Brain connectivity and metacognition in persons with subjective cognitive decline (COSCODE): rationale and study design

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Abstract

Background

Subjective cognitive decline (SCD) is the subjective perception of a decline in memory and/or other cognitive functions in the absence of objective evidence. Some SCD individuals however may suffer from very early stages of neurodegenerative diseases (such as Alzheimer’s disease, AD), minor psychiatric conditions, neurological, and/or somatic comorbidities. Even if a theoretical framework has been established, the etiology of SCD remains far from elucidated. Clinical observations recently lead to the hypothesis that individuals with incipient AD may have overestimated metacognitive judgements of their own cognitive performance, while those with psychiatric disorders typically present underestimated metacognitive judgements. Moreover, brain connectivity changes are known correlates of AD and psychiatric conditions and might be used as biomarkers to discriminate SCD individuals of different etiologies. The aim of the COSCODE study is to identify metacognition, connectivity, behavioral, and biomarker profiles associated with different etiologies of SCD. Here we present its rationale and study design.

Methods

COSCODE is an observational, longitudinal (4 years), prospective clinical cohort study involving 120 SCD, and 80 control study participants (40 individuals with no cognitive impairment, and 40 living with mild cognitive impairment - MCI, or dementia due to AD), all of which will undergo diffusion magnetic resonance imaging (MRI) and functional magnetic resonance imaging (fMRI) as well as behavioral and biomarker assessments at baseline and after 1 and 2 years. Both hypothesis-driven and data-driven cluster analysis approaches will be used to identify SCD sub-types based on metacognition, connectivity, behavioral, and biomarker features.

Conclusion

COSCODE will allow defining and interpreting the constellation of signs and symptoms associated with different etiologies of SCD, paving the way to the development of cost-effective risk assessment and prevention protocols.

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Most cited references 23

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The diagnosis of dementia due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

Guy M McKhann, David S. Knopman, Howard Chertkow … (2011)

The National Institute on Aging and the Alzheimer's Association charged a workgroup with the task of revising the 1984 criteria for Alzheimer's disease (AD) dementia. The workgroup sought to ensure that the revised criteria would be flexible enough to be used by both general healthcare providers without access to neuropsychological testing, advanced imaging, and cerebrospinal fluid measures, and specialized investigators involved in research or in clinical trial studies who would have these tools available. We present criteria for all-cause dementia and for AD dementia. We retained the general framework of probable AD dementia from the 1984 criteria. On the basis of the past 27 years of experience, we made several changes in the clinical criteria for the diagnosis. We also retained the term possible AD dementia, but redefined it in a manner more focused than before. Biomarker evidence was also integrated into the diagnostic formulations for probable and possible AD dementia for use in research settings. The core clinical criteria for AD dementia will continue to be the cornerstone of the diagnosis in clinical practice, but biomarker evidence is expected to enhance the pathophysiological specificity of the diagnosis of AD dementia. Much work lies ahead for validating the biomarker diagnosis of AD dementia. Copyright © 2011. Published by Elsevier Inc.

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The diagnosis of mild cognitive impairment due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

Marilyn Albert, Steven Dekosky, Dennis D Dickson … (2011)

The National Institute on Aging and the Alzheimer's Association charged a workgroup with the task of developing criteria for the symptomatic predementia phase of Alzheimer's disease (AD), referred to in this article as mild cognitive impairment due to AD. The workgroup developed the following two sets of criteria: (1) core clinical criteria that could be used by healthcare providers without access to advanced imaging techniques or cerebrospinal fluid analysis, and (2) research criteria that could be used in clinical research settings, including clinical trials. The second set of criteria incorporate the use of biomarkers based on imaging and cerebrospinal fluid measures. The final set of criteria for mild cognitive impairment due to AD has four levels of certainty, depending on the presence and nature of the biomarker findings. Considerable work is needed to validate the criteria that use biomarkers and to standardize biomarker analysis for use in community settings. Copyright © 2011 The Alzheimer's Association. All rights reserved.

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A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease

Frank Jessen, Rebecca E Amariglio, Martin van Boxtel … (2014)

There is increasing evidence that subjective cognitive decline (SCD) in individuals with unimpaired performance on cognitive tests may represent the first symptomatic manifestation of Alzheimer's disease (AD). The research on SCD in early AD, however, is limited by the absence of common standards. The working group of the Subjective Cognitive Decline Initiative (SCD-I) addressed this deficiency by reaching consensus on terminology and on a conceptual framework for research on SCD in AD. In this publication, research criteria for SCD in pre-mild cognitive impairment (MCI) are presented. In addition, a list of core features proposed for reporting in SCD studies is provided, which will enable comparability of research across different settings. Finally, a set of features is presented, which in accordance with current knowledge, increases the likelihood of the presence of preclinical AD in individuals with SCD. This list is referred to as SCD plus.

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Author and article information

Contributors

Federica Ribaldi:

ORCID: http://orcid.org/0000-0001-9208-4472

federica.ribaldi@unige.ch

Journal

Journal ID (nlm-ta): Alzheimers Res Ther

Journal ID (iso-abbrev): Alzheimers Res Ther

Title: Alzheimer's Research & Therapy

Publisher: BioMed Central (London )

ISSN (Electronic): 1758-9193

Publication date (Electronic): 25 May 2021

Publication date PMC-release: 25 May 2021

Publication date Collection: 2021

Volume: 13

Electronic Location Identifier: 105

Affiliations

[1 ]GRID grid.8591.5, ISNI 0000 0001 2322 4988, Laboratory of Neuroimaging of Aging (LANVIE), , University of Geneva, ; Geneva, Switzerland

[2 ]GRID grid.150338.c, ISNI 0000 0001 0721 9812, Geneva Memory Center, Department of Rehabilitation and Geriatrics, , Geneva University Hospitals, ; Geneva, Switzerland

[3 ]GRID grid.8591.5, ISNI 0000 0001 2322 4988, Center for Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), , University of Geneva, ; Geneva, Switzerland

[4 ]GRID grid.433220.4, ISNI 0000 0004 0390 8241, CIBM Center for Biomedical Imaging, ; Lausanne, Switzerland

[5 ]GRID grid.5333.6, ISNI 0000000121839049, Animal Imaging and Technology, , Ecole Polytechnique Fédérale de Lausanne, ; Lausanne, Switzerland

[6 ]GRID grid.150338.c, ISNI 0000 0001 0721 9812, Department of Radiology, , Geneva University Hospitals, ; Geneva, Switzerland

[7 ]GRID grid.150338.c, ISNI 0000 0001 0721 9812, Division of Radiology, , Geneva University Hospitals, ; Geneva, Switzerland

[8 ]CIMC - Centre d’Imagerie Médicale de Cornavin, Geneva, Switzerland

[9 ]GRID grid.8993.b, ISNI 0000 0004 1936 9457, Department of Surgical Sciences, Radiology, , Uppsala University, ; Uppsala, Sweden

[10 ]GRID grid.8591.5, ISNI 0000 0001 2322 4988, Faculty of Medicine of the University of Geneva, ; Geneva, Switzerland

[11 ]GRID grid.24696.3f, ISNI 0000 0004 0369 153X, Department of Radiology, , Beijing Tiantan Hospital, Capital Medical University, ; Beijing, 100070 P. R. China

[12 ]GRID grid.150338.c, ISNI 0000 0001 0721 9812, Neurodiagnostic and Neurointerventional Division, Diagnostic Department, , Geneva University Hospitals, ; Geneva, Switzerland

[13 ]GRID grid.419422.8, Laboratory of Alzheimer’s Neuroimaging and Epidemiology (LANE), , IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, ; Brescia, Italy

[14 ]GRID grid.8591.5, ISNI 0000 0001 2322 4988, Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Geneva University Neurocenter and Faculty of Medicine, , University of Geneva, ; Geneva, Switzerland

[15 ]GRID grid.150338.c, ISNI 0000 0001 0721 9812, Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, , Geneva University Hospitals, ; Geneva, Switzerland

[16 ]GRID grid.8591.5, ISNI 0000 0001 2322 4988, Cognitive Aging Lab, Faculty of Psychology and Educational Sciences, , University of Geneva, ; Geneva, Switzerland

Author information

Federica Ribaldi http://orcid.org/0000-0001-9208-4472

Article

Publisher ID: 846

DOI: 10.1186/s13195-021-00846-z

PMC ID: 8152092

PubMed ID: 34034799

SO-VID: 22f80ffb-297b-4b1b-94c3-ee593f86ec13

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 11 March 2021

Date accepted : 17 May 2021

Funding

Funded by: SNSF

Award ID: 320030_182772

Award Recipient : Giovanni B. Frisoni

Custom metadata

ScienceOpen disciplines: Neurology

Keywords: subjective cognitive decline,metacognition,connectivity,alzheimer’s disease biomarkers

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ScienceOpen disciplines: Neurology

Keywords: subjective cognitive decline, metacognition, connectivity, alzheimer’s disease biomarkers

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Brain connectivity and metacognition in persons with subjective cognitive decline (COSCODE): rationale and study design

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Most cited references 23

The diagnosis of dementia due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

The diagnosis of mild cognitive impairment due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease

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