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Spinelli EG, Ghirelli A, Basaia S, Cividini C, Riva N, Canu E, Castelnovo V, Domi T, Magnani G, Caso F, Caroppo P, Prioni S, Rossi G, Tremolizzo L, Appollonio I, Silani V, Carrera P, Filippi M, Agosta F. Structural MRI Signatures in Genetic Presentations of the Frontotemporal Dementia/Motor Neuron Disease Spectrum. Neurology 2021; 97:e1594-e1607. [PMID: 34544819 PMCID: PMC8548958 DOI: 10.1212/wnl.0000000000012702] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/09/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To assess cortical, subcortical, and cerebellar gray matter (GM) atrophy using MRI in patients with disorders of the frontotemporal lobar degeneration (FTLD) spectrum with known genetic mutations. METHODS Sixty-six patients carrying FTLD-related mutations were enrolled, including 44 with pure motor neuron disease (MND) and 22 with frontotemporal dementia (FTD). Sixty-one patients with sporadic FTLD (sFTLD) matched for age, sex, and disease severity with genetic FTLD (gFTLD) were also included, as well as 52 healthy controls. A whole-brain voxel-based morphometry (VBM) analysis was performed. GM volumes of subcortical and cerebellar structures were obtained. RESULTS Compared with controls, GM atrophy on VBM was greater and more diffuse in genetic FTD, followed by sporadic FTD and genetic MND cases, whereas patients with sporadic MND (sMND) showed focal motor cortical atrophy. Patients carrying C9orf72 and GRN mutations showed the most widespread cortical volume loss, in contrast with GM sparing in SOD1 and TARDBP. Globally, patients with gFTLD showed greater atrophy of parietal cortices and thalami compared with sFTLD. In volumetric analysis, patients with gFTLD showed volume loss compared with sFTLD in the caudate nuclei and thalami, in particular comparing C9-MND with sMND cases. In the cerebellum, patients with gFTLD showed greater atrophy of the right lobule VIIb than sFTLD. Thalamic volumes of patients with gFTLD with a C9orf72 mutation showed an inverse correlation with Frontal Behavioral Inventory scores. DISCUSSION Measures of deep GM and cerebellar structural involvement may be useful markers of gFTLD, particularly C9orf72-related disorders, regardless of the clinical presentation within the FTLD spectrum.
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Affiliation(s)
- Edoardo Gioele Spinelli
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Alma Ghirelli
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Silvia Basaia
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Camilla Cividini
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Nilo Riva
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Elisa Canu
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Veronica Castelnovo
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Teuta Domi
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Giuseppe Magnani
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Francesca Caso
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Paola Caroppo
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Sara Prioni
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Giacomina Rossi
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Lucio Tremolizzo
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Ildebrando Appollonio
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Vincenzo Silani
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Paola Carrera
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Massimo Filippi
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Federica Agosta
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy.
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