Andrea María Slachevsky Conchol

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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.
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.
Rehabilitation Services for Young-Onset Dementia: Examples from High- and Low-Middle-Income Countries
(2024) Suárez, Aida; Savage, Sharon; Alladi, Suvarna; Carvalho, Viviane; Arshad, Faheem; Camino, Julieta; Caramelli, Paulo; Comas, Adelina; Cook, Julia; Cooper, Claudia; García, Laura; Grasso, Stephanie; Jokel, Regina; Lavoie, Monica; León, Tomás; Priya, Thomas; Ramos, Teresita; Taylor, Cathleen; Townsend, Rosemary; Thöne, Angelika; Slachevsky Chonchol, Andrea; Volkmer, Anna; Weidner, Wendy; Mc O'Connor, Claire
The WHO Dementia Global Action Plan states that rehabilitation services for dementia are required to promote health, reduce disability, and maintain quality of life for those living with dementia. Current services, however, are scarce, particularly for people with young-onset dementia (YOD). This article, written by an international group of multidisciplinary dementia specialists, offers a three-part overview to promote the development of rehabilitation services for YOD. Firstly, we provide a synthesis of knowledge on current evidence-based rehabilitative therapies for early-onset Alzheimer's disease (EOAD), behavioural variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA), and posterior cortical atrophy (PCA). Secondly, we discuss the characteristics of rehabilitation services for YOD, providing examples across three continents for how these services can be embedded in existing settings and the different roles of the rehabilitation multidisciplinary team. Lastly, we conclude by highlighting the potential of telehealth in making rehabilitation services more accessible for people with YOD. Overall, with this paper, we aim to encourage clinical leads to begin introducing at least some rehabilitation into their services, leveraging existing resources and finding support in the collective expertise of the broader multidisciplinary dementia professional community.
Advancements in dementia research, diagnostics, and care in Latin America: Highlights from the 2023 Alzheimer's Association International conference satellite symposium in Mexico City
(2024) Sosa, Ana; Brucki; Sonia; Crivelli, Lucia; Lopera, Francisco; Acosta, Daisy; Acosta, Juliana; Aguilar, Diego; Aguilar.Sara; Allegri, Ricardo; Bertolucci, Paulo; Calandri, Ismael; Carrillo, Maria; Chrem , Patricio; Cornejo, Mario; Custodio, Nilton; Damian, Andrés; Cruz , Leonardo; Duran, Claudia; García, Adolfo; García, Carmen; Gonzales, Mitzi; Grinberg, Lea; Ibanez, Agustin; Illanes, Maryenela; Jack, Clifford; Leon, Jorge; Llibre, Jorge; Luna, José; Matallana, Diana; Miller, Bruce; Naci, Lorina; Parra, Mario; Pericak, Margaret; Piña, Stefanie; França, Elisa de Paula; Ringman, John; Sevlever, Gustavo; Slachevsky Chonchol, Andrea; Kimie, Claudia; Valcour, Victor; Villegas, Andres
Introduction: While Latin America (LatAm) is facing an increasing burden of dementia due to the rapid aging of the population, it remains underrepresented in dementia research, diagnostics, and care. Methods: In 2023, the Alzheimer's Association hosted its eighth satellite symposium in Mexico, highlighting emerging dementia research, priorities, and challenges within LatAm. Results: Significant initiatives in the region, including intracountry support, showcased their efforts in fostering national and international collaborations; genetic studies unveiled the unique genetic admixture in LatAm; researchers conducting emerging clinical trials discussed ongoing culturally specific interventions; and the urgent need to harmonize practices and studies, improve diagnosis and care, and use affordable biomarkers in the region was highlighted. Discussion: The myriad of topics discussed at the 2023 AAIC satellite symposium highlighted the growing research efforts in LatAm, providing valuable insights into dementia biology, genetics, epidemiology, treatment, and care.