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Hirata K, Matsuoka K, Tagai K, Endo H, Tatebe H, Ono M, Kokubo N, Kataoka Y, Oyama A, Shinotoh H, Takahata K, Obata T, Dehghani M, Near J, Kawamura K, Zhang MR, Shimada H, Shimizu H, Kakita A, Yokota T, Tokuda T, Higuchi M, Takado Y. In Vivo Assessment of Astrocyte Reactivity in Patients with Progressive Supranuclear Palsy. Ann Neurol 2024; 96:247-261. [PMID: 38771066 DOI: 10.1002/ana.26962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/12/2024] [Accepted: 04/16/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE Although astrocytic pathology is a pathological hallmark of progressive supranuclear palsy (PSP), its pathophysiological role remains unclear. This study aimed to assess astrocyte reactivity in vivo in patients with PSP. Furthermore, we investigated alterations in brain lactate levels and their relationship with astrocyte reactivity. METHODS We included 30 patients with PSP-Richardson syndrome and 30 healthy controls; in patients, tau deposition was confirmed through 18F-florzolotau positron emission tomography. Myo-inositol, an astroglial marker, and lactate were quantified in the anterior cingulate cortex through magnetic resonance spectroscopy. We measured plasma biomarkers, including glial fibrillary acidic protein as another astrocytic marker. The anterior cingulate cortex was histologically assessed in postmortem samples of another 3 patients with PSP with comparable disease durations. RESULTS The levels of myo-inositol and plasma glial fibrillary acidic protein were significantly higher in patients than those in healthy controls (p < 0.05); these increases were significantly associated with PSP rating scale and cognitive function scores (p < 0.05). The lactate level was high in patients, and correlated significantly with high myo-inositol levels. Histological analysis of the anterior cingulate cortex in patients revealed reactive astrocytes, despite mild tau deposition, and no marked synaptic loss. INTERPRETATION We discovered high levels of astrocyte biomarkers in patients with PSP, suggesting astrocyte reactivity. The association between myo-inositol and lactate levels suggests a link between reactive astrocytes and brain energy metabolism changes. Our results indicate that astrocyte reactivity in the anterior cingulate cortex precedes pronounced tau pathology and neurodegenerative processes in that region, and affects brain function in PSP. ANN NEUROL 2024;96:247-261.
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Affiliation(s)
- Kosei Hirata
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
- Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kiwamu Matsuoka
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Kenji Tagai
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Hironobu Endo
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Harutsugu Tatebe
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Maiko Ono
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
- Institute for Quantum Life Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Naomi Kokubo
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Yuko Kataoka
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Asaka Oyama
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Hitoshi Shinotoh
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
- Neurology Clinic Chiba, Chiba, Japan
| | - Keisuke Takahata
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Takayuki Obata
- Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | | | - Jamie Near
- Physical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Kazunori Kawamura
- Department of Advanced Nuclear Medicine Sciences, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Ming-Rong Zhang
- Department of Advanced Nuclear Medicine Sciences, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Hitoshi Shimada
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
- Center for integrated human brain science, Brain Research Institute, Niigata University, Niigata, Japan
| | - Hiroshi Shimizu
- Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Takanori Yokota
- Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahiko Tokuda
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Makoto Higuchi
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Yuhei Takado
- Advanced Neuroimaging Center, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
- Institute for Quantum Life Science, National Institutes for Quantum Science and Technology, Chiba, Japan
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Hüper L, Steinacker P, Polyakova M, Mueller K, Godulla J, Herzig S, Danek A, Engel A, Diehl‐Schmid J, Classen J, Fassbender K, Fliessbach K, Jahn H, Kassubek J, Kornhuber J, Landwehrmeyer B, Lauer M, Obrig H, Oeckl P, Prudlo J, Saur D, Anderl‐Straub S, Synofzik M, Wagner M, Wiltfang J, Winkelmann J, Volk AE, Huppertz H, Otto M, Schroeter ML. Neurofilaments and progranulin are related to atrophy in frontotemporal lobar degeneration - A transdiagnostic study cross-validating atrophy and fluid biomarkers. Alzheimers Dement 2024; 20:4461-4475. [PMID: 38865340 PMCID: PMC11247715 DOI: 10.1002/alz.13863] [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: 12/21/2023] [Revised: 03/22/2024] [Accepted: 03/24/2024] [Indexed: 06/14/2024]
Abstract
INTRODUCTION Frontotemporal lobar degeneration (FTLD) encompasses behavioral variant frontotemporal dementia (bvFTD), progressive supranuclear palsy, corticobasal syndrome/degeneration, and primary progressive aphasias (PPAs). We cross-validated fluid biomarkers and neuroimaging. METHODS Seven fluid biomarkers from cerebrospinal fluid and serum were related to atrophy in 428 participants including these FTLD subtypes, logopenic variant PPA (lvPPA), Alzheimer's disease (AD), and healthy subjects. Atrophy was assessed by structural magnetic resonance imaging and atlas-based volumetry. RESULTS FTLD subtypes, lvPPA, and AD showed specific profiles for neurofilament light chain, phosphorylated heavy chain, tau, phospho-tau, amyloid beta1-42 from serum/cerebrospinal fluid, and brain atrophy. Neurofilaments related to regional atrophy in bvFTD, whereas progranulin was associated with atrophy in semantic variant PPA. Ubiquitin showed no effects. DISCUSSION Results specify biomarker and atrophy patterns in FTLD and AD supporting differential diagnosis. They identify neurofilaments and progranulin in interaction with structural imaging as promising candidates for monitoring disease progression and therapy. HIGHLIGHTS Study cross-validated neuroimaging and fluid biomarkers in dementia. Five kinds of frontotemporal lobar degeneration and two variants of Alzheimer's disease. Study identifies disease-specific fluid biomarker and atrophy profiles. Fluid biomarkers and atrophy interact in a disease-specific way. Neurofilaments and progranulin are proposed as biomarkers for diagnosis and therapy.
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Remoli G, Schilke ED, Magi A, Ancidoni A, Negro G, Da Re F, Frigo M, Giordano M, Vanacore N, Canevelli M, Ferrarese C, Tremolizzo L, Appollonio I. Neuropathological hints from CSF and serum biomarkers in corticobasal syndrome (CBS): a systematic review. Neurol Res Pract 2024; 6:1. [PMID: 38173024 PMCID: PMC10765833 DOI: 10.1186/s42466-023-00294-0] [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: 05/29/2023] [Accepted: 10/23/2023] [Indexed: 01/05/2024] Open
Abstract
Corticobasal syndrome (CBS) is a clinical syndrome determined by various underlying neurodegenerative disorders requiring a pathological assessment for a definitive diagnosis. A literature review was performed following the methodology described in the Cochrane Handbook for Systematic Reviews to investigate the additional value of traditional and cutting-edge cerebrospinal fluid (CSF) and serum/plasma biomarkers in profiling CBS. Four databases were screened applying predefined inclusion criteria: (1) recruiting patients with CBS; (2) analyzing CSF/plasma biomarkers in CBS. The review highlights the potential role of the association of fluid biomarkers in diagnostic workup of CBS, since they may contribute to a more accurate diagnosis and patient selection for future disease-modifying agent; for example, future trial designs should consider baseline CSF Neurofilament Light Chains (NfL) or progranulin dosage to stratify treatment arms according to neuropathological substrates, and serum NfL dosage might be used to monitor the evolution of CBS. In this scenario, prospective cohort studies, starting with neurological examination and neuropsychological tests, should be considered to assess the correlations of clinical profiles and various biomarkers.
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Affiliation(s)
- Giulia Remoli
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
- Department of Neuroscience, Sapienza University of Roma, Roma, Italy
| | - Edoardo Dalmato Schilke
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy.
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy.
| | - Andrea Magi
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
| | - Antonio Ancidoni
- National Institute of Health, Roma, Italy
- Department of Neuroscience, Sapienza University of Roma, Roma, Italy
| | - Giulia Negro
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
| | - Fulvio Da Re
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
| | - Maura Frigo
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
| | - Martina Giordano
- Neurosurgery Unit, Department of Neuroscience, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
- University of Milan, Milano, Italy
| | - Nicola Vanacore
- National Institute of Health, Roma, Italy
- Department of Neuroscience, Sapienza University of Roma, Roma, Italy
| | - Marco Canevelli
- National Institute of Health, Roma, Italy
- Department of Neuroscience, Sapienza University of Roma, Roma, Italy
| | - Carlo Ferrarese
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
| | - Lucio Tremolizzo
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
| | - Ildebrando Appollonio
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
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Vijiaratnam N, Foltynie T. How should we be using biomarkers in trials of disease modification in Parkinson's disease? Brain 2023; 146:4845-4869. [PMID: 37536279 PMCID: PMC10690028 DOI: 10.1093/brain/awad265] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/18/2023] [Accepted: 07/22/2023] [Indexed: 08/05/2023] Open
Abstract
The recent validation of the α-synuclein seed amplification assay as a biomarker with high sensitivity and specificity for the diagnosis of Parkinson's disease has formed the backbone for a proposed staging system for incorporation in Parkinson's disease clinical studies and trials. The routine use of this biomarker should greatly aid in the accuracy of diagnosis during recruitment of Parkinson's disease patients into trials (as distinct from patients with non-Parkinson's disease parkinsonism or non-Parkinson's disease tremors). There remain, however, further challenges in the pursuit of biomarkers for clinical trials of disease modifying agents in Parkinson's disease, namely: optimizing the distinction between different α-synucleinopathies; the selection of subgroups most likely to benefit from a candidate disease modifying agent; a sensitive means of confirming target engagement; and the early prediction of longer-term clinical benefit. For example, levels of CSF proteins such as the lysosomal enzyme β-glucocerebrosidase may assist in prognostication or allow enrichment of appropriate patients into disease modifying trials of agents with this enzyme as the target; the presence of coexisting Alzheimer's disease-like pathology (detectable through CSF levels of amyloid-β42 and tau) can predict subsequent cognitive decline; imaging techniques such as free-water or neuromelanin MRI may objectively track decline in Parkinson's disease even in its later stages. The exploitation of additional biomarkers to the α-synuclein seed amplification assay will, therefore, greatly add to our ability to plan trials and assess the disease modifying properties of interventions. The choice of which biomarker(s) to use in the context of disease modifying clinical trials will depend on the intervention, the stage (at risk, premotor, motor, complex) of the population recruited and the aims of the trial. The progress already made lends hope that panels of fluid biomarkers in tandem with structural or functional imaging may provide sensitive and objective methods of confirming that an intervention is modifying a key pathophysiological process of Parkinson's disease. However, correlation with clinical progression does not necessarily equate to causation, and the ongoing validation of quantitative biomarkers will depend on insightful clinical-genetic-pathophysiological comparisons incorporating longitudinal biomarker changes from those at genetic risk with evidence of onset of the pathophysiology and those at each stage of manifest clinical Parkinson's disease.
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Affiliation(s)
- Nirosen Vijiaratnam
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Thomas Foltynie
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
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Olfati N, Shoeibi A, Litvan I. Clinical Spectrum of Tauopathies. Front Neurol 2022; 13:944806. [PMID: 35911892 PMCID: PMC9329580 DOI: 10.3389/fneur.2022.944806] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 06/20/2022] [Indexed: 11/20/2022] Open
Abstract
Tauopathies are both clinical and pathological heterogeneous disorders characterized by neuronal and/or glial accumulation of misfolded tau protein. It is now well understood that every pathologic tauopathy may present with various clinical phenotypes based on the primary site of involvement and the spread and distribution of the pathology in the nervous system making clinicopathological correlation more and more challenging. The clinical spectrum of tauopathies includes syndromes with a strong association with an underlying primary tauopathy, including Richardson syndrome (RS), corticobasal syndrome (CBS), non-fluent agrammatic primary progressive aphasia (nfaPPA)/apraxia of speech, pure akinesia with gait freezing (PAGF), and behavioral variant frontotemporal dementia (bvFTD), or weak association with an underlying primary tauopathy, including Parkinsonian syndrome, late-onset cerebellar ataxia, primary lateral sclerosis, semantic variant PPA (svPPA), and amnestic syndrome. Here, we discuss clinical syndromes associated with various primary tauopathies and their distinguishing clinical features and new biomarkers becoming available to improve in vivo diagnosis. Although the typical phenotypic clinical presentations lead us to suspect specific underlying pathologies, it is still challenging to differentiate pathology accurately based on clinical findings due to large phenotypic overlaps. Larger pathology-confirmed studies to validate the use of different biomarkers and prospective longitudinal cohorts evaluating detailed clinical, biofluid, and imaging protocols in subjects presenting with heterogenous phenotypes reflecting a variety of suspected underlying pathologies are fundamental for a better understanding of the clinicopathological correlations.
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Affiliation(s)
- Nahid Olfati
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- UC San Diego Department of Neurosciences, Parkinson and Other Movement Disorder Center, San Diego, CA, United States
| | - Ali Shoeibi
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Irene Litvan
- UC San Diego Department of Neurosciences, Parkinson and Other Movement Disorder Center, San Diego, CA, United States
- *Correspondence: Irene Litvan
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Koga S, Josephs KA, Aiba I, Yoshida M, Dickson DW. Neuropathology and emerging biomarkers in corticobasal syndrome. J Neurol Neurosurg Psychiatry 2022; 93:jnnp-2021-328586. [PMID: 35697501 PMCID: PMC9380481 DOI: 10.1136/jnnp-2021-328586] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/18/2022] [Indexed: 11/05/2022]
Abstract
Corticobasal syndrome (CBS) is a clinical syndrome characterised by progressive asymmetric limb rigidity and apraxia with dystonia, myoclonus, cortical sensory loss and alien limb phenomenon. Corticobasal degeneration (CBD) is one of the most common underlying pathologies of CBS, but other disorders, such as progressive supranuclear palsy (PSP), Alzheimer's disease (AD) and frontotemporal lobar degeneration with TDP-43 inclusions, are also associated with this syndrome.In this review, we describe common and rare neuropathological findings in CBS, including tauopathies, synucleinopathies, TDP-43 proteinopathies, fused in sarcoma proteinopathy, prion disease (Creutzfeldt-Jakob disease) and cerebrovascular disease, based on a narrative review of the literature and clinicopathological studies from two brain banks. Genetic mutations associated with CBS, including GRN and MAPT, are also reviewed. Clinicopathological studies on neurodegenerative disorders associated with CBS have shown that regardless of the underlying pathology, frontoparietal, as well as motor and premotor pathology is associated with CBS. Clinical features that can predict the underlying pathology of CBS remain unclear. Using AD-related biomarkers (ie, amyloid and tau positron emission tomography (PET) and fluid biomarkers), CBS caused by AD often can be differentiated from other causes of CBS. Tau PET may help distinguish AD from other tauopathies and non-tauopathies, but it remains challenging to differentiate non-AD tauopathies, especially PSP and CBD. Although the current clinical diagnostic criteria for CBS have suboptimal sensitivity and specificity, emerging biomarkers hold promise for future improvements in the diagnosis of underlying pathology in patients with CBS.
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Affiliation(s)
- Shunsuke Koga
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Keith A Josephs
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ikuko Aiba
- Department of Neurology, National Hospital Organization Higashinagoya National Hospital, Nagoya, Aichi, Japan
| | - Mari Yoshida
- Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Aichi, Japan
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
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Saito Y, Kamagata K, Wijeratne PA, Andica C, Uchida W, Takabayashi K, Fujita S, Akashi T, Wada A, Shimoji K, Hori M, Masutani Y, Alexander DC, Aoki S. Temporal Progression Patterns of Brain Atrophy in Corticobasal Syndrome and Progressive Supranuclear Palsy Revealed by Subtype and Stage Inference (SuStaIn). Front Neurol 2022; 13:814768. [PMID: 35280291 PMCID: PMC8914081 DOI: 10.3389/fneur.2022.814768] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Differentiating corticobasal degeneration presenting with corticobasal syndrome (CBD-CBS) from progressive supranuclear palsy with Richardson's syndrome (PSP-RS), particularly in early stages, is often challenging because the neurodegenerative conditions closely overlap in terms of clinical presentation and pathology. Although volumetry using brain magnetic resonance imaging (MRI) has been studied in patients with CBS and PSP-RS, studies assessing the progression of brain atrophy are limited. Therefore, we aimed to reveal the difference in the temporal progression patterns of brain atrophy between patients with CBS and those with PSP-RS purely based on cross-sectional data using Subtype and Stage Inference (SuStaIn)—a novel, unsupervised machine learning technique that integrates clustering and disease progression modeling. We applied SuStaIn to the cross-sectional regional brain volumes of 25 patients with CBS, 39 patients with typical PSP-RS, and 50 healthy controls to estimate the two disease subtypes and trajectories of CBS and PSP-RS, which have distinct atrophy patterns. The progression model and classification accuracy of CBS and PSP-RS were compared with those of previous studies to evaluate the performance of SuStaIn. SuStaIn identified distinct temporal progression patterns of brain atrophy for CBS and PSP-RS, which were largely consistent with previous evidence, with high reproducibility (99.7%) under cross-validation. We classified these diseases with high accuracy (0.875) and sensitivity (0.680 and 1.000, respectively) based on cross-sectional structural brain MRI data; the accuracy was higher than that reported in previous studies. Moreover, SuStaIn stage correctly reflected disease severity without the label of disease stage, such as disease duration. Furthermore, SuStaIn also showed the genialized performance of differentiation and reflection for CBS and PSP-RS. Thus, SuStaIn has potential for improving our understanding of disease mechanisms, accurately stratifying patients, and providing prognoses for patients with CBS and PSP-RS.
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Affiliation(s)
- Yuya Saito
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- *Correspondence: Koji Kamagata
| | - Peter A. Wijeratne
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - Christina Andica
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Wataru Uchida
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kaito Takabayashi
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shohei Fujita
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Toshiaki Akashi
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akihiko Wada
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Keigo Shimoji
- Department of Radiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Masaaki Hori
- Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan
| | - Yoshitaka Masutani
- Department of Biomedical Information Sciences, Hiroshima City University Graduate School of Information Sciences, Hiroshima, Japan
| | - Daniel C. Alexander
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Li Q, Li Z, Han X, Shen X, Wang F, Bai L, Li Z, Zhang R, Wang Y, Zhu X. A Panel of Plasma Biomarkers for Differential Diagnosis of Parkinsonian Syndromes. Front Neurosci 2022; 16:805953. [PMID: 35250451 PMCID: PMC8891509 DOI: 10.3389/fnins.2022.805953] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The aim of our study is to explore the most reliable panel of plasma biomarkers for differential diagnosis of parkinsonian syndromes (PDSs). We selected five kinds of neurodegenerative proteins in plasma: neurofilament light chain (NfL), α-synuclein (α-syn), total tau, β-amyloid 42 (Aβ42) and β-amyloid 40 (Aβ40), and investigated the diagnostic value of these biomarkers. Methods A total of 99 plasma samples from patients with Parkinson’s disease (PD), multiple system atrophy (MSA), progressive supranuclear palsy, and age-matched healthy controls (HCs) were enrolled in our study. Plasma NfL, α-syn, total tau, Aβ42, and Aβ40 levels were quantified by ultrasensitive single molecule array immunoassay. We used logistic regression analyses to examine diagnostic accuracy of these plasma biomarkers. Disease severity was assessed by the modified Hoehn and Yahr staging scale, Unified Parkinson’s Disease Rating Scale part III (UPDRS III), and the Mini-Mental State Examination (MMSE), and subsequently, correlation analysis was performed. Results A combination of α-syn, Aβ42, Aβ40, Aβ42/40, and NfL could achieve a best diagnostic value in differentiating PDSs from HC and PD from HC, with an AUC of 0.983 and 0.977, respectively. By adding NfL to measurements of α-syn or Aβ42 or Aβ40 or Aβ42/40, the best discriminating panel was formed in differentiating atypical parkinsonian disorder (APD) and HC, and the discriminatory potential could reach a sensitivity of 100% and specificity of 100% (AUC = 1.000). For further distinguishing PD from APD, we found a combination of NfL, Aβ42, and total tau was the most reliable panel with equally high diagnostic accuracy. With respect to differentiating the subtypes of APD from one another, our results revealed that measurement of NfL, total tau, Aβ42, Aβ40, and Aβ42/40 was the best discriminating panel. Correlation analysis suggests that plasma Aβ42 levels were positively correlated to UPDRS part III scores in MSA. In terms of cognitive function, there was a relationship between plasma Aβ42/40 level and MMSE scores in patients with APD. Conclusion In our study, various combinations of plasma biomarkers have great potentialities in identifying PDSs, with important clinical utility in improving diagnostic accuracy. Plasma NfL may have added value to a blood-based biomarker panel for differentiating PDSs.
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Sato C, Mallipeddi N, Ghoshal N, Wright BA, Day GS, Davis AA, Kim AH, Zipfel GJ, Bateman RJ, Gabelle A, Barthélemy NR. MAPT R406W increases tau T217 phosphorylation in absence of amyloid pathology. Ann Clin Transl Neurol 2021; 8:1817-1830. [PMID: 34342183 PMCID: PMC8419397 DOI: 10.1002/acn3.51435] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 01/07/2023] Open
Abstract
Objective Tau hyperphosphorylation at threonine 217 (pT217) in cerebrospinal fluid (CSF) has recently been linked to early amyloidosis and could serve as a highly sensitive biomarker for Alzheimer’s disease (AD). However, it remains unclear whether other tauopathies induce pT217 modifications. To determine if pT217 modification is specific to AD, CSF pT217 was measured in AD and other tauopathies. Methods Using immunoprecipitation and mass spectrometry methods, we compared CSF T217 phosphorylation occupancy (pT217/T217) and amyloid‐beta (Aβ) 42/40 ratio in cognitively normal individuals and those with symptomatic AD, progressive supranuclear palsy, corticobasal syndrome, and sporadic and familial frontotemporal dementia. Results Individuals with AD had high CSF pT217/T217 and low Aβ42/40. In contrast, cognitively normal individuals and the majority of those with 4R tauopathies had low CSF pT217/T217 and normal Aβ 42/40. We identified a subgroup of individuals with increased CSF pT217/T217 and normal Aβ 42/40 ratio, most of whom were MAPT R406W mutation carriers. Diagnostic accuracies of CSF Aβ 42/40 and CSF pT217/T217, alone and in combination were compared. We show that CSF pT217/T217 × CSF Aβ 42/40 is a sensitive composite biomarker that can separate MAPT R406W carriers from cognitively normal individuals and those with other tauopathies. Interpretation MAPT R406W is a tau mutation that leads to 3R+4R tauopathy similar to AD, but without amyloid neuropathology. These findings suggest that change in CSF pT217/T217 ratio is not specific to AD and might reflect common downstream tau pathophysiology common to 3R+4R tauopathies.
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Affiliation(s)
- Chihiro Sato
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Nipun Mallipeddi
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Nupur Ghoshal
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Brenton A Wright
- Department of Neurosciences, University of California San Diego School of Medicine, La Jolla, California
| | - Gregory S Day
- Department of Neurology, Mayo Clinic Florida, Jacksonville, Florida
| | - Albert A Davis
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri
| | - Albert H Kim
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri.,Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri
| | - Gregory J Zipfel
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri.,Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri.,Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri
| | - Audrey Gabelle
- Department of Neurology, Memory Research and Resources Center, University Hospital of Montpellier, Neurosciences Institute of Montpellier, University of Montpellier, Montpellier, France
| | - Nicolas R Barthélemy
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
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10
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Campese N, Palermo G, Del Gamba C, Beatino MF, Galgani A, Belli E, Del Prete E, Della Vecchia A, Vergallo A, Siciliano G, Ceravolo R, Hampel H, Baldacci F. Progress regarding the context-of-use of tau as biomarker of Alzheimer's disease and other neurodegenerative diseases. Expert Rev Proteomics 2021; 18:27-48. [PMID: 33545008 DOI: 10.1080/14789450.2021.1886929] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction: Tau protein misfolding and accumulation in toxic species is a critical pathophysiological process of Alzheimer's disease (AD) and other neurodegenerative disorders (NDDs). Tau biomarkers, namely cerebrospinal fluid (CSF) total-tau (t-tau), 181-phosphorylated tau (p-tau), and tau-PET tracers, have been recently embedded in the diagnostic criteria for AD. Nevertheless, the role of tau as a diagnostic and prognostic biomarker for other NDDs remains controversial.Areas covered: We performed a systematical PubMed-based review of the most recent advances in tau-related biomarkers for NDDs. We focused on papers published from 2015 to 2020 assessing the diagnostic or prognostic value of each biomarker.Expert opinion: The assessment of tau biomarkers in alternative easily accessible matrices, through the development of ultrasensitive techniques, represents the most significant perspective for AD-biomarker research. In NDDs, novel tau isoforms (e.g. p-tau217) or proteolytic fragments (e.g. N-terminal fragments) may represent candidate diagnostic and prognostic biomarkers and may help monitoring disease progression. Protein misfolding amplification assays, allowing the identification of different tau strains (e.g. 3 R- vs. 4 R-tau) in CSF, may constitute a breakthrough for the in vivo stratification of NDDs. Tau-PET may help tracking the spatial-temporal evolution of tau pathophysiology in AD but its application outside the AD-spectrum deserves further studies.
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Affiliation(s)
- Nicole Campese
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Palermo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Del Gamba
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Alessandro Galgani
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisabetta Belli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Eleonora Del Prete
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Andrea Vergallo
- GRC N° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard De L'hôpital, Sorbonne University, Paris, France
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Harald Hampel
- GRC N° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard De L'hôpital, Sorbonne University, Paris, France
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,GRC N° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard De L'hôpital, Sorbonne University, Paris, France
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11
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Paolini Paoletti F, Gaetani L, Parnetti L. Molecular profiling in Parkinsonian syndromes: CSF biomarkers. Clin Chim Acta 2020; 506:55-66. [PMID: 32142717 DOI: 10.1016/j.cca.2020.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 12/28/2022]
Abstract
An accurate and early diagnosis of degenerative parkinsonian syndromes is a major need for their correct and timely therapeutic management. The current diagnostic criteria are mostly based on clinical features and molecular imaging. However, diagnostic doubts often persist especially in the early stages of diseases when signs are slight, ambiguous and overlapping among different syndromes. Molecular imaging may not be altered in the early stages of diseases, also failing to discriminate among different syndromes. Cerebrospinal fluid (CSF) represents an ideal source of biomarkers reflecting different pathways of neuropathological changes taking place in the brain and preceding the clinical onset. The aim of this review is to provide un update on CSF biomarkers in parkinsonian disorders, discussing in detail their association with neuropathological correlates. Their potential contribution in differential diagnosis and prognostic assessment of different parkinsonian syndromes is also discussed. Before entering the clinical use both for diagnostic and prognostic purposes, these CSF biomarkers need to be thoroughly assessed in terms of pre-analytical and analytical variability, as well as to clinical validation in independent cohorts.
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Affiliation(s)
| | - Lorenzo Gaetani
- Section of Neurology, Department of Medicine, University of Perugia, Italy
| | - Lucilla Parnetti
- Section of Neurology, Department of Medicine, University of Perugia, Italy; Laboratory of Clinical Neurochemistry, Department of Medicine, University of Perugia, Italy
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12
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Gorgoraptis N, Li LM, Whittington A, Zimmerman KA, Maclean LM, McLeod C, Ross E, Heslegrave A, Zetterberg H, Passchier J, Matthews PM, Gunn RN, McMillan TM, Sharp DJ. In vivo detection of cerebral tau pathology in long-term survivors of traumatic brain injury. Sci Transl Med 2019; 11:11/508/eaaw1993. [DOI: 10.1126/scitranslmed.aaw1993] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 08/02/2019] [Indexed: 12/14/2022]
Abstract
Traumatic brain injury (TBI) can trigger progressive neurodegeneration, with tau pathology seen years after a single moderate-severe TBI. Identifying this type of posttraumatic pathology in vivo might help to understand the role of tau pathology in TBI pathophysiology. We used flortaucipir positron emission tomography (PET) to investigate whether tau pathology is present many years after a single TBI in humans. We examined PET data in relation to markers of neurodegeneration in the cerebrospinal fluid (CSF), structural magnetic resonance imaging measures, and cognitive performance. Cerebral flortaucipir binding was variable, with many participants with TBI showing increases in cortical and white matter regions. At the group level, flortaucipir binding was increased in the right occipital cortex in TBI when compared to healthy controls. Flortaucipir binding was associated with increased total tau, phosphorylated tau, and ubiquitin carboxyl-terminal hydrolase L1 CSF concentrations, as well as with reduced fractional anisotropy and white matter tissue density in TBI. Apolipoprotein E (APOE) ε4 genotype affected the relationship between flortaucipir binding and time since injury, CSF β amyloid 1–42 (Aβ42) concentration, white matter tissue density, and longitudinal Mini-Mental State Examination scores in TBI. The results demonstrate that tau PET is a promising approach to investigating progressive neurodegeneration associated with tauopathy after TBI.
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Affiliation(s)
- Nikos Gorgoraptis
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK
| | - Lucia M. Li
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK
| | - Alex Whittington
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK
- Invicro London, London W12 0NN, UK
| | - Karl A. Zimmerman
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK
| | - Linda M. Maclean
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 0XH, UK
| | - Claire McLeod
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 0XH, UK
| | - Ewan Ross
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK
| | - Amanda Heslegrave
- UK Dementia Research Institute, University College London, London WC1N 3BG, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Henrik Zetterberg
- UK Dementia Research Institute, University College London, London WC1N 3BG, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal 431 80, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal 413 45, Sweden
| | | | - Paul M. Matthews
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK
- UK Dementia Research Institute, Imperial College London, London W12 0NN, UK
| | - Roger N. Gunn
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK
- Invicro London, London W12 0NN, UK
| | - Tom M. McMillan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 0XH, UK
| | - David J. Sharp
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK
- UK Dementia Research Institute, Imperial College London, London W12 0NN, UK
- Royal British Legion Centre for Blast Injury Studies, Imperial College London, London, UK
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13
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Corticobasal degeneration and corticobasal syndrome: A review. Clin Park Relat Disord 2019; 1:66-71. [PMID: 34316603 PMCID: PMC8288513 DOI: 10.1016/j.prdoa.2019.08.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 12/19/2022] Open
Abstract
Corticobasal degeneration (CBD) is a rare neurodegenerative disorder. The most common presentation of CBD is the corticobasal syndrome (CBS), which is a constellation of cortical and extrapyramidal symptoms and signs. Clinical-pathological studies have illustrated that CBD can present with diverse clinical phenotypes, including a non-fluent, agrammatic primary progressive aphasia syndrome, a behavioral, dysexecutive and visuospatial syndrome, as well as a progressive supranuclear palsy-like syndrome. Conversely, multiple pathologies, such as CBD, Alzheimer's disease and progressive supranuclear palsy may underlie a patient with CBS. This clinical-pathological overlap emphasizes the need for biomarkers that will assist in the accurate diagnosis of patients with CBS. This review presents an overview of the pathological, genetic, clinical and therapeutic characteristics of CBD, with an emphasis on the imaging (structural and functional) and biochemical (cerebrospinal fluid) biomarkers of CBD.
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14
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Rösler TW, Tayaranian Marvian A, Brendel M, Nykänen NP, Höllerhage M, Schwarz SC, Hopfner F, Koeglsperger T, Respondek G, Schweyer K, Levin J, Villemagne VL, Barthel H, Sabri O, Müller U, Meissner WG, Kovacs GG, Höglinger GU. Four-repeat tauopathies. Prog Neurobiol 2019; 180:101644. [PMID: 31238088 DOI: 10.1016/j.pneurobio.2019.101644] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/21/2019] [Accepted: 06/12/2019] [Indexed: 02/08/2023]
Abstract
Tau is a microtubule-associated protein with versatile functions in the dynamic assembly of the neuronal cytoskeleton. Four-repeat (4R-) tauopathies are a group of neurodegenerative diseases defined by cytoplasmic inclusions predominantly composed of tau protein isoforms with four microtubule-binding domains. Progressive supranuclear palsy, corticobasal degeneration, argyrophilic grain disease or glial globular tauopathy belong to the group of 4R-tauopathies. The present review provides an introduction in the current concept of 4R-tauopathies, including an overview of the neuropathological and clinical spectrum of these diseases. It describes the genetic and environmental etiological factors, as well as the contemporary knowledge about the pathophysiological mechanisms, including post-translational modifications, aggregation and fragmentation of tau, as well as the role of protein degradation mechanisms. Furthermore, current theories about disease propagation are discussed, involving different extracellular tau species and their cellular release and uptake mechanisms. Finally, molecular diagnostic tools for 4R-tauopathies, including tau-PET and fluid biomarkers, and investigational therapeutic strategies are presented. In summary, we report on 4R-tauopathies as overarching disease concept based on a shared pathophysiological concept, and highlight the challenges and opportunities on the way towards a causal therapy.
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Affiliation(s)
- Thomas W Rösler
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany; Dept. of Neurology, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Amir Tayaranian Marvian
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany; Dept. of Neurology, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Matthias Brendel
- Dept. of Nuclear Medicine, University of Munich, 81377 Munich, Germany
| | - Niko-Petteri Nykänen
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany
| | - Matthias Höllerhage
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany; Dept. of Neurology, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Sigrid C Schwarz
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany
| | | | - Thomas Koeglsperger
- Dept. of Neurology, University of Munich, 81377 Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany
| | - Gesine Respondek
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany; Dept. of Neurology, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Kerstin Schweyer
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany; Dept. of Neurology, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Johannes Levin
- Dept. of Neurology, University of Munich, 81377 Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany
| | - Victor L Villemagne
- Dept. of Molecular Imaging and Therapy, Austin Health, Heidelberg, VIC, 3084, Australia; The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia; Dept. of Medicine, Austin Health, University of Melbourne, Melbourne, VIC, Australia
| | - Henryk Barthel
- Dept. of Nuclear Medicine, University of Leipzig, 04103 Leipzig, Germany
| | - Osama Sabri
- Dept. of Nuclear Medicine, University of Leipzig, 04103 Leipzig, Germany
| | - Ulrich Müller
- Institute for Human Genetics, University of Giessen, 35392 Giessen, Germany
| | - Wassilios G Meissner
- Service de Neurologie, CHU Bordeaux, 33000 Bordeaux, France; Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; Dept. of Medicine, University of Otago, Christchurch, New Zealand; New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Gabor G Kovacs
- Institute of Neurology, Medical University of Vienna, 1090 Vienna, Austria; Dept. of Laboratory Medicine and Pathobiology, University of Toronto, Laboratory Medicine Program, University Health Network, Toronto, Canada; Tanz Centre for Research in Neurodegenerative Disease, Krembil Brain Institute, Toronto, Canada
| | - Günter U Höglinger
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany; Dept. of Neurology, Technical University of Munich, School of Medicine, 81675 Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany; Dept. of Neurology, Hannover Medical School, 30625 Hannover, Germany.
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15
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van Rumund A, Aerts MB, Esselink RAJ, Meijer FJA, Verbeek MM, Bloem BR. Parkinson's Disease Diagnostic Observations (PADDO): study rationale and design of a prospective cohort study for early differentiation of parkinsonism. BMC Neurol 2018; 18:69. [PMID: 29764386 PMCID: PMC5954463 DOI: 10.1186/s12883-018-1072-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 05/04/2018] [Indexed: 11/28/2022] Open
Abstract
Background Differentiation of Parkinson’s disease (PD) from the various types of atypical parkinsonism (AP) such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP), dementia with Lewy bodies (DLB), corticobasal syndrome (CBS) and vascular parkinsonism (VP), can be challenging, especially early in the disease course when symptoms overlap. A major unmet need in the diagnostic workup of these disorders is a diagnostic tool that differentiates the various disorders, preferably in the earliest disease stages when the clinical presentation is similar. Many diagnostic tests have been evaluated, but their added value was studied mostly in retrospective case-control studies that included patients with a straightforward clinical diagnosis. Here, we describe the design of a prospective cohort study in patients with parkinsonism in an early disease stage who have an uncertain clinical diagnosis. Our aim is to evaluate the diagnostic accuracy of (1) detailed clinical examination by a movement disorder specialist, (2) magnetic resonance imaging (MRI) techniques and (3) cerebrospinal fluid (CSF) biomarkers. Methods/design Patients with parkinsonism with an uncertain clinical diagnosis and a disease course less than three years will be recruited. Patients will undergo extensive neurological examination, brain MRI including conventional and advanced sequences, and a lumbar puncture. The diagnosis (including level of certainty) will be defined by a movement disorders expert, neuroradiologist and neurochemist based on clinical data, MRI results and CSF results, respectively. The clinical diagnosis after three years’ follow-up will serve as the “gold standard” reference diagnosis, based on consensus criteria and as established by two movement disorder specialists (blinded to the test results). Diagnostic accuracy of individual instruments and added value of brain MRI and CSF analysis after evaluation by a movement disorder expert will be calculated, expressed as the change in percentage of individuals that are correctly diagnosed with PD or AP. Discussion This study will yield new insights into the diagnostic value of clinical evaluation by a movement disorder specialist, brain MRI and CSF analysis in discriminating PD from AP in early disease stages. The outcome has the potential to help clinicians in choosing the optimal diagnostic strategy for patients with an uncertain clinical diagnosis. Trial registration NCT01249768, registered November 26 2010. Electronic supplementary material The online version of this article (10.1186/s12883-018-1072-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anouke van Rumund
- Radboud university medical center, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, P.O.Box 9101, 6500 HB, Nijmegen (935), The Netherlands.
| | - Marjolein B Aerts
- Radboud university medical center, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, P.O.Box 9101, 6500 HB, Nijmegen (935), The Netherlands
| | - Rianne A J Esselink
- Radboud university medical center, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, P.O.Box 9101, 6500 HB, Nijmegen (935), The Netherlands
| | - Frederick J A Meijer
- Radboud university medical center, Department of Radiology and Nuclear medicine, Donders Institute for Brain, Cognition and Behaviour, P.O.Box 9101, 6500 HB, Nijmegen (766), The Netherlands
| | - Marcel M Verbeek
- Radboud university medical center, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, P.O.Box 9101, 6500 HB, Nijmegen (935), The Netherlands.,Radboud university medical center, Department of Laboratory Medicine Nijmegen, Donders Institute for Brain, Cognition and Behaviour, P.O.Box 9101, 6500 HB, Nijmegen (830), The Netherlands
| | - Bastiaan R Bloem
- Radboud university medical center, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, P.O.Box 9101, 6500 HB, Nijmegen (935), The Netherlands
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16
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Lin CH, Yang SY, Horng HE, Yang CC, Chieh JJ, Chen HH, Liu BH, Chiu MJ. Plasma Biomarkers Differentiate Parkinson's Disease From Atypical Parkinsonism Syndromes. Front Aging Neurosci 2018; 10:123. [PMID: 29755341 PMCID: PMC5934438 DOI: 10.3389/fnagi.2018.00123] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 04/11/2018] [Indexed: 12/13/2022] Open
Abstract
Objective: Parkinson’s disease (PD) has significant clinical overlaps with atypical parkinsonism syndromes (APS), which have a poorer treatment response and a more aggressive course than PD. We aimed to identify plasma biomarkers to differentiate PD from APS. Methods: Plasma samples (n = 204) were obtained from healthy controls and from patients with PD, dementia with Lewy bodies (DLB), multiple system atrophy, progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), or frontotemporal dementia (FTD) with parkinsonism (FTD-P) or without parkinsonism. We measured plasma levels of α-synuclein, total tau, p-Tau181, and amyloid beta 42 (Aβ42) by immunomagnetic reduction-based immunoassay. Results: Plasma α-synuclein level was significantly increased in patients with PD and APS when compared with controls and FTD without parkinsonism (p < 0.01). Total tau and p-Tau181 were significantly increased in all disease groups compared to controls, especially in patients with FTD (p < 0.01). A multivariate and receiver operating characteristic curve analysis revealed that a cut-off value for Aβ42 multiplied by p-Tau181 for discriminating patients with FTD from patients with PD and APS was 92.66 (pg/ml)2, with an area under the curve (AUC) of 0.932. An α-synuclein cut-off of 0.1977 pg/ml could separate FTD-P from FTD without parkinsonism (AUC 0.947). In patients with predominant parkinsonism, an α-synuclein cut-off of 1.388 pg/ml differentiated patients with PD from those with APS (AUC 0.87). Conclusion: Our results suggest that integrated plasma biomarkers improve the differential diagnosis of PD from APS (PSP, CBD, DLB, and FTD-P).
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Affiliation(s)
- Chin-Hsien Lin
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Herng-Er Horng
- Graduate Institute of Electro-Optical Science and Technology, College of Science, National Taiwan Normal University, Taipei, Taiwan
| | | | - Jen-Jie Chieh
- Graduate Institute of Electro-Optical Science and Technology, College of Science, National Taiwan Normal University, Taipei, Taiwan
| | | | | | - Ming-Jang Chiu
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Biomedical Engineering, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Psychology, National Taiwan University, Taipei, Taiwan
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17
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Biomarkers in cerebrospinal fluid for synucleinopathies, tauopathies, and other neurodegenerative disorders. HANDBOOK OF CLINICAL NEUROLOGY 2018; 146:99-113. [DOI: 10.1016/b978-0-12-804279-3.00007-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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18
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Constantinides VC, Paraskevas GP, Emmanouilidou E, Petropoulou O, Bougea A, Vekrellis K, Evdokimidis I, Stamboulis E, Kapaki E. CSF biomarkers β-amyloid, tau proteins and a-synuclein in the differential diagnosis of Parkinson-plus syndromes. J Neurol Sci 2017; 382:91-95. [DOI: 10.1016/j.jns.2017.09.039] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/01/2017] [Accepted: 09/26/2017] [Indexed: 10/18/2022]
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19
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Farotti L, Paciotti S, Tasegian A, Eusebi P, Parnetti L. Discovery, validation and optimization of cerebrospinal fluid biomarkers for use in Parkinson's disease. Expert Rev Mol Diagn 2017; 17:771-780. [PMID: 28604235 DOI: 10.1080/14737159.2017.1341312] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Parkinson's disease (PD) is a complex and phenotypically heterogeneous neurodegenerative disease, for which the diagnosis is mainly based on clinical parameters (even if neuroimaging plays a role in diagnostic assessment); as a consequence, misdiagnosis is common, especially in early stages. Thus, there is an urgent need of having available biomarkers in order to achieve an early and accurate diagnosis. Since molecular changes in the brain are reliably and timely reflected in cerebrospinal fluid (CSF), CSF represents an ideal source for biomarkers of different pathophysiological processes characterizing the disease since its early phases. Areas covered: The aim of this review is to provide an update on the role, development and validation of most studied CSF biomarkers showing a role in the diagnosis and/or prognosis of PD. Oligomeric alpha-synuclein, DJ-1, lysosomal enzymes (namely, glucocerebrosidase) show consistent evidence as potential diagnostic biomarkers of PD. Neurofilament light chain may also have a significant role in differentiating PD from other parkinsonisms. Amyloid beta peptide 1-42 has consistently shown a prognostic value in terms of development of cognitive impairment and dementia in PD patients. Expert commentary: CSF biomarkers represent a very promising approach to early and differential diagnosis of PD. The biomarkers available so far need preanalytical and analytical validation in order to have these CSF biomarkers ready for clinical use.
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Affiliation(s)
- Lucia Farotti
- a Clinica Neurologica, Laboratorio di Neurochimica Clinica , Universita degli Studi di Perugia , Perugia , Italy
| | - Silvia Paciotti
- a Clinica Neurologica, Laboratorio di Neurochimica Clinica , Universita degli Studi di Perugia , Perugia , Italy
| | - Anna Tasegian
- a Clinica Neurologica, Laboratorio di Neurochimica Clinica , Universita degli Studi di Perugia , Perugia , Italy
| | - Paolo Eusebi
- a Clinica Neurologica, Laboratorio di Neurochimica Clinica , Universita degli Studi di Perugia , Perugia , Italy
| | - Lucilla Parnetti
- a Clinica Neurologica, Laboratorio di Neurochimica Clinica , Universita degli Studi di Perugia , Perugia , Italy
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Kikuchi A, Okamura N, Hasegawa T, Harada R, Watanuki S, Funaki Y, Hiraoka K, Baba T, Sugeno N, Oshima R, Yoshida S, Kobayashi J, Ezura M, Kobayashi M, Tano O, Mugikura S, Iwata R, Ishiki A, Furukawa K, Arai H, Furumoto S, Tashiro M, Yanai K, Kudo Y, Takeda A, Aoki M. In vivo visualization of tau deposits in corticobasal syndrome by 18F-THK5351 PET. Neurology 2016; 87:2309-2316. [PMID: 27794115 DOI: 10.1212/wnl.0000000000003375] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 08/22/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether 18F-THK5351 PET can be used to visualize tau deposits in brain lesions in live patients with corticobasal syndrome (CBS). METHODS We evaluated the in vitro binding of 3H-THK5351 in postmortem brain tissues from a patient with corticobasal degeneration (CBD). In clinical PET studies, 18F-THK5351 retention in 5 patients with CBS was compared to that in 8 age-matched normal controls and 8 patients with Alzheimer disease (AD). RESULTS 3H-THK5351 was able to bind to tau deposits in the postmortem brain with CBD. In clinical PET studies, the 5 patients with CBS showed significantly higher 18F-THK5351 retention in the frontal, parietal, and globus pallidus than the 8 age-matched normal controls and patients with AD. Higher 18F-THK5351 retention was observed contralaterally to the side associated with greater cortical dysfunction and parkinsonism. CONCLUSIONS 18F-THK5351 PET demonstrated high tracer signal in sites susceptible to tau deposition in patients with CBS. 18F-THK5351 should be considered as a promising candidate radiotracer for the in vivo imaging of tau deposits in CBS.
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Affiliation(s)
- Akio Kikuchi
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan.
| | - Nobuyuki Okamura
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan.
| | - Takafumi Hasegawa
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Ryuichi Harada
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Shoichi Watanuki
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Yoshihito Funaki
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Kotaro Hiraoka
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Toru Baba
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Naoto Sugeno
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Ryuji Oshima
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Shun Yoshida
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Junpei Kobayashi
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Michinori Ezura
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Michiko Kobayashi
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Ohito Tano
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Shunji Mugikura
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Ren Iwata
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Aiko Ishiki
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Katsutoshi Furukawa
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Hiroyuki Arai
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Shozo Furumoto
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Manabu Tashiro
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Kazuhiko Yanai
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Yukitsuka Kudo
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Atsushi Takeda
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Masashi Aoki
- From the Departments of Neurology (A.K., T.H., T.B., N.S., R.O., S.Y., J.K., M.E., M.A.), Pharmacology (N.O., R.H., K.Y.), and Diagnostic Radiology (S.M.), Tohoku University Graduate School of Medicine; Divisions of Cyclotron Nuclear Medicine (S.W., K.H., M.T.) and Radiopharmaceutical Chemistry (Y.F., R.I., S.F.), Cyclotron and Radioisotope Center, and Department of Geriatric and Respiratory Medicine (A.I., K.F., H.A.) and Division of Neuroimaging (Y.K.), Institute of Development, Aging and Cancer, Tohoku University; Department of Neurology (M.K.), Tohoku Pharmaceutical University Hospital; Department of Neurology (O.T.), Sendai Medical Center; and Department of Neurology (A.T.), National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
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Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Agúndez JAG. Cerebrospinal fluid biochemical studies in patients with Parkinson's disease: toward a potential search for biomarkers for this disease. Front Cell Neurosci 2014; 8:369. [PMID: 25426023 PMCID: PMC4227512 DOI: 10.3389/fncel.2014.00369] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 10/20/2014] [Indexed: 12/14/2022] Open
Abstract
The blood-brain barrier supplies brain tissues with nutrients and filters certain compounds from the brain back to the bloodstream. In several neurodegenerative diseases, including Parkinson's disease (PD), there are disruptions of the blood-brain barrier. Cerebrospinal fluid (CSF) has been widely investigated in PD and in other parkinsonian syndromes with the aim of establishing useful biomarkers for an accurate differential diagnosis among these syndromes. This review article summarizes the studies reported on CSF levels of many potential biomarkers of PD. The most consistent findings are: (a) the possible role of CSF urate on the progression of the disease; (b) the possible relations of CSF total tau and phosphotau protein with the progression of PD and with the preservation of cognitive function in PD patients; (c) the possible value of CSF beta-amyloid 1-42 as a useful marker of further cognitive decline in PD patients, and (d) the potential usefulness of CSF neurofilament (NFL) protein levels in the differential diagnosis between PD and other parkinsonian syndromes. Future multicentric, longitudinal, prospective studies with long-term follow-up and neuropathological confirmation would be useful in establishing appropriate biomarkers for PD.
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Affiliation(s)
| | | | - Elena García-Martín
- Department of Biochemistry and Molecular Biology, University of ExtremaduraCáceres, Spain
- AMGenomicsCáceres, Spain
| | - José A. G. Agúndez
- AMGenomicsCáceres, Spain
- Department of Pharmacology, University of ExtremaduraCáceres, Spain
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Grossman M, Elman L, McCluskey L, McMillan CT, Boller A, Powers J, Rascovsky K, Hu W, Shaw L, Irwin DJ, Lee VMY, Trojanowski JQ. Phosphorylated tau as a candidate biomarker for amyotrophic lateral sclerosis. JAMA Neurol 2014; 71:442-8. [PMID: 24492862 DOI: 10.1001/jamaneurol.2013.6064] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
IMPORTANCE An increasingly varied clinical spectrum of cases with amyotrophic lateral sclerosis (ALS) has been identified, and objective criteria for clinical trial eligibility are necessary. OBJECTIVE To develop a cerebrospinal fluid (CSF) biomarker sensitive and specific for the diagnosis of ALS. DESIGN, SETTING, AND PARTICIPANTS A case-control study including 51 individuals with ALS and 23 individuals with a disorder associated with a 4-repeat tauopathy was conducted at an academic medical center. MAIN OUTCOMES AND MEASURES The CSF level of tau phosphorylated at threonine 181 (ptau) and ratio of ptau to total tau (ttau). RESULTS Using a cross-validation prediction procedure, we found significantly reduced CSF levels of ptau and the ptau:ttau ratio in ALS relative to 4-repeat tauopathy and to controls. In the validation cohort, the receiver operating characteristic area under the curve for the ptau:ttau ratio was 0.916, and the comparison of ALS with 4-repeat tauopathy showed 92.0% sensitivity and 91.7% specificity. Correct classification based on a low CSF ptau:ttau ratio was confirmed in 18 of 21 cases (86%) with autopsy-proved or genetically determined disease. In patients with available measures, ptau:ttau in ALS correlated with clinical measures of disease severity, such as the Mini-Mental State Examination (n = 51) and ALS Functional Rating Scale-Revised (n = 42), and regression analyses related the ptau:ttau ratio to magnetic resonance imaging (n = 10) evidence of disease in the corticospinal tract and white matter projections involving the prefrontal cortex. CONCLUSIONS AND RELEVANCE The CSF ptau:ttau ratio may be a candidate biomarker to provide objective support for the diagnosis of ALS.
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Affiliation(s)
- Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Lauren Elman
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Leo McCluskey
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Corey T McMillan
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ashley Boller
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - John Powers
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - William Hu
- Department of Neurology, Emory University, Atlanta, Georgia
| | - Les Shaw
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - David J Irwin
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia3Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medi
| | - Virginia M-Y Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - John Q Trojanowski
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Philadelphia, Pennsylvania
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A porous silicon immunoassay platform for fluorometric determination of α-synuclein in human cerebrospinal fluid. Mikrochim Acta 2014. [DOI: 10.1007/s00604-014-1180-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nutu M, Bourgeois P, Zetterberg H, Portelius E, Andreasson U, Parent S, Lipari F, Hall S, Constantinescu R, Hansson O, Blennow K. Aβ1-15/16 as a Potential Diagnostic Marker in Neurodegenerative Diseases. Neuromolecular Med 2012; 15:169-79. [DOI: 10.1007/s12017-012-8208-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 11/29/2012] [Indexed: 10/27/2022]
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Abstract
PURPOSE OF REVIEW Atypical parkinsonian disorders (APDs) comprise a heterogenous group of disorders including multiple system atrophy (MSA), dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). Based on literature published in 2010, we here review recent advances in the APD field. RECENT FINDINGS Genome-wide association studies have provided robust evidence of increased disease risk conferred by synuclein and tau gene variants in MSA and PSP. Furthermore, advanced imaging tools have been established in the differential diagnosis and as surrogate markers of disease activity in patients with APDs. Finally, although therapeutic options are still disappointing, translational research into disease-modifying strategies has accelerated with the increasing availability of transgenic animal models, particularly for MSA. SUMMARY Remarkable progress has been achieved in the field of APDs, and advances in the genetics, molecular biology and neuroimaging of these disorders will continue to facilitate intensified clinical trial activity.
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