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ABSTRACT: Neuropathological studies suggest that the basal forebrain cholinergic system (BFCS) is affected in Alzheimer's disease (AD), but there is no in vivo evidence of early damage to this system in subjects at high risk of developing AD. Here, we found that mild cognitive impairment (MCI) patients exhibited significant volume reduction of the nucleus basalis of Meynert (NbM) using recently developed probabilistic maps of the BFCS space. In addition, volumes of different magnocellular compartments varied significantly with regional gray matter atrophy in regions known to be affected by AD and were found to correlate with cognitive decline in MCI patients. Bilateral reductions of the horizontal nucleus of the diagonal band of Broca (Ch3) and frontal lobe (medial frontal, orbital, subcallosal gyrus, anterior cingulate, and middle frontal gyrus) were significantly associated with a global decline in cognitive status, whereas volume reduction of the posterior compartment of Ch4 (NbM) and temporal lobe (including hippocampus, entorhinal cortex, and amygdala) were associated with impaired delayed recall in MCI patients. These findings establish, for the first time, a link between degeneration of specific cholinergic compartments of the BFCS and cognitive-related deficits in subjects at high risk of developing AD.
Cerebral Cortex 11/2009; 20(7):1685-95. · 6.54 Impact Factor
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ABSTRACT: Resonance in thalamocortical networks is critically involved in sculpting oscillatory behavior in large ensembles of neocortical cells. Neocortical oscillations provide critical information about the integrity of thalamocortical circuits and functional connectivity of cortical networks, which seem to be significantly disrupted by the neuronal death and synapse loss characterizing Alzheimer's disease (AD). By applying a novel analysis methodology to overcome volume conduction effects between scalp electroencephalographic (EEG) measurements, we were able to estimate the temporal activation of EEG-alpha sources in the thalamus and parieto-occipital regions of the cortex. We found that synaptic flow underlying the lower alpha band (7.5-10 Hz) was abnormally facilitated in patients with mild cognitive impairment (MCI) as compared to healthy elderly individuals, particularly from thalamus to cortex (approximately 38% higher). In addition, the thalamic generator of lower alpha oscillations was also abnormally activated in patients with MCI. Regarding the upper alpha subdivision (10.1-12.5 Hz), both controls and patients with MCI showed a bidirectional decrease of thalamocortical synaptic transmission, which was age-dependent only in the control group. Altogether, our results suggest that functional dynamics of thalamocortical networks differentiate individuals at high risk of developing AD from healthy elderly subjects, supporting the hypothesis that neurodegeneration mechanisms are active years before the patient is clinically diagnosed with dementia.
Human Brain Mapping 06/2009; 30(12):3944-57. · 5.88 Impact Factor
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Rafael Blesa,
Miquel Aguilar,
Jordi Peña Casanova,
Mercé Boada,
Sergi Martínez,
Jordi Alom,
Carlos Hernández de la Hoz,
Jerónimo Sancho,
Óscar Fernández, Eulogio Gil-Neciga,
Jose Félix Martí Massó
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ABSTRACT: Alzheimer disease is the most common form of dementia in Western countries and the leading cause of disability in the over-65 population. Apolipoprotein E (APOE) is a multifunctional protein implied in lipid metabolism and neurobiology. Polymorphisms of the APOE gene have been associated with a variety of medical disorders, from arteriosclerosis to AD. A high frequency of the APOE ϵ4 allele has been found in patients with AD and they seem to have a higher risk of developing the disease. Various authors have suggested a possible relationship between the efficacy of cholinesterase inhibitors and the presence of the APOE ϵ4 allele. The purpose of the present study was to compare prospectively the efficacy of rivastigmine in patients with mild to moderately severe AD presenting different polymorphisms of the APOE gene on chromosome 19 and to determine if there was a difference in the response to rivastigmine treatment in AD patients with the APOE ϵ4 allele (heterozygous or homozygous) versus patients who had other forms of APOE, such as ϵ2 and ϵ3. This was an open-label, nonrandomized, multicenter study in patients over 50 years of age diagnosed with mild to moderately severe AD. The results of the analysis of this study indicate that the presence of at least one APOE ϵ4 allele does not determine a difference in the response to treatment with rivastigmine. The data indicate that knowledge of the patient's genotype is not necessary for treatment with rivastigmine. It would be interesting in the future to analyze the interaction between these 2 factors using other available anticholinesterase drugs.
Alzheimer Disease and Associated Disorders 09/2006; 20(4):248-254. · 2.81 Impact Factor
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Rafael Blesa,
Miquel Aguilar,
Jordi Peña Casanova,
Mercé Boada,
Sergi Martínez,
Jordi Alom,
Carlos Hernández de la Hoz,
Jerónimo Sancho,
Oscar Fernández, Eulogio Gil-Neciga,
Jose Félix Martí Massó
[show abstract]
[hide abstract]
ABSTRACT: Alzheimer disease is the most common form of dementia in Western countries and the leading cause of disability in the over-65 population. Apolipoprotein E (APOE) is a multifunctional protein implied in lipid metabolism and neurobiology. Polymorphisms of the APOE gene have been associated with a variety of medical disorders, from arteriosclerosis to AD. A high frequency of the APOE epsilon4 allele has been found in patients with AD and they seem to have a higher risk of developing the disease. Various authors have suggested a possible relationship between the efficacy of cholinesterase inhibitors and the presence of the APOE epsilon4 allele. The purpose of the present study was to compare prospectively the efficacy of rivastigmine in patients with mild to moderately severe AD presenting different polymorphisms of the APOE gene on chromosome 19 and to determine if there was a difference in the response to rivastigmine treatment in AD patients with the APOE epsilon4 allele (heterozygous or homozygous) versus patients who had other forms of APOE, such as epsilon2 and epsilon3. This was an open-label, nonrandomized, multicenter study in patients over 50 years of age diagnosed with mild to moderately severe AD. The results of the analysis of this study indicate that the presence of at least one APOE epsilon4 allele does not determine a difference in the response to treatment with rivastigmine. The data indicate that knowledge of the patient's genotype is not necessary for treatment with rivastigmine. It would be interesting in the future to analyze the interaction between these 2 factors using other available anticholinesterase drugs.
Alzheimer Disease and Associated Disorders 20(4):248-54. · 2.81 Impact Factor
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ABSTRACT: Abnormal patterns of electroencephalographic (EEG) alpha oscillations in preclinical stages of dementia reveal a selective vulnerability of thalamocortical circuits to the cascade of neurodegenerative events heralding Alzheimer's disease (AD). EEG-alpha slowing characterizes both mild cognitive impairment (MCI) and healthy aging, but it remains ambiguous whether different neural mechanisms underlie this oscillatory behavior in normal and pathological senescence. In this study, we show that the strength of phase coupling and the level of phase predictability between thalamocortical and cortico-cortical EEG sources of low alpha frequency are abnormally facilitated in MCI patients when compared to healthy elderly subjects. Additionally, we found a loss of neural complexity intrinsic to both thalamic and cortical generators of lower alpha in MCI patients, which likely influenced the aberrant phase synchronization behavior between EEG-alpha sources in this high risk group of AD. Taken together, these results suggest that different neural mechanisms account for the well known slowing of alpha rhythm present in normal aging and MCI patients. Whether these anomalous neural coding mechanisms of lower alpha generation in MCI patients represent a potential electrophysiological marker of mild AD is a topic for future research.
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