Publications by authors named "Bruce L. Miller"

Based on historic observations that children with reading disabilities were disproportionately both male and non-right-handed, and that early life insults of the left hemisphere were more frequent in boys and non-right-handed children, it was proposed that early focal neuronal injury disrupts typical patterns of motor hand and language dominance and in the process produces developmental dyslexia. To date, these theories remain controversial. We revisited these earliest theories in a contemporary manner, investigating demographics associated with reading disability, and in a subgroup with and without reading disability, compared structural imaging as well as patterns of activity during tasks of verb generation and non-word repetition using magnetoencephalography source imaging.

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  • Aberrant angiogenesis may contribute to cognitive decline and could serve as a therapeutic target for dementia prevention, though most prior studies have focused on animal models.
  • This study evaluated the relationship between blood markers of angiogenesis and cognitive aging in a sample of 435 older adults, revealing significant associations that varied by sex, particularly in younger women compared to men.
  • Results indicated that higher levels of certain angiogenic markers were linked to better executive function and less brain atrophy, suggesting the potential for targeting angiogenesis in addressing age-related cognitive impairment.
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  • Latin America's genetic diversity offers a unique opportunity to study Alzheimer's disease (AD) and frontotemporal dementia (FTD), with a focus on identifying related genetic variations.
  • The study involved 2,162 participants from six countries who underwent extensive genomic sequencing and analysis to detect genetic factors linked to these dementias.
  • Results highlighted a mix of American, African, and European ancestries, discovered 17 pathogenic variants, and revealed specific genetic variations tied to AD and FTD inheritance patterns in affected families.
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Reward processing involves evaluation of stimuli to inform what an individual works to pursue or avoid. Patients with behavioral variant frontotemporal dementia (bvFTD) often display reward processing changes, including insensitivity to aversive stimuli. It is unknown how early in the disease course reward changes are detectable.

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Introduction: Collaborative dementia care models with care navigation, including the Care Ecosystem, improve outcomes for persons living with dementia (PLWDs) and their caregivers. The effects of continuous care over long periods have not been studied.

Methods: In this randomized clinical trial with 456 PLWD-caregiver dyads with high caregiver burden, we evaluated the cumulative 5-year treatment effect on PLWD quality of life, health care utilization, caregiver depression, self-efficacy, and burden.

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  • The study investigates how reward perception changes in patients with behavioral variant frontotemporal dementia (bvFTD), focusing on olfactory rewards like food and alcohol.
  • It found that stronger positive feelings towards these odors were linked to better connectivity between the ventral pallidum and areas of the brain associated with reward processing, specifically the anterior cingulate cortex and ventromedial prefrontal cortex.
  • Additionally, the research revealed that atrophy in the anterior cingulate cortex affected these perceptions, suggesting that both structural damage and connectivity within reward-related brain regions play vital roles in how pleasant olfactory stimuli are perceived in bvFTD patients.
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  • The human face is essential for expressing emotions and social interaction, but the brain's structural connections to these facial expressions are still unclear.
  • A study of 55 older adults linked specific facial behaviors, like frowning or smiling during emotional videos, to increased gray matter volume in brain regions associated with emotional and motor functions.
  • The results indicate that both emotional and motor brain networks physically represent facial expressions, highlighting the midcingulate cortex's role in coordinating these facial movements during emotions.
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  • Moral decisions often involve tough choices where sometimes helping many people means harming a few.
  • Most research shows that being utilitarian (choosing the most good for the most people) can mean being less sensitive to others' feelings.
  • A study of a person with a brain issue showed they still made selfless choices that helped others, suggesting not everyone with this condition is unfriendly.
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  • * Researchers used automated speech analysis on audio-recorded picture descriptions from 40 FTD patients and 22 healthy controls to identify linguistic features that could help distinguish between the two types of atrophy associated with each variant.
  • * The analysis revealed key speech features that could differentiate between FTD patients and healthy controls as well as between the two variants of FTD, suggesting potential for a non-invasive diagnostic tool that correlates with specific brain areas involved in language and
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  • Some sports and repeated head injuries (like playing football) might lead to brain problems later in life, especially conditions like Frontotemporal Dementia (FTD) and Primary Progressive Aphasia (PPA).
  • Researchers compared people with FTD/PPA to healthy ones to see how many had Traumatic Brain Injuries (TBI) and head impacts.
  • They found that people with FTD/PPA had more sports experience causing head impacts, and those with a history of head injuries had symptoms show up earlier than those without.
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  • Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease linked to abnormal tau protein accumulation, and previous studies were limited in exploring rare genetic variants due to the use of genotype arrays.* -
  • In this study, whole genome sequencing (WGS) on a large cohort allowed researchers to confirm known genetic loci related to PSP and discover new associations, particularly highlighting a different role for the APOE ε2 allele compared to Alzheimer's disease.* -
  • The findings expand knowledge of PSP's genetic underpinnings and identify potential targets for future research into the disease's mechanisms and treatments.*
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  • Diminished activity in the parasympathetic nervous system, particularly baseline respiratory sinus arrhythmia, is linked to empathy issues in individuals with frontotemporal dementia (FTD), especially those with left frontoinsula dysfunction.
  • In a study involving 102 participants, including asymptomatic and symptomatic carriers of the C9orf72 gene mutation, researchers found that those with symptomatic FTD exhibited significantly lower respiratory sinus arrhythmia compared to other groups, indicating disrupted parasympathetic activity.
  • Results showed a correlation between lower respiratory sinus arrhythmia and greater behavioral symptom severity as well as reduced empathic concern, suggesting that parasympathetic deficits might play a role in the progression of FTD.
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Introduction: Alzheimer's disease (AD) neuropathological changes present with amnestic and nonamnestic (atypical) syndromes. The contribution of comorbid neuropathology as a substratum of atypical expression of AD remains under investigated.

Methods: We examined whether atypical AD exhibited increased comorbid neuropathology compared to typical AD and if such neuropathologies contributed to the accelerated clinical decline in atypical AD.

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  • Itching is common in older adults and may indicate neurodegenerative diseases like frontotemporal lobar degeneration (FTLD-SD) and Alzheimer's disease (AD), as certain brain areas associated with itch sensations could be affected by these conditions.
  • A study compared the incidence of itching in patients with FTLD-SD and AD, using brain MRIs and medical records from a research project at UCSF over a period of nearly 20 years.
  • Results showed that itching was more prevalent in FTLD-SD patients (38%) compared to those with AD (18%), suggesting a possible link between unexplained itching and neurodegenerative processes, particularly in those with behavioral variant frontotemporal dementia.
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A Nature Medicine paper published in January 2024 describes eight cases of iatrogenic Alzheimer's disease in individuals who received cadaveric pituitary-derived human growth hormone. The paper's conclusions argue for the transmissibility of Alzheimer's disease, which, if true, would create a significant public health crisis. For example, neurosurgical practices would require substantial revision, and many individuals who have undergone neurosurgical procedures would now be at considerable risk of Alzheimer's disease.

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Background: Tau post-translational modifications (PTMs) result in the gradual build-up of abnormal tau and neuronal degeneration in tauopathies, encompassing variants of frontotemporal lobar degeneration (FTLD) and Alzheimer's disease (AD). Tau proteolytically cleaved by active caspases, including caspase-6, may be neurotoxic and prone to self-aggregation. Also, our recent findings show that caspase-6 truncated tau represents a frequent and understudied aspect of tau pathology in AD in addition to phospho-tau pathology.

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  • A multicenter study involving 18 centers in 12 countries examined 360 patients with frontotemporal dementia (FTD) characterized by right anterior temporal lobe (RATL) atrophy to create a unified clinical description of the syndrome.
  • Key symptoms identified in patients included mental rigidity (78%), disinhibition (74%), and naming difficulties (70%), with cognitive tests revealing specific deficits in social interactions and emotional recognition, though lacking in measuring mental rigidity.
  • The findings represent the largest cohort of its kind, highlighting under-acknowledged symptoms of RATL and providing valuable insights for clinicians to improve early diagnosis and management of FTD patients.
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  • Children with dyslexia show heightened emotional sensitivity, demonstrating more robust reactions to emotional stimuli compared to their peers without dyslexia.
  • A study measured facial expressions, skin reactions, and emotional responses to a sudden loud noise, finding that children with dyslexia had greater reactions.
  • Increased physiological responses in children with dyslexia were linked to higher levels of anxiety, suggesting that their stronger emotional reactions may contribute to common anxiety symptoms in this group.
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Frontotemporal lobar degeneration with neuronal inclusions of the TAR DNA-binding protein 43 (FTLD-TDP) is a fatal neurodegenerative disorder with only a limited number of risk loci identified. We report our comprehensive genome-wide association study as part of the International FTLD-TDP Whole-Genome Sequencing Consortium, including 985 cases and 3,153 controls, and meta-analysis with the Dementia-seq cohort, compiled from 26 institutions/brain banks in the United States, Europe and Australia. We confirm as the strongest overall FTLD-TDP risk factor and identify as a novel FTLD-TDP risk factor.

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Brain clocks, which quantify discrepancies between brain age and chronological age, hold promise for understanding brain health and disease. However, the impact of multimodal diversity (geographical, socioeconomic, sociodemographic, sex, neurodegeneration) on the brain age gap (BAG) is unknown. Here, we analyzed datasets from 5,306 participants across 15 countries (7 Latin American countries -LAC, 8 non-LAC).

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  • The study aimed to identify fluid biomarkers in cerebrospinal fluid (CSF) for progressive supranuclear palsy (PSP) to aid in developing new therapies, utilizing advanced proteomic analysis methods.
  • Researchers analyzed a total of 136 participants across various groups, comparing individuals with PSP (Richardson syndrome) against healthy controls, using sophisticated platforms to assess the presence of specific proteins (SOMAmers) in CSF.
  • Findings revealed that many SOMAmers were differentially expressed in PSP patients, indicating potential biomarkers, with three significant biological pathways linked to disease progression identified, including synaptic functions and cytokine interactions.
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  • In frontotemporal lobar degeneration (FTLD), abnormal protein buildup in the brain correlates with declines in social-emotional and language skills, primarily involving TDP-43 or tau proteins.
  • The study investigates how degeneration patterns in FTLD relate to gene expression of recently evolved genetic regions, using neuroimaging and transcriptomic data to examine targeted brain areas.
  • Results indicate that FTLD subtypes uniquely or overlappingly affect brain regions tied to genes evolved in humans, with a notable relationship between TDP-43 function impairment and cryptic splicing in affected genes.
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Introduction: Variants of uncertain significance (VUS) surged with affordable genetic testing, posing challenges for determining pathogenicity. We examine the pathogenicity of a novel VUS P93S in Annexin A11 (ANXA11) - an amyotrophic lateral sclerosis/frontotemporal dementia-associated gene - in a corticobasal syndrome kindred. Established ANXA11 mutations cause ANXA11 aggregation, altered lysosomal-RNA granule co-trafficking, and transactive response DNA binding protein of 43 kDa (TDP-43) mis-localization.

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  • * A study analyzed 4,685 sporadic FTD cases and found significant genetic variants at the MAPT and APOE loci that increase the risk for the disease, indicating potential genetic overlap with other neurodegenerative diseases.
  • * The genetic risk factors appear to vary by population, with MAPT and APOE associations predominantly found in Central/Nordic and Mediterranean Europeans, suggesting a need for further research into these population-specific features for better understanding of sporadic FTD.
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