Na Young Han

Association between memory impairment and brain metabolite concentrations in North Korean refugees with posttraumatic stress disorder

Individuals with posttraumatic stress disorder (PTSD) had experiences of enormous psychological stress that can result in neurocognitive and neurochemical changes. To date, the causal relationship between them remains unclear. The present study is to investigate the association between neurocognitive characteristics and neural metabolite concentrations in North Korean refugees with PTSD. A total of 53 North Korean refugees with or without PTSD underwent neurocognitive function tests. For neural metabolite scanning, magnetic resonance spectroscopy of the hippocampus and anterior cingulate cortex (ACC) has been conducted. We assessed between-group differences in neurocognitive test scores and metabolite levels. Additionally, a multiple regression analysis was carried out to evaluate the association between neurocognitive function and metabolite levels in patients with PTSD. Memory function, but not other neurocognitive functions, was significantly lower in the PTSD group compared with the non-PTSD group. Hippocampal N-acetylaspartate (NAA) levels were not different between groups; however, NAA levels were significantly lower in the ACC of the PTSD group than the non-PTSD group (t = 2.424, p = 0.019). The multiple regression analysis showed a negative association between hippocampal NAA levels and delayed recall score on the auditory verbal learning test (β = -1.744, p = 0.011) in the non-PTSD group, but not in the PTSD group. We identified specific memory impairment and the role of NAA levels in PTSD. Our findings suggest that hippocampal NAA has a protective role in memory impairment and development of PTSD after exposure to traumatic events.

SLEEP QUALITY IN YOUNG AND MIDDLE AGE-PERIOD IS ASSOCIATED WITH CEREBRAL AMYLOID BURDEN IN COGNITIVELY NORMAL ELDERLY PEOPLE

trate the regions of significance. Results:The association between baseline levels of cognition and inflammation was greater in the Tg than Wt rats in the right nucleus accumbens, whereas in the opposite was seen in the right inferior colliculus. The association between baseline levels of inflammation and change in cognition at follow-up, several regions including the left retrosplenial cortex, right hippocampus, and the right posterior commissure showed higher decrease in cognition of the Tg animals compared to the Wt (Figure 1). Conclusions:At baseline, there is no association between neuroinflammation and cognitive performance; however in more aged rats, baseline levels of PBR is able to predict cognitive decline. The results provide a framework that could potentially be applied in human studies focusing on the detrimental roles of neuroinflammation in AD.

ASSOCIATION OF SERUM THYROID HORMONE WITH CEREBRAL AMYLOID DEPOSITION AND REGIONAL CEREBRAL GLUCOSE METABOLISM IN COGNITIVELY NORMAL, CLINICALLY EUTHYROID ELDERLY INDIVIDUALS

Hyo Jung Choi, Min Soo Byun, Dahyun Yi, Hyewon Baek, Jun Ho Lee, Hyun Jung Kim, Young Min Choe, Bo Kyung Sohn, Jee Wook Kim, Younghwa Lee, Hyunwoong Ko, Na Young Han, Seung Hoon Lee, Kang Ko, Jong Inn Woo, Dong Young Lee, Seoul National University Hospital, Seoul, The Republic of Korea; 2 Medical Research Center Seoul National University, Seoul, The Republic of Korea; Ulsan University Hospital, Ulsan, The Republic of Korea; SMG-SNU Boramae Medical Center, Seoul, South Korea; 5 Hallym University Dongtan Sacred Hospital, Seoul, The Republic of Korea. Contact e-mail: jung830313@hanmail.net

Do Patients Want to Listen to a Diagnosis of Dementia in Korea? Preferences on Disclosing a Diagnosis of Dementia and Discussing Advance Care Planning in Elderly Patients with Memory Concerns and Their Families

Objective In this study, we aimed to investigate preferences regarding the disclosure of a dementia diagnosis and advance care planning (ACP) in patients with memory complaints and their families. Methods A total of 98 patients who visited the department of psychiatry at a tertiary hospital with memory complaints and 62 family members completed a structured questionnaire. The questionnaire included preferences on disclosure of dementia and cancer diagnosis, awareness and preferences on ACP. Results In total, 96.9% of patients were willing to know their dementia diagnosis. There were no significant differences in preferences between the diagnosis of cancer and dementia. Only 24.7% of patients and 45.8% of family members have heard of ACP. However, 82.8% of patients agreed on the necessity of ACP under the current condition. Multivariate analysis revealed that younger patients were more likely to agree with necessity for ACP under the current condition. Conclusion In Korea, patients with memory complaints and their family members strongly favored a disclosure of dementia diagnosis. The majority of participants also agreed on the necessity of ACP. More active involvement of patients is needed in treatment decisions and care planning in cases of dementia as well as other life-threatening illnesses.

HIGH SOCIAL SUPPORTS RELATE WITH LOW IN VIVO ALZHEIMER'S DISEASE PATHOLOGIES IN COGNITIVELY NORMAL ELDERLY INDIVIDUALS

mecamylamine, a combination of 2.5 mg/kg scopolamine and 10 mg mecamylamine, or placebo. Working memory performance was assessed during fMRI and cholinergic challenge using the N-Back Task (NBT). Results:After E2 treatment women without SCD showed a greater increase in frontal activity during theNBT (3-back> 0-back) than women without SCD (p1⁄4 0.01, k1⁄4 200, pcorr1⁄4 0.05). During mecamylamine challenge therewas a significant three-way interaction between SCD status, E2 treatment, and task condition (F(3,480) 1⁄4 2.71, p < 0.05). Women without SCD who received E2 treatment had better 3-back performance during mecamylamine challenge than women who did not receive estradiol (t (16) 1⁄4 2.45, p<0.05: E2 d’ mean 1⁄4 2.41 SD 1⁄4 0.49; no E2 d’ mean 1⁄4 1.82, SD 1⁄4 0.53). Women with SCD who received E2 treatment had worse 3-back performance than women who did not receive E2 treatment (t (16) 1⁄4 -3.68, p<0.05: E2 d’ mean 1⁄4 2.13, SD 1⁄4 0.14; no E2 d’ mean 1⁄4 2.72, SD 1⁄4 0.14). Conclusions: In women without SCD, E2 ameliorated the effects of cholinergic blockade on memory performance. This was not seen in the SCD group. The imaging results further support E2 salutary effects on cholinergic system functioning in normal postmenopausal women but not in womenwith SCD. Postmenopausal SCDmay be amarker of cholinergic vulnerability or E2 unresponsiveness which reduces the cognitive effect of E2.

VOXEL-WISE ANALYSIS OF THE ASSOCIATION BETWEEN FASTING BLOOD INSULIN AND CEREBRAL GLUCOSE METABOLISM IN NONDIABETIC, COGNITIVELY NORMAL ELDERLY INDIVIDUALS

Results:The mean ventricular and sulcal CSF volumes were 31615ml and 276643ml, respectively. The VS ratio was 0.1160.05. Pearson correlation coefficients between the natural log-transformed VS ratio and total brain volume, intracranial volume, brain parenchymal fraction, log-deep WMH, log-periventricular WMH, and age were 0.02 (p1⁄40.52), 0.18, -0.40, 0.21, 0.33, and 0.35, respectively (p-values <0.0001). The VS ratio increased with older age (p<0.0001) independent of sex, total WMH, and ICV. It was also significantly associated with poorer memory performance (b of Z-score1⁄4-1.29; 95% CI -2.41 to -0.17) and poorer executive functioning (b of Z-score1⁄4-1.72; 95% CI -2.78 to -0.67), adjusted for age, sex, log-WMH, and ICV. Conclusions:In this population, a disproportionate increase in ventricular volume relative to sulcal CSF is associated with older age and with poorer memory and executive functioning. Future studies should investigate to what extent this is a biomarker of accelerated cognitive aging.

ASSOCIATION OF HYPERTENSION WITH IN VIVO ALZHEIMER’S DISEASE PATHOLOGIES IN COGNITIVELY NORMAL, MCI AND DEMENTIA INDIVIDUALS

Note : Data Independen CN : Cognit Dementia Rati IN VIVO ALZHEIMER’S DISEASE PATHOLOGIES IN COGNITIVELY NORMAL, MCI AND DEMENTIA INDIVIDUALS So Yeon Jeon, Min Soo Byun, Dahyun Lee, Jun Ho Lee, Young Min Choe, Kang Ko, Seung Hoon Lee, Na Young Han, jee Wook Kim, Bo Kyung Sohn, Jun Young Lee, Dong Young Lee, Seoul National University Hospital, Seoul, Republic of South Korea; Medical Research Center Seoul National University, Seoul, Republic of South Korea; Ulsan University Hospital, Ulsan, Republic of South Korea; Hallym University Dongtan Sacred Hospital, Seoul, Republic of South Korea; SMG-SNU Boramae Medical Center, Seoul, Republic of South Korea; Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of South Korea. Contact e-mail: iris870422@gmail.com

RELATIONSHIP BETWEEN LIFETIME SLEEP EXPERIENCE AND IN VIVO ALZHEIMER’S DISEASE PATHOLOGIES IN COGNITIVELY NORMAL ELDERLY INDIVIDUALS

Dependent variable: beta amyloid positivity 20-39y 0.536 (0.125-2.306) 0.403 1.373 (0.913-2.063) 0.128 40-59y 0.216 (0.067-0.691) 0.010 1.170 (0.804-1.703) 0.412 Recent 0.238 (0.066-0.865) 0.029 0.905 (0.665-1.233) 0.528 Dependent variable: neurodegeneration positivity 20-39y 0.758 (0.224-2.568) 0.656 0.831(0.630-1.097) 0.191 40-59y 0.544 (0.191-1.547) 0.254 0.717(0.545-0.944) 0.018 Recent 1.626 (0.548-4.823) 0.381 0.931(0.735-1.179) 0.551

ASSOCIATION OF SOCIABILITY WITH HIPPOCAMPAL VOLUME IN COGNITIVELY NORMAL MIDDLE- AND OLD-AGED ADULTS

ApoE4 positive. SUVR range was 0.82-1.41 (see Figure). At a cutoff for cortical grey matter SUVR1⁄41.078, 43/240 (17.9%, 95% CI1⁄413-23%) were amyloid positive. Excluding individuals with dementia/neurological/psychiatric disease (n1⁄429), 38/211 (18.0%, 95%CI1⁄413-23%) were amyloid positive. ApoE4 positivity (OR1⁄45.1, 95%CI 2.5-11) was a major risk for amyloid positivity; childhood and midlife cognition were not. Conclusions: In this preliminary analysis the prevalence of amyloid positivity in this population based sample was w18%, slightly lower but not significantly different to that reported in a large meta-analysis of (often self-selected) healthy 70-year-olds (mean 23.1%, 95% CI1⁄419.5-27.2). Further analysis of these data will inform the design of population based approaches to disease prevention.

DIFFERENTIAL ASSOCIATION OF BLOOD INSULIN AND HBA1C WITH CEREBRAL AMYLOID DEPOSITION AND REGIONAL GLUCOSE METABOLISM IN MIDDLE- AND OLD-AGED ADULTS

typical YCN (n1⁄434) and AD (n1⁄445) subjects using data from the Global Alzheimer’s Association Interactive Network (GAAIN). The second step was to employ linear regression to convert florbetapir and PiB SUVr to the Centiloid scale. Results:Replicate analysis of GAAIN PiB data resulted in mean SUVr for YCN (n1⁄434) of 1.00460.048 and AD (n1⁄445) of 2.06760.204 (R 0.997, slope 0.996, intercept -0.002). Our independent study showed that SUVr values (n1⁄446) for florbetapir and PiB were correlated (R 1⁄4 0.900). The regression equating florbetapir SUVr by the Joshi et al method to PiB SUVr by the Klunk et al method was y 1⁄4 0.514x + 0.451 and appeared to support a linear relationship between the two tracers (Figure 1). The average YCN SUVr for florbetapir (0.9860.07) and PiB (1.0160.03), were converted to 1.51612.06 and 0.3262.61 Centiloids, respectively. 74 YCN florbetapir scans from a previous study (Clark et al, 2011), with average SUVr of 0.9660.04 were converted to Centiloids using the same regression equations yielding an average of -1.6067.59 Centiloids. Applied to the same study, a threshold of approximately 22 Centiloids, 3 SD above the young controls, was optimal for distinguishing cases with neuropathologically verified no/sparse vs moderate to frequent plaques. Conclusions:These findings provide for conversion of florbetapir SUVr to Centiloids, potentially allowing improved tracer independent amyloid quantitation.