The prevalence of cortical gray matter atrophy may be overestimated in the healthy aging brain.

Burgmans, Saartje; Boxtel, M.P.J. van; Vuurman, E.F.P.M.; Smeets, Floortje; Gronenschild, E. H. B. M.; Uylings, H.B.M.; Jolles, Jelle

doi:10.1037/a0016161

Cited by 49 publications

(58 citation statements)

References 42 publications

(61 reference statements)

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“…For example, if patients aged 60 and older had general atrophic brain changes with a decrease in the size of the temporal lobes of up to 5%, it was considered natural age-related changes and equal to normal [12,36,38]. The calculation of volume changes of the whole temporal lobe of the brain gives more accurate results of the severity of atrophic changes than calculation of atrophic changes of only the hippocampus, which is confirmed by studies of other authors [39].…”

Section: Methodssupporting

confidence: 68%

Endovascular Application of Low-Energy Laser in the Treatment of Dyscirculatory Angiopathy of Alzheimer’s Type

Maksimovich¹

2012

JBBS

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Purpose:We propose an analysis of dyscirculatory angiopathy of Alzheimer's type (DAAT) endovascular treatment method based on transcatheter revascularization and recovery of collateral and microvascular bed of the brain by means of low-energy transluminal laser irradiation as well as its comparison with traditional Alzheimer's disease (AD) treatment methods. Methods: The research involved 81 patients aged 34 -79 (average age 67). 46 (46.8%) patients were treated using endovascular method-Test Group. 35 (43.2%) patients were given conventional treatment-Control Group. Patients were subdivided: Group (CDR-0): 9 (11.1%), pre-clinical stage or increased AD risk; Group (CDR-1): 24 (29.6%), mild dementia and cognitive impairment; Group (CDR-2): 31 (38.3%), moderate dementia and persistent cognitive impairment; Group (CDR-3): 17 (21.0%), severe dementia and cognitive impairment. Research plan included CT or MRI with subsequent temporal lobes volume calculation, brain scintigraphy (SG), rheoencephalography (REG), and cerebral MUGA. There were indications and contraindications for treatment in Test Group. In Group CDR-0, endovascular intervention was prophylactic, against the background of increasing memory impairment; in Groups CDR-1, CDR-2, CDR-3, it was conducted in 1 to 12 years period from AD symptoms appearance. Conservative treatment with Memantin and Rivastigmine was carried out in Control Group. Results: In Test Group, positive outcome accompanied by prolonged dementia decline, cognitive impairment decrease, and patients' transition to CDR group of an earlier stage, was obtained in all cases. In Control Group, patients' temporary stabilization in their own CDR group was achieved. Conclusions: Endovascular treatment of patients with AD different stages can not only reduce DAAT phenomena but can also cause AD regression possibly accompanied by regenerative processes in the cerebral tissue. Conservative treatment only allows stabilizing the patient's condition for a while.

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Section: Methodssupporting

confidence: 68%

Endovascular Application of Low-Energy Laser in the Treatment of Dyscirculatory Angiopathy of Alzheimer’s Type

Maksimovich¹

2012

JBBS

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“…As a consequence, cross sectional studies are more often conducted in order to estimate age-related changes, although they might produce inconsistent results when compared to longitudinal analyses (Pfefferbaum and Sullivan 2015). Indeed, the cross-sectional approach is easier to implement, but it suffers from major flaws including potential cohort bias and the influence of elder individuals at the presymptomatic stage of a neurodegenerative disorder which may cause an overestimation of the age effect (Burgmans et al, 2009). …”

Section: Studying Aging: Methodological Considerationsmentioning

confidence: 97%

Structural imaging of hippocampal subfields in healthy aging and Alzheimer’s disease

2015

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Hippocampal atrophy, as evidenced using magnetic resonance imaging (MRI), is one of the most validated, easily accessible and widely used biomarkers of Alzheimer's disease (AD). However, its imperfect sensitivity and specificity have highlighted the need to improve the analysis of MRI data. Based on neuropathological data showing a differential vulnerability of hippocampal subfields to AD processes, neuroimaging researchers have tried to capture corresponding morphological changes within the hippocampus. The present review provides an overview of the methodological developments that allow the assessment of hippocampal subfield morphology in vivo, and summarizes the results of studies looking at the effects of AD and normal aging on these structures. Most studies highlighted a focal atrophy of the CA1 subfield in the early (predementia or even preclinical) stages of AD, before atrophy becomes more widespread at the dementia stage, consistent with the pathological literature. Preliminary studies have indicated that looking at this focal atrophy pattern rather than standard whole hippocampus volumetry improves diagnostic accuracy at the mild cognitive impairment (MCI) stage. However, controversies remain regarding changes in hippocampal subfield structure in normal aging and regarding correlations between specific subfield volume and memory abilities, very likely because of the strong methodological variability between studies. Overall, hippocampal subfield analysis has proven to be a promising technique in the study of AD. However, harmonization of segmentation protocols and studies on larger samples are needed to enable accurate comparisons between studies and to confirm the clinical utility of these techniques.

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“…Some have even suggested that cortical decline in aging is caused by undetected disease and is not a feature of normal aging (Burgmans et al, 2009). An important implication of the apparent temporal gap between detectable cerebral and cognitive expression of dementia is that cases with undetected disease in presumably normal samples could bias inferences about normal brain aging (Sliwinski and Buschke, 1999).…”

Section: Normal Aging Versus Alzheimer’s Disease: How To Tell the mentioning

confidence: 99%

What is normal in normal aging? Effects of aging, amyloid and Alzheimer's disease on the cerebral cortex and the hippocampus

Fjell

McEvoy

Holland

et al. 2014

Progress in Neurobiology

672

522

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What can be expected in normal aging, and where does normal aging stop and pathological neurodegeneration begin? With the slow progression of age-related dementias such as Alzheimer’s Disease (AD), it is difficult to distinguish age-related changes from effects of undetected disease. We review recent research on changes of the cerebral cortex and the hippocampus in aging and the borders between normal aging and AD. We argue that prominent cortical reductions are evident in fronto-temporal regions in elderly even with low probability of AD, including regions overlapping the default mode network. Importantly, these regions show high levels of amyloid deposition in AD, and are both structurally and functionally vulnerable early in the disease. This normalcy-pathology homology is critical to understand, since aging itself is the major risk factor for sporadic AD. Thus, rather than necessarily reflecting early signs of disease, these changes may be part of normal aging, and may inform on why the aging brain is so much more susceptible to AD than is the younger brain. We suggest that regions characterized by a high degree of life-long plasticity are vulnerable to detrimental effects of normal aging, and that this age-vulnerability renders them more susceptible to additional, pathological AD-related changes. We conclude that it will be difficult to understand AD without understanding why it preferably affects older brains, and that we need a model that accounts for age-related changes in AD-vulnerable regions independently of AD-pathology.

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The prevalence of cortical gray matter atrophy may be overestimated in the healthy aging brain.

Cited by 49 publications

References 42 publications

Endovascular Application of Low-Energy Laser in the Treatment of Dyscirculatory Angiopathy of Alzheimer’s Type

Endovascular Application of Low-Energy Laser in the Treatment of Dyscirculatory Angiopathy of Alzheimer’s Type

Structural imaging of hippocampal subfields in healthy aging and Alzheimer’s disease

What is normal in normal aging? Effects of aging, amyloid and Alzheimer's disease on the cerebral cortex and the hippocampus

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