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Number of Pages: 3Integrative BiologyGeological Science
White matter integrity and vulnerability to Alzheimer's disease: Preliminary findings and future directions
AbstractNeuroimaging biomarkers that precede cognitive decline have the potential to aid early diagnosis of Alzheimer's disease (AD). A body of diffusion tensor imaging (DTI) work has demonstrated declines in white matter (WM) microstructure in AD and its typical prodromal state, amnestic mild cognitive impairment. The present review summarizes recent evidence suggesting that WM integrity declines are present in individuals at high AD-risk, prior to cognitive decline. The available data suggest that AD-risk is associated with WM integrity declines in a subset of tracts showing decline in symptomatic AD. Specifically, AD-risk has been associated with WM integrity declines in tracts that connect gray matter structures associated with memory function. These tracts include parahippocampal WM, the cingulum, the inferior fronto-occipital fasciculus, and the splenium of the corpus callosum. Preliminary evidence suggests that some AD-risk declines are characterized by increases of radial diffusivity, raising the possibility that a myelin-related pathology may contribute to AD onset. These findings justify future research aimed at a more complete understanding of the neurobiological bases of DTI-based declines in AD. With continued refinement of imaging methods, DTI holds promise as a method to aid identification of presymptomatic AD. This article is part of a Special Issue entitled: Imaging Brain Aging and Neurodegenerative disease
Cardiorespiratory Fitness Diminishes the Effects of Age on White Matter Hyperintensity Volume
White matter hyperintensities (WMHs) are among the most commonly observed marker of cerebrovascular disease. Age is a key risk factor for WMH development. Cardiorespiratory fitness (CRF) is associated with increased vessel compliance, but it remains unknown if high CRF affects WMH volume. This study explored the effects of CRF on WMH volume in community-dwelling older adults. We further tested the possibility of an interaction between CRF and age on WMH volume. Participants were 76 adults between the ages of 59 and 77 (mean age = 65.36 years, SD = 3.92) who underwent a maximal graded exercise test and structural brain imaging. Results indicated that age was a predictor of WMH volume (beta = .32, p = .015). However, an age-by-CRF interaction was observed such that higher CRF was associated with lower WMH volume in older participants (beta = -.25, p = .040). Our findings suggest that higher levels of aerobic fitness may protect cerebrovascular health in older adults
Endothelial Function Is Associated with White Matter Microstructure and Executive Function in Older Adults
Age-related declines in endothelial function can lead to cognitive decline. However, little is known about the relationships between endothelial function and specific neurocognitive functions. This study explored the relationship between measures of endothelial function (reactive hyperemia index; RHI), white matter (WM) health (fractional anisotropy, FA, and WM hyperintensity volume, WMH), and executive function (Trail Making Test (TMT); Trail B - Trail A). Participants were 36 older adults between the ages of 59 and 69 (mean age = 63.89 years, SD = 2.94). WMH volume showed no relationship with RHI or executive function. However, there was a positive relationship between RHI and FA in the genu and body of the corpus callosum. In addition, higher RHI and FA were each associated with better executive task performance. Tractography was used to localize the WM tracts associated with RHI to specific portions of cortex. Results indicated that the RHI-FA relationship observed in the corpus callosum primarily involved tracts interconnecting frontal regions, including the superior frontal gyrus (SFG) and frontopolar cortex, linked with executive function. These findings suggest that superior endothelial function may help to attenuate age-related declines in WM microstructure in portions of the corpus callosum that interconnect prefrontal brain regions involved in executive function
National trends in utilization, mortality, and survival after repair of type B aortic dissection in the Medicare population
ObjectiveThe application of thoracic endovascular aortic repair (TEVAR) has changed treatment paradigms for thoracic aortic disease. We sought to better define specific treatment patterns and outcomes for type B aortic dissection treated with TEVAR or open surgical repair (OSR).MethodsMedicare patients undergoing type B thoracic aortic dissection repair (2000-2010) were identified by use of a validated International Classification of Diseases, Ninth Revision diagnostic and procedural code–based algorithm. Trends in utilization were analyzed by procedure type (OSR vs TEVAR), and patterns in patient characteristics and outcomes were examined.ResultsTotal thoracic aortic dissection repairs increased by 21% between 2000 and 2010 (2.5 to 3 per 100,000 Medicare patients; P = .001). A concomitant increase in TEVAR was seen during the same interval (0.03 to 0.8 per 100,000; P < .001). By 2010, TEVAR represented 27% of all repairs. TEVAR patients had higher rates of comorbid congestive heart failure (12% vs 9%; P < .001), chronic obstructive pulmonary disease (17% vs 10%; P < .001), diabetes (8% vs 5%; P < .001), and chronic renal failure (8% vs 3%; P < .001) compared with OSR patients. For all repairs, patient comorbidity burden increased over time (mean Charlson comorbidity score of 0.79 in 2000, 1.10 in 2010; P = .04). During this same interval, in-hospital mortality rates declined from 47% to 23% (P < .001), a trend seen in both TEVAR and OSR patients. Whereas in-hospital mortality rates and 3-year survival were similar between patients selected for TEVAR and OSR, there was a trend toward women having slightly lower 3-year survival after TEVAR (60% women vs 63% men; P = .07).ConclusionsSurgical treatment of type B aortic dissection has increased over time, reflecting an increase in the utilization of TEVAR. Overall, type B dissection repairs are currently performed at lower mortality risk in patients with more comorbidities
Non-Fasting High-Density Lipoprotein Is Associated With White Matter Microstructure in Healthy Older Adults
A growing body of evidence indicates that biomarkers of cardiovascular risk may be related to cerebral health. However, little is known about the role that non-fasting lipoproteins play in assessing age-related declines in a cerebral biomarker sensitive to vascular compromise, white matter (WM) microstructure. High-density lipoprotein cholesterol (HDL-C) is atheroprotective and low-density lipoprotein cholesterol (LDL-C) is a major atherogenic lipoprotein. This study explored the relationships between non-fasting levels of cholesterol and WM microstructure in healthy older adults. A voxelwise and region of interest approach was used to determine the relationship between cholesterol and fractional anisotropy (FA). Participants included 87 older adults between the ages of 59 and 77 (mean age = 65.5 years, SD = 3.9). Results indicated that higher HDL-C was associated with higher FA in diffuse regions of the brain when controlling for age, sex, and body mass index (BMI). HDL-C was also positively associated with FA in the corpus callosum and fornix. No relationship was observed between LDL-C and FA. Findings suggest that a modifiable lifestyle variable associated with cardiovascular health may help to preserve cerebral WM
Non-fasting High-Density Lipoprotein Is Associated With White Matter Microstructure in Healthy Older Adults
A growing body of evidence indicates that biomarkers of cardiovascular risk may be related to cerebral health. However, little is known about the role that non-fasting lipoproteins play in assessing age-related declines in a cerebral biomarker sensitive to vascular compromise, white matter (WM) microstructure. High-density lipoprotein cholesterol (HDL-C) is atheroprotective and low-density lipoprotein cholesterol (LDL-C) is a major atherogenic lipoprotein. This study explored the relationships between non-fasting levels of cholesterol and WM microstructure in healthy older adults. A voxelwise and region of interest approach was used to determine the relationship between cholesterol and fractional anisotropy (FA). Participants included 87 older adults between the ages of 59 and 77 (mean age = 65.5 years, SD = 3.9). Results indicated that higher HDL-C was associated with higher FA in diffuse regions of the brain when controlling for age, sex, and body mass index (BMI). HDL-C was also positively associated with FA in the corpus callosum and fornix. No relationship was observed between LDL-C and FA. Findings suggest that a modifiable lifestyle variable associated with cardiovascular health may help to preserve cerebral WM
Transiting Exoplanet Yields for the Roman Galactic Bulge Time Domain Survey Predicted from Pixel-Level Simulations
The Nancy Grace Roman Space Telescope (Roman) is NASA's next astrophysics
flagship mission, expected to launch in late 2026. As one of Roman's core
community science surveys, the Galactic Bulge Time Domain Survey (GBTDS) will
collect photometric and astrometric data for over 100 million stars in the
Galactic bulge to search for microlensing planets. To assess the potential with
which Roman can detect exoplanets via transit, we developed and conducted
pixel-level simulations of transiting planets in the GBTDS. From these
simulations, we predict that Roman will find between 60,000 and
200,000 transiting planets, over an order of magnitude more planets than
are currently known. While the majority of these planets will be giants
() on close-in orbits ( au), the yield also includes
between 7,000 and 12,000 small planets (). The
yield for small planets depends sensitively on the observing cadence and season
duration, with variations on the order of 10-20% for modest changes in
either parameter, but is generally insensitive to the trade between surveyed
area and cadence given constant slew/settle times. These predictions depend
sensitively on the Milky Way's metallicity distribution function, highlighting
an opportunity to significantly advance our understanding of exoplanet
demographics, particularly across stellar populations and Galactic
environments.Comment: Accepted to ApJS; 64 pages, 18 figure
Multiple Transits during a Single Conjunction: Identifying Transiting Circumbinary Planetary Candidates from TESS
We present results of a study on identifying circumbinary planet candidates
that produce multiple transits during one conjunction with eclipsing binary
systems. The occurrence of these transits enables us to estimate the
candidates' orbital periods, which is crucial as the periods of the currently
known transiting circumbinary planets are significantly longer than the typical
observational baseline of TESS. Combined with the derived radii, it also
provides valuable information needed for follow-up observations and subsequent
confirmation of a large number of circumbinary planet candidates from TESS.
Motivated by the discovery of the 1108-day circumbinary planet Kepler-1647, we
show the application of this technique to four of Kepler's circumbinary planets
that produce such transits. Our results indicate that in systems where the
circumbinary planet is on a low-eccentricity orbit, the estimated planetary
orbital period is within <10-20% of the true value. This estimate is derived
from photometric observations spanning less than 5% of the planet's period,
demonstrating the strong capability of the technique. Capitalizing on the
current and future eclipsing binaries monitored by NASA's TESS mission, we
estimate that hundreds of circumbinary planets candidates producing multiple
transits during one conjunction will be detected in the TESS data. Such a large
sample will enable statistical understanding of the population of planets
orbiting binary stars and shed new light on their formation and evolution.Comment: 16 pages, 6 figures, 2 tables, AJ accepte
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