kHz Quasi Periodic Oscillations in Low Mass X-ray Binaries as Probes of General Relativity in the Strong Field Regime

We consider the interpretation of a pair of kHz Quasi Periodic Oscillations (QPOs) in the Fourier spectra of two Low Mass X-Ray Binaries, Sco X-1 and 4U1608-52, hosting an old accreting neutron star. The observed frequency difference of these QPOs decreaseas as their frequency increases, contrary to simple beat frequency models, which predict a constant frequency difference. We show that the behaviour of these QPOs is instead well matched in terms of the fundamental frequencies (in the radial and azimuthal directions) for test particle motion in the gravitational field of the neutron star, for reasonable star masses, and nearly independent of the star spin. The radial frequency must be much smaller than the azimuthal one, testifying that kHz QPOs are produced close to the innermost stable orbit. These results are not reproduced through the post--Newtonian (PN) approximation of General Relativity (GR). kHz QPOs from X-ray binaries likely provide an accurate laboratory for strong field GR.Comment: to appear in Physical Review Letters, PRL Latex plus 2 figures in standard PostScript forma

Screening for Emotional Expression in Frontotemporal Dementia: A Pilot Study

Objective. Although emotional blunting is a core feature of behavioral variant frontotemporal dementia (bvFTD), there are no practical clinical measures of emotional expression for the early diagnosis of bvFTD. Method. Three age-matched groups (bvFTD, Alzheimer’s disease (AD), and healthy controls (HC)) of eight participants each were presented with real-life vignettes varying in emotional intensity (high versus low) with either negative or positive outcomes. This study evaluated verbal (self-reports of distress) and visual (presence or absence of facial affect) measures of emotional expression during the vignettes. Results. The bvFTD patients did not differ from the AD and HC groups in reported distress or in the amount of facial affect during vignettes with high emotional intensity or type of outcome. However, the bvFTD patients reported significantly less distress and had correspondingly few facial affective expressions when compared on vignettes of low intensity. Conclusions. Patients with bvFTD require a high intensity of emotional stimulus and are significantly hyporesponsive to low-intensity stimuli. Simple screening or observations of verbal and facial responsiveness to mildly arousing stimuli may aid in differentiating bvFTD from normal subjects and patients with other dementias. Future studies can investigate whether delivering information with high emotional intensity can facilitate communication with patients with bvFTD

False Reports from Patients with Frontotemporal Dementia: Delusions or Confabulations?

Patients with behavioral variant frontotemporal dementia (bvFTD) can make false statements consistent with delusions or confabulations. It is unclear whether bvFTD is primarily associated with either delusions or with confabulations and whether they can be explained by the pathophysiology of this disease. In order to clarify this, we retrospectively surveyed the records of 48 patients with bvFTD for the presence of any false reports and identified four patients. Their false reports included continued interaction with a favorite but dead relation, fictitious marriages with movie stars, and two who claimed that their partner was having an affair. When confronted with the falsity of their statements, the patients conveyed a lack of certainty regarding their external or internal source but persisted in the constancy of their reports. On functional neuroimaging, the patients had predominant frontal involvement. This report found that patients with bvFTD can have both fantastic, wish fulfilling confabulations and typical content-specific delusions. We propose that both phenomena result from known disturbances of ventromedial prefrontal cortex in bvFTD, including deficits in source monitoring and in activating an automatic “doubt tag” for false reports

Critical review of the Appropriate Use Criteria for amyloid imaging: Effect on diagnosis and patient care

INTRODUCTION: The utility of the Appropriate Use Criteria (AUC) for amyloid imaging is not established. METHODS: Fifty-three cognitively impaired patients with clinical F18-florbetapir imaging were classified as early and late onset, as well as AUC-consistent or AUC-inconsistent. Chi-square statistics and t test were used to compare demographic characteristics and clinical outcomes as appropriate. RESULTS: Early-onset patients were more likely to be amyloid positive. Change in diagnosis was more frequent in late-onset cases. Change in therapy was more common in early-onset cases. AUC-consistent and AUC-inconsistent cases had comparable rates of amyloid positivity. We saw no difference in the rate of treatment changes in the AUC-consistent group as opposed to the AUC-inconsistent group. DISCUSSION: The primary role of amyloid imaging in the early-onset group was to confirm the clinically suspected etiology, and in the late-onset group in detecting amyloid-negative cases. The rate of therapeutic changes was significantly greater in the early-onset cases

The physical parameters, excitation and chemistry of the rim, jets and knots of the planetary nebula NGC 7009

We present long-slit optical spectra along the major axis of the planetary nebula NGC 7009. These data allow us to discuss the physical, excitation and chemical properties of all the morphological components of the nebula, including its remarkable systems of knots and jets. The main results of this analysis are the following: i) the electron temperature throughout the nebula is remarkably constant, T_e[OIII] = 10200K; ii) the bright inner rim and inner pair of knots have similar densities of N_e = 6000cm^{-3}, whereas a much lower density of N_e = 1500cm^{-3} is derived for the outer knots as well as for the jets; iii) all the regions (rim, inner knots, jets and outer knots) are mainly radiatively excited; and iv) there are no clear abundance changes across the nebula for He, O, Ne, or S. There is a marginal evidence for an overabundance of nitrogen in the outer knots (ansae), but the inner ones (caps) and the rim have similar N/H values that are at variance with previous results. Our data are compared to the predictions of theoretical models, from which we conclude that the knots at the head of the jets are not matter accumulated during the jet expansion through the circumstellar medium, neither can their origin be explained by the proposed HD or MHD interacting-wind models for the formation of jets/ansae, since the densities as well as the main excitation mechanisms of the knots, disagree with model predictions.Comment: Figure 1 was changed because features were misidentified in the previous version. 17 pages including 5 figures and 3 tables. ApJ in press. Also available at http://www.iac.es/galeria/denise

P1‐349: Advancing Clinical And Biomarker Research In Ad: The Lead Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152716/1/alzjjalz201906904.pd

Consensus classification of posterior cortical atrophy

INTRODUCTION: A classification framework for posterior cortical atrophy (PCA) is proposed to improve the uniformity of definition of the syndrome in a variety of research settings. METHODS: Consensus statements about PCA were developed through a detailed literature review, the formation of an international multidisciplinary working party which convened on four occasions, and a Web-based quantitative survey regarding symptom frequency and the conceptualization of PCA. RESULTS: A three-level classification framework for PCA is described comprising both syndrome- and disease-level descriptions. Classification level 1 (PCA) defines the core clinical, cognitive, and neuroimaging features and exclusion criteria of the clinico-radiological syndrome. Classification level 2 (PCA-pure, PCA-plus) establishes whether, in addition to the core PCA syndrome, the core features of any other neurodegenerative syndromes are present. Classification level 3 (PCA attributable to AD [PCA-AD], Lewy body disease [PCA-LBD], corticobasal degeneration [PCA-CBD], prion disease [PCA-prion]) provides a more formal determination of the underlying cause of the PCA syndrome, based on available pathophysiological biomarker evidence. The issue of additional syndrome-level descriptors is discussed in relation to the challenges of defining stages of syndrome severity and characterizing phenotypic heterogeneity within the PCA spectrum. DISCUSSION: There was strong agreement regarding the definition of the core clinico-radiological syndrome, meaning that the current consensus statement should be regarded as a refinement, development, and extension of previous single-center PCA criteria rather than any wholesale alteration or redescription of the syndrome. The framework and terminology may facilitate the interpretation of research data across studies, be applicable across a broad range of research scenarios (e.g., behavioral interventions, pharmacological trials), and provide a foundation for future collaborative work

A Multiancestral Genome-Wide Exome Array Study of Alzheimer Disease, Frontotemporal Dementia, and Progressive Supranuclear Palsy

Importance Previous studies have indicated a heritable component of the etiology of neurodegenerative diseases such as Alzheimer disease (AD), frontotemporal dementia (FTD), and progressive supranuclear palsy (PSP). However, few have examined the contribution of low-frequency coding variants on a genome-wide level. Objective To identify low-frequency coding variants that affect susceptibility to AD, FTD, and PSP. Design, Setting, and Participants We used the Illumina HumanExome BeadChip array to genotype a large number of variants (most of which are low-frequency coding variants) in a cohort of patients with neurodegenerative disease (224 with AD, 168 with FTD, and 48 with PSP) and in 224 control individuals without dementia enrolled between 2005-2012 from multiple centers participating in the Genetic Investigation in Frontotemporal Dementia and Alzheimer’s Disease (GIFT) Study. An additional multiancestral replication cohort of 240 patients with AD and 240 controls without dementia was used to validate suggestive findings. Variant-level association testing and gene-based testing were performed. Main Outcomes and Measures Statistical association of genetic variants with clinical diagnosis of AD, FTD, and PSP. Results Genetic variants typed by the exome array explained 44%, 53%, and 57% of the total phenotypic variance of AD, FTD, and PSP, respectively. An association with the known AD gene ABCA7 was replicated in several ancestries (discovery P = .0049, European P = .041, African American P = .043, and Asian P = .027), suggesting that exonic variants within this gene modify AD susceptibility. In addition, 2 suggestive candidate genes, DYSF (P = 5.53 × 10−5) and PAXIP1 (P = 2.26 × 10−4), were highlighted in patients with AD and differentially expressed in AD brain. Corroborating evidence from other exome array studies and gene expression data points toward potential involvement of these genes in the pathogenesis of AD. Conclusions and Relevance Low-frequency coding variants with intermediate effect size may account for a significant fraction of the genetic susceptibility to AD and FTD. Furthermore, we found evidence that coding variants in the known susceptibility gene ABCA7, as well as candidate genes DYSF and PAXIP1, confer risk for AD