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Horne K, Carmichael A, Mercieca EC, Glikmann-Johnston Y, Stout JC, Irish M. Delineating the neural substrates of autobiographical memory impairment in Huntington's disease. Eur J Neurosci 2024. [PMID: 39419578 DOI: 10.1111/ejn.16576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 09/12/2024] [Accepted: 10/02/2024] [Indexed: 10/19/2024]
Abstract
Emerging evidence suggests that autobiographical memory (ABM) is altered in Huntington's disease (HD). While these impairments are typically attributed to frontostriatal dysfunction, the neural substrates of ABM impairment in HD remain unexplored. To this end, we assessed ABM in 30 participants with genetically confirmed HD (18 premanifest, 12 manifest) and 24 age-matched healthy controls. Participants completed the Autobiographical Interview to assess free and probed ABM recall and underwent structural brain imaging. Whole-brain voxel-based morphometry (VBM) was used to explore voxel-wise associations between ABM performance and grey matter intensity (False Discovery Rate corrected at q = 0.05). Relative to controls, HD participants displayed significantly less detailed ABM retrieval across free and probed recall conditions, irrespective of disease stage. Recall performance did not differ significantly between manifest and premanifest HD groups. VBM analyses indicated that poorer ABM performance was associated with atrophy of a distributed cortico-subcortical network. Key regions implicated irrespective of ABM condition included the bilateral occipital cortex, left precuneus, right parahippocampal gyrus and right caudate nucleus. In addition, probed ABM recall was associated with the superior and inferior frontal gyri, frontal pole, right hippocampus, nucleus accumbens, paracingulate gyrus and cerebellum. Overall, our findings indicate that ABM impairments in HD reflect the progressive degeneration of a distributed cortico-subcortical brain network comprising medial temporal, frontal, striatal and posterior parietal cortices. Our findings advance our understanding of the neurocognitive profile of HD, providing an important foundation for future interventions to support memory function in this population.
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Affiliation(s)
- Kristina Horne
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Anna Carmichael
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Emily-Clare Mercieca
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Yifat Glikmann-Johnston
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Julie C Stout
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Muireann Irish
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
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2
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Wang X, Li Y, Li B, Shang H, Yang J. Gray matter alterations in Huntington's disease: A meta-analysis of VBM neuroimaging studies. J Neurosci Res 2024; 102:e25366. [PMID: 38953592 DOI: 10.1002/jnr.25366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 05/16/2024] [Accepted: 06/16/2024] [Indexed: 07/04/2024]
Abstract
Increasing neuroimaging studies have attempted to identify biomarkers of Huntington's disease (HD) progression. Here, we conducted voxel-based meta-analyses of voxel-based morphometry (VBM) studies on HD to investigate the evolution of gray matter volume (GMV) alterations and explore the effects of genetic and clinical features on GMV changes. A systematic review was performed to identify the relevant studies. Meta-analyses of whole-brain VBM studies were performed to assess the regional GMV changes in all HD mutation carriers, in presymptomatic HD (pre-HD), and in symptomatic HD (sym-HD). A quantitative comparison was performed between pre-HD and sym-HD. Meta-regression analyses were used to explore the effects of genetic and clinical features on GMV changes. Twenty-eight studies were included, comparing a total of 1811 HD mutation carriers [including 1150 pre-HD and 560 sym-HD] and 969 healthy controls (HCs). Pre-HD showed decreased GMV in the bilateral caudate nuclei, putamen, insula, anterior cingulate/paracingulate gyri, middle temporal gyri, and left dorsolateral superior frontal gyrus compared with HCs. Compared with pre-HD, GMV decrease in sym-HD extended to the bilateral median cingulate/paracingulate gyri, Rolandic operculum and middle occipital gyri, left amygdala, and superior temporal gyrus. Meta-regression analyses found that age, mean lengths of CAG repeats, and disease burden were negatively associated with GMV atrophy of the bilateral caudate and right insula in all HD mutation carriers. This meta-analysis revealed the pattern of GMV changes from pre-HD to sym-HD, prompting the understanding of HD progression. The pattern of GMV changes may be biomarkers for disease progression in HD.
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Affiliation(s)
- Xi Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuming Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Boyi Li
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huifang Shang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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3
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Saffari SE, Soo SA, Mohammadi R, Ng KP, Greene W, Kandiah N. Modelling the Distribution of Cognitive Outcomes for Early-Stage Neurocognitive Disorders: A Model Comparison Approach. Biomedicines 2024; 12:393. [PMID: 38397995 PMCID: PMC10886528 DOI: 10.3390/biomedicines12020393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Cognitive assessments for patients with neurocognitive disorders are mostly measured by the Montreal Cognitive Assessment (MoCA) and Visual Cognitive Assessment Test (VCAT) as screening tools. These cognitive scores are usually left-skewed and the results of the association analysis might not be robust. This study aims to study the distribution of the cognitive outcomes and to discuss potential solutions. Materials and Methods: In this retrospective cohort study of individuals with subjective cognitive decline or mild cognitive impairment, the inverse-transformed cognitive outcomes are modelled using different statistical distributions. The robustness of the proposed models are checked under different scenarios: with intercept-only, models with covariates, and with and without bootstrapping. Results: The main results were based on the VCAT score and validated via the MoCA score. The findings suggested that the inverse transformation method improved the modelling the cognitive scores compared to the conventional methods using the original cognitive scores. The association of the baseline characteristics (age, gender, and years of education) and the cognitive outcomes were reported as estimates and 95% confidence intervals. Bootstrap methods improved the estimate precision and the bootstrapped standard errors of the estimates were more robust. Cognitive outcomes were widely analysed using linear regression models with the default normal distribution as a conventional method. We compared the results of our suggested models with the normal distribution under various scenarios. Goodness-of-fit measurements were compared between the proposed models and conventional methods. Conclusions: The findings support the use of the inverse transformation method to model the cognitive outcomes instead of the original cognitive scores for early-stage neurocognitive disorders where the cognitive outcomes are left-skewed.
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Affiliation(s)
- Seyed Ehsan Saffari
- Centre for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore;
- Department of Neurology, National Neuroscience Institute, Singapore 308433, Singapore;
| | - See Ann Soo
- Dementia Research Centre (Singapore), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore; (S.A.S.); (N.K.)
| | - Raziyeh Mohammadi
- Centre for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore;
| | - Kok Pin Ng
- Department of Neurology, National Neuroscience Institute, Singapore 308433, Singapore;
- Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
| | - William Greene
- Stern School of Business (Emeritus), New York University, New York, NY 10012, USA;
| | - Negaenderan Kandiah
- Dementia Research Centre (Singapore), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore; (S.A.S.); (N.K.)
- Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
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4
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Hobbs NZ, Papoutsi M, Delva A, Kinnunen KM, Nakajima M, Van Laere K, Vandenberghe W, Herath P, Scahill RI. Neuroimaging to Facilitate Clinical Trials in Huntington's Disease: Current Opinion from the EHDN Imaging Working Group. J Huntingtons Dis 2024; 13:163-199. [PMID: 38788082 PMCID: PMC11307036 DOI: 10.3233/jhd-240016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/26/2024]
Abstract
Neuroimaging is increasingly being included in clinical trials of Huntington's disease (HD) for a wide range of purposes from participant selection and safety monitoring, through to demonstration of disease modification. Selection of the appropriate modality and associated analysis tools requires careful consideration. On behalf of the EHDN Imaging Working Group, we present current opinion on the utility and future prospects for inclusion of neuroimaging in HD trials. Covering the key imaging modalities of structural-, functional- and diffusion- MRI, perfusion imaging, positron emission tomography, magnetic resonance spectroscopy, and magnetoencephalography, we address how neuroimaging can be used in HD trials to: 1) Aid patient selection, enrichment, stratification, and safety monitoring; 2) Demonstrate biodistribution, target engagement, and pharmacodynamics; 3) Provide evidence for disease modification; and 4) Understand brain re-organization following therapy. We also present the challenges of translating research methodology into clinical trial settings, including equipment requirements and cost, standardization of acquisition and analysis, patient burden and invasiveness, and interpretation of results. We conclude, that with appropriate consideration of modality, study design and analysis, imaging has huge potential to facilitate effective clinical trials in HD.
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Affiliation(s)
- Nicola Z. Hobbs
- HD Research Centre, UCL Institute of Neurology, UCL, London, UK
| | - Marina Papoutsi
- HD Research Centre, UCL Institute of Neurology, UCL, London, UK
- IXICO plc, London, UK
| | - Aline Delva
- Department of Neurosciences, KU Leuven, Belgium
- Department of Neurology, University Hospitals Leuven, Belgium
| | | | | | - Koen Van Laere
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, KU Leuven, Belgium
- Division of Nuclear Medicine, University Hospitals Leuven, Belgium
| | - Wim Vandenberghe
- Department of Neurosciences, KU Leuven, Belgium
- Department of Neurology, University Hospitals Leuven, Belgium
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5
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Jacquemot C, Bachoud-Lévi AC. Striatum and language processing: Where do we stand? Cognition 2021; 213:104785. [PMID: 34059317 DOI: 10.1016/j.cognition.2021.104785] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 11/18/2022]
Abstract
More than a century ago, Broca (1861), Wernicke (1874) and Lichteim (1885) laid the foundations for the first anatomo-functional model of language, secondarily enriched by Geschwind (1967), leading to the Broca-Wernicke-Lichteim-Geschwind model. This model included the frontal, parietal, and temporal cortices as well as a subcortical structure, which could be the striatum, whose nature and role have remained unclear. Although the emergence of language deficits in patients with striatal injury has challenged the cortical language models developed over the past 30 years, the integration of the striatum into language processing models remains rare. The main argument for not including the striatum in language processing is that the disorders observed in patients with striatal dysfunction may result from the striatal role in cognitive functions beyond language, and not from the impairment of language itself. Indeed, unraveling the role of the striatum and the frontal cortex, linked by the fronto-striatal pathway, is a challenge. Here, we first reviewed the studies that explored the link between striatal functions and the different levels of language (phonetics, phonology, morphology, syntax, and lexico-semantics). We then looked at the language models, which included the striatum, and found that none of them captured the diversity of experimental data in this area. Finally, we propose an integrative anatomo-functional model of language processing combining traditional language processing levels and some "executive" functions, known to improve the efficiency and fluidity of language: control, working memory, and attention. We argue that within this integrative model, the striatum is a central node of a verbal executive network that regulates, monitors, and controls the allocations of limited cognitive resources (verbal working memory and verbal attention), whatever the language level. This model combines data from neurology, psycholinguistics, and cognitive science.
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Affiliation(s)
- Charlotte Jacquemot
- Département d'Etudes Cognitives, École normale supérieure, PSL University, 75005 Paris, France; Inserm U955, Institut Mondor de Recherche Biomédicale, Equipe E01 NeuroPsychologie Interventionnelle, 94000 Créteil, France; Université Paris-Est Créteil, Faculté de médecine, 94000 Créteil, France
| | - Anne-Catherine Bachoud-Lévi
- Département d'Etudes Cognitives, École normale supérieure, PSL University, 75005 Paris, France; Inserm U955, Institut Mondor de Recherche Biomédicale, Equipe E01 NeuroPsychologie Interventionnelle, 94000 Créteil, France; Université Paris-Est Créteil, Faculté de médecine, 94000 Créteil, France; Assistance Publique-Hôpitaux de Paris, National Reference Center for Huntington's Disease, Neurology Department, Henri Mondor-Albert Chenevier Hospital, Créteil, France.
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6
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Franklin GL, Camargo CHF, Meira AT, Lima NSC, Teive HAG. The Role of the Cerebellum in Huntington's Disease: a Systematic Review. THE CEREBELLUM 2020; 20:254-265. [PMID: 33029762 DOI: 10.1007/s12311-020-01198-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 11/25/2022]
Abstract
Huntington's disease (HD) is a rare neurological disorder characterized by progressive motor, cognitive, and psychiatric disturbances. Although striatum degeneration might justify most of the motor symptoms, there is an emerging evidence of involvement of extra-striatal structures, such as the cerebellum. To elucidate the cerebellar involvement and its afferences with motor, psychiatric, and cognitive symptoms in HD. A systematic search in the literature was performed in MEDLINE, LILACS, and Google Scholar databases. The research was broadened to include the screening of reference lists of review articles for additional studies. Studies available in the English language, dating from 1993 through May 2020, were included. Clinical presentation of patients with HD may not be considered as the result of an isolated primary striatal dysfunction. There is evidence that cerebellar involvement is an early event in HD and may occur independently of striatal degeneration. Also, the loss of the compensation role of the cerebellum in HD may be an explanation for the clinical onset of HD. Although more studies are needed to elucidate this association, the current literature supports that the cerebellum may integrate the natural history of neurodegeneration in HD.
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Affiliation(s)
- Gustavo L Franklin
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Rua General Carneiro 1103/102, Centro, Curitiba, Paraná, Brazil.
| | - Carlos Henrique F Camargo
- Neurological Diseases Group, Graduate Program in Internal Medicine, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Alex T Meira
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Rua General Carneiro 1103/102, Centro, Curitiba, Paraná, Brazil
| | - Nayra S C Lima
- Vila Velha University, Vila Velha, Espírito Santo, Brazil
| | - Hélio A G Teive
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Rua General Carneiro 1103/102, Centro, Curitiba, Paraná, Brazil
- Neurological Diseases Group, Graduate Program in Internal Medicine, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, Paraná, Brazil
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7
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Ramirez-Garcia G, Galvez V, Diaz R, Bayliss L, Fernandez-Ruiz J, Campos-Romo A. Longitudinal atrophy characterization of cortical and subcortical gray matter in Huntington's disease patients. Eur J Neurosci 2019; 51:1827-1843. [PMID: 31705594 DOI: 10.1111/ejn.14617] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 10/18/2019] [Accepted: 10/29/2019] [Indexed: 01/18/2023]
Abstract
Huntington's disease (HD) is an inherited neurodegenerative disease with clinical manifestations that involve motor, cognitive and psychiatric deficits. Cross-sectional magnetic resonance imaging (MRI) studies have described the main cortical and subcortical macrostructural atrophy of HD. However, longitudinal studies characterizing progressive atrophy are lacking. This study aimed to describe the cortical and subcortical gray matter atrophy using complementary volumetric and surface-based MRI analyses in a cohort of seventeen early HD patients in a cross-sectional and longitudinal analysis and to correlate the longitudinal volumetric atrophy with the functional decline using several clinical measures. A group of seventeen healthy individuals was included as controls. After obtaining structural MRIs, volumetric analyses were performed in 36 cortical and 7 subcortical regions of interest per hemisphere and surface-based analyses were performed in the whole cortex, caudate, putamen and thalamus. Cross-sectional cortical surface-based and volumetric analyses showed significant decreases in frontoparietal and temporo-occipital cortices, while subcortical volumetric analysis showed significant decreases in all subcortical structures except the hippocampus. The longitudinal surface-based analysis showed widespread cortical thinning with volumetric decreases in the superior frontal lobe, while a subcortical volumetric decrease occurred in the caudate, putamen and thalamus with shape deformation on the anterior, medial and dorsal side. Functional capacity and motor status decline correlated with caudate progressive atrophy, while cognitive decline correlated with left superior frontal and right paracentral progressive atrophy. These results provide new insights into progressive volumetric and surface-based morphometric atrophy of gray matter in HD.
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Affiliation(s)
- Gabriel Ramirez-Garcia
- Unidad Periférica de Neurociencias, Facultad de Medicina, Instituto Nacional de Neurología y Neurocirugía "MVS", Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Víctor Galvez
- Laboratorio de Neurociencias Cognitivas y Desarrollo, Escuela de Psicología, Universidad Panamericana, Ciudad de México, México
| | - Rosalinda Diaz
- Laboratorio de Neuropsicología, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Leo Bayliss
- Departamento de Neurología, Instituto Nacional de Neurología y Neurocirugía "MVS", Ciudad de México, México
| | - Juan Fernandez-Ruiz
- Laboratorio de Neuropsicología, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México.,Instituto de Neuroetología, Universidad Veracruzana, Ciudad de México, México.,Facultad de Psicología, Universidad Veracruzana, Ciudad de México, México
| | - Aurelio Campos-Romo
- Unidad Periférica de Neurociencias, Facultad de Medicina, Instituto Nacional de Neurología y Neurocirugía "MVS", Universidad Nacional Autónoma de México, Ciudad de México, México
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8
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Johnson EB, Gregory S. Huntington's disease: Brain imaging in Huntington's disease. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019; 165:321-369. [PMID: 31481169 DOI: 10.1016/bs.pmbts.2019.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Huntington's disease (HD) gene-carriers show prominent neuronal loss by end-stage disease, and the use of magnetic resonance imaging (MRI) has been increasingly used to quantify brain changes during earlier stages of the disease. MRI offers an in vivo method of measuring structural and functional brain change. The images collected via MRI are processed to measure different anatomical features, such as brain volume, macro- and microstructural changes within white matter and functional brain activity. Structural imaging has demonstrated significant volume loss across multiple white and gray matter regions in HD, particularly within subcortical structures. There also appears to be increasing disorganization of white matter tracts and between-region connectivity with increasing disease progression. Finally, functional changes are thought to represent changes in brain activity underlying compensatory mechanisms in HD. This chapter will provide an overview of the principles of MRI and practicalities associated with using MRI in HD studies, and summarize findings from MRI studies investigating brain structure and function in HD.
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Affiliation(s)
- Eileanoir B Johnson
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sarah Gregory
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
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9
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Van den Boom MA, Jansma JM, Ramsey NF. Rapid acquisition of dynamic control over DLPFC using real-time fMRI feedback. Eur Neuropsychopharmacol 2018; 28:1194-1205. [PMID: 30217551 PMCID: PMC6420021 DOI: 10.1016/j.euroneuro.2018.08.508] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 08/08/2018] [Accepted: 08/14/2018] [Indexed: 12/20/2022]
Abstract
It has been postulated that gaining control over activity in the dorsolateral prefrontal cortex (DLPFC), a key region of the working memory brain network, may be beneficial for cognitive performance and treatment of certain psychiatric disorders. Several studies have reported that, with neurofeedback training, subjects can learn to increase DLPFC activity. However, improvement of dynamic control in terms of switching between low and high activity in DLPFC brain states may potentially constitute more effective self-regulation. Here, we report on feasibility of obtaining dynamic control over DLPFC, meaning the ability to both in- and decrease activity at will, within a single functional MRI scan session. Two groups of healthy volunteers (N = 24) were asked to increase and decrease activity in the left DLPFC as often as possible during fMRI scans (at 7 Tesla), while receiving real-time visual feedback. The experimental group practiced with real-time feedback, whereas the control group received sham feedback. The experimental group significantly increased the speed of intentionally alternating DLPFC activity, while performance of the control group did not change. Analysis of the characteristics of the BOLD signal during successful trials revealed that training with neurofeedback predominantly reduced the time for the DLPFC to return to baseline after activation. These results provide a preliminary indication that people may be able to learn to dynamically down-regulate the level of physiological activity in the DLPFC, and may have implications for psychiatric disorders where DLPFC plays a role.
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Affiliation(s)
- Max Alexander Van den Boom
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, P.O. Box 85500, Utrecht, The Netherlands.
| | - Johan Martijn Jansma
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Nick Franciscus Ramsey
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, P.O. Box 85500, Utrecht, The Netherlands.
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10
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Functional Magnetic Resonance Imaging in Huntington's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 142:381-408. [PMID: 30409260 DOI: 10.1016/bs.irn.2018.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Huntington's disease is an inherited neurodegenerative condition characterized by motor dysfunction, cognitive impairment and neuropsychiatric disturbance. The effects of the underlying pathology on brain morphology are relatively well understood. Numerous structural Magnetic Resonance Imaging (MRI) studies have demonstrated macrostructural change with widespread striatal and cortical atrophy and microstructural white matter loss in premanifest and manifest HD gene carriers. However, disease effects on brain function are less well characterized. Functional MRI provides an opportunity to examine differences in brain activity either in response to a particular task or in the brain at rest. There is increasing evidence that HD gene carriers exhibit altered activation patterns and functional connectivity between brain regions in response to the neurodegenerative process. Here we review the growing literature in this area and critically evaluate the utility of this imaging modality.
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12
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Gregory S, Long JD, Klöppel S, Razi A, Scheller E, Minkova L, Johnson EB, Durr A, Roos RAC, Leavitt BR, Mills JA, Stout JC, Scahill RI, Tabrizi SJ, Rees G. Testing a longitudinal compensation model in premanifest Huntington's disease. Brain 2018; 141:2156-2166. [PMID: 29788038 PMCID: PMC6022638 DOI: 10.1093/brain/awy122] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 02/20/2018] [Accepted: 03/10/2018] [Indexed: 01/07/2023] Open
Abstract
The initial stages of neurodegeneration are commonly marked by normal levels of cognitive and motor performance despite the presence of structural brain pathology. Compensation is widely assumed to account for this preserved behaviour, but despite the apparent simplicity of such a concept, it has proven incredibly difficult to demonstrate such a phenomenon and distinguish it from disease-related pathology. Recently, we developed a model of compensation whereby brain activation, behaviour and pathology, components key to understanding compensation, have specific longitudinal trajectories over three phases of progression. Here, we empirically validate our explicit mathematical model by testing for the presence of compensation over time in neurodegeneration. Huntington's disease is an ideal model for examining longitudinal compensation in neurodegeneration as it is both monogenic and fully penetrant, so disease progression and potential compensation can be monitored many years prior to diagnosis. We defined our conditions for compensation as non-linear longitudinal trajectories of brain activity and performance in the presence of linear neuronal degeneration and applied our model of compensation to a large longitudinal cohort of premanifest and early-stage Huntington's disease patients from the multisite Track-On HD study. Focusing on cognitive and motor networks, we integrated progressive volume loss, task and resting state functional MRI and cognitive and motor behaviour across three sequential phases of neurodegenerative disease progression, adjusted for genetic disease load. Multivariate linear mixed models were fitted and trajectories for each variable tested. Our conceptualization of compensation was partially realized across certain motor and cognitive networks at differing levels. We found several significant network trends that were more complex than that hypothesized in our model. These trends suggest changes to our theoretical model where the network effects are delayed relative to performance effects. There was evidence of compensation primarily in the prefrontal component of the cognitive network, with increased effective connectivity between the left and right dorsolateral prefrontal cortex. Having developed an operational model for the explicit testing of longitudinal compensation in neurodegeneration, it appears that general patterns of our framework are consistent with the empirical data. With the proposed modifications, our operational model of compensation can be used to test for both cross-sectional and longitudinal compensation in neurodegenerative disease with similar patterns to Huntington's disease.
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Affiliation(s)
- Sarah Gregory
- Huntington’s disease Research Centre, UCL Institute of Neurology, University College London, London, UK
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
| | - Jeffrey D Long
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa, City, IA, USA
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Stefan Klöppel
- University Hospital for Old Age Psychiatry, Murtenstrasse 21, 3010 Bern, Switzerland
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
| | - Adeel Razi
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
- Department of Electronic Engineering, N.E.D University of Engineering and Technology, Karachi, Pakistan
| | - Elisa Scheller
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Division, Medical Center, University of Freiburg, Freiburg, Germany
| | - Lora Minkova
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Division, Medical Center, University of Freiburg, Freiburg, Germany
| | - Eileanoir B Johnson
- Huntington’s disease Research Centre, UCL Institute of Neurology, University College London, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Alexandra Durr
- ICM - Institut du Cerveau et de la Moelle Epinière, INSERM U1127, CNRS UMR7225, Sorbonne Universités – UPMC Université Paris VI UMR_S1127and APHP, Genetic department, Pitié-Salpêtrière University Hospital, Paris, France
| | - Raymund A C Roos
- Leiden University Medical Center, Department of Neurology, Leiden, The Netherlands
| | - Blair R Leavitt
- Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia, Canada
| | - James A Mills
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Julie C Stout
- School of Psychological Sciences and Institute of Clinical and Cognitive Neuroscience, Monash University, Melbourne, Australia
| | - Rachael I Scahill
- Huntington’s disease Research Centre, UCL Institute of Neurology, University College London, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Sarah J Tabrizi
- Huntington’s disease Research Centre, UCL Institute of Neurology, University College London, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Geraint Rees
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
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13
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Pandey M, Rajamma U. Huntington's disease: the coming of age. J Genet 2018; 97:649-664. [PMID: 30027901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Huntington's disease (HD) is caused due to an abnormal expansion of polyglutamine repeats in the first exon of huntingtin gene. The mutation in huntingtin causes abnormalities in the functioning of protein, leading to deleterious effects ultimately to the demise of specific neuronal cells.The disease is inherited in an autosomal dominant manner and leads to a plethora of neuropsychiatric behaviour and neuronal cell death mainly in striatal and cortical regions of the brain, eventually leading to death of the individual. The discovery of the mutant gene led to a surge in molecular diagnostics of the disease and in making different transgenic models in different organisms to understand the function of wild-type and mutant proteins. Despite difficult challenges, there has been a significant increase in understanding the functioning of the protein in normal and other gain-of-function interactions in mutant form. However, there have been no significant improvements in treatments of the patients suffering from this ailment and most of the treatment is still symptomatic. HD warrants more attention towards better understanding and treatment as more advancement in molecular diagnostics and therapeutic interventions are available. Several different transgenic models are available in different organisms, ranging from fruit flies to primate monkeys, for studies on understanding the pathogenicity of the mutant gene. It is the right time to assess the advancement in the field and try new strategies for neuroprotection using key pathways as target. The present review highlights the key ingredients of pathology in the HD and discusses important studies for drug trials and future goals for therapeutic interventions.
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Affiliation(s)
- Mritunjay Pandey
- Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
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Domínguez D JF, Poudel G, Stout JC, Gray M, Chua P, Borowsky B, Egan GF, Georgiou-Karistianis N. Longitudinal changes in the fronto-striatal network are associated with executive dysfunction and behavioral dysregulation in Huntington's disease: 30 months IMAGE-HD data. Cortex 2017; 92:139-149. [DOI: 10.1016/j.cortex.2017.04.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 12/16/2016] [Accepted: 04/05/2017] [Indexed: 12/17/2022]
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Tyebji S, Hannan AJ. Synaptopathic mechanisms of neurodegeneration and dementia: Insights from Huntington's disease. Prog Neurobiol 2017; 153:18-45. [PMID: 28377290 DOI: 10.1016/j.pneurobio.2017.03.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 03/19/2017] [Accepted: 03/30/2017] [Indexed: 12/20/2022]
Abstract
Dementia encapsulates a set of symptoms that include loss of mental abilities such as memory, problem solving or language, and reduces a person's ability to perform daily activities. Alzheimer's disease is the most common form of dementia, however dementia can also occur in other neurological disorders such as Huntington's disease (HD). Many studies have demonstrated that loss of neuronal cell function manifests pre-symptomatically and thus is a relevant therapeutic target to alleviate symptoms. Synaptopathy, the physiological dysfunction of synapses, is now being approached as the target for many neurological and psychiatric disorders, including HD. HD is an autosomal dominant and progressive degenerative disorder, with clinical manifestations that encompass movement, cognition, mood and behaviour. HD is one of the most common tandem repeat disorders and is caused by a trinucleotide (CAG) repeat expansion, encoding an extended polyglutamine tract in the huntingtin protein. Animal models as well as human studies have provided detailed, although not exhaustive, evidence of synaptic dysfunction in HD. In this review, we discuss the neuropathology of HD and how the changes in synaptic signalling in the diseased brain lead to its symptoms, which include dementia. Here, we review and discuss the mechanisms by which the 'molecular orchestras' and their 'synaptic symphonies' are disrupted in neurodegeneration and dementia, focusing on HD as a model disease. We also explore the therapeutic strategies currently in pre-clinical and clinical testing that are targeted towards improving synaptic function in HD.
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Affiliation(s)
- Shiraz Tyebji
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Anthony J Hannan
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia; Department of Anatomy and Neuroscience, University of Melbourne, Parkville, Victoria, Australia.
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Clemensson EKH, Clemensson LE, Riess O, Nguyen HP. The BACHD Rat Model of Huntington Disease Shows Signs of Fronto-Striatal Dysfunction in Two Operant Conditioning Tests of Short-Term Memory. PLoS One 2017; 12:e0169051. [PMID: 28045968 PMCID: PMC5207398 DOI: 10.1371/journal.pone.0169051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 12/11/2016] [Indexed: 12/21/2022] Open
Abstract
The BACHD rat is a recently developed transgenic animal model of Huntington disease, a progressive neurodegenerative disorder characterized by extensive loss of striatal neurons. Cognitive impairments are common among patients, and characterization of similar deficits in animal models of the disease is therefore of interest. The present study assessed the BACHD rats' performance in the delayed alternation and the delayed non-matching to position test, two Skinner box-based tests of short-term memory function. The transgenic rats showed impaired performance in both tests, indicating general problems with handling basic aspects of the tests, while short-term memory appeared to be intact. Similar phenotypes have been found in rats with fronto-striatal lesions, suggesting that Huntington disease-related neuropathology might be present in the BACHD rats. Further analyses indicated that the performance deficit in the delayed alternation test might be due to impaired inhibitory control, which has also been implicated in Huntington disease patients. The study ultimately suggests that the BACHD rats might suffer from neuropathology and cognitive impairments reminiscent of those of Huntington disease patients.
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Affiliation(s)
- Erik Karl Håkan Clemensson
- Institute of Medical Genetics and Applied Genomics, Tuebingen, Germany
- Centre for Rare Diseases, Tuebingen, Germany
| | - Laura Emily Clemensson
- Institute of Medical Genetics and Applied Genomics, Tuebingen, Germany
- Centre for Rare Diseases, Tuebingen, Germany
- QPS Austria, Grambach, Austria
| | - Olaf Riess
- Institute of Medical Genetics and Applied Genomics, Tuebingen, Germany
- Centre for Rare Diseases, Tuebingen, Germany
| | - Huu Phuc Nguyen
- Institute of Medical Genetics and Applied Genomics, Tuebingen, Germany
- Centre for Rare Diseases, Tuebingen, Germany
- * E-mail:
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Scahill RI, Andre R, Tabrizi SJ, Aylward EH. Structural imaging in premanifest and manifest Huntington disease. HANDBOOK OF CLINICAL NEUROLOGY 2017; 144:247-261. [PMID: 28947121 DOI: 10.1016/b978-0-12-801893-4.00020-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Huntington disease (HD) neuropathology has a devastating effect on brain structure and consequently brain function; neuroimaging provides a means to assess these effects in gene carriers. In this chapter we first outline the unique utility of structural imaging in understanding HD and discuss some of the acquisition and analysis techniques currently available. We review the existing literature to summarize what we know so far about structural brain changes across the spectrum of disease from premanifest through to manifest disease. We then consider how these neuroimaging findings relate to patient function and nonimaging biomarkers, and can be used to predict disease onset. Finally we review the utility of imaging measures for assessment of treatment efficacy in clinical trials.
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Affiliation(s)
- Rachael I Scahill
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Ralph Andre
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Sarah J Tabrizi
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, United Kingdom.
| | - Elizabeth H Aylward
- Center for Integrative Brain Research, Seattle Children's Research Institute, University of Washington, Seattle, WA, United States
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19
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fMRI in Neurodegenerative Diseases: From Scientific Insights to Clinical Applications. NEUROMETHODS 2016. [DOI: 10.1007/978-1-4939-5611-1_23] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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20
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Poudel GR, Driscoll S, Domínguez D JF, Stout JC, Churchyard A, Chua P, Egan GF, Georgiou-Karistianis N. Functional Brain Correlates of Neuropsychiatric Symptoms in Presymptomatic Huntington’s Disease: The IMAGE-HD Study. J Huntingtons Dis 2015; 4:325-32. [DOI: 10.3233/jhd-150154] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Govinda R. Poudel
- Monash Institute of Cognitive and Clinical Neurosciences/School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Life Sciences Computation Centre, Victorian Life Sciences Computation Initiative (VLSCI), Melbourne, Victoria, Australia
| | - Shannon Driscoll
- Monash Institute of Cognitive and Clinical Neurosciences/School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Juan F. Domínguez D
- Monash Institute of Cognitive and Clinical Neurosciences/School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Julie C. Stout
- Monash Institute of Cognitive and Clinical Neurosciences/School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Andrew Churchyard
- Department of Neurology, Monash Medical Centre, Clayton, Victoria, Australia
| | - Phyllis Chua
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Gary F. Egan
- Monash Institute of Cognitive and Clinical Neurosciences/School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Nellie Georgiou-Karistianis
- Monash Institute of Cognitive and Clinical Neurosciences/School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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Andrews SC, Domínguez JF, Mercieca EC, Georgiou-Karistianis N, Stout JC. Cognitive interventions to enhance neural compensation in Huntington's disease. Neurodegener Dis Manag 2015; 5:155-64. [DOI: 10.2217/nmt.14.58] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
SUMMARY In Huntington's disease (HD), there is growing evidence of neural compensation during neurodegeneration, and that these processes might be modifiable by environmental factors. Cognitive intervention to improve brain function has been trialled only to a very limited extent in HD; however, it has shown promise in other neurodegenerative diseases. In this review, we discuss the evidence for the use of cognitive intervention to boost neural compensation in HD, and find it has potential to delay clinical decline, particularly if applied early in the disease process. Randomized controlled trials of cognitive intervention in HD should be implemented as a next step to gauging the efficacy of this approach to improve outcomes for those with the HD gene.
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Affiliation(s)
- Sophie C Andrews
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Juan F Domínguez
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Emily-Clare Mercieca
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | | | - Julie C Stout
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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22
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Dogan I, Eickhoff CR, Fox PT, Laird AR, Schulz JB, Eickhoff SB, Reetz K. Functional connectivity modeling of consistent cortico-striatal degeneration in Huntington's disease. NEUROIMAGE-CLINICAL 2015; 7:640-52. [PMID: 25844318 PMCID: PMC4375786 DOI: 10.1016/j.nicl.2015.02.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/19/2015] [Accepted: 02/23/2015] [Indexed: 11/25/2022]
Abstract
Huntington's disease (HD) is a progressive neurodegenerative disorder characterized by a complex neuropsychiatric phenotype. In a recent meta-analysis we identified core regions of consistent neurodegeneration in premanifest HD in the striatum and middle occipital gyrus (MOG). For early manifest HD convergent evidence of atrophy was most prominent in the striatum, motor cortex (M1) and inferior frontal junction (IFJ). The aim of the present study was to functionally characterize this topography of brain atrophy and to investigate differential connectivity patterns formed by consistent cortico-striatal atrophy regions in HD. Using areas of striatal and cortical atrophy at different disease stages as seeds, we performed task-free resting-state and task-based meta-analytic connectivity modeling (MACM). MACM utilizes the large data source of the BrainMap database and identifies significant areas of above-chance co-activation with the seed-region via the activation-likelihood-estimation approach. In order to delineate functional networks formed by cortical as well as striatal atrophy regions we computed the conjunction between the co-activation profiles of striatal and cortical seeds in the premanifest and manifest stages of HD, respectively. Functional characterization of the seeds was obtained using the behavioral meta-data of BrainMap. Cortico-striatal atrophy seeds of the premanifest stage of HD showed common co-activation with a rather cognitive network including the striatum, anterior insula, lateral prefrontal, premotor, supplementary motor and parietal regions. A similar but more pronounced co-activation pattern, additionally including the medial prefrontal cortex and thalamic nuclei was found with striatal and IFJ seeds at the manifest HD stage. The striatum and M1 were functionally connected mainly to premotor and sensorimotor areas, posterior insula, putamen and thalamus. Behavioral characterization of the seeds confirmed that experiments activating the MOG or IFJ in conjunction with the striatum were associated with cognitive functions, while the network formed by M1 and the striatum was driven by motor-related tasks. Thus, based on morphological changes in HD, we identified functionally distinct cortico-striatal networks resembling a cognitive and motor loop, which may be prone to early disruptions in different stages of the disease and underlie HD-related cognitive and motor symptom profiles. Our findings provide an important link between morphometrically defined seed-regions and corresponding functional circuits highlighting the functional and ensuing clinical relevance of structural damage in HD. Pre-HD atrophy seeds showed common functional co-activation with a cognitive network. Modeling of manifest-HD seeds delineated a segregation of a cognitive and motor loop. Behavioral decoding of atrophy seeds confirmed functional segregation of networks. Based on morphometric changes in HD distinct corticostriatal networks were identified. Findings depict functional and ensuing clinical relevance of structural damage in HD.
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Affiliation(s)
- Imis Dogan
- Department of Neurology, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany ; Institute of Neuroscience and Medicine (INM-1, INM-4), Research Center Jülich GmbH, 52425 Jülich, Germany ; JARA - Translational Brain Medicine, Aachen, Jülich, Germany
| | - Claudia R Eickhoff
- Institute of Neuroscience and Medicine (INM-1, INM-4), Research Center Jülich GmbH, 52425 Jülich, Germany ; Department of Psychiatry, Psychotherapy and Psychosomatic, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - Peter T Fox
- Research Imaging Center, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78284-7801, USA
| | - Angela R Laird
- Department of Physics, Florida International University, Modesto A. Maidique Campus, CP 204, 11200 SW 8th Street, Miami, FL 33199, USA
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany ; JARA - Translational Brain Medicine, Aachen, Jülich, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine (INM-1, INM-4), Research Center Jülich GmbH, 52425 Jülich, Germany ; Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany ; Institute of Neuroscience and Medicine (INM-1, INM-4), Research Center Jülich GmbH, 52425 Jülich, Germany ; JARA - Translational Brain Medicine, Aachen, Jülich, Germany
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23
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Abnormal cerebellar volume and corticocerebellar dysfunction in early manifest Huntington’s disease. J Neurol 2015; 262:859-69. [DOI: 10.1007/s00415-015-7642-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 01/08/2015] [Accepted: 01/09/2015] [Indexed: 11/27/2022]
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Atangana EN, Homburg D, Vajkoczy P, Schneider UC. Mouse cerebral magnetic resonance imaging fails to visualize brain volume changes after experimental subarachnoid hemorrhage. Acta Neurochir (Wien) 2015; 157:37-42. [PMID: 25398554 DOI: 10.1007/s00701-014-2276-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 11/04/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND Brain atrophy after subarachnoid hemorrhage (SAH) has been detected in humans and might serve as a functional read-out parameter for neuropsychological deficits. To determine whether serial magnetic resonance imaging (MRI) can provide information on brain atrophy in animals as well, mice that had undergone experimental SAH were scanned repeatedly after the bleeding. METHODS Using a 7-T rodent MRI, six mice were evaluated for total hemispheric, cerebrospinal fluid (CSF) and hippocampal volumes on days 1, 2, 4, 21, 28, 42 and 60 after experimental SAH or sham operation, respectively. RESULTS Repeated MRI scanning demonstrated a very high reproducibility with minimum standard deviation. Nevertheless, no significant differences were found between the two groups concerning hemispherical volumes or hippocampal volumes. A transient but significant increase in CSF volume was detected on days 2 and 60 after SAH. Compared with the existing method, no MRI data on brain atrophy in mice after experimental SAH have been published. CONCLUSION Repeated brain MRI in mice after experimental SAH did not provide additional information on brain atrophy. Our data suggest that this is not due to a lack of sensitivity of the method. Despite all promising details about MRI, our results should initiate careful consideration (additional sequences/other questions) before its further use in this certain area, especially since it is expensive and associated with demanding logistics.
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Affiliation(s)
- Etienne N Atangana
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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25
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Eddy CM, Sira Mahalingappa S, Rickards HE. Putting things into perspective: the nature and impact of theory of mind impairment in Huntington's disease. Eur Arch Psychiatry Clin Neurosci 2014; 264:697-705. [PMID: 24647535 DOI: 10.1007/s00406-014-0498-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 03/06/2014] [Indexed: 11/29/2022]
Abstract
In Huntington's disease (HD), frontostriatal dysfunction may lead to deficits in theory of mind (ToM), in addition to broader cognitive impairment. We investigated relationships between patients' spatial and social perspective taking performance and executive deficits, self-reported everyday perspective taking, motor symptoms, functional capacity and quality of life. Thirty patients with symptomatic HD and twenty-three healthy controls of similar age and education completed two ToM tasks, a scale assessing everyday interpersonal perspective taking, a novel object-based spatial perspective taking task (SPT) and executive measures. Ratings of quality of life, psychiatric symptoms, motor symptom severity and functional capacity were also taken for patients. When compared to controls, patients exhibited significant deficits in ToM and spatial perspective taking and lower everyday perspective taking scores. Executive deficits were linked to poor understanding of socially inappropriate remarks and errors in mental state attribution. This may be the first study to show that aspects of ToM performance are linked to spatial perspective taking, motor symptom severity and functional capacity in HD. Our findings indicate that patients with HD exhibit evidence of reduced perspective taking in everyday life in addition to poor performance on social and SPTs. They also emphasise the need to better specify the precise cognitive and neural bases for ToM deficits in neurodegenerative conditions. Further research exploring the impact of striatal degeneration on perspective taking abilities will make a valuable contribution to the continued development of functional models of frontostriatal circuitry.
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Affiliation(s)
- Clare M Eddy
- Department of Neuropsychiatry, BSMHFT, The Barberry National Centre for Mental Health, Edgbaston, Birmingham, UK,
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26
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Wolf RC, Sambataro F, Vasic N, Depping MS, Thomann PA, Landwehrmeyer GB, Süssmuth SD, Orth M. Abnormal resting-state connectivity of motor and cognitive networks in early manifest Huntington's disease. Psychol Med 2014; 44:3341-3356. [PMID: 25066491 DOI: 10.1017/s0033291714000579] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Functional magnetic resonance imaging (fMRI) of multiple neural networks during the brain's 'resting state' could facilitate biomarker development in patients with Huntington's disease (HD) and may provide new insights into the relationship between neural dysfunction and clinical symptoms. To date, however, very few studies have examined the functional integrity of multiple resting state networks (RSNs) in manifest HD, and even less is known about whether concomitant brain atrophy affects neural activity in patients. METHOD Using MRI, we investigated brain structure and RSN function in patients with early HD (n = 20) and healthy controls (n = 20). For resting-state fMRI data a group-independent component analysis identified spatiotemporally distinct patterns of motor and prefrontal RSNs of interest. We used voxel-based morphometry to assess regional brain atrophy, and 'biological parametric mapping' analyses to investigate the impact of atrophy on neural activity. RESULTS Compared with controls, patients showed connectivity changes within distinct neural systems including lateral prefrontal, supplementary motor, thalamic, cingulate, temporal and parietal regions. In patients, supplementary motor area and cingulate cortex connectivity indices were associated with measures of motor function, whereas lateral prefrontal connectivity was associated with cognition. CONCLUSIONS This study provides evidence for aberrant connectivity of RSNs associated with motor function and cognition in early manifest HD when controlling for brain atrophy. This suggests clinically relevant changes of RSN activity in the presence of HD-associated cortical and subcortical structural abnormalities.
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Affiliation(s)
- R C Wolf
- Center for Psychosocial Medicine,Department of General Psychiatry,University of Heidelberg,Heidelberg,Germany
| | - F Sambataro
- Center for Neuroscience and Cognitive Systems@UniTN,Rovereto,Italy
| | - N Vasic
- Department of Psychiatry and Psychotherapy III,Ulm University,Ulm,Germany
| | - M S Depping
- Center for Psychosocial Medicine,Department of General Psychiatry,University of Heidelberg,Heidelberg,Germany
| | - P A Thomann
- Center for Psychosocial Medicine,Department of General Psychiatry,University of Heidelberg,Heidelberg,Germany
| | | | - S D Süssmuth
- Department of Neurology,Ulm University,Ulm,Germany
| | - M Orth
- Department of Neurology,Ulm University,Ulm,Germany
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27
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Scheller E, Minkova L, Leitner M, Klöppel S. Attempted and successful compensation in preclinical and early manifest neurodegeneration - a review of task FMRI studies. Front Psychiatry 2014; 5:132. [PMID: 25324786 PMCID: PMC4179340 DOI: 10.3389/fpsyt.2014.00132] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 09/08/2014] [Indexed: 01/20/2023] Open
Abstract
Several models of neural compensation in healthy aging have been suggested to explain brain activity that aids to sustain cognitive function. Applying recently suggested criteria of "attempted" and "successful" compensation, we reviewed existing literature on compensatory mechanisms in preclinical Huntington's disease (HD) and amnestic mild cognitive impairment (aMCI). Both disorders constitute early stages of neurodegeneration ideal for examining compensatory mechanisms and developing targeted interventions. We strived to clarify whether compensation criteria derived from healthy aging populations can be applied to early neurodegeneration. To concentrate on the close coupling of cognitive performance and brain activity, we exclusively addressed task fMRI studies. First, we found evidence for parallels in compensatory mechanisms between healthy aging and neurodegenerative disease. Several studies fulfilled criteria of attempted compensation, while reports of successful compensation were largely absent, which made it difficult to conclude on. Second, comparing working memory studies in preclinical HD and aMCI, we identified similar compensatory patterns across neurodegenerative disorders in lateral and medial prefrontal cortex. Such patterns included an inverted U-shaped relationship of neurodegeneration and compensatory activity spanning from preclinical to manifest disease. Due to the lack of studies systematically targeting all criteria of compensation, we propose an exemplary study design, including the manipulation of compensating brain areas by brain stimulation. Furthermore, we delineate the benefits of targeted interventions by non-invasive brain stimulation, as well as of unspecific interventions such as physical activity or cognitive training. Unambiguously detecting compensation in early neurodegenerative disease will help tailor interventions aiming at sustained overall functioning and delayed clinical disease onset.
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Affiliation(s)
- Elisa Scheller
- Section of Gerontopsychiatry and Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center (FBI), University Medical Center Freiburg, Freiburg, Germany
- Laboratory for Biological and Personality Psychology, Department of Psychology, University of Freiburg, Freiburg, Germany
| | - Lora Minkova
- Section of Gerontopsychiatry and Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center (FBI), University Medical Center Freiburg, Freiburg, Germany
- Laboratory for Biological and Personality Psychology, Department of Psychology, University of Freiburg, Freiburg, Germany
| | - Mathias Leitner
- Section of Gerontopsychiatry and Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center (FBI), University Medical Center Freiburg, Freiburg, Germany
| | - Stefan Klöppel
- Section of Gerontopsychiatry and Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center (FBI), University Medical Center Freiburg, Freiburg, Germany
- Department of Neurology, University Medical Center Freiburg, Freiburg, Germany
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28
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Wolf RC, Sambataro F, Vasic N, Wolf ND, Thomann PA, Landwehrmeyer GB, Orth M. Longitudinal task-negative network analyses in preclinical Huntington's disease. Eur Arch Psychiatry Clin Neurosci 2014; 264:493-505. [PMID: 24071913 DOI: 10.1007/s00406-013-0447-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 09/02/2013] [Indexed: 02/07/2023]
Abstract
Functional neuroimaging studies have reported task-related brain activation changes in preclinical individuals carrying the Huntington's disease (HD) gene mutation (preHD). Little is known about "task-negative" activity, i.e., patterns of task-related deactivation in preHD, and about the stability of any deactivation changes over the course of the disease. Here, we explored task-related deactivation and functional connectivity of "task-negative" networks (TNNs) in preHD followed over a time period of 2 years. Thirteen far-from-onset preHD (mean time to estimated motor onset = 19.5 years) and thirteen healthy controls were investigated. We used functional magnetic resonance imaging (fMRI), a verbal working memory task, and uni- and multivariate analysis techniques for fMRI data. Behavior was similar in preHD and controls at baseline and did not change 2 years later. At both time points, deactivation was similar in preHD and controls. Within two spatio-temporally distinct TNNs, preHD had lower functional connectivity in the posterior cingulate cortex and higher functional connectivity in the left anterior prefrontal cortex compared to controls (p < 0.05, cluster-corrected). These findings remained stable at follow-up. Anterior prefrontal connectivity correlated with disease burden scores both at baseline and at follow-up. Over time, preHD exhibited higher connectivity in a dorsal cingulate region. Functional connectivity differences within this region were inversely associated with changes of motor function. These data provide first evidence for TNN connectivity changes in preHD followed over a period of 2 years. The relationship between dorsal cingulate connectivity and motor function suggests that "task-negative" activity may capture time-sensitive neural and functional processes in preHD.
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Affiliation(s)
- Robert Christian Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Voßstraße 4, 69115, Heidelberg, Germany,
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Georgiou‐Karistianis N, Stout JC, Domínguez D. JF, Carron SP, Ando A, Churchyard A, Chua P, Bohanna I, Dymowski AR, Poudel G, Egan GF. Functional magnetic resonance imaging of working memory in Huntington's disease: cross-sectional data from the IMAGE-HD study. Hum Brain Mapp 2014; 35:1847-64. [PMID: 23913754 PMCID: PMC6869353 DOI: 10.1002/hbm.22296] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 02/17/2013] [Accepted: 03/11/2013] [Indexed: 01/28/2023] Open
Abstract
We used functional magnetic resonance imaging (fMRI) to investigate spatial working memory (WM) in an N-BACK task (0, 1, and 2-BACK) in premanifest Huntington's disease (pre-HD, n = 35), early symptomatic Huntington's disease (symp-HD, n = 23), and control (n = 32) individuals. Overall, both WM conditions (1-BACK and 2-BACK) activated a large network of regions throughout the brain, common to all groups. However, voxel-wise and time-course analyses revealed significant functional group differences, despite no significant behavioral performance differences. During 1-BACK, voxel-wise blood-oxygen-level-dependent (BOLD) signal activity was significantly reduced in a number of regions from the WM network (inferior frontal gyrus, anterior insula, caudate, putamen, and cerebellum) in pre-HD and symp-HD groups, compared with controls; however, time-course analysis of the BOLD response in the dorsolateral prefrontal cortex (DLPFC) showed increased activation in symp-HD, compared with pre-HD and controls. The pattern of reduced voxel-wise BOLD activity in pre-HD and symp-HD, relative to controls, became more pervasive during 2-BACK affecting the same structures as in 1-BACK, but also incorporated further WM regions (anterior cingulate gyrus, parietal lobe and thalamus). The DLPFC BOLD time-course for 2-BACK showed a reversed pattern to that observed in 1-BACK, with a significantly diminished signal in symp-HD, relative to pre-HD and controls. Our findings provide support for functional brain reorganisation in cortical and subcortical regions in both pre-HD and symp-HD, which are modulated by task difficulty. Moreover, the lack of a robust striatal BOLD signal in pre-HD may represent a very early signature of change observed up to 15 years prior to clinical diagnosis.
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Affiliation(s)
| | - Julie C. Stout
- School of Psychology and PsychiatryMonash UniversityClaytonVictoriaAustralia
| | | | - Sarah P. Carron
- School of Psychology and PsychiatryMonash UniversityClaytonVictoriaAustralia
| | - Ayaka Ando
- School of Psychology and PsychiatryMonash UniversityClaytonVictoriaAustralia
- Howard Florey InstituteFlorey Neuroscience InstitutesParkvilleVictoriaAustralia
| | - Andrew Churchyard
- Department of NeurologyMonash Medical CentreClaytonVictoriaAustralia
| | - Phyllis Chua
- School of Psychology and PsychiatryMonash UniversityClaytonVictoriaAustralia
| | - India Bohanna
- Centre for NeuroscienceUniversity of MelbourneParkvilleVictoriaAustralia
| | - Alicia R. Dymowski
- School of Psychology and PsychiatryMonash UniversityClaytonVictoriaAustralia
- Howard Florey InstituteFlorey Neuroscience InstitutesParkvilleVictoriaAustralia
| | - Govinda Poudel
- School of Psychology and PsychiatryMonash UniversityClaytonVictoriaAustralia
- Monash Biomedical Imaging (MBI)Monash UniversityClaytonVictoriaAustralia
- VLSCI's Life Sciences Computation CentreMelbourneVICAustralia
| | - Gary F. Egan
- Department of NeurologyMonash Medical CentreClaytonVictoriaAustralia
- Centre for NeuroscienceUniversity of MelbourneParkvilleVictoriaAustralia
- Monash Biomedical Imaging (MBI)Monash UniversityClaytonVictoriaAustralia
- VLSCI's Life Sciences Computation CentreMelbourneVICAustralia
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Wolf RC, Sambataro F, Vasic N, Baldas EM, Ratheiser I, Bernhard Landwehrmeyer G, Depping MS, Thomann PA, Sprengelmeyer R, Süssmuth SD, Orth M. Visual system integrity and cognition in early Huntington's disease. Eur J Neurosci 2014; 40:2417-26. [PMID: 24698429 DOI: 10.1111/ejn.12575] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 02/17/2014] [Accepted: 02/27/2014] [Indexed: 10/25/2022]
Abstract
Posterior cortical volume changes and abnormal visuomotor performance are present in patients with Huntington's disease (HD). However, it is unclear whether posterior cortical volume loss contributes to abnormal neural activity, and whether activity changes predict cognitive dysfunction. Using magnetic resonance imaging (MRI), we investigated brain structure and visual network activity at rest in patients with early HD (n = 20) and healthy controls (n = 20). The symbol digit modalities test (SDMT) and subtests of the Visual Object and Space Perception Battery were completed offline. For functional MRI data, a group independent component analysis was used. Voxel-based morphometry was employed to assess regional brain atrophy, and 'biological parametric mapping' analyses were included to investigate the impact of atrophy on neural activity. Patients showed significantly worse visuomotor and visual object performance than controls. Structural analyses confirmed occipitotemporal atrophy. In patients and controls, two spatiotemporally distinct visual systems were identified. Patients showed decreased activity in the left fusiform cortex, and increased left cerebellar activity. These findings remained stable after correction for brain atrophy. Lower fusiform cortex activity was associated with lower SDMT performance and with higher disease burden scores. These associations were absent when cerebellar function was related to task performance and disease burden. The results of this study suggest that regionally specific functional abnormalities of the visual system can account for the worse visuomotor cognition in HD patients. However, occipital volume changes cannot sufficiently explain abnormal neural function in these patients.
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Affiliation(s)
- Robert C Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Voßstraße 4, Heidelberg, 69115, Germany
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Poudel GR, Egan GF, Churchyard A, Chua P, Stout JC, Georgiou-Karistianis N. Abnormal synchrony of resting state networks in premanifest and symptomatic Huntington disease: the IMAGE-HD study. J Psychiatry Neurosci 2014; 39:87-96. [PMID: 24083458 PMCID: PMC3937285 DOI: 10.1503/jpn.120226] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Functional neural impairments have been documented in people with symptomatic Huntington disease (symp-HD) and in premanifest gene carriers (pre-HD). This study aimed to characterize synchrony in resting state cerebral networks in both pre-HD and symp-HD populations and to determine its association with disease burden and neurocognitive functions. METHODS We acquired functional magnetic resonance imaging (fMRI) data from pre-HD, symp-HD and healthy control participants. The fMRI data were analyzed using multisubject independent component analysis and dual regression. We compared networks of interest among the groups using a nonparametric permutation method and correcting for multiple comparisons. RESULTS Our study included 25 people in the pre-HD, 23 in the symp-HD and 18 in the healthy control groups. Compared with the control group, the pre-HD group showed decreased synchrony in the sensorimotor and dorsal attention networks; decreased level of synchrony in the sensorimotor network was associated with poorer motor performance. Compared with the control group, the symp-HD group showed widespread reduction in synchrony in the dorsal attention network, which was associated with poorer cognitive performance. The posterior putamen and superior parietal cortex were functionally disconnected from the frontal executive network in the symp-HD compared with control and pre-HD groups. Furthermore, the left frontoparietal network showed areas of increased synchrony in the symp-HD compared with the pre-HD group. LIMITATIONS We could not directly correct for influence of autonomic changes (e.g., heart rate) and respiration on resting state synchronization. CONCLUSION Our findings suggest that aberrant synchrony in the sensorimotor and dorsal attention networks may serve as an early signature of neural change in pre-HD individuals. The altered synchrony in dorsal attention, frontoparietal and corticostriatal networks may contribute to the development of clinical symptoms in people with Huntington disease.
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Affiliation(s)
| | | | | | | | | | - Nellie Georgiou-Karistianis
- Correspondence to: N. Georgiou-Karistianis, Experimental Neuropsychology Research Unit, School of Psychology and Psychiatry, Monash University, Clayton, Victoria 3800, Australia;
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Functional changes during working memory in Huntington’s disease: 30-month longitudinal data from the IMAGE-HD study. Brain Struct Funct 2013; 220:501-12. [DOI: 10.1007/s00429-013-0670-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 10/31/2013] [Indexed: 10/26/2022]
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Georgiou-Karistianis N, Poudel GR, Domínguez D JF, Langmaid R, Gray MA, Churchyard A, Chua P, Borowsky B, Egan GF, Stout JC. Functional andconnectivity changes during working memory inHuntington’s disease: 18month longitudinal data from the IMAGE-HD study. Brain Cogn 2013; 83:80-91. [DOI: 10.1016/j.bandc.2013.07.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/04/2013] [Accepted: 07/16/2013] [Indexed: 12/15/2022]
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Transcranial magnetic stimulation as a tool for understanding neurophysiology in Huntington's disease: A review. Neurosci Biobehav Rev 2013; 37:1420-33. [DOI: 10.1016/j.neubiorev.2013.05.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 05/07/2013] [Accepted: 05/21/2013] [Indexed: 12/24/2022]
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Unschuld PG, Liu X, Shanahan M, Margolis RL, Bassett SS, Brandt J, Schretlen DJ, Redgrave GW, Hua J, Hock C, Reading SA, van Zijl PCM, Pekar JJ, Ross CA. Prefrontal executive function associated coupling relates to Huntington's disease stage. Cortex 2013; 49:2661-73. [PMID: 23906595 DOI: 10.1016/j.cortex.2013.05.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 05/06/2013] [Accepted: 05/26/2013] [Indexed: 01/21/2023]
Abstract
Huntington's disease (HD) is a neurodegenerative disease caused by cytosine-adenine-guanine (CAG)-repeat expansion in the huntingtin (HTT) gene. Early changes that may precede clinical manifestation of movement disorder include executive dysfunction. The aim of this study was to identify functional network correlates of impaired higher cognitive functioning in relation to HD stage. Blood-oxygenation-level-dependent (BOLD) functional-magnetic resonance imaging (fMRI) and structural-MRI were performed in 53 subjects with the HD-mutation (41 prodromals, 12 early affected) and 52 controls. Disease stage was estimated for each subject with HD-mutation based on age, length of the CAG-repeat expansion mutation and also putaminal atrophy. The Tower of London test was administered with three levels of complexity during fMRI as a challenge of executive function. Functional brain networks of interest were identified based on cortical gray matter voxel-clusters with significantly enhanced task-related functional coupling to the medial prefrontal cortex (MPFC) area. While prodromal HD-subjects showed similar performance levels as controls, multivariate analysis of task-related functional coupling to the MPFC identified reduced connectivity in prodromal and early manifest HD-subjects for a cluster including mainly parts of the left premotor area. Secondary testing indicated a significant moderator effect for task complexity on group differences and on the degree of correlation to measures of HD stage. Our data suggest that impaired premotor-MPFC coupling reflects HD stage related dysfunction of cognitive systems involved in executive function and may be present in prodromal HD-subjects that are still cognitively normal. Additional longitudinal studies may reveal temporal relationships between impaired task-related premotor-MPFC coupling and other brain changes in HD.
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Affiliation(s)
- Paul G Unschuld
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Psychiatry Research and Psychogeriatric Medicine, University of Zürich, Zürich, Switzerland.
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Wolf RC, Klöppel S. Clinical significance of frontal cortex abnormalities in Huntington's disease. Exp Neurol 2013; 247:39-44. [PMID: 23562669 DOI: 10.1016/j.expneurol.2013.03.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 03/03/2013] [Accepted: 03/25/2013] [Indexed: 01/28/2023]
Affiliation(s)
- Robert Christian Wolf
- Center of Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany
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Dumas EM, van den Bogaard SJA, Hart EP, Soeter RP, van Buchem MA, van der Grond J, Rombouts SARB, Roos RAC. Reduced functional brain connectivity prior to and after disease onset in Huntington's disease. NEUROIMAGE-CLINICAL 2013; 2:377-84. [PMID: 24179791 PMCID: PMC3778251 DOI: 10.1016/j.nicl.2013.03.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 02/28/2013] [Accepted: 03/03/2013] [Indexed: 01/18/2023]
Abstract
Background Huntington's disease (HD) is characterised by both regional and generalised neuronal cell loss in the brain. Investigating functional brain connectivity patterns in rest in HD has the potential to broaden the understanding of brain functionality in relation to disease progression. This study aims to establish whether brain connectivity during rest is different in premanifest and manifest HD as compared to controls. Methods At the Leiden University Medical Centre study site of the TRACK-HD study, 20 early HD patients (disease stages 1 and 2), 28 premanifest gene carriers and 28 healthy controls underwent 3 T MRI scanning. Standard and high-resolution T1-weighted images and a resting state fMRI scan were acquired. Using FSL, group differences in resting state connectivity were examined for eight networks of interest using a dual regression method. With a voxelwise correction for localised atrophy, group differences in functional connectivity were examined. Results Brain connectivity of the left middle frontal and pre-central gyrus, and right post central gyrus with the medial visual network was reduced in premanifest and manifest HD as compared to controls (0.05 > p > 0.0001). In manifest HD connectivity of numerous widespread brain regions with the default mode network and the executive control network were reduced (0.05 > p > 0.0001). Discussion Brain regions that show reduced intrinsic functional connectivity are present in premanifest gene carriers and to a much larger extent in manifest HD patients. These differences are present even when the potential influence of atrophy is taken into account. Resting state fMRI could potentially be used for early disease detection in the premanifest phase of HD and for monitoring of disease modifying compounds. We applied resting state fMRI in premanifest and manifest Huntington's disease. Reduced functional brain connectivity was present in premanifest HD gene carriers. Large regions demonstrate reduced functional brain connectivity in manifest HD. Medial visual, default mode and executive control networks were affected.
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Affiliation(s)
- Eve M Dumas
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
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Dogan I, Saß C, Mirzazade S, Kleiman A, Werner CJ, Pohl A, Schiefer J, Binkofski F, Schulz JB, Shah NJ, Reetz K. Neural correlates of impaired emotion processing in manifest Huntington's disease. Soc Cogn Affect Neurosci 2013; 9:671-80. [PMID: 23482620 DOI: 10.1093/scan/nst029] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The complex phenotype of Huntington's disease (HD) encompasses motor, psychiatric and cognitive dysfunctions, including early impairments in emotion recognition. In this first functional magnetic resonance imaging study, we investigated emotion-processing deficits in 14 manifest HD patients and matched controls. An emotion recognition task comprised short video clips displaying one of six basic facial expressions (sadness, happiness, disgust, fear, anger and neutral). Structural changes between patients and controls were assessed by means of voxel-based morphometry. Along with deficient recognition of negative emotions, patients exhibited predominantly lower neural response to stimuli of negative valences in the amygdala, hippocampus, striatum, insula, cingulate and prefrontal cortices, as well as in sensorimotor, temporal and visual areas. Most of the observed reduced activity patterns could not be explained merely by regional volume loss. Reduced activity in the thalamus during fear correlated with lower thalamic volumes. During the processing of sadness, patients exhibited enhanced amygdala and hippocampal activity along with reduced recruitment of the medial prefrontal cortex. Higher amygdala activity was related to more pronounced amygdala atrophy and disease burden. Overall, the observed emotion-related dysfunctions in the context of structural neurodegeneration suggest both disruptions of striatal-thalamo-cortical loops and potential compensation mechanism with greater disease severity in manifest HD.
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Affiliation(s)
- Imis Dogan
- Department of Neurology, RWTH Aachen University, Pauwelsstrasse 30, D-52074 Aachen, Germany. Tel.: +49-241-80-36516; Fax: +49-241-80-33-36516.
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Georgiou-Karistianis N, Scahill R, Tabrizi SJ, Squitieri F, Aylward E. Structural MRI in Huntington's disease and recommendations for its potential use in clinical trials. Neurosci Biobehav Rev 2013; 37:480-90. [PMID: 23376047 DOI: 10.1016/j.neubiorev.2013.01.022] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 01/02/2013] [Accepted: 01/22/2013] [Indexed: 01/18/2023]
Abstract
Huntington's disease (HD) results in progressive impairment of motor and cognitive function and neuropsychiatric disturbance. There are no disease-modifying treatments available, but HD research is entering a critical phase where promising disease-specific therapies are on the horizon. Thus, a pressing need exists for biomarkers capable of monitoring progression and ultimately determining drug efficacy. Neuroimaging provides a powerful tool for assessing disease progression. However, in order to be accepted as biomarkers for clinical trials, imaging measures must be reproducible, robust to scanner differences, sensitive to disease-related change and demonstrate a relationship to clinically meaningful measures. We provide a review of the current structural imaging literature in HD and highlight inconsistencies between studies. We make recommendations for the standardisation of reporting for future studies, such as appropriate cohort characterisation and documentation of methodologies to facilitate comparisons and inform trial design. We also argue for an intensified effort to consider issues highlighted here so that we have the best chance of assessing the efficacy of the therapeutic benefit in forestalling this devastating disease.
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Prefrontal activity in Huntington's disease reflects cognitive and neuropsychiatric disturbances: the IMAGE-HD study. Exp Neurol 2012; 239:218-28. [PMID: 23123406 DOI: 10.1016/j.expneurol.2012.10.020] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 10/24/2012] [Indexed: 11/20/2022]
Abstract
Functional integrity of prefrontal cortico-striatal circuits underlying executive functioning may be compromised by basal ganglia degeneration during Huntington's disease (HD). This study investigated challenged inhibitory attentional control with a shifting response-set (SRS) task whilst assessing neural response via functional magnetic resonance imaging (fMRI) in 35 healthy controls, 35 matched pre-symptomatic (pre-HD) and 30 symptomatic (symp-HD) participants. A ≥70% performance accuracy threshold allowed confident identification of neural activity associated with SRS performance in a sub-set of 33 healthy controls, 32 pre-HD and 20 symp-HD participants. SRS activated dorsolateral prefrontal and dorsal anterior cingulate cortices, premotor, parietal, and basal ganglia regions and deactivated subgenual anterior cingulate cortex. Symp-HD participants showed greater prefrontal functional responses relative to controls and pre-HD, including larger activations and larger deactivations in response to cognitive challenge, consistent with compensatory neural recruitment. We then investigated associations between prefrontal BOLD responses, SRS performance accuracy and neuropsychiatric disturbance in all participants, including those below SRS performance accuracy threshold. We observed that reduced prefrontal responsivity in symp-HD was associated with reduced accuracy in SRS performance, and with increased neuropsychiatric disturbance within domains including executive dysfunction, pathological impulses, disinhibition, and depression. These findings demonstrate prefrontal response during inhibitory attentional control usefully characterises cognitive and neuropsychiatric status in symp-HD. The functional integrity of compensatory prefrontal responses may provide a useful marker for treatments which aim to sustain cognitive function and delay executive and neuropsychiatric disturbance.
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Lambrecq V, Langbour N, Guehl D, Bioulac B, Burbaud P, Rotge JY. Evolution of brain gray matter loss in Huntington's disease: a meta-analysis. Eur J Neurol 2012; 20:315-21. [PMID: 22925174 DOI: 10.1111/j.1468-1331.2012.03854.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 07/12/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Huntington's disease is characterized by neuronal loss throughout the disease course. Voxel-based morphometry studies have reported reductions in gray matter concentration (GMC) in many brain regions in patients with Huntington. The description of the time course of gray matter loss may help to identify some evolution markers. Here, we conducted a meta-analysis of voxel-based morphometry studies of Huntington's disease to describe the evolution of brain gray matter loss. METHODS A systematic search led to the inclusion of 11 articles on Huntington's disease (297 patients and 205 controls). We extracted data from patients with preclinical Huntington, patients with clinical Huntington, and controls. Finally, anatomical likelihood estimation analyses were conducted to identify GMC changes between preclinical patients and controls, between clinical patients and controls, and between preclinical and clinical patients. RESULTS Preclinical patients exhibited gray matter loss in the left basal ganglia and the prefrontal cortex. Clinical patients had bilateral gray matter loss in the basal ganglia, the prefrontal cortex, and the insula. The left striatum was smaller in clinical patients than in preclinical patients. CONCLUSIONS Neurodegenerative processes associated with Huntington's disease, as assessed by GMC reduction, begin in the left hemisphere and extend to the contralateral hemisphere throughout the inexorable course of the disease. Changes in gray matter, especially the volumetric side ratio of the striatum, could represent a relevant biomarker for characterizing the different progression stages of the disease.
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Affiliation(s)
- V Lambrecq
- Institut des Maladies Neurodégénératives, Centre National de la Recherche Scientifique UMR 5293, Université Victor Segalen Bordeaux 2, Bordeaux, France
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Dogan I, Eickhoff SB, Schulz JB, Shah NJ, Laird AR, Fox PT, Reetz K. Consistent neurodegeneration and its association with clinical progression in Huntington's disease: a coordinate-based meta-analysis. NEURODEGENER DIS 2012; 12:23-35. [PMID: 22922585 DOI: 10.1159/000339528] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 05/10/2012] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The neuropathological hallmark of Huntington's disease (HD) is progressive striatal loss starting several years prior to clinical onset. In the past decade, whole-brain magnetic resonance imaging (MRI) studies have provided accumulating evidence for widely distributed cortical and subcortical atrophy in the early course of the disease. OBJECTIVE In order to synthesize current morphometric MRI findings and to investigate the impact of clinical and genetic features on structural changes, we performed a coordinate-based meta-analysis of voxel-based morphometry (VBM) studies in HD. METHODS Twenty HD samples derived from 17 studies were integrated in the analysis comparing a total of 685 HD mutation carriers [345 presymptomatic (pre-HD) and 340 symptomatic (symp-HD) subjects] and 507 controls. Convergent findings across studies were delineated using the anatomical likelihood estimation approach. Effects of genetic and clinical parameters on the likelihood of observing VBM findings were calculated by means of correlation analyses. RESULTS Pre-HD studies featured convergent evidence for neurodegeneration in the basal ganglia, amygdala, thalamus, insula and occipital regions. In symp-HD, cerebral atrophy was more pronounced and spread to cortical regions (i.e., inferior frontal, premotor, sensorimotor, midcingulate, frontoparietal and temporoparietal cortices). Higher cytosine-adenosine-guanosine repeats were associated with striatal degeneration, while parameters of disease progression and motor impairment additionally correlated with cortical atrophy, especially in sensorimotor areas. CONCLUSION This first quantitative meta-analysis in HD demonstrates the extent of striatal atrophy and further consistent extrastriatal degeneration before clinical conversion. Sensorimotor areas seem to be core regions affected in symp-HD and, along with widespread cortical atrophy, may account for the clinical heterogeneity in HD.
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Affiliation(s)
- Imis Dogan
- Department of Neurology, RWTH Aachen University, Aachen.,Institute of Neuroscience and Medicine, Research Center Jülich GmbH, Jülich.,Translational Brain Medicine, Jülich Aachen Research Alliance, Jülich
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, Research Center Jülich GmbH, Jülich.,Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University, Düsseldorf , Germany
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University, Aachen.,Translational Brain Medicine, Jülich Aachen Research Alliance, Jülich
| | - N Jon Shah
- Department of Neurology, RWTH Aachen University, Aachen.,Institute of Neuroscience and Medicine, Research Center Jülich GmbH, Jülich.,Translational Brain Medicine, Jülich Aachen Research Alliance, Jülich
| | - Angela R Laird
- Research Imaging Center, University of Texas Health Science Center San Antonio, San Antonio, Tex. , USA
| | - Peter T Fox
- Research Imaging Center, University of Texas Health Science Center San Antonio, San Antonio, Tex. , USA
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Aachen.,Institute of Neuroscience and Medicine, Research Center Jülich GmbH, Jülich.,Translational Brain Medicine, Jülich Aachen Research Alliance, Jülich
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Blockx I, Verhoye M, Van Audekerke J, Bergwerf I, Kane JX, Delgado Y Palacios R, Veraart J, Jeurissen B, Raber K, von Hörsten S, Ponsaerts P, Sijbers J, Leergaard TB, Van der Linden A. Identification and characterization of Huntington related pathology: an in vivo DKI imaging study. Neuroimage 2012; 63:653-62. [PMID: 22743196 DOI: 10.1016/j.neuroimage.2012.06.032] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 06/10/2012] [Accepted: 06/15/2012] [Indexed: 12/31/2022] Open
Abstract
An important focus of Huntington Disease (HD) research is the identification of symptom-independent biomarkers of HD neuropathology. There is an urgent need for reproducible, sensitive and specific outcome measures, which can be used to track disease onset as well as progression. Neuroimaging studies, in particular diffusion-based MRI methods, are powerful probes for characterizing the effects of disease and aging on tissue microstructure. We report novel diffusional kurtosis imaging (DKI) findings in aged transgenic HD rats. We demonstrate altered diffusion metrics in the (pre)frontal cerebral cortex, external capsule and striatum. Presence of increased diffusion complexity and restriction in the striatum is confirmed by an increased fiber dispersion in this region. Immunostaining of the same specimens reveals decreased number of microglia in the (pre)frontal cortex, and increased numbers of oligodendrocytes in the striatum. We conclude that DKI allows sensitive and specific characterization of altered tissue integrity in this HD rat model, indicating a promising potential for diagnostic imaging of gray and white matter pathology.
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Affiliation(s)
- Ines Blockx
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium.
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Ding H, Qin W, Jiang T, Zhang Y, Yu C. Volumetric variation in subregions of the cerebellum correlates with working memory performance. Neurosci Lett 2011; 508:47-51. [PMID: 22206834 DOI: 10.1016/j.neulet.2011.12.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Revised: 12/07/2011] [Accepted: 12/12/2011] [Indexed: 12/19/2022]
Abstract
We aimed to investigate the relationship between structural variations in the cerebellum and individual differences in working memory performance as assessed by average reaction time (RT) and correction rate (CR) on a 3-back task. High-resolution T1-weighted magnetic resonance images were acquired in 311 healthy young adults. Voxel-based morphometry (VBM) was used to identify cerebellar areas with volumes correlated to working memory performance when controlling for age, gender, years of education and handedness. We found that RT was positively correlated with the grey matter volume (GMV) bilaterally in cerebellar lobules IV/V, VI and VIII, in vermis VII/VIII and in left Crus I; CR was positively correlated with the GMV in the left lobule VI and Crus I. These findings suggest that RT on a working memory task is related to structural variation in both motor and cognitive subregions of the cerebellum, while CR is mainly associated with the cognitive subregions. Our findings provide further evidence that the cerebellum contributes to working memory function.
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Affiliation(s)
- Hui Ding
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
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Giralt A, Puigdellívol M, Carretón O, Paoletti P, Valero J, Parra-Damas A, Saura CA, Alberch J, Ginés S. Long-term memory deficits in Huntington's disease are associated with reduced CBP histone acetylase activity. Hum Mol Genet 2011; 21:1203-16. [PMID: 22116937 DOI: 10.1093/hmg/ddr552] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Huntington's disease (HD) is an autosomal dominant progressive neurodegenerative disorder caused by an expanded CAG/polyglutamine repeat in the coding region of the huntingtin (htt) gene. Although HD is classically considered a motor disorder, there is now considerable evidence that early cognitive deficits appear in patients before the onset of motor disturbances. Here we demonstrate early impairment of long-term spatial and recognition memory in heterozygous HD knock-in mutant mice (Hdh(Q7/Q111)), a genetically accurate HD mouse model. Cognitive deficits are associated with reduced hippocampal expression of CREB-binding protein (CBP) and diminished levels of histone H3 acetylation. In agreement with reduced CBP, the expression of CREB/CBP target genes related to memory, such c-fos, Arc and Nr4a2, was significantly reduced in the hippocampus of Hdh(Q7/Q111) mice compared with wild-type mice. Finally, and consistent with a role of CBP in cognitive impairment in Hdh(Q7/Q111) mice, administration of the histone deacetylase inhibitor trichostatin A rescues recognition memory deficits and transcription of selective CREB/CBP target genes in Hdh(Q7/Q111) mice. These findings demonstrate an important role for CBP in cognitive dysfunction in HD and suggest the use of histone deacetylase inhibitors as a novel therapeutic strategy for the treatment of memory deficits in this disease.
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Affiliation(s)
- A Giralt
- Departament de Biologia Cellular, Immunologia i Neurociències, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
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Walker AG, Ummel JR, Rebec GV. Reduced expression of conditioned fear in the R6/2 mouse model of Huntington's disease is related to abnormal activity in prelimbic cortex. Neurobiol Dis 2011; 43:379-87. [PMID: 21515374 PMCID: PMC3114205 DOI: 10.1016/j.nbd.2011.04.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 03/18/2011] [Accepted: 04/10/2011] [Indexed: 01/29/2023] Open
Abstract
Prefrontal cortex (PFC) dysfunction is common in patients with Huntington's disease (HD), a dominantly inherited neurological disorder, and has been linked to cognitive disruption. We previously reported alterations in neuronal firing patterns recorded from PFC of the R6/2 mouse model of HD. To determine if PFC dysfunction results in behavioral impairments, we evaluated performance of wild-type (WT) and R6/2 mice in a fear conditioning and extinction behavioral task. Fear conditioning and extinction retrieval were similar in both genotypes, but R6/2s exhibited less fear during extinction by freezing less than WTs. A fear reinstatement test after extinction retrieval indicated that faster extinction was not due to poor memory for conditioning. During initial extinction and extinction retrieval training, neuronal activity was recorded from prelimbic (PL) cortex, a subregion of PFC known to be important for fear expression. In WTs, a large number of neurons were activated by the conditioned stimulus during initial extinction and this activation was significantly impaired in R6/2s. Notably, there was no genotype difference in PFC activity during extinction retrieval. Thus, altered extinction is likely a result of reduced fear expression due to impairments in PL activation. Collectively, our results suggest that PFC dysfunction may play a key role in R6/2 cognitive impairments.
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Affiliation(s)
- Adam G. Walker
- Department of Psychological & Brain Science and Program in Neuroscience, Indiana University, Bloomington, IN
| | - Jason R. Ummel
- Department of Psychological & Brain Science and Program in Neuroscience, Indiana University, Bloomington, IN
| | - George V. Rebec
- Department of Psychological & Brain Science and Program in Neuroscience, Indiana University, Bloomington, IN
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He B, Yang L, Wilke C, Yuan H. Electrophysiological imaging of brain activity and connectivity-challenges and opportunities. IEEE Trans Biomed Eng 2011; 58:1918-31. [PMID: 21478071 PMCID: PMC3241716 DOI: 10.1109/tbme.2011.2139210] [Citation(s) in RCA: 170] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Unlocking the dynamic inner workings of the brain continues to remain a grand challenge of the 21st century. To this end, functional neuroimaging modalities represent an outstanding approach to better understand the mechanisms of both normal and abnormal brain functions. The ability to image brain function with ever increasing spatial and temporal resolution has made a significant leap over the past several decades. Further delineation of functional networks could lead to improved understanding of brain function in both normal and diseased states. This paper reviews recent advancements and current challenges in dynamic functional neuroimaging techniques, including electrophysiological source imaging, multimodal neuroimaging integrating fMRI with EEG/MEG, and functional connectivity imaging.
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Affiliation(s)
- Bin He
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA.
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Panegyres PK, Goh JG. The neurology and natural history of patients with indeterminate CAG repeat length mutations of the Huntington disease gene. J Neurol Sci 2011; 301:14-20. [DOI: 10.1016/j.jns.2010.11.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2010] [Revised: 11/14/2010] [Accepted: 11/15/2010] [Indexed: 12/23/2022]
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Dumas EM, van den Bogaard SJA, Ruber ME, Reilman RR, Stout JC, Craufurd D, Hicks SL, Kennard C, Tabrizi SJ, van Buchem MA, van der Grond J, Roos RAC. Early changes in white matter pathways of the sensorimotor cortex in premanifest Huntington's disease. Hum Brain Mapp 2011; 33:203-12. [PMID: 21264990 DOI: 10.1002/hbm.21205] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 07/30/2010] [Accepted: 10/20/2010] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To investigate the function-structure relationship of white matter within different stages of Huntington's disease (HD) using diffusion tensor imaging (DTI). EXPERIMENTAL DESIGN From the TRACK-HD study, an early stage HD group and a premanifest gene carrier group (PMGC) were age-matched to two healthy control groups; all underwent 3-T MRI scanning of the brain. Region of interest (ROI) segmentation of the corpus callosum, caudate nucleus, thalamus, prefrontal cortex, and sensorimotor cortex was applied, and the apparent fiber pathways of these regions were analyzed. Functional measures of motor, oculomotor, cognition, and behavior were correlated to DTI measures. PRINCIPLE OBSERVATIONS: In PMGC versus controls, higher apparent diffusion coefficient (ADC) was seen in white matter pathways of the sensorimotor cortex (P < 0.01) and in the ROI of corpus callosum (P < 0.017). In early HD, fiber tract analysis showed higher ADC in pathways of the corpus callosum, thalamus, sensorimotor, and prefrontal region (P < 0.01). ROI analysis showed higher diffusivity in the corpus callosum and caudate nucleus (P < 0.017). Motor, oculomotor, cognition, and probability of onset within 2 and 5 years, correlated well with ADC measures of the corpus callosum (P < 0.01 - P < 0.005), sensorimotor (P < 0.01 - P < 0.005), and prefrontal region (P < 0.01). CONCLUSIONS Disturbances in the white matter connections of the sensorimotor cortex can be demonstrated not only in manifest HD but also in premanifest gene carriers. Connectivity measures are well related to clinical functioning. DTI measures can be regarded as a potential biomarker for HD, due to their ability to objectify changes in brain structures and their role within brain networks.
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Affiliation(s)
- Eve M Dumas
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.
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Bechtel N, Scahill RI, Rosas HD, Acharya T, van den Bogaard SJA, Jauffret C, Say MJ, Sturrock A, Johnson H, Onorato CE, Salat DH, Durr A, Leavitt BR, Roos RAC, Landwehrmeyer GB, Langbehn DR, Stout JC, Tabrizi SJ, Reilmann R. Tapping linked to function and structure in premanifest and symptomatic Huntington disease. Neurology 2010; 75:2150-60. [PMID: 21068430 DOI: 10.1212/wnl.0b013e3182020123] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Motor signs are functionally disabling features of Huntington disease. Characteristic motor signs define disease manifestation. Their severity and onset are assessed by the Total Motor Score of the Unified Huntington's Disease Rating Scale, a categorical scale limited by interrater variability and insensitivity in premanifest subjects. More objective, reliable, and precise measures are needed which permit clinical trials in premanifest populations. We hypothesized that motor deficits can be objectively quantified by force-transducer-based tapping and correlate with disease burden and brain atrophy. METHODS A total of 123 controls, 120 premanifest, and 123 early symptomatic gene carriers performed a speeded and a metronome tapping task in the multicenter study TRACK-HD. Total Motor Score, CAG repeat length, and MRIs were obtained. The premanifest group was subdivided into A and B, based on the proximity to estimated disease onset, the manifest group into stages 1 and 2, according to their Total Functional Capacity scores. Analyses were performed centrally and blinded. RESULTS Tapping variability distinguished between all groups and subgroups in both tasks and correlated with 1) disease burden, 2) clinical motor phenotype, 3) gray and white matter atrophy, and 4) cortical thinning. Speeded tapping was more sensitive to the detection of early changes. CONCLUSION Tapping deficits are evident throughout manifest and premanifest stages. Deficits are more pronounced in later stages and correlate with clinical scores as well as regional brain atrophy, which implies a link between structure and function. The ability to track motor phenotype progression with force-transducer-based tapping measures will be tested prospectively in the TRACK-HD study.
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Affiliation(s)
- N Bechtel
- Department of Neurology, University of Münster, Münster, Germany.
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