Scientists define new type of memory loss in older adults

Researchers at Mayo Clinic have established new criteria for a memory-loss syndrome in older adults that specifically impacts the brain's limbic system. It can often be mistaken for Alzheimer's disease. The good news: Limbic-predominant Amnestic Neurodegenerative Syndrome, or LANS, progresses more slowly and has a better prognosis, and is now more clearly defined for doctors working to find answers for memory loss patients.

Prior to the researchers developing clinical criteria published in the journal Brain Communications, the hallmarks of the syndrome could be confirmed only by examining brain tissue after a person's death. The proposed criteria provide a framework for neurologists and other experts to classify the condition in patients living with symptoms, offering a more precise diagnosis and potential treatments. They consider factors such as age, severity of memory impairment, brain scans, and biomarkers indicating the deposits of specific proteins in the brain.

The criteria were developed and validated using data from more than 200 participants in databases for the Mayo Clinic Alzheimer's Disease Research Center, the Mayo Clinic Study of Aging and the Alzheimer's Disease Neuroimaging Initiative.

Understanding the condition will lead to better management of symptoms and more tailored therapies for patients suffering from this type of cognitive decline, distinct from Alzheimer's disease, says David T. Jones, M.D., a Mayo Clinic neurologist and senior author of the study.

"In our clinical work, we see patients whose memory symptoms appear to mimic Alzheimer's disease, but when you look at their brain imaging or biomarkers, it's clear they don't have Alzheimer's. Until now, there has not been a specific medical diagnosis to point to, but now we can offer them some answers," Jones says. "This research creates a precise framework that other medical professionals can use to care for their patients. It has major implications for treatment decisions, including amyloid-lowering drugs and new clinical trials, and counseling on their prognosis, genetics and other factors."

Decades of work to understand and classify different types of dementia is ongoing, says Nick Corriveau-Lecavalier, Ph.D., the paper's first author. These findings build upon scientists' continued efforts to untangle neurological conditions that often have similar symptoms or can occur simultaneously, but can have drastically different treatments and prognoses.

"Historically, you might see someone in their 80s with memory problems and think they may have Alzheimer's disease, and that is often how it's being thought of today," Corriveau-Lecavalier says. "With this paper, we are describing a different syndrome that happens much later in life. Often, the symptoms are restricted to memory and will not progress to impact other cognitive domains, so the prognosis is better than with Alzheimer's disease."

Without signs of Alzheimer's disease, the researchers looked at the involvement of one possible culprit -- a buildup of a protein called TDP-43 in the limbic system that scientists have found in the autopsied brain tissue of older adults. Researchers have classified the build-up of these protein deposits as limbic-predominant age-related TDP-43 encephalopathy, or LATE. These protein deposits could be associated with the newly defined memory loss syndrome, but there are also other likely causes and more research is needed, the authors say.

With clinical criteria established by Jones, Corriveau-Lecavalier and co-authors, practitioners could soon diagnose LANS in patients so those living with memory loss might better understand options for treatment and potential progression of the disease, opening doors for research to further illuminate the characteristics of the disease.

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Amnesia caused by head injury reversed in early mouse study

A mouse study designed to shed light on memory loss in people who experience repeated head impacts, such as athletes, suggests the condition could potentially be reversed. The research in mice finds that amnesia and poor memory following head injury is due to inadequate reactivation of neurons involved in forming memories.

The study, conducted by researchers at Georgetown University Medical Center in collaboration with Trinity College Dublin, Ireland, is reported January 16, 2024, in the Journal of Neuroscience.

Importantly for diagnostic and treatment purposes, the researchers found that the memory loss attributed to head injury was not a permanent pathological event driven by a neurodegenerative disease.

Indeed, the researchers could reverse the amnesia to allow the mice to recall the lost memory, potentially allowing cognitive impairment caused by head impact to be clinically reversed.

The Georgetown investigators had previously found that the brain adapts to repeated head impacts by changing the way the synapses in the brain operate.

This can cause trouble in forming new memories and remembering existing memories.

In their new study, investigators were able to trigger mice to remember memories that had been forgotten due to head impacts.

"Our research gives us hope that we can design treatments to return the head-impact brain to its normal condition and recover cognitive function in humans that have poor memory caused by repeated head impacts," says the study's senior investigator, Mark Burns, PhD, a professor and Vice-Chair in Georgetown's Department of Neuroscience and director of the Laboratory for Brain Injury and Dementia.

In the new study, the scientists gave two groups of mice a new memory by training them in a test they had never seen before.

One group was exposed to a high frequency of mild head impacts for one week (similar to contact sport exposure in people) and one group were controls that didn't receive the impacts.

The impacted mice were unable to recall the new memory a week later.

"Most research in this area has been in human brains with chronic traumatic encephalopathy (CTE), which is a degenerative brain disease found in people with a history of repetitive head impact," said Burns.

"By contrast, our goal was to understand how the brain changes in response to the low-level head impacts that many young football players regularly experience."

Researchers have found that, on average, college football players receive 21 head impacts per week with defensive ends receiving 41 head impacts per week.

The number of head impacts to mice in this study were designed to mimic a week of exposure for a college football player, and each single head impact by itself was extraordinarily mild.

Using genetically modified mice allowed the researchers to see the neurons involved in learning new memories, and they found that these memory neurons (the "memory engram") were equally present in both the control mice and the experimental mice.

To understand the physiology underlying these memory changes, the study's first author, Daniel P. Chapman, Ph.D., said, "We are good at associating memories with places, and that's because being in a place, or seeing a photo of a place, causes a reactivation of our memory engrams. This is why we examined the engram neurons to look for the specific signature of an activated neuron. When the mice see the room where they first learned the memory, the control mice are able to activate their memory engram, but the head impact mice were not. This is what was causing the amnesia."

The researchers were able to reverse the amnesia to allow the mice to remember the lost memory using lasers to activate the engram cells.

"We used an invasive technique to reverse memory loss in our mice, and unfortunately this is not translatable to humans," Burns adds.

"We are currently studying a number of non-invasive techniques to try to communicate to the brain that it is no longer in danger, and to open a window of plasticity that can reset the brain to its former state."

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Scientists identify how the brain links memories

Our brains rarely record single memories -- instead, they store memories into groups so that the recollection of one significant memory triggers the recall of others connected by time. As we age, however, our brains gradually lose this ability to link related memories.

Now UCLA researchers have discovered a key molecular mechanism behind memory linking. They've also identified a way to restore this brain function in middle-aged mice -- and an FDA-approved drug that achieves the same thing.

Published in Nature, the findings suggest a new method for strengthening human memory in middle age and a possible early intervention for dementia.

"Our memories are a huge part of who we are," explained Alcino Silva, a distinguished professor of neurobiology and psychiatry at the David Geffen School of Medicine at UCLA. "The ability to link related experiences teaches how to stay safe and operate successfully in the world."

A bit of Biology 101: cells are studded with receptors. To enter a cell, a molecule must latch onto its matching receptor, which operates like a doorknob to provide access inside.

The UCLA team focused on a gene called CCR5 that encodes the CCR5 receptor -- the same one that HIV hitches a ride on to infect the brain cell and cause memory loss in AIDS patients.

Silva's lab demonstrated in earlier research that CCR5 expression reduced memory recall.

In the current study, Silva and his colleagues discovered a central mechanism underlying mice's ability to link their memories of two different cages. A tiny microscope opened a window into the animals' brains, enabling the scientists to observe neurons firing and creating new memories.

Boosting CCR5 gene expression in the brains of middle-aged mice interfered with memory linking. The animals forgot the connection between the two cages.

When the scientists deleted the CCR5 gene in the animals, the mice were able to link memories that normal mice could not.

Silva had previously studied the drug, maraviroc, which the U.S. Food and Drug Administration approved in 2007 for the treatment of HIV infection. His lab discovered that maraviroc also suppressed CCR5 in the brains of mice.

"When we gave maraviroc to older mice, the drug duplicated the effect of genetically deleting CCR5 from their DNA," said Silva, a member of the UCLA Brain Research Institute. "The older animals were able to link memories again."

The finding suggests that maraviroc could be used off-label to help restore middle-aged memory loss, as well as reverse the cognitive deficits caused by HIV infection.

"Our next step will be to organize a clinical trial to test maraviroc's influence on early memory loss with the goal of early intervention," said Silva. "Once we fully understand how memory declines, we possess the potential to slow down the process."

Which begs the question: why does the brain need a gene that interferes with its ability to link memories?

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A brain circuit in the thalamus helps us hold information in mind

As people age, their working memory often declines, making it more difficult to perform everyday tasks. One key brain region linked to this type of memory is the anterior thalamus, which is primarily involved in spatial memory -- memory of our surroundings and how to navigate them.

In a study of mice, MIT researchers have identified a circuit in the anterior thalamus that is necessary for remembering how to navigate a maze. The researchers also found that this circuit is weakened in older mice, but enhancing its activity greatly improves their ability to run the maze correctly.

This region could offer a promising target for treatments that could help reverse memory loss in older people, without affecting other parts of the brain, the researchers say.

"By understanding how the thalamus controls cortical output, hopefully we could find more specific and druggable targets in this area, instead of generally modulating the prefrontal cortex, which has many different functions," says Guoping Feng, the James W. and Patricia T. Poitras Professor in Brain and Cognitive Sciences at MIT, a member of the Broad Institute of Harvard and MIT, and the associate director of the McGovern Institute for Brain Research at MIT.

Feng is the senior author of the study, which appears today in the Proceedings of the National Academy of Sciences. Dheeraj Roy, a NIH K99 Awardee and a McGovern Fellow at the Broad Institute, and Ying Zhang, a J. Douglas Tan Postdoctoral Fellow at the McGovern Institute, are the lead authors of the paper.

Spatial memory

The thalamus, a small structure located near the center of the brain, contributes to working memory and many other executive functions, such as planning and attention. Feng's lab has recently been investigating a region of the thalamus known as the anterior thalamus, which has important roles in memory and spatial navigation.

Previous studies in mice have shown that damage to the anterior thalamus leads to impairments in spatial working memory. In humans, studies have revealed age-related decline in anterior thalamus activity, which is correlated with lower performance on spatial memory tasks.

The anterior thalamus is divided into three sections: ventral, dorsal, and medial. In a study published last year, Feng, Roy and Zhang studied the role of the anterodorsal (AD) thalamus and anteroventral (AV) thalamus in memory formation. They found that the AD thalamus is involved in creating mental maps of physical spaces, while the AV thalamus helps the brain to distinguish these memories from other memories of similar spaces.

In their new study, the researchers wanted to look more deeply at the AV thalamus, exploring its role in a spatial working memory task. To do that, they trained mice to run a simple T-shaped maze. At the beginning of each trial, the mice ran until they reached the T. One arm was blocked off, forcing them to run down the other arm. Then, the mice were placed in the maze again, with both arms open. The mice were rewarded if they chose the opposite arm from the first run. This meant that in order to make the correct decision, they had to remember which way they had turned on the previous run.

As the mice performed the task, the researchers used optogenetics to inhibit activity of either AV or AD neurons during three different parts of the task: the sample phase, which occurs during the first run; the delay phase, while they are waiting for the second run to begin; and the choice phase, when the mice make their decision which way to turn during the second run.

The researchers found that inhibiting AV neurons during the sample or choice phases had no effect on the mice's performance, but when they suppressed AV activity during the delay phase, which lasted 10 seconds or longer, the mice performed much worse on the task.

This suggests that the AV neurons are most important for keeping information in mind while it is needed for a task. In contrast, inhibiting the AD neurons disrupted performance during the sample phase but had little effect during the delay phase. This finding was consistent with the research team's earlier study showing that AD neurons are involved in forming memories of a physical space.

"The anterior thalamus in general is a spatial learning region, but the ventral neurons seem to be needed in this maintenance period, during this short delay," Roy says. "Now we have two subdivisions within the anterior thalamus: one that seems to help with contextual learning and the other that actually helps with holding this information."

Age-related decline

The researchers then tested the effects of age on this circuit. They found that older mice (14 months) performed worse on the T-maze task and their AV neurons were less excitable. However, when the researchers artificially stimulated those neurons, the mice's performance on the task dramatically improved.

Another way to enhance performance in this memory task is to stimulate the prefrontal cortex, which also undergoes age-related decline. However, activating the prefrontal cortex also increases measures of anxiety in the mice, the researchers found.

"If we directly activate neurons in medial prefrontal cortex, it will also elicit anxiety-related behavior, but this will not happen during AV activation," Zhang says. "That is an advantage of activating AV compared to prefrontal cortex."

If a noninvasive or minimally invasive technology could be used to stimulate those neurons in the human brain, it could offer a way to help prevent age-related memory decline, the researchers say. They are now planning to perform single-cell RNA sequencing of neurons of the anterior thalamus to find genetic signatures that could be used to identify cells that would make the best targets.

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People with less memory loss in old age gain more knowledge

Do cognitive abilities change together, or do they change independently of each other? An international research team from the USA, Sweden, and Germany involving the Max Planck Institute for Human Development has presented new findings now published in Science Advances.

At the age of 20, people usually find it easier to learn something new than at the age of 70. People aged 70, however, typically know more about the world than those aged 20. In lifespan psychology this is known as the difference between "fluid" and "crystallized" cognitive abilities. Fluid abilities primarily capture individual differences in brain integrity at the time of measurement, whereas crystallized abilities primarily capture individual differences in accumulated knowledge.

Accordingly, fluid and crystallized abilities differ in their average age trajectories. Fluid abilities like memory already start to decline in middle adulthood. In contrast. crystallized abilities such as vocabulary show increases until later adulthood and only evince decline in advanced old age.

This divergence in the average trajectories of fluid and crystallized abilities has led to the assumption that people can compensate for fluid losses with crystallized gains. For instance, if an individual's memory declines, this loss, it is assumed, can be compensated for by an increase in knowledge.

A study of a research team from Germany, Sweden and the USA now shows that this compensation hypothesis has more limits than previously claimed. The researchers analyzed data from two longitudinal studies, the Virginia Cognitive Aging Project (VCAP) study from the USA and the Betula study from Sweden. In the VCAP study, 3633 female and 1933 male participants aged 18-99 years at the first occasion of measurement were followed for a period of up to 18 years and assessed up to eight times. The Betula study involved 1803 women and 1517 men who were between 25 and 95 years old at the first measurement occasion and examined up to four times over 18 years.

The research team used multivariate methods of change measurement to examine the extent to which individual differences in changes in crystallized abilities are related to individual differences in fluid changes. The findings are clear: The correlations between the two types of changes observed in both studies were very high. Thus, individual differences in cognitive development are, to a large extent, domain-general and do not follow the fluid-crystallized divide. What this means is that individuals who show greater losses in fluid abilities simultaneously show smaller gains in crystallized abilities, and persons whose fluid abilities hardly decline show large gains in crystallized abilities.

These findings are in accordance with the everyday observation that some people remain mentally fit in many areas into very old age while others' cognitive functioning declines across the board.

"In intelligence research, people often talk about a general factor or g-factor of intelligence that expresses the commonality of different cognitive abilities," says the lead author of the study, Elliot Tucker-Drob of the Department of Psychology and the Population Research Center at the University of Texas at Austin, USA. "In previous work, we have already demonstrated that not only individual differences in cognitive abilities at a given point in time can be captured by a general factor, but also changes of cognitive abilities. Our new results confirm this finding and demonstrate that changes in crystallized abilities can indeed be subsumed under a general factor of common change."

"Our findings call for a revision of textbook knowledge," adds Ulman Lindenberger, Director of the Center for Lifespan Psychology at the Max Planck Institute for Human Development in Berlin. "If those who show the largest fluid losses also show the smallest crystallized gains, then this places tighter limits on the compensatory power of knowledge than previously believed." For example, people whose memory is declining, also show a low gain in knowledge, even though they are in most need of such gains. Conversely, individuals with small fluid losses and strong crystallized gains are less likely to be in need of relying on compensatory processes to begin with.

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