Eileen F. Tallman

Perceived Cognitive Function in Breast Cancer Survivors: Evaluating Relationships With Objective Cognitive Performance and Other Symptoms Using the Functional Assessment of Cancer Therapy—Cognitive Function Instrument

CONTEXT Perceived cognitive impairment (PCI) has been shown to be one of the most common symptoms after breast cancer treatment. However, this symptom does not always correlate with objective cognitive performance and is often highly associated with other patient-reported symptoms. OBJECTIVES Using a sample of breast cancer survivors (BCS), this study examined relationships among the Functional Assessment of Cancer Therapy-Cognitive (FACT-Cog) scale, a self-report questionnaire that measures PCI; impact on quality of life (QoL); comments from others (other); perceived cognitive ability (PCA); objective cognitive performance on tests of verbal memory, speed of processing, and executive functioning; and other symptoms (fatigue, depression, anxiety, and sleep disturbance). METHODS The BCS who were aged 40 years or older and at least one year post-chemotherapy treatment were enrolled. Participants completed questionnaires and a brief neuropsychological assessment. RESULTS A total of 88 BCS who were on average 56.7 (SD 8.5) years old and 5.3 (SD 4.1) years post-treatment participated; 94% reported clinically significant PCI. The PCI was significantly correlated with some objective measures of immediate and delayed verbal memory and executive function, whereas PCA was associated with all these measures. The PCI and PCA were both significantly associated with depressive symptoms, fatigue, and anxiety, but only PCI was related to poor global sleep quality. CONCLUSION The PCA was highly correlated with objective neuropsychological performance and may be clinically useful in identifying problems with verbal memory and executive functioning in BCS.

GWAS of longitudinal amyloid accumulation on 18F-florbetapir PET in Alzheimer’s disease implicates microglial activation gene IL1RAP

Brain amyloid deposition is thought to be a seminal event in Alzheimers disease. To identify genes influencing Alzheimers disease pathogenesis, we performed a genome-wide association study of longitudinal change in brain amyloid burden measured by (18)F-florbetapir PET. A novel association with higher rates of amyloid accumulation independent from APOE (apolipoprotein E) ε4 status was identified in IL1RAP (interleukin-1 receptor accessory protein; rs12053868-G; P = 1.38 × 10(-9)) and was validated by deep sequencing. IL1RAP rs12053868-G carriers were more likely to progress from mild cognitive impairment to Alzheimers disease and exhibited greater longitudinal temporal cortex atrophy on MRI. In independent cohorts rs12053868-G was associated with accelerated cognitive decline and lower cortical (11)C-PBR28 PET signal, a marker of microglial activation. These results suggest a crucial role of activated microglia in limiting amyloid accumulation and nominate the IL-1/IL1RAP pathway as a potential target for modulating this process.

Health-related quality of life of African American breast cancer survivors compared with healthy African American women

Background: The diagnosis and treatment of breast cancer can result in an array of late cancer-specific side effects and changes in general well-being. Research has focused on white samples, limiting our understanding of the unique health-related quality of life outcomes of African American breast cancer survivors (BCSs). Even when African American BCSs have been targeted, research is limited by small samples and failure to include comparisons of peers without a history of breast cancer. Objective: The purpose of this study was to compare health-related quality of life of African American female BCSs with that of African American women with no history of breast cancer (control group). Methods: A total of 140 women (62 BCSs and 78 controls), 18 years or older and 2 to 10 years postdiagnosis, were recruited from a breast cancer clinic and cancer support groups. Participants provided informed consent and completed a 1-time survey based on the proximal-distal health-related quality of life model of Brenner et al (1995). Results: After adjusting for age, education, income, and body mass index, results show that African American BCSs experienced more fatigue (P = .001), worse hot flashes (P < .001), and worse sleep quality (P < .001) but more social support from their partner (P = .028) and more positive change (P = .001) compared with African American female controls. Conclusions: Our results suggest that African American female BCSs may experience unique health-related outcomes that transcend age, education, socioeconomic status, and body mass index. Implications for Practice: Findings suggest the importance of understanding the survivorship experience for particular racial and ethnic subgroups to proactively assess difficulties and plan interventions.

Strategies used and data obtained during treatment fidelity monitoring

Background:Treatment fidelity, also called intervention fidelity, is an important component of testing treatment efficacy. Although examples of strategies needed to address treatment fidelity have been provided in several published reports, data describing variations that might compromise efficacy testing have been omitted. Objectives:The aim of this study is to describe treatment fidelity monitoring strategies and data within the context of a nursing clinical trial. Methods:A three-group, randomized, controlled trial compared intervention (paced respiration) to attention control (fast, shallow breathing) to usual care for management of hot flashes and other menopausal symptoms. Data from both staff and participants were collected to assess treatment fidelity. Results:Staff measures for treatment delivery indicated good adherence to protocols. Participant ratings of expectancy and credibility were not statistically different between intervention and attention control; however, the attention control was significantly more acceptable (p < .05). Intervention participant data indicated good treatment receipt and enactment with mean breath rates at each time point falling within the target range. Practice log data for both intervention and attention control indicated lower adherence of once-daily rather than twice-daily practice. Discussion:Despite strengths in fidelity monitoring, some challenges were identified that have implications for other similar intervention studies.

Olfactory identification in subjective cognitive decline and mild cognitive impairment: Association with tau but not amyloid positron emission tomography

We investigated the association between olfactory identification and Alzheimers disease biomarkers, including amyloid, tau, and neurodegeneration.

Relationship of microglial activation measured by [11C]PBR28 PET, atrophy on MRI and plasma biomarkers in individuals with and at-risk for Alzheimer's disease

Score Name Description T-MSBL-FP Mixed L2/L1 RIDGE ADAS ADAS total score 0.683 6 0.076 0.663 6 0.068 0.681 6 0.063 MMSE MMSE score 0.678 6 0.030 0.671 6 0.037 0.681 6 0.042 RAVLT-Total Total score of the first 5 trials 0.592 6 0.070 0.554 6 0.062 0.561 6 0.057 RAVLT-T30 30 minute delay # of words recalled 0.534 6 0.079 0.480 6 0.073 0.492 6 0.071 RAVLT-Recog 30 minute delay recognition score 0.512 6 0.089 0.451 6 0.054 0.470 6 0.055 TRAILSA Trail making A score 0.471 6 0.070 0.446 6 0.069 0.466 6 0.068 TRAILSB Trail making B score 0.584 6 0.104 0.561 6 0.111 0.566 6 0.108 TRAILS(B-A) TRAILSB TRAILSA 0.511 6 0.126 0.467 6 0.126 0.477 6 0.123 Alzheimer’s Imaging Consortium Poster Presentations: IC-P P63

Building a surface atlas of hippocampal subfields from high resolution T2-weighted MRI scans using landmark-free surface registration

The hippocampus is widely studied in neuroimaging field as it plays important roles in memory and learning. However, the critical subfield information is often not explored in most hippocampal studies. We previously proposed a method for hippocampal subfield morphometry by integrating FreeSurfer, FSL, and SPHARM tools. But this method had some limitations, including the analysis of T1-weighted MRI scans without detailed subfield information and hippocampal registration without using important subfield information. To bridge these gaps, in this work, we propose a new framework for building a surface atlas of hippocampal subfields from high resolution T2-weighted MRI scans by integrating state-of-the-art methods for automated segmentation of hippocampal subfields and landmark-free, subfield-aware registration of hippocampal surfaces. Our experimental results have shown the promise of the new framework.

SCENE-ENCODING ACTIVATION AND RESTING-STATE FUNCTIONAL CONNECTIVITY IN OLDER ADULTS WITH SUBJECTIVE COGNITIVE DECLINE AND MILD COGNITIVE IMPAIRMENT

orbital part of middle frontal gyrus and left fusiform. Similar altered pattern was found among aMCI patients. Furthermore, significant correlations between normalized amplitude index and the MMSE were found for all the identified brain regions except for orbital part of middle frontal gyrus (Figure 2). Conclusions: The present study provided robust impaired brain spontaneous activity patterns in AD based on multi-center rsfMRI data. A novel finding was the identification of the strong correlation between the identified brain regions and cognitive performances. This profile indicates the potential of spontaneous activity pattern in the resting state as biomarkers or predictors of disease progression in MCI/AD.

HIGH RED MEAT INTAKE IS ASSOCIATED WITH INCREASED TAU ON [18F]FLORTAUCIPIR PET AND POORER MEMORY

adherence defined as a total score>53), cognitive complaints using the ‘Cognitive change index’ self-report (CCI) and depressive symptoms using ‘Center for Epidemiologic Studies Depression Scale’ (CES-D). Using logistic regression analyses, we investigated whether adherence to dietary guidelines was associated with age, sex, education, BMI, MMSE, depressive symptoms or cognitive complaints. Results:90 (54%) of our subjects adhered to the Dutch dietary guidelines. The adhering and non-adhering groups differed at all dietary components, except for fibers (Figure 1). In the non-adherence group, dietary scores were lowest on the components trans fatty acids, saturated fat, salt and fish. Logistic regression analysis showed a relationship between male sex (OR and 95% CI: 0.364 [0.170-0.779]) and more depressive symptoms (CES-D; OR and 95% CI: 0.920 [0.865-0.979]) with less adherence to the dietary guidelines. We found no association between MMSE or cognitive complaints and adherence to dietary guidelines (Table 1). Conclusions: Almost half of the SCD subjects did not adhere to the dietary guidelines. Our findings suggest that the diet of SCD subjects offers room for improvement, mainly in fat, salt and fish consumption, and could be a target for programs aiming to improve brain health.

WHITE-MATTER MICROSTRUCTURE IN EARLY STAGE ALZHEIMER’S DISEASE

P3-396 WHITE-MATTER MICROSTRUCTURE IN EARLY STAGE ALZHEIMER’S DISEASE Qiuting Wen, Sourajit Mitra Mustafi, Jaroslaw Harezlak, Junjie Li, Shannon L. Risacher, John D. West, Eileen F. Tallman, Martin R. Farlow, Fred W. Unverzagt, Liana G. Apostolova, Andrew J. Saykin, Yu-Chien Wu, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Alzheimer Disease Center, Indianapolis, IN, USA; School of Public Health, Indiana University, Bloomington, IN, USA; Indiana University, Indianapolis, IN, USA. Contact e-mail: wenq@iu.edu