Administrative Supplement Grant

SMART Center Supplement Study 

Abstract: Blood Markers of Neurodegeneration and Neural Mechanisms Underlying Health Information Processing in Persons Managing Chronic Conditions. 

PI: Shirley M. Moore, PhD, RN, FAAN. Administrative Supplement to P30NR015326. NIH, National Institute for Nursing Research, National Institute on Aging.  8/1/18-7/31/18

To advance knowledge addressing early detection of persons at risk for Alzheimer’s Disease and related dementias (ADRD), we are requesting administrative supplemental funds to the parent grant, P30-NR-015326, SMART Center II: Brain-Behavior Connections in Self-management Science. The purpose of this supplement study is to examine associations between four blood markers of neurodegeneration and brain markers of neural processing (using fMRI) in response to health information in persons self-managing chronic conditions. We also will explore the associations among these blood markers of neurodegeneration and a set of clinical measures of neuropsychiatric symptoms and cognitive functioning that have shown some prior evidence of association with preclinical ADRD.

The SMART Center is currently conducting studies testing the hypothesis that individuals who are most capable of processing health information comprised of both analytic and emotion/coping components will achieve optimal self-management outcomes. To test this hypothesis, we are using a validated fMRI protocol exploring the neurobiological mechanisms underlying health information processing. Our protocol examines task differentiation associated with two large-scale neural networks, the default mode network (DMN) and the task positive network (TPN) in response to different types of health information (analytic and emotion/coping).

Thus, the aims of this supplement project are to: (1) Perform pooled analyses of data across seven SMART Center pilot studies to assess associations between blood markers of neurodegenerative processes and neural task differentiation in response to different types of health information. We hypothesize that lower levels of task differentiation will be associated with greater neurodegeneration as measured by blood markers: neurofilament light chain (NF-L), Amyloid beta isoform 42 (AB42), Amyloid beta isoform 40 (AB40), and Tau. (2) Assess the relationships between these blood markers of neurodegeneration and a set of neuropsychiatric and cognitive functioning symptoms associated with preclinical ADRD. It is hypothesized that higher levels of cognitive impairment, social isolation, anxiety, and depressed mood and lower levels of inhibitory control, executive function, memory and decision-making will be associated with greater neurodegeneration. We will also will assess relationships between structural brain markers of neurodegeneration (cortical thickness and hippocampal volume) and blood markers of neurodegeneration and nueropsychosocial and cognitive functioning.

The use of common data elements for measurement of our clinical parameters and stored blood samples across the center studies to allows us to combine data across studies to address important research questions when they arise. Thus, in this secondary analysis, we will pool data from seven pilot studies consisting of different populations: hypertension, cardiovascular events, HIV+, caregivers of medical technology-dependent children, caregivers of the chronically critically ill, and caregivers of cancer patients (N = 145).  If findings from this study show that neural task differentiation is related to markers of neurodegeneration, task differentiation may be a novel factor to be included in the future development of algorithms for early identification of persons at risk for ADRD.