Neurodegenerative

神经退行性
  • 文章类型: Journal Article
    亨廷顿病(HD)是常染色体显性遗传,进行性神经退行性疾病主要在成人衰弱。
    本研究旨在评估各种人口统计学因素的HD相关死亡率趋势。
    从1999年到2019年,对CDCWONDER的死亡证明进行了研究,研究了25岁以上成年人与HD相关的死亡率。每100,000人的年龄调整死亡率(AAMR)和年度百分比变化(APC)进行了计算和分层,年龄组,性别,种族/民族,state,人口普查地区,城市化,和死亡的地方。
    在1999年至2019年之间,由于HD,成年人中发生了22,595例死亡。在此期间,AAMR从0.43增加到0.54(APC=0.50;95%CI:0.18至0.84)。老年人(65-85岁以上)的整体AAMR最高,其次是中年人(45-64岁)和年轻人(25-44岁)(AAMR年龄:1.01vs.AAMR中年:0.68vs.AAMRyoung:0.16)。男性的整体AAMR比女性稍高(AAMR男性:0.54vs.AAMR女性:0.48)。当按种族分层时,非西班牙裔(NH)白人的死亡率明显高于NH非裔美国人(AAMRNHWhite:0.61vs.NH非洲裔美国人:0.35),而西班牙裔/拉丁裔的AAMR最低(0.28)。AAMR还显示出各地区的差异(总体AAMR:中西部:0.63,东北:0.47,西部:0.48,南部:0.46),非大都市地区与HD相关的AAMR(0.66)高于大都市地区(0.47)。
    自1999年以来,美国成年人与HD相关的死亡率有所增加。反思观察到的趋势变化,需要新的策略来优化长期护理设施的护理质量。
    UNASSIGNED: Huntington\'s disease (HD) is an autosomal dominant, progressive neurodegenerative disorder debilitating mainly in adults.
    UNASSIGNED: This study aimed to assess the trends in HD-related mortality regarding various demographic factors.
    UNASSIGNED: Death certificates from the CDC WONDER were studied from 1999 to 2019, for HD-related mortality in adults aged 25 + years. Age-adjusted Mortality Rate (AAMR) per 100,000 persons and Annual Percentage Change (APC) were calculated and stratified by year, age groups, gender, race/ethnicity, state, census region, urbanization, and place of death.
    UNASSIGNED: Between 1999 to 2019, 22,595 deaths occurred in adults due to HD. The AAMR increased from 0.43 to 0.54 during this period (APC = 0.50; 95% CI: 0.18 to 0.84). Old adults (65-85 + years) had the highest overall AAMR, followed by middle-aged adults (45-64 years) and young adults (25-44 years) (AAMR old: 1.01 vs. AAMR middle-age: 0.68 vs. AAMR young: 0.16). Men had slightly greater overall AAMRs than women (AAMR men: 0.54 vs. AAMR women: 0.48). When stratified by race, non-Hispanic (NH) Whites had significantly higher mortality rates than NH African Americans (AAMR NH White: 0.61 vs. NH African American: 0.35), while the AAMR were lowest in Hispanic/Latino (0.28). The AAMRs also showed variation by region (overall AAMR: Midwest: 0.63, Northeast: 0.47, West: 0.48, South: 0.46), and non-metropolitan areas had higher HD-related AAMR (0.66) than metropolitan areas (0.47).
    UNASSIGNED: HD-related mortality in US adults has increased since 1999. Reflecting on the variations in trends observed, new strategies are required to optimize the quality of care in long-term care facilities.
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  • 文章类型: Journal Article
    证据表明,神经退行性疾病和神经精神疾病受肠道微生物组改变的影响。各种疾病都与微生物群失调有关,然而,关于哪些微生物与每种疾病相关,尚无定论。我们研究的目的是系统地回顾过去十年的最新文献,以阐明肠道微生物组是否有助于理解神经退行性疾病的发病机制和进展。大多数纳入的研究表明,某些微生物的相对丰度之间存在很强的相关性,主要是厚壁门和拟杆菌,以及帕金森病(PD)和阿尔茨海默病(AD)等疾病。据推测,微生物及其副产物在脑蛋白积累中具有显著作用,神经炎症,和肠道通透性。微生物种群的估计可能会改善临床结果并阻碍疾病的进展。然而,需要进一步的研究包括更多的疾病和更大的患者样本,并确定与这些疾病相关的特定物种和亚种.
    Evidence shows that neurodegenerative and neuropsychiatric disorders are influenced by alterations in the gut microbiome. Various diseases have been linked to microbiome dysbiosis, yet there are inconclusive data regarding which microorganisms are associated with each disorder. The aim of our study is to systematically review the recent literature of the past decade to clarify whether the gut microbiome contributes to the understanding of pathogenesis and progression of neurodegenerative disorders. Most included studies showed a strong correlation between the relative abundance of certain microorganisms, mainly species of the phyla Firmicutes and Bacteroidetes, and disorders such as Parkinson\'s disease (PD) and Alzheimer\'s disease (AD). It is speculated that the microorganisms and their byproducts have a significant role in brain protein accumulation, neuro-inflammation, and gut permeability. The estimation of microbial populations could potentially improve clinical outcomes and hinder the progression of the disease. However, further research is needed to include more diseases and larger patient samples and identify specific species and subspecies associated with these disorders.
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  • 文章类型: Systematic Review
    背景:无标记运动捕捉(MMC)使用摄像机或深度传感器进行全身跟踪,并提出了一种有希望的方法,可以客观地监控社区环境中的功能表现,帮助临床决策神经退行性疾病,如痴呆。
    目的:本系统综述的主要目的是通过全身追踪研究MMC的应用,量化痴呆症患者的功能表现,轻度认知障碍,帕金森病。
    方法:对Embase的系统搜索,MEDLINE,CINAHL,和Scopus数据库在2022年11月至2023年2月之间进行,共产生1595个结果。纳入标准为MMC和全身追踪。共纳入157项研究进行全文筛选,其中符合筛选标准的26项符合条件的研究纳入审查..
    结果:主要是,选定的研究集中在步态分析(n=24),而其他功能任务,例如坐下来站立(n=5)和踩踏(n=1),也被探索过。然而,纳入的任何研究均未评估日常生活活动.MMC模型在研究中各不相同,包括深度相机(n=18)与标准摄像机(n=5)或移动电话相机(n=2),并使用深度学习模型进行后处理。然而,只有6项研究与已建立的黄金标准动作捕捉模型进行了严格的比较.
    结论:尽管它有潜力成为分析痴呆症患者运动和姿势的有效工具,轻度认知障碍,和帕金森病,需要进一步的研究来确定MMC在量化真实世界中的移动性和功能表现方面的临床应用价值.
    BACKGROUND: Markerless motion capture (MMC) uses video cameras or depth sensors for full body tracking and presents a promising approach for objectively and unobtrusively monitoring functional performance within community settings, to aid clinical decision-making in neurodegenerative diseases such as dementia.
    OBJECTIVE: The primary objective of this systematic review was to investigate the application of MMC using full-body tracking, to quantify functional performance in people with dementia, mild cognitive impairment, and Parkinson disease.
    METHODS: A systematic search of the Embase, MEDLINE, CINAHL, and Scopus databases was conducted between November 2022 and February 2023, which yielded a total of 1595 results. The inclusion criteria were MMC and full-body tracking. A total of 157 studies were included for full-text screening, out of which 26 eligible studies that met the selection criteria were included in the review. .
    RESULTS: Primarily, the selected studies focused on gait analysis (n=24), while other functional tasks, such as sit to stand (n=5) and stepping in place (n=1), were also explored. However, activities of daily living were not evaluated in any of the included studies. MMC models varied across the studies, encompassing depth cameras (n=18) versus standard video cameras (n=5) or mobile phone cameras (n=2) with postprocessing using deep learning models. However, only 6 studies conducted rigorous comparisons with established gold-standard motion capture models.
    CONCLUSIONS: Despite its potential as an effective tool for analyzing movement and posture in individuals with dementia, mild cognitive impairment, and Parkinson disease, further research is required to establish the clinical usefulness of MMC in quantifying mobility and functional performance in the real world.
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  • 文章类型: Journal Article
    本研究研究了富含生物碱的韦尔维奇氏菌叶提取物对链脲佐菌素诱导的2型糖尿病大鼠的神经保护能力。使用标准程序获得了富含生物碱的黄曲霉叶提取物。将链脲佐菌素以45mg/mg体重的剂量腹膜内注射到实验动物中。在此之前,给予动物20%(w/v)果糖一周。将动物分为五组(n=8),包括正常控制(NC),糖尿病控制(DC),用低剂量(50mg/mg体重)和高剂量(100mg/kg体重)的糖尿病大鼠治疗富含韦尔维奇生物碱的叶提取物(即,分别为DWL和DWH)和200mg/kg体重的二甲双胍(MET)。动物在第21天被处死,收集血液和脑组织,用于神经递质的测定,胆碱酯酶,一些ATP活动,氧化应激生物标志物和组织学检查。结果显示糖尿病大鼠置于DWL,DWH和MET显著(p<0.05)降低胆碱能,提高了一些ATP酶活性并改善了氧化应激生物标志物。组织学检查通过改善糖尿病大鼠的神经保护作用来支持这些研究,DWH和MET。因此,可以推测DWL和DWH在糖尿病神经退行性疾病的治疗中可能是有益的。
    The neuroprotective ability of alkaloid-rich leaf extract of Dalbergiella welwitschii in streptozotocin-induced type 2 diabetic rats were investigated in this study. Dalbergiella welwitshii leaf alkaloid-rich extract was obtained using standard procedure. Streptozotocin was injected into the experimental animals intraperitoneally at a dose of 45 mg/mg body weight. Prior to this, the animals were given 20% (w/v) fructose for one week. The animals were grouped into five (n = 8), comprising of normal control (NC), diabetic control (DC), diabetic rats treated with low (50 mg/mg body weight) and high (100 mg/kg body weight) doses of Dalbergiella welwitschii alkaloid-rich leaf extracts (i.e., DWL and DWH respectively) and 200 mg/kg body weight of metformin (MET). The animals were sacrificed on the 21st day, blood and brain tissue were harvested and used for the determination of neurotransmitters, cholinesterase, some ATP activities, oxidative stress biomarkers and histological examination. The results show that diabetic rats placed on DWL, DWH and MET significantly (p < 0.05) reduced cholinergic, elevated some ATPase activities and ameliorated oxidative stress biomarkers. These were supported by the histological examination by improving neuroprotective effects in diabetic rats administered DWL, DWH and MET. Hence, it can be presumed that DWL and DWH could be beneficial in treating diabetic neurodegenerative diseases.
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  • 文章类型: Journal Article
    帕金森病(PD),第二最普遍的神经退行性疾病,预计未来三十年发病率将大幅上升。PD的精确治疗仍然是一个艰巨的挑战,促使正在进行的早期诊断方法的研究。网络药理学,以系统生物学为基础的新兴领域,检查复杂的生物系统网络以识别关键信号节点,促进多靶点治疗分子的发展。这种方法系统地绘制了帕金森病的组成部分,从而降低其复杂性。在这次审查中,我们探索网络药理学工作流程在PD中的应用,讨论这一领域采用的技术,并评估帕金森病背景下网络药理学的当前进展和现状。全面的见解将为探索早期疾病生物标志物和开发具有整体硅片的诊断铺平道路。在体外,体内和临床研究。
    Parkinson\'s disease (PD), the second most prevalent neurodegenerative disorder, is projected to see a significant rise in incidence over the next three decades. The precise treatment of PD remains a formidable challenge, prompting ongoing research into early diagnostic methodologies. Network pharmacology, a burgeoning field grounded in systems biology, examines the intricate networks of biological systems to identify critical signal nodes, facilitating the development of multi-target therapeutic molecules. This approach systematically maps the components of Parkinson\'s disease, thereby reducing its complexity. In this review, we explore the application of network pharmacology workflows in PD, discuss the techniques employed in this field, and evaluate the current advancements and status of network pharmacology in the context of Parkinson\'s disease. The comprehensive insights will pave newer paths to explore early disease biomarkers and to develop diagnosis with a holistic in silico, in vitro, in vivo and clinical studies.
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  • 文章类型: Journal Article
    脑源性神经营养因子(BDNF)及其下游原肌球蛋白受体激酶B(TrkB)信号通路在抗抑郁药物的复原力和作用中起关键作用,使它们成为精神病学研究的突出目标。氧化应激(OS)有助于各种神经系统疾病,包括神经退行性疾病,中风,和精神疾病,并加剧衰老过程。核因子红系2相关因子2(Nrf2)-抗氧化反应元件(ARE)是针对OS诱导的脑损伤的主要细胞防御机制。因此,Nrf2激活可能会对OS相关的细胞损伤产生内源性神经保护作用;TrkB/磷酸肌醇3-激酶(PI3K)/蛋白激酶B(Akt)途径,受BDNF依赖性TrkB信号刺激,激活Nrf2并促进其核易位。然而,神经营养蛋白支持不足通常会导致脑疾病中TrkB信号通路的下调。因此,靶向TrkB激活和Nrf2-ARE系统是治疗神经退行性疾病的有希望的治疗策略。植物化学品,包括吲哚-3-甲醇(I3C)及其代谢产物,二吲哚甲烷(DIM),通过BDNF的模拟活性表现出神经保护作用;Akt磷酸化被诱导,通过阻断Nrf2-kelch样ECH相关蛋白1(Keap1)复合物激活抗氧化防御机制。这篇综述强调了I3C及其衍生物在神经退行性疾病治疗中同时激活神经元防御机制的治疗潜力。
    Brain-derived neurotrophic factor (BDNF) and its downstream tropomyosin receptor kinase B (TrkB) signaling pathway play pivotal roles in the resilience and action of antidepressant drugs, making them prominent targets in psychiatric research. Oxidative stress (OS) contributes to various neurological disorders, including neurodegenerative diseases, stroke, and mental illnesses, and exacerbates the aging process. The nuclear factor erythroid 2-related factor 2 (Nrf2)-antioxidant responsive element (ARE) serves as the primary cellular defense mechanism against OS-induced brain damage. Thus, Nrf2 activation may confer endogenous neuroprotection against OS-related cellular damage; notably, the TrkB/phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) pathway, stimulated by BDNF-dependent TrkB signaling, activates Nrf2 and promotes its nuclear translocation. However, insufficient neurotrophin support often leads to the downregulation of the TrkB signaling pathway in brain diseases. Thus, targeting TrkB activation and the Nrf2-ARE system is a promising therapeutic strategy for treating neurodegenerative diseases. Phytochemicals, including indole-3-carbinol (I3C) and its metabolite, diindolylmethane (DIM), exhibit neuroprotective effects through BDNF\'s mimetic activity; Akt phosphorylation is induced, and the antioxidant defense mechanism is activated by blocking the Nrf2-kelch-like ECH-associated protein 1 (Keap1) complex. This review emphasizes the therapeutic potential of I3C and its derivatives for concurrently activating neuronal defense mechanisms in the treatment of neurodegenerative diseases.
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  • 文章类型: Journal Article
    脑血管疾病(CVD)和阿尔茨海默病(AD)经常同时发生,并可能影响特定的认知领域。本研究的目的是确定CVD和AD负担对老年人横断面和纵向执行功能(EF)和记忆的影响。包括来自国家阿尔茨海默病协调中心数据库的纵向随访参与者(n=3342)。认知结果是EF和记忆综合评分。基线CVD的存在通过MRI上的中度至重度白质高信号或腔隙性梗塞来定义。基线AD病理学通过经由PET或CSF的淀粉样蛋白阳性来定义。线性混合模型检查了CVD的影响,AD,和认知结果的时间,控制性,教育,基线年龄,MoCA得分,以及研究访问的总次数。在基线,与较低EF相关的CVD(p<0.001),而AD与较低的EF和记忆相关(ps<0.001)。仅纵向AD与记忆和EF的更快下降相关(ps<0.001)。这些结果扩展了我们对CVD和AD病理学的理解,强调CVD并不一定表明加速下降。
    Cerebrovascular disease (CVD) and Alzheimer\'s disease (AD) often co-occur and may impact specific cognitive domains. This study\'s goal was to determine effects of CVD and AD burden on cross-sectional and longitudinal executive function (EF) and memory in older adults. Longitudinally followed participants from the National Alzheimer Coordinating Center database (n = 3342) were included. Cognitive outcomes were EF and memory composite scores. Baseline CVD presence was defined by moderate-to-severe white matter hyperintensities or lacunar infarct on MRI. Baseline AD pathology was defined by amyloid positivity via PET or CSF. Linear mixed models examined effects of CVD, AD, and time on cognitive outcomes, controlling for sex, education, baseline age, MoCA score, and total number of study visits. At baseline, CVD associated with lower EF (p < 0.001), while AD associated with lower EF and memory (ps < 0.001). Longitudinally only AD associated with faster declines in memory and EF (ps < 0.001). These results extend our understanding of CVD and AD pathology, highlighting that CVD does not necessarily indicate accelerated decline.
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  • 文章类型: Journal Article
    神经发生是一个对能量要求很高的过程,这就是为什么血管是神经源性生态位的活跃部分,因为它们允许祖细胞急需的氧合。在这方面,虽然被忽视了很长时间,“氧位”应被认为是成人神经发生的重要干预因素。许多神经保护试验失败的一个可能假设是它们依赖于靶向高度特异性神经保护途径的化合物。这种方法可能太有限,考虑到导致细胞死亡的过程的复杂性。因此,研究应该采用更多的多因素方法。在有限范围的具有多模式神经调节能力的药物中,在各种脑损伤模型中,高压氧疗法已证明可有效减少继发性脑损伤。这种疗法不仅作为神经保护机制,而且作为强大的神经再生机制。
    Neurogenesis is a high energy-demanding process, which is why blood vessels are an active part of the neurogenic niche since they allow the much-needed oxygenation of progenitor cells. In this regard, although neglected for a long time, the \"oxygen niche\" should be considered an important intervenient in adult neurogenesis. One possible hypothesis for the failure of numerous neuroprotective trials is that they relied on compounds that target a highly specific neuroprotective pathway. This approach may be too limited, given the complexity of the processes that lead to cell death. Therefore, research should adopt a more multifactorial approach. Among the limited range of agents with multimodal neuromodulatory capabilities, hyperbaric oxygen therapy has demonstrated effectiveness in reducing secondary brain damage in various brain injury models. This therapy functions not only as a neuroprotective mechanism but also as a powerful neuroregenerative mechanism.
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  • 文章类型: Journal Article
    哺乳动物雷帕霉素靶蛋白(mTOR)是一种丝氨酸/苏氨酸激酶,在各种生物过程中起着关键作用。通过整合外部和内部信号,促进基因转录和蛋白质翻译,以及通过调节线粒体和自噬功能。mTOR激酶在两种不同的蛋白质复合物中发挥作用,称为mTOR复合物1(mTORC1)和mTOR复合物2(mTORC2)。参与影响不同细胞过程的独立下游信号通路。尽管mTORC1被广泛研究为一种促增殖因子和如果异常激活的促衰老中枢,mTORC2受到的关注较少,特别是关于其在老龄化调节中的含义。然而,最近的研究为我们带来了越来越多的证据或线索,这意味着mTORC2与衰老的关系,作为mTORC2的独特亚基的遗传消除,例如RICTOR,与mTORC1抑制相比,已被证明可以缓解衰老进程。在这次审查中,首先概述了mTORC2的基本特征,包括其蛋白结构和信号网络。然后,我们重点回顾了mTORC2在细胞衰老和生物体衰老中的分子信号调节,并提出了衰老和非衰老背景下的多方面调控特征。接下来,概述了mTOR抑制剂在抗衰老领域的研究进展,并对未来的前景和挑战进行了展望。如果这篇评论文章可以为我们的读者提供有意义的信息,并呼吁对这一主题进行更多的调查,这是我们的荣幸。
    Mammalian target of rapamycin (mTOR) is a serine/threonine kinase that plays a pivotal role in various biological processes, through integrating external and internal signals, facilitating gene transcription and protein translation, as well as by regulating mitochondria and autophagy functions. mTOR kinase operates within two distinct protein complexes known as mTOR complex 1 (mTORC1) and mTOR complex 2 (mTORC2), which engage separate downstream signaling pathways impacting diverse cellular processes. Although mTORC1 has been extensively studied as a pro-proliferative factor and a pro-aging hub if activated aberrantly, mTORC2 received less attention, particularly regarding its implication in aging regulation. However, recent studies brought increasing evidence or clues for us, which implies the associations of mTORC2 with aging, as the genetic elimination of unique subunits of mTORC2, such as RICTOR, has been shown to alleviate aging progression in comparison to mTORC1 inhibition. In this review, we first summarized the basic characteristics of mTORC2, including its protein architecture and signaling network. We then focused on reviewing the molecular signaling regulation of mTORC2 in cellular senescence and organismal aging, and proposed the multifaceted regulatory characteristics under senescent and nonsenescent contexts. Next, we outlined the research progress of mTOR inhibitors in the field of antiaging and discussed future prospects and challenges. It is our pleasure if this review article could provide meaningful information for our readers and call forth more investigations working on this topic.
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  • 文章类型: Journal Article
    背景:额颞叶变性(FTLD)是65岁以下人群痴呆的主要原因。在FTLD进行面对面评估的几个挑战表明,迫切需要开发远程,可访问,和低负担评估技术。对轻度认知障碍的老年人在家中使用计算机的不显眼监测的研究表明,功能下降反映在计算机使用减少;然而,与智能手机使用的关联是未知的。
    目的:本研究旨在表征智能手机电池使用的日常轨迹,智能手机使用的代理,并检查与FTLD严重程度临床指标的关系。
    方法:参与者为231名成年人(平均年龄52.5,SD14.9岁;n=94,40.7%的男性;n=223,96.5%的非西班牙裔白人)参加了额颞叶变性的高级研究和治疗(ARTFL研究)和家族性额颞叶痴呆的纵向评估(LEFtottotalFrontompanalDeuding研究)包括49例(21.2%)患有轻度神经行为变化且无功能障碍(即,前驱FTLD),43(18.6%)伴有神经行为变化和功能障碍(即,有症状的FTLD),和139名(60.2%)临床正常成年人,其中55(39.6%)在常染色体显性遗传FTLD基因中具有杂合致病性或可能的致病性变异。参与者完成了临床痴呆评分加上国家阿尔茨海默病协调中心额颞叶变性行为和语言领域(CDR+NACCFTLD)量表,神经心理电池;神经精神清单;和脑磁共振成像。ALLFTD移动应用程序安装在参与者的智能手机上,用于远程,被动,并持续监控智能手机的使用。在平均28天(SD4.2;范围14-30)内每15分钟收集电池百分比。为了确定电池百分比的时间模式是否随疾病严重程度而变化,线性混合效应模型检查线性,二次,以及一天中的时间的立方效应以及它们与每种疾病严重程度度量对电池百分比的相互作用。模型因年龄而异,性别,智能手机类型,和估计的智能手机年龄。
    结果:CDR+NACCFTLD全球评分与电池百分比的时间相互作用,因此具有前驱或有症状的FTLD的参与者在一天中显示电池百分比的变化较小(代表较少使用智能手机)比临床正常参与者(两种情况下P<.001)。其他模型显示,评估的所有认知领域的表现较差(即,执行功能,记忆,语言,和视觉空间技能),更多的神经精神症状,和较小的脑容量也与全天使用较少的电池相关(所有情况下P<.001)。
    结论:这些发现支持了一个概念证明,即被动收集有关智能手机使用行为的数据与FTLD的临床损害有关。这项工作强调了未来研究的必要性,以开发和验证对神经退行性疾病的纵向临床下降敏感的被动数字标记。具有增强对神经行为变化的现实监控的潜力。
    BACKGROUND: Frontotemporal lobar degeneration (FTLD) is a leading cause of dementia in individuals aged <65 years. Several challenges to conducting in-person evaluations in FTLD illustrate an urgent need to develop remote, accessible, and low-burden assessment techniques. Studies of unobtrusive monitoring of at-home computer use in older adults with mild cognitive impairment show that declining function is reflected in reduced computer use; however, associations with smartphone use are unknown.
    OBJECTIVE: This study aims to characterize daily trajectories in smartphone battery use, a proxy for smartphone use, and examine relationships with clinical indicators of severity in FTLD.
    METHODS: Participants were 231 adults (mean age 52.5, SD 14.9 years; n=94, 40.7% men; n=223, 96.5% non-Hispanic White) enrolled in the Advancing Research and Treatment of Frontotemporal Lobar Degeneration (ARTFL study) and Longitudinal Evaluation of Familial Frontotemporal Dementia Subjects (LEFFTDS study) Longitudinal Frontotemporal Lobar Degeneration (ALLFTD) Mobile App study, including 49 (21.2%) with mild neurobehavioral changes and no functional impairment (ie, prodromal FTLD), 43 (18.6%) with neurobehavioral changes and functional impairment (ie, symptomatic FTLD), and 139 (60.2%) clinically normal adults, of whom 55 (39.6%) harbored heterozygous pathogenic or likely pathogenic variants in an autosomal dominant FTLD gene. Participants completed the Clinical Dementia Rating plus National Alzheimer\'s Coordinating Center Frontotemporal Lobar Degeneration Behavior and Language Domains (CDR+NACC FTLD) scale, a neuropsychological battery; the Neuropsychiatric Inventory; and brain magnetic resonance imaging. The ALLFTD Mobile App was installed on participants\' smartphones for remote, passive, and continuous monitoring of smartphone use. Battery percentage was collected every 15 minutes over an average of 28 (SD 4.2; range 14-30) days. To determine whether temporal patterns of battery percentage varied as a function of disease severity, linear mixed effects models examined linear, quadratic, and cubic effects of the time of day and their interactions with each measure of disease severity on battery percentage. Models covaried for age, sex, smartphone type, and estimated smartphone age.
    RESULTS: The CDR+NACC FTLD global score interacted with time on battery percentage such that participants with prodromal or symptomatic FTLD demonstrated less change in battery percentage throughout the day (a proxy for less smartphone use) than clinically normal participants (P<.001 in both cases). Additional models showed that worse performance in all cognitive domains assessed (ie, executive functioning, memory, language, and visuospatial skills), more neuropsychiatric symptoms, and smaller brain volumes also associated with less battery use throughout the day (P<.001 in all cases).
    CONCLUSIONS: These findings support a proof of concept that passively collected data about smartphone use behaviors associate with clinical impairment in FTLD. This work underscores the need for future studies to develop and validate passive digital markers sensitive to longitudinal clinical decline across neurodegenerative diseases, with potential to enhance real-world monitoring of neurobehavioral change.
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