151 results match your criteria: "Penn Memory Center[Affiliation]"

In vivo calcium imaging in freely moving rats using miniscopes provides valuable information about the neural mechanisms of behavior in real time. A gradient index (GRIN) lens can be implanted in deep brain structures to relay activity from single neurons. While such procedures have been successful in mice, few reports provide detailed procedures for successful surgery and long-term imaging in rats, which are better suited for studying complex human behaviors.

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US clinical practice guidelines for the diagnostic evaluation of cognitive impairment due to Alzheimer's disease (AD) or a related dementia (ADRD) are two decades old. This evidence-based guideline was developed to empower all clinicians to implement a structured approach for evaluating a patient with symptoms that may represent clinical AD/ADRD. An expert workgroup conducted a review of 7374 publications (133 met inclusion criteria) and developed recommendations as steps in an evaluation process.

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US clinical practice guidelines for the diagnostic evaluation of cognitive impairment due to Alzheimer's disease (AD) or AD and related dementias (ADRD) are decades old and aimed at specialists. This evidence-based guideline was developed to empower all-including primary care-clinicians to implement a structured approach for evaluating a patient with symptoms that may represent clinical AD/ADRD. Through a modified-Delphi approach and guideline-development process (7374 publications were reviewed; 133 met inclusion criteria) an expert workgroup developed recommendations as steps in a patient-centered evaluation process.

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US clinical practice guidelines for the diagnostic evaluation of cognitive impairment due to Alzheimer's Disease (AD) or AD and related dementias (ADRD) are decades old and aimed at specialists. This evidence-based guideline was developed to empower all-including primary care-clinicians to implement a structured approach for evaluating a patient with symptoms that may represent clinical AD/ADRD. As part of the modified Delphi approach and guideline development process (7374 publications were reviewed; 133 met inclusion criteria) an expert workgroup developed recommendations as steps in a patient-centered evaluation process.

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Subject-Level Segmentation Precision Weights for Volumetric Studies Involving Label Fusion.

Hum Brain Mapp

December 2024

Penn Statistics in Imaging and Visualization Endeavor (PennSIVE), Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

In neuroimaging research, volumetric data contribute valuable information for understanding brain changes during both healthy aging and pathological processes. Extracting these measures from images requires segmenting the regions of interest (ROIs), and many popular methods accomplish this by fusing labels from multiple expert-segmented images called atlases. However, post-segmentation, current practices typically treat each subject's measurement equally without incorporating any information about variation in their segmentation precision.

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Genetic and clinical correlates of two neuroanatomical AI dimensions in the Alzheimer's disease continuum.

Transl Psychiatry

October 2024

Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for AI and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Article Synopsis
  • Alzheimer's disease (AD) exhibits varied brain atrophy patterns, identified through a semi-supervised learning technique (Surreal-GAN) that distinguishes between "diffuse-AD" (widespread atrophy) and "MTL-AD" (focal atrophy in the medial temporal lobe) dimensions in patients with mild cognitive impairment (MCI) and AD.
  • Only the "MTL-AD" dimension was linked to known AD genetic risk factors like APOE ε4, and both dimensions were later detected in asymptomatic individuals, revealing their association with different genetic and pathological mechanisms.
  • Aside from brain-related genes, up to 77 additional genes were identified in various organs, pointing to broader
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Article Synopsis
  • Some people with dementia and their families prefer to stay at home as they feel it's the best care, but this isn't the same for everyone.
  • A study with interviews found that many families avoid moving to care facilities until it's absolutely necessary, often because of fear or guilt.
  • It's important for care programs to consider all the reasons families make decisions about where to live and to help them understand their options better.
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Introduction: Sodium phenylbutyrate and taurursodiol (PB and TURSO) is hypothesized to mitigate endoplasmic reticulum stress and mitochondrial dysfunction, two of many mechanisms implicated in Alzheimer's disease (AD) pathophysiology.

Methods: The first-in-indication phase 2a PEGASUS trial was designed to gain insight into PB and TURSO effects on mechanistic targets of engagement and disease biology in AD. The primary clinical efficacy outcome was a global statistical test combining three endpoints relevant to disease trajectory (cognition [Mild/Moderate Alzheimer's Disease Composite Score], function [Functional Activities Questionnaire], and total hippocampal volume on magnetic resonance imaging).

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Cytoarchitectonic gradients of laminar degeneration in behavioural variant frontotemporal dementia.

Brain

January 2025

Digital Neuropathology Laboratory, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.

Article Synopsis
  • Behavioral variant frontotemporal dementia (bvFTD) is primarily linked to tau or TDP-43 protein accumulation, and the study aimed to investigate how these proteinopathies cause different patterns of neurodegeneration in the brain's cortical layers.
  • Researchers compared the distribution of pyramidal neuron degeneration in individuals with bvFTD-tau (27 subjects), bvFTD-TDP (47 subjects), and healthy controls (32 subjects) across various cytoarchitectonic types in the frontal cortex.
  • Findings indicated that while SMI32 immunoreactivity (a measure of neuron health) decreased uniformly in bvFTD-TDP, there was a significant progressive loss in bvFTD-tau, especially in the supragranular
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Introduction: Physical activity is associated with reduced risk of cognitive and functional decline but scalable, sustainable interventions for populations at risk for Alzheimer's disease (AD) and AD and related dementias (ADRD) are lacking.

Methods: A 12-week randomized-controlled trial was conducted with a 3-week follow-up using a national AD prevention registry (GeneMatch). The control group (n = 50) set step goals and received daily feedback.

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Beyond Macrostructure: Is There a Role for Radiomics Analysis in Neuroimaging ?

Magn Reson Med Sci

July 2024

Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.

The most commonly used neuroimaging biomarkers of brain structure, particularly in neurodegenerative diseases, have traditionally been summary measurements from ROIs derived from structural MRI, such as volume and thickness. Advances in MR acquisition techniques, including high-field imaging, and emergence of learning-based methods have opened up opportunities to interrogate brain structure in finer detail, allowing investigators to move beyond macrostructural measurements. On the one hand, superior signal contrast has the potential to make appearance-based metrics that directly analyze intensity patterns, such as texture analysis and radiomics features, more reliable.

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Prevalence and Impact of Bypassing or Overriding Phase 2 Trials in Neurologic Drug Development.

Neurology

July 2024

From the Department of Equity, Ethics and Policy (H.M., R.M., K.V., M.M., J. Kimmelman), McGill University, Montreal, Quebec, Canada; Penn Memory Center (J. Karlawish), University of Pennsylvania, Philadelphia; Clinical Trials Unit (E.A.), Kennedy Krieger Institute, Baltimore, MD; Departments of Psychiatry and Behavioral Sciences and Neurology, Keck School of Medicine (L.S.), and L. Davis School of Gerontology (L.S.), University of Southern California, Los Angeles.

Article Synopsis
  • - The study investigates the prevalence of phase 3 clinical trials for neurologic drugs that started without a positive phase 2 trial, finding that 46% of such trials bypassed or overrode phase 2 outcomes, which could affect the risk/benefit ratio of these trials.
  • - Using data from 2011-2021, the researchers analyzed 1,188 phase 3 trials, concluding that those relying on phase 2 bypass/override had a significantly lower chance of achieving positive primary outcomes, indicating potential issues with efficacy.
  • - The study also found that the practice of bypassing phase 2 trials was not significantly linked to industry funding or testing already approved interventions, suggesting that other factors may drive this trend in neurolog
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Background: Volumetry of subregions in the medial temporal lobe (MTL) computed from automatic segmentation in MRI can track neurodegeneration in Alzheimer's disease. However, image quality may vary in MRI. Poor quality MR images can lead to unreliable segmentation of MTL subregions.

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Article Synopsis
  • This text describes an open-source method for creating a custom operant chamber intended for long-term use with miniature microscopes (miniscopes).
  • The chamber is compatible with both custom and standard accessories, like houselights and levers, allowing for versatile experimental setups.
  • Most components can be easily bought, reducing the need for extensive skills or labor, and it's suggested to build multiple units at once to save on costs by ordering in bulk.
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Introduction: Multimodal evidence indicates Alzheimer's disease (AD) is characterized by early white matter (WM) changes that precede overt cognitive impairment. WM changes have overwhelmingly been investigated in typical, amnestic mild cognitive impairment and AD; fewer studies have addressed WM change in atypical, non-amnestic syndromes. We hypothesized each non-amnestic AD syndrome would exhibit WM differences from amnestic and other non-amnestic syndromes.

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Neighborhood disadvantage reduces cognitive reserve independent of neuropathologic change.

Alzheimers Dement

April 2024

Translational Neuropathology Research Laboratory, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Introduction: Individuals in socioeconomically disadvantaged neighborhoods exhibit increased risk for impaired cognitive function. Whether this association relates to the major dementia-related neuropathologies is unknown.

Methods: This cross-sectional study included 469 autopsy cases from 2011 to 2023.

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Objective: We examined how cognitive complaint types (CCTs) correlate with cognitive testing, perceived stress, and symptom distress in older adults with normal cognition and dementia.

Methods: Older adults (n = 259) with normal cognition, mild cognitive impairment, or mild-stage Alzheimer disease completed cognitive testing and self-report measures (Cognitive Difficulties Scale, Global Distress Index, Perceived Stress Scale). Cross-sectional analyses examined: (1) CCT composition by classification method,( 2) CCTs by diagnostic group, (3) correlations of CCTs with cognitive testing scores, and (4) correlations of CCTs with perceived stress and symptom distress.

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Evaluating correlations between disease biomarkers and clinical outcomes is crucial in biomedical research. During the early stages of many chronic diseases, changes in biomarkers and clinical outcomes are often subtle. A major challenge to detecting subtle correlations is that studies with large sample sizes are usually needed to achieve sufficient statistical power.

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Monoclonal anti-amyloid antibodies for the treatment of Alzheimer's disease and the hesitant geriatrician.

J Am Geriatr Soc

February 2024

Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Perelman School of Medicine, Penn Memory Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

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A New Framework for Dementia Nomenclature.

JAMA Neurol

December 2023

Strategic Partnerships, Lewy Body Dementia Association, Lilburn, Georgia.

Importance: Nomenclature in the field of neurodegenerative diseases presents a challenging problem. Inconsistent use of terms such as Alzheimer disease and dementia has compromised progress in clinical care, research, and development of therapeutics. Dementia-associated stigma further contributes to inconsistent and imprecise language.

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Time out weekly smile: A pilot test of a virtual respite program.

Geriatr Nurs

December 2023

University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA; New Courtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA; Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA. Electronic address:

Respite care provides alternative care for persons living with dementia (PLWD) and is intended to alleviate the burden of caregiving. However, the evaluation of respite programs is limited. Time Out Weekly Smile (TOWS) is a virtual intergenerational respite care program designed to meet the needs of PLWD and their care partners and provide allied health students opportunities to serve as respite volunteers.

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Background: The National Institute on Aging (NIA) Imbedded Pragmatic Alzheimer's Disease and Alzheimer's Related Dementia Clinical Trials (IMPACT) Collaboratory convened a Lived Experience Panel (LEP) to inform the development of research priorities and provide input on conducting embedded pragmatic clinical trials (ePCTs) of dementia care interventions. Given the importance of people with lived experience to dementia research, and the unique considerations of engaging people with dementia, we report on our process for the recruitment, selection, and initial convening of the IMPACT LEP.

Methods: The IMPACT Engaging Partners Team, in partnership with the Alzheimer's Association, sought nominations of individuals with mild cognitive impairment or early-stage dementia, care partners of other people living with dementia (PLWD), and proxy representatives for individuals with mid-to-late stage dementia.

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Article Synopsis
  • The medial temporal lobe is crucial for episodic memory and is affected differently by aging and Alzheimer's disease, with each condition showing distinct patterns of vulnerability.
  • In preclinical Alzheimer's, there's an increase in functional connectivity in the medial temporal lobe, which declines as the disease progresses into its symptomatic phase.
  • Normal aging leads to decreased connectivity in both the Anterior-Temporal and Posterior-Medial networks, indicating a decline in memory-related brain functions across age.
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