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Purpose of review, The goal of our nation-wide initiative is to provide clinicians intuitive and robust tools for accurate diagnosis, therapy monitoring and prognosis of cognitive decline that is based on large-scale multidomain data., Recent findings, We describe a federation framework that allows for statistical analysis of aggregated brain imaging and clinical phenotyping data across memory clinics in Switzerland. The adaptation and deployment of readily available data capturing and federation modules is paralleled by developments in ontology, quality and regulatory control of brain imaging data. Our initiative incentivizes data sharing through the common resource in a way that provides individual researcher with access to large-scale data that surpasses the data acquisition capacity of a single centre. Clinicians benefit from fine-grained epidemiological characterization of own data compared with the rest additional to intuitive tools allowing for computer-based diagnosis of dementia. Finally, our concept aims at closing the loop between group-level results based on aggregate data and individual diagnosis by providing disease models, that is, classifiers for neurocognitive disorders that will enable the computer-based diagnosis of individual patients., Summary, The obtained results will inform recommendations on best clinical practice in all relevant fields focusing on standardization and interoperability of acquired data, privacy protection framework and ethical consideration in the context of evolutive pathology.

Word retrieval in bilingual speakers partly depends on executive control systems in the left prefrontal cortex - including dorsolateral prefrontal cortex (DLPFC). We tested the hypothesis that DLPFC modulates word production of words specifically in a second language (L2) by measuring the effects of anodal transcranial direct current stimulation (anodal-tDCS) over the DLPFC on picture naming and word translation and on event-related potentials (ERPs) and their sources. Twenty-six bilingual participants with "unbalanced" proficiency in two languages were given 20 min of 1.5 mA anodal or sham tDCS (double-blind stimulation design, counterbalanced stimulation order, 1-week intersession delay). The participants then performed the following tasks: verbal and non-verbal fluency during anodal-tDCS stimulation and first and second language (L1 and L2) picture naming and translation [forward (L1 → L2) and backward (L2 → L1)] immediately after stimulation. The electroencephalogram (EEG) was recorded during picture naming and translation. On the behavioral level, anodal-tDCS had an influence on non-verbal fluency but neither on verbal fluency, nor on picture naming and translation. EEG measures revealed significant interactions between Language and Stimulation on picture naming around 380 ms post-stimulus onset and Translation direction and Stimulation on translation around 530 ms post-stimulus onset. These effects suggest that L2 phonological retrieval and phoneme encoding are spatially and temporally segregated in the brain. We conclude that anodal-tDCS stimulation has an effect at a neural level on phonological processes and, critically, that DLPFC-mediated activation is a constraint on language production specifically in L2.

Background : The purpose of this study was to assess decision making in patients with multiple sclerosis (MS) at the earliest clinically detectable time point of the disease. Methods : Patients with definite MS (n = 109) or with clinically isolated syndrome (CIS, n = 56), a disease duration of 3 months to 5 years, and no or only minor neurological impairment (Expanded Disability Status Scale [EDSS] score 0-2.5) were compared to 50 healthy controls using the Iowa Gambling Task (IGT). Results : The performance of definite MS, CIS patients, and controls was comparable for the two main outcomes of the IGT (learning index: p = 0.7; total score: p = 0.6). The IGT learning index was influenced by the educational level and the co-occurrence of minor depression. CIS and MS patients developing a relapse during an observation period of 15 months dated from IGT testing demonstrated a lower learning index in the IGT than patients who had no exacerbation (p = 0.02). When controlling for age, gender and education, the difference between relapsing and non-relapsing patients was at the limit of significance (p = 0.06). Conclusion : Decision making in a task mimicking real life decisions is generally preserved in early MS patients as compared to controls. A possible consequence of MS relapsing activity in the impairment of decision making ability is also suspected in the early phase of MS

The central hypothesis of the study which has been carried out as part of the NRP38 program, is that perturbations of brain energy metabolism are critically involved in the neurodegeneration occurring in Alzheimer's disease (AD) and that they may correlate with early cognitive dysfunctioning. In the present multidisciplinary study we set out to monitor brain energy metabolism using FDG-PET and HMPAO-SPECT imaging in a cohort of individuals over 65 years of age, drawn from the general population. HMPAO-SPECT imaging, which is a simpler and more widely accessible imaging procedure than FDG-PET, was performed under basal conditions and during the performance of a cognitive task (verbal fluency test). Three groups were studied. Two groups (groups I and II) included individuals age 65 or more, with no cognitive impairment and carrying an APOE4 positive or APOE4 negative phenotype, respectively; a third group (group III) included patients with clinical signs of AD. Each subject entering the study underwent an FDG-PET, an HMPAO-SPECT and an extensive battery of neuropsychological tests which assess various aspects of cognitive functioning, with a strong emphasis on working memory, divided attention and executive functions. A total of 101 participants were submitted to brain imaging and neuropsychological testing. Among these, 60 participants received the same set of imaging and neuropsychological tasks 24-36 months after the first set (phase II). In this article, we present a preliminary analysis performed on ten subjects from groups I and II and nine subjects from group III: activation (verbal fluency task) induced a specific pattern of increase in HMPAO retention (including BA 9/10, BA 18 bilaterally and right BA 17). In contrast to controls, in nine AD subjects no significant differences in HMPAO retention were observed when comparing activation and basal conditions. The cellular and molecular mechanisms that underlie the retention of HMPAO, the tracer used for single p