Mahoney Jeannette R, Blumen Helena M, De Sanctis Pierfilippo, Fleysher Roman, Frankini Carolina, Hoang Alexandria, Hoptman Matthew J, Jin Runqiu, Lipton Michael, Nunez Valerie, Twizer Lital, Uy Naomi, Valdivia Ana, Verghese Tanya, Wang Cuiling, Weiss Erica F, Zwerling Jessica, Verghese Joe
Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States.
Department of Medicine, Division of Geriatrics, Albert Einstein College of Medicine, Bronx, NY, United States.
Front Aging Neurosci. 2023 Mar 30;15:1125114. doi: 10.3389/fnagi.2023.1125114. eCollection 2023.
Identification of novel, non-invasive, non-cognitive based markers of Alzheimer's disease (AD) and related dementias are a global priority. Growing evidence suggests that Alzheimer's pathology manifests in sensory association areas well before appearing in neural regions involved in higher-order cognitive functions, such as memory. Previous investigations have not comprehensively examined the interplay of sensory, cognitive, and motor dysfunction with relation to AD progression. The ability to successfully integrate multisensory information across multiple sensory modalities is a vital aspect of everyday functioning and mobility. Our research suggests that multisensory integration, specifically visual-somatosensory integration (VSI), could be used as a novel marker for preclinical AD given previously reported associations with important motor (balance, gait, and falls) and cognitive (attention) outcomes in aging. While the adverse effect of dementia and cognitive impairment on the relationship between multisensory functioning and motor outcomes has been highlighted, the underlying functional and neuroanatomical networks are still unknown. In what follows we detail the protocol for our study, named The VSI Study, which is strategically designed to determine whether preclinical AD is associated with neural disruptions in subcortical and cortical areas that concurrently modulate multisensory, cognitive, and motor functions resulting in mobility decline. In this longitudinal observational study, a total of 208 community-dwelling older adults with and without preclinical AD will be recruited and monitored yearly. Our experimental design affords assessment of multisensory integration as a new behavioral marker for preclinical AD; identification of functional neural networks involved in the intersection of sensory, motor, and cognitive functioning; and determination of the impact of early AD on future mobility declines, including incident falls. Results of The VSI Study will guide future development of innovative multisensory-based interventions aimed at preventing disability and optimizing independence in pathological aging.
识别阿尔茨海默病（AD）及相关痴呆症新的、非侵入性的、基于非认知的标志物是全球优先事项。越来越多的证据表明，阿尔茨海默病病理在感觉联合区出现的时间远早于其在参与高阶认知功能（如记忆）的神经区域出现的时间。以往的研究尚未全面考察感觉、认知和运动功能障碍与AD进展之间的相互作用。成功整合多种感觉模态的多感觉信息的能力是日常功能和活动能力的一个重要方面。我们的研究表明，鉴于此前报道的多感觉整合与衰老过程中重要的运动（平衡、步态和跌倒）和认知（注意力）结果之间的关联，多感觉整合，特别是视觉-躯体感觉整合（VSI），可作为临床前AD的一种新标志物。虽然痴呆症和认知障碍对多感觉功能与运动结果之间关系的不利影响已得到强调，但其潜在的功能和神经解剖网络仍不清楚。在下文，我们详细介绍了我们名为“VSI研究”的研究方案，该方案经过精心设计，旨在确定临床前AD是否与皮层下和皮层区域的神经破坏有关，这些区域同时调节多感觉、认知和运动功能，导致活动能力下降。在这项纵向观察研究中，将招募总共208名有或没有临床前AD的社区居住老年人，并每年进行监测。我们的实验设计能够将多感觉整合评估为临床前AD的一种新行为标志物；识别参与感觉、运动和认知功能交叉的功能性神经网络；并确定早期AD对未来活动能力下降（包括跌倒事件）的影响。“VSI研究”的结果将指导未来基于多感觉的创新干预措施的开发，旨在预防病理性衰老中的残疾并优化独立性。
