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1دورية أكاديمية
المؤلفون: Jennifer Zitser, Isabel Elaine Allen, Neus Falgàs, Michael M Le, Thomas C Neylan, Joel H Kramer, Christine M Walsh
المصدر: PLoS ONE, Vol 17, Iss 6, p e0270095 (2022)
الوصف: ObjectivesTo investigate the objective sleep influencers behind older adult responses to subjective sleep measures, in this case, the Pittsburgh Sleep Quality Index (PSQI). Based on previous literature, we hypothesized that SE would be associated with PSQI reported sleep disruption. Furthermore, because SOL increases progressively with age and it tends to be easily remembered by the patients, we also expected it to be one of the main predictors of the perceived sleep quality in the elderly.MethodsWe studied 32 cognitively healthy community-dwelling older adults (age 74 ± 0.3 years) who completed an at-home sleep assessment (Zeo, Inc.) and the PSQI. Linear mixed models were used to analyze the association of the objective sleep parameters (measured by the Zeo) with the PSQI total score and sub-scores, adjusting for age, gender, years of education and likelihood of sleep apnea.ResultsObjective sleep parameters did not show any association with the PSQI total score. We found that objective measures of Wake after sleep onset (WASO, % and min) were positively associated with the PSQI sleep disturbance component, while SE and Total Sleep Time (TST) were negatively associated with PSQI sleep disturbance. Lastly, objective SE was positively associated with PSQI SE.ConclusionsOur findings showed that WASO, SE and TST, are associated with PSQI sleep disturbance, where the greater WASO, overall lower SE and less TST, were associated with increased subjective report of sleep disturbance. As expected, subjective (PSQI) and objective measures of SE were related. However, PSQI total score did not relate to any of the objective measures. These results suggest that by focusing on the PSQI total score we may miss the insight this easily administered self-report tool can provide. If interpreted in the right way, the PSQI can provide further insight into cognitively healthy older adults that have the likelihood of objective sleep disturbance.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/1932-6203Test
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2دورية أكاديمية
المؤلفون: Jennifer Zitser, Kaitlin B. Casaletto, Adam M. Staffaroni, Claire Sexton, Sophia Weiner-Light, Amy Wolf, Jesse A. Brown, Bruce L. Miller, Joel H. Kramer
المصدر: Frontiers in Aging Neuroscience, Vol 13 (2021)
مصطلحات موضوعية: aging, parkinsonism, UPDRS, cognition, fMRI, motor signs, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
الوصف: Objectives: To characterize the clinical correlates of subclinical Parkinsonian signs, including longitudinal cognitive and neural (via functional connectivity) outcomes, among functionally normal older adults.Methods: Participants included 737 functionally intact community-dwelling older adults who performed prospective comprehensive evaluations at ~15-months intervals for an average of 4.8 years (standard deviation 3.2 years). As part of these evaluations, participants completed the Unified Parkinson's Disease Rating Scale (UPDRS) longitudinally and measures of processing speed, executive functioning and verbal episodic memory. T1-weighted structural scans and task-free functional MRI scans were acquired on 330 participants. We conducted linear mixed-effects models to determine the relationship between changes in UPDRS with cognitive and neural changes, using age, sex, and education as covariates.Results: Cognitive outcomes were processing speed, executive functioning, and episodic memory. Greater within-person increases in UPDRS were associated with more cognitive slowing over time. Although higher average UPDRS scores were significantly associated with overall poorer executive functions, there was no association between UPDRS and executive functioning longitudinally. UPDRS scores did not significantly relate to longitudinal memory performances. Regarding neural correlates, greater increases in UPDRS scores were associated with reduced intra-subcortical network connectivity over time. There were no relationships with intra-frontoparietal or inter-subcortical-frontoparietal connectivity.Conclusions: Our findings add to the aging literature by indicating that mild motor changes are negatively associated with cognition and network connectivity in functionally intact adults.
وصف الملف: electronic resource
العلاقة: https://www.frontiersin.org/articles/10.3389/fnagi.2021.594637/fullTest; https://doaj.org/toc/1663-4365Test
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3مؤتمر
المؤلفون: Jennifer Zitser (10127057), Kaitlin B. Casaletto (7009337), Adam M. Staffaroni (5989220), Claire Sexton (4115794), Sophia Weiner-Light (10127060), Amy Wolf (408984), Jesse A. Brown (10127063), Bruce L. Miller (8450160), Joel H. Kramer (7397261)
مصطلحات موضوعية: Neuroscience, Pathology, Health Care, Psychiatry (incl. Psychotherapy), Clinical Sciences not elsewhere classified, Central Nervous System, Aged Care Nursing, Aged Health Care, Protein Trafficking, aging, parkinsonism, UPDRS, cognition, fMRI, motor signs
الوصف: Objectives: To characterize the clinical correlates of subclinical Parkinsonian signs, including longitudinal cognitive and neural (via functional connectivity) outcomes, among functionally normal older adults. Methods: Participants included 737 functionally intact community-dwelling older adults who performed prospective comprehensive evaluations at ~15-months intervals for an average of 4.8 years (standard deviation 3.2 years). As part of these evaluations, participants completed the Unified Parkinson's Disease Rating Scale (UPDRS) longitudinally and measures of processing speed, executive functioning and verbal episodic memory. T1-weighted structural scans and task-free functional MRI scans were acquired on 330 participants. We conducted linear mixed-effects models to determine the relationship between changes in UPDRS with cognitive and neural changes, using age, sex, and education as covariates. Results: Cognitive outcomes were processing speed, executive functioning, and episodic memory. Greater within-person increases in UPDRS were associated with more cognitive slowing over time. Although higher average UPDRS scores were significantly associated with overall poorer executive functions, there was no association between UPDRS and executive functioning longitudinally. UPDRS scores did not significantly relate to longitudinal memory performances. Regarding neural correlates, greater increases in UPDRS scores were associated with reduced intra-subcortical network connectivity over time. There were no relationships with intra-frontoparietal or inter-subcortical-frontoparietal connectivity. Conclusions: Our findings add to the aging literature by indicating that mild motor changes are negatively associated with cognition and network connectivity in functionally intact adults.
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المصدر: Journal of Clinical Sleep Medicine.
مصطلحات موضوعية: Pulmonary and Respiratory Medicine, Neurology, Neurology (clinical)
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::672b4ae8298dd6eececdec2b67d16572Test
https://doi.org/10.5664/jcsm.10618Test -
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المؤلفون: Jennifer Zitser, Ethan G. Brown, Jill L. Ostrem, Caroline M. Tanner, James B. Rowe, Vy Nguyen, Howie Rosen, Michael D. Geschwind, Ian O. Bledsoe
المصدر: Journal of the Neurological Sciences. :120696
مصطلحات موضوعية: Neurology, Neurology (clinical)
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::29bcedc7a26a2a8cf3f20256620e85a9Test
https://doi.org/10.1016/j.jns.2023.120696Test -
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المؤلفون: Paul Sukhanov, Bruce L. Miller, Jennifer Zitser, Joel H. Kramer, Howard J. Rosen, Lea T. Grinberg, Katherine P. Rankin, Gianina Toller, Harli Grant
المصدر: Neurocase
مصطلحات موضوعية: Pathology, medicine.medical_specialty, Neuroimaging, Disease, Article, 03 medical and health sciences, 0302 clinical medicine, Atrophy, Pick Disease of the Brain, Arts and Humanities (miscellaneous), Alzheimer Disease, Humans, Medicine, Memory impairment, Dementia, 030304 developmental biology, 0303 health sciences, business.industry, Syndrome, Frontotemporal lobar degeneration, medicine.disease, 3. Good health, Frontotemporal Dementia, Pick's disease, Neurology (clinical), business, 030217 neurology & neurosurgery, Frontotemporal dementia
الوصف: The most common neurodegenerative syndrome associated with Pick’s disease pathology (PiD), a type of frontotemporal lobar degeneration, is behavioral variant frontotemporal dementia (bvFTD), which is characterized by profound changes in social behavior. However, in rare cases, PiD can manifest as an Alzheimer’s disease-type dementia featuring early impairment of episodic memory. We describe the longitudinal cognitive and socioemotional changes as well as the structural imaging and neuropathological findings of a patient who presented with late-onset AD-type dementia with PiD. The patient showed slowly progressive episodic memory impairment, followed by executive dysfunctions and changes in social behavior, but preserved visuospatial, language, and motor functions. Consistent with this clinical profile, gray matter atrophy and underlying PiD were most predominantly found in anterior temporal and frontal lobe regions of the salience and semantic-appraisal networks, with relative sparing of language-related temporal lobe structures and parietal areas involved in visuospatial functioning. Our findings from this patient presenting with memory complaints suggest that early bvFTD-like social symptoms such as loss of empathy and disinhibition as well as slow disease progression and paucity of motor symptoms are key clinical features suggestive of a frontotemporal lobar degeneration pathology like PiD. This case report may help improve the ability of clinicians and clinical researchers to predict the pathology of patients with atypical presentations of AD, which will ultimately be critical for enrollment of patients into disease-modifying clinical trials targeting the underlying proteinopathy.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9089c0ab8d45497484678bac6e132a8dTest
https://doi.org/10.1080/13554794.2021.1936072Test -
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المؤلفون: Andreas Brink‐Kjaer, Niraj Gupta, Eric Marin, Jennifer Zitser, Oliver Sum‐Ping, Anahid Hekmat, Flavia Bueno, Ana Cahuas, James Langston, Poul Jennum, Helge B.D. Sorensen, Emmanuel Mignot, Emmanuel During
المصدر: Movement disorders : official journal of the Movement Disorder SocietyReferences.
مصطلحات موضوعية: Neurology, Neurology (clinical)
الوصف: Isolated rapid-eye-movement sleep behavior disorder (iRBD) is in most cases a prodrome of neurodegenerative synucleinopathies, affecting 1% to 2% of middle-aged and older adults; however, accurate ambulatory diagnostic methods are not available. Questionnaires lack specificity in nonclinical populations. Wrist actigraphy can detect characteristic features in individuals with RBD; however, high-frequency actigraphy has been rarely used.The aim was to develop a machine learning classifier using high-frequency (1-second resolution) actigraphy and a short patient survey for detecting iRBD with high accuracy and precision.The method involved analysis of home actigraphy data (for seven nights and more) and a nine-item questionnaire (RBD Innsbruck inventory and three synucleinopathy prodromes of subjective hyposmia, constipation, and orthostatic dizziness) in a data set comprising 42 patients with iRBD, 21 sleep clinic patients with other sleep disorders, and 21 community controls.The actigraphy classifier achieved 95.2% (95% confidence interval [CI]: 88.3-98.7) sensitivity and 90.9% (95% CI: 82.1-95.8) precision. The questionnaire classifier achieved 90.6% accuracy and 92.7% precision, exceeding the performance of the Innsbruck RBD Inventory and prodromal questionnaire alone. Concordant predictions between actigraphy and questionnaire reached a specificity and precision of 100% (95% CI: 95.7-100.0) with 88.1% sensitivity (95% CI: 79.2-94.1) and outperformed any combination of actigraphy and a single question on RBD or prodromal symptoms.Actigraphy detected iRBD with high accuracy in a mixed clinical and community cohort. This cost-effective fully remote procedure can be used to diagnose iRBD in specialty outpatient settings and has potential for large-scale screening of iRBD in the general population. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a10f424b2ca2219419a9bcd6ffe2ff7eTest
https://pubmed.ncbi.nlm.nih.gov/36258659Test -
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المصدر: Journal of women's health (2002), vol 31, iss 7
J Womens Health (Larchmt)مصطلحات موضوعية: Sleep Wake Disorders, Aging, insomnia, factor analysis, menopause, Medical and Health Sciences, Clinical Research, Surveys and Questionnaires, Behavioral and Social Science, Humans, Depression, Contraception/Reproduction, Neurosciences, Original Articles, General Medicine, sleep disturbance, Actigraphy, Brain Disorders, Sleep Quality, Mental Health, sleep onset latency, Female, Self Report, Public Health, Sleep, Sleep Research
الوصف: Background: Validity of the Pittsburgh Sleep Quality Index (PSQI) has not been established for midlife women before menopause, and evidence suggests that two-factor or three-factor models may be more informative than the PSQI global score derived from its seven components. We hypothesized that the PSQI and its factor structure would be valid in premenopausal women. Materials and Methods: We performed a validation study of the PSQI against wrist actigraphy in a community-based convenience sample of 71 healthy premenopausal women (aged 40-50 years). For convergent validity, PSQI and its component scores were compared with homologous actigraphy measures. For discriminant validity, characteristics known to affect sleep quality were compared, including body mass index, exercise, menopausal status, menopausal symptoms, and depressive symptoms measured with the Center for Epidemiological Studies-Depression (CES-D) Scale. Results: The PSQI global score and Components 1 (quality) and 5 (disturbance) were correlated (p
وصف الملف: application/pdf
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::46b334ab9c49cbf183db05c15620b9deTest
https://escholarship.org/uc/item/4208z1tqTest -
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المؤلفون: Andreas Brink-Kjaer, Niraj Gupta, Eric Marin, Jennifer Zitser, Oliver Sum-Ping, Anahid Hekmat, Flavia Bueno, Ana Cahuas, James Langston, Poul Jennum, Helge B.D. Sorensen, Emmanuel Mignot, Emmanuel During
الوصف: BackgroundIsolated rapid-eye-movement sleep behavior disorder (iRBD) is in most cases a prodrome of neurodegenerative synucleinopathies, affecting 1-2% of middle-aged and older adults, however accurate ambulatory diagnostic methods are lacking. Questionnaires lack specificity in non-clinic populations. Wrist actigraphy can detect characteristic features in individuals with RBD, however high frequency actigraphy has rarely been used.ObjectivesTo develop a machine learning classifier using high frequency (1-second resolution) actigraphy and a short patient survey for detecting iRBD with high accuracy and precision.MethodsAnalysis of ≥7 nights home actigraphy data and 9-item questionnaire (RBD Innsbruck inventory and 3 synucleinopathy prodromes of subjective hyposmia, constipation and orthostatic dizziness) in a dataset including 42 patients with iRBD, 21 sleep clinic patients with other sleep disorders, and 21 community controls.ResultsThe actigraphy classifier achieved 95.2% (95% CI: 88.3 - 98.7) sensitivity and 90.9% (95% CI: 82.1 - 95.8) precision. The questionnaire classifier achieved 90.6% accuracy and 92.7% precision, exceeding performance of RBD-I and prodromal questionnaire alone. Concordant predictions between actigraphy and questionnaire reached specificity and precision of 100% (95% CI: 95.7 - 100.0) with 88.1% sensitivity (95% CI: 79.2 - 94.1) and outperformed any combination of actigraphy plus single question on RBD or prodromal symptoms.ConclusionsActigraphy detected iRBD with high accuracy in a mixed clinical and community cohort. This cost-effective fully remote procedure can be used to diagnose iRBD in specialty outpatient settings and has potential for large scale screening of iRBD in the general population.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::1144791c0f161025192bd8d3726fab04Test
https://doi.org/10.1101/2022.04.21.22274011Test -
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المؤلفون: Eoin P. Flanagan, Michael D. Geschwind, A. Sebastian Lopez-Chiriboga, Kyle M. Blackburn, Sanchit Turaga, Sophie Binks, Jennifer Zitser, Jeffrey M. Gelfand, Gregory S. Day, S. Richard Dunham, Stefanie J. Rodenbeck, Stacey L. Clardy, Andrew J. Solomon, Sean J. Pittock, Andrew McKeon, Divyanshu Dubey, Anastasia Zekeridou, Michel Toledano, Lindsey E. Turner, Steven Vernino, Sarosh R. Irani
المصدر: JAMA Neurology. 80:30
مصطلحات موضوعية: Neurology (clinical)
الوصف: ImportanceAutoimmune encephalitis misdiagnosis can lead to harm.ObjectiveTo determine the diseases misdiagnosed as autoimmune encephalitis and potential reasons for misdiagnosis.Design, Setting, and ParticipantsThis retrospective multicenter study took place from January 1, 2014, to December 31, 2020, at autoimmune encephalitis subspecialty outpatient clinics including Mayo Clinic (n = 44), University of Oxford (n = 18), University of Texas Southwestern (n = 18), University of California, San Francisco (n = 17), Washington University in St Louis (n = 6), and University of Utah (n = 4). Inclusion criteria were adults (age ≥18 years) with a prior autoimmune encephalitis diagnosis at a participating center or other medical facility and a subsequent alternative diagnosis at a participating center. A total of 393 patients were referred with an autoimmune encephalitis diagnosis, and of those, 286 patients with true autoimmune encephalitis were excluded.Main Outcomes and MeasuresData were collected on clinical features, investigations, fulfillment of autoimmune encephalitis criteria, alternative diagnoses, potential contributors to misdiagnosis, and immunotherapy adverse reactions.ResultsA total of 107 patients were misdiagnosed with autoimmune encephalitis, and 77 (72%) did not fulfill diagnostic criteria for autoimmune encephalitis. The median (IQR) age was 48 (35.5-60.5) years and 65 (61%) were female. Correct diagnoses included functional neurologic disorder (27 [25%]), neurodegenerative disease (22 [20.5%]), primary psychiatric disease (19 [18%]), cognitive deficits from comorbidities (11 [10%]), cerebral neoplasm (10 [9.5%]), and other (18 [17%]). Onset was acute/subacute in 56 (52%) or insidious (>3 months) in 51 (48%). Magnetic resonance imaging of the brain was suggestive of encephalitis in 19 of 104 patients (18%) and cerebrospinal fluid (CSF) pleocytosis occurred in 16 of 84 patients (19%). Thyroid peroxidase antibodies were elevated in 24 of 62 patients (39%). Positive neural autoantibodies were more frequent in serum than CSF (48 of 105 [46%] vs 7 of 91 [8%]) and included 1 or more of GAD65 (n = 14), voltage-gated potassium channel complex (LGI1 and CASPR2 negative) (n = 10), N-methyl-d-aspartate receptor by cell-based assay only (n = 10; 6 negative in CSF), and other (n = 18). Adverse reactions from immunotherapies occurred in 17 of 84 patients (20%). Potential contributors to misdiagnosis included overinterpretation of positive serum antibodies (53 [50%]), misinterpretation of functional/psychiatric, or nonspecific cognitive dysfunction as encephalopathy (41 [38%]).Conclusions and RelevanceWhen evaluating for autoimmune encephalitis, a broad differential diagnosis should be considered and misdiagnosis occurs in many settings including at specialized centers. In this study, red flags suggesting alternative diagnoses included an insidious onset, positive nonspecific serum antibody, and failure to fulfill autoimmune encephalitis diagnostic criteria. Autoimmune encephalitis misdiagnosis leads to morbidity from unnecessary immunotherapies and delayed treatment of the correct diagnosis.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9bd3e8215dd86a9ca7d70b38a22539d7Test
https://doi.org/10.1001/jamaneurol.2022.4251Test
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