Andrea María Slachevsky Conchol

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Slachevsky Chonchol, Andrea

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Slachevsky Chonchol

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Andrea María Slachevsky Conchol

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Multimodal Neurocognitive Markers of Naturalistic Discourse Typify Diverse Neurodegenerative Diseases
(2022) Birba, Agustina; Fittipaldi, Sol; Cediel Escobar, Judith C.; Gonzalez Campo, Cecilia; Legaz, Agustina; Galiani, Agostina; Díaz Rivera, Mariano N.; Martorell Caro, Miquel; Alifano, Florencia; Piña-Escudero, Stefanie D.; Cardona, Juan Felipe; Neely, Alejandra; Forno, Gonzalo; Carpinella , Mariela; Slachevsky Chonchol, Andrea; Serrano, Cecilia; Sedeño, Lucas; Ibáñez, Agustín; García, Adolfo M.
Neurodegeneration has multiscalar impacts, including behavioral, neuroanatomical, and neurofunctional disruptions. Can disease-differential alterations be captured across such dimensions using naturalistic stimuli? To address this question, we assessed comprehension of four naturalistic stories, highlighting action, nonaction, social, and nonsocial events, in Parkinson's disease (PD) and behavioral variant frontotemporal dementia (bvFTD) relative to Alzheimer's disease patients and healthy controls. Text-specific correlates were evaluated via voxel-based morphometry, spatial (fMRI), and temporal (hd-EEG) functional connectivity. PD patients presented action-text deficits related to the volume of action-observation regions, connectivity across motor-related and multimodal-semantic hubs, and frontal hd-EEG hypoconnectivity. BvFTD patients exhibited social-text deficits, associated with atrophy and spatial connectivity patterns along social-network hubs, alongside right frontotemporal hd-EEG hypoconnectivity. Alzheimer's disease patients showed impairments in all stories, widespread atrophy and spatial connectivity patterns, and heightened occipitotemporal hd-EEG connectivity. Our framework revealed disease-specific signatures across behavioral, neuroanatomical, and neurofunctional dimensions, highlighting the sensitivity and specificity of a single naturalistic task. This investigation opens a translational agenda combining ecological approaches and multimodal cognitive neuroscience for the study of neurodegeneration.
Allostatic-Interoceptive Overload in Frontotemporal Dementia
(2022) Birba, Agustina; Santamaría-García, Hernando; Prado, Pavel; Cruzat, Josefina; Sainz Ballesteros , Agustín; Legaz , Agustina; Fittipaldi, Sol; Duran-Aniotz , Claudia; Slachevsky Chonchol, Andrea; Santibañez , Rodrigo; Sigman , Mariano; M. García , Adolfo; Whelan , Robert; Moguilner , Sebastián; Ibáñez , Agustín
Background : The predictive coding theory of allostatic-interoceptive load states that brain networks mediating autonomic regulation and interoceptive-exteroceptive balance regulate the internal milieu to anticipate future needs and environmental demands. These functions seem to be distinctly compromised in behavioral variant frontotemporal dementia (bvFTD), including alterations of the allostatic-interoceptive network (AIN). Here, we hypothesize that bvFTD is typified by an allostatic-interoceptive overload. Methods : We assessed resting-state heartbeat evoked potential (rsHEP) modulation as well as its behavioral and multimodal neuroimaging correlates in patients with bvFTD relative to healthy control subjects and patients with Alzheimer’s disease (N = 94). We measured 1) resting-state electroencephalography (to assess the rsHEP, prompted by visceral inputs and modulated by internal body sensing), 2) associations between rsHEP and its neural generators (source location), 3) cognitive disturbances (cognitive state, executive functions, facial emotion recognition), 4) brain atrophy, and 5) resting-state functional magnetic resonance imaging functional connectivity (AIN vs. control networks). Results : Relative to healthy control subjects and patients with Alzheimer’s disease, patients with bvFTD presented more negative rsHEP amplitudes with sources in critical hubs of the AIN (insula, amygdala, somatosensory cortex, hippocampus, anterior cingulate cortex). This exacerbated rsHEP modulation selectively predicted the patients’ cognitive profile (including cognitive decline, executive dysfunction, and emotional impairments). In addition, increased rsHEP modulation in bvFTD was associated with decreased brain volume and connectivity of the AIN. Machine learning results confirmed AIN specificity in predicting the bvFTD group. Conclusions : Altogether, these results suggest that bvFTD may be characterized by an allostatic-interoceptive overload manifested in ongoing electrophysiological markers, brain atrophy, functional networks, and cognition.
Automated free speech analysis reveals distinct markers of Alzheimer's and frontotemporal dementia
(2024) Lopes da Cunha, Pamela; Ruiz, Fabián; Ferrante, Franco; Sterpin, Lucas; Ibáñez, Agustín; Slachevsky Chonchol, Andrea; Matallana, Diana; Martínez, Ángela; Hesse, Eugenia; García, Adolfo
Dementia can disrupt how people experience and describe events as well as their own role in them. Alzheimer's disease (AD) compromises the processing of entities expressed by nouns, while behavioral variant frontotemporal dementia (bvFTD) entails a depersonalized perspective with increased third-person references. Yet, no study has examined whether these patterns can be captured in connected speech via natural language processing tools. To tackle such gaps, we asked 96 participants (32 AD patients, 32 bvFTD patients, 32 healthy controls) to narrate a typical day of their lives and calculated the proportion of nouns, verbs, and first- or third-person markers (via part-of-speech and morphological tagging). We also extracted objective properties (frequency, phonological neighborhood, length, semantic variability) from each content word. In our main study (with 21 AD patients, 21 bvFTD patients, and 21 healthy controls), we used inferential statistics and machine learning for group-level and subject-level discrimination. The above linguistic features were correlated with patients' scores in tests of general cognitive status and executive functions. We found that, compared with HCs, (i) AD (but not bvFTD) patients produced significantly fewer nouns, (ii) bvFTD (but not AD) patients used significantly more third-person markers, and (iii) both patient groups produced more frequent words. Machine learning analyses showed that these features identified individuals with AD and bvFTD (AUC = 0.71). A generalizability test, with a model trained on the entire main study sample and tested on hold-out samples (11 AD patients, 11 bvFTD patients, 11 healthy controls), showed even better performance, with AUCs of 0.76 and 0.83 for AD and bvFTD, respectively. No linguistic feature was significantly correlated with cognitive test scores in either patient group. These results suggest that specific cognitive traits of each disorder can be captured automatically in connected speech, favoring interpretability for enhanced syndrome characterization, diagnosis, and monitoring.
Impact of the Pandemic Time on the Mental Health of People with Dementia and Their Family Caregivers in Brazil and Chile: One-Year Follow-Up
(2024) Olavarría, Loreto; Caramelli, Paulo; Lema, José; Bezerra, Caíssa; Pinto, Alejandra; Dos Santos, Lílian; Thumala, Daniela; Santos, Maria; Peredo, Adriana; Barroso, Alana; Carvalho, Karoline; Sepúlveda, Walter; Cardoso, Ludmilla; Tonidandel, Maira; Slachevsky Chonchol, Andrea
Background: Previous studies reported the negative impact of social isolation on mental health in people with dementia (PwD) and their caregivers, butlongitudinal studies seem scarcer. Objective: To describe a one-year follow-up impact of the COVID-19 pandemic on PwD and their caregivers in both Brazil and Chile. Methods: This study analyzed the impact of the pandemic on the psychological and physical health of PwD and their family caregivers after one year of follow-up in three outpatient clinics in Brazil (n = 68) and Chile (n = 61). Results: In both countries, PwD reduced their functional capacity after one year of follow-up (p = 0.017 and p = 0.009; respectively) and caregivers reported worse physical and mental health (p = 0.028 and p = 0.039). Only in Chile, caregivers reported more sadness associated with care (p = 0.001), and reduced time sleeping (p = 0.07). Conclusions: In conclusion, the COVID-19 pandemic appears to have had a long-lasting impact on PwD and their caregivers. However, it is essential to acknowledge that the inherent progression of dementia itself may also influence changes observed over a year.
Gaps in biomedical research in frontotemporal dementia: A call for diversity and disparities focused research
(2024) Nuytemans, Karen; Franzen, Sanne; Broce, Iris J.; Caramelli, Paulo; Ellajosyula, Ratnavalli; Finger, Elizabeth; Gupta, Veer; Gupta, Vivek; Illán-Gala, Ignacio; Loi, Samantha M.; Morhardt, Darby; Pijnenburg, Yolande; Rascovsky, Katya; Williams, Monique M.; Yokoyama, Jennifer S.; Acosta-Uribe, Juliana; Akinyemi, Rufus; Alladi, Suvarna; Ayele, Biniyam A.; Ayhan, Yavuz; Bourdage, Renelle; Castro-Suarez, Sheila; Cruz de Souza, Leonardo; Dacks, Penny; Boer, Sterre C. M. de; Leon, Jessica de; Dodge, Shana; Grasso, Stephanie; Ghoshal, Nupur; Kamath, Vidyulata; Kumfor, Fiona; Matias-Guiu, Jordi A.; Narme, Pauline; Nielsen, T. Rune; Okhuevbie, Daniel; Piña-Escudero, Stefanie; Ruiz-Garcia, Ramiro; Ryan, Brigid; Scarioni, Marta; Slachevsky Chonchol, Andrea; Suarez-Gonzalez, Aida; Lead Tee, Boon; Tsoy , Elena; Ulugut, Hulya; Chiadi U Onyike, Chiadi U.; Babulal, Ganesh M.; ISTAART Frontotemporal Dementia and Related Disorders PIA; ISTAART Diversity and Disparities PIA
Frontotemporal dementia (FTD) is one of the leading causes of young-onset dementia before age 65, typically manifesting as abnormal behavior (in behavioral variant FTD) or language impairment (in primary progressive aphasia). Although FTD affects all populations across the globe, knowledge regarding the pathophysiology and genetics derives primarily from studies conducted in North America and Western Europe. Globally, biomedical research for FTD is hindered by variable access to diagnosis, discussed in this group's earlier article, and by reduced access to expertise, funding, and infrastructure. This perspective paper was produced by two professional interest areas of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART) and discusses the field's current status on the cross-cultural aspects of basic and translational research in FTD (including that focused on epidemiology, genetics, biomarkers, and treatment). It subsequently provides a summary of gaps and needs to address the disparities and advance global FTD biomedical research.
Educational disparities in brain health and dementia across Latin America and the United States
(2024) Gonzalez, Raul; Legaz, Agustina; Moguilner, Sebastián; Cruzat, Josephine; Hernández, Hernán; Baez, Sandra; Cocchi, Rafael; Coronel, Carlos; Medel,Vicente; Tagliazuchi, Enzo; Migeot, Joaquín; Ochoa, Carolina; Maito, Marcelo; Reyes, Pablo; Santamaria, Hernando; Godoy, Maria; Javande, Shireen; García, Adolfo; Matallana, Diana; Avila, José; Slachevsky Chonchol, Andrea; Behrens, María; Custodio, Nilton; Cardona, Juan; Brusco, Ignacio; Bruno, Martín; Sosa, Ana; Pina, Stefanie; Takada, Leonel; França, Elisa; Valcour, Victor; Possin, Katherine; De Oliveira, Maira; Lopera, Francisco; Lawlor, Brian; Hu, Kun; Miller, Bruce; Yokoyama, Jennifer; Gonzalez, Cecilia; Ibañez, Agustin
Background: Education influences brain health and dementia. However, its impact across regions, specifically Latin America (LA) and the United States (US), is unknown. Methods: A total of 1412 participants comprising controls, patients with Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD) from LA and the US were included. We studied the association of education with brain volume and functional connectivity while controlling for imaging quality and variability, age, sex, total intracranial volume (TIV), and recording type. Results: Education influenced brain measures, explaining 24%-98% of the geographical differences. The educational disparities between LA and the US were associated with gray matter volume and connectivity variations, especially in LA and AD patients. Education emerged as a critical factor in classifying aging and dementia across regions. Discussion: The results underscore the impact of education on brain structure and function in LA, highlighting the importance of incorporating educational factors into diagnosing, care, and prevention, and emphasizing the need for global diversity in research. Highlights: Lower education was linked to reduced brain volume and connectivity in healthy controls (HCs), Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD). Latin American cohorts have lower educational levels compared to the those in the United States. Educational disparities majorly drive brain health differences between regions. Educational differences were significant in both conditions, but more in AD than FTLD. Education stands as a critical factor in classifying aging and dementia across regions.
Author Correction: the BrainLat project, a multimodal neuroimaging dataset of neurodegeneration from underrepresented backgrounds
(2024) Prado, Pavel; Medel, Vicente; González, Raúl; Sainz, Agustín; Vidal, Víctor; Santamaría, Hernando; Moguilner, Sebastián; Mejía, Jhony; Slachevsky Chonchol, Andrea; Behrens, Maria Isabel; Aguillón, David; Lopera, Francisco; Parra, Mario; Matallana, Diana; Adrián, Marcelo; García, Adolfo; Custodio, Nilton; Ávila, Alberto; Piña, Stefanie; Birba, Agustina; Fittipaldi, Sol; Legaz, Agustina; Ibáñez, Agustín
In this article the author name Maria Isabel Behrens was incorrectly written as Maria Isabel Beherens. The original article has been corrected.
Neurocognitive correlates of semantic memory navigation in Parkinson's disease
(2024) Toro, Felipe; Migeot, Joaquín; Marchant, Nicolás; Olivares, Daniela; Ferrante, Franco; González, Raúl; González, Cecilia; Fittipaldi, Sol; Rojas, Gonzalo; Moguilner, Sebastian; Slachevsky Chonchol, Andrea; Chaná, Pedro; Ibáñez, Agustín; Chaigneau, Sergio; García, Adolfo
Cognitive studies on Parkinson's disease (PD) reveal abnormal semantic processing. Most research, however, fails to indicate which conceptual properties are most affected and capture patients' neurocognitive profiles. Here, we asked persons with PD, healthy controls, and individuals with behavioral variant frontotemporal dementia (bvFTD, as a disease control group) to read concepts (e.g., 'sun') and list their features (e.g., hot). Responses were analyzed in terms of ten word properties (including concreteness, imageability, and semantic variability), used for group-level comparisons, subject-level classification, and brain-behavior correlations. PD (but not bvFTD) patients produced more concrete and imageable words than controls, both patterns being associated with overall cognitive status. PD and bvFTD patients showed reduced semantic variability, an anomaly which predicted semantic inhibition outcomes. Word-property patterns robustly classified PD (but not bvFTD) patients and correlated with disease-specific hypoconnectivity along the sensorimotor and salience networks. Fine-grained semantic assessments, then, can reveal distinct neurocognitive signatures of PD.
Author Correction: Neurocognitive correlates of semanticmemory navigation in Parkinson’s disease
(2024) Toro, Felipe; Migeot, Joaquín; Marchant, Nicolás; Olivares, Daniela; Ferrante, Franco; González, Raúl; González, Cecilia; Fittipaldi, Sol; Rojas, Gonzalo; Moguilner, Sebastian; Slachevsky Chonchol, Andrea; Chaná, Pedro; Ibáñez, Agustín; Chaigneau, Sergio; García, Adolfo
Correction to: npj Parkinson’s Disease https://doi.org/10.1038/ s41531-024-00630-4, published online 9 January 2024. In this article the funding from ‘Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile, #BL-SRGP2021-01’ for author Adolfo M. García was omitted. The original article has been corrected.
A Multidimensional, Person-Centered Framework for Functional Assessment in Dementia: Insights from the 'What', 'How', 'To Whom', and 'How Much' Questions
(2024) Slachevsky Chonchol, Andrea; Grandi, Fabrissio; Thumala, Daniela; Baez, Sandra; Santamaria, Hernando; Schmitter, Maureen; Parra, Mario
Dementia is a syndrome characterized by cognitive and neuropsychiatric symptoms associated with progressive functional decline (FD). FD is a core diagnostic criterion for dementia, setting the threshold between its prodromal stages and the full-blown disease. The operationalization of FD continues to generate a great deal of controversy. For instance, the threshold of FD for the diagnosis of dementia varies across diagnostic criteria, supporting the need for standardization of this construct. Moreover, there is a need to reconsider how we are measuring FD to set boundaries between normal aging, mild cognitive impairment, and dementia. In this paper, we propose a multidimensional framework that addresses outstanding issues in the assessment of FD: i) What activities of daily living (ADLs) are necessary to sustain an independent living in aging? ii) How to assess FD in individuals with suspected neurocognitive disorders? iii) To whom is the assessment directed? and iv) How much does FD differentiate healthy aging from mild and major neurocognitive disorders? Importantly, the To Whom Question introduces a person-centered approach that regards patients and caregivers as active agents in the assessment process of FD. Thus, once impaired ADLs have been identified, patients can indicate how significant such impairments are for them in daily life. We envisage that this new framework will guide future strategies to enhance functional assessment and treatment of patients with dementia and their caregivers.