Semi-Supervised Multimodal Relevance Vector Regression Improves Cognitive Performance Estimation from Imaging and Biological Biomarkers

Accurate estimation of cognitive scores for patients can help track the progress of neurological diseases. In this paper, we present a novel semi-supervised multimodal relevance vector regression (SM-RVR) method for predicting clinical scores of neurological diseases from multimodal imaging and biological biomarker, to help evaluate pathological stage and predict progression of diseases, e.g., Alzheimer’s diseases (AD). Unlike most existing methods, we predict clinical scores from multimodal (imaging and biological) biomarkers, including MRI, FDG-PET, and CSF. Considering that the clinical scores of mild cognitive impairment (MCI) subjects are often less stable compared to those of AD and normal control (NC) subjects due to the heterogeneity of MCI, we use only the multimodal data of MCI subjects, but no corresponding clinical scores, to train a semi-supervised model for enhancing the estimation of clinical scores for AD and NC subjects. We also develop a new strategy for selecting the most informative MCI subjects. We evaluate the performance of our approach on 202 subjects with all three modalities of data (MRI, FDG-PET and CSF) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. The experimental results show that our SM-RVR method achieves a root-mean-square error (RMSE) of 1.91 and a correlation coefficient (CORR) of 0.80 for estimating the MMSE scores, and also a RMSE of 4.45 and a CORR of 0.78 for estimating the ADAS-Cog scores, demonstrating very promising performances in AD studies

Thalamic cholinergic innervation is spared in Alzheimer disease compared to parkinsonian disorders

There are two major sources of cholinergic projections in the brain. The nucleus basalis of Meynert provides the principal cholinergic input of the cortical mantle and the pedunculopontine nucleus-laterodorsal tegmental complex (PPN-LDTC; hereafter referred to as PPN) provides the major cholinergic input to the thalamus. Cortical cholinergic denervation has previously been shown to be part of Alzheimer and parkinsonian dementia but there is less information about subcortical thalamic cholinergic denervation. We investigated thalamic cholinergic afferent integrity by measuring PPN-Thalamic (PPN-Thal) acetylcholinesterase (AChE) activity via PET imaging in Alzheimer (AD), Parkinson disease without dementia (PD), Parkinson disease with dementia (PDD) and dementia with Lewy bodies (DLB)

Lewy body dementia: The caregiver experience of clinical care

Lewy body dementia (LBD) is the second most common cause of dementia, however, little is known about how the clinical diagnosis of LBD is obtained in the community or the caregiver experience while seeking the diagnosis

Lewy Body Dementia: Caregiver Burden and Unmet Needs

Lewy body dementia (LBD) is a common cause of dementia but to date, little is known about caregiver burden. The Lewy Body Dementia Association (www.LBDA.org) conducted a web-based survey of 962 caregivers (mean age 56y; 88% women). The most common initial symptoms were cognitive (48%), motor (39%), or both (13%). Caregivers expressed concerns about fear of future (77%), feeling stressed (54%), loss of social life (52%) and uncertainty about what to do next (50%). Caregivers reported moderate to severe burden; 80% felt the people around them did not understand their burden and 54% reported feelings of isolation with spousal caregivers reporting more burden than non-spousal caregivers. Only 29% hired in-home assistance while less than 40% used respite or adult day care, geriatric case managers or attended a support group meeting. Lack of service utilization occurred despite two-thirds of caregivers reporting medical crises requiring emergency services, psychiatric care or law enforcement. Caregivers reported preferences for web-based information, directories of LBD expert providers, information on LBD research and location of local support groups. These findings highlight significant unmet needs for LBD caregivers and provide targets for intervention to reduce caregiver burden. Community resources such as the Lewy Body Dementia Association may serve this end, while also providing practical information and support for caregivers

Event-Related Functional Magnetic Resonance Imaging Changes during Relational Retrieval in Normal Aging and Amnestic Mild Cognitive Impairment

The earliest cognitive deficits observed in amnestic mild cognitive impairment (aMCI) appear to center on memory tasks that require relational memory (RM), the ability to link or integrate unrelated pieces of information. RM impairments in aMCI likely reflect neural changes in the medial temporal lobe (MTL) and posterior parietal cortex (PPC). We tested the hypothesis that individuals with aMCI, as compared to cognitively normal (CN) controls, would recruit neural regions outside of the MTL and PPC to support relational memory. To this end, we directly compared the neural underpinnings of successful relational retrieval in aMCI and CN groups, using event-related functional magnetic resonance imaging (fMRI), holding constant the stimuli and encoding task. The fMRI data showed that the CN, compared to the aMCI, group activated left precuneus, left angular gyrus, right posterior cingulate, and right parahippocampal cortex during relational retrieval, while the aMCI group, relative to the CN group, activated superior temporal gyrus and supramarginal gyrus for this comparison. Such findings indicate an early shift in the functional neural architecture of relational retrieval in aMCI, and may prove useful in future studies aimed at capitalizing on functionally intact neural regions as targets for treatment and slowing of the disease course

Event-Related Functional Magnetic Resonance Imaging Changes during Relational Retrieval in Normal Aging and Amnestic Mild Cognitive Impairment

Abstract The earliest cognitive deficits observed in amnestic mild cognitive impairment (aMCI) appear to center on memory tasks that require relational memory (RM), the ability to link or integrate unrelated pieces of information. RM impairments in aMCI likely reflect neural changes in the medial temporal lobe (MTL) and posterior parietal cortex (PPC). We tested the hypothesis that individuals with aMCI, as compared to cognitively normal (CN) controls, would recruit neural regions outside of the MTL and PPC to support relational memory. To this end, we directly compared the neural underpinnings of successful relational retrieval in aMCI and CN groups, using event-related functional magnetic resonance imaging (fMRI), holding constant the stimuli and encoding task. The fMRI data showed that the CN, compared to the aMCI, group activated left precuneus, left angular gyrus, right posterior cingulate, and right parahippocampal cortex during relational retrieval, while the aMCI group, relative to the CN group, activated superior temporal gyrus and supramarginal gyrus for this comparison. Such findings indicate an early shift in the functional neural architecture of relational retrieval in aMCI, and may prove useful in future studies aimed at capitalizing on functionally intact neural regions as targets for treatment and slowing of the disease course. (JINS, 2012, 18, 886-897

Improving clinical cognitive testing: Report of the AAN Behavioral Neurology Section Workgroup

OBJECTIVE: To evaluate the evidence basis of single-domain cognitive tests frequently used by behavioral neurologists in an effort to improve the quality of clinical cognitive assessment. METHODS: Behavioral Neurology Section members of the American Academy of Neurology were surveyed about how they conduct clinical cognitive testing, with a particular focus on the Neurobehavioral Status Exam (NBSE). In contrast to general screening cognitive tests, an NBSE consists of tests of individual cognitive domains (e.g., memory or language) that provide a more comprehensive diagnostic assessment. Workgroups for each of 5 cognitive domains (attention, executive function, memory, language, and spatial cognition) conducted evidence-based reviews of frequently used tests. Reviews focused on suitability for office-based clinical practice, including test administration time, accessibility of normative data, disease populations studied, and availability in the public domain. RESULTS: Demographic and clinical practice data were obtained from 200 respondents who reported using a wide range of cognitive tests. Based on survey data and ancillary information, between 5 and 15 tests in each cognitive domain were reviewed. Within each domain, several tests are highlighted as being well-suited for an NBSE. CONCLUSIONS: We identified frequently used single-domain cognitive tests that are suitable for an NBSE to help make informed choices about clinical cognitive assessment. Some frequently used tests have limited normative data or have not been well-studied in common neurologic disorders. Utilizing standardized cognitive tests, particularly those with normative data based on the individual's age and educational level, can enhance the rigor and utility of clinical cognitive assessment

Memantine in patients with frontotemporal lobar degeneration: a multicentre, randomised, double-blind, placebo-controlled trial

Memantine has been used off-label to treat frontotemporal lobar degeneration (FTD). A previous 26 week open label study suggested a transient, modest benefit on neuropsychiatric symptoms as measured by the Neuropsychiatric Inventory (NPI)

Very Low-mass Stellar and Substellar Companions to Solar-like Stars from MARVELS II: A Short-period Companion Orbiting an F Star with Evidence of a Stellar Tertiary And Significant Mutual Inclination

We report the discovery via radial velocity of a short-period (P = 2.430420 \pm 0.000006 days) companion to the F-type main sequence star TYC 2930-00872-1. A long-term trend in the radial velocities indicates the presence of a tertiary stellar companion with $P > 2000$ days. High-resolution spectroscopy of the host star yields T_eff = 6427 +/- 33 K, log(g) = 4.52 +/- 0.14, and [Fe/H]=-0.04 +/- 0.05. These parameters, combined with the broad-band spectral energy distribution and parallax, allow us to infer a mass and radius of the host star of M_1=1.21 +/- 0.08 M_\odot and R_1=1.09_{-0.13}^{+0.15} R_\odot. We are able to exclude transits of the inner companion with high confidence. The host star's spectrum exhibits clear Ca H and K core emission indicating stellar activity, but a lack of photometric variability and small v*sin(I) suggest the primary's spin axis is oriented in a pole-on configuration. The rotational period of the primary from an activity-rotation relation matches the orbital period of the inner companion to within 1.5 \sigma, suggesting they are tidally locked. If the inner companion's orbital angular momentum vector is aligned with the stellar spin axis, as expected through tidal evolution, then it has a stellar mass of M_2 ~ 0.3-0.4 M_\odot. Direct imaging limits the existence of stellar companions to projected separations < 30 AU. No set of spectral lines and no significant flux contribution to the spectral energy distribution from either companion are detected, which places individual upper mass limits of M < 1.0 M_\odot, provided they are not stellar remnants. If the tertiary is not a stellar remnant, then it likely has a mass of ~0.5-0.6 M_\odot, and its orbit is likely significantly inclined from that of the secondary, suggesting that the Kozai-Lidov mechanism may have driven the dynamical evolution of this system.Comment: 37 pages, 7 tables, 21 figures, Accepted in A