Biomedical subjects

G W Small

Publications and source records attributed to G W Small.

At least 55 records · Page 3Linked to original sources

PubMed1998

Genetic algorithm-based wavelength selection for the near-infrared determination of glucose in biological matrixes: initialization strategies and effects of spectral resolution.

An improved genetic algorithm (GA)-based wavelength selection procedure is developed to optimize both the near-infrared wavelengths used and the number of latent variables employed in building partial least-squares (PLS) calibration models. This GA-based wavelength selection algorithm is applied to the determination of glucose in two different biological matrixes. With random selection of a small number of initial wavelengths, a dramatic reduction in the number of wavelengths required for building the PLS calibration models is observed. The fitness function used to guide the GA, the method of recombination used, and the effect of spectral resolution on the wavelength selection are also studied. In the resolution study, the original data with a point spacing of 2 cm-1 are deresolved to 4-, 8-, and 16-cm-1 point spacings by truncating the collected interferograms before applying the Fourier processing step. The use of lower resolution spectra is found to reduce further the number of final wavelengths selected by the GA, and the performance of the optimal calibration models obtained with the original spectra is maintained with the lower resolution spectra of both 4- and 8-cm-1 point spacing. Degradation in performance is observed with the spectra computed with a point spacing of 16 cm-1, however.

Algorithms↗

PubMed1998

Phantom glucose calibration models from simulated noninvasive human near-infrared spectra.

The validity of published reports claiming to have successfully measured in vivo blood glucose from noninvasive near-infrared spectra collected in a time-dependent manner is challenged on the basis of results obtained from a phantom glucose spectral data set. An in vitro model is used to simulate noninvasive human near-IR spectra. The phantom glucose data set is created by purposely omitting glucose in these modeled samples. Glucose values are then assigned to successive phantom glucose spectra, and multivariate calibration models are generated for glucose based on partial-least squares regression. As expected, calibration models are incapable of predicting glucose values when the glucose assignments are made randomly. Apparently functional models are obtained, however, when glucose assignments are made in a nonrandom, time-dependent manner. Prediction errors from these nonrandom models are essentially identical to those published by other as evidence of successful noninvasive blood glucose measurements. Chance temporal correlations between assigned glucose concentrations and some uncontrolled experimental parameter are responsible for this apparent model functionality.

Calibration↗

PubMed1998

Treatment of Alzheimer's disease: current approaches and promising developments.

Alzheimer's disease (AD) is characterized by a gradual decline in 3 domains: cognition, behavior, and function. Ideally, an effective treatment would target all 3 types of impairment. However, available treatments for AD diminish only certain symptoms and cannot halt the dementing process. Most pharmacologic agents currently available or in development target a specific symptom cluster (e.g., cognitive loss), and are based on the known neurobiology of the disease (e.g., neurotransmitter deficit) or hypothesized antidementia approaches (e.g., anti-inflammation, antioxidation). Two currently available cholinesterase inhibitors improve memory and other aspects of cognition during short-term treatment. Additional cholinergic agents will soon become available. Other promising agents under study for cognitive enhancement or protection include vitamin E, selegiline, estrogen, and nonsteroidal anti-inflammatory drugs. As scientists uncover the basic pathogenetic mechanisms of AD, additional treatments will likely emerge. Therapies for behaviors associated with dementia (e.g., depression, agitation, anxiety) are sometimes effective. Choices of specific medications, including antidepressants, antipsychotics, and anxiolytics, depend on specific side-effect profiles. Psychotherapies aimed at enhancing cognition are ineffective for dementia but nonpharmacologic interventions may minimize depression and agitation and may improve quality of life.

Alzheimer Disease↗

PubMed1998

No genetic association between the LRP receptor and sporadic or late-onset familial Alzheimer disease.

The low-density lipoprotein receptor-related protein gene (LRP1) is often mentioned as a candidate gene for Alzheimer disease (AD) because of its role as a receptor for apolipoprotein E (apoE), a major genetic risk factor for late-onset familial and sporadic AD. A recent association study of a tetranucleotide repeat polymorphism located 5' to the LRP1 gene detected an increase in the 87 base pair allele in AD cases compared to unaffected controls. Additionally, an independent study involving a genomic screen for genes associated with late-onset AD identified a region as a possible location of a late-onset AD gene on chromosome 12p between D12S373 and D12S390, about 10 cM proximal to LRP1. We examined 144 late-onset multiplex AD families, 436 sporadic AD cases, and 240 controls and found no evidence of linkage or association of LRP1 and AD. Our data indicate that genetic variation of the LRP1 gene is not a major risk factor in the etiology of AD.

Age of Onset↗

PubMed1998

Cortical variability and asymmetry in normal aging and Alzheimer's disease.

The onset of Alzheimer's disease (AD) is accompanied by a complex and distributed pattern of neuroanatomic change, difficult to distinguish clinically from dynamic alterations in normal aging. Extreme variations in the sulcal patterns of the human cortex have made it difficult to identify diffuse and focal variations in cortical structure in neurodegenerative disease. We report the first comprehensive 3D statistical analysis of deep sulcal structure in vivo, in both normal aging and dementia. High-resolution 3D T1-weighted fast SPGR (spoiled GRASS) MRI volumes were acquired from 10 patients diagnosed with AD (NINCDS-ARDRA criteria; age: 71.9 +/- 10.7 years) and 10 normal subjects matched for age (72.9 +/- 5.6 years), gender, educational level and handedness. Scans were digitally transformed into Talairach stereotaxic space. To determine specific patterns of cortical variation in dementia patients, 3D average and probabilistic maps of primary deep sulci were developed for both normal and AD groups. Major sulci (including supracallosal, cingulate, marginal, parieto-occipital, anterior and posterior calcarine sulci, and Sylvian fissures) were modeled as complex systems of 3D surfaces using a multi-resolution parametric mesh approach. Variations and asymmetries in their extents, curvature, area and surface complexity were evaluated. Three-dimensional maps of anatomic variability, structural asymmetry and local atrophy indicated severe regionally selective fiber loss in AD. A midsagittal area loss of 24.5% at the corpus callosum's posterior midbody (P < 0.025) matched increases in structural variability in corresponding temporo-parietal projection areas. Confidence limits on 3D cortical variation, visualized in 3D, exhibited severe increases in AD from 2 to 4 mm at the callosum to a peak SD of 19.6 mm at the posterior left Sylvian fissure. Normal Sylvian fissure asymmetries (right higher than left; P < 0.0005), mapped for the first time in three dimensions, were accentuated in AD (P < 0.0002), and were greater in AD than in controls (P < 0.05). Severe AD-related increases in 3D variability and asymmetry may reflect disease-related disruption of the commissural system connecting bilateral temporal and parietal cortical zones, regions known to be at risk of early metabolic dysfunction, perfusion deficits and selective neuronal loss in AD.

Aged↗

PubMed1998

Differential diagnosis and early detection of dementia.

Of the many potential causes of dementia, Alzheimer's disease (AD) is the most common and accounts for approximately two-thirds of cases in older populations. Typical clinical features help differentiate various other conditions. Screening laboratory tests are generally sufficient for routine evaluations; brain imaging assessments also assist in the differential diagnosis by identifying structural and functional abnormalities. Because new treatments for AD are more likely to delay disease onset than to reverse neuronal damage, early detection methods have practical treatment implications. Recent studies combine genetic risk with neuroimaging assessments as a method of early disease detection; additional techniques aimed at increasing sensitivity and specificity are under development. Such strategies should eventually assist in the early detection of AD and therapeutic monitoring of brain function during antidementia treatments.

Adult↗

PubMed1998

Sulcal variability in the Alzheimer's brain: correlations with cognition.

We mapped the three dimensional (3D) extents and variability of selected sulci in the Alzheimer's brain and explored the relationship between sulcal pattern and patient's cognitive performance. High-resolution MRIs of 10 patients with probable Alzheimer's disease (AD) were linearly transformed into a standard "normalized" 3D atlas (known as the Talairach coordinate system) and, on each relevant slice, contours of the left and right Sylvian fissure, anterior and posterior calcarine, callosal, parietooccipital, and cingulate sulci and the floor of the temporal horn of the lateral ventricle were traced. These landmarks were chosen because of their relative invariant location across individuals and because they demarcate functional boundaries relevant in AD. The sulcal contours were resolved into two-dimensional surfaces that cut through a brain volume. All 10 patients' sulcal surfaces were averaged to determine their mean spatial locations in the Talairach coordinate system. The 3D spatial extents of each patient's sulci were compared with their disease severity based on neuropsychological performance. The 3D sulcal variability, within the "normalized" atlas space, ranged from 4.0 mm for the left callosal sulcus to 9.1 mm for the left Sylvian fissure. Significant correlations were found among the spatial extents for the posterior floor of the right temporal horn of the lateral ventricle (r = -0.89, p < 0.001 for vertical extent) and right anterior calcarine sulcus (r = -0.75, p < 0.01 for anterior-posterior extent) with copying ability of the Rey-Osterrieth Complex Figure; the right anterior calcarine also had a significant relationship (r = -0.72, p = 0.02 for anterior-posterior extent) with performance on the Block Design subtest from the Wechsler Adult Intelligence Scale-Revised. Verbal fluency performance measured by the Controlled Oral Word Association Test was significantly related to the left cingulate (r = 0.91, p < 0.001 for anterior-posterior extent, and r = -0.82, p < 0.01 for vertical extent) and right cingulate (r = -0.72, p < or = 0.02 for vertical extent) sulci. This exploratory study is the first to evaluate the relationship between 3D sulcal variability and cognition; our preliminary findings suggest that the 3D pattern of sulci in the AD brain is related to the severity of the disease as reflected by cognitive performance. In the Talairach brain atlas, sulcal variability, within an AD population, approaches 1 cm. This large variability requires correction when functional imaging data are transformed into the Talairach atlas space to "normalize" individual morphologic differences.

Aged↗

PubMed1998

The pathogenesis of Alzheimer's disease.

Despite consensus on clinical and neuropathologic definitions of Alzheimer's disease, limited information is available on its causes and pathogenesis. Current data suggest interactions among the various possible biological and environmental influences that result in a common pathway leading to the disease. Biological influences include genetic mutations causing the disease phenotype and polymorphisms contributing to disease risk. Alterations in immune or inflammatory responses may also represent biological influences. Various environmental influences that may interact with endogenous biological factors include education, traumatic injury, oxidative stress, drugs, and hormone replacement. The author describes some recent findings that suggest possible pathogenic mechanisms, which may eventually have important treatment implications.

Alzheimer Disease↗

PubMed1998

Neuroimaging for diagnosis of dementia.

Although many clinicians consider neuroimaging studies as optional for the differential diagnosis of dementia, clinical experience suggests that they can improve diagnostic accuracy. Data are limited, however, on sensitivity, specificity, and cost-effectiveness of various neuroimaging techniques. The author reviews advantages and disadvantages of neuroimaging techniques for the differential diagnosis of dementia and describes strategies used for early detection of Alzheimer's disease, including combining positron emission tomography scanning with genetic risk assessment. Such approaches could provide a means for in vivo therapeutic monitoring of brain function during experimental antidementia treatment trials.

Aged↗

PubMed1998

Treatment of geriatric depression.

The author reviews clinical issues regarding the treatment of late-life depression. Accurate diagnosis is complicated by the presence of medical illness, dementia syndromes, and heterogeneity of patient populations. Older depressed patients are often sensitive to drug toxicity resulting from age-related pharmacokinetic changes and polypharmacy. Thus, modification in the use of antidepressant drugs is needed to avoid side effects. Numerous antidepressant drugs are safe and efficacious in elderly depressed patients, and newer agents such as the selective serotonin reuptake inhibitors are often preferred over tricyclic antidepressants because of side effect profiles. Nonpharmacological approaches, alone and in combination with antidepressant drugs, are also useful, and maintenance treatments appear to reduce the likelihood of relapse.

Age Factors↗

PubMed1997

Mood state and cerebral metabolism in persons with age-associated memory impairment.

People undergoing medical procedures sometimes experience feelings that may influence the results. In this study, we explore the relationship between changes in mood state self-ratings and cerebral glucose metabolism during positron emission tomography (PET) in persons with age-associated memory impairment (mean age 59.4 +/- 9.8 years). Brain regions of interest involved in both mood and memory were examined. Mood ratings of increased boredom correlated significantly with mesial temporal and parietal asymmetry and decreased parietal metabolism. Mood ratings of increased fatigue correlated with basal ganglia asymmetry and the right basal ganglia and left mesial temporal metabolism. These findings suggest that subjective mood state changes during PET may influence metabolism in brain regions implicated in emotion and memory function in people with age-related memory complaints.

Adult↗

PubMed1997

Determination of glucose in a biological matrix by multivariate analysis of multiple band-pass-filtered Fourier transform near-infrared interferograms.

A multivariate calibration method is described in which Fourier transform near-infrared interferogram data are used to determine clinically relevant levels of glucose in an aqueous matrix of bovine serum albumin (BSA) and triacetin. BSA and triacetin are used to model the protein and triglycerides in blood, respectively, and are present in levels spanning the normal human physiological range. A full factorial experimental design is constructed for the data collection, with glucose at 10 levels, BSA at 4 levels, and triacetin at 4 levels. Gaussian-shaped band-pass digital filters are applied to the interferogram data to extract frequencies associated with an absorption band of interest. Separate filters of various widths are positioned on the glucose band at 4400 cm-1, the BSA band at 4606 cm-1, and the triacetin band at 4446 cm-1. Each filter is applied to the raw interferogram, producing one, two, or three filtered interferograms, depending on the number of filters used. Segments of these filtered interferograms are used together in a partial least-squares regression analysis to build glucose calibration models. The optimal calibration model is realized by use of separate segments of interferograms filtered with three filters centered on the glucose, BSA, and triacetin bands. Over the physiological range of 1-20 mM glucose, this 17-term model exhibits values of R2, standard error of calibration, and standard error of prediction of 98.85%, 0.631 mM, and 0.677 mM, respectively. These results are comparable to those obtained in a conventional analysis of spectral data. The interferogram-based method operates without the use of a separate background measurement and employs only a short section of the interferogram.

Animals↗

PubMed1997

Complete genomic screen in late-onset familial Alzheimer disease. Evidence for a new locus on chromosome 12.

CONTEXT: Four genetic loci have been identified as contributing to Alzheimer disease (AD), including the amyloid precursor protein gene, the presenilin 1 gene, the presenilin 2 gene, and the apolipoprotein E gene, but do not account for all the genetic risk for AD. OBJECTIVE: To identify additional genetic risk factors for late-onset AD. DESIGN: A complete genomic screen was performed (N=280 markers). Critical values for chromosomal regional follow-up were a P value of .05 or less for affected relative pair analysis or sibpair analysis, a parametric lod score of 1.0 or greater, or both. Regional follow-up included analysis of additional markers and a second data set. SETTING: Clinic populations in the continental United States. PATIENTS: From a series of multiplex families affected with late-onset (> or =60 years) AD ascertained during the last 14 years (National Insititute of Neurological Disorders and Stroke-Alzheimer's Disease and Related Disorders Association diagnostic criteria) and for which DNA has been obtained, a subset of 16 families (135 total family members, 52 of whom were patients with AD) was used for the genomic screen. A second subset of 38 families (216 total family members, 89 of whom were patients with AD) was used for the follow-up analysis. MAIN OUTCOME MEASURES: Linkage analysis results generated using both genetic model-dependent (lod score) and model-independent methods. RESULTS: Fifteen chromosomal regions warranted initial follow-up. Follow-up analyses revealed 4 regions of continued interest on chromosomes 4, 6, 12, and 20, with the strongest results observed forchromosome 12. Peak 2-point affecteds-only lod scores (n=54) were 1.3, 1.6, 2.7, and 2.2 and affected relative pairs P values (n=54) were .04, .03, .14, and .04 for D12S373, D12S1057, D12S1042, and D12S390, respectively. Sibpair analysis (n=54) resulted in maximum lod scores (MLSs) of 1.5, 2.6, 3.2, and 2.3 for these markers, with a peak multipoint MLS of 3.5. A priori stratification by APOE genotype identified 27 families that had at least 1 member with AD whose genotype did not contain an APOE*4 allele. Analysis of these 27 families resulted in MLSs of 1.0, 2.4, 3.7, and 3.3 and a peak multipoint MLS of 3.9. CONCLUSIONS: A complete genomic screen in families affected with late-onset AD identified 4 regions of interest after follow-up. Chromosome 12 gave the strongest and most consistent results with a peak multipoint MLS of 3.5, suggesting that this region contains a new susceptibility gene for AD. Additional analyses are necessary to identify the chromosome 12 susceptibility gene for AD and to follow up the regions of interest on chromosomes 4, 6, and 20.

Age of Onset↗

PubMed1997

D2 dopamine receptor A1 allele in Alzheimer disease and aging.

BACKGROUND: The apolipoprotein E4 (APOE*4) allele is a major risk factor for the common forms of late-onset Alzheimer disease (AD), but does not account for all the genetic variation in late-onset AD; hence, other genetic markers must be examined. The D2 dopamine receptor (DRD2) A1 allele is associated with abnormal brain function and decreased DRD2s. These receptors are decreased in hippocampus and amygdala in AD, and allele frequencies may vary with age. OBJECTIVE: To study APOE and DRD2 genotypes in patients with AD and cognitively intact controls of varying ages. DESIGN: The DRD2 and APOE genotypes were examined in 832 unrelated white subjects, including 554 patients with AD (486 sporadic; 68 familial) and 278 controls. Logistic regressions tested A1 allele effects on disease status and age, and DRD2 linkage with AD was investigated in 60 families with late-onset AD. SETTING: University medical centers. SUBJECTS: Patients (mean +/- SD age, 74.6 +/- 8.1 years; range, 52-98 years) had probable AD, according to standard consensus diagnostic criteria; controls (mean +/- SD age, 69.2 +/- 8.6 years; range, 50-93 years) were cognitively intact. MAIN OUTCOME MEASURES: Disease status, age, and DRD2 linkage with AD. RESULTS: No association between the DRD2 and APOE alleles was found, and the presence of the A1 allele did not increase the risk for AD. There was also no evidence of linkage between DRD2 and AD. Age analyses, including both patients and controls, indicated a decrease in A1 allele frequency with age. CONCLUSIONS: The A1 allele does not contribute to AD risk, alone or in combination with the APOE*4 allele. The DRD2 A1 allele frequencies decrease with age in both patients and controls. Thus, studies of DRD2 disease association need to control for age.

Aged↗

PubMed1997

No association or linkage between an intronic polymorphism of presenilin-1 and sporadic or late-onset familial Alzheimer disease.

Recent reports have shown an association between an intronic polymorphism of the presenilin-1 (PSEN1) gene and late-onset (age at onset > 65) familial and sporadic (no family history) Alzheimer disease (AD). The reported association was independent of the effect of the only previously identified gene associated with late-onset AD, APOE. Blood samples were obtained from members of 122 multiplex AD families, 42 unrelated cases of AD with positive family histories of dementia, 456 sporadic cases of AD, and 317 controls of similar ages at examination to the cases. These samples were genotyped for an intronic polymorphism of the PSEN1 gene, located 3' to exon 8, and the data analyzed for evidence of association or linkage. The samples were also genotyped for APOE and the data analyzed to see if the association or linkage changed when controlling for APOE genotype. There was no statistically significant increase (at alpha = .01) in allele 1 (199 bp) or genotype 1/1 in the sporadic AD cases, or in a random sample of one affected from each multiplex family, compared to controls. When examining the effect of the PSEN1 polymorphism while controlling for APOE genotype, APOE genotype was strongly associated with AD, but the PSEN1 polymorphism genotype was not. Model-trait dependent (lod score) and independent (Sim1BD) methods detected no evidence of linkage between PSEN1 and AD. In this independent dataset, the previously reported association between the intronic PSEN1 polymorphism and AD cannot be confirmed, and the conclusion that PSEN1 is a major susceptibility gene for late-onset AD is not supported.

Age of Onset↗

PubMed1997

Mapping histology to metabolism: coregistration of stained whole-brain sections to premortem PET in Alzheimer's disease.

The association between [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) counts obtained 8 h before death and neurofibrillary tangle (NFT) staining density in a patient with Alzheimer's disease (AD) was evaluated. In our patient FDG-PET counts were globally decreased with a greater focal deficit in the left medial temporal region independent of volume loss. After death, whole-brain sections derived from cryomacrotome sectioning were stained for NFTs by the Gallyas method and elastically warped into their native space enabling registration with premortem FDG-PET data. Gallyas staining density was localized to the paralimbic cortex of the basal forebrain, medial temporal, and orbital frontal regions. The poor correlation between NFT staining density and hypometabolism on FDG-PET implicates alternate mechanisms underlying the metabolic defect in AD.

Aged↗

PubMed1997

Characterization of an HL-60 cell variant resistant to the antineoplastic ether lipid 1-O-octadecyl-2-O-methyl-rac-glycero-3-phosphocholine.

A resistant cell line (HL-60R) was selected by incubating HL-60 cells with increasing concentrations of 1-O-octadecyl-2-O-methyl-rac-glycero-3-phosphocholine (ET-18-OCH3) and used to examine the mechanism of resistance to the antineoplastic ether-linked lipid. The HL-60R cells exhibited a > 10-fold increase in resistance when measured by [3H]-thymidine incorporation in comparison to the HL-60 cell line. ET-18-OCH3 binding occurred at 4 degrees C and was not saturable at the concentrations tested (1-100 microM), indicating that the binding was receptor-independent. At 4 degrees C, association of ET-18-OCH3 was low for each cell line. AT 37 degrees C, uptake in the HL-60 cells was approximately 5-fold greater in comparison to HL-60R cells at each concentration tested. However, when the cellular content of ET-18-OCH3 was equal, both cell lines experienced similar declines in cell growth. Cellular incorporation of ether lipid was determined using serum-free media and in the presence of serum albumin or lipoproteins. Reduced uptake by the resistant cell line was observed only in the presence of albumin. A greater proportion of ether lipid could be removed from prelabeled HL-60R cells than from HL-60 cells, by an albumin wash procedure, indicating an increased rate of internalization and retention by the sensitive cell line. ET-18-OCH3 uptake in the HL-60 cell line was also more sensitive to treatment with endocytic (chloroquine, monensin) or metabolic (NaF, KCN) inhibitors. These results suggest that uptake is the principal determinant influencing sensitivity of the resistant cell line and consists of receptor-independent binding followed by internalization. Differential uptake requires the presence of serum albumin and is dependent on the energy-dependent endocytosis of the ether lipid.

Antineoplastic Agents↗

PubMed1997

Mnemonics usage and cognitive decline in age-associated memory impairment.

To determine predictors of cognitive deterioration, the authors performed baseline and 1- to 5-year follow-up (mean +/- SD = 2.5 +/- 1.2 years) neuropsychological assessments on 36 persons (mean age +/- SD = 62.1 +/- 8.0; range = 50 to 81 years) with age-associated memory impairment. Subjects were recruited from a larger group of volunteers, had minimal medical comorbidity, and 25 of them had a family history of Alzheimer's disease. Baseline age and a subjective memory measure indicating reported frequency of mnemonics usage were significant decline predictors. Subjects reporting more frequent mnemonics use at baseline were more likely to show objective cognitive decline at follow-up. Baseline full-scale IQ, educational level, and family history of Alzheimer's disease failed to predict decline. These findings suggest that although age is the strongest decline predictor in some people with age-associated memory impairment, self-perception of memory function may also predict subsequent cognitive loss.

Abbreviations as Topic↗