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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Brain Health Signature in Superagers: A Multimodal Brain MRI Study(2022) GODOY, Laiz de; STUDART-NETO, Adalberto; NITRINI, Ricardo; JAGER, Rolf; BISDAS, Sotirios; LEITE, Claudia da Costa- The Brain Metabolic Signature in Superagers Using In Vivo H-1-MRS: A Pilot Study(2021) GODOY, L. L. de; STUDART-NETO, A.; WYLEZINSKA-ARRIDGE, M.; TSUNEMI, M. H.; MORAES, N. C.; YASSUDA, M. S.; COUTINHO, A. M.; BUCHPIGUEL, C. A.; NITRINI, R.; BISDAS, S.; LEITE, C. da CostaBACKGROUND AND PURPOSE: Youthful memory performance in older adults may reflect an underlying resilience to the conventional pathways of aging. Subjects having this unusual characteristic have been recently termed ?superagers.? This study aimed to explore the significance of imaging biomarkers acquired by H-1-MRS to characterize superagers and to differentiate them from their normal-aging peers. MATERIALS AND METHODS: Fifty-five patients older than 80?years of age were screened using a detailed neuropsychological protocol, and 25 participants, comprising 12 superagers and 13 age-matched controls, were statistically analyzed. We used state-of-the-art 3T H-1-MR spectroscopy to quantify 18 neurochemicals in the posterior cingulate cortex of our subjects. All H-1-MR spectroscopy data were analyzed using LCModel. Results were further processed using 2 approaches to investigate the technique accuracy: 1) comparison of the average concentration of metabolites estimated with Cramer-Rao lower bounds?<20%; and 2) calculation and comparison of the weighted means of metabolites? concentrations. RESULTS: The main finding observed was a higher total N-acetyl aspartate concentration in superagers than in age-matched controls using both approaches (P =?.02 and P =?.03 for the weighted means), reflecting a positive association of total N-acetyl aspartate with higher cognitive performance. CONCLUSIONS: H-1-MR spectroscopy emerges as a promising technique to unravel neurochemical mechanisms related to cognitive aging in vivo and providing a brain metabolic signature in superagers. This may contribute to monitoring future interventional therapies to avoid or postpone the pathologic processes of aging.
- Understanding brain resilience in superagers: a systematic review(2021) GODOY, Laiz Laura de; ALVES, Cesar Augusto Pinheiro Ferreira; SAAVEDRA, Juan Sebastian Martin; STUDART-NETO, Adalberto; NITRINI, Ricardo; LEITE, Claudia da Costa; BISDAS, SotiriosPurpose Superagers are older adults presenting excellent memory performance that may reflect resilience to the conventional pathways of aging. Our contribution aims to shape the evidence body of the known distinctive biomarkers of superagers and their connections with the Brain and Cognitive Reserve and Brain Maintenance concepts. Methods We performed a systematic literature search in PubMed and ScienceDirect with no limit on publication date for studies that evaluated potential biomarkers in superagers classified by validated neuropsychological tests. Methodological quality was assessed using the QUADAS-2 tool. Results Twenty-one studies were included, the majority in neuroimaging, followed by histological, genetic, cognition, and a single one on blood plasma analysis. Superagers exhibited specific regions of cortical preservation, rather than global cortical maintenance, standing out the anterior cingulate and hippocampus regions. Both superagers and controls showed similar levels of amyloid deposition. Moreover, the functional oscillation patterns in superagers resembled those described in young adults. Most of the quality assessment for the included studies showed medium risks of bias. Conclusion This systematic review supports selective cortical preservation in superagers, comprehending regions of the default mode, and salience networks, overlapped by stronger functional connectivity. In this context, the anterior cingulate cortex is highlighted as an imaging and histologic signature of these subjects. Besides, the biomarkers included pointed out that the Brain and Cognitive Reserve and Brain Maintenance concepts are independent and complementary in the superagers' setting.
- Phenotyping Superagers Using Resting-State fMRI(2023) GODOY, L. L. de; STUDART-NETO, A.; PAULA, D. R. de; GREEN, N.; HALDER, A.; ARANTES, P.; CHAIM, K. T.; MORAES, N. C.; YASSUDA, M. S.; NITRINI, R.; DRESLER, M.; LEITE, C. da Costa; PANOVSKA-GRIFFITHS, J.; SODDU, A.; BISDAS, S.BACKGROUND AND PURPOSE: Superagers are defined as older adults with episodic memory performance similar or superior to that in middle-aged adults. This study aimed to investigate the key differences in discriminative networks and their main nodes between superagers and cognitively average elderly controls. In addition, we sought to explore differences in sensitivity in detecting these functional activities across the networks at 3T and 7T MR imaging fields. MATERIALS AND METHODS: Fifty-five subjects 80 years of age or older were screened using a detailed neuropsychological protocol, and 31 participants, comprising 14 superagers and 17 cognitively average elderly controls, were included for analysis. Participants underwent resting-state-fMRI at 3T and 7T MR imaging. A prediction classification algorithm using a penalized regression model on the measurements of the network was used to calculate the probabilities of a healthy older adult being a superager. Additionally, ORs quantified the influence of each node across preselected networks. RESULTS: The key networks that differentiated superagers and elderly controls were the default mode, salience, and language networks. The most discriminative nodes (ORs > 1) in superagers encompassed areas in the precuneus posterior cingulate cortex, prefrontal cortex, temporoparietal junction, temporal pole, extrastriate superior cortex, and insula. The prediction classification model for being a superager showed better performance using the 7T compared with 3T resting-state-fMRI data set. CONCLUSIONS: Our findings suggest that the functional connectivity in the default mode, salience, and language networks can provide potential imaging biomarkers for predicting superagers. The 7T field holds promise for the most appropriate study setting to accurately detect the functional connectivity patterns in superagers.