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Liou JJ, Li J, Berardinelli J, Jin H, Santini T, Noh J, Farhat N, Wu M, Aizenstein H, Mettenburg JM, Yong W, Head E, Ikonomovic M, Ibrahim T, Kofler J. Correlating hippocampal and amygdala volumes with neuropathological burden in neurodegenerative diseases using 7T postmortem MRI. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.15.24307354. [PMID: 38798514 PMCID: PMC11118630 DOI: 10.1101/2024.05.15.24307354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Numerous research groups worldwide have focused on postmortem imaging to bridge the resolution gap between clinical neuroimaging and neuropathology data. We developed a standardized protocol for brain embedding, imaging, and processing, facilitating alignment between antemortem MRI, postmortem MRI, and pathology to observe brain atrophy and structural damage progression over time. Using 7T postmortem ex vivo MRI, we explore the potential correlation of amygdala and hippocampal atrophy with neuropathological burden in both Down syndrome (DS) and Alzheimer's disease (AD) cohorts. Using 7T postmortem ex vivo MRI scans from 66 cases (12 DS and 54 AD) alongside a subset of antemortem scans (n=17), we correlated manually segmented hippocampal and amygdala volumes, adjusted for age, sex, and ApoE4 status, with pathological indicators such as Thal phase, Braak stage, limbic-predominant age-related TDP-43 encephalopathy (LATE) stage, hippocampal sclerosis (HS), and Lewy body (LB) stage. A significant correlation was observed between postmortem and antemortem volumes for the hippocampus, but a similar trend observed for the amygdala did not reach statistical significance. DS individuals exhibited notably smaller hippocampal and amygdala volumes compared to AD subjects. In DS, lower hippocampal and amygdala volumes correlated with more severe Braak stage, without significant associations with Thal phase. LATE and HS pathologies were uncommon in DS cases but trended toward smaller hippocampal volumes. In AD, lower hippocampal volume associated with dementia duration, advanced Thal phase, Braak stage, LATE stage, and HS presence, whereas reduced amygdala volume correlated mainly with severe LATE stage and HS, but not with Thal or Braak stages. No significant LB correlation was detected in either DS or AD cohorts. Hippocampal volume in AD appears influenced by both AD and LATE pathologies, while amygdala volume seems primarily influenced by LATE. In DS, smaller hippocampal volume, relative to AD, appears primarily influenced by tau pathology.
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Chiu SY, Chen R, Wang WE, Armstrong MJ, Boeve BF, Savica R, Ramanan V, Fields JA, Graff-Radford N, Ferman TJ, Kantarci K, Vaillancourt DE. Longitudinal Free-Water Changes in Dementia with Lewy Bodies. Mov Disord 2024; 39:836-846. [PMID: 38477399 PMCID: PMC11102324 DOI: 10.1002/mds.29763] [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: 10/16/2023] [Revised: 01/06/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Diffusion-weighted magnetic resonance imaging (dMRI) examines tissue microstructure integrity in vivo. Prior dementia with Lewy bodies (DLB) diffusion tensor imaging studies yielded mixed results. OBJECTIVE We employed free-water (FW) imaging to assess DLB progression and correlate with clinical decline in DLB. METHODS Baseline and follow-up MRIs were obtained at 12 and/or 24 months for 27 individuals with DLB or mild cognitive impairment with Lewy bodies (MCI-LB). FW was analyzed using the Mayo Clinic Adult Lifespan Template. Primary outcomes were FW differences between baseline and 12 or 24 months. To compare FW change longitudinally, we included 20 cognitively unimpaired individuals from the Alzheimer's Disease Neuroimaging Initiative. RESULTS We followed 23 participants to 12 months and 16 participants to 24 months. Both groups had worsening in Montreal Cognitive Assessment (MoCA) and Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scores. We found significant FW increases at both time points compared to baseline in the insula, amygdala, posterior cingulum, parahippocampal, entorhinal, supramarginal, fusiform, retrosplenial, and Rolandic operculum regions. At 24 months, we found more widespread microstructural changes in regions implicated in visuospatial processing, motor, and cholinergic functions. Between-group analyses (DLB vs. controls) confirmed significant FW changes over 24 months in most of these regions. FW changes were associated with longitudinal worsening of MDS-UPDRS and MoCA scores. CONCLUSIONS FW increased in gray and white matter regions in DLB, likely due to neurodegenerative pathology associated with disease progression. FW change was associated with clinical decline. The findings support dMRI as a promising tool to track disease progression in DLB. © 2024 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Shannon Y. Chiu
- Department of Neurology, University of Florida, Gainesville, FL
- Department of Neurology, Mayo Clinic, Scottsdale, AZ
| | - Robin Chen
- Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, FL
| | - Wei-en Wang
- Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, FL
| | | | | | | | | | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | - Tanis J. Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL
| | - Kejal Kantarci
- Department of Neuroradiology, Mayo Clinic, Rochester, MN
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Ortega-Cruz D, Iglesias JE, Rabano A, Strange BA. Hippocampal sclerosis of aging at post-mortem is evident on MRI more than a decade prior. Alzheimers Dement 2023; 19:5307-5315. [PMID: 37366342 PMCID: PMC10751387 DOI: 10.1002/alz.13352] [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: 03/09/2023] [Revised: 05/05/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Hippocampal sclerosis of aging (HS) is an important component of combined dementia neuropathology. However, the temporal evolution of its histologically-defined features is unknown. We investigated pre-mortem longitudinal hippocampal atrophy associated with HS, as well as with other dementia-associated pathologies. METHODS We analyzed hippocampal volumes from magnetic resonance imaging (MRI) segmentations in 64 dementia patients with longitudinal MRI follow-up and post-mortem neuropathological evaluation, including HS assessment in the hippocampal head and body. RESULTS Significant HS-associated hippocampal volume changes were observed throughout the evaluated timespan, up to 11.75 years before death. These changes were independent of age and Alzheimer's disease (AD) neuropathology and were driven specifically by CA1 and subiculum atrophy. AD pathology, but not HS, was associated significantly with the rate of hippocampal atrophy. DISCUSSION HS-associated volume changes are detectable on MRI earlier than 10 years before death. Based on these findings, volumetric cutoffs could be derived for in vivo differentiation between HS and AD. HIGHLIGHTS Hippocampal atrophy was found in HS+ patients earlier than 10 years before death. These early pre-mortem changes were driven by reduced CA1 and subiculum volumes. Rates of hippocampus and subfield volume decline were independent of HS. In contrast, steeper atrophy rates were associated with AD pathology burden. Differentiation between AD and HS could be facilitated based on these MRI findings.
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Affiliation(s)
- Diana Ortega-Cruz
- Laboratory for Clinical Neuroscience, Center for Biomedical Technology, Universidad Politécnica de Madrid, IdISSC, 28223, Madrid, Spain
- Alzheimer’s Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Center, 28031, Madrid, Spain
| | - Juan Eugenio Iglesias
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, 02129, Boston, MA, USA
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, 02139, Boston, MA, USA
- Centre for Medical Image Computing, University College London, WC1V 6LJ, London, UK
| | - Alberto Rabano
- Alzheimer’s Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Center, 28031, Madrid, Spain
| | - Bryan A. Strange
- Laboratory for Clinical Neuroscience, Center for Biomedical Technology, Universidad Politécnica de Madrid, IdISSC, 28223, Madrid, Spain
- Alzheimer’s Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Center, 28031, Madrid, Spain
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Li JX, Nguyen HL, Qian T, Woodworth DC, Sajjadi SA. Longitudinal hippocampal atrophy in hippocampal sclerosis of aging. AGING BRAIN 2023; 4:100092. [PMID: 37635712 PMCID: PMC10448324 DOI: 10.1016/j.nbas.2023.100092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 08/29/2023] Open
Abstract
Hippocampal sclerosis of aging (HS-A) is a common degenerative neuropathology in older individuals and is associated with dementia. HS-A is characterized by disproportionate hippocampal atrophy at autopsy but cannot be diagnosed during life. Therefore, little is known about the onset and progression of hippocampal atrophy in individuals with HS-A. To better understand the onset and progression of hippocampal atrophy in HS-A, we examined longitudinal hippocampal atrophy using serial MRI in participants with HS-A at autopsy (HS-A+, n = 8) compared to participants with limbic-predominant age-related TDP-43 encephalopathy neuropathological change (LATE-NC) without HS-A (n = 13), Alzheimer's disease neuropathologic change (ADNC) without HS-A or LATE-NC (n = 16), and those without these pathologies (n = 7). We found that participants with HS-A had lower hippocampal volumes compared to the other groups, and this atrophy preceded the onset of dementia. There was also some evidence that rates of hippocampal volume loss were slightly slower in those with HS-A. Together, these results suggest that the disproportionate hippocampal atrophy seen in HS-A may begin early prior to dementia.
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Affiliation(s)
- Janice X. Li
- Department of Neurology, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Hannah L. Nguyen
- Department of Neurology, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Tianchen Qian
- Department of Statistics, University of California, Irvine, Irvine, CA, USA
| | - Davis C. Woodworth
- Department of Neurology, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - S. Ahmad Sajjadi
- Department of Neurology, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
- Department of Pathology, University of California, Irvine, CA, USA
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Ortega-Cruz D, Eugenio Iglesias J, Rabano A, Strange B. Hippocampal sclerosis of aging at post-mortem is evident on MRI more than a decade prior. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.08.531683. [PMID: 36945448 PMCID: PMC10028863 DOI: 10.1101/2023.03.08.531683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
INTRODUCTION Hippocampal sclerosis of aging (HS) is an important component of combined dementia neuropathology. However, the temporal evolution of its histologically-defined features is unknown. We investigated pre-mortem longitudinal hippocampal atrophy associated with HS, as well as with other dementia-associated pathologies. METHODS We analyzed hippocampal volumes from MRI segmentations in 64 dementia patients with longitudinal MRI follow-up and post-mortem neuropathological evaluation, including HS assessment in the hippocampal head and body. RESULTS Significant HS-associated hippocampal volume changes were observed thoughout the evaluated timespan, up to 11.75 years before death. These changes were independent of age and Alzheimer’s Disease (AD) burden, and specifically driven by CA1 and subiculum. AD burden, but not HS, significantly associated with the rate of hippocampal atrophy. DISCUSSION HS-associated volume changes are detectable on MRI earlier than 10 years before death. These findings could contribute to the derivation of volumetric cut-offs for in vivo differentiation between HS and AD.
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Affiliation(s)
- Diana Ortega-Cruz
- Laboratory for Clinical Neuroscience, Center for Biomedical Technology, Universidad Politécnica de Madrid, IdISSC, Madrid, Spain
- Alzheimer’s Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Center, Madrid, Spain
| | - Juan Eugenio Iglesias
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Boston, MA, USA
- Centre for Medical Image Computing, University College London, London, UK
| | - Alberto Rabano
- Alzheimer’s Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Center, Madrid, Spain
| | - Bryan Strange
- Laboratory for Clinical Neuroscience, Center for Biomedical Technology, Universidad Politécnica de Madrid, IdISSC, Madrid, Spain
- Alzheimer’s Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Center, Madrid, Spain
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Inguanzo A, Poulakis K, Mohanty R, Schwarz CG, Przybelski SA, Diaz-Galvan P, Lowe VJ, Boeve BF, Lemstra AW, van de Beek M, van der Flier W, Barkhof F, Blanc F, Loureiro de Sousa P, Philippi N, Cretin B, Demuynck C, Nedelska Z, Hort J, Segura B, Junque C, Oppedal K, Aarsland D, Westman E, Kantarci K, Ferreira D. MRI data-driven clustering reveals different subtypes of Dementia with Lewy bodies. NPJ Parkinsons Dis 2023; 9:5. [PMID: 36670121 PMCID: PMC9859778 DOI: 10.1038/s41531-023-00448-6] [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: 08/30/2022] [Accepted: 01/05/2023] [Indexed: 01/21/2023] Open
Abstract
Dementia with Lewy bodies (DLB) is a neurodegenerative disorder with a wide heterogeneity of symptoms, which suggests the existence of different subtypes. We used data-driven analysis of magnetic resonance imaging (MRI) data to investigate DLB subtypes. We included 165 DLB from the Mayo Clinic and 3 centers from the European DLB consortium and performed a hierarchical cluster analysis to identify subtypes based on gray matter (GM) volumes. To characterize the subtypes, we used demographic and clinical data, as well as β-amyloid, tau, and cerebrovascular biomarkers at baseline, and cognitive decline over three years. We identified 3 subtypes: an older subtype with reduced cortical GM volumes, worse cognition, and faster cognitive decline (n = 49, 30%); a subtype with low GM volumes in fronto-occipital regions (n = 76, 46%); and a subtype of younger patients with the highest cortical GM volumes, proportionally lower GM volumes in basal ganglia and the highest frequency of cognitive fluctuations (n = 40, 24%). This study shows the existence of MRI subtypes in DLB, which may have implications for clinical workout, research, and therapeutic decisions.
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Grants
- R01 AG041851 NIA NIH HHS
- C06 RR018898 NCRR NIH HHS
- P50 AG016574 NIA NIH HHS
- R01 AG040042 NIA NIH HHS
- R01 NS080820 NINDS NIH HHS
- R37 AG011378 NIA NIH HHS
- U01 NS100620 NINDS NIH HHS
- U01 AG006786 NIA NIH HHS
- Alzheimerfonden
- Center for Innovative Medicine (CIMED) Swedish Brain funding (Hjärnfonden) ALF Medicine Swedish Dementia funding (Demensförbundet) Foundation for Geriatric Diseases at Karolinska Institutet Karolinska Institutet travel grants
- Little Family Foundation
- National Institutes of Health (U01-NS100620, P50-AG016574, U01-AG006786, R37-AG011378, R01-AG041851, R01-AG040042, C06-RR018898 and R01-NS080820), Foundation Dr. Corinne Schuler, the Mangurian Foundation for Lewy Body Research, the Elsie and Marvin Dekelboum Family Foundation, the Robert H. and Clarice Smith and Abigail Van Buren Alzheimer’s Disease Research Program
- Projet Hospitalier de Recherche Clinique (PHRC, IDCRB 2012-A00992-41) and Fondation Université de Strasbourg
- The Grant Agency of Charles University (grant PRIMUS 22/MED/011).
- Western Norway Regional Health Authority, the Swedish Foundation for Strategic Research (SSF), the Swedish Research Council (VR)Center for Innovative Medicine (CIMED), the Swedish Brain funding (Hjärnfonden), ALF Medicine.
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Affiliation(s)
- Anna Inguanzo
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
- Medical Psychology Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Konstantinos Poulakis
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Rosaleena Mohanty
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Patricia Diaz-Galvan
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Mayo Clinic, Rochester, MN, US
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, US
| | | | - Afina W Lemstra
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, Netherlands
| | - Marleen van de Beek
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, Netherlands
| | - Wiesje van der Flier
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, Netherlands
| | - Frederik Barkhof
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, Netherlands
- UCL institutes of neurology and center for medical image computing, London, UK
| | - Frederic Blanc
- Day Hospital of Geriatrics, Memory Resource and Research Center (CM2R) of Strasbourg, Department of Geriatrics, Hopitaux Universitaires de Strasbourg, Strasbourg, France
- University of Strasbourg and French National Center for Scientific Research (CNRS), ICube Laboratory and Federation de Medecine Translationnelle de Strasbourg (FMTS), Team Imagerie Multimodale Integrative en Sante (IMIS)/ICONE, Strasbourg, France
| | - Paulo Loureiro de Sousa
- Day Hospital of Geriatrics, Memory Resource and Research Center (CM2R) of Strasbourg, Department of Geriatrics, Hopitaux Universitaires de Strasbourg, Strasbourg, France
- University of Strasbourg and French National Center for Scientific Research (CNRS), ICube Laboratory and Federation de Medecine Translationnelle de Strasbourg (FMTS), Team Imagerie Multimodale Integrative en Sante (IMIS)/ICONE, Strasbourg, France
| | - Nathalie Philippi
- Day Hospital of Geriatrics, Memory Resource and Research Center (CM2R) of Strasbourg, Department of Geriatrics, Hopitaux Universitaires de Strasbourg, Strasbourg, France
- University of Strasbourg and French National Center for Scientific Research (CNRS), ICube Laboratory and Federation de Medecine Translationnelle de Strasbourg (FMTS), Team Imagerie Multimodale Integrative en Sante (IMIS)/ICONE, Strasbourg, France
| | - Benjamin Cretin
- Day Hospital of Geriatrics, Memory Resource and Research Center (CM2R) of Strasbourg, Department of Geriatrics, Hopitaux Universitaires de Strasbourg, Strasbourg, France
- University of Strasbourg and French National Center for Scientific Research (CNRS), ICube Laboratory and Federation de Medecine Translationnelle de Strasbourg (FMTS), Team Imagerie Multimodale Integrative en Sante (IMIS)/ICONE, Strasbourg, France
| | - Catherine Demuynck
- Day Hospital of Geriatrics, Memory Resource and Research Center (CM2R) of Strasbourg, Department of Geriatrics, Hopitaux Universitaires de Strasbourg, Strasbourg, France
- University of Strasbourg and French National Center for Scientific Research (CNRS), ICube Laboratory and Federation de Medecine Translationnelle de Strasbourg (FMTS), Team Imagerie Multimodale Integrative en Sante (IMIS)/ICONE, Strasbourg, France
| | - Zuzana Nedelska
- Department of Radiology, Mayo Clinic, Rochester, MN, US
- Department of Neurology, Charles University, 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Annes University Hospital Brno, Brno, Czech Republic
| | - Jakub Hort
- Department of Neurology, Charles University, 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Annes University Hospital Brno, Brno, Czech Republic
| | - Barbara Segura
- Medical Psychology Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Carme Junque
- Medical Psychology Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ketil Oppedal
- Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
- Stavanger Medical Imaging Laboratory (SMIL), Department of Radiology, Stavanger University Hospital, Stavanger, Norway
- Department of Electrical Engineering and Computer Science, University of Stavanger, Stavanger, Norway
| | - Dag Aarsland
- Department of Neuroimaging, Center for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroimaging, Center for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | | | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.
- Department of Radiology, Mayo Clinic, Rochester, MN, US.
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Huang S, Liu L, Tang X, Xie S, Li X, Kang X, Zhu S. Research progress on the role of hormones in ischemic stroke. Front Immunol 2022; 13:1062977. [PMID: 36569944 PMCID: PMC9769407 DOI: 10.3389/fimmu.2022.1062977] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Ischemic stroke is a major cause of death and disability around the world. However, ischemic stroke treatment is currently limited, with a narrow therapeutic window and unsatisfactory post-treatment outcomes. Therefore, it is critical to investigate the pathophysiological mechanisms following ischemic stroke brain injury. Changes in the immunometabolism and endocrine system after ischemic stroke are important in understanding the pathophysiological mechanisms of cerebral ischemic injury. Hormones are biologically active substances produced by endocrine glands or endocrine cells that play an important role in the organism's growth, development, metabolism, reproduction, and aging. Hormone research in ischemic stroke has made very promising progress. Hormone levels fluctuate during an ischemic stroke. Hormones regulate neuronal plasticity, promote neurotrophic factor formation, reduce cell death, apoptosis, inflammation, excitotoxicity, oxidative and nitrative stress, and brain edema in ischemic stroke. In recent years, many studies have been done on the role of thyroid hormone, growth hormone, testosterone, prolactin, oxytocin, glucocorticoid, parathyroid hormone, and dopamine in ischemic stroke, but comprehensive reviews are scarce. This review focuses on the role of hormones in the pathophysiology of ischemic stroke and discusses the mechanisms involved, intending to provide a reference value for ischemic stroke treatment and prevention.
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Affiliation(s)
- Shuyuan Huang
- Department of Anesthesiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Lu Liu
- Department of Anesthesiology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Xiaodong Tang
- Department of Anesthesiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shulan Xie
- Department of Anesthesiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xinrui Li
- Department of Anesthesiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xianhui Kang
- Department of Anesthesiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China,*Correspondence: Xianhui Kang, ; Shengmei Zhu,
| | - Shengmei Zhu
- Department of Anesthesiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China,*Correspondence: Xianhui Kang, ; Shengmei Zhu,
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Traub J, Otto M, Sell R, Göpfert D, Homola G, Steinacker P, Oeckl P, Morbach C, Frantz S, Pham M, Störk S, Stoll G, Frey A. Serum phosphorylated tau protein 181 and neurofilament light chain in cognitively impaired heart failure patients. Alzheimers Res Ther 2022; 14:149. [PMID: 36217177 PMCID: PMC9549648 DOI: 10.1186/s13195-022-01087-4] [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: 04/08/2022] [Accepted: 09/22/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Chronic heart failure (HF) is known to increase the risk of developing Alzheimer's dementia significantly. Thus, detecting and preventing mild cognitive impairment, which is common in patients with HF, is of great importance. Serum biomarkers are increasingly used in neurological disorders for diagnostics, monitoring, and prognostication of disease course. It remains unclear if neuronal biomarkers may help detect cognitive impairment in this high-risk population. Also, the influence of chronic HF and concomitant renal dysfunction on these biomarkers is not well understood. METHODS Within the monocentric Cognition.Matters-HF study, we quantified the serum levels of phosphorylated tau protein 181 (pTau) and neurofilament light chain (NfL) of 146 extensively phenotyped chronic heart failure patients (aged 32 to 85 years; 15.1% women) using ultrasensitive bead-based single-molecule immunoassays. The clinical work-up included advanced cognitive testing and cerebral magnetic resonance imaging (MRI). RESULTS Serum concentrations of NfL ranged from 5.4 to 215.0 pg/ml (median 26.4 pg/ml) and of pTau from 0.51 to 9.22 pg/ml (median 1.57 pg/ml). We detected mild cognitive impairment (i.e., T-score < 40 in at least one cognitive domain) in 60% of heart failure patients. pTau (p = 0.014), but not NfL, was elevated in this group. Both NfL (ρ = - 0.21; p = 0.013) and pTau (ρ = - 0.25; p = 0.002) related to the cognitive domain visual/verbal memory, as well as white matter hyperintensity volume and cerebral and hippocampal atrophy. In multivariable analysis, both biomarkers were independently influenced by age (T = 4.6 for pTau; T = 5.9 for NfL) and glomerular filtration rate (T = - 2.4 for pTau; T = - 3.4 for NfL). Markers of chronic heart failure, left atrial volume index (T = 4.6) and NT-proBNP (T = 2.8), were further cardiological determinants of pTau and NfL, respectively. In addition, pTau was also strongly affected by serum creatine kinase levels (T = 6.5) and ferritin (T = - 3.1). CONCLUSIONS pTau and NfL serum levels are strongly influenced by age-dependent renal and cardiac dysfunction. These findings point towards the need for longitudinal examinations and consideration of frequent comorbidities when using neuronal serum biomarkers.
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Affiliation(s)
- Jan Traub
- grid.411760.50000 0001 1378 7891Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacherstraße 6, 97080 Würzburg, Germany ,grid.411760.50000 0001 1378 7891Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Würzburg, 97078 Germany
| | - Markus Otto
- grid.410712.10000 0004 0473 882XDepartment of Neurology, University Hospital Ulm, Ulm, Germany ,grid.461820.90000 0004 0390 1701Department of Neurology, University Hospital Halle-Wittenberg, Halle, Germany
| | - Roxane Sell
- grid.411760.50000 0001 1378 7891Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Dennis Göpfert
- grid.411760.50000 0001 1378 7891Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacherstraße 6, 97080 Würzburg, Germany
| | - György Homola
- grid.411760.50000 0001 1378 7891Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Würzburg, 97078 Germany ,grid.411760.50000 0001 1378 7891Department of Neuroradiology, University Hospital Würzburg, Würzburg, Germany
| | - Petra Steinacker
- grid.410712.10000 0004 0473 882XDepartment of Neurology, University Hospital Ulm, Ulm, Germany ,grid.461820.90000 0004 0390 1701Department of Neurology, University Hospital Halle-Wittenberg, Halle, Germany
| | - Patrick Oeckl
- grid.410712.10000 0004 0473 882XDepartment of Neurology, University Hospital Ulm, Ulm, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE e.V.), Ulm, Germany
| | - Caroline Morbach
- grid.411760.50000 0001 1378 7891Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacherstraße 6, 97080 Würzburg, Germany ,grid.411760.50000 0001 1378 7891Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Würzburg, 97078 Germany
| | - Stefan Frantz
- grid.411760.50000 0001 1378 7891Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacherstraße 6, 97080 Würzburg, Germany ,grid.411760.50000 0001 1378 7891Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Würzburg, 97078 Germany
| | - Mirko Pham
- grid.411760.50000 0001 1378 7891Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Würzburg, 97078 Germany ,grid.411760.50000 0001 1378 7891Department of Neuroradiology, University Hospital Würzburg, Würzburg, Germany
| | - Stefan Störk
- grid.411760.50000 0001 1378 7891Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacherstraße 6, 97080 Würzburg, Germany ,grid.411760.50000 0001 1378 7891Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Würzburg, 97078 Germany
| | - Guido Stoll
- grid.411760.50000 0001 1378 7891Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Würzburg, 97078 Germany ,grid.411760.50000 0001 1378 7891Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Anna Frey
- grid.411760.50000 0001 1378 7891Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacherstraße 6, 97080 Würzburg, Germany ,grid.411760.50000 0001 1378 7891Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Würzburg, 97078 Germany
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9
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Bayram E, Coughlin DG, Litvan I. Sex Differences for Clinical Correlates of Alzheimer's Pathology in People with Lewy Body Pathology. Mov Disord 2022; 37:1505-1515. [PMID: 35531707 PMCID: PMC9308759 DOI: 10.1002/mds.29044] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Lewy body (LB) dementias have limited clinical diagnostic accuracy because of frequent copathologies contributing to clinical heterogeneity. Although sex differences in clinical prevalence and frequency of pure LB pathology were shown, differences for clinicopathological correlations are less known. OBJECTIVE The aim of this study was to determine sex differences for clinical associations of Alzheimer's disease (AD) copathology in those with LB pathology. METHODS Data were from National Alzheimer's Coordinating Center for 223 women and 468 men with limbic or neocortical LB, separated into two groups as those with high likelihood and low/intermediate likelihood for LB clinical phenotype based on pathology. Clinical associations of sex and interaction of sex and pathology for the clinical phenotype were analyzed. RESULTS More severe AD copathology was associated with worse cognitive decline and lower likelihood of LB disease clinical phenotype. Women with more severe AD copathology and tau had worse cognitive decline and higher likelihood of AD clinical phenotype than men. Men with more severe AD copathology had lower likelihood of LB clinical phenotype than women. Interaction of sex and pathology was more pronounced in those aged between 70 and 80 years. CONCLUSIONS AD copathology reduces the likelihood of LB clinical phenotype for both women and men; however, men may be at higher risk for LB disease underdiagnosis and women at higher risk for dementia. The use of both LB and AD biomarkers, even when LB or AD pathology is not clinically expected, is necessary for the accurate clinical diagnosis of both LB diseases and AD. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Ece Bayram
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego
| | - David G. Coughlin
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego
| | - Irene Litvan
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego
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10
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Manual and automated analysis of atrophy patterns in dementia with Lewy bodies on MRI. BMC Neurol 2022; 22:114. [PMID: 35331168 PMCID: PMC8943955 DOI: 10.1186/s12883-022-02642-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Dementia with Lewy bodies (DLB) is the second most common dementia type in patients older than 65 years. Its atrophy patterns remain unknown. Its similarities to Parkinson's disease and differences from Alzheimer's disease are subjects of current research. Methods The aim of our study was (i) to form a group of patients with DLB (and a control group) and create a 3D MRI data set (ii) to volumetrically analyze the entire brain in these groups, (iii) to evaluate visual and manual metric measurements of the innominate substance for real-time diagnosis, and (iv) to compare our groups and results with the latest literature. We identified 102 patients with diagnosed DLB in our psychiatric and neurophysiological archives. After exclusion, 63 patients with valid 3D data sets remained. We compared them with a control group of 25 patients of equal age and sex distribution. We evaluated the atrophy patterns in both (1) manually and (2) via Fast Surfers segmentation and volumetric calculations. Subgroup analyses were done of the CSF data and quality of 3D T1 data sets. Results Concordant with the literature, we detected moderate, symmetric atrophy of the hippocampus, entorhinal cortex and amygdala, as well as asymmetric atrophy of the right parahippocampal gyrus in DLB. The caudate nucleus was unaffected in patients with DLB, while all the other measured territories were slightly too moderately atrophied. The area under the curve analysis of the left hippocampus volume ratio (< 3646mm3) revealed optimal 76% sensitivity and 100% specificity (followed by the right hippocampus and left amygdala). The substantia innominata’s visual score attained a 51% optimal sensitivity and 84% specificity, and the measured distance 51% optimal sensitivity and 68% specificity in differentiating DLB from our control group. Conclusions In contrast to other studies, we observed a caudate nucleus sparing atrophy of the whole brain in patients with DLB. As the caudate nucleus is known to be the last survivor in dopamine-uptake, this could be the result of an overstimulation or compensation mechanism deserving further investigation. Its relative hypertrophy compared to all other brain regions could enable an imaging based identification of patients with DLB via automated segmentation and combined volumetric analysis of the hippocampus and amygdala. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02642-0.
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11
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Rao YL, Ganaraja B, Murlimanju BV, Joy T, Krishnamurthy A, Agrawal A. Hippocampus and its involvement in Alzheimer's disease: a review. 3 Biotech 2022; 12:55. [PMID: 35116217 PMCID: PMC8807768 DOI: 10.1007/s13205-022-03123-4] [Citation(s) in RCA: 111] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/16/2022] [Indexed: 12/12/2022] Open
Abstract
Hippocampus is the significant component of the limbic lobe, which is further subdivided into the dentate gyrus and parts of Cornu Ammonis. It is the crucial region for learning and memory; its sub-regions aid in the generation of episodic memory. However, the hippocampus is one of the brain areas affected by Alzheimer's (AD). In the early stages of AD, the hippocampus shows rapid loss of its tissue, which is associated with the functional disconnection with other parts of the brain. In the progression of AD, atrophy of medial temporal and hippocampal regions are the structural markers in magnetic resonance imaging (MRI). Lack of sirtuin (SIRT) expression in the hippocampal neurons will impair cognitive function, including recent memory and spatial learning. Proliferation, differentiation, and migrations are the steps involved in adult neurogenesis. The microglia in the hippocampal region are more immunologically active than the other regions of the brain. Intrinsic factors like hormones, glia, and vascular nourishment are instrumental in the neural stem cell (NSC) functions by maintaining the brain's microenvironment. Along with the intrinsic factors, many extrinsic factors like dietary intake and physical activity may also influence the NSCs. Hence, pro-neurogenic lifestyle could delay neurodegeneration.
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Affiliation(s)
- Y. Lakshmisha Rao
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - B. Ganaraja
- Department of Physiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - B. V. Murlimanju
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Teresa Joy
- Department of Anatomy, College of Medicine, American University of Antigua, Coolidge, Antigua, Antigua and Barbuda
| | - Ashwin Krishnamurthy
- Department of Anatomy, K.S. Hegde Medical Academy, Deralakatte, Nitte University, Mangalore, Karnataka India
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal, 462020 Madhya Pradesh India
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12
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Iwasa K, Yamamoto S, Yamashina K, Yagishita-Kyo N, Maruyama K, Awaji T, Takei Y, Hirasawa A, Yoshikawa K. A peripheral lipid sensor GPR120 remotely contributes to suppression of PGD 2-microglia-provoked neuroinflammation and neurodegeneration in the mouse hippocampus. J Neuroinflammation 2021; 18:304. [PMID: 34961526 PMCID: PMC8711188 DOI: 10.1186/s12974-021-02361-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 12/16/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Neuroinflammation is a key pathological component of neurodegenerative disease and is characterized by microglial activation and the secretion of proinflammatory mediators. We previously reported that a surge in prostaglandin D2 (PGD2) production and PGD2-induced microglial activation could provoke neuroinflammation. We also reported that a lipid sensor GPR120 (free fatty acid receptor 4), which is expressed in intestine, could be activated by polyunsaturated fatty acids (PUFA), thereby mediating secretion of glucagon-like peptide-1 (GLP-1). Dysfunction of GPR120 results in obesity in both mice and humans. METHODS To reveal the relationship between PGD2-microglia-provoked neuroinflammation and intestinal PUFA/GPR120 signaling, we investigated neuroinflammation and neuronal function with gene and protein expression, histological, and behavioral analysis in GPR120 knockout (KO) mice. RESULTS In the current study, we discovered notable neuroinflammation (increased PGD2 production and microglial activation) and neurodegeneration (declines in neurogenesis, hippocampal volume, and cognitive function) in GPR120 KO mice. We also found that Hematopoietic-prostaglandin D synthase (H-PGDS) was expressed in microglia, microglia were activated by PGD2, H-PGDS expression was upregulated in GPR120 KO hippocampus, and inhibition of PGD2 production attenuated this neuroinflammation. GPR120 KO mice exhibited reduced intestinal, plasma, and intracerebral GLP-1 contents. Peripheral administration of a GLP-1 analogue, liraglutide, reduced PGD2-microglia-provoked neuroinflammation and further neurodegeneration in GPR120 KO mice. CONCLUSIONS Our results suggest that neurological phenotypes in GPR120 KO mice are probably caused by dysfunction of intestinal GPR120. These observations raise the possibility that intestinal GLP-1 secretion, stimulated by intestinal GPR120, may remotely contributed to suppress PGD2-microglia-provoked neuroinflammation in the hippocampus.
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Affiliation(s)
- Kensuke Iwasa
- Department of Pharmacology, Faculty of Medicine, Saitama Medical University, 38 Moro-hongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Shinji Yamamoto
- Department of Pharmacology, Faculty of Medicine, Saitama Medical University, 38 Moro-hongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Kota Yamashina
- Department of Pharmacology, Faculty of Medicine, Saitama Medical University, 38 Moro-hongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Nan Yagishita-Kyo
- Department of Pharmacology, Faculty of Medicine, Saitama Medical University, 38 Moro-hongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Kei Maruyama
- Department of Pharmacology, Faculty of Medicine, Saitama Medical University, 38 Moro-hongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Takeo Awaji
- Department of Pharmacology, Faculty of Medicine, Saitama Medical University, 38 Moro-hongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Yoshinori Takei
- Department of Translational Research and Cellular Therapeutics, School of Medicine, Faculty of Medicine, Toho University, 5-21-16 Omori-Nishi, Ota-ku, Tokyo, 143-8540, Japan
| | - Akira Hirasawa
- Department of Genomic Drug Discovery Science, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Yoshida-Shimo-Adachi-cho, Sakyo-ku, Kyoto, 606-8501, Japan.,Institute for Integrated Medical Sciences, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Keisuke Yoshikawa
- Department of Pharmacology, Faculty of Medicine, Saitama Medical University, 38 Moro-hongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
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13
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Li A, Yue L, Xiao S, Liu M. Cognitive Function Assessment and Prediction for Subjective Cognitive Decline and Mild Cognitive Impairment. Brain Imaging Behav 2021; 16:645-658. [PMID: 34491529 DOI: 10.1007/s11682-021-00545-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 11/25/2022]
Abstract
Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative dementia. Recent studies found that subjective cognitive decline (SCD) may be the early clinical precursor that precedes mild cognitive impairment (MCI) for AD. SCD subjects with normal cognition may already have some medial temporal lobe atrophy. Although brain changes by AD have been widely studied in the literature, it is still challenging to investigate the anatomical subtle changes in SCD. This paper proposes a machine learning framework by combination of sparse coding and random forest (RF) to identify the informative imaging biomarkers for assessment and prediction of cognitive functions and their changes in individuals with MCI, SCD and normal control (NC) using magnetic resonance imaging (MRI). First, we compute the volumes from both the regions of interest from whole brain and the subregions of hippocampus and amygdala as the features of structural MRIs. Then, sparse coding is applied to identify the relevant features. Finally, the proximity-based RF is used to combine three sets of volumetric features and establish a regression model for predicting clinical scores. Our method has double feature selections to better explore the relevant features for prediction and is evaluated with the T1-weighted structural MR images from 36 MCI, 112 SCD, 78 NC subjects. The results demonstrate the effectiveness of proposed method. In addition to hippocampus and amygdala, we also found that the fimbria, basal nucleus and cortical nucleus subregions are more important than other regions for prediction of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores and their changes.
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Affiliation(s)
- Aojie Li
- Department of Instrument Science and Engineering, School of EIEE, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Manhua Liu
- Department of Instrument Science and Engineering, School of EIEE, Shanghai Jiao Tong University, Shanghai, China.
- MoE Key Lab of Artificial Intelligence, AI Institute, Shanghai Jiao Tong University, Shanghai, 200240, China.
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14
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Firbank MJ, Durcan R, O'Brien JT, Allan LM, Barker S, Ciafone J, Donaghy PC, Hamilton CA, Lawley S, Roberts G, Taylor JP, Thomas AJ. Hippocampal and insula volume in mild cognitive impairment with Lewy bodies. Parkinsonism Relat Disord 2021; 86:27-33. [PMID: 33823470 DOI: 10.1016/j.parkreldis.2021.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/11/2021] [Accepted: 03/11/2021] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Diagnostic criteria for prodromal dementia with Lewy bodies have recently been published. These include the use of imaging biomarkers to distinguish mild cognitive impairment with Lewy bodies (MCI-LB) from MCI due to other causes. Two potential biomarkers listed, though not formally included in the diagnostic criteria, due to insufficient evidence, are relatively preserved hippocampi, and atrophy of the insula cortex on structural brain imaging. METHODS In this report, we sought to investigate these imaging biomarkers in 105 research subjects, including well characterised groups of patients with MCI-LB (n = 38), MCI with no core features of Lewy body disease (MCI-AD; n = 36) and healthy controls (N = 31). Hippocampal and insula volumes were determined from T1 weighted structural MRI scans, using grey matter segmentation performed with SPM software. RESULTS Adjusting for age, sex and intracranial volume, there were no differences in hippocampal or insula volume between MCI-AD and MCI-LB, although in both conditions volumes were significantly reduced relative to controls. CONCLUSION Our results do not support the use of either hippocampal or insula volume to identify prodromal dementia with Lewy bodies.
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Affiliation(s)
- Michael J Firbank
- Translational and Clinical Research Institute, Newcastle University, UK.
| | - Rory Durcan
- Translational and Clinical Research Institute, Newcastle University, UK
| | | | | | - Sally Barker
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Joanna Ciafone
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Paul C Donaghy
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Calum A Hamilton
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Sarah Lawley
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Gemma Roberts
- Translational and Clinical Research Institute, Newcastle University, UK; Nuclear Medicine Department, Newcastle Upon Tyne Hospitals NHS Foundation Trust, UK
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Alan J Thomas
- Translational and Clinical Research Institute, Newcastle University, UK
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15
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Orad RI, Shiner T. Differentiating dementia with Lewy bodies from Alzheimer's disease and Parkinson's disease dementia: an update on imaging modalities. J Neurol 2021; 269:639-653. [PMID: 33511432 DOI: 10.1007/s00415-021-10402-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 12/16/2022]
Abstract
Dementia with Lewy bodies is the second most common cause of neurodegenerative dementia after Alzheimer's disease. Dementia with Lewy bodies can provide a diagnostic challenge due to the frequent overlap of clinical signs with other neurodegenerative conditions, namely Parkinson's disease dementia, and Alzheimer's disease. Part of this clinical overlap is due to the neuropathological overlap. Dementia with Lewy bodies is characterized by the accumulation of aggregated α-synuclein protein in Lewy bodies, similar to Parkinson's disease and Parkinson's disease dementia. However, it is also frequently accompanied by aggregation of amyloid-beta and tau, the pathological hallmarks of Alzheimer's disease. Neuroimaging is central to the diagnostic process. This review is an overview of both established and evolving imaging methods that can improve diagnostic accuracy and improve management of this disorder.
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Affiliation(s)
- Rotem Iris Orad
- Cognitive Neurology Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, 6, Weismann St, Tel Aviv, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Tamara Shiner
- Cognitive Neurology Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, 6, Weismann St, Tel Aviv, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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16
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Huang L, Chen K, Hu X, Guo Q. Differential Atrophy in the Hippocampal Subfield Volumes in Four Types of Mild Dementia. Front Neurosci 2020; 14:699. [PMID: 32742253 PMCID: PMC7364129 DOI: 10.3389/fnins.2020.00699] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/09/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To investigate the bilateral hippocampal subfield volumetric differences in four types of mild dementia, namely typical Alzheimer's disease (tAD), dementia with Lewy bodies (DLB), semantic dementia (SD), and posterior cortical atrophy (PCA), to assist differential diagnosis. METHODS One hundred three participants, including 22 tAD, 34 SD (17 left SD and 17 right SD), 15 DLB, 12 PCA patients, and 20 normal controls (NC), were recruited. All subjects received standard neuropsychological assessments and magnetic resonance imaging (MRI). The hippocampal subfields were automatically segmented via Freesurfer. The study compared the volumetric differences and used the receiver operating characteristic (ROC) curves to estimate the efficacy of each hippocampal subfield to distinguish between groups. Spearman correlation analysis was used to investigate the relationship between memory recall scores and hippocampal subfield volumes. RESULTS The hippocampal subfield atrophy varied in different groups: tAD, SD, and PCA patients had subregional atrophy in bilateral hippocampi compared to NC, and DLB patients showed preserved volumes; left SD patients suffered the most severe atrophy of the left hippocampus, and right SD patients were atrophied mostly in the right hippocampus. There was no significant difference in the volume of hippocampal subregions between tAD and PCA subjects, but the former tended to be atrophied more asymmetrically. ROC analysis showed that, for discrimination, the areas under the curve (AUC) of some subfields were larger than the total hippocampus, but none observed significant difference. In addition, immediate recall scores were correlated to left CA1, CA2/3, CA4/DG, subiculum, and presubiculum (p < 0.05), and delayed recall scores were strongly related to bilateral CA2/3, CA4/DG, subiculum, and presubiculum (r = 0.38-0.52, p < 0.05). CONCLUSION Differential atrophy patterns in the bilateral hippocampal subfield volumes could serve the differential diagnosis in patients with different causes of mild dementia: left CA1 for tAD; left presubiculum for LSD; right CA4/DG, right presubiculum, and right subiculum for RSD; CA4/DG and right CA2/3 for DLB; right CA2/3 and right CA4/DG for PCA. Additionally, several hippocampal subfield volumes were significantly associated with memory scores, further highlighting the essential role of the hippocampus in memory decline.
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Affiliation(s)
- Lin Huang
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Keliang Chen
- Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaochen Hu
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Qihao Guo
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
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17
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The combined effect of amyloid-β and tau biomarkers on brain atrophy in dementia with Lewy bodies. NEUROIMAGE-CLINICAL 2020; 27:102333. [PMID: 32674011 PMCID: PMC7363702 DOI: 10.1016/j.nicl.2020.102333] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 06/05/2020] [Accepted: 06/26/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Alzheimer's disease (AD)-related pathology is frequently found in patients with dementia with Lewy bodies (DLB). However, it is unknown how amyloid-β and tau-related pathologies influence neurodegeneration in DLB. Understanding the mechanisms underlying brain atrophy in DLB can improve our knowledge about disease progression, differential diagnosis, drug development and testing of anti-amyloid and anti-tau therapies in DLB. OBJECTIVES We aimed at investigating the combined effect of CSF amyloid-β42, phosphorylated tau and total tau on regional brain atrophy in DLB in the European DLB (E-DLB) cohort. METHODS 86 probable DLB patients from the E-DLB cohort with CSF and MRI data were included. Random forest was used to analyze the association of CSF biomarkers (predictors) with visual rating scales for medial temporal lobe atrophy (MTA), posterior atrophy (PA) and global cortical atrophy scale-frontal subscale (GCA-F) (outcomes), including age, sex, education and disease duration as extra predictors. RESULTS DLB patients with abnormal MTA scores had abnormal CSF Aβ42, shorter disease duration and older age. DLB patients with abnormal PA scores had abnormal levels of CSF Aβ42 and p-tau, older age, lower education and shorter disease duration. Abnormal GCA-F scores were associated with lower education, male sex, and older age, but not with any AD-related CSF biomarker. CONCLUSIONS This study shows preliminary data on the potential combined effect of amyloid-β and tau-related pathologies on the integrity of posterior brain cortices in DLB patients, whereas only amyloid-β seems to be related to MTA. Future availability of α-synuclein biomarkers will help us to understand the effect of α-synuclein and AD-related pathologies on brain integrity in DLB.
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Ferman TJ, Aoki N, Boeve BF, Aakre JA, Kantarci K, Graff-Radford J, Parisi JE, Van Gerpen JA, Graff-Radford NR, Uitti RJ, Pedraza O, Murray ME, Wszolek ZK, Reichard RR, Fields JA, Ross OA, Knopman DS, Petersen RC, Dickson DW. Subtypes of dementia with Lewy bodies are associated with α-synuclein and tau distribution. Neurology 2020; 95:e155-e165. [PMID: 32561678 DOI: 10.1212/wnl.0000000000009763] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 12/17/2019] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To determine whether Lewy body disease subgroups have different clinical profiles. METHODS Participants had dementia, autopsy-confirmed transitional or diffuse Lewy body disease (TLBD or DLBD) (n = 244), or Alzheimer disease (AD) (n = 210), and were seen at least twice (mean follow-up 6.2 ± 3.8 years). TLBD and DLBD groups were partitioned based on the presence or absence of neocortical neurofibrillary tangles using Braak staging. Four Lewy body disease subgroups and AD were compared on clinical features, dementia trajectory, and onset latency of probable dementia with Lewy bodies (DLB) or a DLB syndrome defined as probable DLB or dementia with one core feature of parkinsonism or probable REM sleep behavior disorder. RESULTS In TLBD and DLBD without neocortical tangles, diagnostic sensitivity was strong for probable DLB (87% TLBD, 96% DLBD) and the DLB syndrome (97% TLBD, 98% DLBD) with median latencies <1 year from cognitive onset, and worse baseline attention-visual processing but better memory-naming scores than AD. In DLBD with neocortical tangles, diagnostic sensitivity was 70% for probable DLB and 77% for the DLB syndrome with respective median latencies of 3.7 years and 2.7 years from cognitive onset, each associated with tangle distribution. This group had worse baseline attention-visual processing than AD, but comparable memory-naming impairment. TLBD with neocortical tangles had 48% diagnostic sensitivity for probable DLB and 52% for the DLB syndrome, with median latencies >6 years from cognitive onset, and were cognitively similar to AD. Dementia trajectory was slowest for TLBD without neocortical tangles, and fastest for DLBD with neocortical tangles. CONCLUSIONS The phenotypic expression of DLB was associated with the distribution of α-synuclein and tau pathology.
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Affiliation(s)
- Tanis J Ferman
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN.
| | - Naoya Aoki
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Bradley F Boeve
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Jeremiah A Aakre
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Kejal Kantarci
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Jonathan Graff-Radford
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Joseph E Parisi
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Jay A Van Gerpen
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Neill R Graff-Radford
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Ryan J Uitti
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Otto Pedraza
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Melissa E Murray
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Zbigniew K Wszolek
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - R Ross Reichard
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Julie A Fields
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Owen A Ross
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - David S Knopman
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Ronald C Petersen
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
| | - Dennis W Dickson
- From the Departments of Psychiatry and Psychology (T.J.F., O.P.), Neurology (J.A.V.G., N.R.G.-R., R.J.U., Z.K.W.), and Neuroscience (M.E.M., O.A.R., D.W.D.) Mayo Clinic, Jacksonville, FL; Department of Psychiatry (N.A.), Yokohama University Medical Center, Japan; and Departments of Neurology (B.F.B., J.G.-R., D.S.K., R.C.P.), Health Sciences Research (J.A.A.), Radiology (K.K.), Laboratory Medicine and Pathology (J.E.P., R.R.R.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN
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19
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Ye R, Touroutoglou A, Brickhouse M, Katz S, Growdon JH, Johnson KA, Dickerson BC, Gomperts SN. Topography of cortical thinning in the Lewy body diseases. NEUROIMAGE-CLINICAL 2020; 26:102196. [PMID: 32059167 PMCID: PMC7016450 DOI: 10.1016/j.nicl.2020.102196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 11/15/2022]
Abstract
Objective Regional cortical thinning in dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD) may underlie some aspect of their clinical impairments; cortical atrophy likely reflects extensive Lewy body pathology with alpha-synuclein deposits, as well as associated Alzheimer's disease co-pathologies, when present. Here we investigated the topographic distribution of cortical thinning in these Lewy body diseases compared to cognitively normal PD and healthy non-PD control subjects, explored the association of regional thinning with clinical features and evaluated the impact of amyloid deposition. Methods Twenty-one participants with dementia with Lewy bodies (DLB), 16 with Parkinson disease (PD) - associated cognitive impairment (PD-MCI and PDD), and 24 cognitively normal participants with PD underwent MRI, PiB PET, and clinical evaluation. Cortical thickness across the brain and in regions of interest (ROIs) was compared across diagnostic groups and across subgroups stratified by amyloid status, and was related to clinical and cognitive measures. Results DLB and PD-impaired groups shared a similar distribution of cortical thinning that included regions characteristic of AD, as well as the fusiform, precentral, and paracentral gyri. Elevated PiB retention in DLB and PD-impaired but not in PD-normal participants was associated with more extensive and severe cortical thinning, in an overlapping topography that selectively affected the medial temporal lobe in DLB participants. In DLB, greater thinning in AD signature and fusiform regions was associated with greater cognitive impairment. Conclusions The pattern of cortical thinning is similar in DLB and PD-associated cognitive impairment, overlapping with and extending beyond AD signature regions to involve fusiform, precentral, and paracentral regions. Cortical thinning in AD signature and fusiform regions in these diseases reflects cognitive impairment and is markedly accentuated by amyloid co-pathology. Further work will be required to determine whether the distinct topography of cortical thinning in DLB and PD-associated cognitive impairment might have value as a diagnostic and/ or outcome biomarker in clinical trials.
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Affiliation(s)
- Rong Ye
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Alexandra Touroutoglou
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Michael Brickhouse
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Samantha Katz
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - John H Growdon
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Stephen N Gomperts
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA.
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20
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Sun J, Yan S, Song C, Han B. Dual-functional neural network for bilateral hippocampi segmentation and diagnosis of Alzheimer's disease. Int J Comput Assist Radiol Surg 2019; 15:445-455. [PMID: 31883064 DOI: 10.1007/s11548-019-02106-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Knowing the course of Alzheimer's disease is very important to prevent the deterioration of the disease, and accurate segmentation of sensitive lesions can provide a visual basis for the diagnosis results. This study proposes an improved end-to-end dual-functional 3D convolutional neural network for segmenting bilateral hippocampi from 3D brain MRI scans and diagnosing AD progression states simultaneously. METHODS The proposed neural network is based on the V-Net and adopts an end-to-end structure. In order to relieve the excessive amount of convolutional parameters at the bottom of the V-Net, we change them to bottleneck architecture. Based on the segmentation network, we establish a classification network for diagnosing pathological states of brain. In order to balance the two tasks of hippocampi segmentation and brain pathological states diagnosis, we designed a unique loss function. This study included 132 samples, of which 100 were selected as training, and the remaining 32 were used to test the performance of our model. During training, we adopted fivefold cross-validation method. RESULTS We selected the intersection over union and dice coefficient to evaluate the hippocampus segmentation performance, while the brain pathological states diagnosis performance was evaluated by accuracy, specificity, sensitivity, precision and F1 score. By using the proposed neural network, the left hippocampi segmentation Iou and dice coefficient reach 0.8240 ± 0.020 and 0.9035 ± 0.020, respectively. The right hippocampi Iou and dice coefficient reach 0.8454 ± 0.023 and 0.9162 ± 0.023, respectively. The accuracy, specificity, sensitivity, precision and F1 score of three-category classification of brain pathology are 84%, 92%, 84%, 86% and 85%, respectively. CONCLUSION The proposed neural network has two functions of brain pathological states diagnosis and bilateral hippocampi segmentation with higher robustness and accuracy, respectively. The segmented bilateral hippocampi can be used as a reference for clinical decision making or intervention.
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Affiliation(s)
- Jingwen Sun
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, 200093, China
| | - Shiju Yan
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, 200093, China.
| | - Chengli Song
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, 200093, China
| | - Baosan Han
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
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21
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Chimagomedova AS, Zorina NA, Arablinskii AV, Levin OS. [Clinical and neuroimaging heterogeneity of dementia with Lewy bodies]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:25-31. [PMID: 31825386 DOI: 10.17116/jnevro201911909225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To study clinical characteristics of dementia with Lewy bodies (DLB) depending on neuropsychological, neuroimaging and concomitant cerebrovascular changes as well as on the character of disease onset. MATERIAL AND METHODS Forty-five patients with DLB (25 men and 20 women, men age 72.9±7.2 years, illness duration 2.9±2.2) were studied. The diagnosis was made according to international criteria (McKeith, et al, 2017). MRI, clinical/neurological examination and psychometric scales were used. RESULTS AND CONCLUSION Clinical, neuropsychological and neuroimaging results reveal the heterogeneity of DLB, which remains poorly investigated. An analysis of the clinical picture, cognitive profile, neuropsychiatric changes and MRI results identified three subtypes of DLB course: 1) typical; 2) with early psychotic manifestation; 3) atypical (mixed). This approach may improve the diagnosis of DLB, prognosis of disease course and treatment effectiveness.
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Affiliation(s)
- A Sh Chimagomedova
- Russian Medical Academy for Continuous Professional Education, Moscow, Russia
| | - N A Zorina
- Botkin City Clinical Hospital, Moscow, Russia
| | - A V Arablinskii
- Sechenov First Moscow State Medical University, Moscow, Russia; Botkin City Clinical Hospital, Moscow, Russia
| | - O S Levin
- Russian Medical Academy for Continuous Professional Education, Moscow, Russia
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Jellinger KA. Neuropathology and pathogenesis of extrapyramidal movement disorders: a critical update-I. Hypokinetic-rigid movement disorders. J Neural Transm (Vienna) 2019; 126:933-995. [PMID: 31214855 DOI: 10.1007/s00702-019-02028-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/05/2019] [Indexed: 02/06/2023]
Abstract
Extrapyramidal movement disorders include hypokinetic rigid and hyperkinetic or mixed forms, most of them originating from dysfunction of the basal ganglia (BG) and their information circuits. The functional anatomy of the BG, the cortico-BG-thalamocortical, and BG-cerebellar circuit connections are briefly reviewed. Pathophysiologic classification of extrapyramidal movement disorder mechanisms distinguish (1) parkinsonian syndromes, (2) chorea and related syndromes, (3) dystonias, (4) myoclonic syndromes, (5) ballism, (6) tics, and (7) tremor syndromes. Recent genetic and molecular-biologic classifications distinguish (1) synucleinopathies (Parkinson's disease, dementia with Lewy bodies, Parkinson's disease-dementia, and multiple system atrophy); (2) tauopathies (progressive supranuclear palsy, corticobasal degeneration, FTLD-17; Guamian Parkinson-dementia; Pick's disease, and others); (3) polyglutamine disorders (Huntington's disease and related disorders); (4) pantothenate kinase-associated neurodegeneration; (5) Wilson's disease; and (6) other hereditary neurodegenerations without hitherto detected genetic or specific markers. The diversity of phenotypes is related to the deposition of pathologic proteins in distinct cell populations, causing neurodegeneration due to genetic and environmental factors, but there is frequent overlap between various disorders. Their etiopathogenesis is still poorly understood, but is suggested to result from an interaction between genetic and environmental factors. Multiple etiologies and noxious factors (protein mishandling, mitochondrial dysfunction, oxidative stress, excitotoxicity, energy failure, and chronic neuroinflammation) are more likely than a single factor. Current clinical consensus criteria have increased the diagnostic accuracy of most neurodegenerative movement disorders, but for their definite diagnosis, histopathological confirmation is required. We present a timely overview of the neuropathology and pathogenesis of the major extrapyramidal movement disorders in two parts, the first one dedicated to hypokinetic-rigid forms and the second to hyperkinetic disorders.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
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23
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Mason DM, Wang Y, Bhatia TN, Miner KM, Trbojevic SA, Stolz JF, Luk KC, Leak RK. The center of olfactory bulb-seeded α-synucleinopathy is the limbic system and the ensuing pathology is higher in male than in female mice. Brain Pathol 2019; 29:741-770. [PMID: 30854742 DOI: 10.1111/bpa.12718] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 03/03/2019] [Indexed: 12/18/2022] Open
Abstract
At early disease stages, Lewy body disorders are characterized by limbic vs. brainstem α-synucleinopathy, but most preclinical studies have focused solely on the nigrostriatal pathway. Furthermore, male gender and advanced age are two major risk factors for this family of conditions, but their influence on the topographical extents of α-synucleinopathy and the degree of cell loss are uncertain. To fill these gaps, we infused α-synuclein fibrils in the olfactory bulb/anterior olfactory nucleus complex-one of the earliest and most frequently affected brain regions in Lewy body disorders-in 3-month-old female and male mice and in 11-month-old male mice. After 6 months, we observed that α-synucleinopathy did not expand significantly beyond the limbic connectome in the 9-month-old male and female mice or in the 17-month-old male mice. However, the 9-month-old male mice had developed greater α-synucleinopathy, smell impairment and cell loss than age-matched females. By 10.5 months post-infusion, fibril treatment hastened mortality in the 21.5-month-old males, but the inclusions remained centered in the limbic system in the survivors. Although fibril infusions reduced the number of cells expressing tyrosine hydroxylase in the substantia nigra of young males at 6 months post-infusion, this was not attributable to true cell death. Furthermore, mesencephalic α-synucleinopathy, if present, was centered in mesolimbic circuits (ventral tegmental area/accumbens) rather than within strict boundaries of the nigral pars compacta, which were defined here by tyrosine hydroxylase immunolabel. Nonprimate models cannot be expected to faithfully recapitulate human Lewy body disorders, but our murine model seems reasonably suited to (i) capture some aspects of Stage IIb of Lewy body disorders, which displays a heavier limbic than brainstem component compared to incipient Parkinson's disease; and (ii) leverage sex differences and the acceleration of mortality following induction of olfactory α-synucleinopathy.
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Affiliation(s)
- Daniel M Mason
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA
| | - Yaqin Wang
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA
| | - Tarun N Bhatia
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA
| | - Kristin M Miner
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA
| | - Sara A Trbojevic
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA
| | - John F Stolz
- Department of Biological Sciences, Duquesne University, Pittsburgh, PA
| | - Kelvin C Luk
- Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Rehana K Leak
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA
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Balážová Z, Nováková M, Minsterová A, Rektorová I. Structural and Functional Magnetic Resonance Imaging of Dementia With Lewy Bodies. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 144:95-141. [PMID: 30638458 DOI: 10.1016/bs.irn.2018.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia after Alzheimer's disease (AD). Although diagnosis may be challenging, there is increasing evidence that the use of biomarkers according to 2017 revised criteria for diagnosis and management of dementia with Lewy bodies can increase diagnostic accuracy. Apart from nuclear medicine techniques, various magnetic resonance imaging (MRI) techniques have been utilized in attempt to enhance diagnostic accuracy. This chapter reviews structural, functional and diffusion MRI studies in DLB cohorts being compared to healthy controls, AD or dementia in Parkinson's disease (PDD). We also included relatively new MRI methods that may have potential to identify early DLB subjects and aim at examining brain iron and neuromelanin.
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Affiliation(s)
- Zuzana Balážová
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic; Department of Radiology and Nuclear Medicine, University Hospital Brno, Faculty of Medicine, Brno, Czech Republic
| | - Marie Nováková
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic
| | - Alžběta Minsterová
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic
| | - Irena Rektorová
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic; St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
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Oppedal K, Ferreira D, Cavallin L, Lemstra AW, Kate M, Padovani A, Rektorova I, Bonanni L, Wahlund L, Engedal K, Nobili F, Kramberger M, Taylor J, Hort J, Snædal J, Blanc F, Walker Z, Antonini A, Westman E, Aarsland D. A signature pattern of cortical atrophy in dementia with Lewy bodies: A study on 333 patients from the European DLB consortium. Alzheimers Dement 2018; 15:400-409. [DOI: 10.1016/j.jalz.2018.09.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 09/11/2018] [Accepted: 09/30/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Ketil Oppedal
- Centre for Age‐Related MedicineStavanger University HospitalStavangerNorway
- Department of RadiologyStavanger University HospitalStavangerNorway
| | - Daniel Ferreira
- Division of Clinical GeriatricsDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Lena Cavallin
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
- Department of RadiologyKarolinska University HospitalStockholmSweden
| | - Afina W. Lemstra
- Department of Neurology and AlzheimercenterVU Universisty Medical CenterAmsterdamNetherlands
| | - Mara Kate
- Department of Neurology and AlzheimercenterVU Universisty Medical CenterAmsterdamNetherlands
| | - Alessandro Padovani
- Neurology UnitDepartment o Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Irena Rektorova
- 1st Department of NeurologyMedical FacultySt. Anne's Hospital and CEITECMasaryk UniversityBrnoCzech Republic
| | - Laura Bonanni
- Department of Neuroscience Imaging and Clinical Sciences and CESIUniversity G d'Annunzio of Chieti‐PescaraChietiItaly
| | - Lars‐Olof Wahlund
- Division of Clinical GeriatricsDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Knut Engedal
- Norwegian Advisory Unit for Ageing and HealthVestfold Hospital Trust and Oslo University HospitalOsloNorway
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI)University of Genoa and Neurology ClinicsPolyclinic San Martino HospitalGenoaItaly
| | - Milica Kramberger
- Department of NeurologyUniversity Medical Centre LjubljanaMedical facultyUniversity of LjubljanaSlovenia
| | - John‐Paul Taylor
- Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneUnited Kingdom
| | - Jakub Hort
- Memory ClinicDepartment of NeurologyCharles University2nd Faculty of Medicine and Motol University HospitalPragueCzech Republic
- International Clinical Research CenterSt. Anne's University Hospital BrnoBrnoCzech Republic
| | - Jon Snædal
- Landspitali University HospitalReykjavikIceland
| | - Frederic Blanc
- Day Hospital of GeriatricsMemory Resource and Research Centre (CM2R) of StrasbourgDepartment of GeriatricsHôpitaux Universitaires de StrasbourgStrasbourgFrance
- University of Strasbourg and French National Centre for Scientific Research (CNRS)ICube Laboratory and Fédération de Médecine Translationnelle de Strasbourg (FMTS)Team Imagerie Multimodale Intégrative en Santé (IMIS)/ICONEStrasbourgFrance
| | - Zuzana Walker
- University College LondonLondon & Essex Partnership University NHS Foundation TrustUnited Kingdom
| | - Angelo Antonini
- Department of NeuroscienceUniversity of PaduaPadua & Fondazione Ospedale San CamilloVeneziaVeniceItaly
| | - Eric Westman
- Division of Clinical GeriatricsDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
- Department of NeuroimagingCentre for Neuroimaging SciencesInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | - Dag Aarsland
- Centre for Age‐Related MedicineStavanger University HospitalStavangerNorway
- Institute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
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van der Zande JJ, Steenwijk MD, ten Kate M, Wattjes MP, Scheltens P, Lemstra AW. Gray matter atrophy in dementia with Lewy bodies with and without concomitant Alzheimer's disease pathology. Neurobiol Aging 2018; 71:171-178. [DOI: 10.1016/j.neurobiolaging.2018.07.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/19/2018] [Accepted: 07/10/2018] [Indexed: 11/29/2022]
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Zheng F, Cui D, Zhang L, Zhang S, Zhao Y, Liu X, Liu C, Li Z, Zhang D, Shi L, Liu Z, Hou K, Lu W, Yin T, Qiu J. The Volume of Hippocampal Subfields in Relation to Decline of Memory Recall Across the Adult Lifespan. Front Aging Neurosci 2018; 10:320. [PMID: 30364081 PMCID: PMC6191512 DOI: 10.3389/fnagi.2018.00320] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/24/2018] [Indexed: 12/27/2022] Open
Abstract
Background: The hippocampus is an important limbic structure closely related to memory function. However, few studies have focused on the association between hippocampal subfields and age-related memory decline. We investigated the volume alterations of hippocampal subfields at different ages and assessed the correlations with Immediate and Delayed recall abilities. Materials and Methods: A total of 275 participants aged 20-89 years were classified into 4 groups: Young, 20-35 years; Middle-early, 36-50 years; Middle-late, 51-65 years; Old, 66-89 years. All data were acquired from the Dallas Lifespan Brain Study (DLBS). The volumes of hippocampal subfields were obtained using Freesurfer software. Analysis of covariance (ANCOVA) was performed to analyze alterations of subfield volumes among the 4 groups, and multiple comparisons between groups were performed using the Bonferroni method. Spearman correlation with false discovery rate correction was used to investigate the relationship between memory recall scores and hippocampal subfield volumes. Results: Apart from no significant difference in the left parasubiculum (P = 0.269) and a slight difference in the right parasubiculum (P = 0.022), the volumes of other hippocampal subfields were significantly different across the adult lifespan (P < 0.001). The hippocampal fissure volume was increased in the Old group, while volumes for other subfields decreased. In addition, Immediate recall scores were associated with volumes of the bilateral molecular layer, granule cell layer of the dentate gyrus (GC-DG), cornus ammonis (CA) 1, CA2/3, CA4, left fimbria and hippocampal amygdala transition area (HATA), and right fissure (P < 0.05). Delayed recall scores were associated with the bilateral molecular layer, GC-DG, CA2/3 and CA4; left tail, presubiculum, CA1, subiculum, fimbria and HATA (P < 0.05). Conclusion: The parasubiculum volume was not significantly different across the adult lifespan, while atrophy in dementia patients in some studies. Based on these findings, we speculate that volume changes in this region might be considered as a biomarker for dementia disorders. Additionally, several hippocampal subfield volumes were significantly associated with memory scores, further highlighting the key role of the hippocampus in age-related memory decline. These regions could be used to assess the risk of memory decline across the adult lifespan.
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Affiliation(s)
- Fenglian Zheng
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Dong Cui
- College of Radiology, Taishan Medical University, Taian, China
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Li Zhang
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Shitong Zhang
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, China
| | - Yue Zhao
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, China
| | - Xiaojing Liu
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Chunhua Liu
- School of Basic Medical Sciences, Taishan Medical University, Taian, China
| | - Zhengmei Li
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Dongsheng Zhang
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Liting Shi
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Zhipeng Liu
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Kun Hou
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Wen Lu
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Tao Yin
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Jianfeng Qiu
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
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28
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Blamire AM. MR approaches in neurodegenerative disorders. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2018; 108:1-16. [PMID: 30538047 DOI: 10.1016/j.pnmrs.2018.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/22/2018] [Accepted: 11/01/2018] [Indexed: 06/09/2023]
Abstract
Neurodegenerative disease is the umbrella term which refers to a range of clinical conditions causing degeneration of neurons within the central nervous system leading to loss of brain function and eventual death. The most prevalent of these is Alzheimer's disease (AD), which affects approximately 50 million people worldwide and is predicted to reach 75 million by 2030. Neurodegenerative diseases can only be fully diagnosed at post mortem by neuropathological assessment of the type and distribution of protein deposits which characterise each different condition, but there is a clear role for imaging technologies in aiding patient diagnoses in life. Magnetic resonance imaging (MRI) and spectroscopy (MRS) techniques have been applied to study these conditions for many years. In this review, we consider the range of MR-based measurements and describe the findings in AD, but also contrast these with the second most common dementia, dementia with Lewy bodies (DLB). The most definitive observation is the major structural brain changes seen in AD using conventional T1-weighted (T1w) MRI, where medial temporal lobe structures are notably atrophied in most symptomatic patients with AD, but often preserved in DLB. Indeed these findings are sufficiently robust to have been incorporated into clinical diagnostic criteria. Diffusion tensor imaging (DTI) reveals widespread changes in tissue microstructure, with increased mean diffusivity and decreased fractional anisotropy reflecting the degeneration of the white matter structures. There are suggestions that there are subtle differences between AD and DLB populations. At the metabolic level, atrophy-corrected MRS demonstrates reduced density of healthy neurons in brain areas with altered perfusion and in regions known to show higher deposits of pathogenic proteins. As studies have moved from patients with advanced disease and clear dysfunction to patients with earlier presentation such as with mild cognitive impairment (MCI), which in some represents the first signs of their ensuing dementia, the ability of MRI to detect differences has been weaker and further work is still required, ideally in much larger cohorts than previously studied. The vast majority of imaging research in dementia populations has been univariate with respect to the MR-derived parameters considered. To date, none of these measurements has uniquely replicated the patterns of tissue involvement seen by neuropathology, and the ability of MR techniques to deliver a non-invasive diagnosis eludes us. Future opportunities may lie in combining MR and nuclear medicine approaches (position emission tomography, PET) to provide a more complete view of structural and metabolic changes. Such developments will require multi-variate analyses, possibly combined with artificial intelligence or deep learning algorithms, to enhance our ability to combine the array of image-derived information, genetic, gender and lifestyle factors.
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Affiliation(s)
- Andrew M Blamire
- Institute of Cellular Medicine and Centre for In Vivo Imaging, Newcastle University, UK.
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29
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Lee YG, Jeon S, Yoo HS, Chung SJ, Lee SK, Lee PH, Sohn YH, Yun M, Evans AC, Ye BS. Amyloid-β-related and unrelated cortical thinning in dementia with Lewy bodies. Neurobiol Aging 2018; 72:32-39. [PMID: 30205358 DOI: 10.1016/j.neurobiolaging.2018.08.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/19/2018] [Accepted: 08/04/2018] [Indexed: 12/11/2022]
Abstract
Coexisting Alzheimer's disease (AD) pathology is common in patients with dementia with Lewy bodies (DLB). To evaluate the cortical thinning in patients with DLB considering the effect of amyloid-β (Aβ), we compared the regional cortical thickness between control subjects and patients with DLB with abnormal dopamine transporter imaging. Seventeen (43.6%) of 39 patients with DLB and no control subjects had significant Aβ deposition on 18F-florbetaben positron emission tomography. Compared to control (n = 15), Aβ-negative DLB group (n = 21) had cortical thinning in the bilateral insula, entorhinal, basal frontal, and occipito-parietal cortices. Compared to Aβ-negative DLB, Aβ-positive DLB group (n = 15) had a lower cortical thickness in the AD-prone brain regions in addition to the bilateral occipital, basal frontal, and somatomotor cortices. After controlling for the amount of Aβ deposition, DLB group had cortical thinning in the same regions affected in the Aβ-negative DLB group. In summary, patients with DLB had an Aβ-independent cortical thinning, while Aβ was associated with additional cortical thinning in the AD-prone brain regions and the aggravation of DLB-specific cortical thinning.
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Affiliation(s)
- Young-Gun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seun Jeon
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Koo Lee
- Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Ho Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Alan C Evans
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
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30
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Pang CCC, Kiecker C, O'Brien JT, Noble W, Chang RCC. Ammon's Horn 2 (CA2) of the Hippocampus: A Long-Known Region with a New Potential Role in Neurodegeneration. Neuroscientist 2018; 25:167-180. [PMID: 29865938 DOI: 10.1177/1073858418778747] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The hippocampus has a critical role in cognition and human memory and is one of the most studied structures in the brain. Despite more than 400 years of research, little is known about the Ammon's horn region cornu ammonis 2 (CA2) subfield in comparison to other subfield regions (CA1, CA3, and CA4). Recent findings have shown that CA2 plays a bigger role than previously thought. Here, we review understanding of hippocampus and CA2 ontogenesis, together with basic and clinical findings about the potential role of this region in neurodegenerative disease. The CA2 has widespread anatomical connectivity, unique signaling molecules, and intrinsic electrophysiological properties. Experimental studies using in vivo models found that the CA2 region has a role in cognition, especially in social memory and object recognition. In models of epilepsy and hypoxia, the CA2 exhibits higher resilience to cell death and hypoxia in comparison with neighboring regions, and while hippocampal atrophy remains poorly understood in Parkinson's disease (PD) and dementia with Lewy bodies (DLB), findings from postmortem PD brain demonstrates clear accumulation of α-synuclein pathology in CA2, and the CA2-CA3 region shows relatively more atrophy compared with other hippocampal subfields. Taken together, there is a growing body of evidence suggesting that the CA2 can be an ideal hallmark with which to differentiate different neurodegenerative stages of PD. Here, we summarize these recent data and provide new perspectives/ideas for future investigations to unravel the contribution of the CA2 to neurodegenerative diseases.
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Affiliation(s)
- Cindy Chi-Ching Pang
- 1 Laboratory of Neurodegenerative Diseases, School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.,2 Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Clemens Kiecker
- 3 Department of Developmental Neurobiology, King's College London, London, UK
| | - John T O'Brien
- 4 Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Wendy Noble
- 2 Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Raymond Chuen-Chung Chang
- 1 Laboratory of Neurodegenerative Diseases, School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.,5 State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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31
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Jellinger KA, Korczyn AD. Are dementia with Lewy bodies and Parkinson's disease dementia the same disease? BMC Med 2018; 16:34. [PMID: 29510692 PMCID: PMC5840831 DOI: 10.1186/s12916-018-1016-8] [Citation(s) in RCA: 191] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/30/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), which share many clinical, neurochemical, and morphological features, have been incorporated into DSM-5 as two separate entities of major neurocognitive disorders with Lewy bodies. Despite clinical overlap, their diagnosis is based on an arbitrary distinction concerning the time of onset of motor and cognitive symptoms, namely as early cognitive impairment in DLB and later onset following that of motor symptoms in PDD. Their morphological hallmarks - cortical and subcortical α-synuclein/Lewy body plus β-amyloid and tau pathologies - are similar, but clinical differences at onset suggest some dissimilar profiles. Based on recent publications, including the fourth consensus report of the DLB Consortium, a critical overview is provided herein. DISCUSSION The clinical constellations of DLB and PDD include cognitive impairment, parkinsonism, visual hallucinations, and fluctuating attention. Intravitam PET and postmortem studies have revealed a more pronounced cortical atrophy, elevated cortical and limbic Lewy body pathologies, higher Aβ and tau loads in cortex and striatum in DLB compared to PDD, and earlier cognitive defects in DLB. Conversely, multitracer PET studies have shown no differences in cortical and striatal cholinergic and dopaminergic deficits. Clinical management of both DLB and PDD includes cholinesterase inhibitors and other pharmacologic and non-drug strategies, yet with only mild symptomatic effects. Currently, no disease-modifying therapies are available. CONCLUSION DLB and PDD are important dementia syndromes that overlap in many clinical features, genetics, neuropathology, and management. They are currently considered as subtypes of an α-synuclein-associated disease spectrum (Lewy body diseases), from incidental Lewy body disease and non-demented Parkinson's disease to PDD, DLB, and DLB with Alzheimer's disease at the most severe end. Cognitive impairment in these disorders is induced not only by α-synuclein-related neurodegeneration but by multiple regional pathological scores. Both DLB and PDD show heterogeneous pathology and neurochemistry, suggesting that they share important common underlying molecular pathogenesis with Alzheimer's disease and other proteinopathies. While we prefer to view DLB and PDD as extremes on a continuum, there remains a pressing need to more clearly differentiate these syndromes and to understand the synucleinopathy processes leading to either one.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, A-1150, Vienna, Austria.
| | - Amos D Korczyn
- Tel-Aviv University, Sackler Faculty of Medicine, Ramat Aviv, Israel
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Jellinger KA. Dementia with Lewy bodies and Parkinson's disease-dementia: current concepts and controversies. J Neural Transm (Vienna) 2017; 125:615-650. [PMID: 29222591 DOI: 10.1007/s00702-017-1821-9] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 11/28/2017] [Indexed: 12/15/2022]
Abstract
Dementia with Lewy bodies (DLB) and Parkinson's disease-dementia (PDD), although sharing many clinical, neurochemical and morphological features, according to DSM-5, are two entities of major neurocognitive disorders with Lewy bodies of unknown etiology. Despite considerable clinical overlap, their diagnosis is based on an arbitrary distinction between the time of onset of motor and cognitive symptoms: dementia often preceding parkinsonism in DLB and onset of cognitive impairment after onset of motor symptoms in PDD. Both are characterized morphologically by widespread cortical and subcortical α-synuclein/Lewy body plus β-amyloid and tau pathologies. Based on recent publications, including the fourth consensus report of the DLB Consortium, a critical overview is given. The clinical features of DLB and PDD include cognitive impairment, parkinsonism, visual hallucinations, and fluctuating attention. Intravitam PET and post-mortem studies revealed more pronounced cortical atrophy, elevated cortical and limbic Lewy pathologies (with APOE ε4), apart from higher prevalence of Alzheimer pathology in DLB than PDD. These changes may account for earlier onset and greater severity of cognitive defects in DLB, while multitracer PET studies showed no differences in cholinergic and dopaminergic deficits. DLB and PDD sharing genetic, neurochemical, and morphologic factors are likely to represent two subtypes of an α-synuclein-associated disease spectrum (Lewy body diseases), beginning with incidental Lewy body disease-PD-nondemented-PDD-DLB (no parkinsonism)-DLB with Alzheimer's disease (DLB-AD) at the most severe end, although DLB does not begin with PD/PDD and does not always progress to DLB-AD, while others consider them as the same disease. Both DLB and PDD show heterogeneous pathology and neurochemistry, suggesting that they share important common underlying molecular pathogenesis with AD and other proteinopathies. Cognitive impairment is not only induced by α-synuclein-caused neurodegeneration but by multiple regional pathological scores. Recent animal models and human post-mortem studies have provided important insights into the pathophysiology of DLB/PDD showing some differences, e.g., different spreading patterns of α-synuclein pathology, but the basic pathogenic mechanisms leading to the heterogeneity between both disorders deserve further elucidation. In view of the controversies about the nosology and pathogenesis of both syndromes, there remains a pressing need to differentiate them more clearly and to understand the processes leading these synucleinopathies to cause one disorder or the other. Clinical management of both disorders includes cholinesterase inhibitors, other pharmacologic and nonpharmacologic strategies, but these have only a mild symptomatic effect. Currently, no disease-modifying therapies are available.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
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Elder GJ, Mactier K, Colloby SJ, Watson R, Blamire AM, O'Brien JT, Taylor J. The influence of hippocampal atrophy on the cognitive phenotype of dementia with Lewy bodies. Int J Geriatr Psychiatry 2017; 32:1182-1189. [PMID: 28425185 PMCID: PMC5655697 DOI: 10.1002/gps.4719] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 03/16/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The level of hippocampal atrophy in dementia with Lewy bodies (DLB) is typically less than that observed in Alzheimer's disease (AD). However, it is not known how the cognitive phenotype of DLB is influenced by hippocampal atrophy or the atrophy of adjacent medial temporal lobe structures. METHODS Dementia with Lewy bodies (n = 65), AD (n = 76) and control (n = 63) participants underwent 3T magnetic resonance imaging and cognitive Cambridge Cognitive Examination and Mini-Mental State Examination (CAMCOG and MMSE) assessments. Hippocampal volume, and parahippocampal, entorhinal and temporal pole cortical thickness, was compared between groups. Regression models were used to investigate whether hippocampal volume and cortical thickness associated with global cognition and cognitive subdomains. RESULTS Dementia with Lewy bodies, AD and control participants showed significantly different hippocampal, parahippocampal and entorhinal cortical thinning, where atrophy was greatest in AD and intermediate in DLB. Temporal pole thickness was reduced in DLB and AD compared with control participants. In DLB, but not AD, hippocampal volume associated with total CAMCOG, CAMCOG memory and MMSE scores. In DLB, parahippocampal, entorhinal and temporal pole thickness associated with total CAMCOG and CAMCOG memory scores, parahippocampal thickness associated with MMSE scores, and entorhinal thickness associated with CAMCOG executive function scores. CONCLUSIONS In this large sample, these results are in agreement with other studies indicating that hippocampal atrophy is less severe in DLB than AD. Hippocampal atrophy and medial temporal lobe cortical thickness were associated with the severity of cognitive symptoms, suggesting that atrophy in these structures, as a potential proxy of AD pathology, may partly mediate specific DLB cognitive symptoms. © 2017 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Greg J. Elder
- Institute of NeuroscienceNewcastle University, Campus for Ageing and VitalityNewcastle upon TyneUK
| | - Karen Mactier
- Institute of NeuroscienceNewcastle University, Campus for Ageing and VitalityNewcastle upon TyneUK
| | - Sean J. Colloby
- Institute of NeuroscienceNewcastle University, Campus for Ageing and VitalityNewcastle upon TyneUK
| | - Rosie Watson
- The Florey Institute of Neuroscience and Mental HealthParkvilleVICAustralia
| | - Andrew M. Blamire
- Newcastle Magnetic Resonance CentreNewcastle UniversityNewcastle upon TyneUK
| | | | - John‐Paul Taylor
- Institute of NeuroscienceNewcastle University, Campus for Ageing and VitalityNewcastle upon TyneUK
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