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Archer DB, Bricker JT, Chu WT, Burciu RG, Mccracken JL, Lai S, Coombes SA, Fang R, Barmpoutis A, Corcos DM, Kurani AS, Mitchell T, Black ML, Herschel E, Simuni T, Parrish TB, Comella C, Xie T, Seppi K, Bohnen NI, Müller ML, Albin RL, Krismer F, Du G, Lewis MM, Huang X, Li H, Pasternak O, McFarland NR, Okun MS, Vaillancourt DE. Development and Validation of the Automated Imaging Differentiation in Parkinsonism (AID-P): A Multi-Site Machine Learning Study. Lancet Digit Health 2019; 1:e222-e231. [PMID: 32259098 PMCID: PMC7111208 DOI: 10.1016/s2589-7500(19)30105-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 12/12/2022]
Abstract
Background There is a critical need to develop valid, non-invasive biomarkers for Parkinsonian syndromes. The current 17-site, international study assesses whether non-invasive diffusion MRI (dMRI) can distinguish between Parkinsonian syndromes. Methods We used dMRI from 1002 subjects, along with the Movement Disorders Society Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III), to develop and validate disease-specific machine learning comparisons using 60 template regions and tracts of interest in Montreal Neurological Institute (MNI) space between Parkinson's disease (PD) and Atypical Parkinsonism (multiple system atrophy - MSA, progressive supranuclear palsy - PSP), as well as between MSA and PSP. For each comparison, models were developed on a training/validation cohort and evaluated in a test cohort by quantifying the area under the curve (AUC) of receiving operating characteristic (ROC) curves. Findings In the test cohort for both disease-specific comparisons, AUCs were high in the dMRI + MDS-UPDRS (PD vs. Atypical Parkinsonism: 0·962; MSA vs. PSP: 0·897) and dMRI Only (PD vs. Atypical Parkinsonism: 0·955; MSA vs. PSP: 0·926) models, whereas the MDS-UPDRS III Only models had significantly lower AUCs (PD vs. Atypical Parkinsonism: 0·775; MSA vs. PSP: 0·582). Interpretations This study provides an objective, validated, and generalizable imaging approach to distinguish different forms of Parkinsonian syndromes using multi-site dMRI cohorts. The dMRI method does not involve radioactive tracers, is completely automated, and can be collected in less than 12 minutes across 3T scanners worldwide. The use of this test could thus positively impact the clinical care of patients with Parkinson's disease and Parkinsonism as well as reduce the number of misdiagnosed cases in clinical trials.
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Affiliation(s)
- Derek B. Archer
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL
| | - Justin T. Bricker
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL
| | - Winston T. Chu
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL
| | - Roxana G. Burciu
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
| | - Johanna L. Mccracken
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL
| | - Song Lai
- Department of Radiation Oncology & CTSI Human Imaging Core, University of Florida, Gainesville, FL
| | - Stephen A. Coombes
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL
| | - Ruogu Fang
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL
| | - Angelos Barmpoutis
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL
- Digital Worlds Institute, University of Florida, Gainesville, FL
| | - Daniel M. Corcos
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - Ajay S. Kurani
- Department of Radiology, Northwestern University, Chicago, IL
| | - Trina Mitchell
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL
| | - Mieniecia L. Black
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL
| | - Ellen Herschel
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Tanya Simuni
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Todd B. Parrish
- Department of Radiology, Northwestern University, Chicago, IL
| | - Cynthia Comella
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - Tao Xie
- Department of Neurology, University of Chicago Medicine, Chicago, IL
| | - Klaus Seppi
- Department of Neurology, Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Nicolaas I. Bohnen
- Department of Radiology, University of Michigan, Ann Arbor, MI
- Department of Neurology, University of Michigan, Ann Arbor, MI
- Neurology Service & Geriatrics Research, Education, and Clinical Center, VA Ann Arbor Healthcare
- The University of Michigan Morri K. Udall Center of Excellence for Parkinson’s Disease Research, Ann Arbor, MI
| | - Martijn L.T.M. Müller
- Department of Radiology, University of Michigan, Ann Arbor, MI
- The University of Michigan Morri K. Udall Center of Excellence for Parkinson’s Disease Research, Ann Arbor, MI
| | - Roger L. Albin
- Department of Neurology, University of Michigan, Ann Arbor, MI
- Neurology Service & Geriatrics Research, Education, and Clinical Center, VA Ann Arbor Healthcare
- The University of Michigan Morri K. Udall Center of Excellence for Parkinson’s Disease Research, Ann Arbor, MI
| | - Florian Krismer
- Department of Neurology, Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Guangwei Du
- Department of Neurology, Penn State – Milton S. Hershey Medical Center, Hershey, PA
| | - Mechelle M. Lewis
- Department of Neurology, Penn State – Milton S. Hershey Medical Center, Hershey, PA
- Department of Pharmacology, Penn State – Milton S. Hershey Medical Center, Hershey, PA
| | - Xuemei Huang
- Department of Neurology, Penn State – Milton S. Hershey Medical Center, Hershey, PA
- Department of Pharmacology, Penn State – Milton S. Hershey Medical Center, Hershey, PA
- Departments of Neurosurgery, Radiology, and Kinesiology, Penn State - Milton S. Hershey Medical Center, Hershey, PA
| | - Hong Li
- Department of Public Health Sciences, Medical College of South Carolina, Charleston, SC
| | - Ofer Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Nikolaus R. McFarland
- Fixel Institute for Neurological Disease, College of Medicine, University of Florida, Gainesville, FL
- Department of Neurology, University of Florida, McKnight Brain Institute, Gainesville, FL
| | - Michael S. Okun
- Fixel Institute for Neurological Disease, College of Medicine, University of Florida, Gainesville, FL
- Department of Neurology, University of Florida, McKnight Brain Institute, Gainesville, FL
- Department of Neurosurgery, University of Florida, McKnight Brain Institute, Gainesville, FL
| | - David E. Vaillancourt
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL
- Fixel Institute for Neurological Disease, College of Medicine, University of Florida, Gainesville, FL
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL
- Department of Neurology, University of Florida, McKnight Brain Institute, Gainesville, FL
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Abel S, Kolind S. Improving parkinsonism diagnosis with machine learning. Lancet Digit Health 2019; 1:e196-e197. [PMID: 33323265 DOI: 10.1016/s2589-7500(19)30107-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 08/09/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Shawna Abel
- Department of Medicine (Neurology), University of British Columbia, Vancouver, Canada
| | - Shannon Kolind
- Department of Medicine (Neurology), Department of Physics & Astronomy, and Department of Radiology, University of British Columbia, Vancouver, BC, Canada.
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Li Y, Zhang C, Wang P, Xie T, Zeng X, Zhang Y, Cheng O, Yan F. [A partition bagging ensemble learning algorithm for Parkinson's speech data mining]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2019; 36:548-556. [PMID: 31441254 PMCID: PMC10319506 DOI: 10.7507/1001-5515.201803061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Indexed: 11/03/2022]
Abstract
Methods for achieving diagnosis of Parkinson's disease (PD) based on speech data mining have been proven effective in recent years. However, due to factors such as the degree of disease of the data collection subjects and the collection equipment and environment, there are different categories of sample aliasing in the sample space of the acquired data set. Samples in the aliased area are difficult to be identified effectively, which seriously affects the classification accuracy of the algorithm. In order to solve this problem, a partition bagging ensemble learning is proposed in this article, which measures the aliasing degree of the sample by designing the the ratio of sample centroid distance metrics and divides the training set into multiple subsets. And then the method of transfer training of misclassified samples is used to adjust the results of subset partitioning. Finally, the optimized weights of each sub-classifier are used to integrate the test results. The experimental results show that the classification accuracy of the proposed method is significantly improved on two public datasets and the increasement of mean accuracy is up to 25.44%. This method not only effectively improves the classification accuracy of PD speech dataset, but also increases the sample utilization rate, providing a new idea for the diagnosis of PD.
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Affiliation(s)
- Yongming Li
- School of Microelectronics and Communication Engineering, Chongqing University, Chongqing 400044, P.R.China;Collaborative Innovation Center for Brain Science, Chongqing University, Chongqing 400044,
| | - Cheng Zhang
- School of Microelectronics and Communication Engineering, Chongqing University, Chongqing 400044, P.R.China
| | - Pin Wang
- School of Microelectronics and Communication Engineering, Chongqing University, Chongqing 400044, P.R.China
| | - Tingjie Xie
- School of Microelectronics and Communication Engineering, Chongqing University, Chongqing 400044, P.R.China
| | - Xiaoping Zeng
- School of Microelectronics and Communication Engineering, Chongqing University, Chongqing 400044, P.R.China
| | - Yanling Zhang
- Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R.China
| | - Oumei Cheng
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, P.R.China
| | - Fang Yan
- School of Microelectronics and Communication Engineering, Chongqing University, Chongqing 400044, P.R.China
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204
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De Luca CMG, Elia AE, Portaleone SM, Cazzaniga FA, Rossi M, Bistaffa E, De Cecco E, Narkiewicz J, Salzano G, Carletta O, Romito L, Devigili G, Soliveri P, Tiraboschi P, Legname G, Tagliavini F, Eleopra R, Giaccone G, Moda F. Efficient RT-QuIC seeding activity for α-synuclein in olfactory mucosa samples of patients with Parkinson's disease and multiple system atrophy. Transl Neurodegener 2019; 8:24. [PMID: 31406572 PMCID: PMC6686411 DOI: 10.1186/s40035-019-0164-x] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/18/2019] [Indexed: 02/06/2023] Open
Abstract
Background Parkinson’s disease (PD) is a neurodegenerative disorder whose diagnosis is often challenging because symptoms may overlap with neurodegenerative parkinsonisms. PD is characterized by intraneuronal accumulation of abnormal α-synuclein in brainstem while neurodegenerative parkinsonisms might be associated with accumulation of either α-synuclein, as in the case of Multiple System Atrophy (MSA) or tau, as in the case of Corticobasal Degeneration (CBD) and Progressive Supranuclear Palsy (PSP), in other disease-specific brain regions. Definite diagnosis of all these diseases can be formulated only neuropathologically by detection and localization of α-synuclein or tau aggregates in the brain. Compelling evidence suggests that trace-amount of these proteins can appear in peripheral tissues, including receptor neurons of the olfactory mucosa (OM). Methods We have set and standardized the experimental conditions to extend the ultrasensitive Real Time Quaking Induced Conversion (RT-QuIC) assay for OM analysis. In particular, by using human recombinant α-synuclein as substrate of reaction, we have assessed the ability of OM collected from patients with clinical diagnoses of PD and MSA to induce α-synuclein aggregation, and compared their seeding ability to that of OM samples collected from patients with clinical diagnoses of CBD and PSP. Results Our results showed that a significant percentage of MSA and PD samples induced α-synuclein aggregation with high efficiency, but also few samples of patients with the clinical diagnosis of CBD and PSP caused the same effect. Notably, the final RT-QuIC aggregates obtained from MSA and PD samples owned peculiar biochemical and morphological features potentially enabling their discrimination. Conclusions Our study provide the proof-of-concept that olfactory mucosa samples collected from patients with PD and MSA possess important seeding activities for α-synuclein. Additional studies are required for (i) estimating sensitivity and specificity of the technique and for (ii) evaluating its application for the diagnosis of PD and neurodegenerative parkinsonisms. RT-QuIC analyses of OM and cerebrospinal fluid (CSF) can be combined with the aim of increasing the overall diagnostic accuracy of these diseases, especially in the early stages. Electronic supplementary material The online version of this article (10.1186/s40035-019-0164-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Antonio Emanuele Elia
- 2Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology I - Parkinson and Movement Disorders Unit, Milan, Italy
| | - Sara Maria Portaleone
- 3Department of Health Sciences, Università degli Studi di Milano, Otolaryngology Unit, San Paolo Hospital, Milan, Italy
| | - Federico Angelo Cazzaniga
- 1Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5 and Neuropathology, Milan, Italy
| | - Martina Rossi
- 4Department of Neuroscience, Scuola Internazionale Superiore di Studi Avanzati (SISSA), Laboratory of Prion Biology, Trieste, Italy
| | - Edoardo Bistaffa
- 1Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5 and Neuropathology, Milan, Italy
| | - Elena De Cecco
- 4Department of Neuroscience, Scuola Internazionale Superiore di Studi Avanzati (SISSA), Laboratory of Prion Biology, Trieste, Italy
| | - Joanna Narkiewicz
- 4Department of Neuroscience, Scuola Internazionale Superiore di Studi Avanzati (SISSA), Laboratory of Prion Biology, Trieste, Italy
| | - Giulia Salzano
- 4Department of Neuroscience, Scuola Internazionale Superiore di Studi Avanzati (SISSA), Laboratory of Prion Biology, Trieste, Italy
| | - Olga Carletta
- 1Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5 and Neuropathology, Milan, Italy
| | - Luigi Romito
- 2Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology I - Parkinson and Movement Disorders Unit, Milan, Italy
| | - Grazia Devigili
- 2Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology I - Parkinson and Movement Disorders Unit, Milan, Italy
| | - Paola Soliveri
- 2Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology I - Parkinson and Movement Disorders Unit, Milan, Italy
| | - Pietro Tiraboschi
- 1Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5 and Neuropathology, Milan, Italy
| | - Giuseppe Legname
- 4Department of Neuroscience, Scuola Internazionale Superiore di Studi Avanzati (SISSA), Laboratory of Prion Biology, Trieste, Italy
| | - Fabrizio Tagliavini
- 5Fondazione IRCCS Istituto Neurologico Carlo Besta, Scientific Directorate, Milan, Italy
| | - Roberto Eleopra
- 2Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology I - Parkinson and Movement Disorders Unit, Milan, Italy
| | - Giorgio Giaccone
- 1Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5 and Neuropathology, Milan, Italy
| | - Fabio Moda
- 1Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5 and Neuropathology, Milan, Italy
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205
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Weiss HD, Pontone GM. "Pseudo-syndromes" associated with Parkinson disease, dementia, apathy, anxiety, and depression. Neurol Clin Pract 2019; 9:354-359. [PMID: 31583191 PMCID: PMC6745743 DOI: 10.1212/cpj.0000000000000644] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/15/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Physicians treating patients with Parkinson disease must evaluate not only motor symptoms but also acquire expertise in assessing the complex behavioral features that often accompany the disease, such as dementia, apathy, anxiety, and depression. RECENT FINDINGS There is a risk of diagnostic confusion and error because many of the behavioral and motor symptoms accentuate, overlap, or mimic each other. SUMMARY Awareness of potential diagnostic pitfalls and "pseudo-syndromes" should lead to more accurate clinical assessment and better care for our patients.
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Affiliation(s)
- Howard D Weiss
- Sinai Hospital of Baltimore (HDW); Department of Neurology and Neurological Sciences, Johns Hopkins University (HDW); and Department of Psychiatry and Behavioral Sciences, Johns Hopkins University (GMP)
| | - Gregory M Pontone
- Sinai Hospital of Baltimore (HDW); Department of Neurology and Neurological Sciences, Johns Hopkins University (HDW); and Department of Psychiatry and Behavioral Sciences, Johns Hopkins University (GMP)
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206
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Klietz M, Bronzlik P, Nösel P, Wegner F, Dressler DW, Dadak M, Maudsley AA, Sheriff S, Lanfermann H, Ding XQ. Altered Neurometabolic Profile in Early Parkinson's Disease: A Study With Short Echo-Time Whole Brain MR Spectroscopic Imaging. Front Neurol 2019; 10:777. [PMID: 31379726 PMCID: PMC6651356 DOI: 10.3389/fneur.2019.00777] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 07/03/2019] [Indexed: 12/11/2022] Open
Abstract
Objective: To estimate alterations in neurometabolic profile of patients with early stage Parkinson's disease (PD) by using a short echo-time whole brain magnetic resonance spectroscopic imaging (wbMRSI) as possible biomarker for early diagnosis and monitoring of PD. Methods: 20 PD patients in early stage (H&Y ≤ 2) without evidence of severe other diseases and 20 age and sex matched healthy controls underwent wbMRSI. In each subject brain regional concentrations of metabolites N-acetyl-aspartate (NAA), choline (Cho), total creatine (tCr), glutamine (Gln), glutamate (Glu), and myo-inositol (mIns) were obtained in atlas-defined lobar structures including subcortical basal ganglia structures (the left and right frontal lobes, temporal lobes, parietal lobes, occipital lobes, and the cerebellum) and compared between patients and matched healthy controls. Clinical characteristics of the PD patients were correlated with spectroscopic findings. Results: In comparison to controls the PD patients revealed altered lobar metabolite levels in all brain lobes contralateral to dominantly affected body side, i.e., decreases of temporal NAA, Cho, and tCr, parietal NAA and tCr, and frontal as well as occipital NAA. The frontal NAA correlated negatively with the MDS-UPDRS II (R = 22120.585, p = 0.008), MDS-UPDRS IV (R = −0.458, p = 0.048) and total MDS-UPDRS scores (R = −0.679, p = 0.001). Conclusion: In early PD stages metabolic alterations are evident in all contralateral brain lobes demonstrating that the neurodegenerative process affects not only local areas by dopaminergic denervation, but also the functional network within different brain regions. The wbMRSI-detectable brain metabolic alterations reveal the potential to serve as biomarkers for early PD.
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Affiliation(s)
- Martin Klietz
- Department of Neurology, Hannover Medical School, Hanover, Germany
| | - Paul Bronzlik
- Department of Neuroradiology, Hannover Medical School, Hanover, Germany
| | - Patrick Nösel
- Department of Neuroradiology, Hannover Medical School, Hanover, Germany
| | - Florian Wegner
- Department of Neurology, Hannover Medical School, Hanover, Germany
| | - Dirk W Dressler
- Department of Neurology, Hannover Medical School, Hanover, Germany
| | - Mete Dadak
- Department of Neuroradiology, Hannover Medical School, Hanover, Germany
| | - Andrew A Maudsley
- Department of Radiology, University of Miami School of Medicine, Miami, FL, United States
| | - Sulaiman Sheriff
- Department of Radiology, University of Miami School of Medicine, Miami, FL, United States
| | | | - Xiao-Qi Ding
- Department of Neuroradiology, Hannover Medical School, Hanover, Germany
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Belić M, Bobić V, Badža M, Šolaja N, Đurić-Jovičić M, Kostić VS. Artificial intelligence for assisting diagnostics and assessment of Parkinson's disease-A review. Clin Neurol Neurosurg 2019; 184:105442. [PMID: 31351213 DOI: 10.1016/j.clineuro.2019.105442] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/31/2019] [Accepted: 07/11/2019] [Indexed: 01/30/2023]
Abstract
Artificial intelligence, specifically machine learning, has found numerous applications in computer-aided diagnostics, monitoring and management of neurodegenerative movement disorders of parkinsonian type. These tasks are not trivial due to high inter-subject variability and similarity of clinical presentations of different neurodegenerative disorders in the early stages. This paper aims to give a comprehensive, high-level overview of applications of artificial intelligence through machine learning algorithms in kinematic analysis of movement disorders, specifically Parkinson's disease (PD). We surveyed papers published between January 2007 and January 2019, within online databases, including PubMed and Science Direct, with a focus on the most recently published studies. The search encompassed papers dealing with the implementation of machine learning algorithms for diagnosis and assessment of PD using data describing motion of upper and lower extremities. This systematic review presents an overview of 48 relevant studies published in the abovementioned period, which investigate the use of artificial intelligence for diagnostics, therapy assessment and progress prediction in PD based on body kinematics. Different machine learning algorithms showed promising results, particularly for early PD diagnostics. The investigated publications demonstrated the potentials of collecting data from affordable and globally available devices. However, to fully exploit artificial intelligence technologies in the future, more widespread collaboration is advised among medical institutions, clinicians and researchers, to facilitate aligning of data collection protocols, sharing and merging of data sets.
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Affiliation(s)
- Minja Belić
- Innovation Center, School of Electrical Engineering, University of Belgrade, Belgrade, Serbia.
| | - Vladislava Bobić
- Innovation Center, School of Electrical Engineering, University of Belgrade, Belgrade, Serbia; School of Electrical Engineering, University of Belgrade, Belgrade, Serbia.
| | - Milica Badža
- Innovation Center, School of Electrical Engineering, University of Belgrade, Belgrade, Serbia; School of Electrical Engineering, University of Belgrade, Belgrade, Serbia.
| | - Nikola Šolaja
- School of Electrical Engineering, University of Belgrade, Belgrade, Serbia.
| | - Milica Đurić-Jovičić
- Innovation Center, School of Electrical Engineering, University of Belgrade, Belgrade, Serbia.
| | - Vladimir S Kostić
- Clinic of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia.
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Rajput AH, Rajput EF, Bocking SM, Auer RN, Rajput A. Parkinsonism in essential tremor cases: A clinicopathological study. Mov Disord 2019; 34:1031-1040. [PMID: 31180613 PMCID: PMC6771898 DOI: 10.1002/mds.27729] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Essential tremor and Parkinson's syndrome are two common movement disorders that may co-occur in some individuals. There is no diagnostic neuropathology for essential tremor, but in PD and other Parkinson's syndrome variants, the neuropathology is well known. The spectrum of Parkinson's syndrome variants associated with essential tremor, their clinical features, and course have not been determined in autopsy-confirmed cases. OBJECTIVES To identify: diagnostic features of essential tremor/Parkinson's syndrome, different Parkinson's syndrome variants, and long-term clinical profile in such cases. METHODS Patients that had an essential tremor diagnosis and a subsequent clinical or pathological diagnosis of Parkinson's syndrome seen in our clinic during 50 years were included. The diagnosis of parkinsonism was made when bradykinesia, rigidity, and resting tremor were all clinically evident. RESULTS Twenty-one cases were included. All the common variants of parkinsonism co-occurred with essential tremor. The most common was PD (67%) followed by PSP. The pathological findings were not predicted clinically in 2 cases that had essential tremor/PD and in all 5 essential tremor/PSP cases. CONCLUSION In most essential tremor/Parkinson's syndrome patients, the main motor features of parkinsonism-bradykinesia, rigidity, and resting tremor-were identifiable. All known degenerative Parkinson's syndrome variants co-occurred in essential tremor patients. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Ali H. Rajput
- Saskatchewan Movement Disorders ProgramUniversity of Saskatchewan/ Saskatchewan Health AuthoritySaskatoonSaskatchewanCanada
| | - Emma F. Rajput
- Saskatchewan Movement Disorders ProgramUniversity of Saskatchewan/ Saskatchewan Health AuthoritySaskatoonSaskatchewanCanada
| | - Sarah M. Bocking
- Saskatchewan Movement Disorders ProgramUniversity of Saskatchewan/ Saskatchewan Health AuthoritySaskatoonSaskatchewanCanada
| | - Roland N. Auer
- Department of PathologySaskatchewan Health AuthoritySaskatoonSaskatchewanCanada
| | - Alex Rajput
- Saskatchewan Movement Disorders ProgramUniversity of Saskatchewan/ Saskatchewan Health AuthoritySaskatoonSaskatchewanCanada
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Pizarro C, Esteban-Díez I, Espinosa M, Rodríguez-Royo F, González-Sáiz JM. An NMR-based lipidomic approach to identify Parkinson's disease-stage specific lipoprotein-lipid signatures in plasma. Analyst 2019; 144:1334-1344. [PMID: 30564825 DOI: 10.1039/c8an01778f] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Disturbances in lipid composition and lipoproteins metabolism can play a crucial role in the pathogenesis of Parkinson's disease (PD) and other neurodegenerative diseases. The lipidomic strategy proposed here involves lipoprotein profiling using NMR spectroscopy and multivariate data pre-processing and analysis tools on 94 plasma samples (belonging to 38 early-stage PD patients, 10 PD-related dementia patients, 23 persons with Alzheimer's dementia, and 23 healthy control subjects) to firstly differentiate PD patients (irrespective of the stage of the disease) from persons with Alzheimer's disease (AD) as well as from controls, and then to discriminate among PD patients according to disease severity. The whole data set was subdivided into 86 training and 8 external test samples for validation purposes. A two-step classification scheme, based on linear discriminant analysis with variable selection accomplished by a stepwise orthogonalisation procedure, was proposed to optimise classification performance. Careful pre-processing of NMR signals was crucial to ensure data set quality. A total of 30 chemical shift buckets enabled differentiation between PD patients (regardless of disease severity), AD and control subjects, providing classification, cross-validation and external prediction rates of 100% in all cases. Only 15 variables were required to further discriminate between early-stage PD and PD-related dementia, again with 100% correct classifications, and internal/external predictions. The simplicity and effectiveness of the classification methodology proposed support the use of NMR spectroscopy, in combination with chemometrics, as a viable alternative diagnostic tool to conventional PD clinical diagnosis.
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Affiliation(s)
- Consuelo Pizarro
- Department of Chemistry, University of La Rioja, E-26006 Logroño, Spain.
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Network imaging biomarkers: insights and clinical applications in Parkinson's disease. Lancet Neurol 2019; 17:629-640. [PMID: 29914708 DOI: 10.1016/s1474-4422(18)30169-8] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 04/13/2018] [Accepted: 04/25/2018] [Indexed: 12/14/2022]
Abstract
Parkinson's disease presents several practical challenges: it can be difficult to distinguish from atypical parkinsonian syndromes, clinical ratings can be insensitive as markers of disease progression, and its non-motor manifestations are not readily assessed in animal models. These challenges, along with others, are beginning to be addressed by innovative imaging methods to characterise Parkinson's disease-specific functional networks across the whole brain and measure their expression in each patient. These signatures can help improve differential diagnosis, guide selection of patients for clinical trials, and quantify treatment responses and placebo effects in individual patients. The primary Parkinson's disease-related metabolic pattern has been replicated in multiple patient populations and used as an outcome measure in clinical trials. It can also be used as a predictor of near-term phenoconversion in prodromal syndromes, such as rapid eye movement sleep behaviour disorder. Functional network imaging holds great promise for future clinical use in the management of neurodegenerative disorders.
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Chelban V, Bocchetta M, Hassanein S, Haridy NA, Houlden H, Rohrer JD. An update on advances in magnetic resonance imaging of multiple system atrophy. J Neurol 2019; 266:1036-1045. [PMID: 30460448 PMCID: PMC6420901 DOI: 10.1007/s00415-018-9121-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/11/2018] [Indexed: 02/08/2023]
Abstract
In this review, we describe how different neuroimaging tools have been used to identify novel MSA biomarkers, highlighting their advantages and limitations. First, we describe the main structural MRI changes frequently associated with MSA including the 'hot cross-bun' and 'putaminal rim' signs as well as putaminal, pontine, and middle cerebellar peduncle (MCP) atrophy. We discuss the sensitivity and specificity of different supra- and infratentorial changes in differentiating MSA from other disorders, highlighting those that can improve diagnostic accuracy, including the MCP width and MCP/superior cerebellar peduncle (SCP) ratio on T1-weighted imaging, raised putaminal diffusivity on diffusion-weighted imaging, and increased T2* signal in the putamen, striatum, and substantia nigra on susceptibility-weighted imaging. Second, we focus on recent advances in structural and functional MRI techniques including diffusion tensor imaging (DTI), resting-state functional MRI (fMRI), and arterial spin labelling (ASL) imaging. Finally, we discuss new approaches for MSA research such as multimodal neuroimaging strategies and how such markers may be applied in clinical trials to provide crucial data for accurately selecting patients and to act as secondary outcome measures.
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Affiliation(s)
- Viorica Chelban
- Department of Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- Department of Neurology and Neurosurgery, Institute of Emergency Medicine, Toma Ciorbă 1, 2052, Chisinau, Moldova
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK
| | - Sara Hassanein
- Diagnostic Radiology department, Faculty of Medicine Assiut University, Assiut, Egypt
- Department of Brain, Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK
| | - Nourelhoda A Haridy
- Department of Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
| | - Henry Houlden
- Department of Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK.
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212
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Kim JY, Illigens BM, McCormick MP, Wang N, Gibbons CH. Alpha-Synuclein in Skin Nerve Fibers as a Biomarker for Alpha-Synucleinopathies. J Clin Neurol 2019; 15:135-142. [PMID: 30938106 PMCID: PMC6444158 DOI: 10.3988/jcn.2019.15.2.135] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/01/2018] [Accepted: 10/02/2018] [Indexed: 12/05/2022] Open
Abstract
The common pathological features of synucleinopathies are abnormal aggregates of the synaptic protein alpha-synuclein (αSN) in the cytoplasm of neurons or glia. These abnormal aggregates appear several years before the onset of clinical manifestations, and so the early detection of αSN in body fluids or peripheral tissues (e.g., cerebrospinal fluid, colonic mucosa, salivary glands, and skin) is considered a potential tool for identifying synucleinopathies. Performing a skin biopsy is a practical option because it is a relatively noninvasive, safe, and reliable method to measure αSN deposition in the peripheral nervous system. Moreover, there is growing research interest in the use of cutaneous synuclein deposition as a biomarker for synucleinopathies. The aim of this study was to interpret the current data on cutaneous αSN deposition and present the current perspectives and future prospects.
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Affiliation(s)
- Jee Young Kim
- Department of Neurology, Myongji Hospital, Hanyang University Medical Center, Goyang, Korea.
| | - Ben Mw Illigens
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Michael P McCormick
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ningshan Wang
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Christopher H Gibbons
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Buchman AS, Yu L, Wilson RS, Leurgans SE, Nag S, Shulman JM, Barnes LL, Schneider JA, Bennett DA. Progressive parkinsonism in older adults is related to the burden of mixed brain pathologies. Neurology 2019; 92:e1821-e1830. [PMID: 30894446 PMCID: PMC6550497 DOI: 10.1212/wnl.0000000000007315] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 12/17/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To examine whether indices of Parkinson disease (PD) pathology and other brain pathologies are associated with the progression of parkinsonism in older adults. METHODS We used data from decedents who had undergone annual clinical testing prior to death and structured brain autopsy. Parkinsonism was based on assessment with a modified Unified Parkinson's Disease Rating Scale and a clinical diagnosis of PD was based on medical history. We used a series of mixed-effects models controlling for age and sex to investigate the association of PD pathology (nigral neuronal loss and Lewy bodies) and indices of 8 other brain pathologies with the progression of parkinsonism prior to death. RESULTS During an average of 8.5 years' follow-up, more than half (771/1,430, 53.9%) developed parkinsonism proximate to death. On average, parkinsonism was progressive (estimate 0.130, SE 0.005, p < 0.001) in all older adults, but more rapid in adults with a clinical diagnosis of PD (n = 52; 3.6%) (estimate 0.066, SE 0.021, p < 0.001). Progression of parkinsonism was more rapid in adults with PD pathology (estimate 0.087, SE 0.013, p < 0.001). Alzheimer disease and several cerebrovascular pathologies were all independently associated with more rapid progression (all p values <0.05). The association between a higher person-specific weighted pathology score and more rapidly progressive parkinsonism did not differ between individuals with and without a clinical diagnosis of PD (estimate 0.003, SE 0.047, p = 0.957). CONCLUSION The rate of progressive parkinsonism in older adults with and without a clinical diagnosis of PD is related to the burden of mixed brain pathologies.
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Affiliation(s)
- Aron S Buchman
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., S.E.L., S.N., L.L.B., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., S.E.L., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., L.L.B.), and Pathology (Neuropathology) (S.N., J.A.S.), Rush University Medical Center, Chicago, IL; Departments of Neurology, Molecular and Human Genetics, Neuroscience, and Program in Developmental Biology (J.M.S.), Baylor College of Medicine, Houston, TX; and Jan and Dan Duncan Neurological Research Institute (J.M.S.), Texas Children's Hospital, Houston.
| | - Lei Yu
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., S.E.L., S.N., L.L.B., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., S.E.L., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., L.L.B.), and Pathology (Neuropathology) (S.N., J.A.S.), Rush University Medical Center, Chicago, IL; Departments of Neurology, Molecular and Human Genetics, Neuroscience, and Program in Developmental Biology (J.M.S.), Baylor College of Medicine, Houston, TX; and Jan and Dan Duncan Neurological Research Institute (J.M.S.), Texas Children's Hospital, Houston
| | - Robert S Wilson
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., S.E.L., S.N., L.L.B., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., S.E.L., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., L.L.B.), and Pathology (Neuropathology) (S.N., J.A.S.), Rush University Medical Center, Chicago, IL; Departments of Neurology, Molecular and Human Genetics, Neuroscience, and Program in Developmental Biology (J.M.S.), Baylor College of Medicine, Houston, TX; and Jan and Dan Duncan Neurological Research Institute (J.M.S.), Texas Children's Hospital, Houston
| | - Sue E Leurgans
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., S.E.L., S.N., L.L.B., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., S.E.L., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., L.L.B.), and Pathology (Neuropathology) (S.N., J.A.S.), Rush University Medical Center, Chicago, IL; Departments of Neurology, Molecular and Human Genetics, Neuroscience, and Program in Developmental Biology (J.M.S.), Baylor College of Medicine, Houston, TX; and Jan and Dan Duncan Neurological Research Institute (J.M.S.), Texas Children's Hospital, Houston
| | - Sukriti Nag
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., S.E.L., S.N., L.L.B., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., S.E.L., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., L.L.B.), and Pathology (Neuropathology) (S.N., J.A.S.), Rush University Medical Center, Chicago, IL; Departments of Neurology, Molecular and Human Genetics, Neuroscience, and Program in Developmental Biology (J.M.S.), Baylor College of Medicine, Houston, TX; and Jan and Dan Duncan Neurological Research Institute (J.M.S.), Texas Children's Hospital, Houston
| | - Joshua M Shulman
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., S.E.L., S.N., L.L.B., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., S.E.L., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., L.L.B.), and Pathology (Neuropathology) (S.N., J.A.S.), Rush University Medical Center, Chicago, IL; Departments of Neurology, Molecular and Human Genetics, Neuroscience, and Program in Developmental Biology (J.M.S.), Baylor College of Medicine, Houston, TX; and Jan and Dan Duncan Neurological Research Institute (J.M.S.), Texas Children's Hospital, Houston
| | - Lisa L Barnes
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., S.E.L., S.N., L.L.B., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., S.E.L., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., L.L.B.), and Pathology (Neuropathology) (S.N., J.A.S.), Rush University Medical Center, Chicago, IL; Departments of Neurology, Molecular and Human Genetics, Neuroscience, and Program in Developmental Biology (J.M.S.), Baylor College of Medicine, Houston, TX; and Jan and Dan Duncan Neurological Research Institute (J.M.S.), Texas Children's Hospital, Houston
| | - Julie A Schneider
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., S.E.L., S.N., L.L.B., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., S.E.L., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., L.L.B.), and Pathology (Neuropathology) (S.N., J.A.S.), Rush University Medical Center, Chicago, IL; Departments of Neurology, Molecular and Human Genetics, Neuroscience, and Program in Developmental Biology (J.M.S.), Baylor College of Medicine, Houston, TX; and Jan and Dan Duncan Neurological Research Institute (J.M.S.), Texas Children's Hospital, Houston
| | - David A Bennett
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., S.E.L., S.N., L.L.B., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., S.E.L., J.A.S., D.A.B.), Behavioral Sciences (R.S.W., L.L.B.), and Pathology (Neuropathology) (S.N., J.A.S.), Rush University Medical Center, Chicago, IL; Departments of Neurology, Molecular and Human Genetics, Neuroscience, and Program in Developmental Biology (J.M.S.), Baylor College of Medicine, Houston, TX; and Jan and Dan Duncan Neurological Research Institute (J.M.S.), Texas Children's Hospital, Houston
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Radiotracers for imaging of Parkinson's disease. Eur J Med Chem 2019; 166:75-89. [DOI: 10.1016/j.ejmech.2019.01.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/12/2019] [Accepted: 01/13/2019] [Indexed: 12/22/2022]
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215
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Harding Z, Wilkinson T, Stevenson A, Horrocks S, Ly A, Schnier C, Breen DP, Rannikmäe K, Sudlow CLM. Identifying Parkinson's disease and parkinsonism cases using routinely collected healthcare data: A systematic review. PLoS One 2019; 14:e0198736. [PMID: 30703084 PMCID: PMC6354966 DOI: 10.1371/journal.pone.0198736] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 01/11/2019] [Indexed: 12/14/2022] Open
Abstract
Background Population-based, prospective studies can provide important insights into Parkinson’s disease (PD) and other parkinsonian disorders. Participant follow-up in such studies is often achieved through linkage to routinely collected healthcare datasets. We systematically reviewed the published literature on the accuracy of these datasets for this purpose. Methods We searched four electronic databases for published studies that compared PD and parkinsonism cases identified using routinely collected data to a reference standard. We extracted study characteristics and two accuracy measures: positive predictive value (PPV) and/or sensitivity. Results We identified 18 articles, resulting in 27 measures of PPV and 14 of sensitivity. For PD, PPV ranged from 56–90% in hospital datasets, 53–87% in prescription datasets, 81–90% in primary care datasets and was 67% in mortality datasets. Combining diagnostic and medication codes increased PPV. For parkinsonism, PPV ranged from 36–88% in hospital datasets, 40–74% in prescription datasets, and was 94% in mortality datasets. Sensitivity ranged from 15–73% in single datasets for PD and 43–63% in single datasets for parkinsonism. Conclusions In many settings, routinely collected datasets generate good PPVs and reasonable sensitivities for identifying PD and parkinsonism cases. However, given the wide range of identified accuracy estimates, we recommend cohorts conduct their own context-specific validation studies if existing evidence is lacking. Further research is warranted to investigate primary care and medication datasets, and to develop algorithms that balance a high PPV with acceptable sensitivity.
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Affiliation(s)
- Zoe Harding
- College of Medicine & Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Tim Wilkinson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
| | - Anna Stevenson
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Cognitive Ageing and Cognitive Epidemiology, Edinburgh, United Kingdom
| | - Sophie Horrocks
- College of Medicine & Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Amanda Ly
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Christian Schnier
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - David P. Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, Scotland
| | - Kristiina Rannikmäe
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Cathie L. M. Sudlow
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
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216
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Stephenson D, Hill D, Cedarbaum JM, Tome M, Vamvakas S, Romero K, Conrado DJ, Dexter DT, Seibyl J, Jennings D, Nicholas T, Matthews D, Xie Z, Imam S, Maguire P, Russell D, Gordon MF, Stebbins GT, Somer E, Gallagher J, Roach A, Basseches P, Grosset D, Marek K. The Qualification of an Enrichment Biomarker for Clinical Trials Targeting Early Stages of Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2019; 9:553-563. [PMID: 31306141 PMCID: PMC6700608 DOI: 10.3233/jpd-191648] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/31/2019] [Indexed: 12/12/2022]
Abstract
As therapeutic trials target early stages of Parkinson's disease (PD), appropriate patient selection based purely on clinical criteria poses significant challenges. Members of the Critical Path for Parkinson's Consortium formally submitted documentation to the European Medicines Agency (EMA) supporting the use of Dopamine Transporter (DAT) neuroimaging in early PD. Regulatory documents included a comprehensive literature review, a proposed analysis plan of both observational and clinical trial data, and an assessment of biomarker reproducibility and reliability. The research plan included longitudinal analysis of the Parkinson Research Examination of CEP-1347 Trial (PRECEPT) and the Parkinson's Progression Markers Initiative (PPMI) study to estimate the degree of enrichment achieved and impact on future trials in subjects with early motor PD. The presence of reduced striatal DAT binding based on visual reads of single photon emission tomography (SPECT) scans in early motor PD subjects was an independent predictor of faster decline in UPDRS Parts II and III as compared to subjects with scans without evidence of dopaminergic deficit (SWEDD) over 24 months. The EMA issued in 2018 a full Qualification Opinion for the use of DAT as an enrichment biomarker in PD trials targeting subjects with early motor symptoms. Exclusion of SWEDD subjects in future clinical trials targeting early motor PD subjects aims to enrich clinical trial populations with idiopathic PD patients, improve statistical power, and exclude subjects who are unlikely to progress clinically from being exposed to novel test therapeutics.
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Affiliation(s)
| | | | | | - Maria Tome
- European Medicines Agency, Amsterdam, Netherlands
| | | | | | | | | | - John Seibyl
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
| | | | | | | | | | - Syed Imam
- U.S. Food and Drug Administration, National Center for Toxicological Research, Jefferson, AR, USA
| | | | - David Russell
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
| | | | | | | | | | | | | | | | - Kenneth Marek
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
| | - on behalf of the Critical Path for Parkinson’s Consortium
- Critical Path Institute, Tucson, AZ, USA
- University College London, UK
- Biogen, Cambridge, MA, USA
- European Medicines Agency, Amsterdam, Netherlands
- Parkinson’s UK, London, UK
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
- Denali Therapeutics, San Francisco, CA, USA
- Pfizer, Groton, CT, USA
- ADM Diagnostics, Northbrook, IL, USA
- UCB, Brussels, Belgium
- CPP Scientific Advisor, PA, USA
- GE Healthcare, London, UK
- Merck & Co., Philadelphia, PA, USA
- University of Glasgow, Scotland
- Rush University, Chicago, IL, USA
- U.S. Food and Drug Administration, National Center for Toxicological Research, Jefferson, AR, USA
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217
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Du G, Lewis MM, Sica C, Kong L, Huang X. Magnetic resonance T1w/T2w ratio: A parsimonious marker for Parkinson disease. Ann Neurol 2019; 85:96-104. [PMID: 30408230 PMCID: PMC6342624 DOI: 10.1002/ana.25376] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 10/30/2018] [Accepted: 10/31/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Newer magnetic resonance imaging (MRI) techniques have shown promise in capturing early Parkinson disease (PD)-related changes in the substantia nigra pars compacta (SNc), the key pathological loci. Their translational value, however, is hindered by technical complexity and inconsistent results. METHODS A novel yet simple MRI contrast, the T1w/T2w ratio, was used to study 76 PD patients and 70 controls. The T1w/T2w ratio maps were analyzed using both voxel-based and region-of-interest approaches in normalized space. The sensitivity and specificity of the SNc T1w/T2w ratio in discriminating between PD and controls also were assessed. In addition, its diagnostic performance was tested in a subgroup of PD patients with disease duration ≤2 years (PDE). A second independent cohort of 73 PD patients and 49 controls was used for validation. RESULTS Compared to controls, PD patients showed a higher T1w/T2w ratio in both the right (cluster size = 164mm3 , p < 0.0001) and left (cluster size = 213mm3 , p < 0.0001) midbrain that was located ventrolateral to the red nucleus and corresponded to the SNc. The region-of-interest approach confirmed the group difference in the SNc T1w/T2w ratio between PD and controls (p < 0.0001). The SNc T1w/T2w ratio had high sensitivity (0.908) and specificity (0.80) to separate PD and controls (area under the curve [AUC] = 0.926), even for PDE patients (AUC = 0.901, sensitivity = 0.857, specificity = 0.857). These results were validated in the second cohort. INTERPRETATION The T1w/T2w ratio can detect PD-related changes in the SNc and may be used as a novel, parsimonious in vivo biomarker for the disease, particularly for early stage patients, with high translational value for clinical practice and research. ANN NEUROL 2019;85:96-104.
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Affiliation(s)
- Guangwei Du
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, US
| | - Mechelle M. Lewis
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, US
- Department of Pharmacology, Penn State Hershey Medical Center, Hershey, PA, US
| | - Christopher Sica
- Department of Radiology, Penn State Hershey Medical Center, Hershey, PA, US
| | - Lan Kong
- Department of Public Health Sciences, Penn State Hershey Medical Center, Hershey, PA, US
| | - Xuemei Huang
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, US
- Department of Pharmacology, Penn State Hershey Medical Center, Hershey, PA, US
- Department of Radiology, Penn State Hershey Medical Center, Hershey, PA, US
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, PA, US
- Department of Kinesiology, Penn State Hershey Medical Center, Hershey, PA, US
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Maass F, Schulz I, Lingor P, Mollenhauer B, Bähr M. Cerebrospinal fluid biomarker for Parkinson's disease: An overview. Mol Cell Neurosci 2018; 97:60-66. [PMID: 30543858 DOI: 10.1016/j.mcn.2018.12.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/06/2018] [Accepted: 12/08/2018] [Indexed: 01/01/2023] Open
Abstract
In Parkinson's disease (PD), there is a wide field of recent and ongoing search for useful biomarkers for early and differential diagnosis, disease monitoring or subtype characterization. Up to now, no biofluid biomarker has entered the daily clinical routine. Cerebrospinal fluid (CSF) is often used as a source for biomarker development in different neurological disorders because it reflects changes in central-nervous system homeostasis. This review article gives an overview about different biomarker approaches in PD, mainly focusing on CSF analyses. Current state and future perspectives regarding classical protein markers like alpha‑synuclein, but also different "omics" techniques are described. In conclusion, technical advancements in the field already yielded promising results, but further multicenter trials with well-defined cohorts, standardized protocols and integrated data analysis of different modalities are needed before successful translation into routine clinical application.
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Affiliation(s)
- Fabian Maass
- University Medical Center, Department of Neurology, Robert-Koch Strasse 40, 37075 Goettingen, Germany.
| | - Isabel Schulz
- University of Southampton, Faculty of Medicine, 12 University Rd, Southampton SO17 1BJ, United Kingdom
| | - Paul Lingor
- Department of Neurology, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, 81675 Munich, Germany
| | - Brit Mollenhauer
- University Medical Center, Department of Neurology, Robert-Koch Strasse 40, 37075 Goettingen, Germany; Paracelsus-Elena-Klinik, Klinikstrasse 16, 24128 Kassel, Germany
| | - Mathias Bähr
- University Medical Center, Department of Neurology, Robert-Koch Strasse 40, 37075 Goettingen, Germany
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219
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Donadio V. Skin nerve α-synuclein deposits in Parkinson's disease and other synucleinopathies: a review. Clin Auton Res 2018; 29:577-585. [PMID: 30506233 DOI: 10.1007/s10286-018-0581-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 11/19/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE The in vivo diagnosis of synucleinopathies is an important research aim since clinical diagnostic criteria show low accuracy. The skin innervation, especially the autonomic subdivision, is a useful region to search for abnormal α-syn aggregates in synucleinopathies since the peripheral sympathetic nerves can be the earliest-affected neural region and autonomic symptoms may precede the classical symptoms of these disorders. METHODS The major advantages of skin biopsy as an in vivo diagnostic tool for synucleinopathies are that it is an inexpensive and easy-to-perform technique requiring only limited facilities, and that it is repeatable in long-term studies as it causes only minor discomfort to the patient. RESULTS This review analyzes current progress in this area of research that may facilitate the standardization of this method, potentially eliminating differences among laboratories in the implementation of the method. CONCLUSIONS The most suitable and commonly used technique for identifying in vivo α-syn aggregates in skin nerves is indirect immunofluorescence, although several aspects of this approach need to be standardized, particularly when synucleinopathies without autonomic failure present a patchy distribution of abnormal α-syn aggregates in skin nerves. By contrast, synucleinopathies with autonomic failure may present widespread diffusion of abnormal aggregates in autonomic skin nerves.
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Affiliation(s)
- Vincenzo Donadio
- IRCCS Istituto Delle Scienze Neurologiche di Bologna (Italy), UOC Clinica Neurologica, Via Altura 3, 40139, Bologna, Italy.
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Finberg JPM, Schwartz M, Jeries R, Badarny S, Nakhleh MK, Abu Daoud E, Ayubkhanov Y, Aboud-Hawa M, Broza YY, Haick H. Sensor Array for Detection of Early Stage Parkinson's Disease before Medication. ACS Chem Neurosci 2018; 9:2548-2553. [PMID: 29989795 DOI: 10.1021/acschemneuro.8b00245] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Early diagnosis of Parkinson's disease (PD) is important because it affects the choice of therapy and is subject to a relatively high degree of error. In addition, early detection of PD can potentially enable the start of neuroprotective therapy before extensive loss of dopaminergic neurons of the substantia nigra occurs. However, until now, studies for early detection of PD using volatile biomarkers sampled only treated and medicated patients. Therefore, there is a great need to evaluate untreated patients for establishing a real world screening and diagnostic technology. Here we describe for the first time a clinical trial to distinguish between de novo PD and control subjects using an electronic system for detection of volatile molecules in exhaled breath (sensor array). We further determine for the first time the association to other common tests for PD diagnostics as smell, ultrasound, and nonmotor symptoms. The test group consisted of 29 PD patients after initial diagnosis by an experienced neurologist, compared with 19 control subjects of similar age. The sensitivity, specificity, and accuracy values of the sensor array to detect PD from controls were 79%, 84%, and 81% respectively, in comparison with midbrain ultrasonography (93%, 90%, 92%) and smell detection (62%, 89%, 73%). The results confirm previous data showing the potential of sensor arrays to detect PD.
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Affiliation(s)
- John P. M. Finberg
- Neuroscience Department, Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa 3200003, Israel
| | - Miguel Schwartz
- Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa 3200003, Israel
| | - Raneen Jeries
- Department of Chemical Engineering, Technion - Israel Institute of Technology, Haifa 3200003, Israel
| | - Samih Badarny
- Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa 3200003, Israel
| | - Morad K. Nakhleh
- Department of Chemical Engineering, Technion - Israel Institute of Technology, Haifa 3200003, Israel
| | - Enas Abu Daoud
- Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa 3200003, Israel
| | - Yelena Ayubkhanov
- Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa 3200003, Israel
| | - Manal Aboud-Hawa
- Department of Chemical Engineering, Technion - Israel Institute of Technology, Haifa 3200003, Israel
| | - Yoav Y Broza
- Department of Chemical Engineering, Technion - Israel Institute of Technology, Haifa 3200003, Israel
| | - Hossam Haick
- Department of Chemical Engineering, Technion - Israel Institute of Technology, Haifa 3200003, Israel
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T. dos Santos MC, Scheller D, Schulte C, Mesa IR, Colman P, Bujac SR, Bell R, Berteau C, Perez LT, Lachmann I, Berg D, Maetzler W, Nogueira da Costa A. Evaluation of cerebrospinal fluid proteins as potential biomarkers for early stage Parkinson's disease diagnosis. PLoS One 2018; 13:e0206536. [PMID: 30383831 PMCID: PMC6211693 DOI: 10.1371/journal.pone.0206536] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 10/15/2018] [Indexed: 12/31/2022] Open
Abstract
Cerebrospinal fluid (CSF) has often been used as the source of choice for biomarker discovery with the goal to support the diagnosis of neurodegenerative diseases. For this study, we selected 15 CSF protein markers which were identified in previously published clinical investigations and proposed as potential biomarkers for PD diagnosis. We aimed at investigating and confirming their suitability for early stage diagnosis of the disease. The current study was performed in a two-fold confirmatory approach. Firstly, the CSF protein markers were analysed in confirmatory cohort I comprising 80 controls and 80 early clinical PD patients. Through univariate analysis we found significant changes of six potential biomarkers (α-syn, DJ-1, Aβ42, S100β, p-Tau and t-Tau). In order to increase robustness of the observations for potential patient differentiation, we developed-based on a machine learning approach-an algorithm which enabled identifying a panel of markers which would improve clinical diagnosis. Based on that model, a panel comprised of α-syn, S100β and UCHL1 were suggested as promising candidates. Secondly, we aimed at replicating our observations in an independent cohort (confirmatory cohort II) comprising 30 controls and 30 PD patients. The univariate analysis demonstrated Aβ42 as the only reproducible potential biomarker. Taking into account both technical and clinical aspects, these observations suggest that the large majority of the investigated CSF proteins currently proposed as potential biomarkers lack robustness and reproducibility in supporting diagnosis in the early clinical stages of PD.
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Affiliation(s)
| | | | - Claudia Schulte
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tuebingen and German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Irene R. Mesa
- Exploratory Statistics, Global Exploratory Development, UCB Pharma SA, Slough, United Kingdom
| | - Peter Colman
- Exploratory Statistics, Global Exploratory Development, UCB Pharma SA, Slough, United Kingdom
| | - Sarah R. Bujac
- Exploratory Statistics, Global Exploratory Development, UCB Pharma SA, Slough, United Kingdom
| | - Rosie Bell
- Translational Medicine, UCB Biopharma SPRL, Braine L’Alleud, Belgium
| | - Caroline Berteau
- Translational Medicine, UCB Biopharma SPRL, Braine L’Alleud, Belgium
| | - Luis Tosar Perez
- Bioanalytical Sciences, Non Clinical Development, UCB Biopharma SPRL, Braine L’Alleud, Belgium
| | | | - Daniela Berg
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tuebingen and German Center for Neurodegenerative Diseases, Tuebingen, Germany
- Department of Neurology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Walter Maetzler
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tuebingen and German Center for Neurodegenerative Diseases, Tuebingen, Germany
- Department of Neurology, Christian-Albrechts-University Kiel, Kiel, Germany
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Bäckström D, Granåsen G, Domellöf ME, Linder J, Jakobson Mo S, Riklund K, Zetterberg H, Blennow K, Forsgren L. Early predictors of mortality in parkinsonism and Parkinson disease: A population-based study. Neurology 2018; 91:e2045-e2056. [PMID: 30381367 PMCID: PMC6282235 DOI: 10.1212/wnl.0000000000006576] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/15/2018] [Indexed: 01/30/2023] Open
Abstract
Objective To examine mortality and associated risk factors, including possible effects of mild cognitive impairment, imaging, and CSF abnormalities, in a community-based population with incident parkinsonism and Parkinson disease. Methods One hundred eighty-two patients with new-onset, idiopathic parkinsonism were diagnosed from January 2004 through April 2009, in a catchment area of 142,000 inhabitants in Sweden. Patients were comprehensively investigated according to a multimodal research protocol and followed prospectively for up to 13.5 years. A total of 109 patients died. Mortality rates in the general Swedish population were used to calculate standardized mortality ratio and expected survival, and Cox proportional hazard models were used to investigate independent predictors of mortality. Results The standardized mortality ratio for all patients was 1.84 (95% confidence interval 1.50–2.22, p < 0.001). Patients with atypical parkinsonism (multiple system atrophy or progressive supranuclear palsy) had the highest mortality. In early Parkinson disease, a mild cognitive impairment diagnosis, freezing of gait, hyposmia, reduced dopamine transporter activity in the caudate, and elevated leukocytes in the CSF were significantly associated with shorter survival. Conclusion Although patients presenting with idiopathic parkinsonism have reduced survival, the survival is highly dependent on the type and characteristics of the parkinsonian disorder. Patients with Parkinson disease presenting with normal cognitive function seem to have a largely normal life expectancy. The finding of a subtle CSF leukocytosis in patients with Parkinson disease with short survival may have clinical implications.
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Affiliation(s)
- David Bäckström
- From the Department of Pharmacology and Clinical Neuroscience (D.B., M.E.D., J.L., L.F.), Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine (G.G.), Department of Psychology (M.E.D.), and Department of Radiation Sciences, Diagnostic Radiology and Umeå Center for Functional Brain Imaging (S.J.M., K.R.), Umeå University; Institute of Neuroscience and Physiology (H.Z., K.B.), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Mölndal; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience (H.Z.), University College London Institute of Neurology; and UK Dementia Research Institute at UCL (H.Z.), London, UK.
| | - Gabriel Granåsen
- From the Department of Pharmacology and Clinical Neuroscience (D.B., M.E.D., J.L., L.F.), Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine (G.G.), Department of Psychology (M.E.D.), and Department of Radiation Sciences, Diagnostic Radiology and Umeå Center for Functional Brain Imaging (S.J.M., K.R.), Umeå University; Institute of Neuroscience and Physiology (H.Z., K.B.), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Mölndal; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience (H.Z.), University College London Institute of Neurology; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Magdalena Eriksson Domellöf
- From the Department of Pharmacology and Clinical Neuroscience (D.B., M.E.D., J.L., L.F.), Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine (G.G.), Department of Psychology (M.E.D.), and Department of Radiation Sciences, Diagnostic Radiology and Umeå Center for Functional Brain Imaging (S.J.M., K.R.), Umeå University; Institute of Neuroscience and Physiology (H.Z., K.B.), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Mölndal; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience (H.Z.), University College London Institute of Neurology; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Jan Linder
- From the Department of Pharmacology and Clinical Neuroscience (D.B., M.E.D., J.L., L.F.), Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine (G.G.), Department of Psychology (M.E.D.), and Department of Radiation Sciences, Diagnostic Radiology and Umeå Center for Functional Brain Imaging (S.J.M., K.R.), Umeå University; Institute of Neuroscience and Physiology (H.Z., K.B.), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Mölndal; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience (H.Z.), University College London Institute of Neurology; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Susanna Jakobson Mo
- From the Department of Pharmacology and Clinical Neuroscience (D.B., M.E.D., J.L., L.F.), Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine (G.G.), Department of Psychology (M.E.D.), and Department of Radiation Sciences, Diagnostic Radiology and Umeå Center for Functional Brain Imaging (S.J.M., K.R.), Umeå University; Institute of Neuroscience and Physiology (H.Z., K.B.), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Mölndal; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience (H.Z.), University College London Institute of Neurology; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Katrine Riklund
- From the Department of Pharmacology and Clinical Neuroscience (D.B., M.E.D., J.L., L.F.), Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine (G.G.), Department of Psychology (M.E.D.), and Department of Radiation Sciences, Diagnostic Radiology and Umeå Center for Functional Brain Imaging (S.J.M., K.R.), Umeå University; Institute of Neuroscience and Physiology (H.Z., K.B.), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Mölndal; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience (H.Z.), University College London Institute of Neurology; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Henrik Zetterberg
- From the Department of Pharmacology and Clinical Neuroscience (D.B., M.E.D., J.L., L.F.), Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine (G.G.), Department of Psychology (M.E.D.), and Department of Radiation Sciences, Diagnostic Radiology and Umeå Center for Functional Brain Imaging (S.J.M., K.R.), Umeå University; Institute of Neuroscience and Physiology (H.Z., K.B.), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Mölndal; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience (H.Z.), University College London Institute of Neurology; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Kaj Blennow
- From the Department of Pharmacology and Clinical Neuroscience (D.B., M.E.D., J.L., L.F.), Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine (G.G.), Department of Psychology (M.E.D.), and Department of Radiation Sciences, Diagnostic Radiology and Umeå Center for Functional Brain Imaging (S.J.M., K.R.), Umeå University; Institute of Neuroscience and Physiology (H.Z., K.B.), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Mölndal; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience (H.Z.), University College London Institute of Neurology; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Lars Forsgren
- From the Department of Pharmacology and Clinical Neuroscience (D.B., M.E.D., J.L., L.F.), Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine (G.G.), Department of Psychology (M.E.D.), and Department of Radiation Sciences, Diagnostic Radiology and Umeå Center for Functional Brain Imaging (S.J.M., K.R.), Umeå University; Institute of Neuroscience and Physiology (H.Z., K.B.), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Mölndal; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience (H.Z.), University College London Institute of Neurology; and UK Dementia Research Institute at UCL (H.Z.), London, UK
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Gupta HV, Mehta SH, Zhang N, Hentz JG, Shill HA, Driver-Dunckley E, Sabbagh MN, Belden CM, Dugger BN, Beach TG, Serrano GE, Sue LI, Davis K, Adler CH. Are Clinical Certainty Ratings Helpful in the Diagnosis of Parkinson's Disease? Mov Disord Clin Pract 2018; 5:165-170. [PMID: 30363433 DOI: 10.1002/mdc3.12589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 12/07/2017] [Accepted: 12/22/2017] [Indexed: 11/08/2022] Open
Abstract
Background Clinical diagnostic criteria for PD rely on rest tremor, bradykinesia, and rigidity. These features are non-specific and neuropathological confirmation remains the gold standard for diagnosis. This study presents data on clinical certainty ratings in autopsy-proven PD. Methods Subjects were assessed annually by a movement disorders specialist and assigned to a clinical certainty group for PD based on multiple clinical features before autopsy. The three groups considered for analysis are as follows: Group I 0-49% certainty, Group II 50-89% certainty, and Group III 90-100% certainty. All subjects were autopsied and had a standardized neuropathological assessment. Results 275 subjects were assigned a PD certainty at their last visit before death. Group I had 80 subjects, Group II 56 subjects, and Group III 139 subjects. The clinical features recorded in Group I, II, and III, were as follows: rest tremor, bradykinesia, rigidity, postural instability, asymmetric onset, persistent asymmetry, current response to dopaminergic treatment, motor fluctuations, and dyskinesia. Rigidity, postural instability, asymmetric onset, current response to dopaminergic treatment, motor fluctuation, and dyskinesia were more likely to be present in the group which was rated with higher certainty. The final diagnosis of PD was confirmed by neuropathological assessment in 85% of the patients in Group III as compared to 30% in Group II and 5% in Group I. Conclusions High certainty (90-100%) had strong positive predictive value (85%) for autopsy-proven PD as compared to either lower certainty groups (0-49% and 50-89%) which had lower predictive value (5% and 30% respectively).
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Affiliation(s)
- Harsh V Gupta
- Department of Neurology Mayo Clinic Scottsdale AZ USA
| | | | - Nan Zhang
- Department of Biostatistics Mayo Clinic Scottsdale AZ USA
| | - Joseph G Hentz
- Department of Biostatistics Mayo Clinic Scottsdale AZ USA
| | - Holly A Shill
- Department of Neurology Barrow Neurological Institute Phoenix AZ USA
| | | | - Marwan N Sabbagh
- Department of Neurology Barrow Neurological Institute Phoenix AZ USA
| | | | | | | | | | - Lucia I Sue
- Banner Sun Health Research Institute Sun City AZ USA
| | - Kathryn Davis
- Banner Sun Health Research Institute Sun City AZ USA
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224
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Schrag A. Testing the MDS clinical diagnostic criteria for Parkinson's disease. Mov Disord 2018; 33:1518-1520. [DOI: 10.1002/mds.27543] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 09/27/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Anette Schrag
- Department of Clinical and Movement Neurosciences; University College London Institute of Neurology; London United Kingdom
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225
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Affiliation(s)
- David P Breen
- Morton and Gloria Shulman Movement Disorders Clinic and Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Clinic and Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
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226
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Grippe TC, Allam N, Brandão PRDP, Pereira DA, Cardoso FEC, Aguilar ACR, Kessler IM. Is transcranial sonography useful for diagnosing Parkinson's disease in clinical practice? ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:459-466. [PMID: 30066797 DOI: 10.1590/0004-282x20180067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/20/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Transcranial sonography (TCS) is an emerging ancillary examination for diagnosing Parkinson's disease (PD). OBJECTIVE To evaluate TCS features in patients with PD and its mimics, and establish their accuracy in predicting the final clinical diagnosis after follow-up. METHODS We retrospectively studied 85 patients with an initial clinical suspicion of PD, atypical parkinsonism or essential tremor, all of whom underwent TCS. Two specialists reviewed the follow-up clinical visit records and determined the final clinical diagnosis. The accuracy analysis of the TCS was determined using Bayesian statistical methods. RESULTS The finding of substantia nigra hyperechogenicity (> 20 mm2) showed high sensitivity (93.4%) and specificity (86.6%). The positive likelihood ratio showed 6.93-fold greater odds for diagnosing PD than an alternative condition when this finding was present. CONCLUSIONS This study revealed the practical usefulness of TCS in differentiating PD from its prevalent mimics when the clinical diagnosis was initially unclear.
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Affiliation(s)
- Talyta Cortez Grippe
- Universidade de Brasília, Faculdade de Medicina, Brasília DF, Brasil.,Hospital de Base do Distrito Federal, Centro de Referência em Parkinson e Distúrbios do Movimento, Brasília DF, Brasil
| | - Nasser Allam
- Hospital de Base do Distrito Federal, Centro de Referência em Parkinson e Distúrbios do Movimento, Brasília DF, Brasil
| | - Pedro Renato de Paula Brandão
- Hospital de Base do Distrito Federal, Centro de Referência em Parkinson e Distúrbios do Movimento, Brasília DF, Brasil.,Câmara dos Deputados, Departamento Médico, Brasília DF, Brasil
| | - Danilo Assis Pereira
- Instituto Brasileiro de Neuropsicologia e Ciências Cognitivas, Brasília DF, Brasil
| | - Francisco Eduardo Costa Cardoso
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Unidade de Distúrbios do Movimento, Belo Horizonte MG, Brasil
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Zhang H, Zhu L, Sun L, Zhi Y, Ding J, Yuan YS, Shen FF, Li X, Ji P, Wang Z, Niu Q, Zhang KZ. Phosphorylated α-synuclein deposits in sural nerve deriving from Schwann cells: A biomarker for Parkinson's disease. Parkinsonism Relat Disord 2018; 60:57-63. [PMID: 30297212 DOI: 10.1016/j.parkreldis.2018.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/06/2018] [Accepted: 10/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Paresthesia is common in Parkinson's disease (PD) patients. We assumed that peripheral nerve might be implicated. This study aimed to investigate whether phosphorylated α-synuclein (pSNCA) pathology occurred in sural nerve fibers and to explore the underlying pathogenesis of paresthesia of lower limbs associated with PD. METHODS Clinical assessments and sural nerve biopsy were performed to evaluate clinical characteristics and the deposition of total α-synuclein (tSNCA) and pSNCA in biopsy pieces using immunochemistry methods on 16 PD patients and 15 controls. In addition, immunofluorescence staining was performed using certain antibodies to characterize the component of sural nerve and to localize the expression of pSNCA. RESULTS Deposition of pSNCA was found in 16/16 PD patients with a high positive percentage of 100% but in 0/15 controls, however, all biopsy pieces showed positive response to tSNCA immunohistological staining in nerve fibers. pSNCA was expressed mainly in Schwann cells but scarcely in axons, demonstrating a novel pattern of pSNCA expression in peripheral nervous system. CONCLUSION Our findings suggest that peripheral somatic sensory nerve is also involved in SNCA pathology in PD. The search for pSNCA in sural nerve might serve as a novel biomarker for early diagnosis of PD and pSNCA in sural nerve may derive from Schwann cells rather than propagate retrograde along the primary sensory neurons from the central nervous system.
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Affiliation(s)
- Hui Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Lin Zhu
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Li Sun
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Yan Zhi
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Jian Ding
- Department of Neurology, The First People's Hospital of Changzhou, No. 185 Juqian Road, Changzhou, 213003, China
| | - Yong-Sheng Yuan
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Fei-Fei Shen
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiao Li
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Pan Ji
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Zhen Wang
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Qi Niu
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Ke-Zhong Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China.
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228
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Beach TG, Adler CH. Importance of low diagnostic Accuracy for early Parkinson's disease. Mov Disord 2018; 33:1551-1554. [PMID: 30288780 PMCID: PMC6544441 DOI: 10.1002/mds.27485] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/06/2018] [Accepted: 08/09/2018] [Indexed: 01/08/2023] Open
Affiliation(s)
- Thomas G. Beach
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Charles H. Adler
- Department of Neurology, Mayo Clinic Arizona, Scottsdale, Arizona, USA
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Tang Y, Liu B, Yang Y, Wang CM, Meng L, Tang BS, Guo JF. Identifying mild-moderate Parkinson's disease using whole-brain functional connectivity. Clin Neurophysiol 2018; 129:2507-2516. [PMID: 30347309 DOI: 10.1016/j.clinph.2018.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 09/01/2018] [Accepted: 09/07/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Our study aims to extract significant disorder-associated patterns from whole brain functional connectivity to distinguish mild-moderate Parkinson's disease (PD) patients from controls. METHODS Resting-state fMRI data were measured from thirty-six PD individuals and thirty-five healthy controls. Multivariate pattern analysis was applied to investigate whole-brain functional connectivity patterns in individuals with 'mild-moderate' PD. Additionally, the relationship between the asymmetry of functional connectivity and the side of the initial symptoms was also analyzed. RESULTS In a leave-one-out cross-validation, we got the generalization rate of 80.28% for distinguishing PD patients from controls. The most discriminative functional connectivity was found in cortical networks that included the default mode, sensorimotor and attention networks. Compared to patients with the left side initially affected, an increased abnormal functional connectivity was found in patients in whom the right side was initially affected. CONCLUSIONS Our results indicated that discriminative functional connectivity is likely associated with disturbances of cortical networks involved in sensorimotor control and attention. The spatiotemporal patterns of motor asymmetry may be related to the lateralized dysfunction on the early stages of PD. SIGNIFICANCE This study identifies discriminative functional connectivity that is associated with disturbances of cortical networks. Our results demonstrated new evidence regarding the functional brain changes related to the unilateral motor symptoms of early PD.
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Affiliation(s)
- Yan Tang
- School of Information Science and Engineering, Central South University, Changsha, Hunan 410083, China; Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008 Hunan, China
| | - Bailin Liu
- School of Basic Medical Science Central South University, Changsha, Hunan 410083, China
| | - Yuan Yang
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Chang-Min Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008 Hunan, China
| | - Li Meng
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410008 Hunan, China
| | - Bei-Sha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008 Hunan, China; National Clinical Research Center for Geriatric Medicine, Changsha, 410008 Hunan, China; State Key Laboratory of Medical Genetics, Changsha, 410008 Hunan, China
| | - Ji-Feng Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008 Hunan, China; National Clinical Research Center for Geriatric Medicine, Changsha, 410008 Hunan, China; State Key Laboratory of Medical Genetics, Changsha, 410008 Hunan, China.
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Beach TG, Serrano GE, Kremer T, Canamero M, Dziadek S, Sade H, Derkinderen P, Corbillé AG, Letournel F, Munoz DG, White CL, Schneider J, Crary JF, Sue LI, Adler CH, Glass MJ, Intorcia AJ, Walker JE, Foroud T, Coffey CS, Ecklund D, Riss H, Goßmann J, König F, Kopil CM, Arnedo V, Riley L, Linder C, Dave KD, Jennings D, Seibyl J, Mollenhauer B, Chahine L. Immunohistochemical Method and Histopathology Judging for the Systemic Synuclein Sampling Study (S4). J Neuropathol Exp Neurol 2018; 77:793-802. [PMID: 30107604 PMCID: PMC6097838 DOI: 10.1093/jnen/nly056] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Immunohistochemical (IHC) α-synuclein (Asyn) pathology in peripheral biopsies may be a biomarker of Parkinson disease (PD). The multi-center Systemic Synuclein Sampling Study (S4) is evaluating IHC Asyn pathology within skin, colon and submandibular gland biopsies from 60 PD and 20 control subjects. Asyn pathology is being evaluated by a blinded panel of specially trained neuropathologists. Preliminary work assessed 2 candidate immunoperoxidase methods using a set of PD and control autopsy-derived sections from formalin-fixed, paraffin-embedded blocks of the 3 tissues. Both methods had 100% specificity; one, utilizing the 5C12 monoclonal antibody, was more sensitive in skin (67% vs 33%), and was chosen for further use in S4. Four trainee neuropathologists were trained to perform S4 histopathology readings; in subsequent testing, their scoring was compared to that of the trainer neuropathologist on both glass slides and digital images. Specificity and sensitivity were both close to 100% with all readers in all tissue types on both glass slides and digital images except for skin, where sensitivity averaged 75% with digital images and 83.5% with glass slides. Semiquantitative (0-3) density score agreement between trainees and trainer averaged 67% for glass slides and 62% for digital images.
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Affiliation(s)
- Thomas G Beach
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona
| | - Geidy E Serrano
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona
| | - Thomas Kremer
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F Hoffman-La Roche, Ltd, Basel, Switzerland
- Roche Pharma Research and Early Development, Roche Innovation Center, Munich, Penzberg, Germany
| | - Marta Canamero
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F Hoffman-La Roche, Ltd, Basel, Switzerland
- Roche Pharma Research and Early Development, Roche Innovation Center, Munich, Penzberg, Germany
| | - Sebastian Dziadek
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F Hoffman-La Roche, Ltd, Basel, Switzerland
- Roche Pharma Research and Early Development, Roche Innovation Center, Munich, Penzberg, Germany
| | - Hadassah Sade
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F Hoffman-La Roche, Ltd, Basel, Switzerland
- Roche Pharma Research and Early Development, Roche Innovation Center, Munich, Penzberg, Germany
| | - Pascal Derkinderen
- Department of Neurology, CHU Nantes, Inserm, U1235, Nantes University, Nantes F-44035, France
- CHU Angers, Neurobiology and Neuropathology Laboratory, Angers F-49033, France
| | - Anne-Gaëlle Corbillé
- Department of Neurology, CHU Nantes, Inserm, U1235, Nantes University, Nantes F-44035, France
- CHU Angers, Neurobiology and Neuropathology Laboratory, Angers F-49033, France
| | - Franck Letournel
- Department of Neurology, CHU Nantes, Inserm, U1235, Nantes University, Nantes F-44035, France
- CHU Angers, Neurobiology and Neuropathology Laboratory, Angers F-49033, France
| | - David G Munoz
- Laboratory Medicine and Keenan Research Centre for Biomedical Research of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada
| | - Charles L White
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - John F Crary
- Department of Pathology, Fishberg Department of Neuroscience, Friedman Brain Institute, Ronald M. Loeb Center for Alzheimer’s Disease, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lucia I Sue
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona
| | - Charles H Adler
- Department of Neurology, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Michael J Glass
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona
| | - Anthony J Intorcia
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona
| | - Jessica E Walker
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona
| | - Tatiana Foroud
- Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Dixie Ecklund
- Department of Biostatistics, University of Iowa, Iowa City, Iowa
| | - Holly Riss
- Department of Biostatistics, University of Iowa, Iowa City, Iowa
| | | | - Fatima König
- Targos Molecular Pathology GmbH, Kassel, Germany
| | - Catherine M Kopil
- The Michael J. Fox Foundation for Parkinson’s Research, New York, New York
| | - Vanessa Arnedo
- The Michael J. Fox Foundation for Parkinson’s Research, New York, New York
| | - Lindsey Riley
- The Michael J. Fox Foundation for Parkinson’s Research, New York, New York
| | - Carly Linder
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Kuldip D Dave
- The Michael J. Fox Foundation for Parkinson’s Research, New York, New York
| | | | - John Seibyl
- Institute for Neurodegenerative Disorders, New Haven, Connecticut
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel and University Medical Center Goettingen, Goettingen, Germany
| | - Lana Chahine
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
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Lewis MM, Du G, Baccon J, Snyder AM, Murie B, Cooper F, Sica C, Mailman RB, Connor JR, Huang X. Susceptibility MRI captures nigral pathology in patients with parkinsonian syndromes. Mov Disord 2018; 33:1432-1439. [PMID: 29756231 PMCID: PMC6185787 DOI: 10.1002/mds.27381] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/21/2018] [Accepted: 02/13/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Parkinsonisms are neurodegenerative disorders characterized pathologically by α-synuclein-positive (e.g., PD, diffuse Lewy body disease, and MSA) and/or tau-positive (e.g., PSP, cortical basal degeneration) pathology. Using R2* and quantitative susceptibility mapping, susceptibility changes have been reported in the midbrain of living parkinsonian patients, although the exact underlying pathology of these alterations is unknown. OBJECTIVE The current study investigated the pathological correlates of these susceptibility MRI measures. METHODS In vivo MRIs (T1- and T2-weighted, and T2*) and pathology were obtained from 14 subjects enrolled in an NINDS PD Biomarker Program (PDBP). We assessed R2* and quantitative susceptibility mapping values in the SN, semiquantitative α-synuclein, tau, and iron values, as well as neuronal and glial counts. Data were analyzed using age-adjusted Spearman correlations. RESULTS R2* was associated significantly with nigral α-synuclein (r = 0.746; P = 0.003). Quantitative susceptibility mapping correlated significantly with Perls' (r = 0.758; P = 0.003), but not with other pathological measurements. Neither measurement correlated with tau or glial cell counts (r ≤ 0.11; P ≥ 0.129). CONCLUSIONS Susceptibility MRI measurements capture nigral pathologies associated with parkinsonian syndromes. Whereas quantitative susceptibility mapping is more sensitive to iron, R2* may reflect pathological aspects of the disorders beyond iron such as α-synuclein. They may be invaluable tools in diagnosing differential parkinsonian syndromes, and tracking in living patients the dynamic changes associated with the pathological progression of these disorders. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Mechelle M. Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Guangwei Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Jennifer Baccon
- Department of Pathology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pathology and Laboratory Medicine, Akron Children’s Hospital, Akron, OH 44308
| | - Amanda M. Snyder
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Ben Murie
- Department of Pathology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Felicia Cooper
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Christopher Sica
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Richard B. Mailman
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - James R. Connor
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
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Thobois S, Prange S, Scheiber C, Broussolle E. What a neurologist should know about PET and SPECT functional imaging for parkinsonism: A practical perspective. Parkinsonism Relat Disord 2018; 59:93-100. [PMID: 30181086 DOI: 10.1016/j.parkreldis.2018.08.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 12/16/2022]
Abstract
The diagnosis of a parkinsonian syndrome based on clinical criteria remains sometimes difficult, especially at disease onset. Brain or heart molecular imaging techniques (SPECT or PET) can provide a major help to improve and speed up diagnosis, influencing treatment strategies. Presynaptic dopaminergic imaging using either [18F]-Dopa PET or 123I -2β-Carbomethoxy-3β-(4-Iodophenyl)- N-(3-Fluoropropyl) Nortropane ([123I]-Ioflupane)SPECT demonstrates or rules out the presence of a dopaminergic degenerative process. This allows to distinguish Parkinson's disease, Parkinson "plus" syndromes and dementia with Lewy bodies (reduced radiotracers binding) from essential tremor, psychogenic, post-neuroleptic or vascular parkinsonisms, dopa-responsive dystonia and Alzheimer's disease (normal radiotracers binding). For differential diagnosis between Parkinson's disease and Parkinson "plus" syndromes, brain molecular imaging with [18F]-Fluorodeoxyglucose ([18F]-FDG) PET or 99mTc-HMPAO SPECT can provide useful information, whereas [18F]-Dopa PET or [123I]-Ioflupane does not separate these entities. Finally, sympathetic cardiac [123I]-Metaiodobenzylguanidine ([123I]-MIBG) scintigraphy or SPECT can help distinguishing Parkinson's disease and dementia with Lew bodies (decreased binding) from multiple system atrophy and progressive supranuclear palsy (normal binding). New radiotracers notably those targeting the pathological process itself such as Tau aggregates are under development and may provide interesting informations to delineate the different Parkinson "plus" syndromes.
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Affiliation(s)
- Stéphane Thobois
- Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, F-69675, Bron, France; Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, Lyon, France; Univ Lyon, Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, F-69921, Oullins, France.
| | - Stéphane Prange
- Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, F-69675, Bron, France; Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, Lyon, France
| | - Christian Scheiber
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Médecine Nucléaire, Lyon, France
| | - Emmanuel Broussolle
- Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, F-69675, Bron, France; Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, Lyon, France; Univ Lyon, Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, F-69921, Oullins, France
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Berg D, Adler CH, Bloem BR, Chan P, Gasser T, Goetz CG, Halliday G, Lang AE, Lewis S, Li Y, Liepelt-Scarfone I, Litvan I, Marek K, Maetzler C, Mi T, Obeso J, Oertel W, Olanow CW, Poewe W, Rios-Romenets S, Schäffer E, Seppi K, Heim B, Slow E, Stern M, Bledsoe IO, Deuschl G, Postuma RB. Movement disorder society criteria for clinically established early Parkinson's disease. Mov Disord 2018; 33:1643-1646. [DOI: 10.1002/mds.27431] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/26/2018] [Accepted: 04/18/2018] [Indexed: 01/09/2023] Open
Affiliation(s)
- Daniela Berg
- Department of Neurology; Christian-Albrechts-University of Kiel; Kiel Germany
- Department of Neurodegeneration; Hertie-Institute for Clinical Brain Research; Tübingen Germany
| | - Charles H. Adler
- The Parkinson's Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic; Scottsdale Arizona USA
| | - Bastiaan R. Bloem
- Department of Neurology; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour; Nijmegen Netherlands
| | - Piu Chan
- Xuanwu Hospital of Capitol of Medical University; Beijing Peoples Republic of China
| | - Thomas Gasser
- Department of Neurodegeneration; Hertie-Institute for Clinical Brain Research; Tübingen Germany
| | | | - Glenda Halliday
- Neuroscience Research Australia & University of New South Wales; Randwick Australia
| | - Anthony E. Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital; Toronto Ontario Canada
| | - Simon Lewis
- Brain and Mind Centre University of Sydney; Camperdown Australia
| | - Yuan Li
- Xuanwu Hospital of Capitol of Medical University; Beijing Peoples Republic of China
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration; Hertie-Institute for Clinical Brain Research; Tübingen Germany
- German Center for Neurodegenerative Diseases; Tübingen Germany
| | - Irene Litvan
- Department of Neurosciences; University of California San Diego; La Jolla California USA
| | - Kenneth Marek
- Institute for Neurodegenerative Disorders; New Haven Connecticut USA
| | - Corina Maetzler
- Department of Neurology; Christian-Albrechts-University of Kiel; Kiel Germany
| | - Taomian Mi
- Xuanwu Hospital of Capitol of Medical University; Beijing Peoples Republic of China
| | - José Obeso
- University of Navarra-Fundación para la Investigación Médica Aplicada (FIMA); Pamplona Spain
| | - Wolfgang Oertel
- Department of Neurology; Philipps University of Marburg; Marburg Germany
| | - C. Warren Olanow
- Department of Neurology; Mount Sinai School of Medicine; New York New York USA
| | - Werner Poewe
- Department of Neurology; Innsbruck Medical University; Innsbruck Austria
| | | | - Eva Schäffer
- Department of Neurology; Christian-Albrechts-University of Kiel; Kiel Germany
| | - Klaus Seppi
- Department of Neurology; Innsbruck Medical University; Innsbruck Austria
| | - Beatrice Heim
- Department of Neurology; Innsbruck Medical University; Innsbruck Austria
| | - Elizabeth Slow
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital; Toronto Ontario Canada
| | - Matthew Stern
- Penn Neurological Institute; Philadelphia Pennsylvania USA
| | | | - Günther Deuschl
- Department of Neurology; Christian-Albrechts-University of Kiel; Kiel Germany
| | - Ronald B. Postuma
- Department of Neurology; Montreal General Hospital; Montreal Quebec Canada
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Chen-Plotkin AS, Albin R, Alcalay R, Babcock D, Bajaj V, Bowman D, Buko A, Cedarbaum J, Chelsky D, Cookson MR, Dawson TM, Dewey R, Foroud T, Frasier M, German D, Gwinn K, Huang X, Kopil C, Kremer T, Lasch S, Marek K, Marto JA, Merchant K, Mollenhauer B, Naito A, Potashkin J, Reimer A, Rosenthal LS, Saunders-Pullman R, Scherzer CR, Sherer T, Singleton A, Sutherland M, Thiele I, van der Brug M, Van Keuren-Jensen K, Vaillancourt D, Walt D, West A, Zhang J. Finding useful biomarkers for Parkinson's disease. Sci Transl Med 2018; 10:eaam6003. [PMID: 30111645 PMCID: PMC6097233 DOI: 10.1126/scitranslmed.aam6003] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 12/14/2017] [Indexed: 12/11/2022]
Abstract
The recent advent of an "ecosystem" of shared biofluid sample biorepositories and data sets will focus biomarker efforts in Parkinson's disease, boosting the therapeutic development pipeline and enabling translation with real-world impact.
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Affiliation(s)
- Alice S Chen-Plotkin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Roger Albin
- Neurology Service and GRECC, VAAHS, Ann Arbor, MI 48105, USA
- Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Roy Alcalay
- Department of Neurology, Columbia University Medical Center, New York, NY 10032, USA
| | - Debra Babcock
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20824, USA
| | - Vikram Bajaj
- Verily/Google Life Sciences, South San Francisco, CA 94080, USA
| | - Dubois Bowman
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Alex Buko
- Human Metabolome Technology-America, Boston, MA 02134, USA
| | | | | | - Mark R Cookson
- Cell Biology and Gene Expression Section, Laboratory of Neurogenetics, National Institute of Aging, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ted M Dawson
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Richard Dewey
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Mark Frasier
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY 10163, USA
| | - Dwight German
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Katrina Gwinn
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20824, USA
| | - Xuemei Huang
- Department of Neurology, Penn State University-Hershey Medical Center, Hershey, PA 17033, USA
| | - Catherine Kopil
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY 10163, USA
| | - Thomas Kremer
- Pharmaceutical Research and Early Development, NORD Discovery and Translational Area, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland
| | - Shirley Lasch
- Institute for Neurodegenerative Disorders, New Haven, CT 06510, USA
| | - Ken Marek
- Institute for Neurodegenerative Disorders, New Haven, CT 06510, USA
| | - Jarrod A Marto
- Departments of Cancer Biology and Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
- Blais Proteomics Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA
| | | | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, 34128 Kassel, Germany
- University Medical Center, 37075 Goettingen, Germany
| | - Anna Naito
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY 10163, USA
| | - Judith Potashkin
- Department of Cellular and Molecular Pharmacology, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, IL 60064, USA
| | - Alyssa Reimer
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY 10163, USA
| | - Liana S Rosenthal
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Rachel Saunders-Pullman
- Department of Neurology, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY 10003, USA
| | - Clemens R Scherzer
- Center for Advanced Parkinson's Disease Research and Precision Neurology Program, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Todd Sherer
- The Michael J. Fox Foundation for Parkinson's Research, New York, NY 10163, USA
| | - Andrew Singleton
- Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA
| | - Margaret Sutherland
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20824, USA
| | - Ines Thiele
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Luxembourg, Luxembourg
| | | | | | - David Vaillancourt
- Department of Applied Physiology, Biomedical Engineering, and Neurology, University of Florida, Gainesville, FL 32611, USA
| | - David Walt
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Andrew West
- Department of Neurology, University of Alabama, Birmingham, AL 35233, USA
| | - Jing Zhang
- Department of Pathology, University of Washington, Seattle, WA 98195, USA
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Shirzadi Z, Robertson AD, Metcalfe AW, Duff-Canning S, Marras C, Lang AE, Masellis M, MacIntosh BJ. Brain tissue pulsatility is related to clinical features of Parkinson's disease. NEUROIMAGE-CLINICAL 2018; 20:222-227. [PMID: 30090696 PMCID: PMC6079564 DOI: 10.1016/j.nicl.2018.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/05/2018] [Accepted: 07/21/2018] [Indexed: 12/21/2022]
Abstract
Introduction This study investigated whether brain tissue pulsatility is associated with features of disease severity in Parkinson's disease (PD). Methods Data were extracted from the Parkinson's Progression Markers Initiative among 81 adults with PD (confirmed with DATSCAN™). Brain tissue pulsatility was computed using resting state blood oxygenation level dependent (BOLD) MRI in white matter (WM), referred to as BOLDTP. Motor impairment was assessed using the Movement Disorders Society unified Parkinson's disease rating scale. Factor analysis generated composite scores for cognition and vascular risk burden. A linear regression model examined the association of BOLDTP with age, sex, motor impairment, cognition, vascular risk burden and PD duration. In addition, we investigated whether BOLDTP relates to WM hyperintensity (WMH) volume, WM fractional anisotropy (WM-FA) and striatal binding ratio (SBR) of dopamine transporter. Results Motor impairment (t = 2.3, p = .02), vascular burden (t = 2.4, p = .02) and male sex (t = 3.0, p = .003) were independently associated with BOLDTP (r2 = 0.40, p < .001). BOLDTP was correlated with WMH volume (r = 0.22, p = .05) but not WM-FA nor SBR (p > .1). In addition, BOLDTP (t = 2.76, p = .008) and SBR (t = -2.04, p = .04) were independently related to motor impairment (r2 = 0.18, p = .006). Conclusion Our findings show that brain tissue pulsatility from BOLD images in WM is related to neurological and vascular features in PD. BOLDTP may be useful in PD to study small vessel alterations that appear distinct from WM structural changes.
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Affiliation(s)
- Zahra Shirzadi
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.
| | - Andrew D Robertson
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Arron W Metcalfe
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Duff-Canning
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's disease, Toronto western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Connie Marras
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's disease, Toronto western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's disease, Toronto western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Mario Masellis
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada; Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Bradley J MacIntosh
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
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Ortuño-Lizarán I, Beach TG, Serrano GE, Walker DG, Adler CH, Cuenca N. Phosphorylated α-synuclein in the retina is a biomarker of Parkinson's disease pathology severity. Mov Disord 2018; 33:1315-1324. [PMID: 29737566 PMCID: PMC6146055 DOI: 10.1002/mds.27392] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 03/01/2018] [Accepted: 03/04/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND PD patients often have visual alterations, for example, loss of visual acuity, contrast sensitivity or motion perception, and diminished electroretinogram responses. PD pathology is mainly characterized by the accumulation of pathological α-synuclein deposits in the brain, but little is known about how synucleinopathy affects the retina. OBJECTIVE To study the correlation between α-synuclein deposits in the retina and brain of autopsied subjects with PD and incidental Lewy body disease. METHODS We evaluated the presence of phosphorylated α-synuclein in the retina of autopsied subjects with PD (9 subjects), incidental Lewy body disease (4 subjects), and controls (6 subjects) by immunohistochemistry and compared the retinal synucleinopathy with brain disease severity indicators. RESULTS Whereas controls did not show any phosphorylated α-synuclein immunoreactivity in their retina, all PD subjects and 3 of 4 incidental Lewy body disease subjects had phosphorylated α-synuclein deposits in ganglion cell perikarya, dendrites, and axons, some of them resembling brain Lewy bodies and Lewy neurites. The Lewy-type synucleinopathy density in the retina significantly correlated with Lewy-type synucleinopathy density in the brain, with the Unified Parkinson's disease pathology stage and with the motor UPDRS. CONCLUSION These data suggest that phosphorylated α-synuclein accumulates in the retina in parallel with that in the brain, including in early stages preceding development of clinical signs of parkinsonism or dementia. Therefore, the retina may provide an in vivo indicator of brain pathology severity, and its detection could help in the diagnosis and monitoring of disease progression. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
| | - Thomas G. Beach
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | | | - Nicolás Cuenca
- Department of Physiology, Genetics and Microbiology, University of Alicante, Spain
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Lionnet A, Wade MA, Corbillé AG, Prigent A, Paillusson S, Tasselli M, Gonzales J, Durieu E, Rolli-Derkinderen M, Coron E, Duchalais E, Neunlist M, Perkinton MS, Hanger DP, Noble W, Derkinderen P. Characterisation of tau in the human and rodent enteric nervous system under physiological conditions and in tauopathy. Acta Neuropathol Commun 2018; 6:65. [PMID: 30037345 PMCID: PMC6055332 DOI: 10.1186/s40478-018-0568-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 07/06/2018] [Indexed: 12/30/2022] Open
Abstract
Tau is normally a highly soluble phosphoprotein found predominantly in neurons. Six different isoforms of tau are expressed in the adult human CNS. Under pathological conditions, phosphorylated tau aggregates are a defining feature of neurodegenerative disorders called tauopathies. Recent findings have suggested a potential role of the gut-brain axis in CNS homeostasis, and therefore we set out to examine the isoform profile and phosphorylation state of tau in the enteric nervous system (ENS) under physiological conditions and in tauopathies. Surgical specimens of human colon from controls, Parkinson's disease (PD) and progressive supranuclear palsy (PSP) patients were analyzed by Western Blot and immunohistochemistry using a panel of anti-tau antibodies. We found that adult human ENS primarily expresses two tau isoforms, localized in the cell bodies and neuronal processes. We did not observe any difference in the enteric tau isoform profile and phosphorylation state between PSP, PD and control subjects. The htau mouse model of tauopathy also expressed two main isoforms of human tau in the ENS, and there were no apparent differences in ENS tau localization or phosphorylation between wild-type and htau mice. Tau in both human and mouse ENS was found to be phosphorylated but poorly susceptible to dephosphorylation with lambda phosphatase. To investigate ENS tau phosphorylation further, primary cultures from rat enteric neurons, which express four isoforms of tau, were pharmacologically manipulated to show that ENS tau phosphorylation state can be regulated, at least in vitro. Our study is the first to characterize tau in the rodent and human ENS. As a whole, our findings provide a basis to unravel the functions of tau in the ENS and to further investigate the possibility of pathological changes in enteric neuropathies and tauopathies.
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239
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The role of substantia nigra sonography in the differentiation of Parkinson's disease and multiple system atrophy. Transl Neurodegener 2018; 7:15. [PMID: 30062008 PMCID: PMC6055347 DOI: 10.1186/s40035-018-0121-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 07/02/2018] [Indexed: 11/10/2022] Open
Abstract
Background The differential diagnosis of Parkinson's disease (PD) and multiple system atrophy (MSA) remains a challenge, especially in the early stage. Here, we assessed the value of transcranial sonography (TCS) to discriminate non-tremor dominant (non-TD) PD from MSA with predominant parkinsonism (MSA-P). Methods Eighty-six MSA-P patients and 147 age and gender-matched non-TD PD patients who had appropriate temporal acoustic bone windows were included in this study. All the patients were followed up for at least 2 years to confirm the initial diagnosis. Patients with at least one substantia nigra (SN) echogenic size ≥18 mm2 were classified as hyperechogenic, those with at least one SN echogenic size ≥25 mm2 was defined as markedly hyperechogenic. Results The frequency of SN hyperechogenicity in non-TD PD patients was significantly higher than that in MSA-P patients (74.1% vs. 38.4%, p < 0.001). SN hyperechogenicity discriminated non-TD PD from MSA-P with sensitivity of 74.1%, specificity of 61.6%, and positive predictive value of 76.8%. If marked SN hyperechogenicity was used as the cutoff value (≥ 25 mm2), the sensitivity decreased to 46.3%, but the specificity and positive predictive value increased to 80.2 and 80.0%. Additionally, in those patients with SN hyperechogenicity, positive correlation between SN hyperechogenicity area and disease duration was found in non-TD PD rather than in MSA-P patients. In this context, among early-stage patients with disease duration ≤3 years, the sensitivity, specificity and positive predictive value of SN hyperechogenicity further declined to 69.8%, 52.2%, and 66.7%, respectively. Conclusions TCS could help discriminate non-TD PD from MSA-P in a certain extent, but the limitation was also obvious with relatively low specificity, especially in the early stage.
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Ge F, Ding J, Liu Y, Lin H, Chang T. Cerebrospinal fluid NFL in the differential diagnosis of parkinsonian disorders: A meta-analysis. Neurosci Lett 2018; 685:35-41. [PMID: 30036569 DOI: 10.1016/j.neulet.2018.07.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 11/29/2022]
Abstract
Neurofilament light chain (NFL) in cerebrospinal fluid (CSF) is a promising biomarker candidate which may discriminate atypical parkinsonian disorders (APD), mainly including multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD), from Parkinson's disease (PD). We aim to evaluate the diagnostic accuracy of CSF NFL level as a differentiating biomarker between APD and PD. Databases of PubMed, OVID and Web of Science were searched for studies (published until May 31, 2017) that reported on CSF NFL as a diagnostic biomarker between APD and PD. Eight studies were pooled in this meta-analysis, including 341 PD and 396 APD patients and 388 healthy controls. The pooled sensitivity was 82% (95% CI, 68%-91%) and specificity was 85% (95% CI, 79%-89%) in differentiating APD from PD. The pooled positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) were 5.4 (95% CI, 3.6%-8.1%), 0.21 (95% CI, 0.11%-0.40%), and 25 (95% CI, 9%-69%) respectively; and the area under the curve (AUC) was 0.89 (95% CI, 0.86%-0.91%). Subgroup analysis revealed sensitivity and specificity were significantly influenced by study design. The APD subtypes, disease duration and severity were the main heterogeneity sources in specificity. The results of Deeks' test revealed a low risk of publication bias. The CSF NFL level may be used as a biomarker in discriminating APD from PD with high diagnostic accuracy at an early stage of disease. Large and longitudinal studies are still needed on individuals who are suspected to have APD.
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Affiliation(s)
- Fangfang Ge
- Department of Neurology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi Province, PR China
| | - Jiaqi Ding
- Department of Neurology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi Province, PR China
| | - Yu Liu
- Department of Neurology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi Province, PR China
| | - Hong Lin
- Department of Neurology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi Province, PR China.
| | - Ting Chang
- Department of Neurology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi Province, PR China.
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Buchman AS, Nag S, Leurgans SE, Miller J, VanderHorst VGJM, Bennett DA, Schneider JA. Spinal Lewy body pathology in older adults without an antemortem diagnosis of Parkinson's disease. Brain Pathol 2018; 28:560-568. [PMID: 28960595 PMCID: PMC5874164 DOI: 10.1111/bpa.12560] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 09/20/2017] [Indexed: 01/05/2023] Open
Abstract
To test the hypothesis that Lewy body pathology (LBs) is present in the spinal cord of older community-dwelling adults without a clinical diagnosis of Parkinson's disease (PD). We studied 162 prospective autopsies from older adults with PD (N = 6) and without PD (N = 156). We documented the presence of LBs in cerebrum and brainstem structures from each of the six regions used for Braak PD staging and four spinal cord levels (C5/6, T7, L4/5 and S4/5). Parkinsonism proximate to death was based on a previously validated measure present if two or more of the four signs of parkinsonism were present based on a modified version of the Unified Parkinson's Disease Rating Scale (UPDRS). Fifty-three of 156 individuals without PD (34%) had LBs in a least one site within the CNS. About half of cases with LBs in the cerebrum or brainstem, (25/53, 47%) also had spinal LBs. Almost 90% (22/25, 88%) of cases with spinal LBs had LBs in the cerebrum (Braak stages 4-6) and about 10% (3/25, 12%) had only brainstem LBs (Braak stages 1-3). Four of six cases with PD showed LBs in cerebrum, brainstem and spinal cord. Individuals with LBs in the spinal cord were more likely to have clinical parkinsonism proximate to death compared to individuals with LBs in brainstem and cerebrum alone (52% vs. 32%; Chi-Square x2 = 5.368, d.f. = 1, P = 0.0.021) and more severe nigral neuronal loss (48% vs. 11%; Chi-Square x2 = 9.049, d.f. = 1, P = 0.003). These findings were unchanged when we included cases with a history of PD. Older community-dwelling adults without a clinical diagnosis of PD have evidence of LBs throughout the CNS including the spinal cord which is associated with parkinsonism and more severe nigral neuronal loss.
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Affiliation(s)
- Aron S. Buchman
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - Sukriti Nag
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIL
- Department of Pathology (Neuropathology)Rush University Medical CenterChicagoIL
| | - Sue E. Leurgans
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - Jared Miller
- Department of NeurologyBeth Israel Deaconess Medical CenterBostonMA
| | - Veronique G. J. M. VanderHorst
- Department of NeurologyBeth Israel Deaconess Medical CenterBostonMA
- Department of Neurology, Harvard Medical SchoolBostonMA
| | - David A. Bennett
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - Julie A. Schneider
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
- Department of Pathology (Neuropathology)Rush University Medical CenterChicagoIL
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Qiao S, Liu Y, Han F, Guo M, Hou X, Ye K, Deng S, Shen Y, Zhao Y, Wei H, Song B, Yao L, Tian W. An Intelligent Neural Stem Cell Delivery System for Neurodegenerative Diseases Treatment. Adv Healthc Mater 2018; 7:e1800080. [PMID: 29719134 DOI: 10.1002/adhm.201800080] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 04/05/2018] [Indexed: 12/30/2022]
Abstract
Transplanted stem cells constitute a new therapeutic strategy for the treatment of neurological disorders. Emerging evidence indicates that a negative microenvironment, particularly one characterized by the acute inflammation/immune response caused by physical injuries or transplanted stem cells, severely impacts the survival of transplanted stem cells. In this study, to avoid the influence of the increased inflammation following physical injuries, an intelligent, double-layer, alginate hydrogel system is designed. This system fosters the matrix metalloproeinases (MMP) secreted by transplanted stem cell reactions with MMP peptide grafted on the inner layer and destroys the structure of the inner hydrogel layer during the inflammatory storm. Meanwhile, the optimum concentration of the arginine-glycine-aspartate (RGD) peptide is also immobilized to the inner hydrogels to obtain more stem cells before arriving to the outer hydrogel layer. It is found that blocking Cripto-1, which promotes embryonic stem cell differentiation to dopamine neurons, also accelerates this process in neural stem cells. More interesting is the fact that neural stem cell differentiation can be conducted in astrocyte-differentiation medium without other treatments. In addition, the system can be adjusted according to the different parameters of transplanted stem cells and can expand on the clinical application of stem cells in the treatment of this neurological disorder.
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Affiliation(s)
- Shupei Qiao
- School of Life Science and Technology; Harbin Institute of Technology; Harbin 150080 P. R. China
| | - Yi Liu
- Key Laboratory of Bio-Medical Diagnostics; Suzhou Institute of Biomedical Engineering and Technology; Chinese Academy of Sciences; Suzhou 215163 P. R. China
| | - Fengtong Han
- School of Life Science and Technology; Harbin Institute of Technology; Harbin 150080 P. R. China
| | - Mian Guo
- Department of Neurosurgery; The Second Affiliated Hospital of Harbin Medical University; Harbin 150080 P. R. China
| | - Xiaolu Hou
- School of Life Science and Technology; Harbin Institute of Technology; Harbin 150080 P. R. China
| | - Kangruo Ye
- School of Life Science and Technology; Harbin Institute of Technology; Harbin 150080 P. R. China
| | - Shuai Deng
- School of Life Science and Technology; Harbin Institute of Technology; Harbin 150080 P. R. China
| | - Yijun Shen
- School of Life Science and Technology; Harbin Institute of Technology; Harbin 150080 P. R. China
| | - Yufang Zhao
- School of Life Science and Technology; Harbin Institute of Technology; Harbin 150080 P. R. China
| | - Haiying Wei
- Department of Ophthalmology; The First Affiliated Hospital of Harbin Medical University; Harbin 150080 P. R. China
| | - Bing Song
- Cardiff Institute of Tissue Engineering and Repair; School of Dentistry; College of Biomedical and Life Sciences; Cardiff University; CF14 4XY Cardiff UK
| | - Lifen Yao
- Department of Neurology; The First Affiliated Hospital of Harbin Medical University; Harbin 150080 P. R. China
| | - Weiming Tian
- School of Life Science and Technology; Harbin Institute of Technology; Harbin 150080 P. R. China
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Lewczuk P, Riederer P, O’Bryant SE, Verbeek MM, Dubois B, Visser PJ, Jellinger KA, Engelborghs S, Ramirez A, Parnetti L, Jack CR, Teunissen CE, Hampel H, Lleó A, Jessen F, Glodzik L, de Leon MJ, Fagan AM, Molinuevo JL, Jansen WJ, Winblad B, Shaw LM, Andreasson U, Otto M, Mollenhauer B, Wiltfang J, Turner MR, Zerr I, Handels R, Thompson AG, Johansson G, Ermann N, Trojanowski JQ, Karaca I, Wagner H, Oeckl P, van Waalwijk van Doorn L, Bjerke M, Kapogiannis D, Kuiperij HB, Farotti L, Li Y, Gordon BA, Epelbaum S, Vos SJB, Klijn CJM, Van Nostrand WE, Minguillon C, Schmitz M, Gallo C, Mato AL, Thibaut F, Lista S, Alcolea D, Zetterberg H, Blennow K, Kornhuber J, Riederer P, Gallo C, Kapogiannis D, Mato AL, Thibaut F. Cerebrospinal fluid and blood biomarkers for neurodegenerative dementias: An update of the Consensus of the Task Force on Biological Markers in Psychiatry of the World Federation of Societies of Biological Psychiatry. World J Biol Psychiatry 2018; 19:244-328. [PMID: 29076399 PMCID: PMC5916324 DOI: 10.1080/15622975.2017.1375556] [Citation(s) in RCA: 184] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In the 12 years since the publication of the first Consensus Paper of the WFSBP on biomarkers of neurodegenerative dementias, enormous advancement has taken place in the field, and the Task Force takes now the opportunity to extend and update the original paper. New concepts of Alzheimer's disease (AD) and the conceptual interactions between AD and dementia due to AD were developed, resulting in two sets for diagnostic/research criteria. Procedures for pre-analytical sample handling, biobanking, analyses and post-analytical interpretation of the results were intensively studied and optimised. A global quality control project was introduced to evaluate and monitor the inter-centre variability in measurements with the goal of harmonisation of results. Contexts of use and how to approach candidate biomarkers in biological specimens other than cerebrospinal fluid (CSF), e.g. blood, were precisely defined. Important development was achieved in neuroimaging techniques, including studies comparing amyloid-β positron emission tomography results to fluid-based modalities. Similarly, development in research laboratory technologies, such as ultra-sensitive methods, raises our hopes to further improve analytical and diagnostic accuracy of classic and novel candidate biomarkers. Synergistically, advancement in clinical trials of anti-dementia therapies energises and motivates the efforts to find and optimise the most reliable early diagnostic modalities. Finally, the first studies were published addressing the potential of cost-effectiveness of the biomarkers-based diagnosis of neurodegenerative disorders.
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Affiliation(s)
- Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Neurodegeneration Diagnostics, Medical University of Białystok, and Department of Biochemical Diagnostics, University Hospital of Białystok, Białystok, Poland
| | - Peter Riederer
- Center of Mental Health, Clinic and Policlinic of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Sid E. O’Bryant
- Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Marcel M. Verbeek
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Nijmegen, The Netherlands
- Department of Laboratory Medicine, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer center, Nijmegen, The Netherlands
| | - Bruno Dubois
- Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Salpêtrièrie Hospital, INSERM UMR-S 975 (ICM), Paris 6 University, Paris, France
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
- Department of Neurology, Alzheimer Centre, Amsterdam Neuroscience VU University Medical Centre, Amsterdam, The Netherlands
| | | | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Alfredo Ramirez
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Lucilla Parnetti
- Section of Neurology, Center for Memory Disturbances, Lab of Clinical Neurochemistry, University of Perugia, Perugia, Italy
| | | | - Charlotte E. Teunissen
- Neurochemistry Lab and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Harald Hampel
- AXA Research Fund & UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du Cerveau et de la Moelle Épinière (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l’hôpital, Paris, France
| | - Alberto Lleó
- Department of Neurology, Institut d’Investigacions Biomèdiques Sant Pau - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Disorders (DZNE), Bonn, Germany
| | - Lidia Glodzik
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - Mony J. de Leon
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - Anne M. Fagan
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - José Luis Molinuevo
- Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Willemijn J. Jansen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Bengt Winblad
- Karolinska Institutet, Department NVS, Center for Alzheimer Research, Division of Neurogeriatrics, Huddinge, Sweden
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ulf Andreasson
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel and University Medical Center Göttingen, Department of Neurology, Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry & Psychotherapy, University of Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Martin R. Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Inga Zerr
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Clinical Dementia Centre, Department of Neurology, University Medical School, Göttingen, Germany
| | - Ron Handels
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
- Karolinska Institutet, Department NVS, Center for Alzheimer Research, Division of Neurogeriatrics, Huddinge, Sweden
| | | | - Gunilla Johansson
- Karolinska Institutet, Department NVS, Center for Alzheimer Research, Division of Neurogeriatrics, Huddinge, Sweden
| | - Natalia Ermann
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - John Q. Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ilker Karaca
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Holger Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Patrick Oeckl
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Linda van Waalwijk van Doorn
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Nijmegen, The Netherlands
- Department of Laboratory Medicine, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer center, Nijmegen, The Netherlands
| | - Maria Bjerke
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Dimitrios Kapogiannis
- Laboratory of Neurosciences, National Institute on Aging/National Institutes of Health (NIA/NIH), Baltimore, MD, USA
| | - H. Bea Kuiperij
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Nijmegen, The Netherlands
- Department of Laboratory Medicine, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer center, Nijmegen, The Netherlands
| | - Lucia Farotti
- Section of Neurology, Center for Memory Disturbances, Lab of Clinical Neurochemistry, University of Perugia, Perugia, Italy
| | - Yi Li
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - Brian A. Gordon
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Stéphane Epelbaum
- Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Salpêtrièrie Hospital, INSERM UMR-S 975 (ICM), Paris 6 University, Paris, France
| | - Stephanie J. B. Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Catharina J. M. Klijn
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Nijmegen, The Netherlands
| | | | - Carolina Minguillon
- Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Matthias Schmitz
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Clinical Dementia Centre, Department of Neurology, University Medical School, Göttingen, Germany
| | - Carla Gallo
- Departamento de Ciencias Celulares y Moleculares/Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Andrea Lopez Mato
- Chair of Psychoneuroimmunoendocrinology, Maimonides University, Buenos Aires, Argentina
| | - Florence Thibaut
- Department of Psychiatry, University Hospital Cochin-Site Tarnier 89 rue d’Assas, INSERM 894, Faculty of Medicine Paris Descartes, Paris, France
| | - Simone Lista
- AXA Research Fund & UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du Cerveau et de la Moelle Épinière (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l’hôpital, Paris, France
| | - Daniel Alcolea
- Department of Neurology, Institut d’Investigacions Biomèdiques Sant Pau - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
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Barone DA, Henchcliffe C. Rapid eye movement sleep behavior disorder and the link to alpha-synucleinopathies. Clin Neurophysiol 2018; 129:1551-1564. [PMID: 29883833 DOI: 10.1016/j.clinph.2018.05.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/10/2018] [Accepted: 05/18/2018] [Indexed: 01/09/2023]
Abstract
Rapid eye movement (REM) sleep behavior disorder (RBD) involves REM sleep without atonia in conjunction with a recurrent nocturnal dream enactment behavior, with vocalizations such as shouting and screaming, and motor behaviors such as punching and kicking. Secondary RBD is well described in association with neurological disorders including Parkinson's disease (PD), multiple system atrophy (MSA), and other conditions involving brainstem structures such as tumors. However, RBD alone is now considered to be a potential harbinger of later development of neurodegenerative disorders, in particular PD, MSA, dementia with Lewy bodies (DLB), and pure autonomic failure. These conditions are linked by their underpinning pathology of alpha-synuclein protein aggregation. In RBD, it is therefore important to recognize the potential risk for later development of an alpha-synucleinopathy, and to investigate for other potential causes such as medications. Other signs and symptoms have been described in RBD, such as orthostatic hypotension, or depression. While it is important to recognize these features to improve patient management, they may ultimately provide clinical clues that will lead to risk stratification for phenoconversion. A critical need is to improve our ability to counsel patients, particularly with regard to prognosis. The ability to identify who, of those with RBD, is at high risk for later neurodegenerative disorders will be paramount, and would in addition advance our understanding of the prodromal stages of the alpha-synucleinopathies. Moreover, recognition of at-risk individuals for neurodegenerative disorders may ultimately provide a platform for the testing of possible neuroprotective agents for these neurodegenerative disorders.
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245
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Cedarbaum JM. Elephants, Parkinson's Disease, and Proof-of-Concept Clinical Trials. Mov Disord 2018; 33:697-700. [PMID: 29722454 DOI: 10.1002/mds.27398] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/07/2018] [Accepted: 03/08/2018] [Indexed: 02/03/2023] Open
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246
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Lang AE, Espay AJ. Disease Modification in Parkinson's Disease: Current Approaches, Challenges, and Future Considerations. Mov Disord 2018; 33:660-677. [DOI: 10.1002/mds.27360] [Citation(s) in RCA: 203] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 02/04/2018] [Accepted: 02/07/2018] [Indexed: 12/13/2022] Open
Affiliation(s)
- Anthony E. Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Division of Neurology; University of Toronto; Toronto Ontario Canada
| | - Alberto J. Espay
- UC Gardner Neuroscience Institute and Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology; University of Cincinnati; Cincinnati Ohio USA
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247
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Dos Santos MCT, Barreto-Sanz MA, Correia BRS, Bell R, Widnall C, Perez LT, Berteau C, Schulte C, Scheller D, Berg D, Maetzler W, Galante PAF, Nogueira da Costa A. miRNA-based signatures in cerebrospinal fluid as potential diagnostic tools for early stage Parkinson's disease. Oncotarget 2018; 9:17455-17465. [PMID: 29707120 PMCID: PMC5915128 DOI: 10.18632/oncotarget.24736] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 02/25/2018] [Indexed: 12/20/2022] Open
Abstract
Parkinson’s Disease is the second most common neurodegenerative disorder, affecting 1–2% of the elderly population. Its diagnosis is still based on the identification of motor symptoms when a considerable number of dopaminergic neurons are already lost. The development of translatable biomarkers for accurate diagnosis at the earliest stages of PD is of extreme interest. Several microRNAs have been associated with PD pathophysiology. Consequently, microRNAs are emerging as potential biomarkers, especially due to their presence in Cerebrospinal Fluid and peripheral circulation. This study employed small RNA sequencing, protein binding ligand assays and machine learning in a cross-sectional cohort comprising 40 early stage PD patients and 40 well-matched controls. We identified a panel comprising 5 microRNAs (Let-7f-5p, miR-27a-3p, miR-125a-5p, miR-151a-3p and miR-423-5p), with 90% sensitivity, 80% specificity and 82% area under the curve (AUC) for the differentiation of the cohorts. Moreover, we combined miRNA profiles with hallmark-proteins of PD and identified a panel (miR-10b-5p, miR-22-3p, miR-151a-3p and α-synuclein) reaching 97% sensitivity, 90% specificity and 96% AUC. We performed a gene ontology analysis for the genes targeted by the microRNAs present in each panel and showed the likely association of the models with pathways involved in PD pathogenesis.
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Affiliation(s)
- Marcia Cristina T Dos Santos
- Experimental Medicine and Diagnostics, Global Exploratory Development, UCB Biopharma SPRL, Braine-l'Alleud, Belgium
| | | | | | - Rosie Bell
- Centre for Misfolding Diseases, University of Cambridge, Cambridge, UK
| | - Catherine Widnall
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK
| | - Luis Tosar Perez
- Bioanalytical Sciences, Non Clinical Development, UCB Biopharma SPRL, Belgium
| | - Caroline Berteau
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK
| | - Claudia Schulte
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tuebingen and German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | | | - Daniela Berg
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tuebingen and German Center for Neurodegenerative Diseases, Tuebingen, Germany.,Department of Neurology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Walter Maetzler
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tuebingen and German Center for Neurodegenerative Diseases, Tuebingen, Germany.,Department of Neurology, Christian-Albrechts-University Kiel, Kiel, Germany
| | | | - Andre Nogueira da Costa
- Experimental Medicine and Diagnostics, Global Exploratory Development, UCB Biopharma SPRL, Braine-l'Alleud, Belgium
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248
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Potential biomarkers of Parkinson's disease revealed by plasma metabolic profiling. J Chromatogr B Analyt Technol Biomed Life Sci 2018. [DOI: 10.1016/j.jchromb.2018.01.025] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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249
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Xu X, Guan X, Guo T, Zeng Q, Ye R, Wang J, Zhong J, Xuan M, Gu Q, Huang P, Pu J, Zhang B, Zhang M. Brain Atrophy and Reorganization of Structural Network in Parkinson's Disease With Hemiparkinsonism. Front Hum Neurosci 2018; 12:117. [PMID: 29636671 PMCID: PMC5881349 DOI: 10.3389/fnhum.2018.00117] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/12/2018] [Indexed: 11/13/2022] Open
Abstract
Hemiparkinsonism duration in patients with Parkinson's disease (PD) is a key time window to study early pathology of PD. We aimed to comprehensively explore the alterations of deformation and structural network in PD patients with hemiparkinsonism, which could potentially disclose the early biomarker for PD. Thirty-one PD patients with hemiparkinsonism and 37 age- and gender- matched normal controls were included in the present study. First of all, we normalized the left hemisphere of structural images as the contralateral side to the affected limbs. Deformation-based morphometry (DBM) was conducted to evaluate the brain atrophy and/or enlargement. structural networks were constructed by thresholding gray matter volume correlation matrices of 116 regions and analyzed using graph theoretical approaches (e.g., small-worldness, global, and nodal measures). Significantly decreased deformation values were observed in the temporoparietal regions like bilateral middle temporal gyri, ipsilateral precuneus and contralateral Rolandic operculum extending to supramarginal and postcentral gyri. Lower deformation values in contralateral middle temporal gyrus were negatively correlated with higher motor impairment which was dominated by akinesia/rigidity. Moreover, nodal reorganization of structural network mainly located in frontal, temporal, subcortex and cerebellum was bilaterally explored in PD patients with hemiparkinsonism. Increased nodal properties could be commonly observed in frontal lobes. Disruption of subcortex including basal ganglia and amygdala was detected by nodal local efficiency and nodal clustering coefficient. Twelve hubs, mainly from paralimbic-limbic and heteromodal networks, were disrupted and, alternatively, 14 hubs, most of which were located in frontal lobes, were additionally detected in PD patients with hemiparkinsonism. In conclusion, during hemiparkinsonism period, mild brain atrophy in the temporoparietal regions and widespread reorganization of structural network, e.g., enhanced frontal function and disruption of basal ganglia nodes, occurred in both hemispheres. With our data, we can also argue that MTG contralateral to the affected limbs (expressing clinically verified brain atrophy) might be a potential living biomarker to monitor disease progression. Therefore, the combination of DBM and structural network analyses can provide a comprehensive and sensitive evaluation for potential pathogenesis of early PD patients with hemiparkinsonism.
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Affiliation(s)
- Xiaojun Xu
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Guan
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Tao Guo
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Qiaoling Zeng
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Rong Ye
- Department of Neurology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaqiu Wang
- Department of Neurology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jianguo Zhong
- Department of Radiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Min Xuan
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Quanquan Gu
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jiali Pu
- Department of Neurology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Baorong Zhang
- Department of Neurology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Marsili L, Rizzo G, Colosimo C. Diagnostic Criteria for Parkinson's Disease: From James Parkinson to the Concept of Prodromal Disease. Front Neurol 2018; 9:156. [PMID: 29628907 PMCID: PMC5877503 DOI: 10.3389/fneur.2018.00156] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 03/02/2018] [Indexed: 12/21/2022] Open
Abstract
The diagnosis of Parkinson’s disease (PD) is based on clinical features and differently to the common opinion that detecting this condition is easy, seminal clinicopathological studies have shown that up one-fourth of patients diagnosed as PD during life has an alternative diagnosis at postmortem. The misdiagnosis is even higher when only the initial diagnosis is considered, since the diagnostic accuracy improves by time, during follow-up visits. Given that the confirmation of the diagnosis of PD can be only obtained through neuropathology, to improve and facilitate the diagnostic–therapeutic workup in PD, a number of criteria and guidelines have been introduced in the last three decades. In the present paper, we will critically re-appraise the main diagnostic criteria proposed for PD, with particular attention to the recently published criteria by the International Parkinson and Movement Disorder Society (MDS) task force, underlying their novelty and focusing on the diagnostic issues still open. We also emphasize that the MDS-PD criteria encompass the two main previous sets of diagnostic criteria (United Kingdom PD Society Brain Bank and Gelb’s criteria), introducing at the same time new aspects as the use of non-motor symptoms as additional diagnostic features, and the adoption of the concept of prodromal PD, crucial to enroll in clinical trials PD patients in the very early phase of the disease. To better understand the real diffusion of the new MDS-PD diagnostic criteria among neurologists, we have also collected selective opinions of sixteen movement disorder experts from various world regions on their practical approach for the clinical diagnosis of PD. Results from this brief survey showed that, although innovative and complete, the revised diagnostic criteria produced by MDS task force are still scarcely employed among clinicians. We believe that both national and international scientific societies should operate in the future for a broader diffusion of these criteria with specific initiatives, including dedicated events and teaching courses.
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Affiliation(s)
- Luca Marsili
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.,Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, United States
| | - Giovanni Rizzo
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Carlo Colosimo
- Department of Neurology, Santa Maria University Hospital, Terni, Italy
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