Medial Temporal Lobe Atrophy and Depressive Symptoms in Elderly Patients With and Without Alzheimer Disease

Enache, Daniela; Cavallin, Lena; Lindberg, Olof; Farahmand, Bahman; Kramberger, Milica G.; Westman, Eric; Jelić, Vesna; Eriksdotter, Maria; Ballard, Clive; Winblad, Bengt; Wahlund, Lars‐Olof; Aarsland, Dag

doi:10.1177/0891988714541873

Cited by 24 publications

(19 citation statements)

References 255 publications

(395 reference statements)

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“…However, larger study with greater sample size could be done to confirm these findings. people with and without AD and may explain some of the inconsistent observations in previous studies 25 .…”

Section: Discussionmentioning

confidence: 75%

Basal Serum Cortisol Levels, Depression And Medial Temporal Lobe Atrophy In Patients With Mild Cognitive Impairment And Alzheimer’s Disease

Dhikav

Sharma

Mishra

et al. 2015

JDT

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Objectives: Changes in serum cortisol levels have been reported in Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). Atrophy of Medial Temporal Lobes (MTLs) is common in both conditions. Glucocorticoids are known to be neurotoxic and have been believed to cause damage to memory mechanisms in the brains; whether the same is applicable to AD/MCI is not known. Also, they have long been hypothesized to cause atrophy of MTLs but the proof of the same is lacking. The present study was performed to delineate correlations between serum Cortisol levels, Depression in Dementia and Medial Temporal Lobe Atrophy in patients with AD/MCI. Methods: We randomly recruited 28 patients out of a total of 65 presenting with subjective memory complaints to the Department of Neurology, at a tertiary care institute during the study period (July 2014-2015). Morning serum Cortisol levels (8 AM) were analyzed in all patients (n=28) who met the diagnostic criteria for diagnosis of probable AD e.g. National Institute of Neurological and Communicative Disorders and Stroke, Alzheimer's disease related Disease Association criteria (NINCDS-ARDA) and Clinical Dementia Rating (CDR) for AD and MCI respectively. The Cornell Scale for Depression in Dementia (CSDD) was used to evaluate Depression. Visual Rating of Medial Temporal Lobe Atrophy (MTLA) was done using the Scheltens Visual Rating Scale. An association between the Depression and MTLA was evaluated using Pearson correlation coefficient. Results: A total of 28 Patients (M: F=24:4, AD=13, MCI=15) were recruited for the present study. The mean age was 73.39 ±7.6 years and mean duration of illness was 3.4±3 years. Mean Mini Mental State Examination (MMSE) score was 21.7±7.4. A total of 4 patients (14%) had a high basal serum cortisol. Only one case out of these 4 had MCI and the rest had AD. There was a statistically significant correlation between serum Cortisol levels and MTLA (Pearson Correlation Coefficient=0.39, p<0.05). Similarly, a statistically significant correlation was found between serum Cortisol levels and CSDD scores (Pearson Correlation Coefficient=0.49, p<0.05). Likewise, there was a statistically significant negative correlation between MMSE and CSDD (Pearson Correlation Coefficient=-0.48, p<0.001). Conclusion : Statistically significant correlation between Serum Cortisol and MTA Scores as assessed by Scheltens Visual Rating Scores was found (Pearson Correlation Coefficient=0.39, p<0.05; 95% confidence interval=0.02 to 0.66). Similarly, a significantly correlation was present between serum cortisol and CSDD Scores (Pearson Correlation Coefficient=0.49, p<0.05; 95% confidence interval=0.144 to 0.729). This suggests that glucorticoids and depression and MTA in AD/MCI are interrelated and points towards the possible role that increase in endogenous glucocorticoids may play in pathophysiology of AD/MCI.

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Section: Discussionmentioning

confidence: 75%

Basal Serum Cortisol Levels, Depression And Medial Temporal Lobe Atrophy In Patients With Mild Cognitive Impairment And Alzheimer’s Disease

Dhikav

Sharma

Mishra

et al. 2015

JDT

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“…In our previous studies, patients with AD and depressive symptoms had less severe total tau pathology in the cerebrospinal fluid and less severe temporal lobe atrophy than patients with AD and without depressive symptoms, despite a similar cognitive performance . This suggests that patients with AD and depression are in earlier stages of dementia at the time of diagnosis than those without depression, and an early diagnosis may be associated with a higher survival rate, which may explain the lower mortality rate in those treated with antidepressants.…”

Section: Discussionmentioning

confidence: 87%

Antidepressants and mortality risk in a dementia cohort: data from SveDem, the Swedish Dementia Registry

Enache

Fereshtehnejad

Kåreholt

et al. 2016

Acta Psychiatr Scand

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“…L.C. has participated as single rater in seven previous independent studies, achieving intrarater agreement of weighted kappa values between 0.88 and 0.94 for MTA, of 0.70 for GCA-F, and of 0.72 for PA [6,25,27,28,29,30,31,32]. Good interrater agreement has previously been demonstrated for L.C.…”

Section: Methodsmentioning

confidence: 99%

Electroencephalography Is a Good Complement to Currently Established Dementia Biomarkers

Ferreira

Jelić

Cavallin

et al. 2016

Dement Geriatr Cogn Disord

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Background/Aims: Dementia biomarkers that are accessible and easily applicable in nonspecialized clinical settings are urgently needed. Quantitative electroencephalography (qEEG) is a good candidate, and the statistical pattern recognition (SPR) method has recently provided promising results. We tested the diagnostic value of qEEG-SPR in comparison to cognition, structural imaging, and cerebrospinal fluid (CSF) biomarkers. Methods: A total of 511 individuals were recruited from the multicenter NORD EEG study [141 healthy controls, 64 subjective cognitive decline, 124 mild cognitive impairment, 135 Alzheimer's disease (AD), 15 dementia with Lewy bodies/Parkinson's disease with dementia (DLB/PDD), 32 other dementias]. The EEG data were recorded in a standardized way. Structural imaging data were visually rated using scales of atrophy in the medial temporal, frontal, and posterior cortex. Results: qEEG-SPR outperformed structural imaging, cognition, and CSF biomarkers in DLB/PDD diagnosis, outperformed structural imaging in AD diagnosis, and improved the differential diagnosis of AD. In addition, qEEG-SPR allowed differentiation of two clinically different AD subtypes. Conclusion: Adding qEEG to the diagnostic workup substantially increases the detection of AD pathology even in pre-dementia stages and improves differential diagnosis. EEG could serve as a good complement to currently established dementia biomarkers since it is cheap, noninvasive, and extensively applied outside academic centers.

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Medial Temporal Lobe Atrophy and Depressive Symptoms in Elderly Patients With and Without Alzheimer Disease

Cited by 24 publications

References 255 publications

Basal Serum Cortisol Levels, Depression And Medial Temporal Lobe Atrophy In Patients With Mild Cognitive Impairment And Alzheimer’s Disease

Basal Serum Cortisol Levels, Depression And Medial Temporal Lobe Atrophy In Patients With Mild Cognitive Impairment And Alzheimer’s Disease

Antidepressants and mortality risk in a dementia cohort: data from SveDem, the Swedish Dementia Registry

Electroencephalography Is a Good Complement to Currently Established Dementia Biomarkers

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