251
|
Chen Y, Kumfor F, Landin-Romero R, Irish M, Piguet O. The Cerebellum in Frontotemporal Dementia: a Meta-Analysis of Neuroimaging Studies. Neuropsychol Rev 2019; 29:450-464. [PMID: 31428914 DOI: 10.1007/s11065-019-09414-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 08/05/2019] [Indexed: 12/12/2022]
Abstract
Frontotemporal dementia (FTD) is a neurodegenerative brain disorder primarily affecting the frontal and/or temporal lobes. Three main subtypes have been recognized: behavioural-variant FTD (bvFTD), semantic dementia (SD), and progressive nonfluent aphasia (PNFA), each of which has a distinct clinical and cognitive profile. Although the role of the cerebellum in cognition is increasingly accepted, knowledge of cerebellar changes across neuroimaging modalities and their contribution to behavioural and cognitive changes in FTD syndromes is currently scant. We conducted an anatomical/activation likelihood estimation (ALE) meta-analysis in 53 neuroimaging studies (structural MRI: 42; positron emission tomography: 6; functional MRI: 4; single-photon emission computed tomography: 1) to identify the patterns of cerebellar changes and their relations to profiles of behavioural and cognitive deficits in FTD syndromes. Overall, widespread bilateral cerebellar changes were found in FTD and notably the patterns were subtype specific. In bvFTD, ALE peaks were identified in the bilateral Crus, left lobule VI, right lobules VIIb and VIIIb. In SD, focal cerebellar changes were located in the left Crus I and lobule VI. A separate ALE meta-analysis on PNFA studies was not performed due to the limited number of studies available. In addition, the ALE analysis indicated that bilateral Crus I and Crus II were associated with behavioural disruption and cognitive dysfunction. This ALE meta-analysis provides the quantification of the location and extent of cerebellar changes across the main FTD syndromes, which in turn provides evidence of cerebellar contributions to behavioural and cognitive changes in FTD. These results bring new insights into the mechanisms mediating FTD symptomatology.
Collapse
Affiliation(s)
- Yu Chen
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Fiona Kumfor
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Ramon Landin-Romero
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Muireann Irish
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Olivier Piguet
- The University of Sydney, School of Psychology, Brain & Mind Centre, Sydney, NSW, Australia.
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia.
| |
Collapse
|
252
|
Gossye H, Van Broeckhoven C, Engelborghs S. The Use of Biomarkers and Genetic Screening to Diagnose Frontotemporal Dementia: Evidence and Clinical Implications. Front Neurosci 2019; 13:757. [PMID: 31447625 PMCID: PMC6691066 DOI: 10.3389/fnins.2019.00757] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 07/08/2019] [Indexed: 12/12/2022] Open
Abstract
Within the wide range of neurodegenerative brain diseases, the differential diagnosis of frontotemporal dementia (FTD) frequently poses a challenge. Often, signs and symptoms are not characteristic of the disease and may instead reflect atypical presentations. Consequently, the use of disease biomarkers is of importance to correctly identify the patients. Here, we describe how neuropsychological characteristics, neuroimaging and neurochemical biomarkers and screening for causal gene mutations can be used to differentiate FTD from other neurodegenerative diseases as well as to distinguish between FTD subtypes. Summarizing current evidence, we propose a stepwise approach in the diagnostic evaluation. Clinical consensus criteria that take into account a full neuropsychological examination have relatively good accuracy (sensitivity [se] 75–95%, specificity [sp] 82–95%) to diagnose FTD, although misdiagnosis (mostly AD) is common. Structural brain MRI (se 70–94%, sp 89–99%) and FDG PET (se 47–90%, sp 68–98%) or SPECT (se 36–100%, sp 41–100%) brain scans greatly increase diagnostic accuracy, showing greater involvement of frontal and anterior temporal lobes, with sparing of hippocampi and medial temporal lobes. If these results are inconclusive, we suggest detecting amyloid and tau cerebrospinal fluid (CSF) biomarkers that can indicate the presence of AD with good accuracy (se 74–100%, sp 82–97%). The use of P-tau181 and the Aβ1–42/Aβ1–40 ratio significantly increases the accuracy of correctly identifying FTD vs. AD. Alternatively, an amyloid brain PET scan can be performed to differentiate FTD from AD. When autosomal dominant inheritance is suspected, or in early onset dementia, mutation screening of causal genes is indicated and may also be offered to at-risk family members. We have summarized genotype–phenotype correlations for several genes that are known to cause familial frontotemporal lobar degeneration, which is the neuropathological substrate of FTD. The genes most commonly associated with this disease (C9orf72, MAPT, GRN, TBK1) are discussed, as well as some less frequent ones (CHMP2B, VCP). Several other techniques, such as diffusion tensor imaging, tau PET imaging and measuring serum neurofilament levels, show promise for future implementation as diagnostic biomarkers.
Collapse
Affiliation(s)
- Helena Gossye
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB, Antwerp, Belgium.,Institute Born - Bunge, University of Antwerp, Antwerp, Belgium.,Department of Neurology and Center for Neurosciences, UZ Brussel and Vrije Universiteit Brussel, Brussels, Belgium
| | - Christine Van Broeckhoven
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB, Antwerp, Belgium.,Institute Born - Bunge, University of Antwerp, Antwerp, Belgium
| | - Sebastiaan Engelborghs
- Institute Born - Bunge, University of Antwerp, Antwerp, Belgium.,Department of Neurology and Center for Neurosciences, UZ Brussel and Vrije Universiteit Brussel, Brussels, Belgium
| |
Collapse
|
253
|
Bright F, Werry EL, Dobson-Stone C, Piguet O, Ittner LM, Halliday GM, Hodges JR, Kiernan MC, Loy CT, Kassiou M, Kril JJ. Neuroinflammation in frontotemporal dementia. Nat Rev Neurol 2019; 15:540-555. [PMID: 31324897 DOI: 10.1038/s41582-019-0231-z] [Citation(s) in RCA: 138] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2019] [Indexed: 12/12/2022]
Abstract
Frontotemporal dementia (FTD) refers to a group of progressive neurodegenerative disorders with different pathological signatures, genetic variability and complex disease mechanisms, for which no effective treatments exist. Despite advances in understanding the underlying pathology of FTD, sensitive and specific fluid biomarkers for this disease are lacking. As in other types of dementia, mounting evidence suggests that neuroinflammation is involved in the progression of FTD, including cortical inflammation, microglial activation, astrogliosis and differential expression of inflammation-related proteins in the periphery. Furthermore, an overlap between FTD and autoimmune disease has been identified. The most substantial evidence, however, comes from genetic studies, and several FTD-related genes are also implicated in neuroinflammation. This Review discusses specific evidence of neuroinflammatory mechanisms in FTD and describes how advances in our understanding of these mechanisms, in FTD as well as in other neurodegenerative diseases, might facilitate the development and implementation of diagnostic tools and disease-modifying treatments for FTD.
Collapse
Affiliation(s)
- Fiona Bright
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Eryn L Werry
- School of Chemistry, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Carol Dobson-Stone
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.,Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Olivier Piguet
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.,School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.,Centre of Excellence in Cognition and its Disorders, Australian Research Council, Sydney, NSW, Australia
| | - Lars M Ittner
- Dementia Research Centre, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Glenda M Halliday
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.,Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - John R Hodges
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.,Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Centre of Excellence in Cognition and its Disorders, Australian Research Council, Sydney, NSW, Australia
| | - Matthew C Kiernan
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.,Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Clement T Loy
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Michael Kassiou
- School of Chemistry, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Jillian J Kril
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| |
Collapse
|
254
|
Ahn JH, Kim M, Kim JS, Youn J, Jang W, Oh E, Lee PH, Koh SB, Ahn TB, Cho JW. Midbrain atrophy in patients with presymptomatic progressive supranuclear palsy-Richardson's syndrome. Parkinsonism Relat Disord 2019; 66:80-86. [PMID: 31307918 DOI: 10.1016/j.parkreldis.2019.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/27/2019] [Accepted: 07/07/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION In the present study, midbrain atrophy and the pons-to-midbrain area ratio (P/M ratio) were investigated as diagnostic markers for presymptomatic progressive supranuclear palsy-Richardson's syndrome (Pre-PSP-RS). METHODS The present study included 27 patients with probable PSP-RS who underwent brain MRI at least twice before and after the development of clinical symptoms, age- and sex-matched participants with Parkinson's disease (PD, n = 27), and healthy controls (n = 27). The midbrain area, pons area, and P/M ratio of the Pre-PSP-RS, PD, and control subjects were measured using midsagittal images from brain MRI, and the parameters were compared among the groups. RESULTS The midbrain area decreased and the P/M ratio increased significantly in the Pre-PSP-RS patients compared with both the PD and control subjects (midbrain, Pre-PSP-RS vs. PD = 1.01 cm2vs. 1.29 cm2, p < 0.001, Pre-PSP-RS vs. controls = 1.01 cm2vs. 1.29 cm2, p < 0.001; P/M ratio, Pre-PSP-RS vs. PD = 5.27 vs. 4.03, p < 0.001, Pre-PSP-RS vs. controls = 5.27 cm2vs. 4.06 cm2, p < 0.001). The P/M ratio had high sensitivity (vs. PD, 96.3%, vs. control, 88.9%) and specificity (vs. PD, 81.5%, vs. control, 96.3%) in differentiating Pre-PSP-RS patients from PD and control subjects. CONCLUSION Midbrain atrophy precedes the clinical symptoms of PSP-RS and could be a useful diagnostic imaging biomarker for Pre-PSP-RS. Furthermore, this information could play an important role in the development of future treatment strategies.
Collapse
Affiliation(s)
- Jong Hyeon Ahn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea; Neuroscience Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Minkyeong Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea; Neuroscience Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Ji Sun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea; Neuroscience Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jinyoung Youn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea; Neuroscience Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Wooyoung Jang
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, 38 Bangdong-gil, Sacheon, Gangneung, 25440, Republic of Korea
| | - Eungseok Oh
- Department of Neurology, Chungnam National University Hospital, College of Medicine, 282 Munhwa-ro, Jung-Gu, Daejun, 35015, Republic of Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Seong-Beom Koh
- Departments of Neurology, Korea University College of Medicine, Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Tae-Beom Ahn
- Department of Neurology, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Jin Whan Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea; Neuroscience Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| |
Collapse
|
255
|
Test Your Memory (TYM test): diagnostic evaluation of patients with non-Alzheimer dementias. J Neurol 2019; 266:2546-2553. [PMID: 31267204 PMCID: PMC6765477 DOI: 10.1007/s00415-019-09447-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 01/15/2023]
Abstract
Background/aims To validate the use of the Test Your Memory (TYM) test in dementias other than Alzheimer’s disease, and to compare the TYM test to two other short cognitive tests. Methods One hundred and fifty-seven patients with dementia other than typical Alzheimer’s disease were recruited from a specialist memory clinic. Patients completed the TYM test, the revised Addenbrooke’s Cognitive Examination (ACE-R) and Mini-Mental State Examination (MMSE), plus neurological examination, clinical diagnostics and multi-disciplinary team review. Their TYM scores were compared to age-matched controls and an Alzheimer’s disease cohort. Results Patients scored an average of 34.4/50 on the TYM test compared to 46.0/50 in age-matched controls. Using the threshold of 42/50, the TYM test detected 80% of non-Alzheimer dementias. The area under the ROC curve was 0.89 with a PPV of 0.80 and a NPV of 0.84. The TYM test performed better than the ACE-R (using the threshold of 83) which detected 69% of cases and the MMSE (using a threshold of 24) which detected only 27%. Conclusions The TYM test is a useful test in the detection of non-Alzheimer dementia. The TYM test performs much better than the MMSE at detecting non-Alzheimer dementias.
Collapse
|
256
|
Jellinger KA. Neuropathology and pathogenesis of extrapyramidal movement disorders: a critical update-I. Hypokinetic-rigid movement disorders. J Neural Transm (Vienna) 2019; 126:933-995. [PMID: 31214855 DOI: 10.1007/s00702-019-02028-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/05/2019] [Indexed: 02/06/2023]
Abstract
Extrapyramidal movement disorders include hypokinetic rigid and hyperkinetic or mixed forms, most of them originating from dysfunction of the basal ganglia (BG) and their information circuits. The functional anatomy of the BG, the cortico-BG-thalamocortical, and BG-cerebellar circuit connections are briefly reviewed. Pathophysiologic classification of extrapyramidal movement disorder mechanisms distinguish (1) parkinsonian syndromes, (2) chorea and related syndromes, (3) dystonias, (4) myoclonic syndromes, (5) ballism, (6) tics, and (7) tremor syndromes. Recent genetic and molecular-biologic classifications distinguish (1) synucleinopathies (Parkinson's disease, dementia with Lewy bodies, Parkinson's disease-dementia, and multiple system atrophy); (2) tauopathies (progressive supranuclear palsy, corticobasal degeneration, FTLD-17; Guamian Parkinson-dementia; Pick's disease, and others); (3) polyglutamine disorders (Huntington's disease and related disorders); (4) pantothenate kinase-associated neurodegeneration; (5) Wilson's disease; and (6) other hereditary neurodegenerations without hitherto detected genetic or specific markers. The diversity of phenotypes is related to the deposition of pathologic proteins in distinct cell populations, causing neurodegeneration due to genetic and environmental factors, but there is frequent overlap between various disorders. Their etiopathogenesis is still poorly understood, but is suggested to result from an interaction between genetic and environmental factors. Multiple etiologies and noxious factors (protein mishandling, mitochondrial dysfunction, oxidative stress, excitotoxicity, energy failure, and chronic neuroinflammation) are more likely than a single factor. Current clinical consensus criteria have increased the diagnostic accuracy of most neurodegenerative movement disorders, but for their definite diagnosis, histopathological confirmation is required. We present a timely overview of the neuropathology and pathogenesis of the major extrapyramidal movement disorders in two parts, the first one dedicated to hypokinetic-rigid forms and the second to hyperkinetic disorders.
Collapse
Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
| |
Collapse
|
257
|
Nelson PT, Dickson DW, Trojanowski JQ, Jack CR, Boyle PA, Arfanakis K, Rademakers R, Alafuzoff I, Attems J, Brayne C, Coyle-Gilchrist ITS, Chui HC, Fardo DW, Flanagan ME, Halliday G, Hokkanen SRK, Hunter S, Jicha GA, Katsumata Y, Kawas CH, Keene CD, Kovacs GG, Kukull WA, Levey AI, Makkinejad N, Montine TJ, Murayama S, Murray ME, Nag S, Rissman RA, Seeley WW, Sperling RA, White III CL, Yu L, Schneider JA. Limbic-predominant age-related TDP-43 encephalopathy (LATE): consensus working group report. Brain 2019; 142:1503-1527. [PMID: 31039256 PMCID: PMC6536849 DOI: 10.1093/brain/awz099] [Citation(s) in RCA: 824] [Impact Index Per Article: 164.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/10/2019] [Accepted: 02/25/2019] [Indexed: 12/18/2022] Open
Abstract
We describe a recently recognized disease entity, limbic-predominant age-related TDP-43 encephalopathy (LATE). LATE neuropathological change (LATE-NC) is defined by a stereotypical TDP-43 proteinopathy in older adults, with or without coexisting hippocampal sclerosis pathology. LATE-NC is a common TDP-43 proteinopathy, associated with an amnestic dementia syndrome that mimicked Alzheimer's-type dementia in retrospective autopsy studies. LATE is distinguished from frontotemporal lobar degeneration with TDP-43 pathology based on its epidemiology (LATE generally affects older subjects), and relatively restricted neuroanatomical distribution of TDP-43 proteinopathy. In community-based autopsy cohorts, ∼25% of brains had sufficient burden of LATE-NC to be associated with discernible cognitive impairment. Many subjects with LATE-NC have comorbid brain pathologies, often including amyloid-β plaques and tauopathy. Given that the 'oldest-old' are at greatest risk for LATE-NC, and subjects of advanced age constitute a rapidly growing demographic group in many countries, LATE has an expanding but under-recognized impact on public health. For these reasons, a working group was convened to develop diagnostic criteria for LATE, aiming both to stimulate research and to promote awareness of this pathway to dementia. We report consensus-based recommendations including guidelines for diagnosis and staging of LATE-NC. For routine autopsy workup of LATE-NC, an anatomically-based preliminary staging scheme is proposed with TDP-43 immunohistochemistry on tissue from three brain areas, reflecting a hierarchical pattern of brain involvement: amygdala, hippocampus, and middle frontal gyrus. LATE-NC appears to affect the medial temporal lobe structures preferentially, but other areas also are impacted. Neuroimaging studies demonstrated that subjects with LATE-NC also had atrophy in the medial temporal lobes, frontal cortex, and other brain regions. Genetic studies have thus far indicated five genes with risk alleles for LATE-NC: GRN, TMEM106B, ABCC9, KCNMB2, and APOE. The discovery of these genetic risk variants indicate that LATE shares pathogenetic mechanisms with both frontotemporal lobar degeneration and Alzheimer's disease, but also suggests disease-specific underlying mechanisms. Large gaps remain in our understanding of LATE. For advances in prevention, diagnosis, and treatment, there is an urgent need for research focused on LATE, including in vitro and animal models. An obstacle to clinical progress is lack of diagnostic tools, such as biofluid or neuroimaging biomarkers, for ante-mortem detection of LATE. Development of a disease biomarker would augment observational studies seeking to further define the risk factors, natural history, and clinical features of LATE, as well as eventual subject recruitment for targeted therapies in clinical trials.
Collapse
Affiliation(s)
| | | | | | | | | | - Konstantinos Arfanakis
- Rush University Medical Center, Chicago, IL, USA
- Illinois Institute of Technology, Chicago, IL, USA
| | | | | | | | | | | | - Helena C Chui
- University of Southern California, Los Angeles, CA, USA
| | | | | | - Glenda Halliday
- The University of Sydney Brain and Mind Centre and Central Clinical School Faculty of Medicine and Health, Sydney, Australia
| | | | | | | | | | | | | | - Gabor G Kovacs
- Institute of Neurology Medical University of Vienna, Vienna, Austria
| | | | | | | | | | - Shigeo Murayama
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | | | - Sukriti Nag
- Rush University Medical Center, Chicago, IL, USA
| | | | | | | | | | - Lei Yu
- Rush University Medical Center, Chicago, IL, USA
| | | |
Collapse
|
258
|
Croot K, Raiser T, Taylor-Rubin C, Ruggero L, Ackl N, Wlasich E, Danek A, Scharfenberg A, Foxe D, Hodges JR, Piguet O, Kochan NA, Nickels L. Lexical retrieval treatment in primary progressive aphasia: An investigation of treatment duration in a heterogeneous case series. Cortex 2019; 115:133-158. [DOI: 10.1016/j.cortex.2019.01.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/21/2018] [Accepted: 01/09/2019] [Indexed: 10/27/2022]
|
259
|
Use of human pluripotent stem cell-derived cells for neurodegenerative disease modeling and drug screening platform. Future Med Chem 2019; 11:1305-1322. [DOI: 10.4155/fmc-2018-0520] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Most neurodegenerative diseases are characterized by a complex and mostly still unresolved pathology. This fact, together with the lack of reliable disease models, has precluded the development of effective therapies counteracting the disease progression. The advent of human pluripotent stem cells has revolutionized the field allowing the generation of disease-relevant neural cell types that can be used for disease modeling, drug screening and, possibly, cell transplantation purposes. In this Review, we discuss the applications of human pluripotent stem cells, the development of efficient protocols for the derivation of the different neural cells and their applicability for robust in vitro disease modeling and drug screening platforms for most common neurodegenerative conditions.
Collapse
|
260
|
An update on genetic frontotemporal dementia. J Neurol 2019; 266:2075-2086. [PMID: 31119452 PMCID: PMC6647117 DOI: 10.1007/s00415-019-09363-4] [Citation(s) in RCA: 219] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 12/12/2022]
Abstract
Frontotemporal dementia (FTD) is a highly heritable group of neurodegenerative disorders, with around 30% of patients having a strong family history. The majority of that heritability is accounted for by autosomal dominant mutations in the chromosome 9 open reading frame 72 (C9orf72), progranulin (GRN), and microtubule-associated protein tau (MAPT) genes, with mutations more rarely seen in a number of other genes. This review will discuss the recent updates in the field of genetic FTD. Age at symptom onset in genetic FTD is variable with recently identified genetic modifiers including TMEM106B (in GRN carriers particularly) and a polymorphism at a locus containing two overlapping genes LOC101929163 and C6orf10 (in C9orf72 carriers). Behavioural variant FTD (bvFTD) is the most common diagnosis in each of the genetic groups, although in C9orf72 carriers amyotrophic lateral sclerosis either alone, or with bvFTD, is also common. An atypical neuropsychiatric presentation is also seen in C9orf72 carriers and family members of carriers are at greater risk of psychiatric disorders including schizophrenia and autistic spectrum disorders. Large natural history studies of presymptomatic genetic FTD are now underway both in Europe/Canada (GENFI—the Genetic FTD Initiative) and in the US (ARTFL/LEFFTDS study), collaborating together under the banner of the FTD Prevention Initiative (FPI). These studies are taking forward the validation of cognitive, imaging and fluid biomarkers that aim to robustly measure disease onset, staging and progression in genetic FTD. Grey matter changes on MRI and hypometabolism on FDG-PET are seen at least 10 years before symptom onset with white matter abnormalities seen earlier, but the pattern and exact timing of changes differ between different genetic groups. In contrast, tau PET has yet to show promise in genetic FTD. Three key fluid biomarkers have been identified so far that are likely to be helpful in clinical trials—CSF or blood neurofilament light chain levels (in all groups), CSF or blood progranulin levels (in GRN carriers) and CSF poly(GP) dipeptide repeat protein levels (in C9orf72 carriers). Increased knowledge about genetic FTD has led to more clinical presymptomatic genetic testing but this has not yet been mirrored in the development of either an accepted FTD-specific testing protocol or provision of appropriate psychological support mechanisms for those living through the at-risk phase. This will become even more relevant as disease-modifying therapy trials start in each of the genetic groups over the next few years.
Collapse
|
261
|
Hodges JR, Piguet O. Progress and Challenges in Frontotemporal Dementia Research: A 20-Year Review. J Alzheimers Dis 2019; 62:1467-1480. [PMID: 29504536 PMCID: PMC5870022 DOI: 10.3233/jad-171087] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The landscape of frontotemporal dementia (FTD) has evolved remarkably in recent years and is barely recognizable from two decades ago. Knowledge of the clinical phenomenology, cognition, neuroimaging, genetics, pathology of the different subtypes of FTD, and their relations to other neurodegenerative conditions, has increased rapidly, due in part, to the growing interests into these neurodegenerative brain conditions. This article reviews the major advances in the field of FTD over the past 20 years, focusing primarily on the work of Frontier, the frontotemporal dementia clinical research group, based in Sydney, Australia. Topics covered include clinical presentations (cognition, behavior, neuroimaging), pathology, genetics, and disease progression, as well as interventions and carer directed research. This review demonstrates the improvement in diagnostic accuracy and capacity to provide advice on genetic risks, prognosis, and outcome. The next major challenge will be to capitalize on these research findings to develop effective disease modifying drugs, which are currently lacking.
Collapse
Affiliation(s)
- John R Hodges
- The University of Sydney, Sydney Medical School and Brain and Mind Centre, Sydney, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Olivier Piguet
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia.,The University of Sydney, School of Psychology, and Brain and Mind Centre, Sydney, Australia
| |
Collapse
|
262
|
Ciani M, Benussi L, Bonvicini C, Ghidoni R. Genome Wide Association Study and Next Generation Sequencing: A Glimmer of Light Toward New Possible Horizons in Frontotemporal Dementia Research. Front Neurosci 2019; 13:506. [PMID: 31156380 PMCID: PMC6532367 DOI: 10.3389/fnins.2019.00506] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/02/2019] [Indexed: 12/12/2022] Open
Abstract
Frontotemporal Dementia (FTD) is a focal neurodegenerative disease, with a strong genetic background, that causes early onset dementia. The present knowledge about the risk loci and causative mutations of FTD mainly derives from genetic linkage analysis, studies of candidate genes, Genome-Wide Association Studies (GWAS) and Next-Generation Sequencing (NGS) applications. In this review, we report recent insights into the genetics of FTD, and, specifically, the results achieved thanks to GWAS and NGS approaches. Linkage studies of large FTD pedigrees have prompted the identification of causal mutations in different genes: mutations in C9orf72, MAPT, and GRN genes explain the large majority of cases with a high family history of the disease. In cases with a less clear inheritance, GWAS and NGS have contributed to further understand the genetic picture of FTD. GWAS identified several common genetic variants with a modest risk effect. Of interest, many of these variants are in genes belonging to the endo-lysosomal pathway, the immune response and neuronal survival. On the opposite, the NGS approach allowed the identification of rare variants with a strong risk effect. These variants were identified in known FTD-associated genes and again in genes involved in the endo-lysosomal pathway and in the immune response. Interestingly, both approaches demonstrated that several genes are associated to multiple neurodegenerative disorders including FTD. Thanks to these complementary approaches, the genetic picture of FTD is becoming more clear and novel key molecular processes are emerging. This will foster opportunities to move toward prevention and therapy for this incurable disease.
Collapse
Affiliation(s)
- Miriam Ciani
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Luisa Benussi
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Cristian Bonvicini
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Roberta Ghidoni
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| |
Collapse
|
263
|
Sellami L, Meilleur-Durand S, Chouinard AM, Bergeron D, Verret L, Poulin S, Jean L, Fortin MP, Nadeau Y, Molin P, Caron S, Macoir J, Hudon C, Bouchard RW, Laforce R. The Dépistage Cognitif de Québec: A New Clinician's Tool for Early Recognition of Atypical Dementia. Dement Geriatr Cogn Disord 2019; 46:310-321. [PMID: 30481754 DOI: 10.1159/000494348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/05/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Early recognition of atypical dementia remains challenging partly because of lack of cognitive screening instruments precisely tailored for this purpose. METHODS We assessed the validity and reliability of the Dépistage Cognitif de Québec (DCQ; www.dcqtest.org), a newly developed cognitive screening test, to detect atypical dementia using a multicenter cohort of 628 participants. Sensitivity and specificity were compared to the Montreal Cognitive Assessment (MoCA). A predictive diagnostic algorithm for atypical dementia was determined using classification tree analysis. RESULTS The DCQ showed excellent psychometric properties. It was significantly more accurate than the MoCA to detect atypical dementia. All correlations between DCQ indexes and standard neuropsychological measures were significant. A statistical model distinguished typical from atypical dementia with a predictive power of 79%. DISCUSSION The DCQ is a better tool to detect atypical dementia than standard cognitive screening tests. Expanding the clinician's tool kit with the DCQ could reduce missed/delayed identification of atypical dementia and accelerate therapeutic intervention.
Collapse
Affiliation(s)
- Leila Sellami
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Synthia Meilleur-Durand
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Anne-Marie Chouinard
- CERVO Brain Research Centre, École de psychologie, Université Laval, Québec, Québec, Canada
| | - David Bergeron
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Louis Verret
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Stéphane Poulin
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Léonie Jean
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Marie-Pierre Fortin
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Yannick Nadeau
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Pierre Molin
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Stéphanie Caron
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Joël Macoir
- Département de Réadaptation, CERVO Brain Research Centre, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Carol Hudon
- CERVO Brain Research Centre, École de psychologie, Université Laval, Québec, Québec, Canada
| | - Rémi W Bouchard
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada,
| |
Collapse
|
264
|
Panza F, Imbimbo BP, Lozupone M, Greco A, Seripa D, Logroscino G, Daniele A, Colosimo C. Disease-modifying therapies for tauopathies: agents in the pipeline. Expert Rev Neurother 2019; 19:397-408. [PMID: 30973276 DOI: 10.1080/14737175.2019.1606715] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Tauopathies are heterogeneous clinicopathological entities characterized by abnormal neuronal and/or glial inclusions of the microtubule-binding protein tau. Primary tauopathies considered to be diseases correspond to a major class of frontotemporal lobar degeneration (FTLD) neuropathology (FTLD-Tau), including several forms of frontotemporal dementia (FTD) clinical syndromes. Little progress has been made in the past 20 years in developing effective disease-modifying drugs for primary tauopathies and available symptomatic treatments have limited efficacy. Areas covered: Potential disease-modifying drugs in clinical development to slow neuropathological progression of primary tauopathies. Expert opinion: Since the underlying pathology of primary tauopathies consists of abnormal tau protein aggregates, treatments are being developed to interfere with the aggregation process or to promote the clearance of this protein. Unfortunately, disease-modifying treatments remain years away as demonstrated by the recent negative Phase III findings of a tau aggregation inhibitor (LMTM) for treating the behavioral variant of FTD. Further evidence will come from ongoing Phase I/II trials on novel drugs and immunotherapeutics with various targets - prevention of deposition or removal of tau aggregates, inhibition of tau phosphorylation/acetylation, modulation of O-GlcNAcylation, activation of autophagy or ubiquitin-proteasome system pathways, and rescue of selected tau loss of function or suppression of tau gene expression.
Collapse
Affiliation(s)
- Francesco Panza
- a Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.,b Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain , University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico" , Lecce , Italy.,c Geriatric Unit, Fondazione IRCCS , "Casa Sollievo della Sofferenza" , Foggia , Italy
| | - Bruno P Imbimbo
- d Department of Research and Development , Chiesi Farmaceutici , Parma , Italy
| | - Madia Lozupone
- a Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy
| | - Antonio Greco
- c Geriatric Unit, Fondazione IRCCS , "Casa Sollievo della Sofferenza" , Foggia , Italy
| | - Davide Seripa
- c Geriatric Unit, Fondazione IRCCS , "Casa Sollievo della Sofferenza" , Foggia , Italy
| | - Giancarlo Logroscino
- a Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.,b Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain , University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico" , Lecce , Italy
| | - Antonio Daniele
- e Institute of Neurology , Catholic University of Sacred Heart , Rome , Italy.,f Institute of Neurology , Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Carlo Colosimo
- g Department of Neurological Sciences , Santa Maria University Hospital , Terni , Italy
| |
Collapse
|
265
|
Logroscino G, Imbimbo BP, Lozupone M, Sardone R, Capozzo R, Battista P, Zecca C, Dibello V, Giannelli G, Bellomo A, Greco A, Daniele A, Seripa D, Panza F. Promising therapies for the treatment of frontotemporal dementia clinical phenotypes: from symptomatic to disease-modifying drugs. Expert Opin Pharmacother 2019; 20:1091-1107. [PMID: 31002267 DOI: 10.1080/14656566.2019.1598377] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Frontotemporal dementia (FTD) is a heterogeneous clinical entity that includes several disorders characterized by different cellular mechanisms. Distinctive clinical features in FTD include behavioral, affective, and cognitive symptoms. Unfortunately, little progress has been made over the past 20 years in terms of the development of effective disease-modifying drugs with the currently available symptomatic treatments having limited clinical utility. AREAS COVERED This article reviews the principal pharmacological intervention studies for FTD. These are predominantly randomized clinical trials and include symptomatic treatments and potential disease-modifying drugs. EXPERT OPINION There is insufficient evidence on effective treatments for FTD and studies with better methodological backgrounds are needed. Most studies reporting therapeutic benefits were conducted with selective serotonin reuptake inhibitors, while anti-dementia drugs have been ineffective in FTD. Since the underlying pathology of FTD mostly consists of abnormal tau protein or TDP-43 aggregates, treatments are being developed to interfere with their aggregation process or with the clearance of these proteins. Furthermore, disease-modifying treatments remain years away as demonstrated by the recent negative Phase III findings of a tau aggregation inhibitor (LMTM) for treating the behavioral variant of FTD. The results from current ongoing Phase I/II trials will hopefully give light to future treatment options.
Collapse
Affiliation(s)
- Giancarlo Logroscino
- a Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.,b Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain , University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico" , Lecce , Italy
| | - Bruno P Imbimbo
- c Department of Research and Development , Chiesi Farmaceutici , Parma , Italy
| | - Madia Lozupone
- a Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy
| | - Rodolfo Sardone
- d National Institute of Gastroenterology "Saverio de Bellis" , Research Hospital , Castellana Grotte Bari , Italy
| | - Rosa Capozzo
- b Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain , University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico" , Lecce , Italy
| | - Petronilla Battista
- e Istituti Clinici Scientifici Maugeri SPA SB, IRCCS , Institute of Cassano Murge , Bari , Italy
| | - Chiara Zecca
- b Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain , University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico" , Lecce , Italy
| | - Vittorio Dibello
- d National Institute of Gastroenterology "Saverio de Bellis" , Research Hospital , Castellana Grotte Bari , Italy.,f Interdisciplinary Department of Medicine (DIM), Section of Dentistry , University of Bari AldoMoro , Bari , Italy
| | - Gianluigi Giannelli
- d National Institute of Gastroenterology "Saverio de Bellis" , Research Hospital , Castellana Grotte Bari , Italy
| | - Antonello Bellomo
- g Psychiatric Unit, Department of Clinical and Experimental Medicine , University of Foggia , Foggia , Italy
| | - Antonio Greco
- h Geriatric Unit , Fondazione IRCCS "Casa Sollievo della Sofferenza" , Foggia , Italy
| | - Antonio Daniele
- i Institute of Neurology , Catholic University of Sacred Heart , Rome , Italy.,j Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Davide Seripa
- h Geriatric Unit , Fondazione IRCCS "Casa Sollievo della Sofferenza" , Foggia , Italy
| | - Francesco Panza
- a Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs , University of Bari "Aldo Moro" , Bari , Italy.,b Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain , University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico" , Lecce , Italy.,d National Institute of Gastroenterology "Saverio de Bellis" , Research Hospital , Castellana Grotte Bari , Italy.,h Geriatric Unit , Fondazione IRCCS "Casa Sollievo della Sofferenza" , Foggia , Italy
| |
Collapse
|
266
|
Logroscino G, Piccininni M, Binetti G, Zecca C, Turrone R, Capozzo R, Tortelli R, Battista P, Bagoj E, Barone R, Fostinelli S, Benussi L, Ghidoni R, Padovani A, Cappa SF, Alberici A, Borroni B. Incidence of frontotemporal lobar degeneration in Italy: The Salento-Brescia Registry study. Neurology 2019; 92:e2355-e2363. [PMID: 30979859 DOI: 10.1212/wnl.0000000000007498] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 01/19/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The goal of the present work, based on a collaborative research registry in Italy (the Salento-Brescia Registry), was to assess the incidence of frontotemporal lobar degeneration (FTLD) and to define the frequencies of different FTLD phenotypes in the general population. METHODS The study was conducted from January 1, 2017, to December 31, 2017, in 2 Italian provinces: Lecce (in Puglia) in the south (area 2,799.07 km2, inhabitants 802,082) and Brescia (in Lombardy) in the north (area 4,785.62 km2, inhabitants 1,262,678). During the study period, all new cases of FTLD (incident FTLD) were counted, and all patients' records were reviewed. The incidence was standardized to the Italian general population in 2017. RESULTS In the 2 provinces, 63 patients with FTLD were diagnosed. The incidence rate for FTLD was 3.05 (95% confidence interval [CI] 2.34-3.90) per 100,000 person-years (py), while the age-sex standardized incidence rate was 3.09 (95% CI 2.95-3.23) per 100,000 py. In the Italian population, the lifetime risk was 1:400. There was a progressive increase in FTLD incidence across age groups, reaching its peak in the 75- to 79-year-old group, with an incidence rate of 15.97 (95% CI 8.94-26.33) per 100,000 py. The behavioral variant of frontotemporal dementia was the most common phenotype (37%). No difference in crude incidence rate between the 2 provinces was observed. CONCLUSION FTLD is a more common form of dementia than previously recognized, with a risk spanning in a wide age range and with maximum incidence in the mid-70s. Improved knowledge of FTLD epidemiology will help to provide appropriate public health service policies.
Collapse
Affiliation(s)
- Giancarlo Logroscino
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy.
| | - Marco Piccininni
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Giuliano Binetti
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Chiara Zecca
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Rosanna Turrone
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Rosa Capozzo
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Rosanna Tortelli
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Petronilla Battista
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Eriola Bagoj
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Roberta Barone
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Silvia Fostinelli
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Luisa Benussi
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Roberta Ghidoni
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Alessandro Padovani
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Stefano F Cappa
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Antonella Alberici
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| | - Barbara Borroni
- From the Center for Neurodegenerative Diseases and the Aging Brain (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Department of Clinical Research in Neurology, and Department of Basic Medical Sciences, Neuroscience and Sense Organs (G.L., M.P., P.B.), University of Bari "Aldo Moro"; "Pia Fondazione Cardinale G. Panico" (G.L., M.P., C.Z., R.C., R. Tortelli, P.B., R.B.), Tricase, Lecce; IRCCS Centro San Giovanni di Dio Fatebenefratelli (G.B., S.F., L.B., R.G., S.F.C.); Department of Clinical and Experimental Sciences (R. Turrone, A.P., A.A., B.B.), Neurology Unit, University of Brescia; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) (P.B.), University of Firenze; and Department of Neurology (E.B.), Ospedali Riuniti, Foggia, Italy
| |
Collapse
|
267
|
Lansdall CJ, Coyle-Gilchrist ITS, Vázquez Rodríguez P, Wilcox A, Wehmann E, Robbins TW, Rowe JB. Prognostic importance of apathy in syndromes associated with frontotemporal lobar degeneration. Neurology 2019; 92:e1547-e1557. [PMID: 30842292 PMCID: PMC6448451 DOI: 10.1212/wnl.0000000000007249] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 11/21/2018] [Indexed: 12/12/2022] Open
Abstract
Objective To determine the influence of apathy, impulsivity, and behavioral change on survival in patients with frontotemporal dementia, progressive supranuclear palsy, and corticobasal syndrome. Methods We assessed 124 patients from the epidemiologic PiPPIN (Pick's Disease and Progressive Supranuclear Palsy, Prevalence and Incidence) study. Patients underwent detailed baseline cognitive and behavioral assessment focusing on apathy, impulsivity, and behavioral change. Logistic regression identified predictors of death within 2.5 years from assessment, including age, sex, diagnosis, cognition, and 8 neurobehavioral profiles derived from a principal component analysis of neuropsychological and behavioral measures. Results An apathetic neurobehavioral profile predicted death (Wald statistic = 8.119, p = 0.004, Exp(B) = 2.912, confidence interval = >1 [1.396–6.075]) and was elevated in all patient groups. This profile represented apathy, weighted strongly to carer reports from the Apathy Evaluation Scale, Neuropsychiatric Inventory, and Cambridge Behavioral Inventory. Age at assessment, sex, and global cognitive impairment were not significant predictors. Differences in mortality risk across diagnostic groups were accounted for by their neuropsychiatric and behavioral features. Conclusions The relationship between apathy and survival highlights the need to develop more effective and targeted measurement tools to improve its recognition and facilitate treatment. The prognostic importance of apathy suggests that neurobehavioral features might be useful to predict survival and stratify patients for interventional trials. Effective symptomatic interventions targeting the neurobiology of apathy might ultimately also improve prognosis.
Collapse
Affiliation(s)
- Claire J Lansdall
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK.
| | - Ian T S Coyle-Gilchrist
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Patricia Vázquez Rodríguez
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Alicia Wilcox
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Eileen Wehmann
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Trevor W Robbins
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - James B Rowe
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| |
Collapse
|
268
|
Brittain C, McCarthy A, Irizarry MC, McDermott D, Biglan K, Höglinger GU, Lorenzl S, Del Ser T, Boxer AL. Severity dependent distribution of impairments in PSP and CBS: Interactive visualizations. Parkinsonism Relat Disord 2019; 60:138-145. [PMID: 30201421 PMCID: PMC6399076 DOI: 10.1016/j.parkreldis.2018.08.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/29/2018] [Accepted: 08/31/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Progressive supranuclear palsy (PSP) -Richardson's Syndrome and Corticobasal Syndrome (CBS) are the two classic clinical syndromes associated with underlying four repeat (4R) tau pathology. The PSP Rating Scale is a commonly used assessment in PSP clinical trials; there is an increasing interest in designing combined 4R tauopathy clinical trials involving both CBS and PSP. OBJECTIVES To determine contributions of each domain of the PSP Rating Scale to overall severity and characterize the probable sequence of clinical progression of PSP as compared to CBS. METHODS Multicenter clinical trial and natural history study data were analyzed from 545 patients with PSP and 49 with CBS. Proportional odds models were applied to model normalized cross-sectional PSP Rating Scale, estimating the probability that a patient would experience impairment in each domain using the PSP Rating Scale total score as the index of overall disease severity. RESULTS The earliest symptom domain to demonstrate impairment in PSP patients was most likely to be Ocular Motor, followed jointly by Gait/Midline and Daily Activities, then Limb Motor and Mentation, and finally Bulbar. For CBS, Limb Motor manifested first and ocular showed less probability of impairment throughout the disease spectrum. An online tool to visualize predicted disease progression was developed to predict relative disability on each subscale per overall disease severity. CONCLUSION The PSP Rating Scale captures disease severity in both PSP and CBS. Modelling how domains change in relation to one other at varying disease severities may facilitate detection of therapeutic effects in future clinical trials.
Collapse
Affiliation(s)
- Claire Brittain
- Eli Lilly and Company, Lilly Research Center, Sunninghill Road, Windlesham, Surrey GU20 6PH, United Kingdom.
| | - Andrew McCarthy
- Eli Lilly and Company, Lilly Research Center, Sunninghill Road, Windlesham, Surrey GU20 6PH, United Kingdom
| | - Michael C Irizarry
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA
| | - Dana McDermott
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 193, San Francisco, CA, 94158, USA
| | - Kevin Biglan
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA
| | - Günter U Höglinger
- Department of Neurology, Technische Universität München, Arcisstraße 2, D-80333, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen Str. 17, D-81677, Munich, Germany
| | - Stefan Lorenzl
- Department of Neurology, Hospital Agatharied, Norbert-Kerkel-Platz, 83734, Hausham/Obb, Germany
| | - Teodoro Del Ser
- Neurological Department, Alzheimer Project Research Unit, Fundacion Centro Investigacion Enfermedades Neurologicas, Calle de Valderrebollo, 5, 28031, Madrid, Spain
| | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 193, San Francisco, CA, 94158, USA
| |
Collapse
|
269
|
Olfati N, Shoeibi A, Litvan I. Progress in the treatment of Parkinson-Plus syndromes. Parkinsonism Relat Disord 2019; 59:101-110. [DOI: 10.1016/j.parkreldis.2018.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 09/27/2018] [Accepted: 10/01/2018] [Indexed: 01/04/2023]
|
270
|
Agarwal S, Ahmed RM, D'Mello M, Foxe D, Kaizik C, Kiernan MC, Halliday GM, Piguet O, Hodges JR. Predictors of survival and progression in behavioural variant frontotemporal dementia. Eur J Neurol 2019; 26:774-779. [PMID: 30565360 DOI: 10.1111/ene.13887] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/06/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Predicting the course of behavioural variant frontotemporal dementia (bvFTD) remains a major clinical challenge. This study aimed to identify factors that predict survival and clinical progression in bvFTD. METHODS Consecutive patients with clinically probable bvFTD were prospectively followed up over an 8-year period. Baseline neuropsychological variables, presence of a known pathogenic frontotemporal dementia gene mutation and a systematic visual magnetic resonance imaging assessment at baseline were examined as candidate predictors using multivariate modelling. RESULTS After screening 121 cases, the study cohort consisted of 75 patients with probable bvFTD, with a mean age of 60.8 ± 8.5 years, followed up for a mean duration of 7.2 ± 3.5 years from symptom onset. Median survival time from disease onset was 10.8 years and median survival, prior to transition to nursing home, was 8.9 years. A total of 25 of the 75 patients died during the study follow-up period. Survival without dependence was predicted by shorter disease duration at presentation (hazard ratio, 0.49, P = 0.001), greater atrophy in the anterior cingulate cortex (hazard ratio, 1.75, P = 0.047), older age (hazard ratio, 1.07, P = 0.026) and a higher burden of behavioural symptoms (hazard ratio, 1.04, P = 0.015). In terms of disease progression, presence of a known pathogenic frontotemporal dementia mutation (β = 0.46, P < 0.001) was the strongest predictor of progression. Deficits in letter fluency (β = -0.43, P = 0.017) and greater atrophy in the motor cortex (β = 0.51, P = 0.03) were also associated with faster progression. CONCLUSIONS This study provides novel clinical predictors of survival and progression in bvFTD. Our findings are likely to have an impact on prognostication and care planning in this difficult disease.
Collapse
Affiliation(s)
- S Agarwal
- Neurology Unit, Addenbrooke's Hospital, Cambridge, UK.,Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales
| | - R M Ahmed
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales
| | - M D'Mello
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales
| | - D Foxe
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales.,Neuroscience Research Australia (NeuRA), University of New South Wales, Sydney, New South Wales, Australia
| | - C Kaizik
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,Neuroscience Research Australia (NeuRA), University of New South Wales, Sydney, New South Wales, Australia
| | - M C Kiernan
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales
| | - G M Halliday
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,Neuroscience Research Australia (NeuRA), University of New South Wales, Sydney, New South Wales, Australia
| | - O Piguet
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales.,Neuroscience Research Australia (NeuRA), University of New South Wales, Sydney, New South Wales, Australia
| | - J R Hodges
- Central Clinical School and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales
| |
Collapse
|
271
|
Burrell JR, Ballard KJ, Halliday GM, Hodges JR. Aphasia in Progressive Supranuclear Palsy: As Severe as Progressive Non-Fluent Aphasia. J Alzheimers Dis 2019; 61:705-715. [PMID: 29254097 DOI: 10.3233/jad-170743] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Adynamic speech is characteristic of progressive supranuclear palsy (PSP), but higher language deficits have been reported inconsistently, in the context of clinical and pathological overlaps with progressive non-fluent aphasia (PNFA). OBJECTIVE The present study tested two hypotheses: 1) PSP and PNFA display impaired single word repetition, object naming, semantic knowledge, and syntactic comprehension; and 2) PSP have reduced speed on timed cognitive tasks. METHODS Structured clinical and neuropsychological assessments of language were performed on patients with clinically defined PSP and PNFA. Language was tested using the Sydney Language Battery (SYDBAT) and the Test of Reception of Grammar (TROG). RESULTS In total, 144 participants were studied (PSP 22, PNFA 29, and Control 93). PSP patients had prominent eye movement abnormalities, parkinsonism, and falls. All 4 PSP patients who underwent postmortem examination had 4-Repeat tauopathy, with PSP pathology in 3. The frequency and severity of impairment on the SYDBAT (naming, word comprehension, semantic association), and TROG (syntactic comprehension) did not differ between PSP and PNFA, but PSP were significantly slower on timed non-language cognitive tests. CONCLUSION Tested formally, aphasia may be seen in PSP, with a severity similar to that seen in PNFA.
Collapse
Affiliation(s)
- James R Burrell
- Concord General Hospital, Sydney, Australia.,Brain and Mind Centre, University of Sydney Medical School, Sydney, Australia.,The University of Sydney, Sydney, Australia
| | - Kirrie J Ballard
- Neuroscience Research Australia, Sydney, Australia.,The University of Sydney, Sydney, Australia
| | - Glenda M Halliday
- Brain and Mind Centre, University of Sydney Medical School, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia.,Neuroscience Research Australia, Sydney, Australia.,The University of Sydney, Sydney, Australia
| | - John R Hodges
- Brain and Mind Centre, University of Sydney Medical School, Sydney, Australia.,The University of Sydney, Sydney, Australia
| |
Collapse
|
272
|
Lopez OL, Kuller LH. Epidemiology of aging and associated cognitive disorders: Prevalence and incidence of Alzheimer's disease and other dementias. HANDBOOK OF CLINICAL NEUROLOGY 2019; 167:139-148. [DOI: 10.1016/b978-0-12-804766-8.00009-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
|
273
|
Liou CJ, Tong M, Vonsattel JP, de la Monte SM. Altered Brain Expression of Insulin and Insulin-Like Growth Factors in Frontotemporal Lobar Degeneration: Another Degenerative Disease Linked to Dysregulation of Insulin Metabolic Pathways. ASN Neuro 2019; 11:1759091419839515. [PMID: 31081340 PMCID: PMC6535914 DOI: 10.1177/1759091419839515] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/21/2019] [Accepted: 02/06/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Frontotemporal lobar degeneration (FTLD) is the third most common dementing neurodegenerative disease with nearly 80% having no known etiology. OBJECTIVE Growing evidence that neurodegeneration can be linked to dysregulated metabolism prompted us to measure a panel of trophic factors, receptors, and molecules that modulate brain metabolic function in FTLD. METHODS Postmortem frontal (Brodmann's area [BA]8/9 and BA24) and temporal (BA38) lobe homogenates were used to measure immunoreactivity to Tau, phosphorylated tau (pTau), ubiquitin, 4-hydroxynonenal (HNE), transforming growth factor-beta 1 (TGF-β1) and its receptor (TGF-β1R), brain-derived neurotrophic factor (BDNF), nerve growth factor, neurotrophin-3, neurotrophin-4, tropomyosin receptor kinase, and insulin and insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-2 (IGF-2) and their receptors by direct-binding enzyme-linked immunosorbent assay. RESULTS FTLD brains had significantly elevated pTau, ubiquitin, TGF-β1, and HNE immunoreactivity relative to control. In addition, BDNF and neurotrophin-4 were respectively reduced in BA8/9 and BA38, while neurotrophin-3 and nerve growth factor were upregulated in BA38, and tropomyosin receptor kinase was elevated in BA24. Lastly, insulin and insulin receptor expressions were elevated in the frontal lobe, IGF-1 was increased in BA24, IGF-1R was upregulated in all three brain regions, and IGF-2 receptor was reduced in BA24 and BA38. CONCLUSIONS Aberrantly increased levels of pTau, ubiquitin, HNE, and TGF-β1, marking neurodegeneration, oxidative stress, and neuroinflammation, overlap with altered expression of insulin/IGF signaling ligand and receptors in frontal and temporal lobe regions targeted by FTLD. Dysregulation of insulin-IGF signaling networks could account for brain hypometabolism and several characteristic neuropathologic features that characterize FTLD but overlap with Alzheimer's disease, Parkinson's disease, and Dementia with Lewy Body Disease.
Collapse
Affiliation(s)
- Connie J. Liou
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ming Tong
- Warren Alpert Medical School of Brown University, Providence, RI, USA
- Division of Neuropathology, Departments of Pathology, Medicine, Neurology, and Neurosurgery, Rhode Island Hospital, Providence, RI, USA
- Department of Pathology and Laboratory Medicine, the Providence VA Medical Center, Providence, RI, USA
| | - Jean P. Vonsattel
- New York Brain Bank, Taub Institute, Columbia University, New York, NY, USA
| | - Suzanne M. de la Monte
- Warren Alpert Medical School of Brown University, Providence, RI, USA
- Division of Neuropathology, Departments of Pathology, Medicine, Neurology, and Neurosurgery, Rhode Island Hospital, Providence, RI, USA
- Department of Pathology and Laboratory Medicine, the Providence VA Medical Center, Providence, RI, USA
| |
Collapse
|
274
|
Butler PM, Chiong W. Neurodegenerative disorders of the human frontal lobes. HANDBOOK OF CLINICAL NEUROLOGY 2019; 163:391-410. [PMID: 31590743 DOI: 10.1016/b978-0-12-804281-6.00021-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The frontal lobes play an integral role in human socioemotional and cognitive function. Sense of self, moral decisions, empathy, and behavioral monitoring of goal-states all depend on key nodes within frontal cortex. While several neurodegenerative diseases can affect frontal function, frontotemporal dementia (FTD) has particularly serious and specific effects, which thus provide insights into the role of frontal circuits in homeostasis and adaptive behavior. FTD represents a collection of disorders with specific clinical-pathologic correlates, imaging, and genetics. Patients with FTD and initial prefrontal degeneration often present with neuropsychiatric symptoms such as loss of social decorum, new obsessions, or lack of empathy. In those patients with early anterior temporal degeneration, language (particularly in patients with left-predominant disease) and socioemotional changes (particularly in patients with right-predominant disease) precede eventual frontal dysregulation. Herein, we review a brief history of FTD, initial clinical descriptions, and the evolution of nomenclature. Next, we consider clinical features, neuropathology, imaging, and genetics in FTD-spectrum disorders in relation to the integrity of frontal circuits. In particular, we focus our discussion on behavioral variant FTD given its profound impact on cortical and subcortical frontal structures. This review highlights the clinical heterogeneity of behavioral phenotypes as well as the clinical-anatomic convergence of varying proteinopathies at the neuronal, regional, and network level. Recent neuroimaging and modeling approaches in FTD reveal varying network dysfunction centered on frontal-insular cortices, which underscores the role of the human frontal lobes in complex behaviors. We conclude the chapter reviewing the cognitive and behavioral neuroscience findings furnished from studies in FTD related to executive and socioemotional function, reward-processing, decision-making, and sense of self.
Collapse
Affiliation(s)
- P Monroe Butler
- Department of Neurology, UCSF Memory and Aging Center, UCSF School of Medicine, San Francisco, CA, United States
| | - Winston Chiong
- Department of Neurology, UCSF Memory and Aging Center, UCSF School of Medicine, San Francisco, CA, United States.
| |
Collapse
|
275
|
Fabbrini G, Fabbrini A, Suppa A. Progressive supranuclear palsy, multiple system atrophy and corticobasal degeneration. ACTA ACUST UNITED AC 2019; 165:155-177. [DOI: 10.1016/b978-0-444-64012-3.00009-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
276
|
Yiannopoulou KG, Papatriantafyllou JD, Ghika A, Tsinia N, Lykou E, Hatziantoniou E, Agiomyrgiannakis D, Kyrozis A, Papageorgiou SG. Defining Neuropsychiatric Inventory scale differences across frontotemporal dementia syndromes. Psychogeriatrics 2019; 19:32-37. [PMID: 30073726 DOI: 10.1111/psyg.12358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 03/20/2018] [Accepted: 06/29/2018] [Indexed: 12/29/2022]
Abstract
AIM The aim of this study was to assess the ability of Neuropsychiatric Inventory (NPI) scale profiles to differentiate between distinct frontotemporal dementia (FTD) subtypes. METHODS The NPI was used to assess 311 older patients who had been clinically diagnosed with FTD. FTD subtypes included behavioural variant FTD (bvFTD, n = 121), primary progressive aphasia (semantic variant (n = 69), non-fluent agrammatic variant (n = 31), and logopenic variant (n = 0)), FTD-motor neuron disease (n = 4), progressive supranuclear palsy (n = 43), and corticobasal syndrome (n = 43). Total NPI score and scores for each NPI item were correlated across the distinct FTD subtypes. RESULTS Patients with bvFTD showed significantly greater impairment on their total NPI score than patients with corticobasal syndrome (P < 0.001), non-fluent agrammatic variant primary progressive aphasia (P < 0.001), progressive supranuclear palsy (P = 0.002), and semantic variant primary progressive aphasia (P = 0.010). Aggressiveness, euphoria, apathy, disinhibition, irritability, aberrant motor behaviours, and appetite disturbance were significantly higher in bvFTD than in the other subgroups. The lowest NPI scores were generally shown among those with CBS. However, NPI total and specific item values overlapped among the subtypes. CONCLUSIONS Patients with bvFTD showed significantly greater neuropsychiatric dysfunction than those with the other FTD subtypes, as measured by the NPI scale. In contrast, patients with corticobasal syndrome had a comparatively healthier profile. Therefore, differential diagnosis among the FTD subtypes may be guided by the NPI, although the subtype is unlikely to be confirmed on the basis of NPI alone.
Collapse
Affiliation(s)
| | - John D Papatriantafyllou
- Neurological Department, Cognitive Disorders Clinic, General Hospital of Athens "G. Gennimatas", Athens, Greece
| | - Apostolia Ghika
- Cognitive and Movement Disorders Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Niki Tsinia
- Neurological Department, Cognitive Disorders Clinic, General Hospital of Athens "G. Gennimatas", Athens, Greece
| | - Eudoxia Lykou
- Neurological Department, Cognitive Disorders Clinic, General Hospital of Athens "G. Gennimatas", Athens, Greece
| | - Evaggelia Hatziantoniou
- Neurological Department, Cognitive Disorders Clinic, General Hospital of Athens "G. Gennimatas", Athens, Greece
| | - Dimitrios Agiomyrgiannakis
- Neurological Department, Cognitive Disorders Clinic, General Hospital of Athens "G. Gennimatas", Athens, Greece
| | - Andreas Kyrozis
- Cognitive and Movement Disorders Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sokratis G Papageorgiou
- Cognitive and Movement Disorders Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
277
|
Ge W, Jakobsson E. Systems Biology Understanding of the Effects of Lithium on Affective and Neurodegenerative Disorders. Front Neurosci 2018; 12:933. [PMID: 30618562 PMCID: PMC6300566 DOI: 10.3389/fnins.2018.00933] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/27/2018] [Indexed: 01/08/2023] Open
Abstract
Lithium has many widely varying biochemical and phenomenological effects, suggesting that a systems biology approach is required to understand its action. Multiple lines of evidence point to lithium intake and consequent blood levels as important determinants of incidence of neurodegenerative disease, showing that understanding lithium action is of high importance. In this paper we undertake first steps toward a systems approach by analyzing mutual enrichment between the interactomes of lithium-sensitive enzymes and the pathways associated with affective and neurodegenerative disorders. This work integrates information from two important databases, STRING and KEGG pathways. We find that for the majority of neurodegenerative disorders the mutual enrichment is many times greater than chance, reinforcing previous lines of evidence that lithium is an important influence on incidence of neurodegeneration. Our work suggests rational prioritization for which disorders are likely to be most sensitive to lithium and identifies genes that are likely to be useful targets for therapy adjunct to lithium.
Collapse
Affiliation(s)
- Weihao Ge
- National Center for Supercomputing Applications, Urbana-Champaign, Urbana, IL, United States
- Center for Biophysics and Computational Biology, Urbana-Champaign, Urbana, IL, United States
| | - Eric Jakobsson
- National Center for Supercomputing Applications, Urbana-Champaign, Urbana, IL, United States
- Center for Biophysics and Computational Biology, Urbana-Champaign, Urbana, IL, United States
- Department of Molecular and Integrative Physiology University of Illinois at Urbana-Champaign, Urbana, IL, United States
| |
Collapse
|
278
|
Allen M, Wang X, Serie DJ, Strickland SL, Burgess JD, Koga S, Younkin CS, Nguyen TT, Malphrus KG, Lincoln SJ, Alamprese M, Zhu K, Chang R, Carrasquillo MM, Kouri N, Murray ME, Reddy JS, Funk C, Price ND, Golde TE, Younkin SG, Asmann YW, Crook JE, Dickson DW, Ertekin-Taner N. Divergent brain gene expression patterns associate with distinct cell-specific tau neuropathology traits in progressive supranuclear palsy. Acta Neuropathol 2018; 136:709-727. [PMID: 30136084 PMCID: PMC6208732 DOI: 10.1007/s00401-018-1900-5] [Citation(s) in RCA: 23] [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: 12/14/2017] [Revised: 07/26/2018] [Accepted: 08/15/2018] [Indexed: 12/25/2022]
Abstract
Progressive supranuclear palsy (PSP) is a neurodegenerative parkinsonian disorder characterized by tau pathology in neurons and glial cells. Transcriptional regulation has been implicated as a potential mechanism in conferring disease risk and neuropathology for some PSP genetic risk variants. However, the role of transcriptional changes as potential drivers of distinct cell-specific tau lesions has not been explored. In this study, we integrated brain gene expression measurements, quantitative neuropathology traits and genome-wide genotypes from 268 autopsy-confirmed PSP patients to identify transcriptional associations with unique cell-specific tau pathologies. We provide individual transcript and transcriptional network associations for quantitative oligodendroglial (coiled bodies = CB), neuronal (neurofibrillary tangles = NFT), astrocytic (tufted astrocytes = TA) tau pathology, and tau threads and genomic annotations of these findings. We identified divergent patterns of transcriptional associations for the distinct tau lesions, with the neuronal and astrocytic neuropathologies being the most different. We determined that NFT are positively associated with a brain co-expression network enriched for synaptic and PSP candidate risk genes, whereas TA are positively associated with a microglial gene-enriched immune network. In contrast, TA is negatively associated with synaptic and NFT with immune system transcripts. Our findings have implications for the diverse molecular mechanisms that underlie cell-specific vulnerability and disease risk in PSP.
Collapse
Affiliation(s)
- Mariet Allen
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Xue Wang
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Daniel J Serie
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, 32224, USA
| | | | - Jeremy D Burgess
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Shunsuke Koga
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Curtis S Younkin
- Division of Information Technology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Thuy T Nguyen
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | | | - Sarah J Lincoln
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | | | - Kuixi Zhu
- The Center for Innovation in Brain Sciences, University of Arizona, Tucson, AZ, 85721, USA
| | - Rui Chang
- The Center for Innovation in Brain Sciences, University of Arizona, Tucson, AZ, 85721, USA
- Department of Neurology, University of Arizona, Tucson, AZ, 85721, USA
| | | | - Naomi Kouri
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Melissa E Murray
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Joseph S Reddy
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Cory Funk
- Institute for Systems Biology, 401 Terry Avenue N, Seattle, WA, 98109, USA
| | - Nathan D Price
- Institute for Systems Biology, 401 Terry Avenue N, Seattle, WA, 98109, USA
| | - Todd E Golde
- Department of Neuroscience, Center for Translational Research in Neurodegenerative Disease, McKnight Brain Institute, University of Florida, Gainesville, FL, 32610, USA
| | - Steven G Younkin
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Yan W Asmann
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Julia E Crook
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Nilüfer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA.
- Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Birdsall 3, Jacksonville, FL, 32224, USA.
| |
Collapse
|
279
|
Foxe D, Elan E, Burrell JR, Leslie FVC, Devenney E, Kwok JB, Halliday GM, Hodges JR, Piguet O. Intrafamilial Phenotypic Variability in the C9orf72 Gene Expansion: 2 Case Studies. Front Psychol 2018; 9:1615. [PMID: 30233460 PMCID: PMC6129762 DOI: 10.3389/fpsyg.2018.01615] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/13/2018] [Indexed: 12/12/2022] Open
Abstract
The C9orf72 genetic mutation is the most common cause of familial frontotemporal dementia (FTD) and motor neuron disease (MND). Previous family studies suggest that while some common clinical features may distinguish gene carriers from sporadic patients, the clinical features, age of onset and disease progression vary considerably in affected patients. Whilst disease presentations may vary across families, age at disease onset appears to be relatively uniform within each family. Here, we report two individuals with a C9orf72 repeat expansion from two generations of the same family with markedly different age at disease onset, clinical presentation and disease progression: one who developed motor neuron and behavioural symptoms in their mid 40s and died 3 years later with confirmed TDP-43 pathology and MND; and a second who developed cognitive and mild behavioural symptoms in their mid 70s and 8 years later remains alive with only slow deterioration. This report highlights the phenotypic variability, including age of onset, within a family with the C9orf72 repeat expansion.
Collapse
Affiliation(s)
- David Foxe
- School of Psychology, The University of Sydney, Sydney, NSW, Australia.,Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Elle Elan
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - James R Burrell
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,Concord Repatriation General Hospital, Sydney, NSW, Australia
| | | | - Emma Devenney
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - John B Kwok
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Glenda M Halliday
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - John R Hodges
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Olivier Piguet
- School of Psychology, The University of Sydney, Sydney, NSW, Australia.,Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| |
Collapse
|
280
|
Montembeault M, Brambati SM, Gorno-Tempini ML, Migliaccio R. Clinical, Anatomical, and Pathological Features in the Three Variants of Primary Progressive Aphasia: A Review. Front Neurol 2018; 9:692. [PMID: 30186225 PMCID: PMC6110931 DOI: 10.3389/fneur.2018.00692] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/31/2018] [Indexed: 11/22/2022] Open
Abstract
Primary progressive aphasias (PPA) are neurodegenerative diseases clinically characterized by an early and relatively isolated language impairment. Three main clinical variants, namely the nonfluent/agrammatic variant (nfvPPA), the semantic variant (svPPA), and the logopenic variant (lvPPA) have been described, each with specific linguistic/cognitive deficits, corresponding anatomical and most probable pathological features. Since the discovery and the development of diagnostic criteria for the PPA variants by the experts in the field, significant progress has been made in the understanding of these diseases. This review aims to provide an overview of the literature on each of the PPA variant in terms of their clinical, anatomical and pathological features, with a specific focus on recent findings. In terms of clinical advancements, recent studies have allowed a better characterization and differentiation of PPA patients based on both their linguistic and non-linguistic profiles. In terms of neuroimaging, techniques such as diffusion imaging and resting-state fMRI have allowed a deeper understanding of the impact of PPA on structural and functional connectivity alterations beyond the well-defined pattern of regional gray matter atrophy. Finally, in terms of pathology, despite significant advances, clinico-pathological correspondence in PPA remains far from absolute. Nonetheless, the improved characterization of PPA has the potential to have a positive impact on the management of patients. Improved reliability of diagnoses and the development of reliable in vivo biomarkers for underlying neuropathology will also be increasingly important in the future as trials for etiology-specific treatments become available.
Collapse
Affiliation(s)
- Maxime Montembeault
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle Épinière (ICM), FrontLab, Paris, France.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.,Département de Psychologie, Université de Montréal, Montréal, QC, Canada
| | - Simona M Brambati
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.,Département de Psychologie, Université de Montréal, Montréal, QC, Canada
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, University of California at San Francisco, San Francisco, CA, United States
| | - Raffaella Migliaccio
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle Épinière (ICM), FrontLab, Paris, France.,Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Paris, France
| |
Collapse
|
281
|
Chen Y, Kumfor F, Landin‐Romero R, Irish M, Hodges JR, Piguet O. Cerebellar atrophy and its contribution to cognition in frontotemporal dementias. Ann Neurol 2018; 84:98-109. [DOI: 10.1002/ana.25271] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/07/2018] [Accepted: 06/07/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Yu Chen
- School of Psychology University of Sydney
- Brain and Mind Centre University of Sydney
- Australian Research Council Centre of Excellence in Cognition and Its Disorders
| | - Fiona Kumfor
- School of Psychology University of Sydney
- Brain and Mind Centre University of Sydney
- Australian Research Council Centre of Excellence in Cognition and Its Disorders
| | - Ramon Landin‐Romero
- School of Psychology University of Sydney
- Brain and Mind Centre University of Sydney
- Australian Research Council Centre of Excellence in Cognition and Its Disorders
| | - Muireann Irish
- School of Psychology University of Sydney
- Brain and Mind Centre University of Sydney
- Australian Research Council Centre of Excellence in Cognition and Its Disorders
| | - John R. Hodges
- Brain and Mind Centre University of Sydney
- Australian Research Council Centre of Excellence in Cognition and Its Disorders
- Sydney Medical School, University of Sydney Sydney New South Wales Australia
| | - Olivier Piguet
- School of Psychology University of Sydney
- Brain and Mind Centre University of Sydney
- Australian Research Council Centre of Excellence in Cognition and Its Disorders
| |
Collapse
|
282
|
Hughes LE, Rittman T, Robbins TW, Rowe JB. Reorganization of cortical oscillatory dynamics underlying disinhibition in frontotemporal dementia. Brain 2018; 141:2486-2499. [PMID: 29992242 PMCID: PMC6061789 DOI: 10.1093/brain/awy176] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/21/2018] [Accepted: 05/13/2018] [Indexed: 12/16/2022] Open
Abstract
The distribution of pathology in frontotemporal dementia is anatomically selective, to distinct cortical regions and with differential neurodegeneration across the cortical layers. The cytoarchitecture and connectivity of cortical laminae preferentially supports frequency-specific oscillations and hierarchical information transfer between brain regions. We therefore predicted that in frontotemporal dementia, core functional deficits such as disinhibition would be associated with differences in the frequency spectrum and altered cross-frequency coupling between frontal cortical regions. We examined this hypothesis using a 'Go-NoGo' response inhibition paradigm with 18 patients with behavioural variant frontotemporal dementia and 20 healthy aged-matched controls during magnetoencephalography. During Go and NoGo trials, beta desynchronization was severely attenuated in patients. Beta power was associated with increased impulsivity, as measured by the Cambridge Behavioural Inventory, a carer-based questionnaire of changes in everyday behaviour. To quantify the changes in cross-frequency coupling in the frontal lobe, we used dynamic causal modelling to test a family of hierarchical casual models, which included the inferior frontal gyrus, pre-supplementary motor area (preSMA) and primary motor cortex. This analysis revealed evidence for cross-frequency coupling in a fully connected network in both groups. However, in the patient group, we identified a significant loss of reciprocal connectivity of the inferior frontal gyrus, particularly for interactions in the gamma band and for theta to alpha coupling. Importantly, although prefrontal coupling was diminished, gamma connectivity between preSMA and motor cortex was enhanced in patients. We propose that the disruption of behavioural control arises from reduced frequency-specific connectivity of the prefrontal cortex, together with a hyper-synchronous reorganization of connectivity among preSMA and motor regions. These results are supported by preclinical evidence of the selectivity of frontotemporal lobar degeneration on oscillatory dynamics, and provide a clinically relevant yet precise neurophysiological signature of behavioural control as a potential pharmacological target for early phase experimental medicines studies.
Collapse
Affiliation(s)
- Laura E Hughes
- Department of Clinical Neurosciences, University of Cambridge, UK
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Timothy Rittman
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, UK
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, Cambridge, UK
| |
Collapse
|
283
|
The neuroanatomical and neurochemical basis of apathy and impulsivity in frontotemporal lobar degeneration. Curr Opin Behav Sci 2018; 22:14-20. [PMID: 31032387 DOI: 10.1016/j.cobeha.2017.12.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Apathy and impulsivity are common and often coexistent consequences of frontotemporal lobar degeneration (FTLD). They increase patient morbidity and carer distress, but remain under-estimated and poorly treated. Recent trans-diagnostic approaches that span the spectrum of clinical presentations of FTLD and parkinsonism, indicate that apathy and impulsivity can be fractionated into multiple neuroanatomical and pharmacological systems. These include ventral/dorsal fronto-striatal circuits for reward-sensitivity, response-inhibition, and decision-making; moderated by noradrenaline, dopamine, and serotonin. Improved assessment tools, formal models of cognition and behavior, combined with brain imaging and psycho-pharmacology, are creating new therapeutic targets and establishing principles for stratification in future clinical trials.
Collapse
|
284
|
Sami S, Williams N, Hughes LE, Cope TE, Rittman T, Coyle-Gilchrist ITS, Henson RN, Rowe JB. Neurophysiological signatures of Alzheimer's disease and frontotemporal lobar degeneration: pathology versus phenotype. Brain 2018; 141:2500-2510. [PMID: 30060017 PMCID: PMC6061803 DOI: 10.1093/brain/awy180] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 04/27/2018] [Accepted: 05/17/2018] [Indexed: 01/21/2023] Open
Abstract
The disruption of brain networks is characteristic of neurodegenerative dementias. However, it is controversial whether changes in connectivity reflect only the functional anatomy of disease, with selective vulnerability of brain networks, or the specific neurophysiological consequences of different neuropathologies within brain networks. We proposed that the oscillatory dynamics of cortical circuits reflect the tuning of local neural interactions, such that different pathologies are selective in their impact on the frequency spectrum of oscillations, whereas clinical syndromes reflect the anatomical distribution of pathology and physiological change. To test this hypothesis, we used magnetoencephalography from five patient groups, representing dissociated pathological subtypes and distributions across frontal, parietal and temporal lobes: amnestic Alzheimer's disease, posterior cortical atrophy, and three syndromes associated with frontotemporal lobar degeneration. We measured effective connectivity with graph theory-based measures of local efficiency, using partial directed coherence between sensors. As expected, each disease caused large-scale changes of neurophysiological brain networks, with reductions in local efficiency compared to controls. Critically however, the frequency range of altered connectivity was consistent across clinical syndromes that shared a likely underlying pathology, whilst the localization of changes differed between clinical syndromes. Multivariate pattern analysis of the frequency-specific topographies of local efficiency separated the disorders from each other and from controls (accuracy 62% to 100%, according to the groups' differences in likely pathology and clinical syndrome). The data indicate that magnetoencephalography has the potential to reveal specific changes in neurophysiology resulting from neurodegenerative disease. Our findings confirm that while clinical syndromes have characteristic anatomical patterns of abnormal connectivity that may be identified with other methods like structural brain imaging, the different mechanisms of neurodegeneration also cause characteristic spectral signatures of physiological coupling that are not accessible with structural imaging nor confounded by the neurovascular signalling of functional MRI. We suggest that these spectral characteristics of altered connectivity are the result of differential disruption of neuronal microstructure and synaptic physiology by Alzheimer's disease versus frontotemporal lobar degeneration.
Collapse
Affiliation(s)
- Saber Sami
- Department of Clinical Neurosciences, University of Cambridge, UK
| | | | - Laura E Hughes
- Department of Clinical Neurosciences, University of Cambridge, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| | - Thomas E Cope
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Timothy Rittman
- Department of Clinical Neurosciences, University of Cambridge, UK
| | | | - Richard N Henson
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| |
Collapse
|
285
|
|
286
|
Weber A, Schwarz SC, Tost J, Trümbach D, Winter P, Busato F, Tacik P, Windhorst AC, Fagny M, Arzberger T, McLean C, van Swieten JC, Schwarz J, Vogt Weisenhorn D, Wurst W, Adhikary T, Dickson DW, Höglinger GU, Müller U. Epigenome-wide DNA methylation profiling in Progressive Supranuclear Palsy reveals major changes at DLX1. Nat Commun 2018; 9:2929. [PMID: 30050033 PMCID: PMC6062504 DOI: 10.1038/s41467-018-05325-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 06/25/2018] [Indexed: 02/06/2023] Open
Abstract
Genetic, epigenetic, and environmental factors contribute to the multifactorial disorder progressive supranuclear palsy (PSP). Here, we study epigenetic changes by genome-wide analysis of DNA from postmortem tissue of forebrains of patients and controls and detect significant (P < 0.05) methylation differences at 717 CpG sites in PSP vs. controls. Four-hundred fifty-one of these sites are associated with protein-coding genes. While differential methylation only affects a few sites in most genes, DLX1 is hypermethylated at multiple sites. Expression of an antisense transcript of DLX1, DLX1AS, is reduced in PSP brains. The amount of DLX1 protein is increased in gray matter of PSP forebrains. Pathway analysis suggests that DLX1 influences MAPT-encoded Tau protein. In a cell system, overexpression of DLX1 results in downregulation of MAPT while overexpression of DLX1AS causes upregulation of MAPT. Our observations suggest that altered DLX1 methylation and expression contribute to pathogenesis of PSP by influencing MAPT.
Collapse
Affiliation(s)
- Axel Weber
- Institute of Human Genetics, Justus-Liebig-Universität, Gießen, 35392, Germany.
| | - Sigrid C Schwarz
- Department of Neurology, Technische Universität München, Munich, 81377, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, 81377, Germany
| | - Jörg Tost
- Laboratory for Epigenetics and Environment, Centre National de Recherche en Génomique Humaine, CEA-Institut de Biologie Francois Jacob, Evry, 91000, France
| | - Dietrich Trümbach
- Institute of Developmental Genetics, Helmholtz Center München, Munich, 85764, Germany
| | - Pia Winter
- Institute of Human Genetics, Justus-Liebig-Universität, Gießen, 35392, Germany
| | - Florence Busato
- Laboratory for Epigenetics and Environment, Centre National de Recherche en Génomique Humaine, CEA-Institut de Biologie Francois Jacob, Evry, 91000, France
| | - Pawel Tacik
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn Medical Center, Bonn, 53127, Germany
| | - Anita C Windhorst
- Institute of Medical Informatics, Justus-Liebig-Universität, Gießen, 35392, Germany
| | - Maud Fagny
- Laboratory for Epigenetics and Environment, Centre National de Recherche en Génomique Humaine, CEA-Institut de Biologie Francois Jacob, Evry, 91000, France
| | - Thomas Arzberger
- German Center for Neurodegenerative Diseases (DZNE), Munich, 81377, Germany
- Department of Psychiatry, Ludwig-Maximilians-Universität, Munich, 81377, Germany
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-Universität, Munich, 81377, Germany
| | - Catriona McLean
- Alfred Anatomical Pathology and NNF, Victorian Brain Bank, Carlton, VIC, 3053, Australia
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Centre, Rotterdam, 3000, The Netherlands
| | - Johannes Schwarz
- Department of Neurology, Technische Universität München, Munich, 81377, Germany
| | - Daniela Vogt Weisenhorn
- German Center for Neurodegenerative Diseases (DZNE), Munich, 81377, Germany
- Institute of Developmental Genetics, Helmholtz Center München, Munich, 85764, Germany
- Chair of Developmental Genetics, Technische Universität München-Weihenstephan, Neuherberg/Munich, 85764, Germany
| | - Wolfgang Wurst
- German Center for Neurodegenerative Diseases (DZNE), Munich, 81377, Germany
- Institute of Developmental Genetics, Helmholtz Center München, Munich, 85764, Germany
- Chair of Developmental Genetics, Technische Universität München-Weihenstephan, Neuherberg/Munich, 85764, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, 81377, Germany
| | - Till Adhikary
- Institute for Molecular Biology and Tumor Research, Center for Tumor Biology and Immunology, Philipps University, Marburg, 35043, Germany
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Günter U Höglinger
- Department of Neurology, Technische Universität München, Munich, 81377, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, 81377, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, 81377, Germany.
| | - Ulrich Müller
- Institute of Human Genetics, Justus-Liebig-Universität, Gießen, 35392, Germany.
| |
Collapse
|
287
|
Ali F, Josephs K. The diagnosis of progressive supranuclear palsy: current opinions and challenges. Expert Rev Neurother 2018; 18:603-616. [DOI: 10.1080/14737175.2018.1489241] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Farwa Ali
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Keith Josephs
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
288
|
Marshall CR, Hardy CJD, Volkmer A, Russell LL, Bond RL, Fletcher PD, Clark CN, Mummery CJ, Schott JM, Rossor MN, Fox NC, Crutch SJ, Rohrer JD, Warren JD. Primary progressive aphasia: a clinical approach. J Neurol 2018; 265:1474-1490. [PMID: 29392464 PMCID: PMC5990560 DOI: 10.1007/s00415-018-8762-6] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 01/18/2018] [Accepted: 01/19/2018] [Indexed: 12/12/2022]
Abstract
The primary progressive aphasias are a heterogeneous group of focal 'language-led' dementias that pose substantial challenges for diagnosis and management. Here we present a clinical approach to the progressive aphasias, based on our experience of these disorders and directed at non-specialists. We first outline a framework for assessing language, tailored to the common presentations of progressive aphasia. We then consider the defining features of the canonical progressive nonfluent, semantic and logopenic aphasic syndromes, including 'clinical pearls' that we have found diagnostically useful and neuroanatomical and other key associations of each syndrome. We review potential diagnostic pitfalls and problematic presentations not well captured by conventional classifications and propose a diagnostic 'roadmap'. After outlining principles of management, we conclude with a prospect for future progress in these diseases, emphasising generic information processing deficits and novel pathophysiological biomarkers.
Collapse
Affiliation(s)
- Charles R Marshall
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
| | - Chris J D Hardy
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Anna Volkmer
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Lucy L Russell
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Rebecca L Bond
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Phillip D Fletcher
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Camilla N Clark
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Catherine J Mummery
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Jonathan M Schott
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Martin N Rossor
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Nick C Fox
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Sebastian J Crutch
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Jonathan D Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Jason D Warren
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
| |
Collapse
|
289
|
Ryan M, Heverin M, Doherty MA, Davis N, Corr EM, Vajda A, Pender N, McLaughlin R, Hardiman O. Determining the incidence of familiality in ALS: A study of temporal trends in Ireland from 1994 to 2016. NEUROLOGY-GENETICS 2018; 4:e239. [PMID: 29845113 PMCID: PMC5961194 DOI: 10.1212/nxg.0000000000000239] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/06/2018] [Indexed: 11/15/2022]
Abstract
Objective To assess temporal trends in familial amyotrophic lateral sclerosis (FALS) incidence rates in an Irish population and to determine factors influencing FALS ascertainment. Methods Population-based data collected over 23 years, using the Irish amyotrophic lateral sclerosis (ALS) register and DNA biobank, were analyzed and age-standardized rates of FALS and associated familial neuropsychiatric endophenotypes were identified. Results Between 1994 and 2016, 269 patients with a family history of ALS from 197 unique families were included on the register. Using stringent diagnostic criteria for FALS, the mean age-standardized FALS incidence rate for the study period was 11.1% (95% confidence interval [CI], 8.8-13.4). The FALS incidence rate increased steadily from 5.2% in 1994 to 19.1% in 2016, an annual increase of 0.7% (95% CI, 0.5-0.9, p < 0.0001). Inclusion of the presence of neuropsychiatric endophenotypes within kindreds increased the FALS incidence rate to 30%. The incidence of FALS in newly diagnosed individuals from known families increased significantly with time, accounting for 50% of all FALS diagnoses by 2016. The mean annual rate of recategorization from "sporadic ALS" to "FALS" was 3% (95% CI, 2.6-3.8). Conclusions The true population-based rate of FALS is at least 20%. Inclusion of extended endophenotypes within kindreds increases the rate of FALS to 30%. Cross-sectional analysis of clinic-based cohorts and stringent definitions of FALS underestimate the true rate of familial disease. This has implications for genetic counseling and in the recognition of presymptomatic stages of ALS.
Collapse
Affiliation(s)
- Marie Ryan
- Academic Unit of Neurology (M.R., M.H., N.D., E.M.C., A.V., O.H.), Trinity College; Department of Genetics (M.A.D., R.M.), Trinity College; and Department of Psychology (N.P.), Beaumont Hospital, Dublin, Ireland
| | - Mark Heverin
- Academic Unit of Neurology (M.R., M.H., N.D., E.M.C., A.V., O.H.), Trinity College; Department of Genetics (M.A.D., R.M.), Trinity College; and Department of Psychology (N.P.), Beaumont Hospital, Dublin, Ireland
| | - Mark A Doherty
- Academic Unit of Neurology (M.R., M.H., N.D., E.M.C., A.V., O.H.), Trinity College; Department of Genetics (M.A.D., R.M.), Trinity College; and Department of Psychology (N.P.), Beaumont Hospital, Dublin, Ireland
| | - Nicola Davis
- Academic Unit of Neurology (M.R., M.H., N.D., E.M.C., A.V., O.H.), Trinity College; Department of Genetics (M.A.D., R.M.), Trinity College; and Department of Psychology (N.P.), Beaumont Hospital, Dublin, Ireland
| | - Emma M Corr
- Academic Unit of Neurology (M.R., M.H., N.D., E.M.C., A.V., O.H.), Trinity College; Department of Genetics (M.A.D., R.M.), Trinity College; and Department of Psychology (N.P.), Beaumont Hospital, Dublin, Ireland
| | - Alice Vajda
- Academic Unit of Neurology (M.R., M.H., N.D., E.M.C., A.V., O.H.), Trinity College; Department of Genetics (M.A.D., R.M.), Trinity College; and Department of Psychology (N.P.), Beaumont Hospital, Dublin, Ireland
| | - Niall Pender
- Academic Unit of Neurology (M.R., M.H., N.D., E.M.C., A.V., O.H.), Trinity College; Department of Genetics (M.A.D., R.M.), Trinity College; and Department of Psychology (N.P.), Beaumont Hospital, Dublin, Ireland
| | - Russell McLaughlin
- Academic Unit of Neurology (M.R., M.H., N.D., E.M.C., A.V., O.H.), Trinity College; Department of Genetics (M.A.D., R.M.), Trinity College; and Department of Psychology (N.P.), Beaumont Hospital, Dublin, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology (M.R., M.H., N.D., E.M.C., A.V., O.H.), Trinity College; Department of Genetics (M.A.D., R.M.), Trinity College; and Department of Psychology (N.P.), Beaumont Hospital, Dublin, Ireland
| |
Collapse
|
290
|
Wong S, Balleine BW, Kumfor F. A new framework for conceptualizing symptoms in frontotemporal dementia: from animal models to the clinic. Brain 2018; 141:2245-2254. [DOI: 10.1093/brain/awy123] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/13/2018] [Indexed: 12/11/2022] Open
Affiliation(s)
- Stephanie Wong
- The University of Sydney, School of Psychology and Brain and Mind Centre, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Bernard W Balleine
- University of New South Wales, School of Psychology, Sydney, NSW, Australia
| | - Fiona Kumfor
- The University of Sydney, School of Psychology and Brain and Mind Centre, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| |
Collapse
|
291
|
Murley AG, Rowe JB. Neurotransmitter deficits from frontotemporal lobar degeneration. Brain 2018; 141:1263-1285. [PMID: 29373632 PMCID: PMC5917782 DOI: 10.1093/brain/awx327] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/05/2017] [Accepted: 10/03/2017] [Indexed: 12/11/2022] Open
Abstract
Frontotemporal lobar degeneration causes a spectrum of complex degenerative disorders including frontotemporal dementia, progressive supranuclear palsy and corticobasal syndrome, each of which is associated with changes in the principal neurotransmitter systems. We review the evidence for these neurochemical changes and propose that they contribute to symptomatology of frontotemporal lobar degeneration, over and above neuronal loss and atrophy. Despite the development of disease-modifying therapies, aiming to slow neuropathological progression, it remains important to advance symptomatic treatments to reduce the disease burden and improve patients' and carers' quality of life. We propose that targeting the selective deficiencies in neurotransmitter systems, including dopamine, noradrenaline, serotonin, acetylcholine, glutamate and gamma-aminobutyric acid is an important strategy towards this goal. We summarize the current evidence-base for pharmacological treatments and suggest strategies to improve the development of new, effective pharmacological treatments.
Collapse
Affiliation(s)
- Alexander G Murley
- Department of Clinical Neurosciences, University of Cambridge, Herchel Smith Building, Robinson Way, Cambridge, CB2 0SZ, UK
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Herchel Smith Building, Robinson Way, Cambridge, CB2 0SZ, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF, UK
- Behavioural and Clinical Neurosciences Institute, University of Cambridge, Sir William Hardy Building, Downing Street, Cambridge, CB2 3EB, UK
| |
Collapse
|
292
|
Social Cognition Dysfunctions in Neurodegenerative Diseases: Neuroanatomical Correlates and Clinical Implications. Behav Neurol 2018; 2018:1849794. [PMID: 29854017 PMCID: PMC5944290 DOI: 10.1155/2018/1849794] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 04/03/2018] [Accepted: 04/11/2018] [Indexed: 02/07/2023] Open
Abstract
Social cognitive function, involved in the perception, processing, and interpretation of social information, has been shown to be crucial for successful communication and interpersonal relationships, thereby significantly impacting mental health, well-being, and quality of life. In this regard, assessment of social cognition, mainly focusing on four key domains, such as theory of mind (ToM), emotional empathy, and social perception and behavior, has been increasingly evaluated in clinical settings, given the potential implications of impairments of these skills for therapeutic decision-making. With regard to neurodegenerative diseases (NDs), most disorders, characterized by variable disease phenotypes and progression, although similar for the unfavorable prognosis, are associated to impairments of social cognitive function, with consequent negative effects on patients' management. Specifically, in some NDs these deficits may represent core diagnostic criteria, such as for behavioral variant frontotemporal dementia (bvFTD), or may emerge during the disease course as critical aspects, such as for Parkinson's and Alzheimer's diseases. On this background, we aimed to revise the most updated evidence on the neurobiological hypotheses derived from network-based approaches, clinical manifestations, and assessment tools of social cognitive dysfunctions in NDs, also prospecting potential benefits on patients' well-being, quality of life, and outcome derived from potential therapeutic perspectives of these deficits.
Collapse
|
293
|
Shoeibi A, Olfati N, Litvan I. Preclinical, phase I, and phase II investigational clinical trials for treatment of progressive supranuclear palsy. Expert Opin Investig Drugs 2018; 27:349-361. [PMID: 29602288 DOI: 10.1080/13543784.2018.1460356] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Our understanding of the pathological basis of progressive supranuclear palsy (PSP), as the most common atypical parkinsonian syndrome, has greatly increased in recent years and a number of disease-modifying therapies are under evaluation as a result of these advances. AREAS COVERED In this review, we discuss disease-modifying therapeutic options which are currently under evaluation or have been evaluated in preclinical or clinical trials based on their targeted pathophysiologic process. The pathophysiologic mechanisms are broadly divided into three main categories: genetic mechanisms, abnormal post-translational modifications of tau protein, and transcellular tau spread. EXPERT OPINION Once the best therapeutic approaches are identified, it is likely that some combination of interventions will need to be evaluated, but this will take time. It is critical to treat patients at early stages, and development of the Movement Disorder Society PSP diagnostic criteria is an important step in this direction. In addition, development of biological biomarkers such as tau PET and further refinement of tau ligands may help both diagnose early and measure disease progression. In the meantime, a comprehensive, personalized interdisciplinary approach to this disease is absolutely necessary.
Collapse
Affiliation(s)
- Ali Shoeibi
- a Department of Neurology, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Nahid Olfati
- a Department of Neurology, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Irene Litvan
- b UC San Diego Department of Neurosciences , Parkinson and Other Movement Disorder Center , La Jolla , CA , USA
| |
Collapse
|
294
|
Erkkinen MG, Kim MO, Geschwind MD. Clinical Neurology and Epidemiology of the Major Neurodegenerative Diseases. Cold Spring Harb Perspect Biol 2018; 10:a033118. [PMID: 28716886 PMCID: PMC5880171 DOI: 10.1101/cshperspect.a033118] [Citation(s) in RCA: 555] [Impact Index Per Article: 92.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Neurodegenerative diseases are a common cause of morbidity and cognitive impairment in older adults. Most clinicians who care for the elderly are not trained to diagnose these conditions, perhaps other than typical Alzheimer's disease (AD). Each of these disorders has varied epidemiology, clinical symptomatology, laboratory and neuroimaging features, neuropathology, and management. Thus, it is important that clinicians be able to differentiate and diagnose these conditions accurately. This review summarizes and highlights clinical aspects of several of the most commonly encountered neurodegenerative diseases, including AD, frontotemporal dementia (FTD) and its variants, progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), Parkinson's disease (PD), dementia with Lewy bodies (DLB), multiple system atrophy (MSA), and Huntington's disease (HD). For each condition, we provide a brief overview of the epidemiology, defining clinical symptoms and diagnostic criteria, relevant imaging and laboratory features, genetics, pathology, treatments, and differential diagnosis.
Collapse
Affiliation(s)
- Michael G Erkkinen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, California 94158
| | - Mee-Ohk Kim
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, California 94158
| | - Michael D Geschwind
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, California 94158
| |
Collapse
|
295
|
Neuroimmune Tau Mechanisms: Their Role in the Progression of Neuronal Degeneration. Int J Mol Sci 2018; 19:ijms19040956. [PMID: 29570615 PMCID: PMC5979395 DOI: 10.3390/ijms19040956] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/05/2018] [Accepted: 03/08/2018] [Indexed: 12/15/2022] Open
Abstract
Progressive neurodegenerative pathologies in aged populations are an issue of major concern worldwide. The microtubule-associated protein tau is able to self-aggregate to form abnormal supramolecular structures that include small oligomers up to complex polymers. Tauopathies correspond to a group of diseases that share tau pathology as a common etiological agent. Since microglial cells play a preponderant role in innate immunity and are the main source of proinflammatory factors in the central nervous system (CNS), the alterations in the cross-talks between microglia and neuronal cells are the main focus of studies concerning the origins of tauopathies. According to evidence from a series of studies, these changes generate a feedback mechanism reactivating microglia and provoking constant cellular damage. Thus, the previously summarized mechanisms could explain the onset and progression of different tauopathies and their functional/behavioral effects, opening the window towards an understanding of the molecular basis of anomalous tau interactions. Despite clinical and pathological differences, increasing experimental evidence indicates an overlap between tauopathies and synucleinopathies, considering that neuroinflammatory events are involved and the existence of protein misfolding. Neurofibrillary tangles of pathological tau (NFT) and Lewy bodies appear to coexist in certain brain areas. Thus, the co-occurrence of synucleinopathies with tauopathies is evidenced by several investigations, in which NFT were found in the substantia nigra of patients with Parkinson’s disease, suggesting that the pathologies share some common features at the level of neuroinflammatory events.
Collapse
|
296
|
Niccoli T, Partridge L, Isaacs AM. Ageing as a risk factor for ALS/FTD. Hum Mol Genet 2018; 26:R105-R113. [PMID: 28977441 DOI: 10.1093/hmg/ddx247] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 12/13/2022] Open
Abstract
Like many other neurodegenerative diseases, age is a major risk factor in the development of ALS/FTD. But why is this the case? Recent genetic advances have highlighted some of pathways involved in the development of disease, and, strikingly, they appear to substantially overlap with those known to directly modulate the ageing process. Many ALS/FTD linked genes play a direct role in autophagy/lysosomal degradation, one of the most important pathways linked to ageing. However, systemic processes such as inflammation, as well as cellular maintenance pathways, including RNA splicing and nuclear-cytoplasmic transport have been increasingly linked both to disease and ageing. We highlight some of the shared mechanisms between the ageing process itself and emerging pathogenic mechanisms in ALS/FTD.
Collapse
Affiliation(s)
- Teresa Niccoli
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK.,Department of Genetics, Evolution and Environment, Institute of Healthy Ageing, UCL, London WC1E 6BT, UK
| | - Linda Partridge
- Department of Genetics, Evolution and Environment, Institute of Healthy Ageing, UCL, London WC1E 6BT, UK.,Max Planck Institute for Biology of Ageing, 50931 Cologne, Germany
| | - Adrian M Isaacs
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK.,UK Dementia Research Institute at UCL, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| |
Collapse
|
297
|
Lansdall CJ, Coyle-Gilchrist ITS, Jones PS, Vázquez Rodríguez P, Wilcox A, Wehmann E, Dick KM, Robbins TW, Rowe JB. White matter change with apathy and impulsivity in frontotemporal lobar degeneration syndromes. Neurology 2018; 90:e1066-e1076. [PMID: 29453244 PMCID: PMC5874447 DOI: 10.1212/wnl.0000000000005175] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/21/2017] [Indexed: 12/11/2022] Open
Abstract
Objective To identify the white matter correlates of apathy and impulsivity in the major syndromes associated with frontotemporal lobar degeneration, using diffusion-weighted imaging and data from the PiPPIN (Pick's Disease and Progressive Supranuclear Palsy: Prevalence and Incidence) study. We included behavioral and language variants of frontotemporal dementia, corticobasal syndrome, and progressive supranuclear palsy. Methods Seventy patients and 30 controls underwent diffusion tensor imaging at 3-tesla after detailed assessment of apathy and impulsivity. We used tract-based spatial statistics of fractional anisotropy and mean diffusivity, correlating with 8 orthogonal dimensions of apathy and impulsivity derived from a principal component analysis of neuropsychological, behavioral, and questionnaire measures. Results Three components were associated with significant white matter tract abnormalities. Carer-rated change in everyday skills, self-care, and motivation correlated with widespread changes in dorsal frontoparietal and corticospinal tracts, while carer observations of impulsive–apathetic and challenging behaviors revealed disruption in ventral frontotemporal tracts. Objective neuropsychological tests of cognitive control, reflection impulsivity, and reward responsiveness were associated with focal changes in the right frontal lobe and presupplementary motor area. These changes were observed across clinical diagnostic groups, and were not restricted to the disorders for which diagnostic criteria include apathy and impulsivity. Conclusion The current study provides evidence of distinct structural network changes in white matter associated with different neurobehavioral components of apathy and impulsivity across the diverse spectrum of syndromes and pathologies associated with frontotemporal lobar degeneration.
Collapse
Affiliation(s)
- Claire J Lansdall
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK.
| | - Ian T S Coyle-Gilchrist
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - P Simon Jones
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Patricia Vázquez Rodríguez
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Alicia Wilcox
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Eileen Wehmann
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Katrina M Dick
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Trevor W Robbins
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - James B Rowe
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| |
Collapse
|
298
|
Nelson PT, Abner EL, Patel E, Anderson S, Wilcock DM, Kryscio RJ, Van Eldik LJ, Jicha GA, Gal Z, Nelson RS, Nelson BG, Gal J, Azam MT, Fardo DW, Cykowski MD. The Amygdala as a Locus of Pathologic Misfolding in Neurodegenerative Diseases. J Neuropathol Exp Neurol 2018; 77:2-20. [PMID: 29186501 DOI: 10.1093/jnen/nlx099] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Indexed: 12/14/2022] Open
Abstract
Over the course of most common neurodegenerative diseases the amygdala accumulates pathologically misfolded proteins. Misfolding of 1 protein in aged brains often is accompanied by the misfolding of other proteins, suggesting synergistic mechanisms. The multiplicity of pathogenic processes in human amygdalae has potentially important implications for the pathogenesis of Alzheimer disease, Lewy body diseases, chronic traumatic encephalopathy, primary age-related tauopathy, and hippocampal sclerosis, and for the biomarkers used to diagnose those diseases. Converging data indicate that the amygdala may represent a preferential locus for a pivotal transition from a relatively benign clinical condition to a more aggressive disease wherein multiple protein species are misfolded. Thus, understanding of amygdalar pathobiology may yield insights relevant to diagnoses and therapies; it is, however, a complex and imperfectly defined brain region. Here, we review aspects of amygdalar anatomy, connectivity, vasculature, and pathologic involvement in neurodegenerative diseases with supporting data from the University of Kentucky Alzheimer's Disease Center autopsy cohort. Immunohistochemical staining of amygdalae for Aβ, Tau, α-synuclein, and TDP-43 highlight the often-coexisting pathologies. We suggest that the amygdala may represent an "incubator" for misfolded proteins and that it is possible that misfolded amygdalar protein species are yet to be discovered.
Collapse
Affiliation(s)
- Peter T Nelson
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Erin L Abner
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Ela Patel
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Sonya Anderson
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Donna M Wilcock
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Richard J Kryscio
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Linda J Van Eldik
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Gregory A Jicha
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Zsombor Gal
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Ruth S Nelson
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Bela G Nelson
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Jozsef Gal
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Md Tofial Azam
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - David W Fardo
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Matthew D Cykowski
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| |
Collapse
|
299
|
Serpente M, Galimberti D. Autosomal Dominant Frontotemporal Lobar Degeneration: From Genotype to Phenotype. NEURODEGENER DIS 2018. [DOI: 10.1007/978-3-319-72938-1_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
300
|
Burrell JR, Hodges JR. Falls in frontotemporal dementia and related syndromes. HANDBOOK OF CLINICAL NEUROLOGY 2018; 159:195-203. [PMID: 30482314 DOI: 10.1016/b978-0-444-63916-5.00012-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Frontotemporal dementia (FTD) and related diseases are important causes of younger-onset dementia. Falls may be a source of morbidity and mortality in FTD, but remain underreported, and very few high-quality studies have been performed. In this chapter, we briefly review the clinical features of FTD and related syndromes such as motor neuron disease (MND) and atypical parkinsonian syndromes, such as progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). Falls are frequently encountered in patients who present with FTD syndromes. Although cognitive impairment is associated with falls generally, motor symptoms and signs, as seen in FTD cases that overlap with atypical parkinsonian disorders such as PSP or CBS, or MND, appear to pose the greatest risk. At present, very few systematic studies have been performed to determine the precise frequency, timing, diagnostic implications, and complications of falls in FTD. Further studies are required to understand the scope of this problem, and to develop effective treatments and management strategies.
Collapse
Affiliation(s)
- James R Burrell
- Concord Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia; Brain and Mind Centre, University of Sydney Medical School, Sydney, NSW, Australia.
| | - John R Hodges
- Brain and Mind Centre, University of Sydney Medical School, Sydney, NSW, Australia
| |
Collapse
|