1
|
Meade G, Machulda MM, Clark HM, Duffy JR, Botha H, Whitwell JL, Josephs KA, Utianski RL. Identifying and Addressing Functional Communication Challenges in Patients With Behavioral Variant Frontotemporal Dementia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1573-1589. [PMID: 38843453 PMCID: PMC11253250 DOI: 10.1044/2024_ajslp-24-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE We describe the communication challenges of four patients with a neurodegenerative disorder consistent with behavioral variant frontotemporal dementia (bvFTD), characterized by early behavioral and personality changes. By describing their clinical profiles, we identify common barriers to functional communication in this population and provide recommendations for how speech-language pathologists (SLPs) might contribute to minimizing them. METHOD Four patients with bvFTD were selected from a cohort of patients with progressive communication impairments. Three of them returned for at least one follow-up visit. Case histories are presented along with the results of comprehensive speech and language, neuropsychological, and neurological testing. RESULTS At the time of initial evaluation, patients were between the ages of 54 and 66 years and had been experiencing symptoms for 1.5-6 years. Consistent with their bvFTD diagnoses, all patients had prominent behavioral and personality changes that impacted communication. Patients 1 and 2 also had mild aphasia at enrollment, primarily characterized by anomia and loss of word meaning. Patients 3 and 4 both had apraxia of speech and moderate-to-severe aphasia at enrollment with prominent anomia and agrammatism. All four patients had impaired executive functioning and relative sparing of visuospatial skills; episodic memory was also impaired for Patients 2 and 4. Even though functional communication was progressively limited for all patients, none of them received regular support from an SLP. CONCLUSIONS This case series adds to a scant, but growing, literature demonstrating that patients with bvFTD have communication impairments. SLPs are uniquely positioned to identify barriers to functional communication and to provide tailored strategy training to the patients and their care partners over the course of their disease. Systematic evaluation of the efficacy of treatment in this population would be valuable. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25933762.
Collapse
Affiliation(s)
| | - Mary M. Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | | | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN
| | | | | | | |
Collapse
|
2
|
Imokawa T, Yokoyama K, Takahashi K, Oyama J, Tsuchiya J, Sanjo N, Tateishi U. Brain perfusion SPECT in dementia: what radiologists should know. Jpn J Radiol 2024:10.1007/s11604-024-01612-5. [PMID: 38888851 DOI: 10.1007/s11604-024-01612-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024]
Abstract
The findings of brain perfusion single-photon emission computed tomography (SPECT), which detects abnormalities often before changes manifest in morphological imaging, mainly reflect neurodegeneration and contribute to dementia evaluation. A major shift is about to occur in dementia practice to the approach of diagnosing based on biomarkers and treating with disease-modifying drugs. Accordingly, brain perfusion SPECT will be required to serve as a biomarker of neurodegeneration. Hypoperfusion in Alzheimer's disease (AD) is typically seen in the posterior cingulate cortex and precuneus early in the disease, followed by the temporoparietal cortices. On the other hand, atypical presentations of AD such as the posterior variant, logopenic variant, frontal variant, and corticobasal syndrome exhibit hypoperfusion in areas related to symptoms. Additionally, hypoperfusion especially in the precuneus and parietal association cortex can serve as a predictor of progression from mild cognitive impairment to AD. In dementia with Lewy bodies (DLB), the differentiating feature is the presence of hypoperfusion in the occipital lobes in addition to that observed in AD. Hypoperfusion of the occipital lobe is not a remarkable finding, as it is assumed to reflect functional loss due to impairment of the cholinergic and dopaminergic systems rather than degeneration per se. Moreover, the cingulate island sign reflects the degree of AD pathology comorbid in DLB. Frontotemporal dementia is characterized by regional hypoperfusion according to the three clinical types, and the background pathology is diverse. Idiopathic normal pressure hydrocephalus shows apparent hypoperfusion around the Sylvian fissure and corpus callosum and apparent hyperperfusion in high-convexity areas. The cortex or striatum with diffusion restriction on magnetic resonance imaging in prion diseases reflects spongiform degeneration and brain perfusion SPECT reveals hypoperfusion in the same areas. Brain perfusion SPECT findings in dementia should be carefully interpreted considering background pathology.
Collapse
Affiliation(s)
- Tomoki Imokawa
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
- Department of Radiology, Japanese Red Cross Omori Hospital, Ota-Ku, Tokyo, Japan
| | - Kota Yokoyama
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan.
| | - Kanae Takahashi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Jun Oyama
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Junichi Tsuchiya
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Nobuo Sanjo
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| |
Collapse
|
3
|
Rouse MA, Binney RJ, Patterson K, Rowe JB, Lambon Ralph MA. A neuroanatomical and cognitive model of impaired social behaviour in frontotemporal dementia. Brain 2024; 147:1953-1966. [PMID: 38334506 PMCID: PMC11146431 DOI: 10.1093/brain/awae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 12/21/2023] [Accepted: 01/21/2024] [Indexed: 02/10/2024] Open
Abstract
Impaired social cognition is a core deficit in frontotemporal dementia (FTD). It is most commonly associated with the behavioural-variant of FTD, with atrophy of the orbitofrontal and ventromedial prefrontal cortex. Social cognitive changes are also common in semantic dementia, with atrophy centred on the anterior temporal lobes. The impairment of social behaviour in FTD has typically been attributed to damage to the orbitofrontal cortex and/or temporal poles and/or the uncinate fasciculus that connects them. However, the relative contributions of each region are unresolved. In this review, we present a unified neurocognitive model of controlled social behaviour that not only explains the observed impairment of social behaviours in FTD, but also assimilates both consistent and potentially contradictory findings from other patient groups, comparative neurology and normative cognitive neuroscience. We propose that impaired social behaviour results from damage to two cognitively- and anatomically-distinct components. The first component is social-semantic knowledge, a part of the general semantic-conceptual system supported by the anterior temporal lobes bilaterally. The second component is social control, supported by the orbitofrontal cortex, medial frontal cortex and ventrolateral frontal cortex, which interacts with social-semantic knowledge to guide and shape social behaviour.
Collapse
Affiliation(s)
- Matthew A Rouse
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
| | - Richard J Binney
- Cognitive Neuroscience Institute, Department of Psychology, School of Human and Behavioural Sciences, Bangor University, Bangor LL57 2AS, UK
| | - Karalyn Patterson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
| | - James B Rowe
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
- Department of Neurology, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0SZ, UK
| | | |
Collapse
|
4
|
Buccellato FR, D'Anca M, Tartaglia GM, Del Fabbro M, Galimberti D. Frontotemporal dementia: from genetics to therapeutic approaches. Expert Opin Investig Drugs 2024; 33:561-573. [PMID: 38687620 DOI: 10.1080/13543784.2024.2349286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 04/25/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION Frontotemporal dementia (FTD) includes a group of neurodegenerative diseases characterized clinically by behavioral disturbances and by neurodegeneration of brain anterior temporal and frontal lobes, leading to atrophy. Apart from symptomatic treatments, there is, at present, no disease-modifying cure for FTD. AREAS COVERED Three main mutations are known as causes of familial FTD, and large consortia have studied carriers of mutations, also in preclinical Phases. As genetic cases are the only ones in which the pathology can be predicted in life, compounds developed so far are directed toward specific proteins or mutations. Herein, recently approved clinical trials will be summarized, including molecules, mechanisms of action and pharmacological testing. EXPERT OPINION These studies are paving the way for the future. They will clarify whether single mutations should be addressed rather than common proteins depositing in the brain to move from genetic to sporadic FTD.
Collapse
Affiliation(s)
- Francesca R Buccellato
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marianna D'Anca
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
5
|
Jenkins LM, Heywood A, Gupta S, Kouchakidivkolaei M, Sridhar J, Rogalski E, Weintraub S, Popuri K, Rosen H, Wang L. Disinhibition in dementia related to reduced morphometric similarity of cognitive control network. Brain Commun 2024; 6:fcae124. [PMID: 38665960 PMCID: PMC11044061 DOI: 10.1093/braincomms/fcae124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/04/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Disinhibition is one of the most distressing and difficult to treat neuropsychiatric symptoms of dementia. It involves socially inappropriate behaviours, such as hypersexual comments, inappropriate approaching of strangers and excessive jocularity. Disinhibition occurs in multiple dementia syndromes, including behavioural variant frontotemporal dementia, and dementia of the Alzheimer's type. Morphometric similarity networks are a relatively new method for examining brain structure and can be used to calculate measures of network integrity on large scale brain networks and subnetworks such as the salience network and cognitive control network. In a cross-sectional study, we calculated morphometric similarity networks to determine whether disinhibition in behavioural variant frontotemporal dementia (n = 75) and dementia of the Alzheimer's type (n = 111) was associated with reduced integrity of these networks independent of diagnosis. We found that presence of disinhibition, measured by the Neuropsychiatric Inventory Questionnaire, was associated with reduced global efficiency of the cognitive control network in both dementia of the Alzheimer's type and behavioural variant frontotemporal dementia. Future research should replicate this transdiagnostic finding in other dementia diagnoses and imaging modalities, and investigate the potential for intervention at the level of the cognitive control network to target disinhibition.
Collapse
Affiliation(s)
- Lisanne M Jenkins
- Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL 60611, USA
| | - Ashley Heywood
- Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL 60611, USA
| | - Sonya Gupta
- Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL 60611, USA
| | | | - Jaiashre Sridhar
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL 60611, USA
| | - Emily Rogalski
- Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL 60611, USA
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL 60611, USA
| | - Sandra Weintraub
- Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL 60611, USA
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL 60611, USA
| | - Karteek Popuri
- Computer Science, Memorial University of Newfoundland, St. Johns, NL A1C 5S7, Canada
| | - Howard Rosen
- Neurology, University of California, San Francisco, CA 94143, USA
| | - Lei Wang
- Psychiatry and Behavioral Health, Ohio State University, Columbus, OH 43210, USA
| |
Collapse
|
6
|
Ohm DT, Xie SX, Capp N, Arezoumandan S, Cousins KAQ, Rascovsky K, Wolk DA, Van Deerlin VM, Lee EB, McMillan CT, Irwin DJ. Cytoarchitectonic gradients of laminar degeneration in behavioral variant frontotemporal dementia. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.05.588259. [PMID: 38644997 PMCID: PMC11030243 DOI: 10.1101/2024.04.05.588259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Behavioral variant frontotemporal dementia (bvFTD) is a clinical syndrome primarily caused by either tau (bvFTD-tau) or TDP-43 (bvFTD-TDP) proteinopathies. We previously found lower cortical layers and dorsolateral regions accumulate greater tau than TDP-43 pathology; however, patterns of laminar neurodegeneration across diverse cytoarchitecture in bvFTD is understudied. We hypothesized that bvFTD-tau and bvFTD-TDP have distinct laminar distributions of pyramidal neurodegeneration along cortical gradients, a topologic order of cytoarchitectonic subregions based on increasing pyramidal density and laminar differentiation. Here, we tested this hypothesis in a frontal cortical gradient consisting of five cytoarchitectonic types (i.e., periallocortex, agranular mesocortex, dysgranular mesocortex, eulaminate-I isocortex, eulaminate-II isocortex) spanning anterior cingulate, paracingulate, orbitofrontal, and mid-frontal gyri in bvFTD-tau (n=27), bvFTD-TDP (n=47), and healthy controls (HC; n=32). We immunostained all tissue for total neurons (NeuN; neuronal-nuclear protein) and pyramidal neurons (SMI32; non-phosphorylated neurofilament) and digitally quantified NeuN-immunoreactivity (ir) and SMI32-ir in supragranular II-III, infragranular V-VI, and all I-VI layers in each cytoarchitectonic type. We used linear mixed-effects models adjusted for demographic and biologic variables to compare SMI32-ir between groups and examine relationships with the cortical gradient, long-range pathways, and clinical symptoms. We found regional and laminar distributions of SMI32-ir expected for HC, validating our measures within the cortical gradient framework. While SMI32-ir loss was not related to the cortical gradient in bvFTD-TDP, SMI32-ir progressively decreased along the cortical gradient of bvFTD-tau and included greater SMI32-ir loss in supragranular eulaminate-II isocortex in bvFTD-tau vs bvFTD-TDP ( p =0.039). In a structural model for long-range laminar connectivity between infragranular mesocortex and supragranular isocortex, we found a larger laminar ratio of mesocortex-to-isocortex SMI32-ir in bvFTD-tau vs bvFTD-TDP ( p =0.019), suggesting select long-projecting pathways may contribute to isocortical-predominant degeneration in bvFTD-tau. In cytoarchitectonic types with the highest NeuN-ir, we found lower SMI32-ir in bvFTD-tau vs bvFTD-TDP ( p =0.047), suggesting pyramidal neurodegeneration may occur earlier in bvFTD-tau. Lastly, we found that reduced SMI32-ir related to behavioral severity and frontal-mediated letter fluency, not temporal-mediated confrontation naming, demonstrating the clinical relevance and specificity of frontal pyramidal neurodegeneration to bvFTD-related symptoms. Our data suggest loss of neurofilament-rich pyramidal neurons is a clinically relevant feature of bvFTD that selectively worsens along a frontal cortical gradient in bvFTD-tau, not bvFTD-TDP. Therefore, tau-mediated degeneration may preferentially involve pyramidal-rich layers that connect more distant cytoarchitectonic types. Moreover, the hierarchical arrangement of cytoarchitecture along cortical gradients may be an important neuroanatomical framework for identifying which types of cells and pathways are differentially involved between proteinopathies.
Collapse
|
7
|
Corriveau-Lecavalier N, Barnard LR, Botha H, Graff-Radford J, Ramanan VK, Lee J, Dicks E, Rademakers R, Boeve BF, Machulda MM, Fields JA, Dickson DW, Graff-Radford N, Knopman DS, Lowe VJ, Petersen RC, Jack CR, Jones DT. Uncovering the distinct macro-scale anatomy of dysexecutive and behavioural degenerative diseases. Brain 2024; 147:1483-1496. [PMID: 37831661 PMCID: PMC10994526 DOI: 10.1093/brain/awad356] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/28/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
There is a longstanding ambiguity regarding the clinical diagnosis of dementia syndromes predominantly targeting executive functions versus behaviour and personality. This is due to an incomplete understanding of the macro-scale anatomy underlying these symptomatologies, a partial overlap in clinical features and the fact that both phenotypes can emerge from the same pathology and vice versa. We collected data from a patient cohort of which 52 had dysexecutive Alzheimer's disease, 30 had behavioural variant frontotemporal dementia (bvFTD), seven met clinical criteria for bvFTD but had Alzheimer's disease pathology (behavioural Alzheimer's disease) and 28 had amnestic Alzheimer's disease. We first assessed group-wise differences in clinical and cognitive features and patterns of fluorodeoxyglucose (FDG) PET hypometabolism. We then performed a spectral decomposition of covariance between FDG-PET images to yield latent patterns of relative hypometabolism unbiased by diagnostic classification, which are referred to as 'eigenbrains'. These eigenbrains were subsequently linked to clinical and cognitive data and meta-analytic topics from a large external database of neuroimaging studies reflecting a wide range of mental functions. Finally, we performed a data-driven exploratory linear discriminant analysis to perform eigenbrain-based multiclass diagnostic predictions. Dysexecutive Alzheimer's disease and bvFTD patients were the youngest at symptom onset, followed by behavioural Alzheimer's disease, then amnestic Alzheimer's disease. Dysexecutive Alzheimer's disease patients had worse cognitive performance on nearly all cognitive domains compared with other groups, except verbal fluency which was equally impaired in dysexecutive Alzheimer's disease and bvFTD. Hypometabolism was observed in heteromodal cortices in dysexecutive Alzheimer's disease, temporo-parietal areas in amnestic Alzheimer's disease and frontotemporal areas in bvFTD and behavioural Alzheimer's disease. The unbiased spectral decomposition analysis revealed that relative hypometabolism in heteromodal cortices was associated with worse dysexecutive symptomatology and a lower likelihood of presenting with behaviour/personality problems, whereas relative hypometabolism in frontotemporal areas was associated with a higher likelihood of presenting with behaviour/personality problems but did not correlate with most cognitive measures. The linear discriminant analysis yielded an accuracy of 82.1% in predicting diagnostic category and did not misclassify any dysexecutive Alzheimer's disease patient for behavioural Alzheimer's disease and vice versa. Our results strongly suggest a double dissociation in that distinct macro-scale underpinnings underlie predominant dysexecutive versus personality/behavioural symptomatology in dementia syndromes. This has important implications for the implementation of criteria to diagnose and distinguish these diseases and supports the use of data-driven techniques to inform the classification of neurodegenerative diseases.
Collapse
Affiliation(s)
| | | | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Vijay K Ramanan
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Jeyeon Lee
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - Ellen Dicks
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
- Center for Molecular Neurology, Antwerp University, Antwerp, Belgium
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | - David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| |
Collapse
|
8
|
Lindberg O, Li TQ, Lind C, Vestberg S, Almkvist O, Stiernstedt M, Ericson A, Bogdanovic N, Hansson O, Harper L, Westman E, Graff C, Tsevis T, Mannfolk P, Fischer H, Nilsonne G, Petrovic P, Nyberg L, Wahlund LO, Santillo AF. Altered empathy processing in frontotemporal dementia A task-based fMRI study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.21.586051. [PMID: 38585830 PMCID: PMC10996471 DOI: 10.1101/2024.03.21.586051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
A lack of empathy, and particularly its affective components, is a core symptom of behavioural variant frontotemporal dementia (bvFTD). Visual exposure to images of a needle pricking a hand (pain condition) and Q-tips touching a hand (control condition) is an established functional magnetic resonance imaging (fMRI) paradigm used to investigate empathy for pain (EFP; pain condition minus control condition). EFP has been associated with increased blood oxygen level dependent (BOLD) signal in regions known to become atrophic in the early stages in bvFTD, including the anterior insula and the anterior cingulate. We therefore hypothesized that patients with bvFTD would display altered empathy processing in the EFP paradigm. Here we examined empathy processing using the EFP paradigm in 28 patients with bvFTD and 28 sex and age matched controls. Participants underwent structural MRI, task-based and resting-state fMRI. The Interpersonal Reactivity Index (IRI) was used as a measure of different facets of empathic function outside the scanner. The EFP paradigm was analysed at a whole brain level and using two regions-of-interest approaches, one based on a metanalysis of affective perceptual empathy versus cognitive evaluative empathy and one based on the controĺs activation pattern. In controls, EFP was linked to an expected increase of BOLD signal that displayed an overlap with the pattern of atrophy in the bvFTD patients (insula and anterior cingulate). Additional regions with increased signal were the supramarginal gyrus and the occipital cortex. These latter regions were the only ones that displayed increased BOLD signal in bvFTD patients. BOLD signal increase under the affective perceptual empathy but not the cognitive evaluative empathy region of interest was significantly greater in controls than in bvFTD patients. The controĺs rating on their empathic concern subscale of the IRI was significantly correlated with the BOLD signal in the EFP paradigm, as were an informantś ratings of the patientś empathic concern subscale. This correlation was not observed on other subscales of the IRI or when using the patient's self-ratings. Finally, controls and patients showed different connectivity patterns in empathy related networks during resting-state fMRI, mainly in nodes overlapping the ventral attention network. Our results indicate that reduced neural activity in regions typically affected by pathology in bvFTD is associated with reduced empathy processing, and a predictor of patientś capacity to experience affective empathy.
Collapse
Affiliation(s)
- Olof Lindberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
| | - Tie-Qiang Li
- Department of Clinical Science, Intervention, and Technology, Karolinska Institute, Sweden
- Department of Medical Radiation and Nuclear Medicine, Karolinska University Hospital, Sweden
| | - Cecilia Lind
- Department of community medicine and rehabilitation, geriatrics Umeå university, Umeå university, Sweden
| | | | - Ove Almkvist
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
- Department of Psychology, Stockholm, Sweden
| | - Mikael Stiernstedt
- Umeå center for Functional Brain Imaging (UFBI), Umeå University, Sweden
| | - Anita Ericson
- Department of community medicine and rehabilitation, geriatrics Umeå university, Umeå university, Sweden
| | - Nenad Bogdanovic
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Luke Harper
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Eric Westman
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
| | - Caroline Graff
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
- Karolinska university hospital, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Center for Alzheimer Research, Karolinska Institutet, Solna, Sweden
| | - Theofanis Tsevis
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
- Karolinska university hospital, Stockholm, Sweden
| | - Peter Mannfolk
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Håkan Fischer
- Department of Psychology, Stockholm, Sweden
- Stockholm University Brain Imaging Centre (SUBIC), Stockholm, Sweden
- Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Gustav Nilsonne
- Department of Psychology, Stockholm, Sweden
- Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institute, Sweden
| | - Predrag Petrovic
- Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institute, Sweden
- Center for Cognitive and Computational Psychiatry, Department of Clinical Neuroscience, Karolinska Institute, Sweden
| | - Lars Nyberg
- Umeå center for Functional Brain Imaging (UFBI), Umeå University, Sweden
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
- Department of Medical and Translational Biology, Umeå University, Umeå, Sweden
| | - Lars-Olof Wahlund
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Division of Clinical Geriatrics, Centre for Alzheimer Research, Neo, 14183 Huddinge, Sweden
| | - Alexander F Santillo
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | | |
Collapse
|
9
|
Ma D, Stocks J, Rosen H, Kantarci K, Lockhart SN, Bateman JR, Craft S, Gurcan MN, Popuri K, Beg MF, Wang L. Differential diagnosis of frontotemporal dementia subtypes with explainable deep learning on structural MRI. Front Neurosci 2024; 18:1331677. [PMID: 38384484 PMCID: PMC10879283 DOI: 10.3389/fnins.2024.1331677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/08/2024] [Indexed: 02/23/2024] Open
Abstract
Background Frontotemporal dementia (FTD) represents a collection of neurobehavioral and neurocognitive syndromes that are associated with a significant degree of clinical, pathological, and genetic heterogeneity. Such heterogeneity hinders the identification of effective biomarkers, preventing effective targeted recruitment of participants in clinical trials for developing potential interventions and treatments. In the present study, we aim to automatically differentiate patients with three clinical phenotypes of FTD, behavioral-variant FTD (bvFTD), semantic variant PPA (svPPA), and nonfluent variant PPA (nfvPPA), based on their structural MRI by training a deep neural network (DNN). Methods Data from 277 FTD patients (173 bvFTD, 63 nfvPPA, and 41 svPPA) recruited from two multi-site neuroimaging datasets: the Frontotemporal Lobar Degeneration Neuroimaging Initiative and the ARTFL-LEFFTDS Longitudinal Frontotemporal Lobar Degeneration databases. Raw T1-weighted MRI data were preprocessed and parcellated into patch-based ROIs, with cortical thickness and volume features extracted and harmonized to control the confounding effects of sex, age, total intracranial volume, cohort, and scanner difference. A multi-type parallel feature embedding framework was trained to classify three FTD subtypes with a weighted cross-entropy loss function used to account for unbalanced sample sizes. Feature visualization was achieved through post-hoc analysis using an integrated gradient approach. Results The proposed differential diagnosis framework achieved a mean balanced accuracy of 0.80 for bvFTD, 0.82 for nfvPPA, 0.89 for svPPA, and an overall balanced accuracy of 0.84. Feature importance maps showed more localized differential patterns among different FTD subtypes compared to groupwise statistical mapping. Conclusion In this study, we demonstrated the efficiency and effectiveness of using explainable deep-learning-based parallel feature embedding and visualization framework on MRI-derived multi-type structural patterns to differentiate three clinically defined subphenotypes of FTD: bvFTD, nfvPPA, and svPPA, which could help with the identification of at-risk populations for early and precise diagnosis for intervention planning.
Collapse
Affiliation(s)
- Da Ma
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Jane Stocks
- Department of Psychiatry and Behavioral Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Howard Rosen
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Samuel N. Lockhart
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - James R. Bateman
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Suzanne Craft
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Metin N. Gurcan
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Karteek Popuri
- Department of Computer Science, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
| | - Lei Wang
- Department of Psychiatry and Behavioral Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, United States
| | | |
Collapse
|
10
|
Chen P, Zhang S, Zhao K, Kang X, Rittman T, Liu Y. Robustly uncovering the heterogeneity of neurodegenerative disease by using data-driven subtyping in neuroimaging: A review. Brain Res 2024; 1823:148675. [PMID: 37979603 DOI: 10.1016/j.brainres.2023.148675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/19/2023] [Accepted: 11/07/2023] [Indexed: 11/20/2023]
Abstract
Neurodegenerative diseases are associated with heterogeneity in genetics, pathology, and clinical manifestation. Understanding this heterogeneity is particularly relevant for clinical prognosis and stratifying patients for disease modifying treatments. Recently, data-driven methods based on neuroimaging have been applied to investigate the subtyping of neurodegenerative disease, helping to disentangle this heterogeneity. We reviewed brain-based subtyping studies in aging and representative neurodegenerative diseases, including Alzheimer's disease, mild cognitive impairment, frontotemporal dementia, and Lewy body dementia, from January 2000 to November 2022. We summarized clustering methods, validation, robustness, reproducibility, and clinical relevance of 71 eligible studies in the present study. We found vast variations in approaches between studies, including ten neuroimaging modalities, 24 cluster algorithms, and 41 methods of cluster number determination. The clinical relevance of subtyping studies was evaluated by summarizing the analysis method of clinical measurements, showing a relatively low clinical utility in the current studies. Finally, we conclude that future studies of heterogeneity in neurodegenerative disease should focus on validation, comparison between subtyping approaches, and prioritise clinical utility.
Collapse
Affiliation(s)
- Pindong Chen
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China; Department of Clinical Neurosciences, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Shirui Zhang
- School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China
| | - Kun Zhao
- School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China
| | - Xiaopeng Kang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Timothy Rittman
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Yong Liu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China.
| |
Collapse
|
11
|
Corriveau-Lecavalier N, Barnard LR, Przybelski SA, Gogineni V, Botha H, Graff-Radford J, Ramanan VK, Forsberg LK, Fields JA, Machulda MM, Rademakers R, Gavrilova RH, Lapid MI, Boeve BF, Knopman DS, Lowe VJ, Petersen RC, Jack CR, Kantarci K, Jones DT. Assessing network degeneration and phenotypic heterogeneity in genetic frontotemporal lobar degeneration by decoding FDG-PET. Neuroimage Clin 2023; 41:103559. [PMID: 38147792 PMCID: PMC10944211 DOI: 10.1016/j.nicl.2023.103559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 12/28/2023]
Abstract
Genetic mutations causative of frontotemporal lobar degeneration (FTLD) are highly predictive of a specific proteinopathy, but there exists substantial inter-individual variability in their patterns of network degeneration and clinical manifestations. We collected clinical and 18Fluorodeoxyglucose-positron emission tomography (FDG-PET) data from 39 patients with genetic FTLD, including 11 carrying the C9orf72 hexanucleotide expansion, 16 carrying a MAPT mutation and 12 carrying a GRN mutation. We performed a spectral covariance decomposition analysis between FDG-PET images to yield unbiased latent patterns reflective of whole brain patterns of metabolism ("eigenbrains" or EBs). We then conducted linear discriminant analyses (LDAs) to perform EB-based predictions of genetic mutation and predominant clinical phenotype (i.e., behavior/personality, language, asymptomatic). Five EBs were significant and explained 58.52 % of the covariance between FDG-PET images. EBs indicative of hypometabolism in left frontotemporal and temporo-parietal areas distinguished GRN mutation carriers from other genetic mutations and were associated with predominant language phenotypes. EBs indicative of hypometabolism in prefrontal and temporopolar areas with a right hemispheric predominance were mostly associated with predominant behavioral phenotypes and distinguished MAPT mutation carriers from other genetic mutations. The LDAs yielded accuracies of 79.5 % and 76.9 % in predicting genetic status and predominant clinical phenotype, respectively. A small number of EBs explained a high proportion of covariance in patterns of network degeneration across FTLD-related genetic mutations. These EBs contained biological information relevant to the variability in the pathophysiological and clinical aspects of genetic FTLD, and for offering valuable guidance in complex clinical decision-making, such as decisions related to genetic testing.
Collapse
Affiliation(s)
- Nick Corriveau-Lecavalier
- Department of Neurology, Mayo Clinic Rochester, USA; Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | | | | | | | - Hugo Botha
- Department of Neurology, Mayo Clinic Rochester, USA
| | | | | | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic Jacksonville, USA; VIB-UA Center for Molecular Neurology, VIB, University of Antwerp, Belgium
| | | | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | | | | | - Val J Lowe
- Department of Radiology, Mayo Clinic Rochester, USA
| | | | | | | | - David T Jones
- Department of Neurology, Mayo Clinic Rochester, USA; Department of Radiology, Mayo Clinic Rochester, USA.
| |
Collapse
|
12
|
Shen T, Vogel JW, Duda J, Phillips JS, Cook PA, Gee J, Elman L, Quinn C, Amado DA, Baer M, Massimo L, Grossman M, Irwin DJ, McMillan CT. Novel data-driven subtypes and stages of brain atrophy in the ALS-FTD spectrum. Transl Neurodegener 2023; 12:57. [PMID: 38062485 PMCID: PMC10701950 DOI: 10.1186/s40035-023-00389-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND TDP-43 proteinopathies represent a spectrum of neurological disorders, anchored clinically on either end by amyotrophic lateral sclerosis (ALS) and frontotemporal degeneration (FTD). The ALS-FTD spectrum exhibits a diverse range of clinical presentations with overlapping phenotypes, highlighting its heterogeneity. This study was aimed to use disease progression modeling to identify novel data-driven spatial and temporal subtypes of brain atrophy and its progression in the ALS-FTD spectrum. METHODS We used a data-driven procedure to identify 13 anatomic clusters of brain volume for 57 behavioral variant FTD (bvFTD; with either autopsy-confirmed TDP-43 or TDP-43 proteinopathy-associated genetic variants), 103 ALS, and 47 ALS-FTD patients with likely TDP-43. A Subtype and Stage Inference (SuStaIn) model was trained to identify subtypes of individuals along the ALS-FTD spectrum with distinct brain atrophy patterns, and we related subtypes and stages to clinical, genetic, and neuropathological features of disease. RESULTS SuStaIn identified three novel subtypes: two disease subtypes with predominant brain atrophy in either prefrontal/somatomotor regions or limbic-related regions, and a normal-appearing group without obvious brain atrophy. The limbic-predominant subtype tended to present with more impaired cognition, higher frequencies of pathogenic variants in TBK1 and TARDBP genes, and a higher proportion of TDP-43 types B, E and C. In contrast, the prefrontal/somatomotor-predominant subtype had higher frequencies of pathogenic variants in C9orf72 and GRN genes and higher proportion of TDP-43 type A. The normal-appearing brain group showed higher frequency of ALS relative to ALS-FTD and bvFTD patients, higher cognitive capacity, higher proportion of lower motor neuron onset, milder motor symptoms, and lower frequencies of genetic pathogenic variants. The overall SuStaIn stages also correlated with evidence for clinical progression including longer disease duration, higher King's stage, and cognitive decline. Additionally, SuStaIn stages differed across clinical phenotypes, genotypes and types of TDP-43 pathology. CONCLUSIONS Our findings suggest distinct neurodegenerative subtypes of disease along the ALS-FTD spectrum that can be identified in vivo, each with distinct brain atrophy, clinical, genetic and pathological patterns.
Collapse
Affiliation(s)
- Ting Shen
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jacob W Vogel
- Department of Clinical Sciences, SciLifeLab, Lund University, 222 42, Lund, Sweden
| | - Jeffrey Duda
- Penn Image Computing and Science Lab (PICSL), Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jeffrey S Phillips
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Philip A Cook
- Penn Image Computing and Science Lab (PICSL), Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - James Gee
- Penn Image Computing and Science Lab (PICSL), Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Lauren Elman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Colin Quinn
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Defne A Amado
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Michael Baer
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Lauren Massimo
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - David J Irwin
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Digital Neuropathology Laboratory, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Corey T McMillan
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| |
Collapse
|
13
|
Brown JA, Lee AJ, Fernhoff K, Pistone T, Pasquini L, Wise AB, Staffaroni AM, Luisa Mandelli M, Lee SE, Boxer AL, Rankin KP, Rabinovici GD, Luisa Gorno Tempini M, Rosen HJ, Kramer JH, Miller BL, Seeley WW. Functional network collapse in neurodegenerative disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.01.569654. [PMID: 38106054 PMCID: PMC10723363 DOI: 10.1101/2023.12.01.569654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Cognitive and behavioral deficits in Alzheimer's disease (AD) and frontotemporal dementia (FTD) result from brain atrophy and altered functional connectivity. However, it is unclear how atrophy relates to functional connectivity disruptions across dementia subtypes and stages. We addressed this question using structural and functional MRI from 221 patients with AD (n=82), behavioral variant FTD (n=41), corticobasal syndrome (n=27), nonfluent (n=34) and semantic (n=37) variant primary progressive aphasia, and 100 cognitively normal individuals. Using partial least squares regression, we identified three principal structure-function components. The first component showed overall atrophy correlating with primary cortical hypo-connectivity and subcortical/association cortical hyper-connectivity. Components two and three linked focal syndrome-specific atrophy to peri-lesional hypo-connectivity and distal hyper-connectivity. Structural and functional component scores predicted global and domain-specific cognitive deficits. Anatomically, functional connectivity changes reflected alterations in specific brain activity gradients. Eigenmode analysis identified temporal phase and amplitude collapse as an explanation for atrophy-driven functional connectivity changes.
Collapse
Affiliation(s)
- Jesse A. Brown
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Alex J. Lee
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Kristen Fernhoff
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Taylor Pistone
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Lorenzo Pasquini
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Amy B. Wise
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Adam M. Staffaroni
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Maria Luisa Mandelli
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Suzee E. Lee
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Adam L. Boxer
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Katherine P. Rankin
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Gil D. Rabinovici
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Maria Luisa Gorno Tempini
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Howard J. Rosen
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Joel H. Kramer
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Bruce L. Miller
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - William W. Seeley
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, San Francisco, CA, USA
| | | |
Collapse
|
14
|
Eldaief MC, Brickhouse M, Katsumi Y, Rosen H, Carvalho N, Touroutoglou A, Dickerson BC. Atrophy in behavioural variant frontotemporal dementia spans multiple large-scale prefrontal and temporal networks. Brain 2023; 146:4476-4485. [PMID: 37201288 PMCID: PMC10629759 DOI: 10.1093/brain/awad167] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/10/2023] [Accepted: 04/16/2023] [Indexed: 05/20/2023] Open
Abstract
The identification of a neurodegenerative disorder's distributed pattern of atrophy-or atrophy 'signature'-can lend insights into the cortical networks that degenerate in individuals with specific constellations of symptoms. In addition, this signature can be used as a biomarker to support early diagnoses and to potentially reveal pathological changes associated with said disorder. Here, we characterized the cortical atrophy signature of behavioural variant frontotemporal dementia (bvFTD). We used a data-driven approach to estimate cortical thickness using surface-based analyses in two independent, sporadic bvFTD samples (n = 30 and n = 71, total n = 101), using age- and gender-matched cognitively and behaviourally normal individuals. We found highly similar patterns of cortical atrophy across the two independent samples, supporting the reliability of our bvFTD signature. Next, we investigated whether our bvFTD signature targets specific large-scale cortical networks, as is the case for other neurodegenerative disorders. We specifically asked whether the bvFTD signature topographically overlaps with the salience network, as previous reports have suggested. We hypothesized that because phenotypic presentations of bvFTD are diverse, this would not be the case, and that the signature would cross canonical network boundaries. Consistent with our hypothesis, the bvFTD signature spanned rostral portions of multiple networks, including the default mode, limbic, frontoparietal control and salience networks. We then tested whether the signature comprised multiple anatomical subtypes, which themselves overlapped with specific networks. To explore this, we performed a hierarchical clustering analysis. This yielded three clusters, only one of which extensively overlapped with a canonical network (the limbic network). Taken together, these findings argue against the hypothesis that the salience network is preferentially affected in bvFTD, but rather suggest that-at least in patients who meet diagnostic criteria for the full-blown syndrome-neurodegeneration in bvFTD encompasses a distributed set of prefrontal, insular and anterior temporal nodes of multiple large-scale brain networks, in keeping with the phenotypic diversity of this disorder.
Collapse
Affiliation(s)
- Mark C Eldaief
- Frontotemporal Disorders Unit and Alzheimer’s Disease Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Center for Brain Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Michael Brickhouse
- Frontotemporal Disorders Unit and Alzheimer’s Disease Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Yuta Katsumi
- Frontotemporal Disorders Unit and Alzheimer’s Disease Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Howard Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Nicole Carvalho
- Frontotemporal Disorders Unit and Alzheimer’s Disease Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Alexandra Touroutoglou
- Frontotemporal Disorders Unit and Alzheimer’s Disease Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Bradford C Dickerson
- Frontotemporal Disorders Unit and Alzheimer’s Disease Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| |
Collapse
|
15
|
Sokołowski A, Roy ARK, Goh SM, Hardy EG, Datta S, Cobigo Y, Brown JA, Spina S, Grinberg L, Kramer J, Rankin KP, Seeley WW, Sturm VE, Rosen HJ, Miller BL, Perry DC. Neuropsychiatric symptoms and imbalance of atrophy in behavioral variant frontotemporal dementia. Hum Brain Mapp 2023; 44:5013-5029. [PMID: 37471695 PMCID: PMC10502637 DOI: 10.1002/hbm.26428] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/25/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
Behavioral variant frontotemporal dementia is characterized by heterogeneous frontal, insular, and anterior temporal atrophy patterns that vary along left-right and dorso-ventral axes. Little is known about how these structural imbalances impact clinical symptomatology. The goal of this study was to assess the frequency of frontotemporal asymmetry (right- or left-lateralization) and dorsality (ventral or dorsal predominance of atrophy) and to investigate their clinical correlates. Neuropsychiatric symptoms and structural images were analyzed for 250 patients with behavioral variant frontotemporal dementia. Frontotemporal atrophy was most often symmetric while left-lateralized (9%) and right-lateralized (17%) atrophy were present in a minority of patients. Atrophy was more often ventral (32%) than dorsal (3%) predominant. Patients with right-lateralized atrophy were characterized by higher severity of abnormal eating behavior and hallucinations compared to those with left-lateralized atrophy. Subsequent analyses clarified that eating behavior was associated with right atrophy to a greater extent than a lack of left atrophy, and hallucinations were driven mainly by right atrophy. Dorsality analyses showed that anxiety, euphoria, and disinhibition correlated with ventral-predominant atrophy. Agitation, irritability, and depression showed greater severity with a lack of regional atrophy, including in dorsal regions. Aberrant motor behavior and apathy were not explained by asymmetry or dorsality. This study provides additional insight into how anatomical heterogeneity influences the clinical presentation of patients with behavioral variant frontotemporal dementia. Behavioral symptoms can be associated not only with the presence or absence of focal atrophy, but also with right/left or dorsal/ventral imbalance of gray matter volume.
Collapse
Affiliation(s)
- Andrzej Sokołowski
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Ashlin R. K. Roy
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Sheng‐Yang M. Goh
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Emily G. Hardy
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Samir Datta
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Jesse A. Brown
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Salvatore Spina
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Lea Grinberg
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Joel Kramer
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - William W. Seeley
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Department of PathologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Virginia E. Sturm
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - David C. Perry
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| |
Collapse
|
16
|
Ohm DT, Rhodes E, Bahena A, Capp N, Lowe M, Sabatini P, Trotman W, Olm CA, Phillips J, Prabhakaran K, Rascovsky K, Massimo L, McMillan C, Gee J, Tisdall MD, Yushkevich PA, Lee EB, Grossman M, Irwin DJ. Neuroanatomical and cellular degeneration associated with a social disorder characterized by new ritualistic belief systems in a TDP-C patient vs. a Pick patient. Front Neurol 2023; 14:1245886. [PMID: 37900607 PMCID: PMC10600461 DOI: 10.3389/fneur.2023.1245886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/15/2023] [Indexed: 10/31/2023] Open
Abstract
Frontotemporal dementia (FTD) is a spectrum of clinically and pathologically heterogenous neurodegenerative dementias. Clinical and anatomical variants of FTD have been described and associated with underlying frontotemporal lobar degeneration (FTLD) pathology, including tauopathies (FTLD-tau) or TDP-43 proteinopathies (FTLD-TDP). FTD patients with predominant degeneration of anterior temporal cortices often develop a language disorder of semantic knowledge loss and/or a social disorder often characterized by compulsive rituals and belief systems corresponding to predominant left or right hemisphere involvement, respectively. The neural substrates of these complex social disorders remain unclear. Here, we present a comparative imaging and postmortem study of two patients, one with FTLD-TDP (subtype C) and one with FTLD-tau (subtype Pick disease), who both developed new rigid belief systems. The FTLD-TDP patient developed a complex set of values centered on positivity and associated with specific physical and behavioral features of pigs, while the FTLD-tau patient developed compulsive, goal-directed behaviors related to general themes of positivity and spirituality. Neuroimaging showed left-predominant temporal atrophy in the FTLD-TDP patient and right-predominant frontotemporal atrophy in the FTLD-tau patient. Consistent with antemortem cortical atrophy, histopathologic examinations revealed severe loss of neurons and myelin predominantly in the anterior temporal lobes of both patients, but the FTLD-tau patient showed more bilateral, dorsolateral involvement featuring greater pathology and loss of projection neurons and deep white matter. These findings highlight that the regions within and connected to anterior temporal lobes may have differential vulnerability to distinct FTLD proteinopathies and serve important roles in human belief systems.
Collapse
Affiliation(s)
- Daniel T. Ohm
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Emma Rhodes
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Alejandra Bahena
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Noah Capp
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - MaKayla Lowe
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Philip Sabatini
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Winifred Trotman
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher A. Olm
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Jeffrey Phillips
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Karthik Prabhakaran
- Penn Image Computing and Science Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Lauren Massimo
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Corey McMillan
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - James Gee
- Penn Image Computing and Science Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - M. Dylan Tisdall
- Center for Advanced Magnetic Resonance Imaging and Spectroscopy, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Paul A. Yushkevich
- Penn Image Computing and Science Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Edward B. Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - David J. Irwin
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
17
|
Vogel JW, Corriveau-Lecavalier N, Franzmeier N, Pereira JB, Brown JA, Maass A, Botha H, Seeley WW, Bassett DS, Jones DT, Ewers M. Connectome-based modelling of neurodegenerative diseases: towards precision medicine and mechanistic insight. Nat Rev Neurosci 2023; 24:620-639. [PMID: 37620599 DOI: 10.1038/s41583-023-00731-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/26/2023]
Abstract
Neurodegenerative diseases are the most common cause of dementia. Although their underlying molecular pathologies have been identified, there is substantial heterogeneity in the patterns of progressive brain alterations across and within these diseases. Recent advances in neuroimaging methods have revealed that pathological proteins accumulate along specific macroscale brain networks, implicating the network architecture of the brain in the system-level pathophysiology of neurodegenerative diseases. However, the extent to which 'network-based neurodegeneration' applies across the wide range of neurodegenerative disorders remains unclear. Here, we discuss the state-of-the-art of neuroimaging-based connectomics for the mapping and prediction of neurodegenerative processes. We review findings supporting brain networks as passive conduits through which pathological proteins spread. As an alternative view, we also discuss complementary work suggesting that network alterations actively modulate the spreading of pathological proteins between connected brain regions. We conclude this Perspective by proposing an integrative framework in which connectome-based models can be advanced along three dimensions of innovation: incorporating parameters that modulate propagation behaviour on the basis of measurable biological features; building patient-tailored models that use individual-level information and allowing model parameters to interact dynamically over time. We discuss promises and pitfalls of these strategies for improving disease insights and moving towards precision medicine.
Collapse
Affiliation(s)
- Jacob W Vogel
- Department of Clinical Sciences, SciLifeLab, Lund University, Lund, Sweden.
| | - Nick Corriveau-Lecavalier
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Acadamy, University of Gothenburg, Mölndal and Gothenburg, Sweden
| | - Joana B Pereira
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Neuro Division, Department of Clinical Neurosciences, Karolinska Institute, Stockholm, Sweden
| | - Jesse A Brown
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Anne Maass
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, CA, USA
| | - Dani S Bassett
- Departments of Bioengineering, Electrical and Systems Engineering, Physics and Astronomy, Neurology and Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Santa Fe Institute, Santa Fe, NM, USA
| | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.
| |
Collapse
|
18
|
Brown A, Salo SK, Savage G. Frontal variant Alzheimer's disease: A systematic narrative synthesis. Cortex 2023; 166:121-153. [PMID: 37356113 DOI: 10.1016/j.cortex.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 01/03/2023] [Accepted: 05/22/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Frontal variant Alzheimer's disease (fvAD) is considered a rare form of Alzheimer's disease (AD) which may be misdiagnosed as behavioural variant frontotemporal dementia (bvFTD). The literature has tended to conflate behavioural and executive dysfunction in fvAD cohorts and uses both AD diagnostic criteria and bvFTD diagnostic criteria to classify fvAD cohorts. The primary aim of this narrative synthesis was to summarise neuropsychological findings in fvAD cohorts in the context of established AD pathology. METHODS EMBASE, PsycINFO, PROQUEST and MEDLINE databases were searched for studies eligible for inclusion. Studies with both neuropsychological and biomarker evidence were included in the final narrative synthesis. RESULTS Ten studies were reviewed, including samples totalling 342 fvAD participants, 178 typical AD participants and 250 bvFTD participants. The review revealed areas worthy of further investigation that may aid differential diagnosis, including the degree of executive dysfunction in fvAD cohorts relative to bvFTD cohorts, the onset of behavioural and cognitive symptomatology, and similarities between fvAD and typical AD cognitive profiles. CONCLUSION There was insufficient neuropsychological evidence to clearly differentiate fvAD and bvFTD cognitive phenotypes, however, the review has highlighted distinctive features of the two disorders that may guide differential diagnosis in future research. Moreover, the review has highlighted issues involving disparate diagnostic criteria used to classify fvAD cohorts, contributing to variation in findings.
Collapse
Affiliation(s)
- Andrea Brown
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Sarah K Salo
- Department of Psychology, Swansea University, Swansea, UK; School of Psychology, University of Plymouth, Plymouth, UK
| | - Greg Savage
- School of Psychological Sciences, Macquarie University, Sydney, Australia.
| |
Collapse
|
19
|
Shen T, Vogel JW, Duda J, Phillips JS, Cook PA, Gee J, Elman L, Quinn C, Amado DA, Baer M, Massimo L, Grossman M, Irwin DJ, McMillan CT. Novel data-driven subtypes and stages of brain atrophy in the ALS-FTD spectrum. RESEARCH SQUARE 2023:rs.3.rs-3183113. [PMID: 37609205 PMCID: PMC10441467 DOI: 10.21203/rs.3.rs-3183113/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Background TDP-43 proteinopathies represents a spectrum of neurological disorders, anchored clinically on either end by amyotrophic lateral sclerosis (ALS) and frontotemporal degeneration (FTD). The ALS-FTD spectrum exhibits a diverse range of clinical presentations with overlapping phenotypes, highlighting its heterogeneity. This study aimed to use disease progression modeling to identify novel data-driven spatial and temporal subtypes of brain atrophy and its progression in the ALS-FTD spectrum. Methods We used a data-driven procedure to identify 13 anatomic clusters of brain volumes for 57 behavioral variant FTD (bvFTD; with either autopsy-confirmed TDP-43 or TDP-43 proteinopathy-associated genetic variants), 103 ALS, and 47 ALS-FTD patients with likely TDP-43. A Subtype and Stage Inference (SuStaIn) model was trained to identify subtypes of individuals along the ALS-FTD spectrum with distinct brain atrophy patterns, and we related subtypes and stages to clinical, genetic, and neuropathological features of disease. Results SuStaIn identified three novel subtypes: two disease subtypes with predominant brain atrophy either in prefrontal/somatomotor regions or limbic-related regions, and a normal-appearing group without obvious brain atrophy. The Limbic-predominant subtype tended to present with more impaired cognition, higher frequencies of pathogenic variants in TBK1 and TARDBP genes, and a higher proportion of TDP-43 type B, E and C. In contrast, the Prefrontal/Somatomotor-predominant subtype had higher frequencies of pathogenic variants in C9orf72 and GRN genes and higher proportion of TDP-43 type A. The normal-appearing brain group showed higher frequency of ALS relative to ALS-FTD and bvFTD patients, higher cognitive capacity, higher proportion of lower motor neuron onset, milder motor symptoms, and lower frequencies of genetic pathogenic variants. Overall SuStaIn stages also correlated with evidence for clinical progression including longer disease duration, higher King's stage, and cognitive decline. Additionally, SuStaIn stages differed across clinical phenotypes, genotypes and types of TDP-43 pathology. Conclusions Our findings suggest distinct neurodegenerative subtypes of disease along the ALS-FTD spectrum that can be identified in vivo, each with distinct brain atrophy, clinical, genetic and pathological patterns.
Collapse
Affiliation(s)
- Ting Shen
- University of Pennsylvania Perelman School of Medicine
| | | | - Jeffrey Duda
- University of Pennsylvania Perelman School of Medicine
| | | | - Philip A Cook
- University of Pennsylvania Perelman School of Medicine
| | - James Gee
- University of Pennsylvania Perelman School of Medicine
| | - Lauren Elman
- University of Pennsylvania Perelman School of Medicine
| | - Colin Quinn
- University of Pennsylvania Perelman School of Medicine
| | - Defne A Amado
- University of Pennsylvania Perelman School of Medicine
| | - Michael Baer
- University of Pennsylvania Perelman School of Medicine
| | | | | | - David J Irwin
- University of Pennsylvania Perelman School of Medicine
| | | |
Collapse
|
20
|
Toller G, Cobigo Y, Callahan P, Appleby BS, Brushaber D, Domoto-Reilly K, Forsberg LK, Ghoshal N, Graff-Radford J, Graff-Radford NR, Grossman M, Heuer HW, Kornak J, Kremers W, Lapid MI, Leger G, Litvan I, Mackenzie IR, Pascual MB, Ramos EM, Rascovsky K, Rojas JC, Staffaroni AM, Tartaglia MC, Toga A, Weintraub S, Wszolek ZK, Boeve BF, Boxer AL, Rosen HJ, Rankin KP. Multisite ALLFTD study modeling progressive empathy loss from the earliest stages of behavioral variant frontotemporal dementia. Alzheimers Dement 2023; 19:2842-2852. [PMID: 36591730 PMCID: PMC10314956 DOI: 10.1002/alz.12898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/19/2022] [Accepted: 10/27/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Empathy relies on fronto-cingular and temporal networks that are selectively vulnerable in behavioral variant frontotemporal dementia (bvFTD). This study modeled when in the disease process empathy changes begin, and how they progress. METHODS Four hundred thirty-one individuals with asymptomatic genetic FTD (n = 114), genetic and sporadic bvFTD (n = 317), and 163 asymptomatic non-carrier controls were enrolled. In sub-samples, we investigated empathy measured by the informant-based Interpersonal Reactivity Index (IRI) at each disease stage and over time (n = 91), and its correspondence to underlying atrophy (n = 51). RESULTS Empathic concern (estimate = 4.38, 95% confidence interval [CI] = 2.79, 5.97; p < 0.001) and perspective taking (estimate = 5.64, 95% CI = 3.81, 7.48; p < 0.001) scores declined between the asymptomatic and very mild symptomatic stages regardless of pathogenic variant status. More rapid loss of empathy corresponded with subcortical atrophy. DISCUSSION Loss of empathy is an early and progressive symptom of bvFTD that is measurable by IRI informant ratings and can be used to monitor behavior in neuropsychiatry practice and treatment trials.
Collapse
Affiliation(s)
- Gianina Toller
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, San Francisco, CA, USA
| | - Yann Cobigo
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, San Francisco, CA, USA
| | - Patrick Callahan
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, San Francisco, CA, USA
| | | | | | | | | | | | | | | | | | - Hilary W. Heuer
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, San Francisco, CA, USA
| | - John Kornak
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, San Francisco, CA, USA
| | | | | | - Gabriel Leger
- University of California, San Diego, San Diego, CA, USA
| | - Irene Litvan
- University of California, San Diego, San Diego, CA, USA
| | - Ian R. Mackenzie
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | - Julio C. Rojas
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, San Francisco, CA, USA
| | - Adam M. Staffaroni
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, San Francisco, CA, USA
| | | | - Arthur Toga
- University of Southern California, Los Angeles, CA, USA
| | - Sandra Weintraub
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | | | | | - Adam L. Boxer
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, San Francisco, CA, USA
| | - Howard J. Rosen
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, San Francisco, CA, USA
| | - Katherine P. Rankin
- University of California, San Francisco, Memory and Aging Center, Department of Neurology, San Francisco, CA, USA
| |
Collapse
|
21
|
Rijpma MG, Montembeault M, Shdo S, Kramer JH, Miller BL, Rankin KP. Semantic knowledge of social interactions is mediated by the hedonic evaluation system in the brain. Cortex 2023; 161:26-37. [PMID: 36878098 PMCID: PMC10365613 DOI: 10.1016/j.cortex.2022.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/20/2022] [Accepted: 12/14/2022] [Indexed: 02/10/2023]
Abstract
Attaching semantic meaning to sensory information received from both inside and outside our bodies is a fundamental function of the human brain. The theory of Controlled Semantic Cognition (CSC) proposes that the formation of semantic knowledge relies on connections between spatially distributed modality-specific spoke-nodes, and a modality-general hub in the anterior temporal lobes (ATLs). This theory can also be applied to social semantic knowledge, though certain domain-specific spoke-nodes may make a disproportionate contribution to the understanding of social concepts. The ATLs have strong connections with spoke-node structures such as the subgenual ACC (sgACC) and the orbitofrontal cortex (OFC) that play an important role in predicting the hedonic value of stimuli. We hypothesized that in addition to the ATL semantic hub, a social semantic task would also require input from hedonic evaluation structures. We used voxel based morphometry (VBM) to examine structural brain-behavior relationships in 152 patients with neurodegeneration (Alzheimer's disease [N = 12], corticobasal syndrome (N = 18], progressive supranuclear palsy [N = 13], behavioral variant frontotemporal dementia [N = 56], and primary progressive aphasia (PPA) [N = 53]) using the Social Interaction Vocabulary Task (SIVT). This task measures the ability to correctly match a social term (e.g. "gossiping") with a visual depiction of that social interaction. As predicted, VBM showed that worse SIVT scores corresponded with volume loss in bilateral ATL semantic hub regions, but also in the sgACC, OFC, caudate and putamen (pFWE <0.05). These results support the CSC model of a hub-and-spoke organization of social semantic knowledge with the ATL as a domain-general semantic hub, and ventromedial and striatal structures as domain specific spoke-nodes. Importantly, these results suggest that correct comprehension of social semantic concepts requires emotional 'tagging' of a concept by the evaluation system, and that the social deficits observed in some neurodegenerative disease syndromes may be caused by the break-down of this mechanism.
Collapse
Affiliation(s)
- Myrthe G Rijpma
- Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Ln, Suite 190, USA.
| | - Maxime Montembeault
- Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Ln, Suite 190, USA
| | - Suzanne Shdo
- Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Ln, Suite 190, USA
| | - Joel H Kramer
- Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Ln, Suite 190, USA
| | - Bruce L Miller
- Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Ln, Suite 190, USA
| | - Katherine P Rankin
- Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Ln, Suite 190, USA
| |
Collapse
|
22
|
Godefroy V, Sezer I, Bouzigues A, Montembeault M, Koban L, Plassmann H, Migliaccio R. Altered delay discounting in neurodegeneration: insight into the underlying mechanisms and perspectives for clinical applications. Neurosci Biobehav Rev 2023; 146:105048. [PMID: 36669749 DOI: 10.1016/j.neubiorev.2023.105048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/12/2022] [Accepted: 01/14/2023] [Indexed: 01/19/2023]
Abstract
Steeper delay discounting (i.e., the extent to which future rewards are perceived as less valuable than immediate ones) has been proposed as a transdiagnostic process across different health conditions, in particular psychiatric disorders. Impulsive decision-making is a hallmark of different neurodegenerative conditions but little is known about delay discounting in the domain of neurodegenerative conditions. We reviewed studies on delay discounting in patients with Parkinson's disease (PD) and in patients with dementia (Alzheimer's disease / AD or frontotemporal dementia / FTD). We proposed that delay discounting could be an early marker of the neurodegenerative process. We developed the idea that altered delay discounting is associated with overlapping but distinct neurocognitive mechanisms across neurodegenerative diseases: dopaminergic-related disorders of reward processing in PD, memory/projection deficits due to medial temporal atrophy in AD, modified reward processing due to orbitofrontal atrophy in FTD. Neurodegeneration could provide a framework to decipher the neuropsychological mechanisms of value-based decision-making. Further, delay discounting could become a marker of interest in clinical practice, in particular for differential diagnosis.
Collapse
Affiliation(s)
- Valérie Godefroy
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France; Marketing Area, INSEAD, Fontainebleau, France; Control-Interoception-Attention Team, Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Sorbonne University, Paris, France.
| | - Idil Sezer
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France
| | - Arabella Bouzigues
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France
| | - Maxime Montembeault
- Douglas Research Centre, Montréal, Canada; Department of Psychiatry, McGill University, Montréal, Canada
| | - Leonie Koban
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, Bron, France
| | - Hilke Plassmann
- Marketing Area, INSEAD, Fontainebleau, France; Control-Interoception-Attention Team, Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Sorbonne University, Paris, France
| | - Raffaella Migliaccio
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France; Centre de Référence des Démences Rares ou Précoces, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Institute of Memory and Alzheimer's Disease, Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
| |
Collapse
|
23
|
Tanguy D, Rametti-Lacroux A, Bouzigues A, Saracino D, Le Ber I, Godefroy V, Morandi X, Jannin P, Levy R, Batrancourt B, Migliaccio R, Azuar C, Dubois B, Lecouturier K, Araujo CM, Janvier E, Jourdain A, Rametti-Lacroux A, Coriou S, Brochard VB, Gaudebout C, Ferrand-Verdejo J, Bonnefous L, Pochan-Leva F, Jeanne L, Joulié M, Provost M, Renaud R, Hachemi S, Guillemot V, Bendetowicz D, Carle G, Socha J, Pineau F, Marin F, Liu Y, Mullot P, Mousli A, Blossier A, Visentin G, Tanguy D, Godefroy V, Sezer I, Boucly M, Cabrol-Douat B, Odobez R, Marque C, Tessereau-Barbot D, Raud A, Funkiewiez A, Chamayou C, Cognat E, Le Bozec M, Bouzigues A, Le Du V, Bombois S, Simard C, Fulcheri P, Guitton H, Peltier C, Lejeune FX, Jorgensen L, Mariani LL, Corvol JC, Valero-Cabre A, Garcin B, Volle E, Le Ber I, Migliaccio R, Levy R. Behavioural disinhibition in frontotemporal dementia investigated within an ecological framework. Cortex 2023; 160:152-166. [PMID: 36658040 DOI: 10.1016/j.cortex.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 09/29/2022] [Accepted: 11/09/2022] [Indexed: 12/29/2022]
Abstract
Disinhibition is a core symptom in behavioural variant frontotemporal dementia (bvFTD) particularly affecting the daily lives of both patients and caregivers. Yet, characterisation of inhibition disorders is still unclear and management options of these disorders are limited. Questionnaires currently used to investigate behavioural disinhibition do not differentiate between several subtypes of disinhibition, encompass observation biases and lack of ecological validity. In the present work, we explored disinhibition in an original semi-ecological situation, by distinguishing three categories of disinhibition: compulsivity, impulsivity and social disinhibition. First, we measured prevalence and frequency of these disorders in 23 bvFTD patients and 24 healthy controls (HC) in order to identify the phenotypical heterogeneity of disinhibition. Then, we examined the relationships between these metrics, the neuropsychological scores and the behavioural states to propose a more comprehensive view of these neuropsychiatric manifestations. Finally, we studied the context of occurrence of these disorders by investigating environmental factors potentially promoting or reducing them. As expected, we found that patients were more compulsive, impulsive and socially disinhibited than HC. We found that 48% of patients presented compulsivity (e.g., repetitive actions), 48% impulsivity (e.g., oral production) and 100% of the patients group showed social disinhibition (e.g., disregards for rules or investigator). Compulsivity was negatively related with emotions recognition. BvFTD patients were less active if not encouraged in an activity, and their social disinhibition decreased as activity increased. Finally, impulsivity and social disinhibition decreased when patients were asked to focus on a task. Summarising, this study underlines the importance to differentiate subtypes of disinhibition as well as the setting in which they are exhibited, and points to stimulating area for non-pharmacological management.
Collapse
Affiliation(s)
- Delphine Tanguy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Armelle Rametti-Lacroux
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Arabella Bouzigues
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Dario Saracino
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtriѐre, Department of Neurology, IM2A, Paris, France
| | - Isabelle Le Ber
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtriѐre, Department of Neurology, IM2A, Paris, France
| | - Valérie Godefroy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Xavier Morandi
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Pierre Jannin
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Richard Levy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France; AP-HP, Groupe Hospitalier Pitié-Salpêtriѐre, Department of Neurology, IM2A, Paris, France
| | - Bénédicte Batrancourt
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France.
| | - Raffaella Migliaccio
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtriѐre, Department of Neurology, IM2A, Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Addition of the FTD Module to the Neuropsychiatric Inventory improves classification of frontotemporal dementia spectrum disorders. J Neurol 2023; 270:2674-2687. [PMID: 36811680 PMCID: PMC10129920 DOI: 10.1007/s00415-023-11596-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/24/2023]
Abstract
Most neuropsychiatric symptoms (NPS) common in frontotemporal dementia (FTD) are currently not part of the Neuropsychiatric Inventory (NPI). We piloted an FTD Module that included eight extra items to be used in conjunction with the NPI. Caregivers of patients with behavioural variant FTD (n = 49), primary progressive aphasia (PPA; n = 52), Alzheimer's dementia (AD; n = 41), psychiatric disorders (n = 18), presymptomatic mutation carriers (n = 58) and controls (n = 58) completed the NPI and FTD Module. We investigated (concurrent and construct) validity, factor structure and internal consistency of the NPI and FTD Module. We performed group comparisons on item prevalence, mean item and total NPI and NPI with FTD Module scores, and multinomial logistic regression to determine its classification abilities. We extracted four components, together explaining 64.1% of the total variance, of which the largest indicated the underlying dimension 'frontal-behavioural symptoms'. Whilst apathy (original NPI) occurred most frequently in AD, logopenic and non-fluent variant PPA, the most common NPS in behavioural variant FTD and semantic variant PPA were loss of sympathy/empathy and poor response to social/emotional cues (part of FTD Module). Patients with primary psychiatric disorders and behavioural variant FTD showed the most severe behavioural problems on both the NPI as well as the NPI with FTD Module. The NPI with FTD Module correctly classified more FTD patients than the NPI alone. By quantifying common NPS in FTD the NPI with FTD Module has large diagnostic potential. Future studies should investigate whether it can also prove a useful addition to the NPI in therapeutic trials.
Collapse
|
25
|
Díaz-Rivera MN, Birba A, Fittipaldi S, Mola D, Morera Y, de Vega M, Moguilner S, Lillo P, Slachevsky A, González Campo C, Ibáñez A, García AM. Multidimensional inhibitory signatures of sentential negation in behavioral variant frontotemporal dementia. Cereb Cortex 2022; 33:403-420. [PMID: 35253864 PMCID: PMC9837611 DOI: 10.1093/cercor/bhac074] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Processing of linguistic negation has been associated to inhibitory brain mechanisms. However, no study has tapped this link via multimodal measures in patients with core inhibitory alterations, a critical approach to reveal direct neural correlates and potential disease markers. METHODS Here we examined oscillatory, neuroanatomical, and functional connectivity signatures of a recently reported Go/No-go negation task in healthy controls and behavioral variant frontotemporal dementia (bvFTD) patients, typified by primary and generalized inhibitory disruptions. To test for specificity, we also recruited persons with Alzheimer's disease (AD), a disease involving frequent but nonprimary inhibitory deficits. RESULTS In controls, negative sentences in the No-go condition distinctly involved frontocentral delta (2-3 Hz) suppression, a canonical inhibitory marker. In bvFTD patients, this modulation was selectively abolished and significantly correlated with the volume and functional connectivity of regions supporting inhibition (e.g. precentral gyrus, caudate nucleus, and cerebellum). Such canonical delta suppression was preserved in the AD group and associated with widespread anatomo-functional patterns across non-inhibitory regions. DISCUSSION These findings suggest that negation hinges on the integrity and interaction of spatiotemporal inhibitory mechanisms. Moreover, our results reveal potential neurocognitive markers of bvFTD, opening a new agenda at the crossing of cognitive neuroscience and behavioral neurology.
Collapse
Affiliation(s)
- Mariano N Díaz-Rivera
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,Agencia Nacional de Promoción Científica y Tecnológica (ANPCyT), C1425FQD, Godoy Cruz 2370, Buenos Aires, Argentina
| | - Agustina Birba
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina
| | - Sol Fittipaldi
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina
| | - Débora Mola
- Instituto de Investigaciones Psicológicas, CONICET, 5000, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Yurena Morera
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, Campus de Guajara, 38205 La Laguna, Santa Cruz de Tenerife, Spain
| | - Manuel de Vega
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, Campus de Guajara, 38205 La Laguna, Santa Cruz de Tenerife, Spain
| | - Sebastian Moguilner
- Global Brain Health Institute, University of California, San Francisco, CA94158, US; and Trinity College, Dublin D02DP21, , Ireland.,Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, 8320000, Santiago, Chile
| | - Patricia Lillo
- Departamento de Neurología Sur, Facultad de Medicina, Universidad de Chile, 8380000, Santiago, Chile.,Unidad de Neurología, Hospital San José, 8380000, Santiago, Chile.,Geroscience Center for Brain Health and Metabolism (GERO), 7800003, Santiago, Chile
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), 7800003, Santiago, Chile.,Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, Neuroscience and East Neuroscience Departments, Faculty of Medicine, Institute of Biomedical Sciences (ICBM), University of Chile, 8380000, Santiago, Chile.,Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, 7500000, Santiago, Chile.,Departamento de Medicina, Servicio de Neurología, Clínica Alemana-Universidad del Desarrollo, 7550000, Santiago, Chile
| | - Cecilia González Campo
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina
| | - Agustín Ibáñez
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina.,Global Brain Health Institute, University of California, San Francisco, CA94158, US; and Trinity College, Dublin D02DP21, , Ireland.,Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, 8320000, Santiago, Chile
| | - Adolfo M García
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina.,Global Brain Health Institute, University of California, San Francisco, CA94158, US; and Trinity College, Dublin D02DP21, , Ireland.,Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, 7550000, Santiago, Chile
| |
Collapse
|
26
|
Schievink WI, Maya M, Barnard Z, Taché RB, Prasad RS, Wadhwa VS, Moser FG, Nuño M. The reversible impairment of behavioral variant frontotemporal brain sagging syndrome: Challenges and opportunities. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12367. [PMID: 36544987 PMCID: PMC9760785 DOI: 10.1002/trc2.12367] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 12/23/2022]
Abstract
Introduction Due to loss of brain buoyancy, spontaneous spinal cerebrospinal fluid (CSF) leaks cause orthostatic headaches but also can cause symptoms indistinguishable from behavioral variant frontotemporal dementia (bvFTD) due to severe brain sagging (including the frontal and temporal lobes), as visualized on brain magnetic resonance imaging. However, the detection of these CSF leaks may require specialized spinal imaging techniques, such as digital subtraction myelography (DSM). Methods We performed DSM in the lateral decubitus position under general anesthesia in 21 consecutive patients with frontotemporal dementia brain sagging syndrome (4 women and 17 men; mean age 56.2 years [range: 31-70 years]). Results Nine patients (42.8%) were found to have a CSF-venous fistula, a recently discovered type of CSF leak that cannot be detected on conventional spinal imaging. All nine patients underwent uneventful surgical ligation of the fistula. Complete or near-complete and sustained resolution of bvFTD symptoms was obtained by all nine patients, accompanied by reversal of brain sagging, but in only three (25.0%) of the twelve patients in whom no CSF-venous fistula could be detected (P = 0.0011), and who were treated with non-targeted therapies. Discussion Concerns about a spinal CSF leak should not be dismissed in patients with frontotemporal brain sagging syndrome, even when conventional spinal imaging is normal. However, even with this specialized imaging the source of the loss of spinal CSF remains elusive in more than half of patients.
Collapse
Affiliation(s)
- Wouter I. Schievink
- Department of NeurosurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Marcel Maya
- Department of ImagingCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Zachary Barnard
- Department of NeurosurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Rachelle B. Taché
- Department of NeurosurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Ravi S. Prasad
- Department of ImagingCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Vikram S. Wadhwa
- Department of ImagingCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Franklin G. Moser
- Department of ImagingCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Miriam Nuño
- Department of Public Health SciencesUniversity of CaliforniaDavisCaliforniaUSA
| |
Collapse
|
27
|
Ferreira LK, Lindberg O, Santillo AF, Wahlund LO. Functional connectivity in behavioral variant frontotemporal dementia. Brain Behav 2022; 12:e2790. [PMID: 36306386 PMCID: PMC9759144 DOI: 10.1002/brb3.2790] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/13/2022] [Accepted: 09/24/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Functional connectivity (FC)-which reflects relationships between neural activity in different brain regions-has been used to explore the functional architecture of the brain in neurodegenerative disorders. Although an increasing number of studies have explored FC changes in behavioral variant frontotemporal dementia (bvFTD), there is no focused, in-depth review about FC in bvFTD. METHODS Comprehensive literature search and narrative review to summarize the current field of FC in bvFTD. RESULTS (1) Decreased FC within the salience network (SN) is the most consistent finding in bvFTD; (2) FC changes extend beyond the SN and affect the interplay between networks; (3) results within the Default Mode Network are mixed; (4) the brain as a network is less interconnected and less efficient in bvFTD; (5) symptoms, functional impairment, and cognition are associated with FC; and (6) the functional architecture resembles patterns of neuropathological spread. CONCLUSIONS FC has potential as a biomarker, and future studies are expected to advance the field with multicentric initiatives, longitudinal designs, and methodological advances.
Collapse
Affiliation(s)
- Luiz Kobuti Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden
| | - Olof Lindberg
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Alexander F Santillo
- Clinical Memory Research Unit and Psychiatry, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Lars-Olof Wahlund
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
28
|
Tan HHG, Westeneng H, Nitert AD, van Veenhuijzen K, Meier JM, van der Burgh HK, van Zandvoort MJE, van Es MA, Veldink JH, van den Berg LH. MRI Clustering Reveals Three ALS Subtypes With Unique Neurodegeneration Patterns. Ann Neurol 2022; 92:1030-1045. [PMID: 36054734 PMCID: PMC9826424 DOI: 10.1002/ana.26488] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The purpose of this study was to identify subtypes of amyotrophic lateral sclerosis (ALS) by comparing patterns of neurodegeneration using brain magnetic resonance imaging (MRI) and explore their phenotypes. METHODS We performed T1-weighted and diffusion tensor imaging in 488 clinically well-characterized patients with ALS and 338 control subjects. Measurements of whole-brain cortical thickness and white matter connectome fractional anisotropy were adjusted for disease-unrelated variation. A probabilistic network-based clustering algorithm was used to divide patients into subgroups of similar neurodegeneration patterns. Clinical characteristics and cognitive profiles were assessed for each subgroup. In total, 512 follow-up scans were used to validate clustering results longitudinally. RESULTS The clustering algorithm divided patients with ALS into 3 subgroups of 187, 163, and 138 patients. All subgroups displayed involvement of the precentral gyrus and are characterized, respectively, by (1) pure motor involvement (pure motor cluster [PM]), (2) orbitofrontal and temporal involvement (frontotemporal cluster [FT]), and (3) involvement of the posterior cingulate cortex, parietal white matter, temporal operculum, and cerebellum (cingulate-parietal-temporal cluster [CPT]). These subgroups had significantly distinct clinical profiles regarding male-to-female ratio, age at symptom onset, and frequency of bulbar symptom onset. FT and CPT revealed higher rates of cognitive impairment on the Edinburgh cognitive and behavioral ALS screen (ECAS). Longitudinally, clustering remained stable: at 90.4% of their follow-up visits, patients clustered in the same subgroup as their baseline visit. INTERPRETATION ALS can manifest itself in 3 main patterns of cerebral neurodegeneration, each associated with distinct clinical characteristics and cognitive profiles. Besides the pure motor and frontotemporal dementia (FTD)-like variants of ALS, a new neuroimaging phenotype has emerged, characterized by posterior cingulate, parietal, temporal, and cerebellar involvement. ANN NEUROL 2022;92:1030-1045.
Collapse
Affiliation(s)
- Harold H. G. Tan
- Department of Neurology, UMC Utrecht Brain Center University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Henk‐Jan Westeneng
- Department of Neurology, UMC Utrecht Brain Center University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Abram D. Nitert
- Department of Neurology, UMC Utrecht Brain Center University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Kevin van Veenhuijzen
- Department of Neurology, UMC Utrecht Brain Center University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Jil M. Meier
- Department of Neurology, UMC Utrecht Brain Center University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Hannelore K. van der Burgh
- Department of Neurology, UMC Utrecht Brain Center University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Martine J. E. van Zandvoort
- Department of Neurology, UMC Utrecht Brain Center University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands,Department of Experimental PsychologyUtrecht UniversityUtrechtThe Netherlands
| | - Michael A. van Es
- Department of Neurology, UMC Utrecht Brain Center University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Jan H. Veldink
- Department of Neurology, UMC Utrecht Brain Center University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Leonard H. van den Berg
- Department of Neurology, UMC Utrecht Brain Center University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| |
Collapse
|
29
|
Altered reward processing underpins emotional apathy in dementia. COGNITIVE, AFFECTIVE, & BEHAVIORAL NEUROSCIENCE 2022; 23:354-370. [PMID: 36417157 PMCID: PMC10049956 DOI: 10.3758/s13415-022-01048-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/24/2022]
Abstract
Abstract
Introduction
While apathy is broadly defined as a loss of motivation, it is increasingly recognised as a multidimensional syndrome spanning executive, emotional, and initiation domains. Emotional apathy is purportedly driven by deficits in using socioemotional rewards to guide behaviour, yet the link between these symptoms and reward processing, and their common neural correlates, has not been directly examined.
Methods
Sixty-four patients (33 behavioural-variant frontotemporal dementia, 14 Alzheimer’s disease, 8 semantic dementia, 6 progressive nonfluent aphasia, 3 logopenic progressive aphasia) were classified into high (HEA; n = 36) and low (LEA; n = 28) emotional apathy groups based on emotional apathy subscale scores on the Dimensional Apathy Scale. Patients and age-matched healthy controls (n = 27) performed an instrumental reward learning task where they learned to associate cues with either social or monetary outcomes.
Results
HEA patients showed impaired learning on both the social and monetary reward conditions, relative to LEA patients (p = 0.016) and controls (p = 0.005). Conversely, the LEA group did not differ from controls (p = 0.925). Importantly, multiple regression analyses indicated that social reward learning significantly predicted emotional apathy. Voxel-based morphometry analyses revealed that emotional apathy and social reward learning were both associated with orbitofrontal cortex, ventral striatum, and insula atrophy.
Discussion
Our results demonstrate a unique link between impaired social reward learning and emotional apathy in dementia and reveal a shared neurobiological basis. Greater understanding of these neurocognitive mechanisms of reward processing will help improve the identification of emotional apathy in dementia and inform the development of novel interventions to address these symptoms.
Collapse
|
30
|
Godefroy V, Batrancourt B, Charron S, Bouzigues A, Sezer I, Bendetowicz D, Carle G, Rametti-Lacroux A, Bombois S, Cognat E, Migliaccio R, Levy R. Disentangling Clinical Profiles of Apathy in Behavioral Variant Frontotemporal Dementia. J Alzheimers Dis 2022; 90:639-654. [PMID: 36155506 PMCID: PMC9697059 DOI: 10.3233/jad-220370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Apathy is highly frequent in behavioral variant frontotemporal dementia (bvFTD). It is presumed to involve different pathophysiological mechanisms and neuroanatomical regions. OBJECTIVE We explored the hypothesis that subgroups showing distinct profiles of apathy and distinct patterns of atrophy within frontal lobes could be disentangled in bvFTD. METHODS Using data-driven clustering applied to 20 bvFTD patients, we isolated subgroups according to their profiles on the three subscales of the Dimensional Apathy Scale (DAS). We explored their apathy profiles and atrophy patterns. Apathy profiles were characterized through both subjective measures of apathy by questionnaires and measures including objective behavioral metrics. Atrophy patterns were obtained by voxel-based morphometry, contrasting each bvFTD subgroup with healthy controls (N = 16). RESULTS By clustering based on DAS dimensions, we disentangled three subgroups of bvFTD patients, with distinct apathy profiles and atrophy patterns. One subgroup, which presented the smallest pattern of atrophy (including orbitofrontal cortex) with a right asymmetry, was characterized by high self-reported emotional and initiation apathy and by a self-initiation deficit reversible by external guidance. In other subgroups showing more diffuse bilateral atrophies extending to lateral prefrontal cortex, apathy was not reversible by external guidance and more difficulty to focus on goal-management was observed, especially in the subgroup with the largest atrophy and highest levels of executive apathy. CONCLUSION Distinct clinical profiles of apathy, corresponding to distinct anatomical subtypes of bvFTD, were identified. These findings have implications for clinicians in a perspective of precision medicine as they could contribute to personalize treatments of apathy.
Collapse
Affiliation(s)
- Valérie Godefroy
- Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Bénédicte Batrancourt
- Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Sylvain Charron
- INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, Paris, France.,Department of Neuroradiology, Hôpital Sainte-Anne, Université de Paris, Paris, France
| | - Arabella Bouzigues
- Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Idil Sezer
- Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - David Bendetowicz
- Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France.,Department of Neurology, IM2A, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Behavioural Neuropsychiatry Unit, AP-HP, Hôpital de la Salpêtrière, Paris, France
| | - Guilhem Carle
- Behavioural Neuropsychiatry Unit, AP-HP, Hôpital de la Salpêtrière, Paris, France
| | - Armelle Rametti-Lacroux
- Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Stéphanie Bombois
- Department of Neurology, IM2A, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Emmanuel Cognat
- UMRS 1144, INSERM, F-5010, Université de Paris, Paris, France.,Centre de Neurologie Cognitive, Hôpital Lariboisière Fernand-Widal, APHP Nord, Paris, France
| | - Raffaella Migliaccio
- Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France.,Department of Neurology, IM2A, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Behavioural Neuropsychiatry Unit, AP-HP, Hôpital de la Salpêtrière, Paris, France
| | - Richard Levy
- Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France.,Department of Neurology, IM2A, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Behavioural Neuropsychiatry Unit, AP-HP, Hôpital de la Salpêtrière, Paris, France
| |
Collapse
|
31
|
Pressman PS, Chen KH, Casey J, Sillau S, Chial HJ, Filley CM, Miller BL, Levenson RW. Incongruences Between Facial Expression and Self-Reported Emotional Reactivity in Frontotemporal Dementia and Related Disorders. J Neuropsychiatry Clin Neurosci 2022; 35:192-201. [PMID: 35989572 PMCID: PMC10723939 DOI: 10.1176/appi.neuropsych.21070186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Emotional reactivity normally involves a synchronized coordination of subjective experience and facial expression. These aspects of emotional reactivity can be uncoupled by neurological illness and produce adverse consequences for patient and caregiver quality of life because of misunderstandings regarding the patient's presumed internal state. Frontotemporal dementia (FTD) is often associated with altered social and emotional functioning. FTD is a heterogeneous disease, and socioemotional changes in patients could result from altered internal experience, altered facial expressive ability, altered language skills, or other factors. The authors investigated how individuals with FTD subtypes differ from a healthy control group regarding the extent to which their facial expressivity aligns with their self-reported emotional experience. METHODS Using a compound measure of emotional reactivity to assess reactions to three emotionally provocative videos, the authors explored potential explanations for differences in alignment of facial expressivity with emotional experience, including parkinsonism, physiological reactivity, and nontarget verbal responses. RESULTS Participants with the three main subtypes of FTD all tended to express less emotion on their faces than they did through self-report. CONCLUSIONS Exploratory analyses suggest that reasons for this incongruence likely differ not only between but also within diagnostic subgroups.
Collapse
Affiliation(s)
- Peter S Pressman
- Department of Neurology Behavioral Neurology Section (Pressman, Filley), Alzheimer's and Cognition Center (Pressman, Sillau, Chial), Linda Crnic Institute for Down Syndrome (Chial), and Marcus Institute for Brain Health (Filley), University of Colorado Anschutz Medical Campus, Aurora; Berkeley Psychophysiology Laboratory, University of California, Berkeley (Chen, Casey, Levenson); Memory and Aging Center, University of California, San Francisco (Miller)
| | - Kuan Hua Chen
- Department of Neurology Behavioral Neurology Section (Pressman, Filley), Alzheimer's and Cognition Center (Pressman, Sillau, Chial), Linda Crnic Institute for Down Syndrome (Chial), and Marcus Institute for Brain Health (Filley), University of Colorado Anschutz Medical Campus, Aurora; Berkeley Psychophysiology Laboratory, University of California, Berkeley (Chen, Casey, Levenson); Memory and Aging Center, University of California, San Francisco (Miller)
| | - James Casey
- Department of Neurology Behavioral Neurology Section (Pressman, Filley), Alzheimer's and Cognition Center (Pressman, Sillau, Chial), Linda Crnic Institute for Down Syndrome (Chial), and Marcus Institute for Brain Health (Filley), University of Colorado Anschutz Medical Campus, Aurora; Berkeley Psychophysiology Laboratory, University of California, Berkeley (Chen, Casey, Levenson); Memory and Aging Center, University of California, San Francisco (Miller)
| | - Stefan Sillau
- Department of Neurology Behavioral Neurology Section (Pressman, Filley), Alzheimer's and Cognition Center (Pressman, Sillau, Chial), Linda Crnic Institute for Down Syndrome (Chial), and Marcus Institute for Brain Health (Filley), University of Colorado Anschutz Medical Campus, Aurora; Berkeley Psychophysiology Laboratory, University of California, Berkeley (Chen, Casey, Levenson); Memory and Aging Center, University of California, San Francisco (Miller)
| | - Heidi J Chial
- Department of Neurology Behavioral Neurology Section (Pressman, Filley), Alzheimer's and Cognition Center (Pressman, Sillau, Chial), Linda Crnic Institute for Down Syndrome (Chial), and Marcus Institute for Brain Health (Filley), University of Colorado Anschutz Medical Campus, Aurora; Berkeley Psychophysiology Laboratory, University of California, Berkeley (Chen, Casey, Levenson); Memory and Aging Center, University of California, San Francisco (Miller)
| | - Christopher M Filley
- Department of Neurology Behavioral Neurology Section (Pressman, Filley), Alzheimer's and Cognition Center (Pressman, Sillau, Chial), Linda Crnic Institute for Down Syndrome (Chial), and Marcus Institute for Brain Health (Filley), University of Colorado Anschutz Medical Campus, Aurora; Berkeley Psychophysiology Laboratory, University of California, Berkeley (Chen, Casey, Levenson); Memory and Aging Center, University of California, San Francisco (Miller)
| | - Bruce L Miller
- Department of Neurology Behavioral Neurology Section (Pressman, Filley), Alzheimer's and Cognition Center (Pressman, Sillau, Chial), Linda Crnic Institute for Down Syndrome (Chial), and Marcus Institute for Brain Health (Filley), University of Colorado Anschutz Medical Campus, Aurora; Berkeley Psychophysiology Laboratory, University of California, Berkeley (Chen, Casey, Levenson); Memory and Aging Center, University of California, San Francisco (Miller)
| | - Robert W Levenson
- Department of Neurology Behavioral Neurology Section (Pressman, Filley), Alzheimer's and Cognition Center (Pressman, Sillau, Chial), Linda Crnic Institute for Down Syndrome (Chial), and Marcus Institute for Brain Health (Filley), University of Colorado Anschutz Medical Campus, Aurora; Berkeley Psychophysiology Laboratory, University of California, Berkeley (Chen, Casey, Levenson); Memory and Aging Center, University of California, San Francisco (Miller)
| |
Collapse
|
32
|
Bouzigues A, Russell LL, Peakman G, Bocchetta M, Greaves CV, Convery RS, Todd E, Rowe JB, Borroni B, Galimberti D, Tiraboschi P, Masellis M, Tartaglia MC, Finger E, van Swieten JC, Seelaar H, Jiskoot L, Sorbi S, Butler CR, Graff C, Gerhard A, Langheinrich T, Laforce R, Sanchez-Valle R, de Mendonça A, Moreno F, Synofzik M, Vandenberghe R, Ducharme S, Le Ber I, Levin J, Danek A, Otto M, Pasquier F, Santana I, Rohrer JD, Nelson A, Bouzigues A, Heller C, Greaves CV, Cash D, Thomas DL, Todd E, Benotmane H, Zetterberg H, Swift IJ, Nicholas J, Samra K, Russell LL, Bocchetta M, Shafei R, Convery RS, Timberlake C, Cope T, Rittman T, Benussi A, Premi E, Gasparotti R, Archetti S, Gazzina S, Cantoni V, Arighi A, Fenoglio C, Scarpini E, Fumagalli G, Borracci V, Rossi G, Giaccone G, Caroppo P, Tiraboschi P, Prioni S, Redaelli V, Tang-Wai D, Rogaeva E, Castelo-Branco M, Keren R, Black S, Mitchell S, Shoesmith C, Bartha R, Rademakers R, Poos J, Papma JM, Giannini L, Minkelen R, Pijnenburg Y, Nacmias B, Ferrari C, Polito C, Lombardi G, Bessi V, Veldsman M, Andersson C, Thonberg H, Öijerstedt L, Jelic V, Thompson P, Langheinrich T, Lladó A, Antonell A, Olives J, Balasa M, Bargalló N, Borrego-Ecija S, Verdelho A, Maruta C, Ferreira CB, Miltenberger G, do Couto FS, Gabilondo A, Gorostidi A, Villanua J, Cañada M, Tainta M, Zulaica M, Barandiaran M, Alves P, Bender B, Wilke C, Graf L, Vogels A, Vandenbulcke M, Van Damme P, Bruffaerts R, Poesen K, Rosa-Neto P, Gauthier S, Camuzat A, Brice A, Bertrand A, Funkiewiez A, Rinaldi D, Saracino D, Colliot O, Sayah S, Prix C, Wlasich E, Wagemann O, Loosli S, Schönecker S, Hoegen T, Lombardi J, Anderl-Straub S, Rollin A, Kuchcinski G, Bertoux M, Lebouvier T, Deramecourt V, Santiago B, Duro D, Leitão MJ, Almeida MR, Tábuas-Pereira M, Afonso S, Engel A, Polyakova M. Anomia is present pre-symptomatically in frontotemporal dementia due to MAPT mutations. J Neurol 2022; 269:4322-4332. [PMID: 35348856 PMCID: PMC9294015 DOI: 10.1007/s00415-022-11068-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION A third of frontotemporal dementia (FTD) is caused by an autosomal-dominant genetic mutation in one of three genes: microtubule-associated protein tau (MAPT), chromosome 9 open reading frame 72 (C9orf72) and progranulin (GRN). Prior studies of prodromal FTD have identified impaired executive function and social cognition early in the disease but few have studied naming in detail. METHODS We investigated performance on the Boston Naming Test (BNT) in the GENetic Frontotemporal dementia Initiative cohort of 499 mutation carriers and 248 mutation-negative controls divided across three genetic groups: C9orf72, MAPT and GRN. Mutation carriers were further divided into 3 groups according to their global CDR plus NACC FTLD score: 0 (asymptomatic), 0.5 (prodromal) and 1 + (fully symptomatic). Groups were compared using a bootstrapped linear regression model, adjusting for age, sex, language and education. Finally, we identified neural correlates of anomia within carriers of each genetic group using a voxel-based morphometry analysis. RESULTS All symptomatic groups performed worse on the BNT than controls with the MAPT symptomatic group scoring the worst. Furthermore, MAPT asymptomatic and prodromal groups performed significantly worse than controls. Correlates of anomia in MAPT mutation carriers included bilateral anterior temporal lobe regions and the anterior insula. Similar bilateral anterior temporal lobe involvement was seen in C9orf72 mutation carriers as well as more widespread left frontal atrophy. In GRN mutation carriers, neural correlates were limited to the left hemisphere, and involved frontal, temporal, insula and striatal regions. CONCLUSION This study suggests the development of early anomia in MAPT mutation carriers, likely to be associated with impaired semantic knowledge. Clinical trials focused on the prodromal period within individuals with MAPT mutations should use language tasks, such as the BNT for patient stratification and as outcome measures.
Collapse
Affiliation(s)
- Arabella Bouzigues
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Lucy L Russell
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Georgia Peakman
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Martina Bocchetta
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Caroline V Greaves
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Rhian S Convery
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Emily Todd
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - James B Rowe
- Trust and Medical Research Council Cognition and Brain Sciences Unit, Department of Clinical Neurosciences and Cambridge University Hospitals NHS, University of Cambridge, Cambridge, UK
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
| | | | - Harro Seelaar
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Lize Jiskoot
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Sandro Sorbi
- Department of Neurofarba, University of Florence, Florence, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Chris R Butler
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford, UK.,Department of Brain Sciences, Imperial College London, London, UK
| | - Caroline Graff
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Bioclinicum, Karolinska Institutet, Solna, Sweden.,Unit for Hereditary Dementias, Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK.,Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg, Essen, Germany
| | - Tobias Langheinrich
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK.,Cerebral Function Unit, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK
| | - Robert Laforce
- Département Des Sciences Neurologiques, Clinique Interdisciplinaire de Mémoire, CHU de Québec, and Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | | | - Fermin Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia University Hospital, San Sebastian, Gipuzkoa, Spain.,Neuroscience Area, Biodonostia Health Research Institute, Gipuzkoa, San Sebastian, Spain
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany.,Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium.,Neurology Service, University Hospitals Leuven, Leuven, Belgium.,Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Simon Ducharme
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada.,Department of Neurology & Neurosurgery, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Isabelle Le Ber
- Paris Brain Institute - Institut du Cerveau - ICM, Inserm U1127, CNRS UMR 7225, Sorbonne Université, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France.,Centre de Référence Des Démences Rares Ou Précoces, IM2A, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France.,Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France
| | - Johannes Levin
- Neurologische Klinik Und Poliklinik, Ludwig-Maximilians-Universität, Munich, Germany.,Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster of Systems Neurology, Munich, Germany
| | - Adrian Danek
- Neurologische Klinik Und Poliklinik, Ludwig-Maximilians-Universität, Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Florence Pasquier
- Univ Lille, Lille, France.,Inserm 1172, Lille, France.,CHU, CNR-MAJ, Labex Distalz, LiCEND Lille, Lille, France
| | - Isabel Santana
- Neurology Service, Faculty of Medicine, University Hospital of Coimbra (HUC), University of Coimbra, Coimbra, Portugal.,Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Jonathan D Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Why can spontaneous intracranial hypotension cause behavioral changes? A case report and multimodality neuroimaging comparison with frontotemporal dementia. Cortex 2022; 155:322-332. [DOI: 10.1016/j.cortex.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/26/2022] [Accepted: 07/30/2022] [Indexed: 11/22/2022]
|
34
|
Jenkins LM, Wang L, Rosen H, Weintraub S. A transdiagnostic review of neuroimaging studies of apathy and disinhibition in dementia. Brain 2022; 145:1886-1905. [PMID: 35388419 PMCID: PMC9630876 DOI: 10.1093/brain/awac133] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/18/2022] [Accepted: 03/13/2022] [Indexed: 11/12/2022] Open
Abstract
Apathy and disinhibition are common and highly distressing neuropsychiatric symptoms associated with negative outcomes in persons with dementia. This paper is a critical review of functional and structural neuroimaging studies of these symptoms transdiagnostically in dementia of the Alzheimer type, which is characterized by prominent amnesia early in the disease course, and behavioural variant frontotemporal dementia, characterized by early social-comportmental deficits. We describe the prevalence and clinical correlates of these symptoms and describe methodological issues, including difficulties with symptom definition and different measurement instruments. We highlight the heterogeneity of findings, noting however, a striking similarity of the set of brain regions implicated across clinical diagnoses and symptoms. These regions involve several key nodes of the salience network, and we describe the functions and anatomical connectivity of these brain areas, as well as present a new theoretical account of disinhibition in dementia. Future avenues for research are discussed, including the importance of transdiagnostic studies, measuring subdomains of apathy and disinhibition, and examining different units of analysis for deepening our understanding of the networks and mechanisms underlying these extremely distressing symptoms.
Collapse
Affiliation(s)
- Lisanne M Jenkins
- Correspondence to: Lisanne Jenkins 710 N Lakeshore Drive, Suite 1315 Chicago, IL 60611, USA E-mail:
| | - Lei Wang
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, OH 43210, USA
| | - Howie Rosen
- Weill Institute for Neurosciences, School of Medicine, University of California, San Francisco, CA, USA 94158
| | - Sandra Weintraub
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA,Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA 60611
| |
Collapse
|
35
|
Toller G, Mandelli ML, Cobigo Y, Rosen HJ, Kramer JH, Miller BL, Gorno-Tempini ML, Rankin KP. Right uncinate fasciculus supports socioemotional sensitivity in health and neurodegenerative disease. Neuroimage Clin 2022; 34:102994. [PMID: 35487131 PMCID: PMC9125782 DOI: 10.1016/j.nicl.2022.102994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/24/2022] [Accepted: 03/23/2022] [Indexed: 11/17/2022]
Abstract
The uncinate fasciculus (UF) connects fronto-insular and temporal gray matter regions involved in visceral emotional reactivity and semantic appraisal, but the precise role of this tract in socioemotional functioning is not well-understood. Using the Revised-Self Monitoring (RSMS) informant questionnaire, we examined whether fractional anisotropy (FA) in the right UF corresponded to socioemotional sensitivity during face-to-face interactions in 145 individuals (40 healthy older adults [NC], and 105 patients with frontotemporal lobar degeneration [FTLD] syndromes in whom this tract is selectively vulnerable, including 31 behavioral variant frontotemporal dementia [bvFTD], 39 semantic variant primary progressive aphasia [svPPA], and 35 nonfluent variant primary progressive aphasia [nfvPPA]). Voxelwise and region-of-interest-based DWI analyses revealed that FA in the right but not left UF significantly predicted RSMS score in the full sample, and in NC and svPPA subgroups alone. Right UF integrity did not predict RSMS score in the bvFTD group, but gray matter volume in the right orbitofrontal cortex adjacent to the UF was a significant predictor. Our results suggest that better socioemotional sensitivity is specifically supported by right UF white matter, highlighting a key neuro-affective relationship found in both healthy aging and neurologically affected individuals. The finding that poorer socioemotional sensitivity corresponded to right UF damage in svPPA but was more robustly influenced by gray matter atrophy adjacent to the UF in bvFTD may have important implications for endpoint selection in clinical trial design for patients with FTLD.
Collapse
Affiliation(s)
- Gianina Toller
- Memory and Aging Center, University of California, San Francisco, United States.
| | - Maria Luisa Mandelli
- Memory and Aging Center, University of California, San Francisco, United States.
| | - Yann Cobigo
- Memory and Aging Center, University of California, San Francisco, United States.
| | - Howard J Rosen
- Memory and Aging Center, University of California, San Francisco, United States.
| | - Joel H Kramer
- Memory and Aging Center, University of California, San Francisco, United States.
| | - Bruce L Miller
- Memory and Aging Center, University of California, San Francisco, United States.
| | | | - Katherine P Rankin
- Memory and Aging Center, University of California, San Francisco, United States.
| |
Collapse
|
36
|
Shafiei G, Bazinet V, Dadar M, Manera AL, Collins DL, Dagher A, Borroni B, Sanchez-Valle R, Moreno F, Laforce R, Graff C, Synofzik M, Galimberti D, Rowe JB, Masellis M, Tartaglia MC, Finger E, Vandenberghe R, de Mendonça A, Tagliavini F, Santana I, Butler C, Gerhard A, Danek A, Levin J, Otto M, Sorbi S, Jiskoot LC, Seelaar H, van Swieten JC, Rohrer JD, Misic B, Ducharme S. Network structure and transcriptomic vulnerability shape atrophy in frontotemporal dementia. Brain 2022; 146:321-336. [PMID: 35188955 PMCID: PMC9825569 DOI: 10.1093/brain/awac069] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/14/2021] [Accepted: 01/30/2022] [Indexed: 01/13/2023] Open
Abstract
Connections among brain regions allow pathological perturbations to spread from a single source region to multiple regions. Patterns of neurodegeneration in multiple diseases, including behavioural variant of frontotemporal dementia (bvFTD), resemble the large-scale functional systems, but how bvFTD-related atrophy patterns relate to structural network organization remains unknown. Here we investigate whether neurodegeneration patterns in sporadic and genetic bvFTD are conditioned by connectome architecture. Regional atrophy patterns were estimated in both genetic bvFTD (75 patients, 247 controls) and sporadic bvFTD (70 patients, 123 controls). First, we identified distributed atrophy patterns in bvFTD, mainly targeting areas associated with the limbic intrinsic network and insular cytoarchitectonic class. Regional atrophy was significantly correlated with atrophy of structurally- and functionally-connected neighbours, demonstrating that network structure shapes atrophy patterns. The anterior insula was identified as the predominant group epicentre of brain atrophy using data-driven and simulation-based methods, with some secondary regions in frontal ventromedial and antero-medial temporal areas. We found that FTD-related genes, namely C9orf72 and TARDBP, confer local transcriptomic vulnerability to the disease, modulating the propagation of pathology through the connectome. Collectively, our results demonstrate that atrophy patterns in sporadic and genetic bvFTD are jointly shaped by global connectome architecture and local transcriptomic vulnerability, providing an explanation as to how heterogenous pathological entities can lead to the same clinical syndrome.
Collapse
Affiliation(s)
| | | | - Mahsa Dadar
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada,Radiology and Nuclear Medicine, Laval University, Quebec City, QC, Canada
| | - Ana L Manera
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - D Louis Collins
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Alain Dagher
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Raquel Sanchez-Valle
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d’Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Fermin Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia University Hospital, San Sebastian, Gipuzkoa, Spain,Neuroscience Area, Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, and Faculté de Médecine, Université Laval, Quebec, QC, Canada
| | - Caroline Graff
- Department of Geriatric Medicine, Karolinska University Hospital-Huddinge, Stockholm, Sweden,Unit for Hereditary Dementias, Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany,Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Daniela Galimberti
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Dino Ferrari Center, Milan, Italy
| | - James B Rowe
- University of Cambridge, Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, and MRC Cognition and Brain Sciences Unit, Cambridge, UK
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Maria Carmela Tartaglia
- Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, Toronto, ON, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium,Neurology Service, University Hospitals Leuven, Leuven, Belgium,Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | | | - Fabrizio Tagliavini
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milan, Italy
| | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal,Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Chris Butler
- Department of Clinical Neurology, University of Oxford, Oxford, UK,Department of Brain Sciences, Imperial College London, London, UK
| | - Alex Gerhard
- Division of Neuroscience and Experimental Psychology, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK,Department of Geriatric Medicine and Nuclear Medicine, University of Duisburg-Essen, Duisburg and Essen, Germany
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany,Clinical Research Unit, German Center for Neurodegenerative Diseases (DZNE), Munich, Germany,Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - Markus Otto
- Department of Neurology, University Hospital Ulm, Ulm, Germany
| | - Sandro Sorbi
- Department of Neurofarba, University of Florence, Florence, Italy,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Lize C Jiskoot
- Department of Neurology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Harro Seelaar
- Department of Neurology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Jonathan D Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, UK
| | - Bratislav Misic
- Correspondence to: Bratislav Misic 3801 Rue University Webster 211, Montreal QC H3A 2B4, Canada E-mail:
| | | | | | | |
Collapse
|
37
|
Scarioni M, Gami-Patel P, Peeters CFW, de Koning F, Seelaar H, Mol MO, van Swieten JC, Rozemuller AJM, Hoozemans JJM, Pijnenburg YAL, Dijkstra AA. Psychiatric symptoms of frontotemporal dementia and subcortical (co-)pathology burden: new insights. Brain 2022; 146:307-320. [PMID: 35136978 PMCID: PMC9825544 DOI: 10.1093/brain/awac043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/09/2021] [Accepted: 12/19/2021] [Indexed: 01/12/2023] Open
Abstract
Three subtypes of distinct pathological proteins accumulate throughout multiple brain regions and shape the heterogeneous clinical presentation of frontotemporal lobar degeneration (FTLD). Besides the main pathological subtypes, co-occurring pathologies are common in FTLD brain donors. The objective of this study was to investigate how the location and burden of (co-)pathology correlate to early psychiatric and behavioural symptoms of FTLD. Eighty-seven brain donors from The Netherlands Brain Bank cohort (2008-2017) diagnosed with FTLD were included: 46 FTLD-TAR DNA-binding protein 43 (FTLD-TDP), 34 FTLD-tau, and seven FTLD-fused-in-sarcoma (FTLD-FUS). Post-mortem brain tissue was dissected into 20 standard regions and stained for phosphorylated TDP-43, phosphorylated tau, FUS, amyloid-β, and α-synuclein. The burden of each pathological protein in each brain region was assessed with a semi-quantitative score. Clinical records were reviewed for early psychiatric and behavioural symptoms. Whole-brain clinico-pathological partial correlations were calculated (local false discovery rate threshold = 0.01). Elaborating on the results, we validated one finding using a quantitative assessment of TDP-43 pathology in the granular layer of the hippocampus in FTLD-TDP brain donors with (n = 15) and without (n = 15) hallucinations. In subcortical regions, the presence of psychiatric symptoms showed positive correlations with increased hippocampal pathology burden: hallucinations with TDP-43 in the granular layer (R = 0.33), mania with TDP-43 in CA1 (R = 0.35), depression with TDP-43 in CA3 and with parahippocampal tau (R = 0.30 and R = 0.23), and delusions with CA3 tau (R = 0.26) and subicular amyloid-β (R = 0.25). Behavioural disinhibition showed positive correlations with tau burden in the thalamus (R = 0.29) and with both TDP-43 and amyloid-β burden in the subthalamus (R = 0.23 and R = 0.24). In the brainstem, the presence of α-synuclein co-pathology in the substantia nigra correlated with disinhibition (R = 0.24), tau pathology in the substantia nigra correlated with depression (R = 0.25) and in the locus coeruleus with both depression and perseverative/compulsive behaviour (R = 0.26 and R = 0.32). The quantitative assessment of TDP-43 in the granular layer validated the higher burden of TDP-43 pathology in brain donors with hallucinations compared to those without hallucinations (P = 0.007). Our results show that psychiatric symptoms of FTLD are linked to subcortical pathology burden in the hippocampus, and hallucinations are linked to a higher burden of TDP-43 in the granular layer. Co-occurring non-FTLD pathologies in subcortical regions could contribute to configuring the clinical phenotype of FTLD.
Collapse
Affiliation(s)
- Marta Scarioni
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Priya Gami-Patel
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Carel F W Peeters
- Division of Mathematical and Statistical Methods—Biometris, Wageningen University and Research, Wageningen, The Netherlands,Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, The Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Florianne de Koning
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands,Department of Pathology, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Harro Seelaar
- Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Merel O Mol
- Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Annemieke J M Rozemuller
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Anke A Dijkstra
- Correspondence to: Anke A. Dijkstra De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands E-mail:
| |
Collapse
|
38
|
Anderl‐Straub S, Lausser L, Lombardi J, Uttner I, Fassbender K, Fliessbach K, Huppertz H, Jahn H, Kornhuber J, Obrig H, Schneider A, Semler E, Synofzik M, Danek A, Prudlo J, Kassubek J, Landwehrmeyer B, Lauer M, Volk AE, Wiltfang J, Diehl‐Schmid J, Ludolph AC, Schroeter ML, Kestler HA, Otto M. Predicting disease progression in behavioral variant frontotemporal dementia. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12262. [PMID: 35005196 PMCID: PMC8719425 DOI: 10.1002/dad2.12262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/24/2021] [Accepted: 10/01/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION The behavioral variant of frontotemporal dementia (bvFTD) is a rare neurodegenerative disease. Reliable predictors of disease progression have not been sufficiently identified. We investigated multivariate magnetic resonance imaging (MRI) biomarker profiles for their predictive value of individual decline. METHODS One hundred five bvFTD patients were recruited from the German frontotemporal lobar degeneration (FTLD) consortium study. After defining two groups ("fast progressors" vs. "slow progressors"), we investigated the predictive value of MR brain volumes for disease progression rates performing exhaustive screenings with multivariate classification models. RESULTS We identified areas that predict disease progression rate within 1 year. Prediction measures revealed an overall accuracy of 80% across our 50 top classification models. Especially the pallidum, middle temporal gyrus, inferior frontal gyrus, cingulate gyrus, middle orbitofrontal gyrus, and insula occurred in these models. DISCUSSION Based on the revealed marker combinations an individual prognosis seems to be feasible. This might be used in clinical studies on an individualized progression model.
Collapse
Affiliation(s)
| | - Ludwig Lausser
- Institute of Medical Systems BiologyUniversity of UlmUlmGermany
| | | | - Ingo Uttner
- Department of NeurologyUniversity of UlmUlmGermany
| | | | - Klaus Fliessbach
- Clinic for Neurodegenerative Diseases and Geriatric PsychiatryUniversity Hospital BonnBonnGermany
| | | | - Holger Jahn
- Department of Psychiatry and PsychotherapyUniversity Hospital Hamburg EppendorfHamburgGermany
| | - Johannes Kornhuber
- Department of Psychiatry and PsychotherapyUniversity ErlangenErlangenGermany
| | - Hellmuth Obrig
- Max‐Planck‐Institute of Human Cognitive and Brain Sciences & Clinic for Cognitive NeurologyUniversity Hospital LeipzigLeipzigGermany
| | - Anja Schneider
- Clinic for Neurodegenerative Diseases and Geriatric PsychiatryUniversity Hospital BonnBonnGermany
- German Center for Neurodegenerative Diseases (DZNE)BonnGermany
| | - Elisa Semler
- Department of NeurologyUniversity of UlmUlmGermany
| | - Matthis Synofzik
- Department of Neurodegenerative DiseasesCenter of Neurology and Hertie‐Institute for Clinical Brain ResearchUniversityTübingenGermany
- German Center for Neurodegenerative Diseases (DZNE)TübingenGermany
| | - Adrian Danek
- Department of NeurologyLudwig‐Maximilians‐Universität MünchenMunichGermany
| | - Johannes Prudlo
- Department of NeurologyRostock University Medical Center and German Center for Neurodegenerative Diseases (DZNE)RostockGermany
| | - Jan Kassubek
- Department of NeurologyUniversity of UlmUlmGermany
| | | | - Martin Lauer
- Department of Psychiatry and PsychotherapyUniversity of WürzburgWürzburgGermany
| | - Alexander E. Volk
- Institute for Human GeneticsUniversity Hospital Hamburg EppendorfHamburgGermany
| | - Jens Wiltfang
- Department of Psychiatry and PsychotherapyUniversity Medical Center Göttingen (UMG)GöttingenGermany
- German Center for Neurodegenerative Diseases (DZNE)GöttingenGermany
- Neurosciences and Signaling GroupInstitute of Biomedicine (iBiMED)Department of Medical SciencesUniversity of AveiroAveiroPortugal
| | - Janine Diehl‐Schmid
- Department of Psychiatry and PsychotherapyTechnical University of MunichMunichGermany
| | | | - Matthias L. Schroeter
- Max‐Planck‐Institute of Human Cognitive and Brain Sciences & Clinic for Cognitive NeurologyUniversity Hospital LeipzigLeipzigGermany
| | - Hans A. Kestler
- Institute of Medical Systems BiologyUniversity of UlmUlmGermany
| | - Markus Otto
- Department of NeurologyUniversity of UlmUlmGermany
- Department of NeurologyMartin Luther University Halle‐WittenbergUniversity clinic HalleHalle (Saale)Germany
| | | |
Collapse
|
39
|
Vuksanović V, Staff RT, Morson S, Ahearn T, Bracoud L, Murray AD, Bentham P, Kipps CM, Harrington CR, Wischik CM. Degeneration of basal and limbic networks is a core feature of behavioural variant frontotemporal dementia. Brain Commun 2021; 3:fcab241. [PMID: 34939031 PMCID: PMC8688778 DOI: 10.1093/braincomms/fcab241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/13/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
The behavioural variant of frontotemporal dementia is a clinical syndrome characterized by changes in behaviour, cognition and functional ability. Although atrophy in frontal and temporal regions would appear to be a defining feature, neuroimaging studies have identified volumetric differences distributed across large parts of the cortex, giving rise to a classification into distinct neuroanatomical subtypes. Here, we extended these neuroimaging studies to examine how distributed patterns of cortical atrophy map onto brain network hubs. We used baseline structural magnetic resonance imaging data collected from 213 behavioural variant of frontotemporal dementia patients meeting consensus diagnostic criteria and having definite evidence of frontal and/or temporal lobe atrophy from a global clinical trial conducted in 70 sites in Canada, United States of America, Australia, Asia and Europe. These were compared with data from 244 healthy elderly subjects from a well-characterized cohort study. We have used statistical methods of hierarchical agglomerative clustering of 68 regional cortical and subcortical volumes (34 in each hemisphere) to determine the reproducibility of previously described neuroanatomical subtypes in a global study. We have also attempted to link the structural findings to clinical features defined systematically using well-validated clinical scales (Addenbrooke’s Cognitive Examination Revised, the Mini-Mental Status Examination, the Frontotemporal Dementia Rating Scale and the Functional Assessment Questionnaire) and subscales derived from them. Whilst we can confirm that the subtypes are robust, they have limited value in explaining the clinical heterogeneity of the syndrome. We have found that a common pattern of degeneration affecting a small number of subcortical, limbic and frontal nodes within highly connected networks (most previously identified as rich club members or functional binding nodes) is shared by all the anatomical subtypes. Degeneration in these core regions is correlated with cognitive and functional impairment, but less so with behavioural impairment. These findings suggest that degeneration in highly connected basal, limbic and frontal networks is a core feature of the behavioural variant of frontotemporal dementia phenotype irrespective of neuroanatomical and clinical heterogeneity, and may underly the impairment of integration in cognition, function and behaviour responsible for the loss of insight that characterizes the syndrome.
Collapse
Affiliation(s)
- Vesna Vuksanović
- Swansea University Medical School, Health Data Research UK, Swansea University, Swansea SA2 8PP, UK.,School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK.,TauRx Therapeutics, Aberdeen AB24 5RP, UK
| | - Roger T Staff
- Medical Physics, NHS Grampian, Aberdeen AB25 2ZD, UK
| | - Suzannah Morson
- TauRx Therapeutics, Aberdeen AB24 5RP, UK.,School of Psychology, University of Aberdeen, Aberdeen AB24 3FX, UK
| | - Trevor Ahearn
- Medical Physics, NHS Grampian, Aberdeen AB25 2ZD, UK
| | | | - Alison D Murray
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | | | - Christopher M Kipps
- University Hospital Southampton and University of Southampton, Southampton SO16 6YD, UK
| | - Charles R Harrington
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK.,TauRx Therapeutics, Aberdeen AB24 5RP, UK
| | - Claude M Wischik
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK.,TauRx Therapeutics, Aberdeen AB24 5RP, UK
| |
Collapse
|
40
|
Geraudie A, Battista P, García AM, Allen IE, Miller ZA, Gorno-Tempini ML, Montembeault M. Speech and language impairments in behavioral variant frontotemporal dementia: A systematic review. Neurosci Biobehav Rev 2021; 131:1076-1095. [PMID: 34673112 DOI: 10.1016/j.neubiorev.2021.10.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 01/11/2023]
Abstract
Although behavioral variant frontotemporal dementia (bvFTD) is classically defined by behavioral and socio-emotional changes, impairments often extend to other cognitive functions. These include early speech and language deficits related to the disease's core neural disruptions. Yet, their scope and clinical relevance remains poorly understood. This systematic review characterizes such disturbances in bvFTD, considering clinically, neuroanatomically, genetically, and neuropathologically defined subgroups. We included 181 experimental studies, with at least 5 bvFTD patients diagnosed using accepted criteria, comparing speech and language outcomes between bvFTD patients and healthy controls or between bvFTD subgroups. Results reveal extensive and heterogeneous deficits across cohorts, with (a) consistent lexico-semantic, reading & writing, and prosodic impairments; (b) inconsistent deficits in motor speech and grammar; and (c) relative preservation of phonological skills. Also, preliminary findings suggest that the severity of speech and language deficits might be associated with global cognitive impairment, predominantly temporal or fronto-temporal atrophy and MAPT mutations (vs C9orf72). Although under-recognized, these impairments contribute to patient characterization and phenotyping, while potentially informing diagnosis and management.
Collapse
Affiliation(s)
- Amandine Geraudie
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Neurology Department, Toulouse University Hospital, Toulouse, France
| | - Petronilla Battista
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, USA; Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Via Generale Nicola Bellomo, Bari, Italy
| | - Adolfo M García
- Global Brain Health Institute, University of California, San Francisco, USA; Universidad De San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Isabel E Allen
- Global Brain Health Institute, University of California, San Francisco, USA; Department of Epidemiology & Biostatistics, University of California San Francisco, CA, USA
| | - Zachary A Miller
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, USA
| | - Maxime Montembeault
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA.
| |
Collapse
|
41
|
Murley AG, Tsvetanov KA, Rouse MA, Jones PS, Sværke K, Li W, Carpenter A, Rowe JB. Proton magnetic resonance spectroscopy in frontotemporal lobar degeneration-related syndromes. Neurobiol Aging 2021; 111:64-70. [PMID: 34971846 PMCID: PMC8776136 DOI: 10.1016/j.neurobiolaging.2021.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/11/2021] [Accepted: 10/23/2021] [Indexed: 12/13/2022]
Abstract
There is an urgent need for a better understanding of the pathophysiology of cognitive impairment in syndromes associated with frontotemporal lobar degeneration. Here, we used magnetic resonance spectroscopy to quantify metabolite deficits in sixty patients with a clinical syndrome associated with frontotemporal lobar degeneration (behavioral variant frontotemporal dementia n = 11, progressive supranuclear palsy n = 26, corticobasal syndrome n = 11, primary progressive aphasias n = 12), and 38 age- and sex-matched healthy controls. We measured nine metabolites in the right inferior frontal gyrus, superior temporal gyrus and right primary visual cortex. Metabolite concentrations were corrected for age, sex, and partial volume then compared with cognitive and behavioral measures using canonical correlation analysis. Metabolite concentrations varied significantly by brain region and diagnosis (region x metabolite x diagnosis interaction F(64) = 1.73, p < 0.001, corrected for age, sex, and atrophy within the voxel). N-acetyl aspartate and glutamate concentrations were reduced in the right prefrontal cortex in behavioral variant frontotemporal dementia and progressive supranuclear palsy, even after partial volume correction. The reduction of these metabolites was associated with executive dysfunction and behavioral impairment (canonical correlation analysis R = 0.85, p < 0.001).
Collapse
Affiliation(s)
- Alexander G Murley
- Department of Clinical Neurosciences, University of Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, UK.
| | | | - Matthew A Rouse
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - P Simon Jones
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Katrine Sværke
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Win Li
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Adrian Carpenter
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, UK; MRC Cognition and Brain, Sciences Unit, University of Cambridge, UK
| |
Collapse
|
42
|
Le C, Finger E. Pharmacotherapy for Neuropsychiatric Symptoms in Frontotemporal Dementia. CNS Drugs 2021; 35:1081-1096. [PMID: 34426949 DOI: 10.1007/s40263-021-00854-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 10/20/2022]
Abstract
Despite significant progress in the understanding of the frontotemporal dementias (FTDs), there remains no disease-modifying treatment for these conditions, and limited effective symptomatic treatment. Behavioural variant frontotemporal dementia (bvFTD) is the most common FTD syndrome, and is characterized by severe impairments in behaviour, personality and cognition. Neuropsychiatric symptoms are common features of bvFTD but are present in the other FTD syndromes. Current treatment strategies therefore focus on ameliorating the neuropsychiatric features. Here we review the rationale for current treatments related to each of the main neuropsychiatric symptoms forming the diagnostic criteria for bvFTD relevant to all FTD subtypes, and two additional symptoms not currently part of the diagnostic criteria: lack of insight and psychosis. Given the paucity of effective treatments for these symptoms, we highlight how contributing mechanisms delineated in cognitive neuroscience may inform future approaches to clinical trials and more precise symptomatic treatments for FTDs.
Collapse
Affiliation(s)
- Christine Le
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
| |
Collapse
|
43
|
|
44
|
González-Alcaide G, Fernández-Ríos M, Redolat R, Serra E. Research on Emotion Recognition and Dementias: Foundations and Prospects. J Alzheimers Dis 2021; 82:939-950. [PMID: 34120903 DOI: 10.3233/jad-210096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The study of emotion recognition could be crucial for detecting alterations in certain cognitive areas or as an early sign of neurological disorders. OBJECTIVE The main objective of the study is to characterize research development on emotion recognition, identifying the intellectual structure that supports this area of knowledge, and the main lines of research attracting investigators' interest. METHODS We identified publications on emotion recognition and dementia included in the Web of Science Core Collection, analyzing the scientific output and main disciplines involved in generating knowledge in the area. A co-citation analysis and an analysis of the bibliographic coupling between the retrieved documents elucidated the thematic orientations of the research and the reference works that constitute the foundation for development in the field. RESULTS A total of 345 documents, with 24,282 bibliographic references between them, were included. This is an emerging research area, attracting the interest of investigators in Neurosciences, Psychology, Clinical Neurology, and Psychiatry, among other disciplines. Four prominent topic areas were identified, linked to frontotemporal dementia, autism spectrum disorders, Alzheimer's disease, and Parkinson's and Huntington disease. Many recent papers focus on the detection of mild cognitive impairment. CONCLUSION Impaired emotion recognition may be a key sign facilitating the diagnosis and early treatment of different neurodegenerative diseases as well as for triggering the necessary provision of social and family support, explaining the growing research interest in this area.
Collapse
Affiliation(s)
| | - Mercedes Fernández-Ríos
- Departamento de Psicología Evolutiva y de la Educación, Universitat de Valencia, Valencia, Spain.,Asociación Familiares Alzheimer Valencia (AFAV), Valencia, Spain
| | - Rosa Redolat
- Departamento de Psicobiología, Universitat de Valencia, Valencia, Spain
| | - Emilia Serra
- Departamento de Psicología Evolutiva y de la Educación, Universitat de Valencia, Valencia, Spain
| |
Collapse
|
45
|
Illán‐Gala I, Casaletto KB, Borrego‐Écija S, Arenaza‐Urquijo EM, Wolf A, Cobigo Y, Goh SYM, Staffaroni AM, Alcolea D, Fortea J, Blesa R, Clarimon J, Iulita MF, Brugulat‐Serrat A, Lladó A, Grinberg LT, Possin K, Rankin KP, Kramer JH, Rabinovici GD, Boxer A, Seeley WW, Sturm VE, Gorno‐Tempini ML, Miller BL, Sánchez‐Valle R, Perry DC, Lleó A, Rosen HJ. Sex differences in the behavioral variant of frontotemporal dementia: A new window to executive and behavioral reserve. Alzheimers Dement 2021; 17:1329-1341. [PMID: 33590953 PMCID: PMC8364861 DOI: 10.1002/alz.12299] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/10/2020] [Accepted: 01/02/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Biological sex is an increasingly recognized factor driving clinical and structural heterogeneity in Alzheimer's disease, but its role in the behavioral variant of frontotemporal dementia (bvFTD) is unknown. METHODS We included 216 patients with bvFTD and 235 controls with magnetic resonance imaging (MRI) from a large multicenter cohort. We compared the clinical characteristics and cortical thickness between men and women with bvFTD and controls. We followed the residuals approach to study behavioral and cognitive reserve. RESULTS At diagnosis, women with bvFTD showed greater atrophy burden in the frontotemporal regions compared to men despite similar clinical characteristics. For a similar amount of atrophy, women demonstrated better-than-expected scores on executive function and fewer changes in apathy, sleep, and appetite than men. DISCUSSION Our findings suggest that women might have greater behavioral and executive reserve than men, and neurodegeneration must be more severe in women to produce symptoms similar in severity to those in men.
Collapse
|
46
|
Rijpma MG, Shdo SM, Shany-Ur T, Toller G, Kramer JH, Miller BL, Rankin KP. Salience driven attention is pivotal to understanding others' intentions. Cogn Neuropsychol 2021; 38:88-106. [PMID: 33522407 DOI: 10.1080/02643294.2020.1868984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Interpreting others' beliefs, desires and intentions is known as "theory of mind" (ToM), and is often evaluated using simplified measurement tools, which may not correctly reflect the brain circuits that are required for real-life ToM functioning. We aimed to identify the brain structures necessary to correctly infer intentions from realistic scenarios by administering The Awareness of Social Inference Test, Enriched subtest to 47 patients with behavioural variant frontotemporal dementia, 24 patients with progressive supranuclear palsy syndrome, 31 patients with Alzheimer's syndrome, and 77 older healthy controls. Neuroimaging data was analyzed using voxel based morphometry, and participants' understanding of intentions was correlated with voxel-wise and region-of interest data. We found that structural integrity of the cinguloinsular cortex in the salience network (SN) was more pivotal for accurate ToM than previously described, emphasizing the importance of the SN for selectively recognizing and attending to social cues during ToM inferences.
Collapse
Affiliation(s)
- Myrthe G Rijpma
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Suzanne M Shdo
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Tal Shany-Ur
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Gianina Toller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Katherine P Rankin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| |
Collapse
|
47
|
Long Z, Irish M, Hodges JR, Halliday G, Piguet O, Burrell JR. Amyotrophic lateral sclerosis features predict TDP-43 pathology in frontotemporal lobar degeneration. Neurobiol Aging 2021; 107:11-20. [PMID: 34371283 DOI: 10.1016/j.neurobiolaging.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 11/30/2022]
Abstract
Clinical and pathological heterogeneity is common in patients with frontotemporal lobar degeneration (FTLD) pathology. This investigated clinical or imaging characteristics that differentiate FTLD-TDP from FTLD-tau, FTLD-TDP subtypes from each other, or pathological stages of FTLD-TDP. Initial clinical, neuropsychological and neuroimaging characteristics were compared between pathologically defined FTLD-tau and FTLD-TDP groups. Voxel-based morphometry analyses contrasted grey matter atrophy patterns. Twenty-six FTLD-TDP, 28 FTLD-tau and 78 controls were included. Amyotrophic lateral sclerosis features, when present, were highly specific FTLD-TDP, which displayed greater cortical and subcortical atrophy than FTLD-tau. FTLD-TDP-43 type B had significantly shorter survival than type A. Type A patients were more cognitively impaired than type B, and basal ganglia atrophy appeared to distinguish type A from type B. Age at onset and survival duration were comparable between stages II and IV. In conclusion, Amyotrophic lateral sclerosis features may be useful in distinguishing FTLD-TDP from FTLD-tau. TDP-43 type A and B appear to present with distinct profiles. The relationship between clinical features and pathological staging in FTLD-TDP-43 is complex, and TDP-43 subtyping may have more clinical utility.
Collapse
Affiliation(s)
- Zhe Long
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; The Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Muireann Irish
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia; School of Psychology, The University of Sydney, Sydney, New South Wales, Australia; ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia
| | - John R Hodges
- The Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia; ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia
| | - Glenda Halliday
- The Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Olivier Piguet
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia; School of Psychology, The University of Sydney, Sydney, New South Wales, Australia; ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia
| | - James R Burrell
- The Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia; Concord Medical School, The University of Sydney, Sydney, New South Wales, Australia; ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia.
| |
Collapse
|
48
|
Ranasinghe KG, Toller G, Cobigo Y, Chiang K, Callahan P, Eliazer C, Kramer JH, Rosen HJ, Miller BL, Rankin KP. Computationally derived anatomic subtypes of behavioral variant frontotemporal dementia show temporal stability and divergent patterns of longitudinal atrophy. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12183. [PMID: 34268446 PMCID: PMC8274310 DOI: 10.1002/dad2.12183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/15/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Behavioral variant frontotemporal dementia (bvFTD) can be computationally divided into four distinct anatomic subtypes based on patterns of frontotemporal and subcortical atrophy. To more precisely predict disease trajectories of individual patients, the temporal stability of each subtype must be characterized. METHODS We investigated the longitudinal stability of the four previously identified anatomic subtypes in 72 bvFTD patients. We also applied a voxel-wise mixed effects model to examine subtype differences in atrophy patterns across multiple timepoints. RESULTS Our results demonstrate the stability of the anatomic subtypes at baseline and over time. While they had common salience network atrophy, each subtype showed distinctive baseline and longitudinal atrophy patterns. DISCUSSION Recognizing these anatomically heterogeneous subtypes and their different patterns of atrophy progression in early bvFTD will improve disease course prediction in individual patients. Longitudinal volumetric predictions based on these anatomic subtypes may be used as a more accurate endpoint in treatment trials.
Collapse
Affiliation(s)
- Kamalini G. Ranasinghe
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Gianina Toller
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Yann Cobigo
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Kevin Chiang
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Patrick Callahan
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Caleb Eliazer
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Joel H. Kramer
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Howard J. Rosen
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Bruce L. Miller
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Katherine P. Rankin
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| |
Collapse
|
49
|
Magrath Guimet N, Miller BL, Allegri RF, Rankin KP. What Do We Mean by Behavioral Disinhibition in Frontotemporal Dementia? Front Neurol 2021; 12:707799. [PMID: 34305805 PMCID: PMC8292604 DOI: 10.3389/fneur.2021.707799] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Abstract
Behavioral variant frontotemporal dementia, unlike other forms of dementia, is primarily characterized by changes in behavior, personality, and language, with disinhibition being one of its core symptoms. However, because there is no single definition that captures the totality of behavioral symptoms observed in these patients, disinhibition is an umbrella term used to encompass socially disruptive or morally unacceptable behaviors that may arise from distinct neural etiologies. This paper aims to review the current knowledge about behavioral disinhibition in this syndrome, considering the cultural factors related to our perception of behavior, the importance of phenomenological interpretation, neuroanatomy, the brain networks involved and, finally, a new neuroscientific theory that offers a conceptual framework for understanding the diverse components of behavioral disinhibition in this neurodegenerative disorder.
Collapse
Affiliation(s)
- Nahuel Magrath Guimet
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires, Argentina
| | - Bruce L Miller
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Ricardo F Allegri
- Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires, Argentina.,Department of Neurosciences, Universidad de la Costa (CUC), Barranquilla, Colombia
| | - Katherine P Rankin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| |
Collapse
|
50
|
Yang WFZ, Toller G, Shdo S, Kotz SA, Brown J, Seeley WW, Kramer JH, Miller BL, Rankin KP. Resting functional connectivity in the semantic appraisal network predicts accuracy of emotion identification. NEUROIMAGE-CLINICAL 2021; 31:102755. [PMID: 34274726 PMCID: PMC8319356 DOI: 10.1016/j.nicl.2021.102755] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/01/2021] [Accepted: 07/03/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Structural and task-based functional studies associate emotion reading with frontotemporal brain networks, though it remains unclear whether functional connectivity (FC) alone predicts emotion reading ability. The predominantly frontotemporal salience and semantic appraisal (SAN) networks are selectively impacted in neurodegenerative disease syndromes like behavioral-variant frontotemporal dementia (bvFTD) and semantic-variant primary progressive aphasia (svPPA). Accurate emotion identification diminishes in some of these patients, but studies investigating the source of this symptom in patients have predominantly examined structural rather than functional brain changes. Thus, we investigated the impact of altered connectivity on their emotion reading. METHODS One-hundred-eighty-five participants (26 bvFTD, 21 svPPA, 24 non-fluent variant PPA, 24 progressive supranuclear palsy, 49 Alzheimer's disease, 41 neurologically healthy older controls) underwent task-free fMRI, and completed the Emotion Evaluation subtest of The Awareness of Social Inference Test (TASIT-EET), watching videos and selecting labels for actors' emotions. RESULTS As expected, patients averaged significantly worse on emotion reading, but with wide inter-individual variability. Across all groups, lower mean FC in the SAN, but not other ICNs, predicted worse TASIT-EET performance. Node-pair analysis revealed that emotion identification was predicted by FC between 1) right anterior temporal lobe (RaTL) and right anterior orbitofrontal (OFC), 2) RaTL and right posterior OFC, and 3) left basolateral amygdala and left posterior OFC. CONCLUSION Emotion reading test performance predicts FC in specific SAN regions mediating socioemotional semantics, personalized evaluations, and salience-driven attention, highlighting the value of emotion testing in clinical and research settings to index neural circuit dysfunction in patients with neurodegeneration and other neurologic disorders.
Collapse
Affiliation(s)
- Winson F Z Yang
- Memory and Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, United States; Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, Netherlands.
| | - Gianina Toller
- Memory and Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, United States.
| | - Suzanne Shdo
- Memory and Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, United States.
| | - Sonja A Kotz
- Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, Netherlands.
| | - Jesse Brown
- Memory and Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, United States.
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, United States.
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, United States.
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, United States.
| | - Katherine P Rankin
- Memory and Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, United States.
| |
Collapse
|