ORCID Profile
0000-0001-7542-3241
Current Organisation
Columbia University Medical Center
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Publisher: Oxford University Press (OUP)
Date: 16-03-2021
Abstract: Cognitive resilience is an important modulating factor of cognitive decline in Alzheimer’s disease, but the functional brain mechanisms that support cognitive resilience remain elusive. Given previous findings in normal ageing, we tested the hypothesis that higher segregation of the brain’s connectome into distinct functional networks represents a functional mechanism underlying cognitive resilience in Alzheimer’s disease. Using resting-state functional MRI, we assessed both resting-state functional MRI global system segregation, i.e. the balance of between-network to within-network connectivity, and the alternate index of modularity Q as predictors of cognitive resilience. We performed all analyses in two independent s les for validation: (i) 108 in iduals with autosomal dominantly inherited Alzheimer’s disease and 71 non-carrier controls and (ii) 156 amyloid-PET-positive subjects across the spectrum of sporadic Alzheimer’s disease and 184 amyloid-negative controls. In the autosomal dominant Alzheimer’s disease s le, disease severity was assessed by estimated years from symptom onset. In the sporadic Alzheimer’s s le, disease stage was assessed by temporal lobe tau-PET (i.e. composite across Braak stage I and III regions). In both s les, we tested whether the effect of disease severity on cognition was attenuated at higher levels of functional network segregation. For autosomal dominant Alzheimer’s disease, we found higher functional MRI-assessed system segregation to be associated with an attenuated effect of estimated years from symptom onset on global cognition (P = 0.007). Similarly, for patients with sporadic Alzheimer’s disease, higher functional MRI-assessed system segregation was associated with less decrement in global cognition (P = 0.001) and episodic memory (P = 0.004) per unit increase of temporal lobe tau-PET. Confirmatory analyses using the alternate index of modularity Q revealed consistent results. In conclusion, higher segregation of functional connections into distinct large-scale networks supports cognitive resilience in Alzheimer’s disease.
Publisher: Springer Science and Business Media LLC
Date: 06-11-2013
Publisher: Wiley
Date: 07-10-2014
Publisher: Wiley
Date: 10-12-2016
DOI: 10.1016/J.JALZ.2016.10.007
Abstract: Numerous diagnostic criteria have tried to tackle the variability in clinical manifestations and problematic diagnosis of vascular cognitive impairment (VCI) but none have been universally accepted. These criteria have not been readily comparable, impacting on clinical diagnosis rates and in turn prevalence estimates, research, and treatment. The Vascular Impairment of Cognition Classification Consensus Study (VICCCS) involved participants (81% academic researchers) from 27 countries in an online Delphi consensus study. Participants reviewed previously proposed concepts to develop new guidelines. VICCCS had a mean of 122 (98-153) respondents across the study and a 67% threshold to represent consensus. VICCCS redefined VCI including classification of mild and major forms of VCI and subtypes. It proposes new standardized VCI-associated terminology and future research priorities to address gaps in current knowledge. VICCCS proposes a consensus-based updated conceptualization of VCI intended to facilitate standardization in research.
Publisher: Springer Science and Business Media LLC
Date: 27-02-2019
Location: United States of America
No related grants have been discovered for Yaakov Stern.