Causes and Correlates of Brain Atrophy: A population-based MRI study

__Abstract__ In 1906, Alois Alzheimer described for the first time a form of dementia that later became known as Alzheimer’s disease. At necropsy, he had observed that the brain of a 51-year-old woman with progressive cognitive decline was filled with –at that time still anonymous– amyloid plaques and neurofibrillary tangles. Since then, numerous investigators saw in patients with dementia the same pathological findings that Alzheimer had seen. Clinically, Alzheimer’s disease is recognized by a long period of progressive cognitive decline. Braak and Braak showed in the late eighties that the accumulation of plaques and tangles in the brain follows a predictable pattern over time that parallels this cognitive decline. In their now widely accepted staging system, they identify a long phase where the medial temporal lobe is the first area to be afflicted whereas only in the later disease stages the pathology involves the isocortices. However, recent pathological studies show that brains of elderly patients, unlike the middle–aged patient that Alzheimer had observed, who in life receive a diagnosis of Alzheimer’s disease have a rather mixed bag of brain pathology. Not only the traditionally recognized amyloid plaques and neurofibrillary tangles are observed but also cerebrovascular disease is found which could have contributed to the cognitive decline. The search for causes of Alzheimer’s disease is hampered by its long preclinical period and the pathological diversity that contribute to clinical symptoms of Alzheimer’s disease

A Bayesian network approach for coastal risk analysis and decision making

Emergency management and long-term planning in coastal areas depend on detailed assessments (meter scale) of flood and erosion risks. Typically, models of the risk chain are fragmented into smaller parts, because the physical processes involved are very complex and consequences can be diverse. We developed a Bayesian network (BN) approach to integrate the separate models. An important contribution is the learning algorithm for the BN. As input data, we used hindcast and synthetic extreme event scenarios, information on land use and vulnerability relationships (e.g., depth-damage curves). As part of the RISC-KIT (Resilience-Increasing Strategies for Coasts toolKIT) project, we successfully tested the approach and algorithm in a range of morphological settings. We also showed that it is possible to include hazards from different origins, such as marine and riverine sources. In this article, we describe the application to the town of Wells-next-the-Sea, Norfolk, UK, which is vulnerable to storm surges. For any storm input scenario, the BN estimated the percentage of affected receptors in different zones of the site by predicting their hazards and damages. As receptor types, we considered people, residential and commercial properties, and a saltmarsh ecosystem. Additionally, the BN displays the outcome of different disaster risk reduction (DRR) measures. Because the model integrates the entire risk chain with DRR measures and predicts in real-time, it is useful for decision support in risk management of coastal areas.European Community's 7th Framework Programme through the grant to RISC-KIT (Resilience-increasing Strategies for Coasts - Toolkit"), contract no. 603458

Silent brain infarcts and the risk of dementia and cognitive decline

BACKGROUND: Silent brain infarcts are frequently seen on magnetic resonance imaging (MRI) in healthy elderly people and may be associated with dementia and cognitive decline. METHODS: We studied the association between silent brain infarcts and the risk of dementia and cognitive decline in 1015 participants of the prospective, population-based Rotterdam Scan Study, who were 60 to 90 years of age and free of dementia and stroke at base line. Participants underwent neuropsychological testing and cerebral MRI at base line in 1995 to 1996 and again in 1999 to 2000 and were monitored for dementia throughout the study period. We performed Cox proportional-hazards and multiple linear-regression analyses, adjusted for age, sex, and level of education and for the presence or absence of subcortical atrophy and white-matter lesions. RESULTS: During 3697 person-years of follow-up (mean per person, 3.6 years), dementia developed in 30 of the 1015 participants. The presence of silent brain infarcts at base line more than doubled the risk of dementia (hazard ratio, 2.26; 95 percent confidence interval, 1.09 to 4.70). The presence of silent brain infarcts on the base-line MRI was associated with worse performance on neuropsychological tests and a steeper decline in global cognitive function. Silent thalamic infarcts were associated with a decline in memory performance, and nonthalamic infarcts with a decline in psychomotor speed. When participants with silent brain infarcts at base line were subdivided into those with and those without additional infarcts at follow-up, the decline in cognitive function was restricted to those with additional silent infarcts. CONCLUSIONS: Elderly people with silent brain infarcts have an increased risk of dementia and a steeper decline in cognitive function than those without such lesions

Homocysteine and brain atrophy on MRI of non-demented elderly

Patients with Alzheimer's disease have higher plasma homocysteine levels than controls, but it is uncertain whether higher plasma homocysteine levels are involved in the early pathogenesis of the disease. Hippocampal, amygdalar and global brain atrophy on brain MRI have been proposed as early markers of Alzheimer's disease. In the Rotterdam Scan Study, a population-based study of age-related brain changes in 1077 non-demented people aged 60-90 years, we investigated the association between plasma homocysteine levels and severity of hippocampal, amygdalar and global brain atrophy on MRI. We used axial T(1)-weighted MRIs to visualize global cortical brain atrophy (measured semi-quantitatively; range 0-15) and a 3D HASTE (half-Fourier acquisition single-shot turbo spin echo) sequence in 511 participants to measure hippocampal and amygdalar volumes. We had non-fasting plasma homocysteine levels in 1031 of the participants and in 505 of the participants with hippocampal and amygdalar volumes. Individuals with higher plasma homocysteine levels had, on average, more cortical atrophy [0.23 units (95% CI 0.07-0.38 units) per standard deviation increase in plasma homocysteine levels] and more hippocampal atrophy [difference in left hippocampal volume -0.05 ml (95% CI -0.09 to -0.01) and in right hippocampal volume -0.03 ml (95% CI -0.07 to 0.01) per standard deviation increase in plasma homocysteine levels]. No association was observed between plasma homocysteine levels and amygdalar atrophy. These results support the hypothesis that higher plasma homocysteine levels are associated with more atrophy of the hippocampus and cortical regions in elderly at risk of Alzheimer's disease

Higher estrogen levels are not associated with larger hippocampi and better memory performance

BACKGROUND: Estrogens may prevent cognitive decline and Alzheimer disease. Animal study findings have shown beneficial effects of estrogen on the brain, particularly on the hippocampus, a structure related to memory performance and early Alzheimer disease. OBJECTIVE: To investigate whether higher levels of endogenous estradiol in older women and men are associated with larger hippocampal volumes on magnetic resonance imaging and better memory performance. DESIGN AND SETTING: Cross-sectional analysis within the Rotterdam Scan Study, a population-based study in the Netherlands of elderly subjects who do not have dementia. PARTICIPANTS: Two hundred ten women and 202 men, aged 60 to 90 years, with plasma levels of total estradiol and, in part, 162 women and 149 men also with levels of bioavailable and free estradiol. MAIN OUTCOME MEASURE: Hippocampal volumes on magnetic resonance imaging and memory performance (delayed recall). RESULTS: Women with higher total estradiol levels had smaller hippocampal volumes and poorer memory performance -0.29 mL (95% confidence interval, -0.57 to -0.00) and -0.4 (95% confidence interval, -1.3 to 0.5) fewe

Synergistic effects of drought and deforestation on the resilience of the south-eastern Amazon rainforest

The south-eastern Amazon rainforest is subject to ongoing deforestation and is expected to become drier due to climate change. Recent analyses of the distribution of tree cover in the tropics show three modes that have been interpreted as representing alternative stable states: forest, savanna and treeless states. This situation implies that a change in environmental conditions, such as in the climate, could cause critical transitions from a forest towards a savanna ecosystem. Shifts to savanna might also occur if perturbations such as deforestation exceed a critical threshold. Recovering the forest would be difficult as the savanna will be stabilized by a feedback between tree cover and fire. Here we explore how environmental changes and perturbations affect the forest by using a simple model with alternative tree-cover states. We focus on the synergistic effects of precipitation reduction and deforestation on the probability of regime shifts in the south-eastern Amazon rainforest. The analysis indicated that in a large part of the south-eastern Amazon basin rainforest and savanna could be two alternative states, although massive forest dieback caused by mean-precipitation reduction alone is unlikely. However, combinations of deforestation and climate change triggered up to 6.6 times as many local regime shifts than the two did separately, causing large permanent forest losses in the studied region. The results emphasize the importance of reducing deforestation rates in order to prevent a climate-induced dieback of the south-eastern Amazon rainforest

Feature selection and novelty in computational aesthetics

[Abstract] An approach for exploring novelty in expression-based evolutionary art systems is presented. The framework is composed of a feature extractor, a classifier, an evolutionary engine and a supervisor. The evolutionary engine exploits shortcomings of the classifier, generating misclassified instances. These instances update the training set and the classifier is re-trained. This iterative process forces the evolutionary algorithm to explore new paths leading to the creation of novel imagery. The experiments presented and analyzed herein explore different feature selection methods and indicate the validity of the approach.Portugal. Fundação para a Ciência e a Tecnologia; PTDC/EIA–EIA/115667/2009Galicia.Consellería de Innovación, Industria e Comercio ; PGIDIT10TIC105008P

Bone mineral density increases in trans persons after 1 year of hormonal treatment : a multicenter prospective observational study

Sex steroids are important determinants of bone acquisition and bone homeostasis. Cross-sex hormonal treatment (CHT) in transgender persons can affect bone mineral density (BMD). The aim of this study was to investigate in a prospective observational multicenter study the first-year effects of CHT on BMD in transgender persons. A total of 231 transwomen and 199 transmen were included who completed the first year of CHT. Transwomen were treated with cyproterone acetate and oral or transdermal estradiol; transmen received transdermal or intramuscular testosterone. A dual-energy X-ray absorptiometry (DXA) was performed to measure lumbar spine (LS), total hip (TH), and femoral neck (FN) BMD before and after 1 year of CHT. In transwomen, an increase in LS (+3.67%, 95% confidence interval [CI] 3.20 to 4.13%, p < 0.001), TH (+0.97%, 95% CI 0.62 to 1.31%, p < 0.001), and FN (+1.86%, 95% CI 1.41 to 2.31%, p < 0.001) BMD was found. In transmen, TH BMD increased after 1 year of CHT (+1.04%, 95% CI 0.64 to 1.44%, p < 0.001). No changes were observed in FN BMD (–0.46%, 95% CI –1.07 to 0.16%, p = 0.144). The increase in LS BMD was larger in transmen aged ≥50 years (+4.32%, 95% CI 2.28 to 6.36%, p = 0.001) compared with transmen aged <50 years (+0.68%, 95% CI 0.19 to 1.17%, p = 0.007). In conclusion, BMD increased in transgender persons after 1 year of CHT. In transmen of postmenopausal age, the LS BMD increased more than in younger transmen, which may lead to the hypothesis that the increase in BMD in transmen is the result of the aromatization of testosterone to estradiol