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Exercise Engagement as a Moderator of the Effects of APOE Genotype on Amyloid Deposition [Original Contribution]
Head, D., Bugg, J. M., Goate, A. M., Fagan, A. M., Mintun, M. A., Benzinger, T., Holtzman, D. M., Morris, J. C. Mon, 09 Jan 2012 12:41:03 -0800
Objective APOE 4 status has been associated with greater cortical amyloid deposition, whereas exercise has been associated with less in cognitively normal adults. The primary objective here was to examine whether physical exercise moderates the association between APOE genotype and amyloid deposition in cognitively normal adults. Design APOE genotyping data and answers to a questionnaire on physical exercise engagement over the last decade were obtained in conjunction with cerebrospinal fluid (CSF) samples and amyloid imaging with carbon 11–labeled Pittsburgh Compound B ([11C]PiB) positron emission tomography. Participants were classified as either low or high exercisers based on exercise guidelines of the American Heart Association. Setting Knight Alzheimer's Disease Research Center at Washington University, St Louis, Missouri. Participants A total of 201 cognitively normal adults (135 of whom were women) aged 45 to 88 years were recruited from the Knight Alzheimer’s Disease Research Center. Samples of CSF were collected from 165 participants. Amyloid imaging was performed for 163 participants. Results APOE 4 carriers evidenced higher [11C]PiB binding (P < .001) and lower CSF Aβ42 levels (P < .001) than did noncarriers. Our previous findings of higher [11C]PiB binding (P = .005) and lower CSF Aβ42 levels (P = .009) in more sedentary individuals were replicated. Most importantly, we observed a novel interaction between APOE status and exercise engagement for [11C]PiB binding (P = .008) such that a more sedentary lifestyle was significantly associated with higher [11C]PiB binding for 4 carriers (P = .013) but not for noncarriers (P = .20). All findings remained significant after controlling for age; sex; educational level; body mass index; the presence or history of hypertension, diabetes mellitus, heart problems, or depression; and the interval between assessments. Conclusion Collectively, these results suggest that cognitively normal sedentary APOE 4–positive individuals may be at augmented risk for cerebral amyloid deposition.
A Unique Manifestation of Pupillary Fatigue in Autoimmune Autonomic Ganglionopathy [Observation]
Muppidi, S., Scribner, M., Gibbons, C. H., Adams-Huet, B., Spaeth, E. B., Vernino, S. Mon, 09 Jan 2012 12:40:46 -0800
Objective To demonstrate a unique abnormality of the pupillary light reflex in patients with autoimmune autonomic ganglionopathy (AAG). Design Case series. Setting Autonomic clinics at 2 university hospitals (University of Texas Southwestern Medical Center and Beth Israel Deaconess Medical Center). Participants Seven patients with antibody-positive AAG. Interventions All patients with AAG underwent either monocular or binocular infrared pupillometry using a standard 2-second light stimulus at a defined intensity. Findings were compared with those from healthy control subjects and patients with other autonomic disorders. The light stimulus used in this study was selected to eliminate the normal phenomenon of pupil escape. Main Outcome Measures The time to onset of redilation as well as other indices of pupillary constriction to light stimulus. Results Patients with AAG exhibited premature pupillary redilation (mean [SD], 1.02 [0.20] seconds) compared with healthy control subjects (mean [SD], 2.24 [0.10] seconds) and other patients with autonom
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Exercise Engagement as a Moderator of the Effects of APOE Genotype on Amyloid Deposition [Original Contribution]
Head, D., Bugg, J. M., Goate, A. M., Fagan, A. M., Mintun, M. A., Benzinger, T., Holtzman, D. M., Morris, J. C. Mon, 09 Jan 2012 12:41:03 -0800
Objective APOE 4 status has been associated with greater cortical amyloid deposition, whereas exercise has been associated with less in cognitively normal adults. The primary objective here was to examine whether physical exercise moderates the association between APOE genotype and amyloid deposition in cognitively normal adults. Design APOE genotyping data and answers to a questionnaire on physical exercise engagement over the last decade were obtained in conjunction with cerebrospinal fluid (CSF) samples and amyloid imaging with carbon 11–labeled Pittsburgh Compound B ([11C]PiB) positron emission tomography. Participants were classified as either low or high exercisers based on exercise guidelines of the American Heart Association. Setting Knight Alzheimer's Disease Research Center at Washington University, St Louis, Missouri. Participants A total of 201 cognitively normal adults (135 of whom were women) aged 45 to 88 years were recruited from the Knight Alzheimer’s Disease Research Center. Samples of CSF were collected from 165 participants. Amyloid imaging was performed for 163 participants. Results APOE 4 carriers evidenced higher [11C]PiB binding (P < .001) and lower CSF Aβ42 levels (P < .001) than did noncarriers. Our previous findings of higher [11C]PiB binding (P = .005) and lower CSF Aβ42 levels (P = .009) in more sedentary individuals were replicated. Most importantly, we observed a novel interaction between APOE status and exercise engagement for [11C]PiB binding (P = .008) such that a more sedentary lifestyle was significantly associated with higher [11C]PiB binding for 4 carriers (P = .013) but not for noncarriers (P = .20). All findings remained significant after controlling for age; sex; educational level; body mass index; the presence or history of hypertension, diabetes mellitus, heart problems, or depression; and the interval between assessments. Conclusion Collectively, these results suggest that cognitively normal sedentary APOE 4–positive individuals may be at augmented risk for cerebral amyloid deposition.
A Unique Manifestation of Pupillary Fatigue in Autoimmune Autonomic Ganglionopathy [Observation]
Muppidi, S., Scribner, M., Gibbons, C. H., Adams-Huet, B., Spaeth, E. B., Vernino, S. Mon, 09 Jan 2012 12:40:46 -0800
Objective To demonstrate a unique abnormality of the pupillary light reflex in patients with autoimmune autonomic ganglionopathy (AAG). Design Case series. Setting Autonomic clinics at 2 university hospitals (University of Texas Southwestern Medical Center and Beth Israel Deaconess Medical Center). Participants Seven patients with antibody-positive AAG. Interventions All patients with AAG underwent either monocular or binocular infrared pupillometry using a standard 2-second light stimulus at a defined intensity. Findings were compared with those from healthy control subjects and patients with other autonomic disorders. The light stimulus used in this study was selected to eliminate the normal phenomenon of pupil escape. Main Outcome Measures The time to onset of redilation as well as other indices of pupillary constriction to light stimulus. Results Patients with AAG exhibited premature pupillary redilation (mean [SD], 1.02 [0.20] seconds) compared with healthy control subjects (mean [SD], 2.24 [0.10] seconds) and other patients with autonom
Sites:
Family Practice Notebook: Neurology: Covers Autonomic, Cerebellum, Chorea, Cranial Nerve, Cognitive, CSF, Demyelinating, Disability, Examination, Headache, Level of Consciousness, Motor, Procedure, Seizure, Sensory, Symptom Evaluation and Tremor. Related chapters from other specialties include Cardiovascular, Dermatology, Ophthalmo...Foundation for Education and Research in Neurological Emergencies: Information about this non-profit organization for improving the care of Emergency Department patients with neurological emergencies. Offers free educational courses and sponsors research for Emergency Physicians.
General Practice Notebook - Neurology: Coverage of this medical specialty.
HowStuffWorks: How Your Brain Works: Every animal you can think of -- mammals, birds, reptiles, fish, amphibians -- all have brains. But the human brain is unique. It gives us the power to think, plan, speak, imagine... Find out all about this amazing organ.
Institute for Nerve Medicine: Presenting information on disorders of the cranial, spinal and peripheral nerves. Includes illustrated descriptions of treatment options.
Iowa Neuroradiology Library: Department of Neurology, University of Iowa Hospitals and Clinics. Radiology teaching file.
National Institute of Neurological Disorders and Stroke: An NIH site with research and clinical information on disorders of the brain and nervous system.
Neuroconsult: Information resource on Clinical Neurology. Covering areas such as alzheimers, epilepsy, migraine, motor neurone, multiple sclerosis, pain, parkinsons, schizophrenia, and stroke.
NeuroExam.com: neuroexam.com is an interactive online guide to the neurologic examination, with video demonstrations. It is a companion to 'The NeuroExam Video' and 'Neuroanatomy Through Clinical Cases', both by Hal Blumenfeld
Neurological Teaching Videos: Digital video of the neurologic exam [Online registration, (free) required] by Wright State University.
Neurology Channel: NeurologyChannel is a comprehensive resource for seizures, stroke, coma, Alzheimer's, headaches, migraines, Parkinson's, and other brain and nervous system disorders. Features patient forum and neurologist search.
Neurology in Clinical Practice, 3e: An online professional neurology reference.
Neurology Jobs: Physician employment opportunities for all specialties in North America.
Neurology-Info.net: Information about the nervous system in health and disease. Part of the ALtruis Biomedical Network.
NeurologyLinx: Neurologist keep current with free medical news and daily newsletters. NeurologyLinx and MDLinx aggregates the most current medical journal news and research from premier medical and healthcare journals and news sources. Comprehensive, specialized content updated every day on the web and in email...
Neurosciences on the Internet: Neurosciences on the Internet contains a searchable and browsable index of neuroscience resources available on the World Wide Web and other parts of the Internet. Neurobiology, neurology, neurosurgery, psychiatry, psychology, cognitive science sites and information on human neurological diseases...
Oregon Nerve Center: The Oregon Nerve Center is a leading center for research in the field of neurology.
