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Wang X, Chen H, Wen R, Ou P, Huang Y, Deng L, Shi L, Chen W, Chen H, Wang J, He C, Liu C. Exploring functional and structural connectivity disruptions in spinocerebellar ataxia type 3: Insights from gradient analysis. CNS Neurosci Ther 2024; 30:e14842. [PMID: 39014518 PMCID: PMC11251871 DOI: 10.1111/cns.14842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/30/2024] [Accepted: 06/23/2024] [Indexed: 07/18/2024] Open
Abstract
AIMS Spinocerebellar Ataxia Type 3 (SCA3) is a rare genetic ataxia that impacts the entire brain and is characterized as a neurodegenerative disorder affecting the neural network. This study explores how alterations in the functional hierarchy, connectivity, and structural changes within specific brain regions significantly contribute to the heterogeneity of symptom manifestations in patients with SCA3. METHODS We prospectively recruited 51 patients with SCA3 and 59 age-and sex-matched healthy controls. All participants underwent comprehensive multimodal neuroimaging and clinical assessments. In SCA3 patients, an innovative approach utilizing gradients in resting-state functional connectivity (FC) was employed to examine atypical patterns of hierarchical processing topology from sensorimotor to supramodal regions in the cerebellum and cerebrum. Coupling analyses of abnormal FC and structural connectivity among regions of interest (ROIs) in the brain were also performed to characterize connectivity alterations. Additionally, relationships between quantitative ROI values and clinical variables were explored. RESULTS Patients with SCA3 exhibited either compression or expansion within the primary sensorimotor-to-supramodal gradient through four distinct calculation methods, along with disruptions in FC and structural connectivity coupling. A comprehensive correlation was identified between the altered gradients and the clinical manifestations observed in patients. Notably, altered fractional anisotropy values were not significantly correlated with clinical variables. CONCLUSION Abnormal gradients and connectivity in the cerebellar and cerebral cortices in SCA3 patients may contribute to disrupted motor-to-supramodal functions. Moreover, these findings support the potential utility of FCG analysis as a biomarker for diagnosing SCA3 and assessing treatment efficacy.
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Affiliation(s)
- Xingang Wang
- Department of Radiology, 7T Magnetic Resonance Translational Medicine Research Center, Southwest HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Hui Chen
- Department of Radiology, 7T Magnetic Resonance Translational Medicine Research Center, Southwest HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Ru Wen
- Department of Radiology, 7T Magnetic Resonance Translational Medicine Research Center, Southwest HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Peiling Ou
- Department of Radiology, 7T Magnetic Resonance Translational Medicine Research Center, Southwest HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Yonghua Huang
- Department of Radiology, 7T Magnetic Resonance Translational Medicine Research Center, Southwest HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Lihua Deng
- Department of Radiology, 7T Magnetic Resonance Translational Medicine Research Center, Southwest HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Linfeng Shi
- Department of Radiology, 7T Magnetic Resonance Translational Medicine Research Center, Southwest HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Wei Chen
- MR Research Collaboration TeamSiemens Healthineers Ltd.WuhanChina
| | - Huafu Chen
- Department of Radiology, 7T Magnetic Resonance Translational Medicine Research Center, Southwest HospitalArmy Medical University (Third Military Medical University)ChongqingChina
- Biomedical EngineeringUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Jian Wang
- Department of Radiology, 7T Magnetic Resonance Translational Medicine Research Center, Southwest HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Changchun He
- College of Blockchain IndustryChengdu University of Information TechnologyChengduChina
| | - Chen Liu
- Department of Radiology, 7T Magnetic Resonance Translational Medicine Research Center, Southwest HospitalArmy Medical University (Third Military Medical University)ChongqingChina
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Rodríguez-Labrada R, Canales-Ochoa N, Galicia-Polo MDL, Cruz-Rivas E, Romanzetti S, Peña-Acosta A, Estupiñán-Rodríguez A, Vázquez-Mojena Y, Dogan I, Auburger G, Reetz K, Velázquez-Pérez L. Structural Brain Correlates of Sleep Microstructure in Spinocerebellar Ataxia Type 2 and its Role on Clinical Phenotype. CEREBELLUM (LONDON, ENGLAND) 2024:10.1007/s12311-024-01674-1. [PMID: 38438827 DOI: 10.1007/s12311-024-01674-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/06/2024]
Abstract
The influence of brain atrophy on sleep microstructure in Spinocerebellar Ataxias (SCAs) has not been extensively explored limiting the use of these sleep traits as surrogate biomarkers of neurodegeneration and clinical phenotype. The objective of the study is to explore the relationship between sleep microstructure and brain atrophy in SCA2 and its role in the clinical phenotype. Fourteen SCA2 mutation carriers (7 pre-manifest and 7 manifest subjects) underwent polysomnographic, structural MRI, and clinical assessments. Particularly, markers of REM and non-REM sleep microstructure, measures of cerebellar and brainstem atrophy, and clinical scores were analyzed through correlation and mediation analyses. The sleep spindle activity exhibited a negative correlation with the number of trials required to complete the verbal memory test (VMT), and a positive correlation with the cerebellar volume, but the significance of the latter correlation did not survive multiple testing corrections. However, the causal mediation analyses unveiled that sleep spindle activity significantly mediates the association between cerebellar atrophy and VMT performance. Regarding REM sleep, both phasic EMG activity and REM sleep without atonia exhibited significant associations with pontine atrophy and disease severity measures. However, they did not demonstrate a causal mediation effect between the atrophy measures and disease severity. Our study provides evidence about the association of the pontocerebellar atrophy with sleep microstructure in SCA2 offering insights into the cerebellar involvement in cognition via the control of the sleep spindle activity. Therefore, our findings may help to understand the disease pathogenesis and to better characterize sleep microstructure parameters as disease biomarkers.Clinical trial registration number (TRN): No applicable.
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Affiliation(s)
- Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad St 16 between 12 St & 16 St. 80100, Holguin, Cuba.
- Cuban Centre for Neurosciences, 190 St, between 25 St & 27 St, 11300, Playa, Havana, Cuba.
| | - Nalia Canales-Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad St 16 between 12 St & 16 St. 80100, Holguin, Cuba
| | | | | | - Sandro Romanzetti
- Department of Neurology, RWTH Aachen University, Pauwelsstr. 3052074, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH, RWTH Aachen University, 52074, Aachen, Germany
| | - Arnoy Peña-Acosta
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad St 16 between 12 St & 16 St. 80100, Holguin, Cuba
| | - Annelié Estupiñán-Rodríguez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad St 16 between 12 St & 16 St. 80100, Holguin, Cuba
| | - Yaimeé Vázquez-Mojena
- Cuban Centre for Neurosciences, 190 St, between 25 St & 27 St, 11300, Playa, Havana, Cuba
| | - Imis Dogan
- Department of Neurology, RWTH Aachen University, Pauwelsstr. 3052074, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH, RWTH Aachen University, 52074, Aachen, Germany
| | - Georg Auburger
- Clinic of Neurology, Experimental Neurology, Goethe University Frankfurt, University Hospital, 60590, Frankfurt, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Pauwelsstr. 3052074, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH, RWTH Aachen University, 52074, Aachen, Germany
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad St 16 between 12 St & 16 St. 80100, Holguin, Cuba.
- Cuban Academy of Sciences, Cuba St 460, Between Teniente Rey & Amargura , 10100, Habana Vieja, Havana, Cuba.
- Department of Human Physiology, Medical University of Havana, 146 St, 3102, 11300, Playa, Havana, Cuba.
- Faculty of Chemistry, University of Havana, Zapata St Between G St & Carlitos Aguirre St., 10400, Plaza de La Revolución, Havana, Cuba.
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3
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Al-Arab N, Hannoun S. White matter integrity assessment in spinocerebellar ataxia type 2 (SCA2) patients. Clin Radiol 2024; 79:67-72. [PMID: 37953094 DOI: 10.1016/j.crad.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 10/10/2023] [Accepted: 10/15/2023] [Indexed: 11/14/2023]
Abstract
AIM To assess the burden of white matter (WM) damage in the cerebrum and cerebellum of spinocerebellar ataxia type 2 (SCA2) patients in an attempt to identify key regions affected by the neurodegenerative processes using diffusion tensor imaging (DTI). MATERIALS AND METHODS Nine SCA2 patients and 16 age-matched healthy controls were examined twice (SCA2 patients 3.6 ± 0.7 years and controls 3.3 ± 1.0 years apart) on the same 1.5 T scanner by acquiring T1-weighted and diffusion-weighted (b-value = 1,000 s/mm2) images. Using tract-based spatial statistics, DTI analysis on fractional anisotropy (FA), mean diffusivity (MD), axial (AD)/radial (RD) diffusivity was performed. RESULTS At baseline magnetic resonance imaging (MRI), FA was significantly decreased in SCA2 patients in the corticospinal tracts, inferior and superior cerebellar peduncles, middle cerebellar peduncles, cerebral peduncles, right superior and posterior corona radiata. RD was only significantly increased in SCA2 patients in the middle cerebellar peduncles. No significant AD and MD changes were observed. Tract-based spatial statistics (TBSS) analysis between SCA2 patients at baseline and at follow-up showed no significant changes in any of the DTI metrics. CONCLUSIONS DTI is a sensitive tool for following the progression of WM neurodegeneration and severity assessment in patients with SCA2. These findings add to a better understanding of the neurological underpinnings of the symptoms experienced by SCA2 patients.
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Affiliation(s)
- N Al-Arab
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - S Hannoun
- Medical Imaging Sciences Program, Division of Health Professions, Faculty of Public Health, American University of Beirut, Beirut, Lebanon; Abu-Haidar Neuroscience Institute, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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4
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Siciliano L, Olivito G, Urbini N, Silveri MC, Leggio M. The rising role of cognitive reserve and associated compensatory brain networks in spinocerebellar ataxia type 2. J Neurol 2023; 270:5071-5084. [PMID: 37421466 PMCID: PMC10511586 DOI: 10.1007/s00415-023-11855-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/10/2023]
Abstract
Pre-existing or enhanced cognitive abilities influence symptom onset and severity in neurodegenerative diseases, which improve an individual's ability to deal with neurodegeneration. This process is named cognitive reserve (CR), and it has acquired high visibility in the field of neurodegeneration. However, the investigation of CR has been neglected in the context of cerebellar neurodegenerative disorders. The present study assessed CR and its impact on cognitive abilities in spinocerebellar ataxia type 2 (SCA2), which is a rare cerebellar neurodegenerative disease. We investigated the existence of CR networks in terms of compensatory mechanisms and neural reserve driven by increased cerebello-cerebral functional connectivity. The CR of 12 SCA2 patients was assessed using the Cognitive Reserve Index Questionnaire (CRIq), which was developed for appraising life-span CR. Patients underwent several neuropsychological tests to evaluate cognitive functioning and a functional MRI examination. Network based statistics analysis was used to assess functional brain networks. The results revealed significant correlations of CRIq measures with cognitive domains and patterns of increased connectivity in specific cerebellar and cerebral regions, which likely indicated CR networks. This study showed that CR may influence disease-related cognitive deficits, and it was related to the effective use of specific cerebello-cerebral networks that reflect a CR biomarker.
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Affiliation(s)
- Libera Siciliano
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Giusy Olivito
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Nicole Urbini
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | | | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
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5
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The Perturbational Map of Low Frequency Repetitive Transcranial Magnetic Stimulation of Primary Motor Cortex in Movement Disorders. BRAIN DISORDERS 2023. [DOI: 10.1016/j.dscb.2023.100071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
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6
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Lopes da Cunha P, Fittipaldi S, González Campo C, Kauffman M, Rodríguez-Quiroga S, Yacovino DA, Ibáñez A, Birba A, García AM. Social concepts and the cerebellum: behavioural and functional connectivity signatures in cerebellar ataxic patients. Philos Trans R Soc Lond B Biol Sci 2023; 378:20210364. [PMID: 36571119 PMCID: PMC9791482 DOI: 10.1098/rstb.2021.0364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 09/26/2022] [Indexed: 12/27/2022] Open
Abstract
Neurocognitive research on social concepts underscores their reliance on fronto-temporo-limbic regions mediating broad socio-cognitive skills. Yet, the field has neglected another structure increasingly implicated in social cognition: the cerebellum. The present exploratory study examines this link combining a novel naturalistic text paradigm, a relevant atrophy model and functional magnetic resonance imaging. Fifteen cerebellar ataxia (CA) patients with focal cerebellar atrophy and 29 matched controls listened to a social text (highlighting interpersonal events) as well as a non-social text (focused on a single person's actions), and answered comprehension questionnaires. We compared behavioural outcomes between groups and examined their association with cerebellar connectivity. CA patients showed deficits in social text comprehension and normal scores in the non-social text. Also, social text outcomes in controls selectively correlated with connectivity between the cerebellum and key regions subserving multi-modal semantics and social cognition, including the superior and medial temporal gyri, the temporal pole and the insula. Conversely, brain-behaviour associations involving the cerebellum were abolished in the patients. Thus, cerebellar structures and connections seem involved in processing social concepts evoked by naturalistic discourse. Such findings invite new theoretical and translational developments integrating social neuroscience with embodied semantics. This article is part of the theme issue 'Concepts in interaction: social engagement and inner experiences'.
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Affiliation(s)
- Pamela Lopes da Cunha
- Cognitive Neuroscience Center, University of San Andrés, Buenos Aires B1644BID, Argentina
- National Agency for Scientific Promotion and Technology (ANPCyT), Buenos Aires, C1425FQD, Argentina
| | - Sol Fittipaldi
- Cognitive Neuroscience Center, University of San Andrés, Buenos Aires B1644BID, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
- Global Brain Health Institute, University of California San Francisco, 94158-2324, US and Trinity College Dublin, D02 PN40, Ireland
- Latin American Brain Health Institute (BrainLat), Adolfo Ibáñez University, Santiago, 7550344, Chile
| | - Cecilia González Campo
- Cognitive Neuroscience Center, University of San Andrés, Buenos Aires B1644BID, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
| | - Marcelo Kauffman
- Consultorio y Laboratorio de Neurogenética, Centro Universitario de Neurología “José María Ramos Mejía” y División Neurología, Hospital JM Ramos Mejía, Facultad de Medicina, UBA, Buenos Aires, C1221ADC, Argentina
- School of Medicine, UBA, CONICET, Buenos Aires, C1121ABG, Argentina
| | - Sergio Rodríguez-Quiroga
- Consultorio y Laboratorio de Neurogenética, Centro Universitario de Neurología “José María Ramos Mejía” y División Neurología, Hospital JM Ramos Mejía, Facultad de Medicina, UBA, Buenos Aires, C1221ADC, Argentina
| | - Darío Andrés Yacovino
- Department of Neurology, Dr. Cesar Milstein Hospital, Buenos Aires, C1221ACI, Argentina
- Memory and Balance Clinic, Buenos Aires, C1425BPC, Argentina
| | - Agustín Ibáñez
- Cognitive Neuroscience Center, University of San Andrés, Buenos Aires B1644BID, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
- Global Brain Health Institute, University of California San Francisco, 94158-2324, US and Trinity College Dublin, D02 PN40, Ireland
- Latin American Brain Health Institute (BrainLat), Adolfo Ibáñez University, Santiago, 7550344, Chile
| | - Agustina Birba
- Cognitive Neuroscience Center, University of San Andrés, Buenos Aires B1644BID, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
| | - Adolfo M. García
- Cognitive Neuroscience Center, University of San Andrés, Buenos Aires B1644BID, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
- Global Brain Health Institute, University of California San Francisco, 94158-2324, US and Trinity College Dublin, D02 PN40, Ireland
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, 9170022, Chile
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Marapin RS, van der Horn HJ, van der Stouwe AMM, Dalenberg JR, de Jong BM, Tijssen MAJ. Altered brain connectivity in hyperkinetic movement disorders: A review of resting-state fMRI. Neuroimage Clin 2022; 37:103302. [PMID: 36669351 PMCID: PMC9868884 DOI: 10.1016/j.nicl.2022.103302] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Hyperkinetic movement disorders (HMD) manifest as abnormal and uncontrollable movements. Despite reported involvement of several neural circuits, exact connectivity profiles remain elusive. OBJECTIVES Providing a comprehensive literature review of resting-state brain connectivity alterations using resting-state fMRI (rs-fMRI). We additionally discuss alterations from the perspective of brain networks, as well as correlations between connectivity and clinical measures. METHODS A systematic review was performed according to PRISMA guidelines and searching PubMed until October 2022. Rs-fMRI studies addressing ataxia, chorea, dystonia, myoclonus, tics, tremor, and functional movement disorders (FMD) were included. The standardized mean difference was used to summarize findings per region in the Automated Anatomical Labeling atlas for each phenotype. Furthermore, the activation likelihood estimation meta-analytic method was used to analyze convergence of significant between-group differences per phenotype. Finally, we conducted hierarchical cluster analysis to provide additional insights into commonalities and differences across HMD phenotypes. RESULTS Most articles concerned tremor (51), followed by dystonia (46), tics (19), chorea (12), myoclonus (11), FMD (11), and ataxia (8). Altered resting-state connectivity was found in several brain regions: in ataxia mainly cerebellar areas; for chorea, the caudate nucleus; for dystonia, sensorimotor and basal ganglia regions; for myoclonus, the thalamus and cingulate cortex; in tics, the basal ganglia, cerebellum, insula, and frontal cortex; for tremor, the cerebello-thalamo-cortical circuit; finally, in FMD, frontal, parietal, and cerebellar regions. Both decreased and increased connectivity were found for all HMD. Significant spatial convergence was found for dystonia, FMD, myoclonus, and tremor. Correlations between clinical measures and resting-state connectivity were frequently described. CONCLUSION Key brain regions contributing to functional connectivity changes across HMD often overlap. Possible increases and decreases of functional connections of a specific region emphasize that HMD should be viewed as a network disorder. Despite the complex interplay of physiological and methodological factors, this review serves to gain insight in brain connectivity profiles across HMD phenotypes.
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Affiliation(s)
- Ramesh S Marapin
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Harm J van der Horn
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands
| | - A M Madelein van der Stouwe
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Jelle R Dalenberg
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Bauke M de Jong
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands
| | - Marina A J Tijssen
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands.
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8
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Chen X, Huang Z, Lin W, Li M, Ye Z, Qiu Y, Xia X, Chen N, Hu J, Gan S, Chen Q. Altered brain white matter structural motor network in spinocerebellar ataxia type 3. Ann Clin Transl Neurol 2022; 10:225-236. [PMID: 36479904 PMCID: PMC9930426 DOI: 10.1002/acn3.51713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/07/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Spinocerebellar ataxia type 3 is a disorder within the brain network. However, the relationship between the brain network and disease severity is still unclear. This study aims to investigate changes in the white matter (WM) structural motor network, both in preclinical and ataxic stages, and its relationship with disease severity. METHODS For this study, 20 ataxic, 20 preclinical SCA3 patients, and 20 healthy controls were recruited and received MRI scans. Disease severity was quantified using the SARA and ICARS scores. The WM motor structural network was created using probabilistic fiber tracking and was analyzed using graph theory and network-based statistics at global, nodal, and edge levels. In addition, the correlations between network topological measures and disease duration or clinical scores were analyzed. RESULTS Preclinical patients showed increasing assortativity of the motor network, altered subnetwork including 12 edges of 11 nodes, and 5 brain regions presenting reduced nodal strength. In ataxic patients assortativity of the motor network also increased, but global efficiency, global strength, and transitivity decreased. Ataxic patients showed a wider altered subnetwork and a higher number of reduced nodal strengths. A negative correlation between the transitivity of the motor network and SARA and ICARS scores was observed in ataxic patients. INTERPRETATION Changes to the WM motor network in SCA3 start before ataxia onset, and WM motor network involvement increases with disease progression. Global network topological measures of the WM motor network appear to be a promising image biomarker for disease severity. This study provides new insights into the pathophysiology of disease in SCA3/MJD.
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Affiliation(s)
- Xin‐Yuan Chen
- Department of Rehabilitation MedicineThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Zi‐Qiang Huang
- Department of RadiologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Wei Lin
- Department of NeurologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Meng‐Cheng Li
- Department of RadiologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Zhi‐Xian Ye
- Department of NeurologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Yu‐Sen Qiu
- Department of NeurologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Xiao‐Yue Xia
- Department of RadiologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Na‐Ping Chen
- Department of RadiologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Jian‐Ping Hu
- Department of RadiologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Shi‐Rui Gan
- Department of NeurologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Qun‐Lin Chen
- Department of RadiologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
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9
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Guo J, Jiang Z, Liu X, Li H, Biswal BB, Zhou B, Sheng W, Gao Q, Chen H, Fan Y, Zhu W, Wang J, Chen H, Liu C. Cerebello-cerebral resting-state functional connectivity in spinocerebellar ataxia type 3. Hum Brain Mapp 2022; 44:927-936. [PMID: 36250694 PMCID: PMC9875927 DOI: 10.1002/hbm.26113] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/24/2022] [Accepted: 09/26/2022] [Indexed: 01/28/2023] Open
Abstract
Spinocerebellar ataxia type 3 (SCA3) is a neurodegenerative disorder characterized by progressive motor and nonmotor deficits concomitant with degenerative pathophysiological changes within the cerebellum. The cerebellum is topographically organized into cerebello-cerebral circuits that create distinct functional networks regulating movement, cognition, and affect. SCA3-associated motor and nonmotor symptoms are possibly related not only to intracerebellar changes but also to disruption of the connectivity within these cerebello-cerebral circuits. However, to date, no comprehensive investigation of cerebello-cerebral connectivity in SCA3 has been conducted. The present study aimed to identify cerebello-cerebral functional connectivity alterations and associations with downstream clinical phenotypes and upstream topographic markers of cerebellar neurodegeneration in patients with SCA3. This study included 45 patients with SCA3 and 49 healthy controls. Voxel-based morphometry and resting-state functional magnetic resonance imaging (MRI) were performed to characterize the cerebellar atrophy and to examine the cerebello-cerebral functional connectivity patterns. Structural MRI confirmed widespread gray matter atrophy in the motor and cognitive cerebellum of patients with SCA3. We found reduced functional connectivity between the cerebellum and the cerebral cortical networks, including the somatomotor, frontoparietal, and default networks; however, increased connectivity was observed between the cerebellum and the dorsal attention network. These abnormal patterns correlated with the CAG repeat expansion and deficits in global cognition. Our results indicate the contribution of cerebello-cerebral networks to the motor and cognitive impairments in patients with SCA3 and reveal that such alterations occur in association with cerebellar atrophy. These findings add important insights into our understanding of the role of the cerebellum in SCA3.
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Affiliation(s)
- Jing Guo
- The Center of Psychosomatic MedicineSichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of ChinaChengduChina,The Clinical Hospital of Chengdu Brain Science InstituteSchool of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina,Department of RadiologySouthwest Hospital, Army Medical University (Third Military Medical University)ChongqingChina
| | - Zhouyu Jiang
- The Clinical Hospital of Chengdu Brain Science InstituteSchool of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina,MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan ProvinceUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Xinyuan Liu
- The Clinical Hospital of Chengdu Brain Science InstituteSchool of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina,MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan ProvinceUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Haoru Li
- The Clinical Hospital of Chengdu Brain Science InstituteSchool of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina,MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan ProvinceUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Bharat B. Biswal
- The Clinical Hospital of Chengdu Brain Science InstituteSchool of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina,Department of Biomedical EngineeringNew Jersey Institute of TechnologyNewarkNew JerseyUSA
| | - Bo Zhou
- The Center of Psychosomatic MedicineSichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of ChinaChengduChina
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science InstituteSchool of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina,MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan ProvinceUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Qing Gao
- The Clinical Hospital of Chengdu Brain Science InstituteSchool of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina,MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan ProvinceUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Hui Chen
- Department of RadiologySouthwest Hospital, Army Medical University (Third Military Medical University)ChongqingChina
| | - Yunshuang Fan
- The Clinical Hospital of Chengdu Brain Science InstituteSchool of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina,MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan ProvinceUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Wenyan Zhu
- Data Processing DepartmentYidu Cloud Technology, Inc.BeijingChina
| | - Jian Wang
- Department of RadiologySouthwest Hospital, Army Medical University (Third Military Medical University)ChongqingChina
| | - Huafu Chen
- The Center of Psychosomatic MedicineSichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of ChinaChengduChina,The Clinical Hospital of Chengdu Brain Science InstituteSchool of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina,Department of RadiologySouthwest Hospital, Army Medical University (Third Military Medical University)ChongqingChina
| | - Chen Liu
- Department of RadiologySouthwest Hospital, Army Medical University (Third Military Medical University)ChongqingChina
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10
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Siciliano L, Olivito G, Urbini N, Silveri MC, Leggio M. “Mens Sana in Corpore Sano”: The Emerging Link of Motor Reserve with Motor and Cognitive Abilities and Compensatory Brain Networks in SCA2 Patients. Biomedicines 2022; 10:biomedicines10092166. [PMID: 36140267 PMCID: PMC9496032 DOI: 10.3390/biomedicines10092166] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
The ability to resiliently cope with neuropathological lesions is a key scientific concern. Accordingly, this study aims to investigate whether motor reserve (MR), likely to be boosted by exercise engagement in a lifetime, affects motor symptom severity, cognitive functioning, and functional brain networks in spinocerebellar ataxia type 2 (SCA2)—a cerebellar neurodegenerative disease. The MR of 12 SCA2 patients was assessed using the Motor Reserve Index Questionnaire (MRIq), developed ad hoc for estimating lifespan MR. The International Cooperative Ataxia Rating Scale was used to assess clinical motor features, and neuropsychological tests were used to evaluate cognitive functioning. Patients underwent an MRI examination, and network-based statistics (NBS) analysis was carried out to detect patterns of functional connectivity (FC). Significant correlations were found between MRIq measures and the severity of motor symptoms, educational and intellectual levels, executive function, and processing speed. NBS analysis revealed a higher FC within subnetworks consisting of specific cerebellar and cerebral areas. FC patterns were positively correlated with MRIq measures, likely indicating the identification of an MR network. The identified network might reflect a biomarker likely to underlie MR, influenced by education and cognitive functioning, and impacting the severity of motor symptoms.
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Affiliation(s)
- Libera Siciliano
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Giusy Olivito
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Nicole Urbini
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | | | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
- Correspondence:
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11
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Chen H, Dai L, Zhang Y, Feng L, Jiang Z, Wang X, Xie D, Guo J, Chen H, Wang J, Liu C. Network Reconfiguration Among Cerebellar Visual, and Motor Regions Affects Movement Function in Spinocerebellar Ataxia Type 3. Front Aging Neurosci 2022; 14:773119. [PMID: 35478700 PMCID: PMC9036064 DOI: 10.3389/fnagi.2022.773119] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/14/2022] [Indexed: 12/01/2022] Open
Abstract
Background Spinocerebellar ataxia type 3 (SCA3) is a rare movement disorder characterized with ataxia. Previous studies on movement disorders show that the whole-brain functional network tends to be more regular, and these reconfigurations correlate with genetic and clinical variables. Methods To test whether the brain network in patients with SCA3 follows a similar reconfiguration course to other movement disorders, we recruited 41 patients with SCA3 (mean age = 40.51 ± 12.13 years; 23 male) and 41 age and sex-matched healthy individuals (age = 40.10 ± 11.56 years; 24 male). In both groups, the whole-brain network topology of resting-state functional magnetic resonance imaging (rs-fMRI) was conducted using graph theory, and the relationships among network topologies, cytosine-adenine-guanine (CAG) repeats, clinical symptoms, and functional connectivity were explored in SCA3 patients using partial correlation analysis, controlling for age and sex. Results The brain networks tended to be more regular with a higher clustering coefficient, local efficiency, and modularity in patients with SCA3. Hubs in SCA3 patients were reorganized as the number of hubs increased in motor-related areas and decreased in cognitive areas. At the global level, small-worldness and normalized clustering coefficients were significantly positively correlated with clinical motor symptoms. At the nodal level, the clustering coefficient and local efficiency increased significantly in the visual (bilateral cuneus) and sensorimotor (right cerebellar lobules IV, V, VI) networks and decreased in the cognitive areas (right middle frontal gyrus). The clustering coefficient and local efficiency in the bilateral cuneus gyrus were negatively correlated with clinical motor symptoms. The functional connectivity between right caudate nucleus and bilateral calcarine gyrus were negatively correlated with disease duration, while connectivity between right posterior cingulum gyrus and left cerebellar lobule III, left inferior occipital gyrus and right cerebellar lobule IX was positively correlated. Conclusion Our results demonstrate that a more regular brain network occurred in SCA3 patients, with motor and visual-related regions, such as, cerebellar lobules and cuneus gyrus, both forayed neighbor nodes as “resource predators” to compensate for normal function, with motor and visual function having the higher priority comparing with other high-order functions. This study provides new information about the neurological mechanisms underlying SCA3 network topology impairments in the resting state, which give a potential guideline for future clinical treatments. Clinical Trial Registration [www.ClinicalTrials.gov], identifier [ChiCTR1800019901].
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Affiliation(s)
- Hui Chen
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Limeng Dai
- Department of Medical Genetics, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yuhan Zhang
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Liu Feng
- Department of Laboratory Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Zhenzhen Jiang
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xingang Wang
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jing Guo
- Biomedical Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- *Correspondence: Huafu Chen,
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Jian Wang,
| | - Chen Liu
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Chen Liu,
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12
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Pierce JE, Péron J. The basal ganglia and the cerebellum in human emotion. Soc Cogn Affect Neurosci 2021; 15:599-613. [PMID: 32507876 PMCID: PMC7328022 DOI: 10.1093/scan/nsaa076] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 04/03/2020] [Accepted: 06/02/2020] [Indexed: 12/26/2022] Open
Abstract
The basal ganglia (BG) and the cerebellum historically have been relegated to a functional role in producing or modulating motor output. Recent research, however, has emphasized the importance of these subcortical structures in multiple functional domains, including affective processes such as emotion recognition, subjective feeling elicitation and reward valuation. The pathways through the thalamus that connect the BG and cerebellum directly to each other and with extensive regions of the cortex provide a structural basis for their combined influence on limbic function. By regulating cortical oscillations to guide learning and strengthening rewarded behaviors or thought patterns to achieve a desired goal state, these regions can shape the way an individual processes emotional stimuli. This review will discuss the basic structure and function of the BG and cerebellum and propose an updated view of their functional role in human affective processing.
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Affiliation(s)
- Jordan E Pierce
- Clinical and Experimental Neuropsychology Laboratory, University of Geneva, 1205 Geneva, Switzerland
| | - Julie Péron
- Clinical and Experimental Neuropsychology Laboratory, University of Geneva, 1205 Geneva, Switzerland.,Neuropsychology Unit, Neurology Department, University Hospitals of Geneva, 1205 Geneva, Switzerland
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13
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Srinivasan SS, Tuckute G, Zou J, Gutierrez-Arango S, Song H, Barry RL, Herr HM. Agonist-antagonist myoneural interface amputation preserves proprioceptive sensorimotor neurophysiology in lower limbs. Sci Transl Med 2021; 12:12/573/eabc5926. [PMID: 33298564 DOI: 10.1126/scitranslmed.abc5926] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/22/2020] [Accepted: 10/06/2020] [Indexed: 12/12/2022]
Abstract
The brain undergoes marked changes in function and functional connectivity after limb amputation. The agonist-antagonist myoneural interface (AMI) amputation is a procedure that restores physiological agonist-antagonist muscle relationships responsible for proprioceptive sensory feedback to enable greater motor control. We compared results from the functional neuroimaging of individuals (n = 29) with AMI amputation, traditional amputation, and no amputation. Individuals with traditional amputation demonstrated a significant decrease in proprioceptive activity, measured by activation of Brodmann area 3a, whereas functional activation in individuals with AMIs was not significantly different from controls with no amputation (P < 0.05). The degree of proprioceptive activity in the brain strongly correlated with fascicle activity in the peripheral muscles and performance on motor tasks (P < 0.05), supporting the mechanistic basis of the AMI procedure. These results suggest that surgical techniques designed to restore proprioceptive peripheral neuromuscular constructs result in desirable central sensorimotor plasticity.
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Affiliation(s)
- Shriya S Srinivasan
- Harvard-MIT Program in Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. .,MIT Center for Extreme Bionics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Greta Tuckute
- MIT Center for Extreme Bionics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Jasmine Zou
- MIT Center for Extreme Bionics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Samantha Gutierrez-Arango
- MIT Center for Extreme Bionics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Hyungeun Song
- Harvard-MIT Program in Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.,MIT Center for Extreme Bionics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Robert L Barry
- Harvard-MIT Program in Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. .,Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, USA.,Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
| | - Hugh M Herr
- MIT Center for Extreme Bionics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
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14
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Mascalchi M, Vella A. Neuroimaging Biomarkers in SCA2 Gene Carriers. Int J Mol Sci 2020; 21:ijms21031020. [PMID: 32033120 PMCID: PMC7037189 DOI: 10.3390/ijms21031020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 01/27/2020] [Accepted: 01/31/2020] [Indexed: 12/12/2022] Open
Abstract
A variety of Magnetic Resonance (MR) and nuclear medicine (NM) techniques have been used in symptomatic and presymptomatic SCA2 gene carriers to explore, in vivo, the physiopathological biomarkers of the neurological dysfunctions characterizing the associated progressive disease that presents with a cerebellar syndrome, or less frequently, with a levodopa-responsive parkinsonian syndrome. Morphometry performed on T1-weighted images and diffusion MR imaging enable structural and microstructural evaluation of the brain in presymptomatic and symptomatic SCA2 gene carriers, in whom they show the typical pattern of olivopontocerebellar atrophy observed at neuropathological examination. Proton MR spectroscopy reveals, in the pons and cerebellum of SCA2 gene carriers, a more pronounced degree of abnormal neurochemical profile compared to other spinocerebellar ataxias with decreased NAA/Cr and Cho/Cr, increased mi/Cr ratios, and decreased NAA and increased mI concentrations. These neurochemical abnormalities are detectable also in presymtomatic gene carriers. Resting state functional MRI (rsfMRI) demonstrates decreased functional connectivity within the cerebellum and of the cerebellum with fronto-parietal cortices and basal ganglia in symptomatic SCA2 subjects. 18F-fluorodeoxyglucose Positron Emission Tomography (PET) shows a symmetric decrease of the glucose uptake in the cerebellar cortex, the dentate nucleus, the brainstem and the parahippocampal cortex. Single photon emission tomography and PET using several radiotracers have revealed almost symmetric nigrostriatal dopaminergic dysfunction irrespective of clinical signs of parkinsonism which are already present in presymtomatic gene carriers. Longitudinal small size studies have proven that morphometry and diffusion MR imaging can track neurodegeneration in SCA2, and hence serve as progression biomarkers. So far, such a capability has not been reported for proton MR spectroscopy, rsfMRI and NM techniques. A search for the best surrogate marker for future clinical trials represents the current challenge for the neuroimaging community.
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Affiliation(s)
- Mario Mascalchi
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50121 Florence, Italy
- Correspondence: ; Tel.: +39-329-808-1701
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15
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Naeije G, Wens V, Coquelet N, Sjøgård M, Goldman S, Pandolfo M, De Tiège XP. Age of onset determines intrinsic functional brain architecture in Friedreich ataxia. Ann Clin Transl Neurol 2020; 7:94-104. [PMID: 31854120 PMCID: PMC6952309 DOI: 10.1002/acn3.50966] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/30/2019] [Accepted: 11/18/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Friedreich ataxia (FRDA) is the commonest hereditary ataxia in Caucasians. Most patients are homozygous for expanded GAA triplet repeats in the first intron of the frataxin (FXN) gene, involved in mitochondrial iron metabolism. Here, we used magnetoencephalography (MEG) to characterize the main determinants of FRDA-related changes in intrinsic functional brain architecture. METHODS Five minutes of MEG signals were recorded at rest from 18 right-handed FRDA patients (mean age 27 years, 9 females; mean SARA score: 21.4) and matched healthy individuals. The MEG connectome was estimated as resting-state functional connectivity (rsFC) matrices involving 37 nodes from six major resting state networks and the cerebellum. Source-level rsFC maps were computed using leakage-corrected broad-band (3-40 Hz) envelope correlations. Post hoc median-split was used to contrast rsFC in FRDA patients with different clinical characteristics. Nonparametric permutations and Spearman rank correlation test were used for statistics. RESULTS High rank correlation levels were found between rsFC and age of symptoms onset in FRDA mostly between the ventral attention, the default-mode, and the cerebellar networks; patients with higher rsFC developing symptoms at an older age. Increased rsFC was found in FRDA with later age of symptoms onset compared to healthy subjects. No correlations were found between rsFC and other clinical parameters. CONCLUSION Age of symptoms onset is a major determinant of FRDA patients' intrinsic functional brain architecture. Higher rsFC in FRDA patients with later age of symptoms onset supports compensatory mechanisms for FRDA-related neural network dysfunction and position neuromagnetic rsFC as potential marker of FRDA neural reserve.
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Affiliation(s)
- Gilles Naeije
- Laboratoire de Cartographie fonctionnelle du CerveauULB Neuroscience Institute (UNI)Université libre de Bruxelles (ULB)BrusselsBelgium
- Department of NeurologyCUB Hôpital ErasmeUniversité libre de Bruxelles (ULB)BrusselsBelgium
| | - Vincent Wens
- Laboratoire de Cartographie fonctionnelle du CerveauULB Neuroscience Institute (UNI)Université libre de Bruxelles (ULB)BrusselsBelgium
- Department of Functional NeuroimagingService of Nuclear MedicineCUB Hôpital ErasmeUniversité libre de Bruxelles (ULB)BrusselsBelgium
| | - Nicolas Coquelet
- Laboratoire de Cartographie fonctionnelle du CerveauULB Neuroscience Institute (UNI)Université libre de Bruxelles (ULB)BrusselsBelgium
| | - Martin Sjøgård
- Laboratoire de Cartographie fonctionnelle du CerveauULB Neuroscience Institute (UNI)Université libre de Bruxelles (ULB)BrusselsBelgium
| | - Serge Goldman
- Laboratoire de Cartographie fonctionnelle du CerveauULB Neuroscience Institute (UNI)Université libre de Bruxelles (ULB)BrusselsBelgium
- Department of Functional NeuroimagingService of Nuclear MedicineCUB Hôpital ErasmeUniversité libre de Bruxelles (ULB)BrusselsBelgium
| | - Massimo Pandolfo
- Department of NeurologyCUB Hôpital ErasmeUniversité libre de Bruxelles (ULB)BrusselsBelgium
| | - Xavier P. De Tiège
- Laboratoire de Cartographie fonctionnelle du CerveauULB Neuroscience Institute (UNI)Université libre de Bruxelles (ULB)BrusselsBelgium
- Department of Functional NeuroimagingService of Nuclear MedicineCUB Hôpital ErasmeUniversité libre de Bruxelles (ULB)BrusselsBelgium
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16
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Gigante AF, Lelli G, Romano R, Pellicciari R, Di Candia A, Mancino PV, Pau M, Fiore P, Defazio G. The Relationships Between Ataxia and Cognition in Spinocerebellar Ataxia Type 2. THE CEREBELLUM 2019; 19:40-47. [DOI: 10.1007/s12311-019-01079-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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17
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Mascalchi M, Vella A. Neuroimaging Applications in Chronic Ataxias. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 143:109-162. [PMID: 30473193 DOI: 10.1016/bs.irn.2018.09.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT) and positron emission tomography (PET) are the main instruments for neuroimaging investigation of patients with chronic ataxia. MRI has a predominant diagnostic role in the single patient, based on the visual detection of three patterns of atrophy, namely, spinal atrophy, cortical cerebellar atrophy and olivopontocerebellar atrophy, which correlate with the aetiologies of inherited or sporadic ataxia. In fact spinal atrophy is observed in Friedreich ataxia, cortical cerebellar atrophy in Ataxia Telangectasia, gluten ataxia and Sporadic Adult Onset Ataxia and olivopontocerebellar atrophy in Multiple System Atrophy cerebellar type. The 39 types of dominantly inherited spinocerebellar ataxias show either cortical cerebellar atrophy or olivopontocerebellar atrophy. T2 or T2* weighted MR images can contribute to the diagnosis by revealing abnormally increased or decreased signal with a characteristic distribution. These include symmetric T2 hyperintensity of the posterior and lateral columns of the cervical spinal cord in Friedreich ataxia, diffuse and symmetric hyperintensity of the cerebellar cortex in Infantile Neuro-Axonal Dystrophy, symmetric hyperintensity of the peridentate white matter in Cerebrotendineous Xanthomatosis, and symmetric hyperintensity of the middle cerebellar peduncles and peridentate white matter, cerebral white matter and corpus callosum in Fragile X Tremor Ataxia Syndrome. Abnormally decreased T2 or T2* signal can be observed with a multifocal distribution in Ataxia Telangectasia and with a symmetric distribution in the basal ganglia in Multiple System Atrophy. T2 signal hypointensity lining diffusely the outer surfaces of the brainstem, cerebellum and cerebrum enables diagnosis of superficial siderosis of the central nervous system. The diagnostic role of nuclear medicine techniques is smaller. SPECT and PET show decreased uptake of radiotracers investigating the nigrostriatal system in Multiple System Atrophy and in patients with Fragile X Tremor Ataxia Syndrome. Semiquantitative or quantitative MRI, SPECT and PET data describing structural, microstructural and functional changes of the cerebellum, brainstem, and spinal cord have been widely applied to investigate physiopathological changes in patients with chronic ataxias. Moreover they can track diseases progression with a greater sensitivity than clinical scales. So far, a few small-size and single center studies employed neuroimaging techniques as surrogate markers of treatment effects in chronic ataxias.
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Affiliation(s)
- Mario Mascalchi
- Meyer Children Hospital, Florence, Italy; Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
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18
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Hernandez-Castillo CR, King M, Diedrichsen J, Fernandez-Ruiz J. Unique degeneration signatures in the cerebellar cortex for spinocerebellar ataxias 2, 3, and 7. Neuroimage Clin 2018; 20:931-938. [PMID: 30308379 PMCID: PMC6178193 DOI: 10.1016/j.nicl.2018.09.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/13/2018] [Accepted: 09/25/2018] [Indexed: 12/14/2022]
Abstract
Spinocerebellar ataxias (SCAs) are a heterogeneous group of neurodegenerative diseases that selectively affect vulnerable neuronal populations in the cerebellum and other subcortical regions. While previous studies have reported subtype differences in the absolute amount of degeneration in specific regions of interest, they failed to account for two important factors. First, they did not control for overall differences in the severity of the degeneration pattern, and second, they did not fully characterize the spatial pattern of degeneration for each SCA subtype. Here, we provide a systematic characterization of the spatial degeneration patterns for three polyQ SCAs (55 patients, either SCA2, SCA3, or SCA7) while controlling for the severity of the degeneration pattern. After this correction, the cerebellar degeneration pattern can successfully classify between the three different SCA subtypes with high cross-validated accuracy. Specifically, degeneration in SCA3 disproportionally affects motor regions of the cerebellar cortex, which explains the relatively severe motor symptoms observed in this subtype. Our results demonstrate that each of the three studied SCA subtypes has a unique cerebellar degeneration signature, hinting at differences in the disease process. Clinically, these differentiable patterns of cerebellar degeneration can be used to reliably discern subtypes, even at relatively early stages of the disease.
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Affiliation(s)
- Carlos R Hernandez-Castillo
- CONACYT - Instituto de Neuroetologia, Universidad Veracruzana, Xalapa, Mexico; Brain and Mind Institute, Western University, London, ON, Canada.
| | - Maedbh King
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Jörn Diedrichsen
- Brain and Mind Institute, Western University, London, ON, Canada; Department of Computer Science and Department of Statistical and Actuarial Sciences, Western University, London, ON, Canada
| | - Juan Fernandez-Ruiz
- Departamento de Fisiologia, Facultad de Medicina, Universidad Nacional Autonoma de Mexico. Mexico
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19
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Han Q, Yang J, Xiong H, Shang H. Voxel-based meta-analysis of gray and white matter volume abnormalities in spinocerebellar ataxia type 2. Brain Behav 2018; 8:e01099. [PMID: 30125476 PMCID: PMC6160648 DOI: 10.1002/brb3.1099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 07/21/2018] [Accepted: 07/23/2018] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To identify the consistent findings from the whole-brain voxel-based morphometry (VBM) studies on spinocerebellar ataxia type 2 (SCA2). METHODS The whole-brain VBM studies comparing SCA2 patients and healthy controls (HCs) were systematically searched in PubMed, Embase databases from January 2000 to June 2017. The coordinates with significant differences in gray matter (GM) and white matter (WM) between SCA2 patients and HCs were extracted separately from each cluster. A meta-analysis was performed using anisotropic effect size-based signed differential mapping (AES-SDM) software. RESULTS A total of five studies with 65 SCA2 patients and 124 HCs were included in the GM meta-analysis. Four of the five studies with 50 SCA2 patients and 109 HCs were included in the WM meta-analysis. Significant and consistent GM volume reductions were detected in bilateral cerebellar hemispheres, cerebellar vermis, the right fusiform gyrus, the right parahippocampal gyrus, and the right lingual gyrus. The WM volume reductions were observed in bilateral cerebellar hemispheres, cerebellar vermis, middle cerebellar peduncles, pons, and bilateral cortico-spinal projections. The findings of the study remained largely unchanged in jackknife sensitivity analysis. CONCLUSIONS The consistent findings from our meta-analysis showed that GM volume reductions in SCA2 patients were not limited in cerebellum while significant WM volume reductions widely existed in cerebellum and pyramidal system. The findings provide morphological basis for further studies on SCA2.
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Affiliation(s)
- Qing Han
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hai Xiong
- Department of Geriatrics, The Fourth Affiliated Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Huifang Shang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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20
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Hernandez-Castillo CR, Diedrichsen J, Aguilar-Castañeda E, Iglesias M. Decoupling between the hand territory and the default mode network after bilateral arm transplantation: four-year follow-up case study. Brain Imaging Behav 2018; 12:296-302. [PMID: 28185062 DOI: 10.1007/s11682-017-9683-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Several studies have suggested both a local and network reorganization of the sensorimotor system following amputation. Transplantation of a new limb results in a new shifting of cortical activity in the local territory of the transplanted limb. However, there is a lack of information about the reversibility of the abnormalities at the network level. The objective of this study was to characterize the functional connectivity changes between the cortical territory of the new hand and two intrinsic network of interest: the sensorimotor network (SMN) and the default mode network (DMN) of one patient whom received bilateral forearm transplants. Using resting-state fMRI these two networks were identified across four different time points, starting four months after the transplantation surgery and during three consecutive years while the patient underwent physical rehabilitation. The topology of the SMN was disrupted at the first acquisition and over the years returned to its canonical pattern. Analysis of the DMN showed the normal topology with no significant changes across acquisitions. Functional connectivity between the missing hand's cortical territory and the SMN increased over time. Accordingly, functional connectivity between the missing hand's cortical territory and the DMN became anticorrelated over time. Our results suggest that after transplantation a new reorganization occurs at the network level, supporting the idea that extreme behavioral changes can affect not only the local rewiring but also the intrinsic network organization in neurologically healthy subjects. Overall this study provides new insight on the complex dynamics of brain organization.
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Affiliation(s)
- Carlos R Hernandez-Castillo
- CONACYT - Instituto de Neuroetologia, Universidad Veracruzana, Av. Luis Cartelazo Ayala s/n, Col. Industrial Ánimas, Xalapa, Veracruz, Mexico. .,The Brain and Mind Institute, Western University, London, Canada.
| | - Jörn Diedrichsen
- The Brain and Mind Institute, Western University, London, Canada
| | - Erika Aguilar-Castañeda
- Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suarez", Ciudad de México, Mexico
| | - Martin Iglesias
- Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, Mexico
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21
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Lupo M, Olivito G, Iacobacci C, Clausi S, Romano S, Masciullo M, Molinari M, Cercignani M, Bozzali M, Leggio M. The cerebellar topography of attention sub-components in spinocerebellar ataxia type 2. Cortex 2018; 108:35-49. [PMID: 30121445 DOI: 10.1016/j.cortex.2018.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 06/07/2018] [Accepted: 07/16/2018] [Indexed: 01/10/2023]
Abstract
Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant neurodegenerative disease characterized by a progressive cerebellar syndrome and multiple-domain cognitive impairments. The cerebellum is known to contribute to distinct functional networks related to higher-level functions. The aims of the present study were to investigate the different sub-components of attention and to analyse possible correlations between attention deficits and specific cerebellar regions in SCA2 patients. To this purpose, 11 SCA2 patients underwent an exhaustive attention battery that evaluated several attention sub-components. The SCA2 group performed below the normal range in tasks assessing selective attention, divided attention, and sustained attention, obtaining negative Z-scores. These results were confirmed by non-parametric Mann-Whitney U tests that showed significant differences between SCA2 and control subjects in the same sub-components of the attention battery, allowing us to speculate on cerebellar involvement when a high cognitive demand is required (i.e., multisensory integration, sequencing, prediction of events, and inhibition of inappropriate response behaviours). The voxel-based morphometry analysis showed a pattern of significantly reduced grey matter volume in specific cerebellar lobules. In particular, the SCA2 patients showed significant grey matter loss in bilateral regions of the anterior cerebellar hemisphere (IV) and in the posterior lobe (VI-IX) and posterior vermis (VI-IX). Statistical analysis found significant correlations between grey matter reductions in the VIIb/VIIIa cerebellar lobules and impairments in Sustained and Divided Attention tasks and between grey matter reduction in the vermal VI lobule and impairment in the Go/NoGo task. For the first time, the study demonstrated the involvement of specific cerebellar lobules in different sub-components of the attention domain, giving further support to the inclusion of the cerebellum within the attention network.
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Affiliation(s)
- Michela Lupo
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy.
| | - Giusy Olivito
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy; Neuroimaging Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Claudia Iacobacci
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy; PhD Program in Behavioral Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Silvia Clausi
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Silvia Romano
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | | | - Marco Molinari
- Neurorehabilitation 1 and Spinal Center, Robotic Neurorehabilitation Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Mara Cercignani
- Neuroimaging Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy; Clinical Imaging Science Center, Brighton and Sussex Medical School, Brighton, UK
| | - Marco Bozzali
- Neuroimaging Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy; Clinical Imaging Science Center, Brighton and Sussex Medical School, Brighton, UK
| | - Maria Leggio
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Psychology, Sapienza University of Rome, Rome, Italy
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22
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Cocozza S, Costabile T, Tedeschi E, Abate F, Russo C, Liguori A, Del Vecchio W, Paciello F, Quarantelli M, Filla A, Brunetti A, Saccà F. Cognitive and functional connectivity alterations in Friedreich's ataxia. Ann Clin Transl Neurol 2018; 5:677-686. [PMID: 29928651 PMCID: PMC5989773 DOI: 10.1002/acn3.555] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/14/2018] [Accepted: 02/22/2018] [Indexed: 01/26/2023] Open
Abstract
Objective The aim of this study was to perform the first resting-state functional MRI (RS-fMRI) analysis in Friedreich's ataxia (FRDA) patients to assess possible brain functional connectivity (FC) differences in these patients, and test their correlations with neuropsychological performances. Methods In total, 24 FRDA patients (M/F: 15/9, mean age 31.3 ± 15.0) and 24 healthy controls (HC; M/F: 15/9, mean age 30.7 ± 15.5) were enrolled in this cross-sectional study. All patients underwent a thorough neuropsychological battery, investigating different cognitive domains. RS-fMRI data were analyzed using a seed-based approach, probing the FC of cortical areas potentially referable to specific executive and cognitive functions compromised in FRDA. Results Compared to HC, FRDA patients showed overall worse neuropsychological scores in several domains, including global cognitive assessment, spatial memory, visuoperception and visuospatial functions, and executive functions. Analysis of RS-fMRI data showed a higher FC in FRDA patients compared to HC between paracingulate gyri and the medial frontal gryrus, between the superior frontal gyrus and bilateral angular gyri, and between the middle temporal gyrus and the cingulate gyrus, with a reduced FC between the medial frontal gryrus and the cerebellum. Interpretation We found a reduction in FC between frontal areas and the contralateral cerebellar cortex in FRDA, in line with the known alteration in cerebello-cortical pathway in this condition. On the other hand, a higher FC between different cortical areas was shown, possibly reflecting a compensatory phenomenon. These results, in conjunction with clinical findings, may shed new light on the pattern of supratentorial and infratentorial involvement, and on dynamics of brain plasticity in this disease.
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Affiliation(s)
- Sirio Cocozza
- Department of Advanced Biomedical Sciences University "Federico II" Naples Italy
| | - Teresa Costabile
- Department of Neurosciences and Reproductive and Odontostomatological Sciences University "Federico II" Naples Italy
| | - Enrico Tedeschi
- Department of Advanced Biomedical Sciences University "Federico II" Naples Italy
| | - Filomena Abate
- Department of Neurosciences and Reproductive and Odontostomatological Sciences University "Federico II" Naples Italy
| | - Camilla Russo
- Department of Advanced Biomedical Sciences University "Federico II" Naples Italy
| | - Agnese Liguori
- Department of Neurosciences and Reproductive and Odontostomatological Sciences University "Federico II" Naples Italy
| | - Walter Del Vecchio
- Institute of Biostructure and Bioimaging National Research Council Naples Italy
| | - Francesca Paciello
- Department of Neurosciences and Reproductive and Odontostomatological Sciences University "Federico II" Naples Italy
| | - Mario Quarantelli
- Institute of Biostructure and Bioimaging National Research Council Naples Italy
| | - Alessandro Filla
- Department of Neurosciences and Reproductive and Odontostomatological Sciences University "Federico II" Naples Italy
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences University "Federico II" Naples Italy
| | - Francesco Saccà
- Department of Neurosciences and Reproductive and Odontostomatological Sciences University "Federico II" Naples Italy
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23
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Hohenfeld C, Werner CJ, Reetz K. Resting-state connectivity in neurodegenerative disorders: Is there potential for an imaging biomarker? Neuroimage Clin 2018; 18:849-870. [PMID: 29876270 PMCID: PMC5988031 DOI: 10.1016/j.nicl.2018.03.013] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 02/06/2018] [Accepted: 03/14/2018] [Indexed: 12/14/2022]
Abstract
Biomarkers in whichever modality are tremendously important in diagnosing of disease, tracking disease progression and clinical trials. This applies in particular for disorders with a long disease course including pre-symptomatic stages, in which only subtle signs of clinical progression can be observed. Magnetic resonance imaging (MRI) biomarkers hold particular promise due to their relative ease of use, cost-effectiveness and non-invasivity. Studies measuring resting-state functional MR connectivity have become increasingly common during recent years and are well established in neuroscience and related fields. Its increasing application does of course also include clinical settings and therein neurodegenerative diseases. In the present review, we critically summarise the state of the literature on resting-state functional connectivity as measured with functional MRI in neurodegenerative disorders. In addition to an overview of the results, we briefly outline the methods applied to the concept of resting-state functional connectivity. While there are many different neurodegenerative disorders cumulatively affecting a substantial number of patients, for most of them studies on resting-state fMRI are lacking. Plentiful amounts of papers are available for Alzheimer's disease (AD) and Parkinson's disease (PD), but only few works being available for the less common neurodegenerative diseases. This allows some conclusions on the potential of resting-state fMRI acting as a biomarker for the aforementioned two diseases, but only tentative statements for the others. For AD, the literature contains a relatively strong consensus regarding an impairment of the connectivity of the default mode network compared to healthy individuals. However, for AD there is no considerable documentation on how that alteration develops longitudinally with the progression of the disease. For PD, the available research points towards alterations of connectivity mainly in limbic and motor related regions and networks, but drawing conclusions for PD has to be done with caution due to a relative heterogeneity of the disease. For rare neurodegenerative diseases, no clear conclusions can be drawn due to the few published results. Nevertheless, summarising available data points towards characteristic connectivity alterations in Huntington's disease, frontotemporal dementia, dementia with Lewy bodies, multiple systems atrophy and the spinocerebellar ataxias. Overall at this point in time, the data on AD are most promising towards the eventual use of resting-state fMRI as an imaging biomarker, although there remain issues such as reproducibility of results and a lack of data demonstrating longitudinal changes. Improved methods providing more precise classifications as well as resting-state network changes that are sensitive to disease progression or therapeutic intervention are highly desirable, before routine clinical use could eventually become a reality.
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Affiliation(s)
- Christian Hohenfeld
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Cornelius J Werner
- RWTH Aachen University, Department of Neurology, Aachen, Germany; RWTH Aachen University, Section Interdisciplinary Geriatrics, Aachen, Germany
| | - Kathrin Reetz
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany.
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24
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Reetz K, Rodríguez-Labrada R, Dogan I, Mirzazade S, Romanzetti S, Schulz JB, Cruz-Rivas EM, Alvarez-Cuesta JA, Aguilera Rodríguez R, Gonzalez Zaldivar Y, Auburger G, Velázquez-Pérez L. Brain atrophy measures in preclinical and manifest spinocerebellar ataxia type 2. Ann Clin Transl Neurol 2018; 5:128-137. [PMID: 29468174 PMCID: PMC5817824 DOI: 10.1002/acn3.504] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/06/2017] [Accepted: 10/21/2017] [Indexed: 01/11/2023] Open
Abstract
Objective Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominantly inherited neurodegenerative disease mainly affecting the cerebellum and brainstem. In this Cuban-German research collaboration, we aimed to characterize atrophy patterns and associations with clinical measures in preclinical and manifest SCA2. Methods In this study, 16 nonmanifest SCA2 mutation carriers, 26 manifest patients with SCA2, and 18 healthy control subjects underwent magnetic resonance imaging, as well as genetic and clinical characterization including assessment of ataxia (Scale for the Assessment and Rating of Ataxia) and saccade velocity in Cuba were enrolled. Semiautomated quantitative volumetry of the cerebellum and brainstem, subdivided into the medulla oblongata, the pontine brainstem, and mesencephalon was performed. Additionally, the anteroposterior diameter of the pontine brainstem was measured. Results Analysis of volumetric data revealed degeneration of the cerebellum and brainstem, in particular of pontine volumes and the anteroposterior diameter of the pons, in both manifest SCA2 patients and individuals at risk for SCA2 compared to controls. Comparing patients with nonataxic preclinical SCA2 mutation carriers, we found more pronounced reductions of the pontine brainstem and cerebellum in manifest SCA2. Volumetric data further showed associations with CAG repeat length and predicted age of onset in preclinical SCA2 individuals, and by trend with ataxia signs in patients. Although saccade velocity was associated with reduction in the pontine brainstem in preclinical and manifest SCA2, reduced ability to suppress interfering stimuli measured by the Stroop task was related to cerebellar volume loss in patients. Interpretation Preclinical SCA2 mutation carriers exhibit brain abnormalities, which could be targeted as surrogate parameters for disease progression and in future preventive trials.
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Affiliation(s)
- Kathrin Reetz
- Department of Neurology RWTH Aachen University Pauwelsstr. 3052074 Aachen Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University 52074 Aachen Germany
| | - Roberto Rodríguez-Labrada
- Department Clinical Neurophysiology Centre for the Research and Rehabilitation of Hereditary Ataxias Calle Libertad 26 Holguín 80100 Cuba
| | - Imis Dogan
- Department of Neurology RWTH Aachen University Pauwelsstr. 3052074 Aachen Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University 52074 Aachen Germany
| | - Shahram Mirzazade
- Department of Neurology RWTH Aachen University Pauwelsstr. 3052074 Aachen Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University 52074 Aachen Germany
| | - Sandro Romanzetti
- Department of Neurology RWTH Aachen University Pauwelsstr. 3052074 Aachen Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University 52074 Aachen Germany
| | - Jörg B Schulz
- Department of Neurology RWTH Aachen University Pauwelsstr. 3052074 Aachen Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University 52074 Aachen Germany
| | - Edilia M Cruz-Rivas
- Department of Imaging Clinical-Surgical Hospital "Lucía Iñiguez". Avenue "Celia Sanchez 1 Holguín Cuba
| | - Jose A Alvarez-Cuesta
- Department of Imaging Clinical-Surgical Hospital "Lucía Iñiguez". Avenue "Celia Sanchez 1 Holguín Cuba
| | - Raul Aguilera Rodríguez
- Department Clinical Neurophysiology Centre for the Research and Rehabilitation of Hereditary Ataxias Calle Libertad 26 Holguín 80100 Cuba
| | - Yanetza Gonzalez Zaldivar
- Department Molecular Genetics Centre for the Research and Rehabilitation of Hereditary Ataxias Calle Libertad 26 Holguín 80100 Cuba
| | - Georg Auburger
- Experimental Neurology Goethe University Medical School 60590 Frankfurt/Main Germany
| | - Luis Velázquez-Pérez
- Department Clinical Neurophysiology Centre for the Research and Rehabilitation of Hereditary Ataxias Calle Libertad 26 Holguín 80100 Cuba
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25
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Mormina E, Petracca M, Bommarito G, Piaggio N, Cocozza S, Inglese M. Cerebellum and neurodegenerative diseases: Beyond conventional magnetic resonance imaging. World J Radiol 2017; 9:371-388. [PMID: 29104740 PMCID: PMC5661166 DOI: 10.4329/wjr.v9.i10.371] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 07/18/2017] [Accepted: 08/02/2017] [Indexed: 02/06/2023] Open
Abstract
The cerebellum plays a key role in movement control and in cognition and cerebellar involvement is described in several neurodegenerative diseases. While conventional magnetic resonance imaging (MRI) is widely used for brain and cerebellar morphologic evaluation, advanced MRI techniques allow the investigation of cerebellar microstructural and functional characteristics. Volumetry, voxel-based morphometry, diffusion MRI based fiber tractography, resting state and task related functional MRI, perfusion, and proton MR spectroscopy are among the most common techniques applied to the study of cerebellum. In the present review, after providing a brief description of each technique’s advantages and limitations, we focus on their application to the study of cerebellar injury in major neurodegenerative diseases, such as multiple sclerosis, Parkinson’s and Alzheimer’s disease and hereditary ataxia. A brief introduction to the pathological substrate of cerebellar involvement is provided for each disease, followed by the review of MRI studies exploring structural and functional cerebellar abnormalities and by a discussion of the clinical relevance of MRI measures of cerebellar damage in terms of both clinical status and cognitive performance.
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Affiliation(s)
- Enricomaria Mormina
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Neuroradiology Unit, Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, 98100 Messina, Italy
| | - Maria Petracca
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Giulia Bommarito
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
| | - Niccolò Piaggio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
- Department of Neuroradiology, San Martino Hospital, 16132 Genoa, Italy
| | - Sirio Cocozza
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80138 Naples, Italy
| | - Matilde Inglese
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
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26
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Velázquez-Pérez LC, Rodríguez-Labrada R, Fernandez-Ruiz J. Spinocerebellar Ataxia Type 2: Clinicogenetic Aspects, Mechanistic Insights, and Management Approaches. Front Neurol 2017; 8:472. [PMID: 28955296 PMCID: PMC5601978 DOI: 10.3389/fneur.2017.00472] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 08/25/2017] [Indexed: 12/14/2022] Open
Abstract
Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant cerebellar ataxia that occurs as a consequence of abnormal CAG expansions in the ATXN2 gene. Progressive clinical features result from the neurodegeneration of cerebellum and extra-cerebellar structures including the pons, the basal ganglia, and the cerebral cortex. Clinical, electrophysiological, and imaging approaches have been used to characterize the natural history of the disease, allowing its classification into four distinct stages, with special emphasis on the prodromal stage, which is characterized by a plethora of motor and non-motor features. Neuropathological investigations of brain tissue from SCA2 patients reveal a widespread involvement of multiple brain systems, mainly cerebellar and brainstem systems. Recent findings linking ataxin-2 intermediate expansions to other neurodegenerative diseases such as amyotrophic lateral sclerosis have provided insights into the ataxin-2-related toxicity mechanism in neurodegenerative diseases and have raised new ethical challenges to molecular predictive diagnosis of SCA2. No effective neuroprotective therapies are currently available for SCA2 patients, but some therapeutic options such as neurorehabilitation and some emerging neuroprotective drugs have shown palliative benefits.
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Affiliation(s)
- Luis C Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Medical University of Holguín "Mariana Grajales", Holguín, Cuba
| | - Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Physical Culture School, University of Holguin "Oscar Lucero", Holguín, Cuba
| | - Juan Fernandez-Ruiz
- Department of Physiology, Medicine School, UNAM, Cuernavaca, Mexico.,Psychology School, Universidad Veracruzana, Xalapa, Mexico
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27
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Olivito G, Cercignani M, Lupo M, Iacobacci C, Clausi S, Romano S, Masciullo M, Molinari M, Bozzali M, Leggio M. Neural substrates of motor and cognitive dysfunctions in SCA2 patients: A network based statistics analysis. NEUROIMAGE-CLINICAL 2017; 14:719-725. [PMID: 28393013 PMCID: PMC5377430 DOI: 10.1016/j.nicl.2017.03.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/07/2017] [Accepted: 03/24/2017] [Indexed: 01/04/2023]
Abstract
Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant neurodegenerative disease characterized by a progressive cerebellar syndrome, which can be isolated or associated with extracerebellar signs. It has been shown that patients affected by SCA2 present also cognitive impairments and psychiatric symptoms. The cerebellum is known to modulate cortical activity and to contribute to distinct functional networks related to higher-level functions beyond motor control. It is therefore conceivable that one or more networks, rather than isolated regions, may be dysfunctional in cerebellar degenerative diseases and that an abnormal connectivity within specific cerebello-cortical regions might explain the widespread deficits typically observed in patients. In the present study, the network-based statistics (NBS) approach was used to assess differences in functional connectivity between specific cerebellar and cerebral “nodes” in SCA2 patients. Altered inter-nodal connectivity was found between more posterior regions in the cerebellum and regions in the cerebral cortex clearly related to cognition and emotion. Furthermore, more anterior cerebellar lobules showed altered inter-nodal connectivity with motor and somatosensory cerebral regions. The present data suggest that in SCA2 a cerebellar dysfunction affects long-distance cerebral regions and that the clinical symptoms may be specifically related with connectivity changes between motor and non-motor cerebello-cortical nodes. A cerebellar dysfunction affects long-distance cerebral regions in SCA2 patients. Connectivity changes affect sensorimotor and cognitive cerebello-cortical nodes. Cerebellar symptoms may be related to altered cerebello-cerebral connectivity.
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Affiliation(s)
- G Olivito
- Ataxia Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - M Cercignani
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Clinical Imaging Science Center, Brighton and Sussex Medical School, Brighton, UK
| | - M Lupo
- Ataxia Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - C Iacobacci
- Ataxia Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Psychology, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy
| | - S Clausi
- Ataxia Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Psychology, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy
| | - S Romano
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), "Sapienza" University of Rome-Sant'Andrea Hospital, Rome, Italy
| | - M Masciullo
- SPInal REhabilitation Lab, IRCCS Fondazione Santa Lucia,Rome, Italy
| | - M Molinari
- Neurorehabilitation 1 and Spinal Center, Robotic Neurorehabilitation Lab, IRCCS Santa Lucia Foundation, Rome, Italy
| | - M Bozzali
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - M Leggio
- Ataxia Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Psychology, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy
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28
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Subramony SH. Degenerative Ataxias: challenges in clinical research. Ann Clin Transl Neurol 2016; 4:53-60. [PMID: 28078315 PMCID: PMC5221462 DOI: 10.1002/acn3.374] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 10/17/2016] [Accepted: 10/18/2016] [Indexed: 01/05/2023] Open
Abstract
The degenerative ataxias are a very heterogeneous group of disorders that include numerous genetic diseases as well as apparently “sporadic” entities. There has been an explosion of discoveries related to genetic defects and related pathomechanisms that has brought us to the threshold of meaningful therapies in some but not all of these diseases. There also continues to be lack of knowledge of the causation of disease in a sizeable proportion of these patients. The overall rarity of ataxias as a whole and certainly of the individual genetic entities together with slow and variable progression and variable prognosis in juxtaposition with a rapid development of possible therapies in the horizon such as gene replacement and gene knock‐down strategies places the ataxias in a unique position distinct from other similar neurodegenerative diseases. The pace of laboratory research seems not matched by the pace of clinical research and clinical trial readiness. This review summarizes the author's views on the various challenges in translational research in ataxias and hopes to stimulate further thought and discussions on how to bring real help to these patients.
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Affiliation(s)
- Sub H Subramony
- Department of Neurology University of Florida College of Medicine and McKnight Brain Institute Gainesville Florida
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29
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Huang SR, Wu YT, Jao CW, Soong BW, Lirng JF, Wu HM, Wang PS. CAG repeat length does not associate with the rate of cerebellar degeneration in spinocerebellar ataxia type 3. Neuroimage Clin 2016; 13:97-105. [PMID: 27942452 PMCID: PMC5133648 DOI: 10.1016/j.nicl.2016.11.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/07/2016] [Accepted: 11/09/2016] [Indexed: 12/14/2022]
Abstract
This cross-sectional study investigated the correlation between the CAG repeat length and the degeneration of cerebellum in spinocerebellar ataxia type 3 (SCA3) patients based on neuroimaging approaches. Forty SCA3 patients were recruited and classified into two subgroups according to their CAG repeat lengths (≥ 74 and < 74). We measured each patient's Scale for the Assessment and Rating of Ataxia (SARA) score, N-acetylaspartate (NAA)/creatine (Cr) ratios based on magnetic resonance spectroscopy (MRS), and 3-dimensional fractal dimension (3D-FD) values derived from magnetic resonance imaging (MRI) results. Furthermore, the 3D-FD values were used to construct structural covariance networks based on graph theoretical analysis. The results revealed that SCA3 patients with a longer CAG repeat length demonstrated earlier disease onset. However, the CAG repeat length did not significantly correlate with their SARA scores, cerebellar NAA/Cr ratios or cerebellar 3D-FD values. Network dissociation between cerebellar regions and parietal-occipital regions was found in SCA3 patients with CAG ≥ 74, but not in those with CAG < 74. In conclusion, the CAG repeat length is uncorrelated with the change of SARA score, cerebellar function and cerebellar structure in SCA3. Nevertheless, a longer CAG repeat length may indicate early structural covariance network dissociation.
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Affiliation(s)
- Shang-Ran Huang
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, No.155, Sec. 2, Linong St., Taipei, Taiwan
| | - Yu-Te Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, No.155, Sec. 2, Linong St., Taipei, Taiwan
- Institute of Biophotonics, National Yang-Ming University, No.155, Sec. 2, Linong St., Taipei, Taiwan
| | - Chii-Wen Jao
- Institute of Biophotonics, National Yang-Ming University, No.155, Sec. 2, Linong St., Taipei, Taiwan
| | - Bing-Wen Soong
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan
- School of Medicine, National Yang-Ming University, No.155, Sec. 2, Linong St., Taipei, Taiwan
| | - Jiing-Feng Lirng
- School of Medicine, National Yang-Ming University, No.155, Sec. 2, Linong St., Taipei, Taiwan
- Department of Radiology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan
| | - Hsiu-Mei Wu
- School of Medicine, National Yang-Ming University, No.155, Sec. 2, Linong St., Taipei, Taiwan
- Department of Radiology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan
| | - Po-Shan Wang
- Institute of Biophotonics, National Yang-Ming University, No.155, Sec. 2, Linong St., Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan
- School of Medicine, National Yang-Ming University, No.155, Sec. 2, Linong St., Taipei, Taiwan
- Department of Neurology, Taipei Municipal Gan-Dau Hospital, No.12, Ln. 225, Zhixing Rd., Taipei, Taiwan
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30
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Robertson EE, Hall DA, McAsey AR, O'Keefe JA. Fragile X-associated tremor/ataxia syndrome: phenotypic comparisons with other movement disorders. Clin Neuropsychol 2016; 30:849-900. [PMID: 27414076 PMCID: PMC7336900 DOI: 10.1080/13854046.2016.1202239] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 06/12/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The purpose of this paper is to review the typical cognitive and motor impairments seen in fragile X-associated tremor/ataxia syndrome (FXTAS), essential tremor (ET), Parkinson disease (PD), spinocerebellar ataxias (SCAs), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) in order to enhance diagnosis of FXTAS patients. METHODS We compared the cognitive and motor phenotypes of FXTAS with each of these other movement disorders. Relevant neuropathological and neuroimaging findings are also reviewed. Finally, we describe the differences in age of onset, disease severity, progression rates, and average lifespan in FXTAS compared to ET, PD, SCAs, MSA, and PSP. We conclude with a flow chart algorithm to guide the clinician in the differential diagnosis of FXTAS. RESULTS By comparing the cognitive and motor phenotypes of FXTAS with the phenotypes of ET, PD, SCAs, MSA, and PSP we have clarified potential symptom overlap while elucidating factors that make these disorders unique from one another. In summary, the clinician should consider a FXTAS diagnosis and testing for the Fragile X mental retardation 1 (FMR1) gene premutation if a patient over the age of 50 (1) presents with cerebellar ataxia and/or intention tremor with mild parkinsonism, (2) has the middle cerebellar peduncle (MCP) sign, global cerebellar and cerebral atrophy, and/or subcortical white matter lesions on MRI, or (3) has a family history of fragile X related disorders, intellectual disability, autism, premature ovarian failure and has neurological signs consistent with FXTAS. Peripheral neuropathy, executive function deficits, anxiety, or depression are supportive of the diagnosis. CONCLUSIONS Distinct profiles in the cognitive and motor domains between these movement disorders may guide practitioners in the differential diagnosis process and ultimately lead to better medical management of FXTAS patients.
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Affiliation(s)
- Erin E Robertson
- a Department of Anatomy and Cell Biology , Rush University , Chicago , IL , USA
| | - Deborah A Hall
- b Department of Neurological Sciences , Rush University , Chicago , IL , USA
| | - Andrew R McAsey
- a Department of Anatomy and Cell Biology , Rush University , Chicago , IL , USA
| | - Joan A O'Keefe
- a Department of Anatomy and Cell Biology , Rush University , Chicago , IL , USA
- b Department of Neurological Sciences , Rush University , Chicago , IL , USA
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Hernandez-Castillo CR, Galvez V, Mercadillo R, Diaz R, Campos-Romo A, Fernandez-Ruiz J. Extensive White Matter Alterations and Its Correlations with Ataxia Severity in SCA 2 Patients. PLoS One 2015; 10:e0135449. [PMID: 26263162 PMCID: PMC4532454 DOI: 10.1371/journal.pone.0135449] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 07/22/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Previous studies of SCA2 have revealed significant degeneration of white matter tracts in cerebellar and cerebral regions. The motor deficit in these patients may be attributable to the degradation of projection fibers associated with the underlying neurodegenerative process. However, this relationship remains unclear. Statistical analysis of diffusion tensor imaging enables an unbiased whole-brain quantitative comparison of the diffusion proprieties of white matter tracts in vivo. METHODS Fourteen genetically confirmed SCA2 patients and aged-matched healthy controls participated in the study. Tract-based spatial statistics were performed to analyze structural white matter damage using two different measurements: fractional anisotropy (FA) and mean diffusivity (MD). Significant diffusion differences were correlated with the patient's ataxia impairment. RESULTS Our analysis revealed decreased FA mainly in the inferior/middle/superior cerebellar peduncles, the bilateral posterior limb of the internal capsule and the bilateral superior corona radiata. Increases in MD were found mainly in cerebellar white matter, medial lemniscus, and middle cerebellar peduncle, among other regions. Clinical impairment measured with the SARA score correlated with FA in superior parietal white matter and bilateral anterior corona radiata. Correlations with MD were found in cerebellar white matter and the middle cerebellar peduncle. CONCLUSION Our findings show significant correlations between diffusion measurements in key areas affected in SCA2 and measures of motor impairment, suggesting a disruption of information flow between motor and sensory-integration areas. These findings result in a more comprehensive view of the clinical impact of the white matter degeneration in SCA2.
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Affiliation(s)
- Carlos R. Hernandez-Castillo
- Consejo Nacional de Ciencia y Tecnología—Cátedras—Instituto de Neuroetologia, Universidad Veracruzana, Mexico DF, Mexico
| | - Victor Galvez
- Instituto de Neuroetologia, Universidad Veracruzana, Xalapa, Mexico
| | - Roberto Mercadillo
- Cátedras Consejo Nacional de Ciencia y Tecnología, Área de Neurociencias, Departamento de Biología de la Reproducción, Universidad Autónoma Metropolitana, Mexico DF, Mexico
| | - Rosalinda Diaz
- Laboratorio de Neuropsicología, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico DF, Mexico
| | - Aurelio Campos-Romo
- Unidad Periferica de Neurociencias, Facultad de Medicina Universidad Nacional Autonoma de Mexico/Instituto Nacional de Neurología y Neurocirugía, Mexico DF, Mexico
| | - Juan Fernandez-Ruiz
- Laboratorio de Neuropsicología, Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico DF, Mexico
- * E-mail:
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