing motor performance and learning than internal focus (IF) instructions, which focus on body movements (e.g., arm or foot motion). Nonetheless, the impact of visuospatial working memory capacity (WMC) in this context, especially among children, has been less investigated. This research sought to examine the effects of EF compared to IF on the skill acquisition and motor learning of a dart-throwing task among children with both high and low visuospatial WMC. Forty-eight boys aged 9-11 (Mage: 9.67 ± 0.76 years) were grouped by high or low WMC based on spatial span and memory tests, then assigned to receive either EF or IF instructions. The experiment comprised three stages: practice, retention, and two transfer tests, including throwing from a longer distance and a dual-task scenario with added cognitive load (tone counting). Results showed that EF outperformed IF at all stages. While WMC did not affect performance during practice and retention, children with low WMC performed better than those with high WMC during the longer distance test. In dual-task conditions, an EF continued to surpass an IF, whilst the WMC exerted no significant impact. The present findings suggest that an EF relative to an IF promotes more automatic movement and enhanced multitasking, while the impact of visuospatial WMC was less than expected, highlighting the benefits of EF in teaching motor skills to children, regardless of visuospatial WMC.
- MeSH
- Child MeSH
- Memory, Short-Term * physiology MeSH
- Humans MeSH
- Motor Skills * physiology MeSH
- Attention * physiology MeSH
- Psychomotor Performance * physiology MeSH
- Learning physiology MeSH
- Space Perception physiology MeSH
- Visual Perception physiology MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
Background and Objectives: The aim of this study was to determine the effect of immersive virtual reality used as a short-term multifaceted activity with a focus on motor and cognitive function in patients with Parkinson's Disease. The sub-objective focused on quality of life in the study group of patients. Materials and Methods: Nineteen patients (64.2 ± 12.8 years) were included in this study. Inclusion criteria for this study: adult patients in Hoehn and Yahr's stage 1-3, cooperative, with stable health status, independent and mobile. IVR therapy was performed twice a week for 20 min for one month. Input and output measurements were taken within 14 days of starting or ending therapy. The 10 Meter Walk test was used to examine and assess both comfortable and fast walking, and the Timed Up and Go (TUG) + s dual task was applied to quickly assess the highest possible level of functional mobility. The Berg Balance Scale test (BBS) was used to assess balance with a 14-item balance scale containing specific movement tasks. The standardized Parkinson's Disease Questionnaire (PDQ-39) was used to assess quality of life. Data were processed in the PAST program using a nonparametric paired Wilcoxon test. The significance level was set at α = 0.05. The value of the r score was used to evaluate the effect size. Results: A significant reduction in the time in the fast walk 10MWT (p = 0.006; r = 0.63) and TUG (p < 0.001; r = 0.80) parameter were found after therapy. Significant improvement in the BBS score was found after applied therapy (p = 0.016; r = 0.55). In the PDQ-39 questionnaire, significant improvements were found in the study group after therapy in the domains of mobility (p = 0.027; r = 0.51) and emotional well-being (p = 0.011; r = 0.58). Conclusions: The results of this study indicate a positive effect of virtual reality therapy on balance and gait, which is also good in terms of reducing the risk of falls in the study group. Therapy also promoted quality of life in the study group.
- MeSH
- Cognition physiology MeSH
- Quality of Life * psychology MeSH
- Middle Aged MeSH
- Humans MeSH
- Parkinson Disease * psychology physiopathology therapy complications MeSH
- Postural Balance physiology MeSH
- Surveys and Questionnaires MeSH
- Aged MeSH
- Virtual Reality Exposure Therapy methods MeSH
- Virtual Reality * MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
RATIONALE: Patients who experience seizures, including PNES, are usually advised to discontinue driving, or have their driving privileges revoked until a determined period of seizure-freedom is achieved. In this retrospective study, patients with PNES who requested driving privileges or reported having resumed driving were compared to those who did not on measures of depression, anxiety, PTSD, and cognitive flexibility/motor speed. METHODS: DiagnosisofPNESwasconfirmedwithvideo-EEG.Demographicand clinical dataand requests for reinstatement of driving privileges (requiring 6 or more months seizure freedom) and reports of decisions to resume driving were noted. Tests of motor speed and hand eye coordination and self-report questionnaires of depression, anxiety and PTSD administered as part of neuropsychological assessment were analyzed. RESULTS: A total of 403 patients with PNES evaluated in 2010-2020 were identified. Of those, 365 patients were eligible for inclusion, and of those, 60 applied for driving privileges or reported that they resumed driving. When the two groups were compared, the group that applied for driving privileges or decided to resume driving was significantly less depressed (p = 0.001) when tested than the group that did not. Furthermore, a significant difference was seen in measures of motor performance between those who requested to resume driving and those who did not (DKEFS T1, p = 0.006, DKEFS T2, p = 0.001, DKEFS T3, p = 0.002, DKEFS T4, p = 0.001; GPT dominant, p = 0.05, GPT non-dominant, p = 0.003). CONCLUSION: Driving a motor vehicle is a useful measure of improvement for PNES because patients with seizures are required to discontinue driving until seizure-freedom is achieved. This study revealed that lower levels of depression and better fine motor functioning were associated with reported seizure-freedom and driving resumption. Depression is commonly associated with diminished performance (slower motor response times and impaired fine motor movements) on tests of motor functioning, both of which may result in less interest in pursuing permission to resume driving. These findings suggest that mood symptoms (and associated performance on measures of motor speed and coordination) may have prognostic significance in patients diagnosed with PNES. This also suggests that timely treatment of depression in newly diagnosed patients with PNES may be indicated.
- MeSH
- Depression psychology diagnosis etiology MeSH
- Adult MeSH
- Electroencephalography MeSH
- Conversion Disorder psychology diagnosis MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Neuropsychological Tests MeSH
- Stress Disorders, Post-Traumatic psychology diagnosis MeSH
- Psychomotor Performance physiology MeSH
- Psychophysiologic Disorders diagnosis psychology MeSH
- Retrospective Studies MeSH
- Automobile Driving * psychology MeSH
- Anxiety psychology etiology diagnosis MeSH
- Seizures * psychology diagnosis MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Evidence on the impact of complex neighborhood environment, including air pollution, greenness, and neighborhood socioeconomic deprivation (nSED) on cognitive health in older adults remains scarce. Both cognition and neighborhood environment are associated with physical activity, but little is known about the potential mediating role of physical activity in this association. METHODS: Cross-sectional data of the Czech arm of the HAPIEE cohort study examined 4,178 participants (55.6% women) aged 45-69 years. Global cognitive score was constructed from memory, verbal fluency, and concentration domains. The exposures, assigned to participant's addresses, include 4-year (2000-2003) average concentrations of PM2.5, greenness index calculated from tree crown canopy cover estimation (2000), and census-based nSED characteristics. Physical activity and other covariates were assessed by a questionnaire. Structural equation modelling was used to estimate standardized β coefficients for the relationships between neighborhood environment, physical activity and cognitive performance. RESULTS: After controlling for a range of covariates, global cognitive function was inversely associated with PM2.5 (β = -0.087; 95%CI: 0.122 to -0.052) and nSED (β = -0.147; 95%CI: 0.182 to -0.115), and positively associated with greenness (β = 0.036; 95%CI: 0.001 to 0.069). We identified a weak but statistically significant mediating role of physical activity in the associations of PM2.5 exposures and nSED on global cognitive score. Total mediation proportions ranged from 3.9% to 6.5% for nSED and PM2.5, respectively. CONCLUSIONS: The neighborhood environment was associated with cognitive health in older individuals; the associations were partially mediated by physical activity.
- MeSH
- Residence Characteristics * MeSH
- Neighborhood Characteristics MeSH
- Exercise * MeSH
- Cognition * MeSH
- Air Pollutants analysis MeSH
- Middle Aged MeSH
- Humans MeSH
- Particulate Matter analysis MeSH
- Cross-Sectional Studies MeSH
- Aged MeSH
- Air Pollution analysis MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
BACKGROUND: The cerebellum is one of the major central nervous structures consistently altered in obesity. Its role in higher cognitive function, parts of which are affected by obesity, is mediated through projections to and from the cerebral cortex. We therefore investigated the relationship between body mass index (BMI) and cerebellocerebral connectivity. METHODS: We utilized the Human Connectome Project's Young Adults dataset, including functional magnetic resonance imaging (fMRI) and behavioral data, to perform connectome-based predictive modeling (CPM) restricted to cerebellocerebral connectivity of resting-state fMRI and task-based fMRI. We developed a Python-based open-source framework to perform CPM, a data-driven technique with built-in cross-validation to establish brain-behavior relationships. Significance was assessed with permutation analysis. RESULTS: We found that (i) cerebellocerebral connectivity predicted BMI, (ii) task-general cerebellocerebral connectivity predicted BMI more reliably than resting-state fMRI and individual task-based fMRI separately, (iii) predictive networks derived this way overlapped with established functional brain networks (namely, frontoparietal networks, the somatomotor network, the salience network, and the default mode network), and (iv) we found there was an inverse overlap between networks predictive of BMI and networks predictive of cognitive measures adversely affected by overweight/obesity. CONCLUSIONS: Our results suggest obesity-specific alterations in cerebellocerebral connectivity, specifically with regard to task execution. With brain areas and brain networks relevant to task performance implicated, these alterations seem to reflect a neurobiological substrate for task performance adversely affected by obesity.
- MeSH
- Adult MeSH
- Body Mass Index * MeSH
- Connectome * methods MeSH
- Humans MeSH
- Magnetic Resonance Imaging * methods MeSH
- Young Adult MeSH
- Cerebellum * diagnostic imaging physiology MeSH
- Nerve Net diagnostic imaging physiology MeSH
- Obesity diagnostic imaging MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
The aim of this work was to study the effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) on the subnetwork of subcortical and cortical motor regions and on the whole brain connectivity using the functional connectivity analysis in Parkinson's disease (PD). The high-density source space EEG was acquired and analyzed in 43 PD subjects in DBS on and DBS off stimulation states (off medication) during a cognitive-motor task. Increased high gamma band (50-100 Hz) connectivity within subcortical regions and between subcortical and cortical motor regions was significantly associated with the Movement Disorders Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS) III improvement after DBS. Whole brain neural correlates of cognitive performance were also detected in the high gamma (50-100 Hz) band. A whole brain multifrequency connectivity profile was found to classify optimal and suboptimal responders to DBS with a positive predictive value of 0.77, negative predictive value of 0.55, specificity of 0.73, and sensitivity of 0.60. Specific connectivity patterns related to PD, motor symptoms improvement after DBS, and therapy responsiveness predictive connectivity profiles were uncovered.
- MeSH
- Electroencephalography methods MeSH
- Deep Brain Stimulation * methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Brain physiopathology diagnostic imaging MeSH
- Subthalamic Nucleus * physiopathology MeSH
- Parkinson Disease * therapy physiopathology MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH