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Mohammadi H, Ariaei A, Ghobadi Z, Gorgich EAC, Rustamzadeh A. Which neuroimaging and fluid biomarkers method is better in theranostic of Alzheimer's disease? An umbrella review. IBRO Neurosci Rep 2024; 16:403-417. [PMID: 38497046 PMCID: PMC10940808 DOI: 10.1016/j.ibneur.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/24/2024] [Indexed: 03/19/2024] Open
Abstract
Biomarkers are measured to evaluate physiological and pathological processes as well as responses to a therapeutic intervention. Biomarkers can be classified as diagnostic, prognostic, predictor, clinical, and therapeutic. In Alzheimer's disease (AD), multiple biomarkers have been reported so far. Nevertheless, finding a specific biomarker in AD remains a major challenge. Three databases, including PubMed, Web of Science, and Scopus were selected with the keywords of Alzheimer's disease, neuroimaging, biomarker, and blood. The results were finalized with 49 potential CSF/blood and 35 neuroimaging biomarkers. To distinguish normal from AD patients, amyloid-beta42 (Aβ42), plasma glial fibrillary acidic protein (GFAP), and neurofilament light (NFL) as potential biomarkers in cerebrospinal fluid (CSF) as well as the serum could be detected. Nevertheless, most of the biomarkers fairly change in the CSF during AD, listed as kallikrein 6, virus-like particles (VLP-1), galectin-3 (Gal-3), and synaptotagmin-1 (Syt-1). From the neuroimaging aspect, atrophy is an accepted biomarker for the neuropathologic progression of AD. In addition, Magnetic resonance spectroscopy (MRS), diffusion weighted imaging (DWI), diffusion tensor imaging (DTI), tractography (DTT), positron emission tomography (PET), and functional magnetic resonance imaging (fMRI), can be used to detect AD. Using neuroimaging and CSF/blood biomarkers, in combination with artificial intelligence, it is possible to obtain information on prognosis and follow-up on the different stages of AD. Hence physicians could select the suitable therapy to attenuate disease symptoms and follow up on the efficiency of the prescribed drug.
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Affiliation(s)
- Hossein Mohammadi
- Department of Bioimaging, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences (MUI), Isfahan, Islamic Republic of Iran
| | - Armin Ariaei
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Zahra Ghobadi
- Advanced Medical Imaging Ward, Pars Darman Medical Imaging Center, Karaj, Islamic Republic of Iran
| | - Enam Alhagh Charkhat Gorgich
- Department of Anatomy, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Islamic Republic of Iran
| | - Auob Rustamzadeh
- Cellular and Molecular Research Center, Research Institute for Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Mak E, Reid RI, Przybelski SA, Lesnick TG, Schwarz CG, Senjem ML, Raghavan S, Vemuri P, Jack CR, Min HK, Jain MK, Miyagawa T, Forsberg LK, Fields JA, Savica R, Graff-Radford J, Jones DT, Botha H, St Louis EK, Knopman DS, Ramanan VK, Dickson DW, Graff-Radford NR, Ferman TJ, Petersen RC, Lowe VJ, Boeve BF, O'Brien JT, Kantarci K. Influences of amyloid-β and tau on white matter neurite alterations in dementia with Lewy bodies. NPJ Parkinsons Dis 2024; 10:76. [PMID: 38570511 PMCID: PMC10991290 DOI: 10.1038/s41531-024-00684-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
Dementia with Lewy bodies (DLB) is a neurodegenerative condition often co-occurring with Alzheimer's disease (AD) pathology. Characterizing white matter tissue microstructure using Neurite Orientation Dispersion and Density Imaging (NODDI) may help elucidate the biological underpinnings of white matter injury in individuals with DLB. In this study, diffusion tensor imaging (DTI) and NODDI metrics were compared in 45 patients within the dementia with Lewy bodies spectrum (mild cognitive impairment with Lewy bodies (n = 13) and probable dementia with Lewy bodies (n = 32)) against 45 matched controls using conditional logistic models. We evaluated the associations of tau and amyloid-β with DTI and NODDI parameters and examined the correlations of AD-related white matter injury with Clinical Dementia Rating (CDR). Structural equation models (SEM) explored relationships among age, APOE ε4, amyloid-β, tau, and white matter injury. The DLB spectrum group exhibited widespread white matter abnormalities, including reduced fractional anisotropy, increased mean diffusivity, and decreased neurite density index. Tau was significantly associated with limbic and temporal white matter injury, which was, in turn, associated with worse CDR. SEM revealed that amyloid-β exerted indirect effects on white matter injury through tau. We observed widespread disruptions in white matter tracts in DLB that were not attributed to AD pathologies, likely due to α-synuclein-related injury. However, a fraction of the white matter injury could be attributed to AD pathology. Our findings underscore the impact of AD pathology on white matter integrity in DLB and highlight the utility of NODDI in elucidating the biological basis of white matter injury in DLB.
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Affiliation(s)
- Elijah Mak
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Robert I Reid
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Scott A Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Timothy G Lesnick
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Hoon Ki Min
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Manoj K Jain
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Erik K St Louis
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
- Center for Sleep Medicine, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Dennis W Dickson
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Tanis J Ferman
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Ronald C Petersen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
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Andersen E, Casteigne B, Chapman WD, Creed A, Foster F, Lapins A, Shatz R, Sawyer RP. Diagnostic biomarkers in Alzheimer’s disease. Biomark Neuropsychiatry 2021. [DOI: 10.1016/j.bionps.2021.100041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Schumacher J, Gunter JL, Przybelski SA, Jones DT, Graff-Radford J, Savica R, Schwarz CG, Senjem ML, Jack CR, Lowe VJ, Knopman DS, Fields JA, Kremers WK, Petersen RC, Graff-Radford NR, Ferman TJ, Boeve BF, Thomas AJ, Taylor JP, Kantarci K. Dementia with Lewy bodies: association of Alzheimer pathology with functional connectivity networks. Brain 2021; 144:3212-3225. [PMID: 34114602 PMCID: PMC8634124 DOI: 10.1093/brain/awab218] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/19/2021] [Accepted: 04/22/2021] [Indexed: 11/22/2022] Open
Abstract
Dementia with Lewy bodies (DLB) is neuropathologically defined by the presence of α-synuclein aggregates, but many DLB cases show concurrent Alzheimer's disease pathology in the form of amyloid-β plaques and tau neurofibrillary tangles. The first objective of this study was to investigate the effect of Alzheimer's disease co-pathology on functional network changes within the default mode network (DMN) in DLB. Second, we studied how the distribution of tau pathology measured with PET relates to functional connectivity in DLB. Twenty-seven DLB, 26 Alzheimer's disease and 99 cognitively unimpaired participants (balanced on age and sex to the DLB group) underwent tau-PET with AV-1451 (flortaucipir), amyloid-β-PET with Pittsburgh compound-B (PiB) and resting-state functional MRI scans. The resing-state functional MRI data were used to assess functional connectivity within the posterior DMN. This was then correlated with overall cortical flortaucipir PET and PiB PET standardized uptake value ratio (SUVr). The strength of interregional functional connectivity was assessed using the Schaefer atlas. Tau-PET covariance was measured as the correlation in flortaucipir SUVr between any two regions across participants. The association between region-to-region functional connectivity and tau-PET covariance was assessed using linear regression. Additionally, we identified the region with highest and the region with lowest tau SUVrs (tau hot- and cold spots) and tested whether tau SUVr in all other brain regions was associated with the strength of functional connectivity to these tau hot and cold spots. A reduction in posterior DMN connectivity correlated with overall higher cortical tau- (r = -0.39, P = 0.04) and amyloid-PET uptake (r = -0.41, P = 0.03) in the DLB group, i.e. patients with DLB who have more concurrent Alzheimer's disease pathology showed a more severe loss of DMN connectivity. Higher functional connectivity between regions was associated with higher tau covariance in cognitively unimpaired, Alzheimer's disease and DLB. Furthermore, higher functional connectivity of a target region to the tau hotspot (i.e. inferior/medial temporal cortex) was related to higher flortaucipir SUVrs in the target region, whereas higher functional connectivity to the tau cold spot (i.e. sensory-motor cortex) was related to lower flortaucipir SUVr in the target region. Our findings suggest that a higher burden of Alzheimer's disease co-pathology in patients with DLB is associated with more Alzheimer's disease-like changes in functional connectivity. Furthermore, we found an association between the brain's functional network architecture and the distribution of tau pathology that has recently been described in Alzheimer's disease. We show that this relationship also exists in patients with DLB, indicating that similar mechanisms of connectivity-dependent occurrence of tau pathology might be at work in both diseases.
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Affiliation(s)
- Julia Schumacher
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, UK
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Jeffrey L Gunter
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Scott A Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Matthew L Senjem
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Walter K Kremers
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | - Tanis J Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Alan J Thomas
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Wakasugi N, Hanakawa T. It Is Time to Study Overlapping Molecular and Circuit Pathophysiologies in Alzheimer's and Lewy Body Disease Spectra. Front Syst Neurosci 2021; 15:777706. [PMID: 34867224 PMCID: PMC8637125 DOI: 10.3389/fnsys.2021.777706] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/28/2021] [Indexed: 12/30/2022] Open
Abstract
Alzheimer's disease (AD) is the leading cause of dementia due to neurodegeneration and is characterized by extracellular senile plaques composed of amyloid β1 - 42 (Aβ) as well as intracellular neurofibrillary tangles consisting of phosphorylated tau (p-tau). Dementia with Lewy bodies constitutes a continuous spectrum with Parkinson's disease, collectively termed Lewy body disease (LBD). LBD is characterized by intracellular Lewy bodies containing α-synuclein (α-syn). The core clinical features of AD and LBD spectra are distinct, but the two spectra share common cognitive and behavioral symptoms. The accumulation of pathological proteins, which acquire pathogenicity through conformational changes, has long been investigated on a protein-by-protein basis. However, recent evidence suggests that interactions among these molecules may be critical to pathogenesis. For example, Aβ/tau promotes α-syn pathology, and α-syn modulates p-tau pathology. Furthermore, clinical evidence suggests that these interactions may explain the overlapping pathology between AD and LBD in molecular imaging and post-mortem studies. Additionally, a recent hypothesis points to a common mechanism of prion-like progression of these pathological proteins, via neural circuits, in both AD and LBD. This suggests a need for understanding connectomics and their alterations in AD and LBD from both pathological and functional perspectives. In AD, reduced connectivity in the default mode network is considered a hallmark of the disease. In LBD, previous studies have emphasized abnormalities in the basal ganglia and sensorimotor networks; however, these account for movement disorders only. Knowledge about network abnormalities common to AD and LBD is scarce because few previous neuroimaging studies investigated AD and LBD as a comprehensive cohort. In this paper, we review research on the distribution and interactions of pathological proteins in the brain in AD and LBD, after briefly summarizing their clinical and neuropsychological manifestations. We also describe the brain functional and connectivity changes following abnormal protein accumulation in AD and LBD. Finally, we argue for the necessity of neuroimaging studies that examine AD and LBD cases as a continuous spectrum especially from the proteinopathy and neurocircuitopathy viewpoints. The findings from such a unified AD and Parkinson's disease (PD) cohort study should provide a new comprehensive perspective and key data for guiding disease modification therapies targeting the pathological proteins in AD and LBD.
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Affiliation(s)
- Noritaka Wakasugi
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takashi Hanakawa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Integrated Neuroanatomy and Neuroimaging, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Low soluble amyloid-β 42 is associated with smaller brain volume in Parkinson's disease. Parkinsonism Relat Disord 2021; 92:15-21. [PMID: 34656902 DOI: 10.1016/j.parkreldis.2021.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 09/19/2021] [Accepted: 10/10/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION We sought to examine whether levels of soluble alpha-synuclein (α-syn), amyloid-beta (Aβ42), phosphorylated tau (p-tau), and total tau (t-tau), as measured in cerebrospinal fluid (CSF), are associated with changes in brain volume in Parkinson's disease. METHODS We assessed the 4-year change in total brain volume (n = 99) and baseline CSF α-syn, Aβ42, p-tau, and t-tau of Parkinson Progression Markers Initiative participants. We used linear mixed models to assess the longitudinal effect of baseline CSF biomarkers on total and regional brain volume and thickness as well as linear regression for cross-sectional analyses at baseline and year 2. All models were adjusted for age and gender; brain volume models also adjusted for baseline intracranial volume. Bonferroni correction was applied. RESULTS The 4-year change in total brain volume was -21.2 mm3 (95% confidence interval, -26.1, -16.3). There were no significant associations between the 4-year change in total brain volume and baseline levels of any CSF biomarker (all p-values > 0.05). On cross-sectional analyses, CSF Aβ42 was linearly associated with total brain volume at baseline (R2 = 0.60, p = 0.0004) and at year 2 (R2 = 0.66, p < 0.0001), with CSF Aβ42 < 1100 pg/ml, the threshold for brain amyloid pathology, associated with smaller total brain volume at baseline (p = 0.0010) and at year 2 (p = 0.0002). CSF α-syn was linearly associated with total brain volume at baseline (R2 = 0.58, p = 0.0044) but not at year 2 (R2 = 0.58, p = 0.1342). CONCLUSION Reduction in soluble Aβ42 is associated with lower total brain volume in Parkinson's disease.
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Mehra S, Gadhe L, Bera R, Sawner AS, Maji SK. Structural and Functional Insights into α-Synuclein Fibril Polymorphism. Biomolecules 2021; 11:1419. [PMID: 34680054 PMCID: PMC8533119 DOI: 10.3390/biom11101419] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 12/21/2022] Open
Abstract
Abnormal accumulation of aggregated α-synuclein (α-Syn) is seen in a variety of neurodegenerative diseases, including Parkinson's disease (PD), multiple system atrophy (MSA), dementia with Lewy body (DLB), Parkinson's disease dementia (PDD), and even subsets of Alzheimer's disease (AD) showing Lewy-body-like pathology. These synucleinopathies exhibit differences in their clinical and pathological representations, reminiscent of prion disorders. Emerging evidence suggests that α-Syn self-assembles and polymerizes into conformationally diverse polymorphs in vitro and in vivo, similar to prions. These α-Syn polymorphs arising from the same precursor protein may exhibit strain-specific biochemical properties and the ability to induce distinct pathological phenotypes upon their inoculation in animal models. In this review, we discuss clinical and pathological variability in synucleinopathies and several aspects of α-Syn fibril polymorphism, including the existence of high-resolution molecular structures and brain-derived strains. The current review sheds light on the recent advances in delineating the structure-pathogenic relationship of α-Syn and how diverse α-Syn molecular polymorphs contribute to the existing clinical heterogeneity in synucleinopathies.
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Affiliation(s)
- Surabhi Mehra
- Department of Biosciences and Bioengineering, IIT Bombay, Powai, Mumbai 400076, India; (L.G.); (R.B.); (A.S.S.)
| | | | | | | | - Samir K. Maji
- Department of Biosciences and Bioengineering, IIT Bombay, Powai, Mumbai 400076, India; (L.G.); (R.B.); (A.S.S.)
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Chen X, Necus J, Peraza LR, Mehraram R, Wang Y, O'Brien JT, Blamire A, Kaiser M, Taylor JP. The functional brain favours segregated modular connectivity at old age unless affected by neurodegeneration. Commun Biol 2021; 4:973. [PMID: 34400752 PMCID: PMC8367990 DOI: 10.1038/s42003-021-02497-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 07/22/2021] [Indexed: 11/29/2022] Open
Abstract
Brain's modular connectivity gives this organ resilience and adaptability. The ageing process alters the organised modularity of the brain and these changes are further accentuated by neurodegeneration, leading to disorganisation. To understand this further, we analysed modular variability-heterogeneity of modules-and modular dissociation-detachment from segregated connectivity-in two ageing cohorts and a mixed cohort of neurodegenerative diseases. Our results revealed that the brain follows a universal pattern of high modular variability in metacognitive brain regions: the association cortices. The brain in ageing moves towards a segregated modular structure despite presenting with increased modular heterogeneity-modules in older adults are not only segregated, but their shape and size are more variable than in young adults. In the presence of neurodegeneration, the brain maintains its segregated connectivity globally but not locally, and this is particularly visible in dementia with Lewy bodies and Parkinson's disease dementia; overall, the modular brain shows patterns of differentiated pathology.
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Affiliation(s)
- Xue Chen
- College of Control Science and Engineering, China University of Petroleum (East China), Qingdao, China.
- Interdisciplinary Computing and Complex BioSystems (ICOS) research group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | - Joe Necus
- Interdisciplinary Computing and Complex BioSystems (ICOS) research group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom.
- University of Nottingham, NIHR Nottingham Biomedical Research Centre, School of Medicine, Nottingham, UK.
| | - Luis R Peraza
- Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
- IXICO Plc, London, UK
| | - Ramtin Mehraram
- Interdisciplinary Computing and Complex BioSystems (ICOS) research group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
- Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
- Experimental Oto-rhino-laryngology (ExpORL) Research Group, Department of Neurosciences, KU Leuven, Leuven, Belgium
- NIHR Newcastle Biomedical Research Centre, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - Yanjiang Wang
- College of Control Science and Engineering, China University of Petroleum (East China), Qingdao, China
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge School of Medicine, Cambridge, United Kingdom
| | - Andrew Blamire
- Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
| | - Marcus Kaiser
- Interdisciplinary Computing and Complex BioSystems (ICOS) research group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
- University of Nottingham, NIHR Nottingham Biomedical Research Centre, School of Medicine, Nottingham, UK
- Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
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Combi R, Salsone M, Villa C, Ferini-Strambi L. Genetic Architecture and Molecular, Imaging and Prodromic Markers in Dementia with Lewy Bodies: State of the Art, Opportunities and Challenges. Int J Mol Sci 2021; 22:3960. [PMID: 33921279 PMCID: PMC8069386 DOI: 10.3390/ijms22083960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/03/2021] [Accepted: 04/09/2021] [Indexed: 11/16/2022] Open
Abstract
Dementia with Lewy bodies (DLB) is one of the most common causes of dementia and belongs to the group of α-synucleinopathies. Due to its clinical overlap with other neurodegenerative disorders and its high clinical heterogeneity, the clinical differential diagnosis of DLB from other similar disorders is often difficult and it is frequently underdiagnosed. Moreover, its genetic etiology has been studied only recently due to the unavailability of large cohorts with a certain diagnosis and shows genetic heterogeneity with a rare contribution of pathogenic mutations and relatively common risk factors. The rapid increase in the reported cases of DLB highlights the need for an easy, efficient and accurate diagnosis of the disease in its initial stages in order to halt or delay the progression. The currently used diagnostic methods proposed by the International DLB consortium rely on a list of criteria that comprises both clinical observations and the use of biomarkers. Herein, we summarize the up-to-now reported knowledge on the genetic architecture of DLB and discuss the use of prodromal biomarkers as well as recent promising candidates from alternative body fluids and new imaging techniques.
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Affiliation(s)
- Romina Combi
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
| | - Maria Salsone
- Institute of Molecular Bioimaging and Physiology, National Research Council, 20054 Segrate (MI), Italy;
- Department of Clinical Neurosciences, Neurology-Sleep Disorder Center, IRCCS San Raffaele Scientific Institute, 20127 Milan, Italy
| | - Chiara Villa
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
| | - Luigi Ferini-Strambi
- Department of Clinical Neurosciences, Neurology-Sleep Disorder Center, IRCCS San Raffaele Scientific Institute, 20127 Milan, Italy
- Department of Clinical Neurosciences, “Vita-Salute” San Raffaele University, 20127 Milan, Italy
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10
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Chen Q, Lowe VJ, Boeve BF, Przybelski SA, Miyagawa T, Senjem ML, Jack CR, Lesnick TG, Kremers WK, Fields JA, Min HK, Schwarz CG, Gunter JL, Graff-Radford J, Savica R, Knopman DS, Jones D, Ferman TJ, Graff-Radford NR, Petersen RC, Kantarci K. β-Amyloid PET and 123I-FP-CIT SPECT in Mild Cognitive Impairment at Risk for Lewy Body Dementia. Neurology 2021; 96:e1180-e1189. [PMID: 33408148 PMCID: PMC8055344 DOI: 10.1212/wnl.0000000000011454] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/26/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To determine the clinical phenotypes associated with the β-amyloid PET and dopamine transporter imaging (123I-FP-CIT SPECT) findings in mild cognitive impairment (MCI) with the core clinical features of dementia with Lewy bodies (DLB; MCI-LB). METHODS Patients with MCI who had at least 1 core clinical feature of DLB (n = 34) were grouped into β-amyloid A+ or A- and 123I-FP-CIT SPECT D+ or D- groups based on previously established abnormality cut points for A+ with Pittsburgh compound B PET standardized uptake value ratio (PiB SUVR) ≥1.48 and D+ with putamen z score with DaTQUANT <-0.82 on 123I-FP-CIT SPECT. Individual patients with MCI-LB fell into 1 of 4 groups: A+D+, A+D-, A-D+, or A-D-. Log-transformed PiB SUVR and putamen z score were tested for associations with patient characteristics. RESULTS The A-D+ biomarker profile was most common (38.2%), followed by A+D+ (26.5%) and A-D- (26.5%). The least common was the A+D- biomarker profile (8.8%). The A+ group was older, had a higher frequency of APOE ε4 carriers, and had a lower Mini-Mental State Examination score than the A- group. The D+ group was more likely to have probable REM sleep behavior disorder. Lower putamen DaTQUANT z scores and lower PiB SUVRs were independently associated with higher Unified Parkinson's Disease Rating Scale-III scores. CONCLUSIONS A majority of patients with MCI-LB are characterized by low β-amyloid deposition and reduced dopaminergic activity. β-Amyloid PET and 123I-FP-CIT SPECT are complementary in characterizing clinical phenotypes of patients with MCI-LB.
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Affiliation(s)
- Qin Chen
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Val J Lowe
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Bradley F Boeve
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Scott A Przybelski
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Toji Miyagawa
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Matthew L Senjem
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Clifford R Jack
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Timothy G Lesnick
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Walter K Kremers
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Julie A Fields
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Hoon-Ki Min
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Christopher G Schwarz
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Jeffrey L Gunter
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Jonathan Graff-Radford
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Rodolfo Savica
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - David S Knopman
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - David Jones
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Tanis J Ferman
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Neill R Graff-Radford
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Ronald C Petersen
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL
| | - Kejal Kantarci
- From the Department of Neurology (Q.C.), West China Hospital of Sichuan University, Chengdu; Departments of Radiology (Q.C., V.J.L., M.L.S., C.R.J., H.-K.M., C.G.S., J.L.G., K.K.), Neurology (B.F.B., T.M., J.G.-R., R.S., D.S.K., D.J., R.C.P.), Health Sciences Research (S.A.P., T.G.L., W.K.K.), and Psychology and Psychiatry (J.A.F.), Mayo Clinic, Rochester, MN; and Departments of Psychology and Psychiatry (T.J.F.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL.
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Patel KP, Wymer DT, Bhatia VK, Duara R, Rajadhyaksha CD. Multimodality Imaging of Dementia: Clinical Importance and Role of Integrated Anatomic and Molecular Imaging. Radiographics 2021; 40:200-222. [PMID: 31917652 DOI: 10.1148/rg.2020190070] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Neurodegenerative diseases are a devastating group of disorders that can be difficult to accurately diagnose. Although these disorders are difficult to manage owing to relatively limited treatment options, an early and correct diagnosis can help with managing symptoms and coping with the later stages of these disease processes. Both anatomic structural imaging and physiologic molecular imaging have evolved to a state in which these neurodegenerative processes can be identified relatively early with high accuracy. To determine the underlying disease, the radiologist should understand the different distributions and pathophysiologic processes involved. High-spatial-resolution MRI allows detection of subtle morphologic changes, as well as potential complications and alternate diagnoses, while molecular imaging allows visualization of altered function or abnormal increased or decreased concentration of disease-specific markers. These methodologies are complementary. Appropriate workup and interpretation of diagnostic studies require an integrated, multimodality, multidisciplinary approach. This article reviews the protocols and findings at MRI and nuclear medicine imaging, including with the use of flurodeoxyglucose, amyloid tracers, and dopaminergic transporter imaging (ioflupane). The pathophysiology of some of the major neurodegenerative processes and their clinical presentations are also reviewed; this information is critical to understand how these imaging modalities work, and it aids in the integration of clinical data to help synthesize a final diagnosis. Radiologists and nuclear medicine physicians aiming to include the evaluation of neurodegenerative diseases in their practice should be aware of and familiar with the multiple imaging modalities available and how using these modalities is essential in the multidisciplinary management of patients with neurodegenerative diseases.©RSNA, 2020.
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Affiliation(s)
- Kunal P Patel
- From the Department of Radiology, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL 33140
| | - David T Wymer
- From the Department of Radiology, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL 33140
| | - Vinay K Bhatia
- From the Department of Radiology, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL 33140
| | - Ranjan Duara
- From the Department of Radiology, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL 33140
| | - Chetan D Rajadhyaksha
- From the Department of Radiology, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL 33140
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12
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Cazzaniga FA, De Luca CMG, Bistaffa E, Consonni A, Legname G, Giaccone G, Moda F. Cell-free amplification of prions: Where do we stand? PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2020; 175:325-358. [PMID: 32958239 DOI: 10.1016/bs.pmbts.2020.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Neurodegenerative diseases (NDs) such as Alzheimer's disease (AD), Parkinson's disease (PD), atypical parkinsonisms, frontotemporal dementia (FTLD) and prion diseases are characterized by the accumulation of misfolded proteins in the central nervous system (CNS). Although the cause for the initiation of protein aggregation is not well understood, these aggregates are disease-specific. For instance, AD is characterized by the intraneuronal accumulation of tau and extracellular deposition of amyloid-β (Aβ), PD is marked by the intraneuronal accumulation of α-synuclein, many FTLD are associated with the accumulation of TDP-43 while prion diseases show aggregates of misfolded prion protein. Hence, misfolded proteins are considered disease-specific biomarkers and their identification and localization in the CNS, collected postmortem, is required for a definitive diagnosis. With the development of two innovative cell-free amplification techniques named Protein Misfolding Cyclic Amplification (PMCA) and Real-Time Quaking-Induced Conversion (RT-QuIC), traces of disease-specific biomarkers were found in CSF and other peripheral tissues (e.g., urine, blood, and olfactory mucosa) of patients with different NDs. These techniques exploit an important feature shared by many misfolded proteins, that is their ability to interact with their normally folded counterparts and force them to undergo similar structural rearrangements. Essentially, RT-QuIC and PMCA mimic in vitro the same pathological processes of protein misfolding which occur in vivo in a very rapid manner. For this reason, they have been employed for studying different aspects of protein misfolding but, overall, they seem to be very promising for the premortem diagnosis of NDs.
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Affiliation(s)
- Federico Angelo Cazzaniga
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5 and Neuropathology, Milan, Italy
| | | | - Edoardo Bistaffa
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5 and Neuropathology, Milan, Italy
| | - Alessandra Consonni
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Neurology IV-Neuroimmunology and Neuromuscular Diseases Unit, Milan, Italy
| | - Giuseppe Legname
- Laboratory of Prion Biology, Department of Neuroscience, Scuola Internazionale Superiore Di Studi Avanzati (SISSA), Trieste, Italy
| | - Giorgio Giaccone
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5 and Neuropathology, Milan, Italy
| | - Fabio Moda
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5 and Neuropathology, Milan, Italy.
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13
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The combined effect of amyloid-β and tau biomarkers on brain atrophy in dementia with Lewy bodies. NEUROIMAGE-CLINICAL 2020; 27:102333. [PMID: 32674011 PMCID: PMC7363702 DOI: 10.1016/j.nicl.2020.102333] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 06/05/2020] [Accepted: 06/26/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Alzheimer's disease (AD)-related pathology is frequently found in patients with dementia with Lewy bodies (DLB). However, it is unknown how amyloid-β and tau-related pathologies influence neurodegeneration in DLB. Understanding the mechanisms underlying brain atrophy in DLB can improve our knowledge about disease progression, differential diagnosis, drug development and testing of anti-amyloid and anti-tau therapies in DLB. OBJECTIVES We aimed at investigating the combined effect of CSF amyloid-β42, phosphorylated tau and total tau on regional brain atrophy in DLB in the European DLB (E-DLB) cohort. METHODS 86 probable DLB patients from the E-DLB cohort with CSF and MRI data were included. Random forest was used to analyze the association of CSF biomarkers (predictors) with visual rating scales for medial temporal lobe atrophy (MTA), posterior atrophy (PA) and global cortical atrophy scale-frontal subscale (GCA-F) (outcomes), including age, sex, education and disease duration as extra predictors. RESULTS DLB patients with abnormal MTA scores had abnormal CSF Aβ42, shorter disease duration and older age. DLB patients with abnormal PA scores had abnormal levels of CSF Aβ42 and p-tau, older age, lower education and shorter disease duration. Abnormal GCA-F scores were associated with lower education, male sex, and older age, but not with any AD-related CSF biomarker. CONCLUSIONS This study shows preliminary data on the potential combined effect of amyloid-β and tau-related pathologies on the integrity of posterior brain cortices in DLB patients, whereas only amyloid-β seems to be related to MTA. Future availability of α-synuclein biomarkers will help us to understand the effect of α-synuclein and AD-related pathologies on brain integrity in DLB.
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Kim D, Hwang HY, Kwon HJ. Targeting Autophagy In Disease: Recent Advances In Drug Discovery. Expert Opin Drug Discov 2020; 15:1045-1064. [DOI: 10.1080/17460441.2020.1773429] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Dasol Kim
- Chemical Genomics Global Research Laboratory, Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, Republic of Korea
| | - Hui-Yun Hwang
- Chemical Genomics Global Research Laboratory, Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, Republic of Korea
| | - Ho Jeong Kwon
- Chemical Genomics Global Research Laboratory, Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, Republic of Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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15
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Ye R, Touroutoglou A, Brickhouse M, Katz S, Growdon JH, Johnson KA, Dickerson BC, Gomperts SN. Topography of cortical thinning in the Lewy body diseases. NEUROIMAGE-CLINICAL 2020; 26:102196. [PMID: 32059167 PMCID: PMC7016450 DOI: 10.1016/j.nicl.2020.102196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 11/15/2022]
Abstract
Objective Regional cortical thinning in dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD) may underlie some aspect of their clinical impairments; cortical atrophy likely reflects extensive Lewy body pathology with alpha-synuclein deposits, as well as associated Alzheimer's disease co-pathologies, when present. Here we investigated the topographic distribution of cortical thinning in these Lewy body diseases compared to cognitively normal PD and healthy non-PD control subjects, explored the association of regional thinning with clinical features and evaluated the impact of amyloid deposition. Methods Twenty-one participants with dementia with Lewy bodies (DLB), 16 with Parkinson disease (PD) - associated cognitive impairment (PD-MCI and PDD), and 24 cognitively normal participants with PD underwent MRI, PiB PET, and clinical evaluation. Cortical thickness across the brain and in regions of interest (ROIs) was compared across diagnostic groups and across subgroups stratified by amyloid status, and was related to clinical and cognitive measures. Results DLB and PD-impaired groups shared a similar distribution of cortical thinning that included regions characteristic of AD, as well as the fusiform, precentral, and paracentral gyri. Elevated PiB retention in DLB and PD-impaired but not in PD-normal participants was associated with more extensive and severe cortical thinning, in an overlapping topography that selectively affected the medial temporal lobe in DLB participants. In DLB, greater thinning in AD signature and fusiform regions was associated with greater cognitive impairment. Conclusions The pattern of cortical thinning is similar in DLB and PD-associated cognitive impairment, overlapping with and extending beyond AD signature regions to involve fusiform, precentral, and paracentral regions. Cortical thinning in AD signature and fusiform regions in these diseases reflects cognitive impairment and is markedly accentuated by amyloid co-pathology. Further work will be required to determine whether the distinct topography of cortical thinning in DLB and PD-associated cognitive impairment might have value as a diagnostic and/ or outcome biomarker in clinical trials.
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Affiliation(s)
- Rong Ye
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Alexandra Touroutoglou
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Michael Brickhouse
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Samantha Katz
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - John H Growdon
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Stephen N Gomperts
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA.
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16
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Inui S, Sakurai K, Hashizume Y. Voxel-Based Morphometry Analysis of Structural MRI for Differentiation Between Dementia with Lewy Bodies and Alzheimer's Disease [Letter]. Neuropsychiatr Dis Treat 2020; 16:179-180. [PMID: 32021210 PMCID: PMC6970627 DOI: 10.2147/ndt.s234350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/11/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Shohei Inui
- Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan.,Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keita Sakurai
- Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan
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Schumacher J, Cromarty R, Gallagher P, Firbank MJ, Thomas AJ, Kaiser M, Blamire AM, O'Brien JT, Peraza LR, Taylor JP. Structural correlates of attention dysfunction in Lewy body dementia and Alzheimer's disease: an ex-Gaussian analysis. J Neurol 2019; 266:1716-1726. [PMID: 31006825 PMCID: PMC6586700 DOI: 10.1007/s00415-019-09323-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 04/09/2019] [Accepted: 04/11/2019] [Indexed: 11/13/2022]
Abstract
BACKGROUND Lewy body dementia (LBD) and Alzheimer's disease (AD) are common forms of degenerative dementia. While they are characterized by different clinical profiles, attentional deficits are a common feature. The objective of this study was to investigate how attentional problems in LBD and AD differentially affect different aspects of reaction time performance and to identify possible structural neural correlates. METHODS We studied reaction time data from an attention task comparing 39 LBD patients, 28 AD patients, and 22 age-matched healthy controls. Data were fitted to an ex-Gaussian model to characterize different facets of the reaction time distribution (mean reaction time, reaction time variability, and the subset of extremely slow responses). Correlations between ex-Gaussian parameters and grey and white matter volume were assessed by voxel-based morphometry. RESULTS Both dementia groups showed an increase in extremely slow responses. While there was no difference between AD and controls with respect to mean reaction time and variability, both were significantly increased in LBD patients compared to controls and AD. There were widespread correlations between mean reaction time and variability and grey matter loss in AD, but not in LBD. CONCLUSIONS This study shows that different aspects of reaction time performance are differentially affected by AD and LBD, with a difference in structural neural correlates underlying the observed behavioural deficits. While impaired attentional performance is linked to brain atrophy in AD, in LBD it might be related to functional or microstructural rather than macrostructural changes.
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Affiliation(s)
- Julia Schumacher
- Institute of Neuroscience, Newcastle University, Biomedical Research Building 3rd Floor, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK.
| | - Ruth Cromarty
- Institute of Neuroscience, Newcastle University, Biomedical Research Building 3rd Floor, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - Peter Gallagher
- Institute of Neuroscience, Newcastle University, The Henry Wellcome Building, Newcastle upon Tyne, NE2 4HH, UK
| | - Michael J Firbank
- Institute of Neuroscience, Newcastle University, Biomedical Research Building 3rd Floor, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - Alan J Thomas
- Institute of Neuroscience, Newcastle University, Biomedical Research Building 3rd Floor, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - Marcus Kaiser
- Institute of Neuroscience, Newcastle University, The Henry Wellcome Building, Newcastle upon Tyne, NE2 4HH, UK
- Interdisciplinary Computing and Complex BioSystems (ICOS) Research Group, School of Computing, Newcastle University, Newcastle upon Tyne, NE4 5TG, UK
| | - Andrew M Blamire
- Institute of Cellular Medicine and Newcastle Magnetic Resonance Centre, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge School of Medicine, Cambridge, CB2 0SP, UK
| | - Luis R Peraza
- Institute of Neuroscience, Newcastle University, Biomedical Research Building 3rd Floor, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
- Institute of Neuroscience, Newcastle University, The Henry Wellcome Building, Newcastle upon Tyne, NE2 4HH, UK
| | - John-Paul Taylor
- Institute of Neuroscience, Newcastle University, Biomedical Research Building 3rd Floor, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
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Wilson H, Pagano G, Politis M. Dementia spectrum disorders: lessons learnt from decades with PET research. J Neural Transm (Vienna) 2019; 126:233-251. [PMID: 30762136 PMCID: PMC6449308 DOI: 10.1007/s00702-019-01975-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 01/21/2019] [Indexed: 02/07/2023]
Abstract
The dementia spectrum encompasses a range of disorders with complex diagnosis, pathophysiology and limited treatment options. Positron emission tomography (PET) imaging provides insights into specific neurodegenerative processes underlying dementia disorders in vivo. Here we focus on some of the most common dementias: Alzheimer's disease, Parkinsonism dementias including Parkinson's disease with dementia, dementia with Lewy bodies, progressive supranuclear palsy and corticobasal syndrome, and frontotemporal lobe degeneration. PET tracers have been developed to target specific proteinopathies (amyloid, tau and α-synuclein), glucose metabolism, cholinergic system and neuroinflammation. Studies have shown distinct imaging abnormalities can be detected early, in some cases prior to symptom onset, allowing disease progression to be monitored and providing the potential to predict symptom onset. Furthermore, advances in PET imaging have identified potential therapeutic targets and novel methods to accurately discriminate between different types of dementias in vivo. There are promising imaging markers with a clinical application on the horizon, however, further studies are required before they can be implantation into clinical practice.
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Affiliation(s)
- Heather Wilson
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | - Gennaro Pagano
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | - Marios Politis
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK.
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Risacher SL, Saykin AJ. Neuroimaging in aging and neurologic diseases. HANDBOOK OF CLINICAL NEUROLOGY 2019; 167:191-227. [PMID: 31753134 DOI: 10.1016/b978-0-12-804766-8.00012-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neuroimaging biomarkers for neurologic diseases are important tools, both for understanding pathology associated with cognitive and clinical symptoms and for differential diagnosis. This chapter explores neuroimaging measures, including structural and functional measures from magnetic resonance imaging (MRI) and molecular measures primarily from positron emission tomography (PET), in healthy aging adults and in a number of neurologic diseases. The spectrum covers neuroimaging measures from normal aging to a variety of dementias: late-onset Alzheimer's disease [AD; including mild cognitive impairment (MCI)], familial and nonfamilial early-onset AD, atypical AD syndromes, posterior cortical atrophy (PCA), logopenic aphasia (lvPPA), cerebral amyloid angiopathy (CAA), vascular dementia (VaD), sporadic and familial behavioral-variant frontotemporal dementia (bvFTD), semantic dementia (SD), progressive nonfluent aphasia (PNFA), frontotemporal dementia with motor neuron disease (FTD-MND), frontotemporal dementia with amyotrophic lateral sclerosis (FTD-ALS), corticobasal degeneration (CBD), progressive supranuclear palsy (PSP), dementia with Lewy bodies (DLB), Parkinson's disease (PD) with and without dementia, and multiple systems atrophy (MSA). We also include a discussion of the appropriate use criteria (AUC) for amyloid imaging and conclude with a discussion of differential diagnosis of neurologic dementia disorders in the context of neuroimaging.
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Affiliation(s)
- Shannon L Risacher
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States.
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Camacho V, Gómez-Grande A, Sopena P, García-Solís D, Gómez Río M, Lorenzo C, Rubí S, Arbizu J. Amyloid PET in neurodegenerative diseases with dementia. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2018.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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van der Zande JJ, Steenwijk MD, ten Kate M, Wattjes MP, Scheltens P, Lemstra AW. Gray matter atrophy in dementia with Lewy bodies with and without concomitant Alzheimer's disease pathology. Neurobiol Aging 2018; 71:171-178. [DOI: 10.1016/j.neurobiolaging.2018.07.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/19/2018] [Accepted: 07/10/2018] [Indexed: 11/29/2022]
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Mak E, Donaghy PC, McKiernan E, Firbank MJ, Lloyd J, Petrides GS, Thomas AJ, O'Brien JT. Beta amyloid deposition maps onto hippocampal and subiculum atrophy in dementia with Lewy bodies. Neurobiol Aging 2018; 73:74-81. [PMID: 30339962 DOI: 10.1016/j.neurobiolaging.2018.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
Abstract
Although dementia with Lewy bodies (DLB) is a synucleinopathy, it is frequently accompanied by beta amyloid (Aβ) accumulation. Elucidating the relationships of Aβ with gray matter atrophy in DLB may yield insights regarding the contributions of comorbid Alzheimer's disease to its disease progression. Twenty healthy controls and 25 DLB subjects underwent clinical assessment, [18F]-Florbetapir, and 3T magnetic resonance imaging. FreeSurfer was used to estimate cortical thickness and subcortical volumes, and PetSurfer was used to quantify [18F]-Florbetapir standardized uptake value ratio. Principal component analysis was used to identify the dominant Aβ component for correlations with regional cortical thickness, hippocampal subfields, and subcortical structures. Relative to healthy controls, the DLB group demonstrated increased Aβ in widespread regions encompassing the frontal and temporoparietal cortices, whereas cortical thinning was restricted to the temporal lobe. Among DLB subjects, the Aβ component was significantly associated with more severe hippocampal and subiculum atrophy. These findings may reflect an early process of superimposed AD-like atrophy in DLB, thereby conferring support for the therapeutic potential of anti-Aβ interventions in people with DLB.
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Affiliation(s)
- Elijah Mak
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Paul C Donaghy
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | | | - Michael J Firbank
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Jim Lloyd
- Nuclear Medicine Department, Newcastle Upon Tyne Hospitals, NHS Foundation Trust, Newcastle upon Tyne, UK
| | - George S Petrides
- Nuclear Medicine Department, Newcastle Upon Tyne Hospitals, NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Alan J Thomas
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
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Lee YG, Jeon S, Yoo HS, Chung SJ, Lee SK, Lee PH, Sohn YH, Yun M, Evans AC, Ye BS. Amyloid-β-related and unrelated cortical thinning in dementia with Lewy bodies. Neurobiol Aging 2018; 72:32-39. [PMID: 30205358 DOI: 10.1016/j.neurobiolaging.2018.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/19/2018] [Accepted: 08/04/2018] [Indexed: 12/11/2022]
Abstract
Coexisting Alzheimer's disease (AD) pathology is common in patients with dementia with Lewy bodies (DLB). To evaluate the cortical thinning in patients with DLB considering the effect of amyloid-β (Aβ), we compared the regional cortical thickness between control subjects and patients with DLB with abnormal dopamine transporter imaging. Seventeen (43.6%) of 39 patients with DLB and no control subjects had significant Aβ deposition on 18F-florbetaben positron emission tomography. Compared to control (n = 15), Aβ-negative DLB group (n = 21) had cortical thinning in the bilateral insula, entorhinal, basal frontal, and occipito-parietal cortices. Compared to Aβ-negative DLB, Aβ-positive DLB group (n = 15) had a lower cortical thickness in the AD-prone brain regions in addition to the bilateral occipital, basal frontal, and somatomotor cortices. After controlling for the amount of Aβ deposition, DLB group had cortical thinning in the same regions affected in the Aβ-negative DLB group. In summary, patients with DLB had an Aβ-independent cortical thinning, while Aβ was associated with additional cortical thinning in the AD-prone brain regions and the aggravation of DLB-specific cortical thinning.
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Affiliation(s)
- Young-Gun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seun Jeon
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Koo Lee
- Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Ho Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Alan C Evans
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
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Camacho V, Gómez-Grande A, Sopena P, García-Solís D, Gómez Río M, Lorenzo C, Rubí S, Arbizu J. Amyloid PET in neurodegenerative diseases with dementia. Rev Esp Med Nucl Imagen Mol 2018; 37:397-406. [PMID: 29776894 DOI: 10.1016/j.remn.2018.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/01/2018] [Accepted: 03/05/2018] [Indexed: 11/16/2022]
Abstract
Alzheimer's disease (AD) is a neurodegenerative condition characterized by progressive cognitive decline and memory loss, and is the most common form of dementia. Amyloid plaques with neurofibrillary tangles are a neuropathological hallmark of AD that produces synaptic dysfunction and culminates later in neuronal loss. Amyloid PET is a useful, available and non-invasive technique that provides in vivo information about the cortical amyloid burden. In the latest revised criteria for the diagnosis of AD biomarkers were defined and integrated: pathological and diagnostic biomarkers (increased retention on fibrillar amyloid PET or decreased Aβ1-42 and increased T-Tau or P-Tau in CSF) and neurodegeneration or topographical biomarkers (temporoparietal hypometabolism on 18F-FDG PET and temporal atrophy on MRI). Recently specific recommendations have been created as a consensus statement on the appropriate use of the imaging biomarkers, including amyloid PET: early-onset cognitive impairment/dementia, atypical forms of AD, mild cognitive impairment with early age of onset, and to differentiate between AD and other neurodegenerative diseases that occur with dementia. Amyloid PET is also contributing to the development of new therapies for AD, as well as in research studies for the study of other neurodegenerative diseases that occur with dementia where the deposition of Aβ amyloid is involved in its pathogenesis. In this paper, we review some general concepts and study the use of amyloid PET in depth and its relationship with neurodegenerative diseases and other diagnostic techniques.
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Affiliation(s)
- V Camacho
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España.
| | - A Gómez-Grande
- Servicio de Medicina Nuclear, Hospital 12 de Octubre, Madrid, España
| | - P Sopena
- Servicio de Medicina Nuclear, Hospital Vithas-Nisa 9 de Octubre, Valencia, España; Servicio de Medicina Nuclear, Hospital Universitario y Politécnico la Fe, Valencia, España
| | - D García-Solís
- Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - M Gómez Río
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria de Granada (IBS), Granada, España
| | - C Lorenzo
- Servicio de Medicina Nuclear, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - S Rubí
- Servicio de Medicina Nuclear, Hospital Universitari Son Espases, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, España
| | - J Arbizu
- Servicio de Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, Navarra, España
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Nagahama Y, Okina T, Suzuki N. Neuropsychological Differences Related to Age in Dementia with Lewy Bodies. Dement Geriatr Cogn Dis Extra 2017; 7:188-194. [PMID: 28690632 PMCID: PMC5498935 DOI: 10.1159/000477296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 04/30/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS To examine the influence of age on neuropsychological performances in dementia with Lewy bodies (DLB) and Alzheimer disease (AD) patients. METHODS We examined memory, executive, and visuo-constructional performances in 202 DLB patients and 236 AD patients. We divided the subjects into three age groups (65-74, 75-84, and 85-95 years old), and evaluated the differences in neuropsychological performances. RESULTS Recent memory in the DLB group was significantly better than that in the age-matched AD group when comparing the age groups 65-74 years and 75-84 years; however, memory impairment in the DLB patients in the age group 85-95 years was comparable with that in the age-matched AD patients. In contrast to recent memory, the other assessed neuropsychological performances, such as visuospatial and executive functions, showed no significant change in differences between the DLB and AD groups with advancing age. CONCLUSION Our study revealed that the nature of memory impairment in DLB patients changes according to age. DLB patients in the young-old and old-old age groups showed significantly better memory performance than the age-matched AD patients, whereas memory performance of the DLB patients in the oldest-old age group was similar to that of the age-matched AD patients. This may be associated with the increased rate of coexisting AD pathology in DLB patients with older age.
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Affiliation(s)
- Yasuhiro Nagahama
- Kawasaki Memorial Hospital, Kawasaki City, Japan.,Department of Geriatric Neurology, Shiga Medical Center, Moriyama City, Japan
| | - Tomoko Okina
- Department of Geriatric Neurology, Shiga Medical Center, Moriyama City, Japan
| | - Norio Suzuki
- Department of Geriatric Neurology, Shiga Medical Center, Moriyama City, Japan
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Xia C, Dickerson BC. Multimodal PET Imaging of Amyloid and Tau Pathology in Alzheimer Disease and Non-Alzheimer Disease Dementias. PET Clin 2017; 12:351-359. [PMID: 28576172 PMCID: PMC5690983 DOI: 10.1016/j.cpet.2017.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Biomarkers of the molecular pathology underpinning dementia syndromes are increasingly recognized as crucial for diagnosis and development of disease-modifying treatments. Amyloid PET imaging is an integral part of the diagnostic assessment of Alzheimer disease. Its use has also deepened understanding of the role of amyloid pathology in Lewy body disorders and aging. Tau PET imaging is an imaging biomarker that will likely play an important role in the diagnosis, monitoring, and treatment in dementias. Using tau PET imaging to examine how tau pathology relates to amyloid and other markers of neurodegeneration will serve to better understand the pathophysiologic cascade that leads to dementia.
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Affiliation(s)
- Chenjie Xia
- Department of Neurology, Jewish General Hospital, McGill University, 3755 Chemin de la Côte-Sainte-Catherine Road, Suite E-005, Montreal, QC H3T 1E2, Canada
| | - Bradford C Dickerson
- Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital, Harvard University, 149 13th Street, Suite 2691, Charlestown, Boston, MA 02129, USA.
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Mashima K, Ito D, Kameyama M, Osada T, Tabuchi H, Nihei Y, Yoshizaki T, Noguchi E, Tanikawa M, Iizuka T, Date Y, Ogata Y, Nakahara T, Iwabuchi Y, Jinzaki M, Murakami K, Suzuki N. Extremely Low Prevalence of Amyloid Positron Emission Tomography Positivity in Parkinson's Disease without Dementia. Eur Neurol 2017; 77:231-237. [PMID: 28285306 DOI: 10.1159/000464322] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/16/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Most cases of dementia with Lewy bodies (DLB) show Alzheimer's disease pathology-like senile plaques and neurofibrillary tangles. Several studies have also revealed a high prevalence of positive amyloid imaging with positron emission tomography (PET) in DLB and moderate prevalence in Parkinson's disease (PD) with dementia. However, it remains unclear in PD without dementia as to when the brain β amyloid (Aβ) burden begins and progresses. Our study aimed to determine the prevalence of Aβ deposition in PD without dementia using amyloid PET. METHODS This was a cross-sectional study on 33 patients with PD without dementia, of whom 21 had normal cognition and 12 met the criteria for PD-mild cognitive impairment. All subjects underwent neuropsychological assessment and [18F] florbetaben (FBB) PET. RESULTS All subjects had Lewy body-related disorders, displaying a significantly reduced myocardial [123I] metaiodobenzylguanidine uptake. The cortical FBB-binding pattern in all subjects, including APOE e4 carriers, suggested negative Aβ deposition. CONCLUSION Patients with PD without dementia exhibit an extremely low prevalence of Aβ positivity compared with those reported in cognitively normal elderly controls. Further longitudinal imaging studies and long-term follow-up are needed; however, our findings provide novel insights for understanding Aβ metabolism in PD.
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Affiliation(s)
- Kyoko Mashima
- Department of Neurology, Keio University School of Medicine, Tokyo, Germany
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Politis M, Pagano G, Niccolini F. Imaging in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 132:233-274. [DOI: 10.1016/bs.irn.2017.02.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Association between Aβ and tau accumulations and their influence on clinical features in aging and Alzheimer's disease spectrum brains: A [ 11C]PBB3-PET study. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2016; 6:11-20. [PMID: 28138509 PMCID: PMC5257028 DOI: 10.1016/j.dadm.2016.12.009] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Introduction Amyloid-β (Aβ) and tau accumulations may occur independently and concurrently as exemplified by primary age-related tauopathy and Alzheimer's disease (AD), respectively. Interactions between Aβ and tau accumulations and their influence on clinical features, however, are still unclear. Methods Associations among clinical symptoms, gray-matter volume, regional tau, and Aβ deposition assessed by positron emission tomography with [11C]pyridinyl-butadienyl-benzothiazole 3 (PBB3) and [11C]Pittsburgh compound-B (PiB), were evaluated in 17 AD, 9 mild cognitive impairment due to AD, and 28 PiB(−)-cognitive healthy controls (HCs). Results High tau burden was associated with aging and low-level education in PiB(−)-HC and AD-spectrum groups, and with high Aβ burden and low-level education in all subjects. It was not Aβ but tau accumulation that showed significant associations with cognitive performance even in PiB(−)-HC. Discussion The present study indicated aging and low-level education after Aβ would be enhancers for tau pathology, associated with neurodegeneration and cognitive impairment in healthy and diseased elderly individuals.
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Sarro L, Senjem ML, Lundt ES, Przybelski SA, Lesnick TG, Graff-Radford J, Boeve BF, Lowe VJ, Ferman TJ, Knopman DS, Comi G, Filippi M, Petersen RC, Jack CR, Kantarci K. Amyloid-β deposition and regional grey matter atrophy rates in dementia with Lewy bodies. Brain 2016; 139:2740-2750. [PMID: 27452602 PMCID: PMC5035818 DOI: 10.1093/brain/aww193] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/15/2016] [Accepted: 06/20/2016] [Indexed: 12/17/2022] Open
Abstract
Alzheimer's disease pathology frequently coexists with Lewy body disease at autopsy in patients with probable dementia with Lewy bodies. More than half of patients with probable dementia with Lewy bodies have high amyloid-β deposition as measured with 11C-Pittsburgh compound B binding on positron emission tomography. Biomarkers of amyloid-β deposition precede neurodegeneration on magnetic resonance imaging during the progression of Alzheimer's disease, but little is known about how amyloid-β deposition relates to longitudinal progression of atrophy in patients with probable dementia with Lewy bodies. We investigated the associations between baseline 11C-Pittsburgh compound B binding on positron emission tomography and the longitudinal rates of grey matter atrophy in a cohort of clinically diagnosed patients with dementia with Lewy bodies (n = 20), who were consecutively recruited to the Mayo Clinic Alzheimer's Disease Research Centre. All patients underwent 11C-Pittsburgh compound B positron emission tomography and magnetic resonance imaging examinations at baseline. Follow-up magnetic resonance imaging was performed after a mean (standard deviation) interval of 2.5 (1.1) years. Regional grey matter loss was determined on three-dimensional T1-weighted magnetic resonance imaging with the tensor-based morphometry-symmetric normalization technique. Linear regression was performed between baseline 11C-Pittsburgh compound B standard unit value ratio and longitudinal change in regional grey matter volumes from an in-house modified atlas. We identified significant associations between greater baseline 11C-Pittsburgh compound B standard unit value ratio and greater grey matter loss over time in the posterior cingulate gyrus, lateral and medial temporal lobe, and occipital lobe as well as caudate and putamen nuclei, after adjusting for age (P < 0.05). Greater baseline 11C-Pittsburgh compound B standard unit value ratio was also associated with greater ventricular expansion rates (P < 0.01) and greater worsening over time in Clinical Dementia Rating Scale, sum of boxes (P = 0.02). In conclusion, in patients with probable dementia with Lewy bodies, higher amyloid-β deposition at baseline is predictive of faster neurodegeneration in the cortex and also in the striatum. This distribution is suggestive of possible interactions among amyloid-β, tau and α-synuclein aggregates, which needs further investigation. Furthermore, higher amyloid-β deposition at baseline predicts a faster clinical decline over time in patients with probable dementia with Lewy bodies.
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Affiliation(s)
- Lidia Sarro
- 1 Department of Radiology, Mayo Clinic, Rochester, MN, USA 2 Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy 3 Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Matthew L Senjem
- 1 Department of Radiology, Mayo Clinic, Rochester, MN, USA 4 Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Emily S Lundt
- 5 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Scott A Przybelski
- 5 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Timothy G Lesnick
- 5 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | | | - Val J Lowe
- 1 Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Tanis J Ferman
- 7 Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Giancarlo Comi
- 3 Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- 2 Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy 3 Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Ronald C Petersen
- 5 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA 6 Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Kejal Kantarci
- 1 Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Delgado-Alvarado M, Gago B, Navalpotro-Gomez I, Jiménez-Urbieta H, Rodriguez-Oroz MC. Biomarkers for dementia and mild cognitive impairment in Parkinson's disease. Mov Disord 2016; 31:861-81. [PMID: 27193487 DOI: 10.1002/mds.26662] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 04/15/2016] [Accepted: 04/18/2016] [Indexed: 12/27/2022] Open
Abstract
Cognitive decline is one of the most frequent and disabling nonmotor features of Parkinson's disease. Around 30% of patients with Parkinson's disease experience mild cognitive impairment, a well-established risk factor for the development of dementia. However, mild cognitive impairment in patients with Parkinson's disease is a heterogeneous entity that involves different types and extents of cognitive deficits. Because it is not currently known which type of mild cognitive impairment confers a higher risk of progression to dementia, it would be useful to define biomarkers that could identify these patients to better study disease progression and possible interventions. In this sense, the identification among patients with Parkinson's disease and mild cognitive impairment of biomarkers associated with dementia would allow the early detection of this process. This review summarizes studies from the past 25 years that have assessed the potential biomarkers of dementia and mild cognitive impairment in Parkinson's disease patients. Despite the potential importance, no biomarker has as yet been validated. However, features such as low levels of epidermal and insulin-like growth factors or uric acid in plasma/serum and of Aß in CSF, reduction of cerebral cholinergic innervation and metabolism measured by PET mainly in posterior areas, and hippocampal atrophy in MRI might be indicative of distinct deficits with a distinct risk of dementia in subgroups of patients. Longitudinal studies combining the existing techniques and new approaches are needed to identify patients at higher risk of dementia. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Manuel Delgado-Alvarado
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Belén Gago
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Irene Navalpotro-Gomez
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Haritz Jiménez-Urbieta
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - María C Rodriguez-Oroz
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Neurology Department, University Hospital Donostia, San Sebastián, Spain.,Ikerbasque (Basque Foundation for Science), Bilbao, Spain.,Basque Center on Cognition, Brain and Language (BCBL), San Sebastián, Spain.,Physiology Department, Medical School University of Navarra, Pamplona, Spain
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Ruffmann C, Calboli FCF, Bravi I, Gveric D, Curry LK, de Smith A, Pavlou S, Buxton JL, Blakemore AIF, Takousis P, Molloy S, Piccini P, Dexter DT, Roncaroli F, Gentleman SM, Middleton LT. Cortical Lewy bodies and Aβ burden are associated with prevalence and timing of dementia in Lewy body diseases. Neuropathol Appl Neurobiol 2015; 42:436-50. [DOI: 10.1111/nan.12294] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/24/2015] [Accepted: 11/03/2015] [Indexed: 01/16/2023]
Affiliation(s)
- C. Ruffmann
- Neuroepidemiology and Ageing Research Unit; School of Public Health; Imperial College; London UK
- Centro Parkinson; Istituti Clinici di Perfezionamento di Milano; Milano Italy
| | - F. C. F. Calboli
- Neuroepidemiology and Ageing Research Unit; School of Public Health; Imperial College; London UK
| | - I. Bravi
- Division of Brain Sciences; Department of Medicine; Imperial College; London UK
| | - D. Gveric
- Division of Brain Sciences; Department of Medicine; Imperial College; London UK
| | - L. K. Curry
- Neuroepidemiology and Ageing Research Unit; School of Public Health; Imperial College; London UK
| | - A. de Smith
- Genomics of Common Disease; School of Public Health; Imperial College; London UK
- Department of Epidemiology and Biostatistics; University of California, San Francisco; San Francisco CA USA
| | - S. Pavlou
- Genomics of Common Disease; School of Public Health; Imperial College; London UK
- Department of Molecular Virology; Cyprus Institute of Neurology and Genetics; Nicosia Cyprus
| | - J. L. Buxton
- Section of Investigative Medicine; Department of Medicine; Imperial College; London UK
| | - A. I. F. Blakemore
- Section of Investigative Medicine; Department of Medicine; Imperial College; London UK
| | - P. Takousis
- Neuroepidemiology and Ageing Research Unit; School of Public Health; Imperial College; London UK
| | - S. Molloy
- Division of Brain Sciences; Department of Medicine; Imperial College; London UK
| | - P. Piccini
- Division of Brain Sciences; Department of Medicine; Imperial College; London UK
| | - D. T. Dexter
- Division of Brain Sciences; Department of Medicine; Imperial College; London UK
| | - F. Roncaroli
- Institute of Brain Behaviour and Mental Health; University of Manchester; Manchester UK
| | - S. M. Gentleman
- Division of Brain Sciences; Department of Medicine; Imperial College; London UK
| | - L. T. Middleton
- Neuroepidemiology and Ageing Research Unit; School of Public Health; Imperial College; London UK
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Omachi Y, Ito K, Arima K, Matsuda H, Nakata Y, Sakata M, Sato N, Nakagome K, Motohashi N. Clinical impact of (11)C-Pittsburgh compound-B positron emission tomography carried out in addition to magnetic resonance imaging and single-photon emission computed tomography on the diagnosis of Alzheimer's disease in patients with dementia and mild cognitive impairment. Psychiatry Clin Neurosci 2015; 69:741-51. [PMID: 26085054 DOI: 10.1111/pcn.12326] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 05/31/2015] [Accepted: 06/16/2015] [Indexed: 12/12/2022]
Abstract
AIMS The purpose of this study was to evaluate the clinical impact of addition of [(11)C]Pittsburgh compound-B positron emission tomography ((11)C-PiB PET) on routine clinical diagnosis of Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI), and to assess diagnostic agreement between clinical criteria and research criteria of the National Institute on Aging-Alzheimer's Association. METHODS The diagnosis in 85 patients was made according to clinical criteria. Imaging examinations, including both magnetic resonance imaging and single-photon emission computed tomography/computed tomography to identify neuronal injury (NI), and (11)C-PiB PET to identify amyloid were performed, and all subjects were re-categorized according to the research criteria. RESULTS Among 40 patients with probable AD dementia (ProAD), 37 were NI-positive, 29 were (11)C-PiB-positive, and 27 who were both NI- and (11C-PiB-positive were categorized as having 'ProAD dementia with a high level of evidence of the AD pathophysiological process'. Among 20 patients with possible AD dementia (PosAD), 17 were NI-positive, and six who were both NI- and (11)C-PiB-positive were categorized as having 'PosAD with evidence of the AD pathophysiological process'. Among 25 patients with MCI, 18 were NI-positive, 13 were (11)C-PiB-positive, and 10 who were both NI- and (11)C-PiB-positive were categorized as having 'MCI due to AD-high likelihood'. CONCLUSIONS Diagnostic concordance between clinical criteria and research criteria may not be high in this study. (11)C-PiB PET may be of value in making the diagnosis of dementia and MCI in cases with high diagnostic uncertainty.
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Affiliation(s)
- Yoshie Omachi
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kimiteru Ito
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kunimasa Arima
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yasuhiro Nakata
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masuhiro Sakata
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Noriko Sato
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kazuyuki Nakagome
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Nobutaka Motohashi
- Department of Neuropsychiatry, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan
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Shimada H, Hirano S, Sinotoh H, Ota T, Tanaka N, Sato K, Yamada M, Fukushi K, Irie T, Zhang MR, Higuchi M, Kuwabara S, Suhara T. Dementia with Lewy bodies can be well-differentiated from Alzheimer's disease by measurement of brain acetylcholinesterase activity-a [11C]MP4A PET study. Int J Geriatr Psychiatry 2015; 30:1105-13. [PMID: 26280153 DOI: 10.1002/gps.4338] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 07/07/2015] [Accepted: 07/08/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the diagnostic performance of brain acetylcholinesterase (AChE) activity measurement using N-[(11) C]-methyl-4-piperidyl acetate (MP4A) and PET in patients with dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). METHODS Participants were 14 DLB patients, 25 AD patients and 18 age-matched healthy controls (HC). All subjects underwent PET scans and MP4A to measure regional brain AChE activity. We performed anatomical standardization of each brain image, and k3 values, an index of AChE activity, in each voxel were estimated by nonlinear least squares analysis. Volumes of interest (VOIs) were identified on parametric k3 images in frontal, temporal, parietal and occipital cortices, and in anterior and posterior cingulate gyri (ACG and PCG). In each VOI, the differential diagnostic performance between AD and DLB of k3 values was assessed by area under the curve (AUC) of the receiver-operating characteristic. Voxel-based statistical analyses were also performed. RESULTS Mean cortical AChE activities in AD patients (-8.2% compared with normal mean) and DLB patients (-27.8%) were lower than HCs (p < 0.05, p < 0.001, respectively). There was a significant difference in mean cortical AChE activities between AD and DLB patients (p < 0.001). All regional brain AChE activities of defined VOIs except ACG were able to well discriminate DLB from AD, and notably performance was the most significant in PCG (AUC = 0.989, 95% CI: 0.965-1.000). CONCLUSIONS Brain cholinergic deficit is consistently prominent in DLB compared with AD. PET measurement of brain AChE activity may be useful for the differential diagnosis between DLB and AD.
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Affiliation(s)
- H Shimada
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
| | - S Hirano
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan.,Department of Neurology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, Japan
| | - H Sinotoh
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan.,Neurology Chiba Clinic, Chiba-shi, Chiba, Japan
| | - T Ota
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan.,Department of Psychiatry, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - N Tanaka
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
| | - K Sato
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan.,Department of Psychiatry, Teikyo University Chiba Medical Center, Ichihara-shi, Chiba, Japan
| | - M Yamada
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan.,Precursory Research for Embryonic Science and Technology, Japan Science and Technology Agency, Chiyoda-ku, Tokyo, Japan
| | - K Fukushi
- Molecular Probe Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
| | - T Irie
- Molecular Probe Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
| | - M R Zhang
- Molecular Probe Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
| | - M Higuchi
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
| | - S Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, Japan
| | - T Suhara
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
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Yoon JH, Kim M, Moon SY, Yong SW, Hong JM. Olfactory function and neuropsychological profile to differentiate dementia with Lewy bodies from Alzheimer's disease in patients with mild cognitive impairment: A 5-year follow-up study. J Neurol Sci 2015; 355:174-9. [PMID: 26076880 DOI: 10.1016/j.jns.2015.06.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 06/05/2015] [Accepted: 06/08/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is a well-known precursor of Alzheimer's disease (AD) but often also precedes dementia with Lewy bodies (DLB). The early differentiation of DLB from AD is important to delay disease progression. Olfactory dysfunction is a well-known early sign of both AD and Lewy body disorders, including Parkinson's disease (PD) and DLB. Thus, the aim of the present study was to determine whether olfactory and neuropsychological tests can aid in the differentiation of DLB from AD at the MCI stage. METHODS The present study included 122 MCI patients who were monitored until they developed dementia or until their condition stabilized; the follow-up period averaged 4.9 years (range: 3.9-6.2 years). Baseline olfactory function as measured with the Cross-Cultural Smell Identification (CCSI) test and neuropsychological data were compared. RESULTS During the follow-up period, 32 subjects developed probable AD (MCI-AD), 18 had probable DLB (MCI-DLB), 45 did not convert to dementia (MCI-stable), and eight developed a non-AD/DLB dementia. The mean CCSI score (95% confidence interval [CI]) in patients with MCI-DLB (4.6; 95% CI: 4.0-5.3) was significantly lower than that of MCI-AD patients (6.4; 95% CI: 6.0-6.7, p<0.001) and MCI-stable patients (7.3; 95% CI: 6.9-7.8, p<0.001). The area under the curve of the receiver operating characteristic to discriminate MCI-DLB from MCI-AD using CCSI scores was (0.84; 95% CI: 0.72-0.97). Frontal-executive function and visuospatial ability was worse in patients with MCI-DLB, while verbal recognition memory impairment was greater in those with MCI-AD. CONCLUSION Olfactory and neuropsychological tests can help predict conversion to DLB or AD in patients with MCI.
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Affiliation(s)
- Jung Han Yoon
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea.
| | - Min Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Seok Woo Yong
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Ji Man Hong
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
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Petrou M, Dwamena BA, Foerster BR, MacEachern MP, Bohnen NI, Müller ML, Albin RL, Frey KA. Amyloid deposition in Parkinson's disease and cognitive impairment: a systematic review. Mov Disord 2015; 30:928-35. [PMID: 25879534 DOI: 10.1002/mds.26191] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 01/22/2015] [Accepted: 01/26/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Varying degrees of cortical amyloid deposition are reported in the setting of Parkinsonism with cognitive impairment. We performed a systematic review to estimate the prevalence of Alzheimer disease (AD) range cortical amyloid deposition among patients with Parkinson's disease with dementia (PDD), Parkinson's disease with mild cognitive impairment (PD-MCI) and dementia with Lewy bodies (DLB). We included amyloid positron emission tomography (PET) imaging studies using Pittsburgh Compound B (PiB). METHODS We searched the databases Ovid MEDLINE, PubMed, Embase, Scopus, and Web of Science for articles pertaining to amyloid imaging in Parkinsonism and impaired cognition. We identified 11 articles using PiB imaging to quantify cortical amyloid. We used the metan module in Stata, version 11.0, to calculate point prevalence estimates of patients with "PiB-positive" studies, that is, patients showing AD range cortical Aβ-amyloid deposition. Heterogeneity was assessed. A scatterplot was used to assess publication bias. RESULTS Overall pooled prevalence of "PiB-positive" studies across all three entities along the spectrum of Parkinson's disease and impaired cognition (specifically PDD, PD-MCI, and DLB) was 0.41 (95% confidence interval [CI], 0.24-0.57). Prevalence of "PiB-positive" studies was 0.68 (95% CI, 0.55-0.82) in the DLB group, 0.34 (95% CI, 0.13-0.56) in the PDD group, and 0.05 (95% CI, -0.07-0.17) in the PD-MCI group. CONCLUSIONS Substantial variability occurs in the prevalence of "PiB-positive" studies in subjects with Parkinsonism and cognitive impairment. Higher prevalence of PiB-positive studies was encountered among subjects with DLB as opposed to subjects with PDD. The PD-MCI subjects showed overall lower prevalence of PiB-positive studies than reported findings in non-PD-related MCI. © 2015 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Myria Petrou
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ben A Dwamena
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Veterans Administration Healthcare System, Ann Arbor, Michigan, USA
| | - Bradley R Foerster
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Veterans Administration Healthcare System, Ann Arbor, Michigan, USA
| | - Mark P MacEachern
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicolaas I Bohnen
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Veterans Administration Healthcare System, Ann Arbor, Michigan, USA.,Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.,Univerity of Michigan Morris K. Udall Center for Excellence in Parkinson's Disease Research, Ann Arbor, Michigan, USA
| | - Martijn Ltm Müller
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Roger L Albin
- Veterans Administration Healthcare System, Ann Arbor, Michigan, USA.,Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.,Univerity of Michigan Morris K. Udall Center for Excellence in Parkinson's Disease Research, Ann Arbor, Michigan, USA
| | - Kirk A Frey
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan, USA
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Frey KA, Petrou M. Imaging Amyloidopathy in Parkinson Disease and Parkinsonian Dementia Syndromes. Clin Transl Imaging 2015; 3:57-64. [PMID: 25745616 DOI: 10.1007/s40336-015-0104-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Dementia arising in patients with Parkinson disease or parkinsonian neurodegeneration comprises a heterogeneous neuropathology. Clinical labeling of patients with both dementia and Parkinson disease is dichotomous, depending on the temporal development of cognitive impairment and motor parkinsonism. Patients with dementia arising first (or within the first year of PD) are classified as dementia with Lewy bodies; patients with PD for more than one year before cognitive decline are classified as Parkinson disease with dementia. Despite this differential clinical classification, autopsy studies demonstrate variable admixtures of cortical synuicleinopathy, Aβ-amyloidopathy and tau neurofibrillary tangle deposition. There are no routine clinical diagnostic measures that accurately distinguish the underlying neuropathologies in individual patients. In the present paper, we review the published literature describing characteristics of fibrillary Aβ-amyloid deposition on the basis of PET radiotracer imaging in patients with Parkinson disease and in parkinsonian dementia syndromes. Although individual reports often include only small-to-modest subject numbers, there is overall suggestion that PD patients have a lower incidence of Aβ-amyloid deposition than seen amongst elderly normal subjects, and that Parkinson disease with dementia patients have a lower incidence of Aβ-amyloid deposition than do patients with dementia with Lewy bodies. These apparent features contrast the findings of Aβ-amyloid-PET imaging in normal aging and the development of Alzheimer disease, where Aβ-amyloid deposition arises asymptomatically and apparently many years before development of signs or symptoms of dementia. It is proposed that focused, prospective studies are needed to further address and understand the complex role(s) of Aβ-amyloid pathology in Parkinson disease, and that this understanding will be critical to the development of targeted disease-modifying therapy for dementia in PD.
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Affiliation(s)
- Kirk A Frey
- Departments of Radiology and Neurology and the Molecular and Behavioral Neuroscience Institute, The University of Michigan, Ann Arbor, MI USA
| | - Myria Petrou
- Departments of Radiology and Neurology and the Molecular and Behavioral Neuroscience Institute, The University of Michigan, Ann Arbor, MI USA
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Amyloid PET imaging: applications beyond Alzheimer's disease. Clin Transl Imaging 2015; 3:39-55. [PMID: 25741489 PMCID: PMC4339781 DOI: 10.1007/s40336-014-0098-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 12/22/2014] [Indexed: 12/14/2022]
Abstract
As a biomarker of beta-amyloid, positron emission tomography (PET) amyloid imaging offers a unique opportunity to detect the presence of this protein in the human body during life. Besides Alzheimer's disease (AD), deposits of beta-amyloid in the brain are also present in other neurodegenerative diseases associated to dementia, such as Parkinson's disease and dementia with Lewy bodies, as well as in other processes affecting brain function, such as cerebral amyloid angiopathy, brain trauma, Down's syndrome and meningiomas, as shown by post-mortem pathology studies. Furthermore, in systemic amyloidosis other organs besides the brain are affected, and amyloid PET imaging may be suitable for the identification of these extra-cerebral amyloid depositions. Finally, the potential use of amyloid PET tracer accumulation in cerebral white matter (WM) as a marker of myelin is being investigated, leading to some promising results in patients with WM lesions and multiple sclerosis. In this article, a review of the ongoing research pointing to a broader application of amyloid PET imaging in clinical practice beyond AD is provided.
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Donaghy P, Thomas AJ, O'Brien JT. Amyloid PET Imaging in Lewy body disorders. Am J Geriatr Psychiatry 2015; 23:23-37. [PMID: 23831180 DOI: 10.1016/j.jagp.2013.03.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 02/19/2013] [Accepted: 03/01/2013] [Indexed: 11/25/2022]
Abstract
Lewy body (LB) disorders, including Parkinson disease (PD), Parkinson disease dementia (PDD), and dementia with Lewy bodies (DLB), are the second most common type of neurodegenerative dementia. Although the pathological hallmarks of LB disorders are Lewy bodies and Lewy neurites, cortical amyloid-beta (Aβ) deposition is also often seen. The relationship between Aβ pathology and dementia in LB disorders is unclear. Recently, positron emission tomography Aβ ligands have been developed that enable in vivo imaging of Aβ. In this paper we review amyloid imaging studies in LB disorders. LB disorders are associated with lower mean cortical Aβ ligand binding compared with Alzheimer disease. In DLB and PDD many subjects have normal levels of cortical Aβ, though a subset show increased Aβ ligand binding. Those with DLB show greater ligand binding than PDD; binding does not appear to be increased in PD without dementia. Cortical Aβ deposition may be a factor in the development of cognitive impairment in some cases of dementia in LB disorders. Amyloid imaging is of limited use in the diagnosis of LB disorders but Aβ deposition may predict the future development of dementia in PD. Reports of correlation between Aβ deposition and symptom profile, severity, and progression have been inconsistent. Some results suggest a synergistic interaction between Aβ and α-synuclein. Interpretation of the current evidence is hampered by differing methodologies across studies and small sample sizes. Large, prospective longitudinal studies are needed to clarify the association of Aβ with symptom development, progression, severity, and treatment response in LB disorders.
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Affiliation(s)
- Paul Donaghy
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom.
| | - Alan J Thomas
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
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Ishii K, Hosokawa C, Hyodo T, Sakaguchi K, Usami K, Shimamoto K, Hosono M, Yamazoe Y, Murakami T. Regional glucose metabolic reduction in dementia with Lewy bodies is independent of amyloid deposition. Ann Nucl Med 2014; 29:78-83. [PMID: 25270712 PMCID: PMC4835511 DOI: 10.1007/s12149-014-0911-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 09/21/2014] [Indexed: 11/29/2022]
Abstract
Purpose There is evidence that some cases of patients with dementia with Lewy bodies (DLB) can demonstrate Alzheimer disease (AD) like reduced glucose metabolism without amyloid deposition. The aim of this study was to clarify whether regional hypometabolism is related to amyloid deposits in the DLB brain and measure the degree of regional hypometabolism. Methods Ten consecutive subjects with DLB and 10 AD patients who underwent both Pittsburgh compound B (PiB)-PET and 18F-fluoro-2-deoxyglucose (FDG)-PET were included in this study. Regional standardized uptake value ratio (SUVR)s normalised to cerebellar cortices were calculated in the FDG- and PiB-PET images. Results All AD patients and five DLB patients showed amyloid deposits (PiB positive). In the DLB group the parietotemporal and occipital metabolism were significantly lower than those in the AD group but there was no difference between the posterior cingulate hypometabolism between DLB and AD groups. There were no differences in regional glucose metabolism between PiB positive and negative DLB patients. Conclusions In the DLB brain, it is suggested that decreased regional glucose metabolism is unrelated to amyloid deposits, although the hypometabolic area overlaps with the AD hypometabolic area and the degree of parietotemporal and occipital hypometabolism in DLB brain is much larger than that in AD brain.
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Affiliation(s)
- Kazunari Ishii
- Neurocognitive Disorders Center, Kinki University Hospital, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan,
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Zhang S, Smailagic N, Hyde C, Noel‐Storr AH, Takwoingi Y, McShane R, Feng J. (11)C-PIB-PET for the early diagnosis of Alzheimer's disease dementia and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev 2014; 2014:CD010386. [PMID: 25052054 PMCID: PMC6464750 DOI: 10.1002/14651858.cd010386.pub2] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND According to the latest revised National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (now known as the Alzheimer's Association) (NINCDS-ADRDA) diagnostic criteria for Alzheimer's disease dementia, the confidence in diagnosing mild cognitive impairment (MCI) due to Alzheimer's disease dementia is raised with the application of imaging biomarkers. These tests, added to core clinical criteria, might increase the sensitivity or specificity of a testing strategy. However, the accuracy of biomarkers in the diagnosis of Alzheimer's disease dementia and other dementias has not yet been systematically evaluated. A formal systematic evaluation of the sensitivity, specificity, and other properties of positron emission tomography (PET) imaging with the (11)C-labelled Pittsburgh Compound-B ((11)C-PIB) ligand was performed. OBJECTIVES To determine the diagnostic accuracy of the (11)C- PIB-PET scan for detecting participants with MCI at baseline who will clinically convert to Alzheimer's disease dementia or other forms of dementia over a period of time. SEARCH METHODS The most recent search for this review was performed on 12 January 2013. We searched MEDLINE (OvidSP), EMBASE (OvidSP), BIOSIS Previews (ISI Web of Knowledge), Web of Science and Conference Proceedings (ISI Web of Knowledge), PsycINFO (OvidSP), and LILACS (BIREME). We also requested a search of the Cochrane Register of Diagnostic Test Accuracy Studies (managed by the Cochrane Renal Group).No language or date restrictions were applied to the electronic searches and methodological filters were not used so as to maximise sensitivity. SELECTION CRITERIA We selected studies that had prospectively defined cohorts with any accepted definition of MCI with baseline (11)C-PIB-PET scan. In addition, we only selected studies that applied a reference standard for Alzheimer's dementia diagnosis for example NINCDS-ADRDA or Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. DATA COLLECTION AND ANALYSIS We screened all titles generated by electronic database searches. Two review authors independently assessed the abstracts of all potentially relevant studies. The identified full papers were assessed for eligibility and data were extracted to create two by two tables. Two independent assessors performed quality assessment using the QUADAS 2 tool. We used the hierarchical summary receiver operating characteristic (ROC) model to produce a summary ROC curve. MAIN RESULTS Conversion from MCI to Alzheimer's disease dementia was evaluated in nine studies. The quality of the evidence was limited. Of the 274 participants included in the meta-analysis, 112 developed Alzheimer's dementia. Based on the nine included studies, the median proportion converting was 34%. The studies varied markedly in how the PIB scans were done and interpreted.The sensitivities were between 83% and 100% while the specificities were between 46% and 88%. Because of the variation in thresholds and measures of (11)C-PIB amyloid retention, we did not calculate summary sensitivity and specificity. Although subject to considerable uncertainty, to illustrate the potential strengths and weaknesses of (11)C-PIB-PET scans we estimated from the fitted summary ROC curve that the sensitivity was 96% (95% confidence interval (CI) 87 to 99) at the included study median specificity of 58%. This equated to a positive likelihood ratio of 2.3 and a negative likelihood ratio of 0.07. Assuming a typical conversion rate of MCI to Alzheimer's dementia of 34%, for every 100 PIB scans one person with a negative scan would progress and 28 with a positive scan would not actually progress to Alzheimer's dementia.There were limited data for formal investigation of heterogeneity. We performed two sensitivity analyses to assess the influence of type of reference standard and the use of a pre-specified threshold. There was no effect on our findings. AUTHORS' CONCLUSIONS Although the good sensitivity achieved in some included studies is promising for the value of (11)C-PIB-PET, given the heterogeneity in the conduct and interpretation of the test and the lack of defined thresholds for determination of test positivity, we cannot recommend its routine use in clinical practice.(11)C-PIB-PET biomarker is a high cost investigation, therefore it is important to clearly demonstrate its accuracy and standardise the process of the (11)C-PIB diagnostic modality prior to it being widely used.
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Affiliation(s)
- Shuo Zhang
- China Medical UniversityDepartment of Neurology, Shengjing Hospital36 Shanhao StreetShenyangLiaoningChina110004
| | - Nadja Smailagic
- University of CambridgeInstitute of Public HealthForvie SiteRobinson WayCambridgeUKCB2 0SR
| | - Chris Hyde
- University of Exeter Medical School, University of ExeterInstitute of Health ResearchVeysey BuildingSalmon Pool LaneExeterUKEX2 4SG
| | - Anna H Noel‐Storr
- University of OxfordRadcliffe Department of MedicineRoom 4401c (4th Floor)John Radcliffe Hospital, HeadingtonOxfordUKOX3 9DU
| | - Yemisi Takwoingi
- University of BirminghamPublic Health, Epidemiology and BiostatisticsEdgbastonBirminghamUKB15 2TT
| | - Rupert McShane
- University of OxfordRadcliffe Department of MedicineRoom 4401c (4th Floor)John Radcliffe Hospital, HeadingtonOxfordUKOX3 9DU
| | - Juan Feng
- Shengjing Hospital, China Medical UniversityDepartment of Neurology36 Shanhao StreetShenyangChina110004
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Gomperts SN. Imaging the Role of Amyloid in PD Dementia and Dementia with Lewy Bodies. Curr Neurol Neurosci Rep 2014; 14:472. [DOI: 10.1007/s11910-014-0472-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Le Heron CJ, Wright SL, Melzer TR, Myall DJ, MacAskill MR, Livingston L, Keenan RJ, Watts R, Dalrymple-Alford JC, Anderson TJ. Comparing cerebral perfusion in Alzheimer's disease and Parkinson's disease dementia: an ASL-MRI study. J Cereb Blood Flow Metab 2014; 34:964-70. [PMID: 24619276 PMCID: PMC4050238 DOI: 10.1038/jcbfm.2014.40] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 02/05/2014] [Accepted: 02/08/2014] [Indexed: 11/08/2022]
Abstract
Emerging evidence suggests that Alzheimer's disease (AD) and Parkinson's disease dementia (PDD) share neurodegenerative mechanisms. We sought to directly compare cerebral perfusion in these two conditions using arterial spin labeling magnetic resonance imaging (ASL-MRI). In total, 17 AD, 20 PDD, and 37 matched healthy controls completed ASL and structural MRI, and comprehensive neuropsychological testing. Alzheimer's disease and PDD perfusion was analyzed by whole-brain voxel-based analysis (to assess absolute blood flow), a priori specified region of interest analysis, and principal component analysis (to generate a network differentiating the two groups). Corrections were made for cerebral atrophy, age, sex, education, and MRI scanner software version. Analysis of absolute blood flow showed no significant differences between AD and PDD. Comparing each group with controls revealed an overlapping, posterior pattern of hypoperfusion, including posterior cingulate gyrus, precuneus, and occipital regions. The perfusion network that differentiated AD and PDD groups identified relative differences in medial temporal lobes (AD
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Affiliation(s)
| | - Sarah L Wright
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Tracy R Melzer
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Daniel J Myall
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Michael R MacAskill
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Leslie Livingston
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Ross J Keenan
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Christchurch Radiology Group, Christchurch, New Zealand
| | - Richard Watts
- College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - John C Dalrymple-Alford
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Tim J Anderson
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
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Compta Y, Parkkinen L, Kempster P, Selikhova M, Lashley T, Holton JL, Lees AJ, Revesz T. The significance of α-synuclein, amyloid-β and tau pathologies in Parkinson's disease progression and related dementia. NEURODEGENER DIS 2013; 13:154-6. [PMID: 24028925 PMCID: PMC4194631 DOI: 10.1159/000354670] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 07/24/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Dementia is one of the milestones of advanced Parkinson's disease (PD), with its neuropathological substrate still being a matter of debate, particularly regarding its potential mechanistic implications. OBJECTIVE The aim of this study was to review the relative importance of Lewy-related α-synuclein and Alzheimer's tau and amyloid-β (Aβ) pathologies in disease progression and dementia in PD. METHODS We reviewed studies conducted at the Queen Square Brain Bank, Institute of Neurology, University College London, using large PD cohorts. RESULTS Cortical Lewy- and Alzheimer-type pathologies are associated with milestones of poorer prognosis and with non-tremor predominance, which have been, in turn, linked to dementia. The combination of these pathologies is the most robust neuropathological substrate of PD-related dementia, with cortical Aβ burden determining a faster progression to dementia. CONCLUSION The shared relevance of these pathologies in PD progression and dementia is in line with experimental data suggesting synergism between α-synuclein, tau and Aβ and with studies testing these proteins as disease biomarkers, hence favouring the eventual testing of therapeutic strategies targeting these proteins in PD.
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Affiliation(s)
- Yaroslau Compta
- Parkinson Disease and Movement Disorders Unit, Neurology Service, IDIBAPS, CIBERNED, Hospital Clínic, Barcelona, Spain
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Abstract
Neurodegenerative disorders leading to dementia are common diseases that affect many older and some young adults. Neuroimaging methods are important tools for assessing and monitoring pathological brain changes associated with progressive neurodegenerative conditions. In this review, the authors describe key findings from neuroimaging studies (magnetic resonance imaging and radionucleotide imaging) in neurodegenerative disorders, including Alzheimer's disease (AD) and prodromal stages, familial and atypical AD syndromes, frontotemporal dementia, amyotrophic lateral sclerosis with and without dementia, Parkinson's disease with and without dementia, dementia with Lewy bodies, Huntington's disease, multiple sclerosis, HIV-associated neurocognitive disorder, and prion protein associated diseases (i.e., Creutzfeldt-Jakob disease). The authors focus on neuroimaging findings of in vivo pathology in these disorders, as well as the potential for neuroimaging to provide useful information for differential diagnosis of neurodegenerative disorders.
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Affiliation(s)
- Shannon L. Risacher
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, and Indiana Alzheimer Disease Center Indiana University School of Medicine, Indianapolis, Indiana
| | - Andrew J. Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, and Indiana Alzheimer Disease Center Indiana University School of Medicine, Indianapolis, Indiana
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Abstract
There is increasing use of neuroimaging modalities, including PET, for diagnosing dementia. For example, FDG-PET demonstrates hypometabolic regions in the posterior cingulate gyri, precuneus, and parietotemporal association cortices, while amyloid PET indicates amyloid deposition in Alzheimer disease and mild cognitive impairment due to Alzheimer disease. Furthermore, the use of combination PET with structural MR imaging can improve the diagnostic accuracy of dementia. In other neurodegenerative dementias, each disease exhibits a specific metabolic reduction pattern. In dementia with Lewy bodies, occipital glucose metabolism is decreased, while in frontotemporal dementia, frontal and anterior temporal metabolism is predominantly decreased. These FDG-PET findings and positive or negative amyloid deposits are important biomarkers for various neurodegenerative dementias.
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Affiliation(s)
- K Ishii
- From the Neurocognitive Disorders Center, Kinki University Hospital, Osaka, Japan.
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