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3 results on '"Cleudiana Lima Carvalho"'

1. In vivo imaging evidence of poor cognitive resilience to Alzheimer's disease pathology in subjects with very low cognitive reserve from a low‐middle income environment

Author

Geraldo F. Busatto, Fabio Henrique deGobbi Porto, Daniele de Paula Faria, Paula Squarzoni, Artur Martins Coutinho, Alexandre Teles Garcez, Pedro Gomes Penteado Rosa, Naomi Antunes da Costa, Cleudiana Lima Carvalho, Leticia Torralbo, Jullie Rosana deAlmeida Hernandes, Carla Rachel Ono, Sonia Maria Dozzi Brucki, Ricardo Nitrini, Carlos Alberto Buchpiguel, Fabio Luis Souza Duran, and Orestes Vicente Forlenza

Subjects
Alzheimer's disease, biomarkers, cognitive reserve, cognitive resilience, dementia, low education, Neurology. Diseases of the nervous system, RC346-429, Geriatrics, RC952-954.6
Abstract

Abstract INTRODUCTION: Reduced cognitive reserve (CR) due to very low educational (VLE) levels may influence high dementia rates in low‐middle income environments, leading to decreased cognitive resilience (RES) to Alzheimer´s disease (AD) pathology. However, in vivo findings in VLE groups confirming this prediction are lacking. METHODS: Cognitively impaired patients (with clinically defined AD dementia or amnestic mild cognitive impairment) and cognitively unimpaired older adults (n = 126) were recruited for a positron emission tomography (PET) and magnetic resonance imaging (MRI) investigation in Brazil, including 37 VLE individuals (≤5 years of education). A CR score was generated combining educational attainment and vocabulary knowledge. RES indices to AD pathology were calculated using standardized residuals from linear regression models relating current cognitive performance (episodic memory or overall cognition) to amyloid beta (Aβ) burden Pittsburgh compound‐B ([11C]PiB‐PET). RESULTS: Aβ burden was lower in VLE relative to highly‐educated subjects (controlling for age, sex, and Mini‐Mental Status Exam [MMSE] scores) in the overall cognitively impaired sample, and in dementia subjects when the three clinically defined groups were evaluated separately. In bivariate regression analyses for the overall sample, the RES index based on a composite cognitive score was predicted by CR, socioeconomic status, and hippocampal volume (but not white matter hyperintensities or intracranial volume [ICV]); in the multivariate model, only CR retained significance (and similar results were obtained in the Aβ‐positive subsample). In the multivariate model for the overall sample using the RES index based on memory performance, CR, hippocampal volume, and ICV were significant predictors, whereas only CR retained significance in Aβ‐positive subjects. DISCUSSION: Lower CR consistently predicted less resilience to AD pathology in older adults from a low‐middle income environment.

Published
2020
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2. Author response for 'Hippocampal subregional volume changes in elders classified using positron emission tomography-based Alzheimer's biomarkers of beta-amyloid deposition and neurodegeneration'

Author

Ricardo Nitrini, Sonia Maria Dozzi Brucki, Pedro G.P. Rosa, Fábio Henrique de Gobbi Porto, Geraldo Busatto Filho, Naomi Antunes da Costa, Daniele de Paula Faria, Paula Squarzoni, Leticia Torralbo, Clarice Gameiro da Fonseca Pachi, Orestes Vicente Forlenza, Claudia da Costa Leite, Cleudiana Lima Carvalho, Carlos Alberto Buchpiguel, Artur Martins Coutinho, and Fabio Luiz de Souza Duran

Subjects
Pathology, medicine.medical_specialty, Amyloid deposition, medicine.diagnostic_test, Positron emission tomography, business.industry, Neurodegeneration, medicine, Hippocampal formation, medicine.disease, business, Beta (finance)
Published
2020

3. Hippocampal subregional volume changes in elders classified using positron emission tomography-based Alzheimer's biomarkers of β-amyloid deposition and neurodegeneration

Author

Artur Martins Coutinho, Claudia da Costa Leite, Ricardo Nitrini, Orestes Vicente Forlenza, Cleudiana Lima Carvalho, Daniele de Paula Faria, Carlos Alberto Buchpiguel, Sonia Maria Dozzi Brucki, Paula Squarzoni, Naomi Antunes da Costa, Leticia Torralbo, Fabio Luiz de Souza Duran, Fábio Henrique de Gobbi Porto, Clarice Gameiro da Fonseca Pachi, Pedro G.P. Rosa, and Geraldo Busatto Filho

Subjects
0301 basic medicine, Male, medicine.medical_specialty, Neuroimaging, Hippocampal formation, Hippocampus, 03 medical and health sciences, Cellular and Molecular Neuroscience, Protein Aggregates, 0302 clinical medicine, Alzheimer Disease, Internal medicine, medicine, Humans, Cognitive Dysfunction, Carbon Radioisotopes, Cognitive decline, Cognitive impairment, Aged, Aged, 80 and over, Amyloid beta-Peptides, Aniline Compounds, medicine.diagnostic_test, business.industry, Neurodegeneration, Subiculum, Magnetic resonance imaging, Organ Size, medicine.disease, Magnetic Resonance Imaging, White Matter, Thiazoles, 030104 developmental biology, Endocrinology, Positron emission tomography, Positron-Emission Tomography, Biomarker (medicine), Female, Atrophy, Radiopharmaceuticals, business, 030217 neurology & neurosurgery, Biomarkers
Abstract

Changes in hippocampal subfield volumes (HSV) along the Alzheimer's disease (AD) continuum have been scarcely investigated to date in elderly subjects classified based on the presence of β-amyloid aggregation and signs of neurodegeneration. We classified patients (either sex) with mild dementia compatible with AD (n = 35) or amnestic mild cognitive impairment (n = 39), and cognitively unimpaired subjects (either sex; n = 26) using [11 C]PIB-PET to assess β-amyloid aggregation (A+) and [18 F]FDG-PET to account for neurodegeneration ((N)+). Magnetic resonance imaging-based automated methods were used for HSV and white matter hyperintensity (WMH) measurements. Significant HSV reductions were found in A+(N)+ subjects in the presubiculum/subiculum complex and molecular layer, related to worse memory performance. In both the A+(N)+ and A+(N)- categories, subicular volumes were inversely correlated with the degree of Aβ deposition. The A-(N)+ subgroup showed reduced HSV relative to the A-(N)- subgroup also in the subiculum/presubiculum. Combining all (N)- subjects, HSV were lower in subjects presenting significant cognitive decline irrespective of A+/A- classification (controlling for WMH load); these between-group differences were detected again in the presubiculum, but also involved the CA4 and granular layer. These findings demonstrate that differential HSV reductions are detectable both in (N)+ and (N)- categories along the AD continuum, and are directly related to the severity of cognitive deficits. HSV reductions are larger both in A+(N)+ and A+(N)- subjects in direct proportion to the degree of Aβ deposition. The meaningful HSV reductions detected in the A-(N)+ subgroup highlights the strength of biomarker-based classifications outside of the classical AD continuum.

Published
2020

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