Research Spotlight

Ma, M., J. Yao, Y. Chen, H. Liu, D. Xia, H. Tian, X. Wang, E. Wu, X. Wang and X. Ding (2020). “Is Ross Syndrome a New Type of Synucleinopathy? A Brief Research Report.” Front Neurosci 14: 635.

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Ross syndrome (RS) is a rare peripheral autonomic system disorder characterized by tonic pupil, hyporeflexia, and segmental anhidrosis. Neuropathological studies show that RS results from the selective cholinergic nerve degeneration. However, the cause and underlying mechanisms are largely unknown. Here, we show α-synuclein accumulation in the autonomic nerve terminals in the lesser curvature of stomach of patients with RS. In addition, immunohistochemical findings demonstrate that a dominant degeneration of cholinergic fibers is exhibited in patients with RS, while main degeneration of adrenergic fibers is demonstrated in patients with pure autonomic failure in their gastrointestinal and urinary system. Our study suggests that RS belongs to α-synucleinopathies. Moreover, our findings indicate that adrenergic nerves and cholinergic nerves are not equally damaged in different types of pure autonomic dysfunctions.

Kormos, R. L., C. F. J. Antonides, D. J. Goldstein, J. A. Cowger, R. C. Starling, J. K. Kirklin, J. E. Rame, D. Rosenthal, M. L. Mooney, K. Caliskan, S. R. Messe, J. J. Teuteberg, P. Mohacsi, M. S. Slaughter, E. V. Potapov, V. Rao, H. Schima, J. Stehlik, S. Joseph, S. C. Koenig and F. D. Pagani (2020). “Updated definitions of adverse events for trials and registries of mechanical circulatory support: A consensus statement of the mechanical circulatory support academic research consortium.” J Heart Lung Transplant 39(8): 735-750.

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Over 25 years ago, it became clear that heart transplantation would become a treatment option for only a limited group of carefully selected patients with advanced heart failure (HF) because of limited donor heart organ availability and restrictive transplant eligibility criteria. This reality energized research focused on clinical applications of implantable left ventricular assist devices (LVADs) for long-term mechanical circulatory support (MCS). Applying LVAD therapy as a bridge to transplant not only reduced transplant waiting list mortality but also provided an opportunity to explore the feasibility of longer-term durable LVAD support for the ultimate application of LVAD support as permanent therapy. Experiences from patients being supported for longer periods for bridge-to-transplant indication helped establish acceptable safety criteria of LVADs to support the feasibility for a clinical trial (i.e., Randomized Evaluation of Mechanical Assistances for Treatment of Congestive Heart Failure clinical trial), establishing an indication for permanent LVAD use (destination therapy) for those patients ineligible to receive a cardiac transplant. [No abstract; excerpt from article].

Kono, T. and A. Fichera (2020). “Surgical Prophylaxis of Crohn Disease Recurrence: “Light at the End of The Tunnel”.” Ann Surg 272(2): 218-219.

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Management of Crohn disease (CD) has been in constant evolution over the past 4 decades. Advances in the medical field have reduced the need for primary surgery, but postoperative clinical, endoscopic, and ultimately surgical recurrence remains an unsolved problem. Disease recurrence typically starts on the mesenteric side of the bowel and it is predominantly located at the anastomotic or peri-anastomotic level especially in the small bowel and terminal ileal disease. Local peri-anastomotic factors have been studied including localized ischemia and denervation, local cytokine production, and more recently changes in the local microbiome, in part resulting from fecal stasis, increased transit time, and reduced or impaired motility at the anastomotic level. [No abstract; excerpt from article].

Kobashigawa, J., P. Shah, S. Joseph, M. Olymbios, G. Bhat, K. Dhital, H. Eisen, E. Kransdorf, J. Patel, R. Skorka, S. Pinney, M. E. Wilson and S. Hall (2020). “Frailty in Heart Transplantation: Report from the Heart Workgroup of a Consensus Conference on Frailty.” Am J Transplant July 13. [Epub ahead of print.].

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A consensus conference on frailty in solid-organ transplantation took place on February 11, 2018 to discuss the latest developments in frailty, adopt a standardized approach to assessment and generate ideas for future research. The findings and consensus of the Frailty Heart Workgroup (American Society of Transplantation’s Thoracic and Critical Care Community of Practice) are presented here. Frailty is defined as a clinically recognizable state of increased vulnerability resulting from aging-associated decline in reserve and function across multiple physiologic systems such that the ability to cope with every day or acute stressors is compromised. Frailty is increasingly recognized as a distinct biologic entity that can adversely affect outcomes before and after heart transplantation. A greater proportion of patients referred for heart transplantation are older and have more complex co-morbidities. However, outcomes data in the pre-transplant setting, particularly for younger patients, is limited. Therefore, there is a need to develop objective frailty assessment tools for risk stratification in patients with advanced heart disease. These tools will help to determine appropriate recipient selection for advanced heart disease therapies including heart transplantation and mechanical circulatory support, improve overall outcomes and help distinguish frailty phenotypes amenable to intervention.

Kiselica, A. M., A. N. Kaser, T. A. Webber, B. J. Small and J. F. Benge (2020). “Development and Preliminary Validation of Standardized Regression-Based Change Scores as Measures of Transitional Cognitive Decline.” Arch Clin Neuropsychol Jul 21;acaa042. [Epub ahead of print.].

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OBJECTIVE: An increasing focus in Alzheimer’s disease and aging research is to identify transitional cognitive decline. One means of indexing change over time in serial cognitive evaluations is to calculate standardized regression-based (SRB) change indices. This paper includes the development and preliminary validation of SRB indices for the Uniform Data Set 3.0 Neuropsychological Battery, as well as base rate data to aid in their interpretation. METHOD: The sample included 1,341 cognitively intact older adults with serial assessments over 0.5-2 years in the National Alzheimer’s Coordinating Center Database. SRB change scores were calculated in half of the sample and then validated in the other half of the sample. Base rates of SRB decline were evaluated at z-score cut-points, corresponding to two-tailed p-values of .20 (z = -1.282), .10 (z = -1.645), and .05 (z = -1.96). We examined convergent associations of SRB indices for each cognitive measure with each other as well as concurrent associations of SRB indices with clinical dementia rating sum of box scores (CDR-SB). RESULTS: SRB equations were able to significantly predict the selected cognitive variables. The base rate of at least one significant SRB decline across the entire battery ranged from 26.70% to 58.10%. SRB indices for cognitive measures demonstrated theoretically expected significant positive associations with each other. Additionally, CDR-SB impairment was associated with an increasing number of significantly declined test scores. CONCLUSIONS: This paper provides preliminary validation of SRB indices in a large sample, and we present a user-friendly tool for calculating SRB values.