Xi Mei’s research while affiliated with First Affiliated Hospital of China Medical University and other places

Objective The most prevalent types of dementia in older adults are Alzheimer's disease (AD) and Lewy body dementia (LBD), and they have overlapping clinical symptoms. We aimed to define amounts of cortical activation and to identify indicators of brain function to better distinguish between these types of dementia and aid diagnosis using functional near-infrared spectroscopy (fNIRS). Methods Oxygenated hemoglobin (HbO) concentrations in the brains of patients with AD and LBD were detected using fNIRS. Brain function was assessed using a verbal fluency task (VFT). Resting-state and task-state cortical activations were investigated to determine differences between AD and LBD. Blood samples were analyzed to identify relevant biomarkers. The clinical and HbO variables were compared between AD and LBD. Functional connectivity at rest and correlations between HbO variables and blood biomarkers were analyzed. The sensitivity and specificity of the parameters for differentiating the dementias were evaluated using areas under the receiver operating characteristic (ROC) curves (AUCs). Results This study recruited 28 inpatients with AD and 25 with LBD. Mean HbO concentrations did not significantly differ in the resting state (p > 0.05), whereas functional connectivity significantly differed (t = −3.449, p = 0.001) between the groups. Mean HbO concentrations during the VFT, were significantly lower in the left temporal (p = 0.031), right dorsolateral prefrontal (p = 0.001), and right temporal (p = 0.011) cortices of the AD, than the LBD group. Blood amyloid-β (Aβ)42 levels were significantly higher in the AD group (p = 0.023), whereas significantly more α-synuclein was expressed in the LBD group (p = 0.012). Correlation analysis of cognition-related blood biomarkers with HbO concentrations associated higher plasma Aβ42 level with lower HbO concentrations in the right pre-motor and supplementary motor cortex (r = −0.378; p = 0.005) and higher glial fibrillary acidic protein (GFAP) levels in the lower right pars triangularis (r = −0.378; p = 0.006) at rest. Levels of the blood biomarker Aβ significantly and negatively correlated with HbO concentrations in the right temporal cortex (r = −0.329, p = 0.016) during the VFT. The AUC was significantly higher for the combination of multiple fNIRS indicators compared with individual cognitive or blood indicators (AUC = 0.9314). Conclusion The characteristics of HbO measured using fNIRS can help distinguish AD from LBD in older adults.

Objective Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) are common neurodegenerative diseases with distinct but overlapping pathogenic mechanisms. The clinical similarities between these diseases often result in high misdiagnosis rates, leading to serious consequences. Peripheral blood mononuclear cells (PBMCs) are easy to collect and can accurately reflect the immune characteristics of both DLB and AD. Methods We utilized time‐of‐flight mass cytometry (CyTOF) with single‐cell resolution to quantitatively analyze peripheral PBMCs, identifying 1228 immune characteristics. Based on the top‐selected immune features, we constructed immunological elastic net (iEN) models. Results These models demonstrated high diagnostic efficacy in distinguishing diseased samples from healthy donors as well as distinguishing AD and DLB cases. The selected features reveal that the primary peripheral immune characteristic of AD is a decrease in total T cells, while DLB is characterized by low expression of I‐kappa‐B‐alpha (IKBα) in the classical monocyte subset. Conclusions These findings suggest that peripheral immune characteristics could serve as potential biomarkers, facilitating the diagnosis of neurodegenerative diseases.

BACKGROUND Alzheimer’s disease (AD) is a common type of dementia due to neuronal impairment. In addition, psychobehavioral symptoms including severe sleep disorders, depression and anxiety can occur in most patients with AD. CASE SUMMARY We report a case of a 68-year-old woman with a 2-year history of AD. She initially presented with memory loss, progressively more severe, leading to a depressive and anxious status. The clinical symptoms also included severe sleep disturbances. Considering the age and health state of the patient, a non-pharmacological treatment of bright light therapy was used to improve her sleep quality. The treatment was provided for 30 minutes twice a day, during 8:30 am to 9:00 am and 16:30 pm to 17:00 pm. After 4 weeks of therapy, the sleep quality notably improved, with a marked decrease in daytime sleep, increase in nighttime sleep, and disappearance of nocturnal activity. The depression and anxiety were also suppressed significantly. CONCLUSION This case report suggested that bright light therapy can have a positive effect on sleep quality in elderly patients with AD and can be used as an effective and safe non-pharmacological treatment.

Objective This study aimed to investigate cortical activation and functional connectivity in the cortex during working memory (WM) tasks in patients with Alzheimer’s disease (AD) using functional near-infrared spectroscopy (fNIRS). Methods A total of 17 older adults with AD and 17 cognitively normal (CN) participants were recruited. fNIRS was utilized to monitor oxygenated hemoglobin (HbO) concentrations in the frontotemporal lobe, while participants performed WM tasks to examine WM impairments in subjects with AD. Student’s t-test for continuous variables and the chi-square test for categorical variables were used to compare the clinical and HbO variables between the AD and CN groups. Functional connectivity was analyzed using Pearson’s correlation coefficient between the time series of each channel-to-channel pair. Results The changes in HbO concentrations and cortical activations during the WM task showed that the HbO concentration curve of the CN group was higher than that of the AD group during the encoding and maintenance phases of the WM task. Although in the brain region scale, there were no significant differences in average HbO concentrations between the two groups, many channels located in the frontal and temporal lobes showed significant differences ( p < 0.05) in the average HbO (channels 7 and 32) and slope HbO values (channels 7, 8, 9, 23, 30, 34, and 38) during the WM task. The average functional connectivity of the AD group was significantly lower than that of the CN group ( p < 0.05). The functional connectivity was stronger in the frontopolar (FP) region than in other areas in both groups. Conclusion This study revealed there were significant differences in HbO concentration in older adult patients with AD compared to CN during the WM task. The characteristics of HbO measured by the fNIRS technique can be valuable for distinguishing between AD and CN in older adults.

BACKGROUND Perception is frequently impaired in patients with Alzheimer’s disease (AD). Several patients exhibit visual or haptic hallucinations. CASE SUMMARY A 71-year-old Chinese man presented with visual and haptic hallucinations he had been experiencing for 2 weeks. The clinical manifestations were the feeling of insects crawling and biting the limbs and geison. He looked for the insects while itching and scratching, which led to skin breakage on the limbs. He was treated with topical and anti-allergic drugs in several dermatology departments without any significant improvement. After admission, the patient was administered risperidone (0.5 mg) and duloxetine (2 mg/day). One week later, the dose of risperidone was increased to 2 mg/day, and that of duloxetine was increased to 60 mg/day. After 2 weeks of treatment, the patient’s sensation of insects crawling and biting disappeared, and his mood stabilized. CONCLUSION This patient manifested psychiatric behavioral symptoms caused by AD brain atrophy. It was important to re-evaluate the patient’s cognitive-psychological status when the patient repeatedly went to the hospital for treatment. Follow-up attention to cognitive function and the consideration of perceptual deficits as early manifestations of AD should be considered.

Surface-enhanced Raman spectroscopy (SERS), a rapid, low-cost, non-invasive, ultrasensitive, and label-free technique, has been widely used in-situ and ex-situ biomedical diagnostics questions. However, analyzing and interpreting the untargeted spectral data remains challenging due to the difficulty of designing an optimal data pre-processing and modelling procedure. In this paper, we propose a Multi-branch Attention Raman Network (MBA-RamanNet) with a multi-branch attention module, including the convolutional block attention module (CBAM) branch, deep convolution module (DCM) branch, and branch weights, to extract more global and local information of characteristic Raman peaks which are more distinctive for classification tasks. CBAM, including channel and spatial aspects, is adopted to enhance the distinctive global information on Raman peaks. DCM is used to supplement local information of Raman peaks. Autonomously trained branch weights are applied to fuse the features of each branch, thereby optimizing the global and local information of the characteristic Raman peaks for identifying diseases. Extensive experiments are performed for two different neurological disorders classification tasks via untargeted serum SERS data. The results demonstrate that MBA-RamanNet outperforms commonly used CNN methods with an accuracy of 88.24% for the classification of healthy controls, mild cognitive impairment, Alzheimer’s disease, and Non-Alzheimer’s dementia; an accuracy of 90% for the classification of healthy controls, elderly depression, and elderly anxiety.

Delirium is an acute reversible neuropsychiatric syndrome caused by multiple factors. It is associated with many adverse clinical outcomes including cognitive impairment, functional decline, prolonged hospitalization, and increased nursing service. The prevalence of delirium was high in department of cardiology, geriatric, and intensive care unit of hospital. With the increase in the aged population, further increases in delirium seem likely. However, it remains poorly recognized in the clinical practice. This article comprehensively discusses the latest research perspectives on the epidemiological data, risk factors, preventive interventions, overlapping symptoms, and clinical measures of delirium, including specific measures to manage delirium in clinical real-world situations. This article helps readers improve their knowledge and understanding of delirium and helps clinicians quickly identify and implement timely therapeutic measures to address various delirium subtypes that occur in the clinical settings to ensure patients are treated as aggressively as possible.

Background: As a non-pharmacologic treatment, bright light therapy (BLT) is often used to improve affective disorders and memory function. In this study, we aimed to determine the effect of BLT on depression and electrophysiological features of the brain in patients with Alzheimer’s disease (AD) and their caregivers using a light-emitting diode device of 14000 lux. Methods: A 4-week case-control trial was conducted. Neuropsychiatric and electroencephalogram (EEG) examination were evaluated at baseline and after 4 weeks. EEG power in delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), and beta (12–30 Hz) bands was calculated for our main analysis. Demographic and clinical variables were analyzed using Student’s t test and the chi-square test. Pearson’s correlation was used to determine the correlation between electrophysiological features, blood biochemical indicators, and cognitive assessment scale scores. Results: In this study, 22 in-patients with AD and 23 caregivers were recruited. After BLT, the Hamilton depression scale score decreased in the fourth week. Compared with the age-matched controls of their caregivers, a higher spectral power at the lower delta and theta frequencies was observed in the AD group. After BLT, the EEG power of the delta and theta frequencies in the AD group decreased. No change was observed in blood amyloid concentrations before and after BLT. Conclusion: In conclusion, a 4-week course of BLT significantly suppressed depression in patients with AD and their caregivers. Moreover, changes in EEG power were also significant in both groups.