Background: The apolipoprotein E (APOE) ɛ4 allele is a well-known risk factor for AD and is associated with higher amyloid deposition and earlier dementia onset. However, the relationship between amyloid pathology and the most common APOE allele, ɛ3, has not been well studied. Objective: In this study, we aimed to identify the risk factors predicting amyloid PET positivity in patients with mild cognitive impairment (MCI) and APOE ɛ3/ɛ3 genotypes. Methods: We retrospectively reviewed the medical records of MCI patients with APOE ɛ3/ɛ3 genotypes who underwent amyloid PET scanning. Demographics, neuropsychological tests, and brain MRI were obtained. We analyzed which risk factors could affect amyloid PET positivity in MCI patients with APOE ɛ3/ɛ3 genotypes using logistic regression models. Results: We recruited 171 MCI patients with APOE ɛ3/ɛ3 genotypes in this study. Out of 171 patients, 49 patients (28.65%) showed positive results in the amyloid PET scans. In a multivariate logistic regression model, amyloid positivity was associated with frontal atrophy (OR = 2.63, p = 0.009), and CDR-SOB scores (OR = 2.46, p = 0.013). The odds ratio for amyloid PET positivity in patients older than and equal to 75 years with both frontal atrophy and CDR-SOB scores >1.0 was 3.63. Conclusion: Our study demonstrated that frontal atrophy, high CDR-SOB scores, and old age were risk factors associated with amyloid PET positivity in MCI with APOE ɛ3/ɛ3 genotypes.
<b><i>Introduction:</i></b> Subjective cognitive decline (SCD) is a self-reported cognitive decline without objective cognitive impairment. The relationship between audiometric hearing loss (HL) and cognitive function has not been reported in SCD. The purpose of this study was to investigate whether HL affects cognition-related indexes in SCD individuals. <b><i>Methods:</i></b> This is a cross-sectional study that used the baseline data of a multicenter cohort study that monitors clinical progression from SCD to dementia. Individuals aged ≥60 years who reported cognitive decline but had no objective cognitive impairment on comprehensive neuropsychological tests were recruited. Participants were grouped into the normal-hearing (NH) and bilateral HL groups. The demographics, clinical characteristics, dementia biomarkers, global cognition, questionnaire scores, neuropsychological test scores, and segmental brain volumes from MRI were compared between the groups. <b><i>Results:</i></b> Of a total of 120 participants, one hundred and two had NH (<i>n</i> = 57) or bilateral HL (<i>n</i> = 45). There were no group differences in the demographic and clinical data except the age. The biomarkers, global cognition, and questionnaire scores were not different between the groups. The HL group performed worse (the <i>z</i>-score of −0.06) in the Stroop Color Word Test than the NH group (0.27) (<i>p</i> = 0.025). Brain volumetric analysis revealed that the HL group had reduced gray matter volumes in four brain subregions: left temporal pole, left caudal middle frontal gyrus, left hippocampus, and right isthmus of the cingulate gyrus. <b><i>Conclusion:</i></b> In SCD, HL exerted an adverse effect on cognitive function, primarily frontal executive function tested in the Stroop task. HL was also related to gray matter volume reductions in brain subregions, although causality needs further investigation. This study may provide evidence for a potential link between hearing and cognition in SCD, an emerging clinical entity.
Background and PurposeRecent studies have shown that several nonmotor symptoms differ between Parkinson's disease (PD) and drug-induced parkinsonism (DIP). However, there have been no reports on cardiovascular autonomic function in DIP, and so this study investigated whether cardiovascular autonomic function differs between PD and DIP patients.MethodsThis study consecutively enrolled 20 DIP patients, 99 drug-naïve PD patients, and 25 age-matched healthy controls who underwent head-up tilt-table testing and 24-h ambulatory blood pressure monitoring.ResultsOrthostatic hypotension was more frequent in patients with PD or DIP than in healthy controls. In DIP, orthostatic hypotension was associated with the underlying psychiatric diseases and neuroleptics use, whereas prokinetics were not related to orthostatic hypotension. The supine blood pressure, nighttime blood pressure, and nocturnal blood pressure dipping did not differ significantly between the DIP and control groups. Supine hypertension and nocturnal hypertension were more frequent in PD patients than in controls.ConclusionsThe included DIP patients frequently exhibited orthostatic hypotension that was associated with the underlying diseases as well as the nature of and exposure time to the offending drugs. Clinicians should individualize the manifestations of DIP according to underlying diseases as well as the action mechanism of and exposure time to each offending drug.
Background Subjective cognitive decline(SCD) has been considered as at risk state to progress to mild cognitive impairment(MCI) or Alzheimer's disease(AD) dementia. The purpose of this study is to set up cohort and to identify risk factors for the progression to MCI or dementia from amnestic SCD Method We enrolled subjects aged 60 years or older complaining of persistent cognitive decline. To include higher risk SCD patients with rapidly progression, subjects needs to have 7% to 50% of the verbal memory and over 7% of the rest subtests of comprehensive neuropsychological battery. We named this state of SCD as an amnestic SCD. Brain magnetic resonance imaging (MRI) volumetry, visual and standardized uptake value ratio (SUVR) analysis of 18F‐Florbetaben brain amyloid‐beta Positron Emission Tomography (PET) were. Blood amyloid oligomerization was measured by the Multimer Detection System‐Oligomeric Aβ (MDS‐OAβ) method. Quantitative EEG were also analyzed. Sleep time and physical activity were collected with wearable device (Fitbit alta). Gait speed, body mass index, and muscle strength were measured. Result We analyzed 120 SCD subjects (male 53, female 67). Mean age and education were 70.9 and 11.2 years. 25 (20.8%) showed amyloid positive PET and 26(21.6%) had APOE ε4 allele. Positive amyloid PET SCD had higher frequency of APOE ε4 (48%) compared to amyloid negative SCD (14%). Positive amyloid PET SCD also had lower delayed verbal memory score and lower frontal inferior, anterior, medial and lateral temporal and lateral parietal regional brain volume ratio. Power spectral analysis of EEG showed increased relative theta /alpha ratio in the bilateral frontal regions. sLORETA showed increased theta spectrum in the left superior temporal, transverse temporal and fusiform area in amyloid positive SCD. MDS‐OAβ was positive in 55.1% which was not associated with SUVR value of amyloid PET. Conclusion Amnestic SCD with amyloid PET positive showed higher APOE ε4 allele, lower regional brain volume in AD related areas, lower verbal memory score and higher relative theta/alpha ratio in the frontal area. Longitudinal follow‐up for the next 3 years will identify risk factors for the progression to MCI or dementia and clinical significance of blood MDS‐OAβ value.
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