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Hobbs NZ, Papoutsi M, Delva A, Kinnunen KM, Nakajima M, Van Laere K, Vandenberghe W, Herath P, Scahill RI. Neuroimaging to Facilitate Clinical Trials in Huntington's Disease: Current Opinion from the EHDN Imaging Working Group. J Huntingtons Dis 2024; 13:163-199. [PMID: 38788082 DOI: 10.3233/jhd-240016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
Neuroimaging is increasingly being included in clinical trials of Huntington's disease (HD) for a wide range of purposes from participant selection and safety monitoring, through to demonstration of disease modification. Selection of the appropriate modality and associated analysis tools requires careful consideration. On behalf of the EHDN Imaging Working Group, we present current opinion on the utility and future prospects for inclusion of neuroimaging in HD trials. Covering the key imaging modalities of structural-, functional- and diffusion- MRI, perfusion imaging, positron emission tomography, magnetic resonance spectroscopy, and magnetoencephalography, we address how neuroimaging can be used in HD trials to: 1) Aid patient selection, enrichment, stratification, and safety monitoring; 2) Demonstrate biodistribution, target engagement, and pharmacodynamics; 3) Provide evidence for disease modification; and 4) Understand brain re-organization following therapy. We also present the challenges of translating research methodology into clinical trial settings, including equipment requirements and cost, standardization of acquisition and analysis, patient burden and invasiveness, and interpretation of results. We conclude, that with appropriate consideration of modality, study design and analysis, imaging has huge potential to facilitate effective clinical trials in HD.
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Affiliation(s)
- Nicola Z Hobbs
- HD Research Centre, UCL Institute of Neurology, UCL, London, UK
| | - Marina Papoutsi
- HD Research Centre, UCL Institute of Neurology, UCL, London, UK
- IXICO plc, London, UK
| | - Aline Delva
- Department of Neurosciences, KU Leuven, Belgium
- Department of Neurology, University Hospitals Leuven, Belgium
| | | | | | - Koen Van Laere
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, KU Leuven, Belgium
- Division of Nuclear Medicine, University Hospitals Leuven, Belgium
| | - Wim Vandenberghe
- Department of Neurosciences, KU Leuven, Belgium
- Department of Neurology, University Hospitals Leuven, Belgium
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Bonassi G, Semprini M, Mandich P, Trevisan L, Marchese R, Lagravinese G, Barban F, Pelosin E, Chiappalone M, Mantini D, Avanzino L. Neural oscillations modulation during working memory in pre-manifest and early Huntington's disease. Brain Res 2023; 1820:148540. [PMID: 37598900 DOI: 10.1016/j.brainres.2023.148540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/21/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION We recently demonstrated specific spectral signatures associated with updating of memory information, working memory (WM) maintenance and readout, with relatively high spatial resolution by means of high-density electroencephalography (hdEEG). WM is impaired already in early symptomatic HD (early-HD) and in pre-manifest HD (pre-HD). The aim of this study was to test whether hdEEG coupled to source localization allows for the identification of neuronal oscillations in specific frequency bands in 16 pre-HD and early-HD during different phases of a WM task. METHODS We examined modulation of neural oscillations by event-related synchronization and desynchronization (ERS/ERD) of θ, β, gamma low, γLOW and γHIGH EEG bands in a-priori selected large fronto-parietal network, including the insula and the cerebellum. RESULTS We found: (i) Reduced θ oscillations in HD with respect to controls in almost all the areas of the WM network during the update and readout phases; (ii) Modulation of β oscillations, which increased during the maintenance phase of the WM task in both groups; (iii) correlation of γHIGH oscillations during WM task with disease burden score in HD patients. CONCLUSIONS Our data show reduced phase-specific modulation of oscillations in pre-HD and early-HD, even in the presence of preserved dynamic of modulation. Particularly, reduced synchronization in the θ band in the areas of the WM network, consistent with abnormal long-range coordination of neuronal activity within this network, was found in update and readout phases in HD groups.
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Affiliation(s)
- Gaia Bonassi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy
| | - Marianna Semprini
- Rehab Technologies, Istituto Italiano di Tecnologia, 16163 Genoa, Italy
| | - Paola Mandich
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Lucia Trevisan
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | | | - Giovanna Lagravinese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Federico Barban
- Rehab Technologies, Istituto Italiano di Tecnologia, 16163 Genoa, Italy; Dept. of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, 16145 Genoa, Italy
| | - Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Michela Chiappalone
- Rehab Technologies, Istituto Italiano di Tecnologia, 16163 Genoa, Italy; Dept. of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, 16145 Genoa, Italy
| | - Dante Mantini
- Research Center for Motor Control and Neuroplasticity, KU Leuven, 3001 Leuven, Belgium; Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Laura Avanzino
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; Department of Experimental Medicine, Section of Human Physiology, University of Genoa, 16132 Genoa, Italy.
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3
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Roussakis AA, Gennaro M, Gordon MF, Reilmann R, Borowsky B, Rynkowski G, Lao-Kaim NP, Papoutsou Z, Savola JM, Hayden MR, Owen DR, Kalk N, Lingford-Hughes A, Gunn RN, Searle G, Tabrizi SJ, Piccini P. A PET-CT study on neuroinflammation in Huntington's disease patients participating in a randomized trial with laquinimod. Brain Commun 2023; 5:fcad084. [PMID: 37020532 PMCID: PMC10069663 DOI: 10.1093/braincomms/fcad084] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 12/19/2022] [Accepted: 03/17/2023] [Indexed: 04/05/2023] Open
Abstract
Microglia activation, an indicator of central nervous system inflammation, is believed to contribute to the pathology of Huntington's disease. Laquinimod is capable of regulating microglia. By targeting the translocator protein, 11C-PBR28 PET-CT imaging can be used to assess the state of regional gliosis in vivo and explore the effects of laquinimod treatment. This study relates to the LEGATO-HD, multi-centre, double-blinded, Phase 2 clinical trial with laquinimod (US National Registration: NCT02215616). Fifteen patients of the UK LEGATO-HD cohort (mean age: 45.2 ± 7.4 years; disease duration: 5.6 ± 3.0 years) were treated with laquinimod (0.5 mg, N = 4; 1.0 mg, N = 6) or placebo (N = 5) daily. All participants had one 11C-PBR28 PET-CT and one brain MRI scan before laquinimod (or placebo) and at the end of treatment (12 months apart). PET imaging data were quantified to produce 11C-PBR28 distribution volume ratios. These ratios were calculated for the caudate and putamen using the reference Logan plot with the corpus callosum as the reference region. Partial volume effect corrections (Müller-Gartner algorithm) were applied. Differences were sought in Unified Huntington's Disease Rating Scale scores and regional distribution volume ratios between baseline and follow-up and between the two treatment groups (laquinimod versus placebo). No significant change in 11C-PBR28 distribution volume ratios was found post treatment in the caudate and putamen for both those treated with laquinimod (N = 10) and those treated with placebo (N = 5). Over time, the patients treated with laquinimod did not show a significant clinical improvement. Data from the 11C-PBR28 PET-CT study indicate that laquinimod may not have affected regional translocator protein expression and clinical performance over the studied period.
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Affiliation(s)
| | - Marta Gennaro
- Brain Sciences, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
| | | | | | | | | | - Nicholas P Lao-Kaim
- Brain Sciences, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
| | - Zoe Papoutsou
- Brain Sciences, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
| | | | - Michael R Hayden
- Centre for Molecular Medicine and Therapeutics, BC Children’s Hospital and Research Institute, University of British Columbia, Vancouver V5Z 4H4, Canada
| | - David R Owen
- Brain Sciences, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
| | - Nicola Kalk
- Brain Sciences, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
| | - Anne Lingford-Hughes
- Brain Sciences, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
| | - Roger N Gunn
- Brain Sciences, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
- Invicro, Hammersmith Hospital,, London W12 0NN, UK
| | | | - Sarah J Tabrizi
- Huntington’s Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Paola Piccini
- Brain Sciences, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
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McColgan P, Gregory S, Zeun P, Zarkali A, Johnson EB, Parker C, Fayer K, Lowe J, Nair A, Estevez-Fraga C, Papoutsi M, Zhang H, Scahill RI, Tabrizi SJ, Rees G. Neurofilament light-associated connectivity in young-adult Huntington's disease is related to neuronal genes. Brain 2022; 145:3953-3967. [PMID: 35758263 PMCID: PMC9679168 DOI: 10.1093/brain/awac227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 05/27/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
Upregulation of functional network connectivity in the presence of structural degeneration is seen in the premanifest stages of Huntington's disease (preHD) 10-15 years from clinical diagnosis. However, whether widespread network connectivity changes are seen in gene carriers much further from onset has yet to be explored. We characterized functional network connectivity throughout the brain and related it to a measure of disease pathology burden (CSF neurofilament light, NfL) and measures of structural connectivity in asymptomatic gene carriers, on average 24 years from onset. We related these measurements to estimates of cortical and subcortical gene expression. We found no overall differences in functional (or structural) connectivity anywhere in the brain comparing control and preHD participants. However, increased functional connectivity, particularly between posterior cortical areas, correlated with increasing CSF NfL level in preHD participants. Using the Allen Human Brain Atlas and expression-weighted cell-type enrichment analysis, we demonstrated that this functional connectivity upregulation occurred in cortical regions associated with regional expression of genes specific to neuronal cells. This relationship was validated using single-nucleus RNAseq data from post-mortem Huntington's disease and control brains showing enrichment of neuronal-specific genes that are differentially expressed in Huntington's disease. Functional brain networks in asymptomatic preHD gene carriers very far from disease onset show evidence of upregulated connectivity correlating with increased disease burden. These changes occur among brain areas that show regional expression of genes specific to neuronal GABAergic and glutamatergic cells.
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Affiliation(s)
- Peter McColgan
- Huntington’s Disease Centre, Department of Neurodegenerative disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Sarah Gregory
- Huntington’s Disease Centre, Department of Neurodegenerative disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Paul Zeun
- Huntington’s Disease Centre, Department of Neurodegenerative disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Angeliki Zarkali
- Dementia Research Centre, University College London, London WC1N 3AR, UK
| | - Eileanoir B Johnson
- Huntington’s Disease Centre, Department of Neurodegenerative disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Christopher Parker
- Department of Computer Science and Centre for Medical Image Computing, University College London, London WC1V 6LJ, UK
| | - Kate Fayer
- Huntington’s Disease Centre, Department of Neurodegenerative disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Jessica Lowe
- Huntington’s Disease Centre, Department of Neurodegenerative disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Akshay Nair
- Huntington’s Disease Centre, Department of Neurodegenerative disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Carlos Estevez-Fraga
- Huntington’s Disease Centre, Department of Neurodegenerative disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Marina Papoutsi
- Huntington’s Disease Centre, Department of Neurodegenerative disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Hui Zhang
- Dementia Research Centre, University College London, London WC1N 3AR, UK
| | - Rachael I Scahill
- Huntington’s Disease Centre, Department of Neurodegenerative disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Sarah J Tabrizi
- Huntington’s Disease Centre, Department of Neurodegenerative disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
- Dementia Research Centre, University College London, London WC1N 3AR, UK
| | - Geraint Rees
- University College London Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK
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5
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Tabrizi SJ, Schobel S, Gantman EC, Mansbach A, Borowsky B, Konstantinova P, Mestre TA, Panagoulias J, Ross CA, Zauderer M, Mullin AP, Romero K, Sivakumaran S, Turner EC, Long JD, Sampaio C. A biological classification of Huntington's disease: the Integrated Staging System. Lancet Neurol 2022; 21:632-644. [PMID: 35716693 DOI: 10.1016/s1474-4422(22)00120-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 02/11/2022] [Accepted: 03/11/2022] [Indexed: 12/24/2022]
Abstract
The current research paradigm for Huntington's disease is based on participants with overt clinical phenotypes and does not address its pathophysiology nor the biomarker changes that can precede by decades the functional decline. We have generated a new research framework to standardise clinical research and enable interventional studies earlier in the disease course. The Huntington's Disease Integrated Staging System (HD-ISS) comprises a biological research definition and evidence-based staging centred on biological, clinical, and functional assessments. We used a formal consensus method that involved representatives from academia, industry, and non-profit organisations. The HD-ISS characterises individuals for research purposes from birth, starting at Stage 0 (ie, individuals with the Huntington's disease genetic mutation without any detectable pathological change) by using a genetic definition of Huntington's disease. Huntington's disease progression is then marked by measurable indicators of underlying pathophysiology (Stage 1), a detectable clinical phenotype (Stage 2), and then decline in function (Stage 3). Individuals can be precisely classified into stages based on thresholds of stage-specific landmark assessments. We also demonstrated the internal validity of this system. The adoption of the HD-ISS could facilitate the design of clinical trials targeting populations before clinical motor diagnosis and enable data standardisation across ongoing and future studies.
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Affiliation(s)
- Sarah J Tabrizi
- UCL Huntington's Disease Centre, Department of Neurodegenerative Diseases, UCL Queen Square Institute of Neurology, UK Dementia Research Institute, University College London, UK.
| | - Scott Schobel
- Product Development Neuroscience, F Hoffmann-La Roche, Basel, Switzerland
| | | | | | | | | | - Tiago A Mestre
- Parkinson's Disease and Movement Disorders Centre, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | | | - Christopher A Ross
- Division of Neurobiology, Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Departments of Neurology, Neuroscience, and Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - Klaus Romero
- Critical Path Institute, Tucson, Arizona 85718, USA
| | | | | | - Jeffrey D Long
- Department of Psychiatry, Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - Cristina Sampaio
- CHDI Management/CHDI Foundation, Princeton, NJ, USA; Clinical Pharmacology Laboratory, Faculdade de Medicina de Lisboa, University of Lisbon, Lisbon, Portugal.
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Khan W, Alusi S, Tawfik H, Hussain A. The relationship between non-motor features and weight-loss in the premanifest stage of Huntington's disease. PLoS One 2021; 16:e0253817. [PMID: 34197537 PMCID: PMC8248657 DOI: 10.1371/journal.pone.0253817] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/14/2021] [Indexed: 11/19/2022] Open
Abstract
Weight-loss is an integral part of Huntington's disease (HD) that can start before the onset of motor symptoms. Investigating the underlying pathological processes may help in the understanding of this devastating disease as well as contribute to its management. However, the complex behavior and associations of multiple biological factors is impractical to be interpreted by the conventional statistics or human experts. For the first time, we combine a clinical dataset, expert knowledge and machine intelligence to model the multi-dimensional associations between the potentially relevant factors and weight-loss activity in HD, specifically at the premanifest stage. The HD dataset is standardized and transformed into required knowledge base with the help of clinical HD experts, which is then processed by the class rule mining and self-organising maps to identify the significant associations. Statistical results and experts' report indicate a strong association between severe weight-loss in HD at the premanifest stage and measures of certain cognitive, psychiatric functional ability factors. These results suggest that the mechanism underlying weight-loss in HD is, at least partly related to dysfunction of certain areas of the brain, a finding that may have not been apparent otherwise. These associations will aid the understanding of the pathophysiology of the disease and its progression and may in turn help in HD treatment trials.
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Affiliation(s)
- Wasiq Khan
- School of Computer Science and Mathematics, Liverpool John Moores University, Liverpool, United Kingdom
| | - Sundus Alusi
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Hissam Tawfik
- School of Built Environment, Engineering and Computing, Leeds Beckett University, Leeds, United Kingdom
| | - Abir Hussain
- School of Computer Science and Mathematics, Liverpool John Moores University, Liverpool, United Kingdom
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7
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Langley C, Gregory S, Osborne-Crowley K, O'Callaghan C, Zeun P, Lowe J, Johnson EB, Papoutsi M, Scahill RI, Rees G, Tabrizi SJ, Robbins TW, Sahakian BJ. Fronto-striatal circuits for cognitive flexibility in far from onset Huntington's disease: evidence from the Young Adult Study. J Neurol Neurosurg Psychiatry 2021; 92:143-149. [PMID: 33130575 PMCID: PMC7841479 DOI: 10.1136/jnnp-2020-324104] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/11/2020] [Accepted: 09/22/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Cognitive flexibility, which is key for adaptive decision-making, engages prefrontal cortex (PFC)-striatal circuitry and is impaired in both manifest and premanifest Huntington's disease (pre-HD). The aim of this study was to examine cognitive flexibility in a far from onset pre-HD cohort to determine whether an early impairment exists and if so, whether fronto-striatal circuits were associated with this deficit. METHODS In the present study, we examined performance of 51 pre-HD participants (mean age=29.22 (SD=5.71) years) from the HD Young Adult Study cohort and 53 controls matched for age, sex and IQ, on the Cambridge Neuropsychological Test Automated Battery (CANTAB) Intra-Extra Dimensional Set-Shift (IED) task. This cohort is unique as it is the furthest from disease onset comprehensively studied to date (mean years=23.89 (SD=5.96) years). The IED task measures visual discrimination learning, cognitive flexibility and specifically attentional set-shifting. We used resting-state functional MRI to examine whether the functional connectivity between specific fronto-striatal circuits was dysfunctional in pre-HD, compared with controls, and whether these circuits were associated with performance on the critical extradimensional shift stage. RESULTS Our results demonstrated that the CANTAB IED task detects a mild early impairment in cognitive flexibility in a pre-HD group far from onset. Attentional set-shifting was significantly related to functional connectivity between the ventrolateral PFC and ventral striatum in healthy controls and to functional connectivity between the dorsolateral PFC and caudate in pre-HD participants. CONCLUSION We postulate that this incipient impairment of cognitive flexibility may be associated with intrinsically abnormal functional connectivity of fronto-striatal circuitry in pre-HD.
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Affiliation(s)
| | - Sarah Gregory
- Huntington's Disease Centre, Department of Neurodegenerative disease, Institute of Neurology, University College London, London, UK
| | - Katie Osborne-Crowley
- Huntington's Disease Centre, Department of Neurodegenerative disease, Institute of Neurology, University College London, London, UK
- Division of Equity, Diversity and Inclusion, University of New South Wales, Sydney, New South Wales, Australia
| | - Claire O'Callaghan
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Paul Zeun
- Huntington's Disease Centre, Department of Neurodegenerative disease, Institute of Neurology, University College London, London, UK
| | - Jessica Lowe
- Huntington's Disease Centre, Department of Neurodegenerative disease, Institute of Neurology, University College London, London, UK
| | - Eileanoir B Johnson
- Huntington's Disease Centre, Department of Neurodegenerative disease, Institute of Neurology, University College London, London, UK
| | - Marina Papoutsi
- Huntington's Disease Centre, Department of Neurodegenerative disease, Institute of Neurology, University College London, London, UK
| | - Rachael I Scahill
- Huntington's Disease Centre, Department of Neurodegenerative disease, Institute of Neurology, University College London, London, UK
| | - Geraint Rees
- University College London Institute of Cognitive Neuroscience, UCL, London, UK
| | - Sarah J Tabrizi
- Huntington's Disease Centre, Department of Neurodegenerative disease, Institute of Neurology, University College London, London, UK
| | - Trevor W Robbins
- Department of Psychology and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
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Tan B, Shishegar R, Poudel GR, Fornito A, Georgiou-Karistianis N. Cortical morphometry and neural dysfunction in Huntington's disease: a review. Eur J Neurol 2020; 28:1406-1419. [PMID: 33210786 DOI: 10.1111/ene.14648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/22/2020] [Accepted: 11/12/2020] [Indexed: 01/09/2023]
Abstract
Numerous neuroimaging techniques have been used to identify biomarkers of disease progression in Huntington's disease (HD). To date, the earliest and most sensitive of these is caudate volume; however, it is becoming increasingly evident that numerous changes to cortical structures, and their interconnected networks, occur throughout the course of the disease. The mechanisms by which atrophy spreads from the caudate to these cortical regions remains unknown. In this review, the neuroimaging literature specific to T1-weighted and diffusion-weighted magnetic resonance imaging is summarized and new strategies for the investigation of cortical morphometry and the network spread of degeneration in HD are proposed. This new avenue of research may enable further characterization of disease pathology and could add to a suite of biomarker/s of disease progression for patient stratification that will help guide future clinical trials.
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Affiliation(s)
- Brendan Tan
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Rosita Shishegar
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia.,Australian e-Health Research Centre, CSIRO, Melbourne, VIC, Australia.,Monash Biomedical Imaging, Melbourne, VIC, Australia
| | - Govinda R Poudel
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia.,Sydney Imaging, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.,Australian Catholic University, Melbourne, VIC, Australia
| | - Alex Fornito
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia.,Monash Biomedical Imaging, Melbourne, VIC, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
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9
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Shishegar R, Harding IH, Corben LA, Delatycki MB, Storey E, Egan GF, Georgiou-Karistianis N. Longitudinal Increases in Cerebral Brain Activation During Working Memory Performance in Friedreich Ataxia: 24-Month Data from IMAGE-FRDA. THE CEREBELLUM 2020; 19:182-191. [PMID: 31898277 DOI: 10.1007/s12311-019-01094-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Friedreich ataxia (FRDA) has been associated with functional abnormalities in cerebral and cerebellar networks, particularly in the ventral attention network. However, how functional alterations change with disease progression remains largely unknown. Longitudinal changes in brain activation, associated with working memory performance (N-back task), and grey matter volume were assessed over 24 months in 21 individuals with FRDA and 28 healthy controls using functional and structural magnetic resonance imaging, respectively. Participants also completed a neurocognitive battery assessing working memory (digit span), executive function (Stroop, Haylings), and set-shifting (Trail Making Test). Individuals with FRDA displayed significantly increased brain activation over 24 months in ventral attention brain regions, including bilateral insula and inferior frontal gyrus (pars triangularis and pars opercularis), compared with controls, but there was no difference in working memory (N-back) performance between groups. Moreover, there were no significant differences in grey matter volume changes between groups. Significant correlations between brain activations and both clinical severity and age at disease onset were observed in FRDA individuals only at 24 months. There was significant longitudinal decline in Trail Making Test (TMT) difference score (B-A) in individuals with FRDA, compared with controls. These findings provide the first evidence of increased longitudinal activation over time in the cerebral cortex in FRDA, compared with controls, despite comparable working memory performance. This finding represents a possible compensatory response in the ventral attention network to help sustain working memory performance in individuals with FRDA.
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Affiliation(s)
- Rosita Shishegar
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Monash Biomedical Imaging, Monash University, Melbourne, Australia.,The Australian e-Health Research Centre, CSIRO, Melbourne, Australia
| | - Ian H Harding
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Louise A Corben
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Martin B Delatycki
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Clinical Genetics, Austin Health, Melbourne, Australia
| | - Elsdon Storey
- Department of Medicine, Monash University, Melbourne, Australia
| | - Gary F Egan
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
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Cheong RY, Gabery S, Petersén Å. The Role of Hypothalamic Pathology for Non-Motor Features of Huntington's Disease. J Huntingtons Dis 2020; 8:375-391. [PMID: 31594240 PMCID: PMC6839491 DOI: 10.3233/jhd-190372] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Huntington’s disease (HD) is a fatal genetic neurodegenerative disorder. It has mainly been considered a movement disorder with cognitive symptoms and these features have been associated with pathology of the striatum and cerebral cortex. Importantly, individuals with the mutant huntingtin gene suffer from a spectrum of non-motor features often decades before the motor disorder manifests. These symptoms and signs include a range of psychiatric symptoms, sleep problems and metabolic changes with weight loss particularly in later stages. A higher body mass index at diagnosis is associated with slower disease progression. The common psychiatric symptom of apathy progresses with the disease. The fact that non-motor features are present early in the disease and that they show an association to disease progression suggest that unravelling the underlying neurobiological mechanisms may uncover novel targets for early disease intervention and better symptomatic treatment. The hypothalamus and the limbic system are important brain regions that regulate emotion, social cognition, sleep and metabolism. A number of studies using neuroimaging, postmortem human tissue and genetic manipulation in animal models of the disease has collectively shown that the hypothalamus and the limbic system are affected in HD. These findings include the loss of neuropeptide-expressing neurons such as orexin (hypocretin), oxytocin, vasopressin, somatostatin and VIP, and increased levels of SIRT1 in distinct nuclei of the hypothalamus. This review provides a summary of the results obtained so far and highlights the potential importance of these changes for the understanding of non-motor features in HD.
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Affiliation(s)
- Rachel Y Cheong
- Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Sanaz Gabery
- Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Åsa Petersén
- Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
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11
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Ganguly J, Murgai A, Sharma S, Aur D, Jog M. Non-invasive Transcranial Electrical Stimulation in Movement Disorders. Front Neurosci 2020; 14:522. [PMID: 32581682 PMCID: PMC7290124 DOI: 10.3389/fnins.2020.00522] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/27/2020] [Indexed: 12/19/2022] Open
Abstract
Dysfunction within large-scale brain networks as the basis for movement disorders is an accepted hypothesis. The treatment options for restoring network function are limited. Non-invasive brain stimulation techniques such as repetitive transcranial magnetic stimulation are now being studied to modify the network. Transcranial electrical stimulation (tES) is also a portable, cost-effective, and non-invasive way of network modulation. Transcranial direct current stimulation and transcranial alternating current stimulation have been studied in Parkinson’s disease, dystonia, tremor, and ataxia. Transcranial pulsed current stimulation and transcranial random noise stimulation are not yet studied enough. The literature in the use of these techniques is intriguing, yet many unanswered questions remain. In this review, we highlight the studies using these four potential tES techniques and their electrophysiological basis and consider the therapeutic implication in the field of movement disorders. The objectives are to consolidate the current literature, demonstrate that these methods are feasible, and encourage the application of such techniques in the near future.
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Affiliation(s)
- Jacky Ganguly
- Movement Disorder Centre, London Health Sciences Centre, The University of Western Ontario, London, ON, Canada
| | - Aditya Murgai
- Movement Disorder Centre, London Health Sciences Centre, The University of Western Ontario, London, ON, Canada
| | - Soumya Sharma
- Movement Disorder Centre, London Health Sciences Centre, The University of Western Ontario, London, ON, Canada
| | - Dorian Aur
- Movement Disorder Centre, London Health Sciences Centre, The University of Western Ontario, London, ON, Canada
| | - Mandar Jog
- Movement Disorder Centre, London Health Sciences Centre, The University of Western Ontario, London, ON, Canada
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12
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Furlong LS, Jakabek D, Power BD, Owens-Walton C, Wilkes FA, Walterfang M, Velakoulis D, Egan G, Looi JC, Georgiou-Karistianis N. Morphometric in vivo evidence of thalamic atrophy correlated with cognitive and motor dysfunction in Huntington's disease: The IMAGE-HD study. Psychiatry Res Neuroimaging 2020; 298:111048. [PMID: 32120305 DOI: 10.1016/j.pscychresns.2020.111048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 02/09/2020] [Accepted: 02/14/2020] [Indexed: 01/18/2023]
Abstract
In Huntington's disease (HD), neurodegeneration causes progressive atrophy to the striatum, cortical areas, and white matter tracts - components of corticostriatal circuitry. Such processes may affect the thalamus, a key circuit node. We investigated whether differences in dorsal thalamic morphology were detectable in HD, and whether thalamic atrophy was associated with neurocognitive, neuropsychiatric and motor dysfunction. Magnetic resonance imaging scans and clinical outcome measures were obtained from 34 presymptomatic HD (pre-HD), 29 early symptomatic HD (symp-HD), and 26 healthy control individuals who participated in the IMAGE-HD study. Manual region of interest (ROI) segmentation was conducted to measure dorsal thalamic volume, and thalamic ROI underwent shape analysis using the spherical harmonic point distribution method. The symp-HD group had significant thalamic volumetric reduction and global shape deflation, indicative of atrophy, compared to pre-HD and control groups. Thalamic atrophy significantly predicted neurocognitive and motor dysfunction within the symp-HD group only. Thalamic morphology differentiates symp-HD from pre-HD and healthy individuals. Thalamic changes may be one of the structural bases (endomorphotypes), of the endophenotypic neurocognitive and motor manifestations of disease. Future research should continue to investigate the thalamus as a potential in vivo biomarker of disease progression in HD.
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Affiliation(s)
- Lisa S Furlong
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, School of Clinical Medicine, Australian National University Medical School, Canberra, Australia; John Curtin School of Medical Research, Australian National University, Canberra, Australia.
| | - David Jakabek
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
| | - Brian D Power
- School of Medicine Fremantle, The University of Notre Dame Australia, Fremantle, Australia; Clinical Research Centre, North Metropolitan Health Service - Mental Health, WA, Australia
| | - Conor Owens-Walton
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, School of Clinical Medicine, Australian National University Medical School, Canberra, Australia
| | - Fiona A Wilkes
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, School of Clinical Medicine, Australian National University Medical School, Canberra, Australia
| | - Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne Neuropsychiatry Centre, and University of Melbourne, Melbourne, Australia
| | - Dennis Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne Neuropsychiatry Centre, and University of Melbourne, Melbourne, Australia
| | - Gary Egan
- School of Psychological Sciences and The Turner Institute for Brain and Mental Health Monash University, Clayton, Australia; Monash Biomedical Imaging, Monash University, Clayton, Australia; Life Sciences Computation Centre, Victorian Life Sciences Computation Initiative, Melbourne, Australia
| | - Jeffrey Cl Looi
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, School of Clinical Medicine, Australian National University Medical School, Canberra, Australia; Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne Neuropsychiatry Centre, and University of Melbourne, Melbourne, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences and The Turner Institute for Brain and Mental Health Monash University, Clayton, Australia
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13
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Jamadar SD. The CRUNCH model does not account for load-dependent changes in visuospatial working memory in older adults. Neuropsychologia 2020; 142:107446. [PMID: 32234498 DOI: 10.1016/j.neuropsychologia.2020.107446] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 01/23/2023]
Abstract
Numerous neuroimaging studies have shown that older adults tend to activate the brain to a greater extent than younger adults during the performance of a task. This is typically interpreted as evidence for cognitive compensation. The Compensation-Related Utilisation of Neural Circuits Hypothesis (CRUNCH) model is a highly influential model of compensation, and states that increased functional magnetic resonance imaging (fMRI) activity in older adults compared to younger adults should reverse at higher levels of task difficulty. Here, the CRUNCH model was tested using a visuospatial working memory paradigm. fMRI activity in older vs. younger adults was in the opposite direction to that predicted by the model. Given that the CRUNCH model is the predominant model of compensation, this result was surprising. These results were followed up with a systematic review of the CRUNCH in healthy ageing literature. A surprisingly small number of published studies (4) have tested the predictions of the CRUNCH model. Further experimental work is required to validate the CRUNCH model in cognitive ageing.
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Affiliation(s)
- Sharna D Jamadar
- Turner Institute for Brain and Mental Health, Monash University, Wellington Rd, Melbourne, VIC, 3800, Australia; Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Melbourne, VIC, 3800, Australia; Australian Research Council Centre of Excellence for Integrative Brain Function, Melbourne, VIC, 3800, Australia.
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14
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Soloveva MV, Jamadar SD, Hughes M, Velakoulis D, Poudel G, Georgiou-Karistianis N. Brain compensation during response inhibition in premanifest Huntington's disease. Brain Cogn 2020; 141:105560. [PMID: 32179366 DOI: 10.1016/j.bandc.2020.105560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 01/21/2023]
Abstract
Premanifest Huntington's disease (pre-HD) individuals typically show increased task-related functional magnetic resonance imaging (fMRI), suggested to reflect compensatory strategies. Despite the evidence, no study has attempted to understand the compensatory process in light of 'formal' models of compensation. We used a quantitative model of compensation - the Compensation-Related Utilization of Neural Circuits Hypothesis (CRUNCH), to characterise compensation in pre-HD using fMRI. Pre-HD individuals (n = 15) and controls (n = 15) performed a modified stop-signal task that incremented in four levels of stop difficulty. Our results did not support the critical assumption of the CRUNCH model - controls did not show increased fMRI activity with increased level of stop difficulty; however, controls showed decreased fMRI activity with increased stop difficulty in right inferior frontal gyrus and right caudate nucleus. Relative to controls, pre-HD individuals showed increased fMRI activity in right inferior frontal gyrus and in right caudate nucleus at higher levels of stop difficulty, which is the opposite effect to that predicted by the model. Our findings suggest a compensatory process of the response inhibition network in pre-HD; however, the pattern of fMRI activity was not in the manner expected by CRUNCH.
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Affiliation(s)
- Maria V Soloveva
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria 3800, Australia
| | - Sharna D Jamadar
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria 3800, Australia; Monash Biomedical Imaging, 770 Blackburn Road, Clayton, Victoria 3800, Australia; Australian Research Council Centre of Excellence for Integrative Brain Function, Clayton, Victoria 3800, Australia
| | - Matthew Hughes
- School of Health Sciences, Brain and Psychological Sciences Centre, Swinburne University, Hawthorn, Victoria 3122, Australia
| | - Dennis Velakoulis
- Department of Psychiatry, Melbourne Neuropsychiatry Center, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Govinda Poudel
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria 3800, Australia; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria 3000, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria 3800, Australia.
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15
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Wijeratne PA, Johnson EB, Eshaghi A, Aksman L, Gregory S, Johnson HJ, Poudel GR, Mohan A, Sampaio C, Georgiou-Karistianis N, Paulsen JS, Tabrizi SJ, Scahill RI, Alexander DC. Robust Markers and Sample Sizes for Multicenter Trials of Huntington Disease. Ann Neurol 2020; 87:751-762. [PMID: 32105364 PMCID: PMC7187160 DOI: 10.1002/ana.25709] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 01/20/2023]
Abstract
Objective The identification of sensitive biomarkers is essential to validate therapeutics for Huntington disease (HD). We directly compare structural imaging markers across the largest collective imaging HD dataset to identify a set of imaging markers robust to multicenter variation and to derive upper estimates on sample sizes for clinical trials in HD. Methods We used 1 postprocessing pipeline to retrospectively analyze T1‐weighted magnetic resonance imaging (MRI) scans from 624 participants at 3 time points, from the PREDICT‐HD, TRACK‐HD, and IMAGE‐HD studies. We used mixed effects models to adjust regional brain volumes for covariates, calculate effect sizes, and simulate possible treatment effects in disease‐affected anatomical regions. We used our model to estimate the statistical power of possible treatment effects for anatomical regions and clinical markers. Results We identified a set of common anatomical regions that have similarly large standardized effect sizes (>0.5) between healthy control and premanifest HD (PreHD) groups. These included subcortical, white matter, and cortical regions and nonventricular cerebrospinal fluid (CSF). We also observed a consistent spatial distribution of effect size by region across the whole brain. We found that multicenter studies were necessary to capture treatment effect variance; for a 20% treatment effect, power of >80% was achieved for the caudate (n = 661), pallidum (n = 687), and nonventricular CSF (n = 939), and, crucially, these imaging markers provided greater power than standard clinical markers. Interpretation Our findings provide the first cross‐study validation of structural imaging markers in HD, supporting the use of these measurements as endpoints for both observational studies and clinical trials. ANN NEUROL 2020;87:751–762
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Affiliation(s)
- Peter A Wijeratne
- Center for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - Eileanoir B Johnson
- Huntington's Disease Research Center, Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom
| | - Arman Eshaghi
- Center for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom.,Queen Square Multiple Sclerosis Center, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Leon Aksman
- Center for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - Sarah Gregory
- Huntington's Disease Research Center, Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom
| | - Hans J Johnson
- Departments of Neurology and Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA.,Department of Biomedical Engineering, College of Engineering, University of Iowa, Iowa City, IA
| | - Govinda R Poudel
- Mary Mackillop Institute of Health Research, Australian Catholic University, Melbourne, Australia
| | | | | | - Nellie Georgiou-Karistianis
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Nursing, Medicine, and Health Sciences, Monash University, Clayton Campus, Victoria, Australia
| | - Jane S Paulsen
- Departments of Neurology and Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Sarah J Tabrizi
- Huntington's Disease Research Center, Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom
| | - Rachael I Scahill
- Huntington's Disease Research Center, Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom
| | | | - Daniel C Alexander
- Center for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
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16
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Soloveva MV, Jamadar SD, Velakoulis D, Poudel G, Georgiou-Karistianis N. Brain compensation during visuospatial working memory in premanifest Huntington's disease. Neuropsychologia 2020; 136:107262. [DOI: 10.1016/j.neuropsychologia.2019.107262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 01/21/2023]
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17
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Gregory S, Odish OFF, Mayer I, Mills J, Johnson EB, Scahill RI, Rothwell J, Rees G, Long JD, Tabrizi SJ, Roos RAC, Orth M. Multimodal characterization of the visual network in Huntington's disease gene carriers. Clin Neurophysiol 2019; 130:2053-2059. [PMID: 31541982 DOI: 10.1016/j.clinph.2019.08.018] [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: 06/11/2019] [Revised: 07/25/2019] [Accepted: 08/12/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE A sensorimotor network structural phenotype predicted motor task performance in a previous study in Huntington's disease (HD) gene carriers. We investigated in the visual network whether structure - function - behaviour relationship patterns, and the effects of the HD mutation, extended beyond the sensorimotor network. METHODS We used multimodal visual network MRI structural measures (cortical thickness and white matter connectivity), plus visual evoked potentials and task performance (Map Search; Symbol Digit Modalities Test) in healthy controls and HD gene carriers. RESULTS Using principal component (PC) analysis, we identified a structure - function relationship common to both groups. PC scores differed between groups indicating white matter disorganization (higher RD, lower FA) and slower, and more disperse, VEP signal transmission (higher VEP P100 latency and lower VEP P100 amplitude) in HD than controls while task performance was similar. CONCLUSIONS HD may be associated with reduced white matter organization and efficient visual network function but normal task performance. SIGNIFICANCE These findings indicate that structure - function relationships in the visual network, and the effects of the HD mutation, share some commonalities with those in the sensorimotor network. However, implications for task performance differ between the two networks suggesting the influence of network specific factors.
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Affiliation(s)
- Sarah Gregory
- Huntington's Disease Centre, UCL Institute of Neurology, London, UK
| | - Omar F F Odish
- Department of Neurology, University Medical Center Groningen, Groningen, the Netherlands
| | - Isabella Mayer
- Department of Neurology, Ulm University Hospital, Ulm, Germany
| | - James Mills
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | | | | | - John Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology, Queen Square, London, UK
| | - Geraint Rees
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK
| | - Jeffrey D Long
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA; Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - Sarah J Tabrizi
- Huntington's Disease Centre, UCL Institute of Neurology, London, UK
| | - Raymund A C Roos
- Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Michael Orth
- Department of Neurology, Ulm University Hospital, Ulm, Germany.
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18
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Pini L, Jacquemot C, Cagnin A, Meneghello F, Semenza C, Mantini D, Vallesi A. Aberrant brain network connectivity in presymptomatic and manifest Huntington's disease: A systematic review. Hum Brain Mapp 2019; 41:256-269. [PMID: 31532053 PMCID: PMC7268025 DOI: 10.1002/hbm.24790] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/29/2019] [Accepted: 08/26/2019] [Indexed: 12/12/2022] Open
Abstract
Resting‐state functional magnetic resonance imaging (rs‐fMRI) has the potential to shed light on the pathophysiological mechanisms of Huntington's disease (HD), paving the way to new therapeutic interventions. A systematic literature review was conducted in three online databases according to PRISMA guidelines, using keywords for HD, functional connectivity, and rs‐fMRI. We included studies investigating connectivity in presymptomatic (pre‐HD) and manifest HD gene carriers compared to healthy controls, implementing seed‐based connectivity, independent component analysis, regional property, and graph analysis approaches. Visual network showed reduced connectivity in manifest HD, while network/areas underpinning motor functions were consistently altered in both manifest HD and pre‐HD, showing disease stage‐dependent changes. Cognitive networks underlying executive and attentional functions showed divergent anterior–posterior alterations, possibly reflecting compensatory mechanisms. The involvement of these networks in pre‐HD is still unclear. In conclusion, aberrant connectivity of the sensory‐motor network is observed in the early stage of HD while, as pathology spreads, other networks might be affected, such as the visual and executive/attentional networks. Moreover, sensory‐motor and executive networks exhibit hyper‐ and hypo‐connectivity patterns following different spatiotemporal trajectories. These findings could potentially help to implement future huntingtin‐lowering interventions.
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Affiliation(s)
- Lorenzo Pini
- Department of Neuroscience & Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Charlotte Jacquemot
- Département d'Etudes Cognitives, Ecole Normale Supérieure-PSL University, Paris, France.,Laboratoire de NeuroPsychologie Interventionnelle, Institut Mondor de Recherche Biomédicale, Institut National de la Santé et Recherche Médical (INSERM) U955, Equipe 01, Créteil, France.,Faculté de Médecine, Université Paris Est Créteil, Créteil, France
| | - Annachiara Cagnin
- Department of Neuroscience & Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Francesca Meneghello
- Cognitive Neuroscience Research Group, IRCCS San Camillo Hospital, Venice, Italy
| | - Carlo Semenza
- Department of Neuroscience & Padova Neuroscience Center, University of Padova, Padova, Italy.,Cognitive Neuroscience Research Group, IRCCS San Camillo Hospital, Venice, Italy
| | - Dante Mantini
- Research Center for Motor Control and Neuroplasticity, KU Leuven, Leuven, Belgium.,Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
| | - Antonino Vallesi
- Department of Neuroscience & Padova Neuroscience Center, University of Padova, Padova, Italy.,Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
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19
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Shishegar R, Rajapakse S, Georgiou-Karistianis N. Altered Cortical Morphometry in Pre-manifest Huntington's Disease: Cross-sectional Data from the IMAGE-HD Study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2019:2844-2847. [PMID: 31946485 DOI: 10.1109/embc.2019.8857240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Huntington's disease (HD) is an inherited progressive neurodegenerative disease mainly associated with subcortical striatal atrophy. There is also strong evidence showing cerebral atrophy and cortical thinning; however, limited research has investigated altered patterns of cortical folding in this disease. Here, we investigated cortical morphometry via both gyrification index (GI, a measure of cortical folding) and cortical thinning. The localized GI was examined using a novel GI, namely LB-GI. As part of a cross-sectional study, pre-manifest (pre-HD) individuals (n = 29) and matched controls (n = 29) underwent T1-MRI using data from the IMAGE-HD study. Compared to controls, pre-HD individuals demonstrated significantly lower GI in the left superior parietal and the right superior temporal regions and greater cortical thinning in the bilateral pre-central and the superior frontal gyri and left caudal middle frontal gyrus, as well as the superior parietal region. For the first time, we report evidence of abnormal localized cortical folding in pre-HD. We also provide evidence that cortical folding impacts different regions of the cortical surface more so than cortical thickness. As a result, we propose a potential new biological marker that may increase our understanding of the neuropathology of HD. Greater understanding of brain changes could inform new therapeutic approaches and target points for clinical trials.
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20
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Johnson EB, Gregory S. Huntington's disease: Brain imaging in Huntington's disease. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019; 165:321-369. [PMID: 31481169 DOI: 10.1016/bs.pmbts.2019.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Huntington's disease (HD) gene-carriers show prominent neuronal loss by end-stage disease, and the use of magnetic resonance imaging (MRI) has been increasingly used to quantify brain changes during earlier stages of the disease. MRI offers an in vivo method of measuring structural and functional brain change. The images collected via MRI are processed to measure different anatomical features, such as brain volume, macro- and microstructural changes within white matter and functional brain activity. Structural imaging has demonstrated significant volume loss across multiple white and gray matter regions in HD, particularly within subcortical structures. There also appears to be increasing disorganization of white matter tracts and between-region connectivity with increasing disease progression. Finally, functional changes are thought to represent changes in brain activity underlying compensatory mechanisms in HD. This chapter will provide an overview of the principles of MRI and practicalities associated with using MRI in HD studies, and summarize findings from MRI studies investigating brain structure and function in HD.
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Affiliation(s)
- Eileanoir B Johnson
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sarah Gregory
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
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21
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Spatial memory in Huntington’s disease: A comparative review of human and animal data. Neurosci Biobehav Rev 2019; 98:194-207. [DOI: 10.1016/j.neubiorev.2019.01.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 11/26/2018] [Accepted: 01/14/2019] [Indexed: 12/24/2022]
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22
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Petrella LI, Castelhano JM, Ribeiro M, Sereno JV, Gonçalves SI, Laço MN, Hayden MR, Rego AC, Castelo-Branco M. A whole brain longitudinal study in the YAC128 mouse model of Huntington's disease shows distinct trajectories of neurochemical, structural connectivity and volumetric changes. Hum Mol Genet 2019; 27:2125-2137. [PMID: 29668904 DOI: 10.1093/hmg/ddy119] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/26/2018] [Indexed: 12/20/2022] Open
Abstract
Huntington's disease (HD) is a neurodegenerative disorder causing cognitive and motor impairments, evolving to death within 15-20 years after symptom onset. We previously established a mouse model with the entire human HD gene containing 128 CAG repeats (YAC128) which accurately recapitulates the natural history of the human disease. Defined time points in this natural history enable the understanding of longitudinal trajectories from the neurochemical and structural points of view using non-invasive high-resolution multi-modal imaging. Accordingly, we designed a longitudinal structural imaging (MRI and DTI) and spectroscopy (1H-MRS) study in YAC128, at 3, 6, 9 and 12 months of age, at 9.4 T. Structural analysis (MRI/DTI), confirmed that the striatum is the earliest affected brain region, but other regions were also identified through connectivity analysis (pre-frontal cortex, hippocampus, globus pallidus and thalamus), suggesting a striking homology with the human disease. Importantly, we found for the first time, a negative correlation between striatal and hippocampal changes only in YAC128. In fact, the striatum showed accelerated volumetric decay in HD, as opposed to the hippocampus. Neurochemical analysis of the HD striatum suggested early neurometabolic alterations in neurotransmission and metabolism, with a significant increase in striatal GABA levels, and specifically anticorrelated levels of N-acetyl aspartate and taurine, suggesting that the later is homeostatically adjusted for neuroprotection, as neural loss, indicated by the former, is progressing. These results provide novel insights into the natural history of HD and prove a valuable role for longitudinal multi-modal panels of structural and metabolite/neurotransmission in the YAC128 model.
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Affiliation(s)
- Lorena I Petrella
- Institute of Nuclear Science Applied to Health, University of Coimbra, 3000-548 Coimbra, Portugal.,Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal
| | - João M Castelhano
- Institute of Nuclear Science Applied to Health, University of Coimbra, 3000-548 Coimbra, Portugal.,Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Mario Ribeiro
- Institute of Nuclear Science Applied to Health, University of Coimbra, 3000-548 Coimbra, Portugal.,Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal
| | - José V Sereno
- Institute of Nuclear Science Applied to Health, University of Coimbra, 3000-548 Coimbra, Portugal.,Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Sónia I Gonçalves
- Institute of Nuclear Science Applied to Health, University of Coimbra, 3000-548 Coimbra, Portugal.,Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal.,Neuroplasticity and Neural Activity Laboratory, Champalimaud Centre for the Unknown, 1400-038 Lisbon, Portugal
| | - Mário N Laço
- Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Michael R Hayden
- Department of Medical Genetics, Centre for Molecular Medicine and Therapeutics, Child and Family Research Institute, University of British Columbia, Vancouver, BC V5Z 4H4, Canada
| | - A Cristina Rego
- Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Miguel Castelo-Branco
- Institute of Nuclear Science Applied to Health, University of Coimbra, 3000-548 Coimbra, Portugal.,Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
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Functional Magnetic Resonance Imaging in Huntington's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 142:381-408. [PMID: 30409260 DOI: 10.1016/bs.irn.2018.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Huntington's disease is an inherited neurodegenerative condition characterized by motor dysfunction, cognitive impairment and neuropsychiatric disturbance. The effects of the underlying pathology on brain morphology are relatively well understood. Numerous structural Magnetic Resonance Imaging (MRI) studies have demonstrated macrostructural change with widespread striatal and cortical atrophy and microstructural white matter loss in premanifest and manifest HD gene carriers. However, disease effects on brain function are less well characterized. Functional MRI provides an opportunity to examine differences in brain activity either in response to a particular task or in the brain at rest. There is increasing evidence that HD gene carriers exhibit altered activation patterns and functional connectivity between brain regions in response to the neurodegenerative process. Here we review the growing literature in this area and critically evaluate the utility of this imaging modality.
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Migliore S, D'Aurizio G, Curcio G, Squitieri F. Task-switching abilities in pre-manifest Huntington's disease subjects. Parkinsonism Relat Disord 2018; 60:111-117. [PMID: 30201420 DOI: 10.1016/j.parkreldis.2018.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/31/2018] [Accepted: 09/04/2018] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Huntington's Disease (HD) cognitive dysfunction occurs before unequivocal motor signs become apparent. The predominant early cognitive abnormal domains may include deficits in psychomotor speed, negative emotion recognition and executive functioning. Our study is aimed to investigate the executive control of cognition in pre-manifest (pre) HD subjects, by means of a task-switching protocol. METHODS We recruited 30 pre-HD subjects and 18 age-, sex- and education-matched Healthy Controls (HC). Subjects were assigned to two experimental groups: 15 pre-HD1 with a Total Motor Score (TMS) ≤4 (far from onset) and 15 pre-HD2 with a 5 ≤ TMS≤9 (near to onset and Diagnostic Confidence Level (DCL) still<4). Two different tasks were performed in rapid and random succession, so that the task was either changed from one trial to the next one (switch trials) or repeated (repetition trials). Switch trials are usually slower than repetitions, causing a so-called Switch Cost (SC). RESULTS Pre-HD subjects had worse performance than HC in the switch and repetition trials, as indicated by increased SC and reaction times. In particular, pre-HD2 showed impaired switching abilities with reaction times slower than pre-HD1 and HC. CONCLUSIONS Our study highlighted a task-switching impairment since HD was still at a pre-manifest stage. Such abnormalities worsen when pre-HD subjects start to show subtle motor manifestations, still nonspecific and insufficient to define the clinical diagnosis of HD (DCL<4). Considering that such abilities have obvious implications for activities of daily living, early cognitive rehabilitation programs addressing such deficits might be useful in the premanifest stage of the disease.
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Affiliation(s)
- Simone Migliore
- Huntington and Rare Diseases Unit, IRCCS Casa Sollievo della Sofferenza Hospital (Rome CSS-Mendel), Viale Cappuccini, 1, 71013, San Giovanni Rotondo, Italy.
| | - Giulia D'Aurizio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, 67100, Coppito, AQ, Italy
| | - Giuseppe Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, 67100, Coppito, AQ, Italy
| | - Ferdinando Squitieri
- Huntington and Rare Diseases Unit, IRCCS Casa Sollievo della Sofferenza Hospital (Rome CSS-Mendel), Viale Cappuccini, 1, 71013, San Giovanni Rotondo, Italy
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Lahr J, Minkova L, Tabrizi SJ, Stout JC, Klöppel S, Scheller E. Working Memory-Related Effective Connectivity in Huntington's Disease Patients. Front Neurol 2018; 9:370. [PMID: 29915555 PMCID: PMC5994408 DOI: 10.3389/fneur.2018.00370] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/07/2018] [Indexed: 11/30/2022] Open
Abstract
Huntington’s disease (HD) is a genetically caused neurodegenerative disorder characterized by heterogeneous motor, psychiatric, and cognitive symptoms. Although motor symptoms may be the most prominent presentation, cognitive symptoms such as memory deficits and executive dysfunction typically co-occur. We used functional magnetic resonance imaging (fMRI) and task fMRI-based dynamic causal modeling (DCM) to evaluate HD-related changes in the neural network underlying working memory (WM). Sixty-four pre-symptomatic HD mutation carriers (preHD), 20 patients with early manifest HD symptoms (earlyHD), and 83 healthy control subjects performed an n-back fMRI task with two levels of WM load. Effective connectivity was assessed in five predefined regions of interest, comprising bilateral inferior parietal cortex, left anterior cingulate cortex, and bilateral dorsolateral prefrontal cortex. HD mutation carriers performed less accurately and more slowly at high WM load compared with the control group. While between-group comparisons of brain activation did not reveal differential recruitment of the cortical WM network in mutation carriers, comparisons of brain connectivity as identified with DCM revealed a number of group differences across the whole WM network. Most strikingly, we observed decreasing connectivity from several regions toward right dorsolateral prefrontal cortex (rDLPFC) in preHD and even more so in earlyHD. The deterioration in rDLPFC connectivity complements results from previous studies and might mirror beginning cortical neural decline at premanifest and early manifest stages of HD. We were able to characterize effective connectivity in a WM network of HD mutation carriers yielding further insight into patterns of cognitive decline and accompanying neural deterioration.
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Affiliation(s)
- Jacob Lahr
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,Freiburg Brain Imaging Center, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - Lora Minkova
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,Freiburg Brain Imaging Center, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - Sarah J Tabrizi
- Department of Neurodegenerative Disease, Institute of Neurology, University College London, London, United Kingdom
| | - Julie C Stout
- School of Psychological Sciences, Institute of Clinical and Cognitive Neuroscience, Monash University, Melbourne, VIC, Australia
| | - Stefan Klöppel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,Freiburg Brain Imaging Center, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,Center for Geriatric Medicine and Gerontology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Elisa Scheller
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,Freiburg Brain Imaging Center, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany
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27
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Abstract
Magnetic resonance imaging (MRI) is a noninvasive technique used routinely to image the body in both clinical and research settings. Through the manipulation of radio waves and static field gradients, MRI uses the principle of nuclear magnetic resonance to produce images with high spatial resolution, appropriate for the investigation of brain structure and function.
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Affiliation(s)
- Sarah Gregory
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, UK.
| | - Rachael I Scahill
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, UK
| | - Geraint Rees
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, UK
| | - Sarah Tabrizi
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, UK
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28
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Selvadurai LP, Harding IH, Corben LA, Georgiou-Karistianis N. Cerebral abnormalities in Friedreich ataxia: A review. Neurosci Biobehav Rev 2018; 84:394-406. [DOI: 10.1016/j.neubiorev.2017.08.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 06/06/2017] [Accepted: 08/10/2017] [Indexed: 12/31/2022]
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Harding IH, Corben LA, Delatycki MB, Stagnitti MR, Storey E, Egan GF, Georgiou-Karistianis N. Cerebral compensation during motor function in Friedreich ataxia: The IMAGE-FRDA study. Mov Disord 2017; 32:1221-1229. [PMID: 28556242 DOI: 10.1002/mds.27023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 03/21/2017] [Accepted: 03/23/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Friedreich ataxia is characterized by progressive motor incoordination that is linked to peripheral, spinal, and cerebellar neuropathology. Cerebral abnormalities are also reported in Friedreich ataxia, but their role in disease expression remains unclear. METHODS In this cross-sectional functional magnetic resonance imaging study, 25 individuals with Friedreich ataxia and 33 healthy controls performed simple (self-paced single-finger) and complex (visually cued multifinger) tapping tasks to respectively gauge basic and attentionally demanding motor behavior. For each task, whole brain functional activations were compared between groups and correlated with disease severity and offline measures of motor dexterity. RESULTS During simple finger tapping, cerebral hyperactivation in individuals with Friedreich ataxia at the lower end of clinical severity and cerebral hypoactivation in those more severely affected was observed in premotor/ventral attention brain regions, including the supplementary motor area and anterior insula. Greater activation in this network correlated with greater offline finger tapping precision. Complex, attentionally demanding finger tapping was also associated with cerebral hyperactivation, but in this case within dorsolateral prefrontal regions of the executive control network and superior parietal regions of the dorsal attention system. Greater offline motor precision was associated with less activation in the dorsal attention network. DISCUSSION Compensatory activity is evident in the cerebral cortex in individuals with Friedreich ataxia. Early compensation followed by later decline in premotor/ventral attention systems demonstrates capacity-limited neural reserve, while the additional engagement of higher order brain networks is indicative of compensatory task strategies. Network-level changes in cerebral brain function thus potentially serve to mitigate the impact of motor impairments in Friedreich ataxia. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Ian H Harding
- School of Psychological Sciences & Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
| | - Louise A Corben
- School of Psychological Sciences & Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
- Bruce Lefroy Centre, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Martin B Delatycki
- School of Psychological Sciences & Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
- Bruce Lefroy Centre, Murdoch Childrens Research Institute, Melbourne, Australia
- Clinical Genetics, Austin Health, Melbourne, Australia
| | - Monique R Stagnitti
- School of Psychological Sciences & Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
| | - Elsdon Storey
- Department of Medicine, Monash University, Melbourne, Australia
| | - Gary F Egan
- School of Psychological Sciences & Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences & Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
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30
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Domínguez D JF, Poudel G, Stout JC, Gray M, Chua P, Borowsky B, Egan GF, Georgiou-Karistianis N. Longitudinal changes in the fronto-striatal network are associated with executive dysfunction and behavioral dysregulation in Huntington's disease: 30 months IMAGE-HD data. Cortex 2017; 92:139-149. [DOI: 10.1016/j.cortex.2017.04.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 12/16/2016] [Accepted: 04/05/2017] [Indexed: 12/17/2022]
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31
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Piano C, Imperatori C, Losurdo A, Bentivoglio AR, Cortelli P, Della Marca G. Sleep-related modifications of EEG connectivity in the sensory-motor networks in Huntington Disease: An eLORETA study and review of the literature. Clin Neurophysiol 2017; 128:1354-1363. [DOI: 10.1016/j.clinph.2016.11.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/22/2016] [Accepted: 11/25/2016] [Indexed: 11/29/2022]
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D JFD, Stout JC, Poudel G, Churchyard A, Chua P, Egan GF, Georgiou-Karistianis N. Multimodal imaging biomarkers in premanifest and early Huntington's disease: 30-month IMAGE-HD data. Br J Psychiatry 2016; 208:571-8. [PMID: 26678864 DOI: 10.1192/bjp.bp.114.156588] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 02/11/2015] [Indexed: 01/05/2023]
Abstract
BACKGROUND The discovery of potential disease-modifying therapies in a neurodegenerative condition like Huntington's disease depends on the availability of sensitive biomarkers that reflect decline across disease stages and that are functionally and clinically relevant. AIMS To quantify macrostructural and microstructural changes in participants with premanifest and symptomatic Huntington's disease over 30 months, and to establish their functional and clinical relevance. METHOD Multimodal magnetic resonance imaging study measuring changes in macrostructural (volume) and microstructural (diffusivity) measures in 40 patients with premanifest Huntington's disease, 36 patients with symptomatic Huntington's disease and 36 healthy control participants over three testing sessions spanning 30 months. RESULTS Relative to controls, there was greater longitudinal atrophy in participants with symptomatic Huntington's disease in whole brain, grey matter, caudate and putamen, as well as increased caudate fractional anisotropy; caudate volume loss was the only measure to differ between premanifest Huntington's disease and control groups. Changes in caudate volume and fractional anisotropy correlated with each other and neurocognitive decline; caudate volume loss also correlated with clinical and disease severity. CONCLUSIONS Caudate neurodegeneration, especially atrophy, may be the most suitable candidate surrogate biomarker for consideration in the development of upcoming clinical trials.
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Affiliation(s)
- Juan F Domínguez D
- Juan F. Domínguez D., PhD, Julie C. Stout, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Govinda Poudel, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia, Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia and VLSCI Life Sciences Computation Centre, Melbourne, Victoria, Australia; Andrew Churchyard, MD, PhD, Department of Neurology, Monash Medical Centre, Clayton, Victoria, Australia; Phyllis Chua, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Gary F. Egan, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia and Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia; Nellie Georgiou-Karistianis, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Julie C Stout
- Juan F. Domínguez D., PhD, Julie C. Stout, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Govinda Poudel, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia, Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia and VLSCI Life Sciences Computation Centre, Melbourne, Victoria, Australia; Andrew Churchyard, MD, PhD, Department of Neurology, Monash Medical Centre, Clayton, Victoria, Australia; Phyllis Chua, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Gary F. Egan, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia and Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia; Nellie Georgiou-Karistianis, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Govinda Poudel
- Juan F. Domínguez D., PhD, Julie C. Stout, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Govinda Poudel, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia, Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia and VLSCI Life Sciences Computation Centre, Melbourne, Victoria, Australia; Andrew Churchyard, MD, PhD, Department of Neurology, Monash Medical Centre, Clayton, Victoria, Australia; Phyllis Chua, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Gary F. Egan, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia and Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia; Nellie Georgiou-Karistianis, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Andrew Churchyard
- Juan F. Domínguez D., PhD, Julie C. Stout, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Govinda Poudel, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia, Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia and VLSCI Life Sciences Computation Centre, Melbourne, Victoria, Australia; Andrew Churchyard, MD, PhD, Department of Neurology, Monash Medical Centre, Clayton, Victoria, Australia; Phyllis Chua, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Gary F. Egan, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia and Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia; Nellie Georgiou-Karistianis, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Phyllis Chua
- Juan F. Domínguez D., PhD, Julie C. Stout, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Govinda Poudel, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia, Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia and VLSCI Life Sciences Computation Centre, Melbourne, Victoria, Australia; Andrew Churchyard, MD, PhD, Department of Neurology, Monash Medical Centre, Clayton, Victoria, Australia; Phyllis Chua, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Gary F. Egan, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia and Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia; Nellie Georgiou-Karistianis, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Gary F Egan
- Juan F. Domínguez D., PhD, Julie C. Stout, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Govinda Poudel, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia, Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia and VLSCI Life Sciences Computation Centre, Melbourne, Victoria, Australia; Andrew Churchyard, MD, PhD, Department of Neurology, Monash Medical Centre, Clayton, Victoria, Australia; Phyllis Chua, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Gary F. Egan, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia and Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia; Nellie Georgiou-Karistianis, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Nellie Georgiou-Karistianis
- Juan F. Domínguez D., PhD, Julie C. Stout, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Govinda Poudel, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia, Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia and VLSCI Life Sciences Computation Centre, Melbourne, Victoria, Australia; Andrew Churchyard, MD, PhD, Department of Neurology, Monash Medical Centre, Clayton, Victoria, Australia; Phyllis Chua, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Gary F. Egan, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia and Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia; Nellie Georgiou-Karistianis, PhD, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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33
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Domínguez JFD, Ng ACL, Poudel G, Stout JC, Churchyard A, Chua P, Egan GF, Georgiou-Karistianis N. Iron accumulation in the basal ganglia in Huntington's disease: cross-sectional data from the IMAGE-HD study. J Neurol Neurosurg Psychiatry 2016; 87:545-9. [PMID: 25952334 DOI: 10.1136/jnnp-2014-310183] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 04/19/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To measure iron accumulation in the basal ganglia in Huntington's disease (HD) using quantitative susceptibility mapping (QSM), and to ascertain its relevance in terms of clinical and disease severity. METHODS In this cross-sectional investigation, T2* weighted imaging was undertaken on 31 premanifest HD, 32 symptomatic HD and 30 control participants as part of the observational IMAGE-HD study. Group differences in iron accumulation were ascertained with QSM. Associations between susceptibility values and disease severity were also investigated. RESULTS Compared with controls, both premanifest and symptomatic HD groups showed significantly greater iron content in pallidum, putamen and caudate. Additionally, iron accumulation in both putamen and caudate was significantly associated with disease severity. CONCLUSIONS These findings provide the first evidence that QSM is sensitive to iron deposition in subcortical target areas across premanifest and symptomatic stages of HD. Such findings could open up new avenues for biomarker development and therapeutic intervention.
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Affiliation(s)
- Juan F D Domínguez
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Amanda C L Ng
- Department of Anatomy and Neuroscience, The University of Melbourne, Parkville, Victoria, Australia
| | - Govinda Poudel
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia VLSCI Life Sciences Computation Centre, Melbourne, Victoria, Australia
| | - Julie C Stout
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Andrew Churchyard
- Department of Neurology, Monash Medical Centre, Clayton, Victoria, Australia
| | - Phyllis Chua
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Gary F Egan
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia
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Subjective sleep problems in Huntington's disease: A pilot investigation of the relationship to brain structure, neurocognitive, and neuropsychiatric function. J Neurol Sci 2016; 364:148-53. [PMID: 27084236 DOI: 10.1016/j.jns.2016.03.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 03/10/2016] [Accepted: 03/11/2016] [Indexed: 01/27/2023]
Abstract
Subjective reports of sleep disturbance are a common feature of Huntington's disease (HD); however, there is limited research investigating the relationship between sleep problems with changes in brain and behaviour. This study aimed to investigate whether subjective reports of sleep problems in HD are associated with brain volume, neurocognitive decline, and neuropsychiatric symptoms. This retrospective pilot study used brain volume, neurocognitive and neuropsychiatric data from premanifest (pre-HD) and symptomatic HD (symp-HD). Subjective sleep problem was measured using the sleep item of the Beck's Depression Inventory-II (BDI-II). Pre-HD individuals reporting sleep problems had significantly poorer neuropsychiatric outcomes compared to those not reporting sleep problems. In the symp-HD group, those with sleep problems had significantly accelerated thalamic degeneration and poorer neuropsychiatric outcomes compared to those without sleep problems. There was no relationship between subjective sleep problems and neurocognitive measures. These findings suggest an association between subjective sleep disturbance, neuropathology, and development of neuropsychiatric symptoms in HD. Further studies using quantitative EEG-based monitoring of sleep in HD and changes in the brain and behaviour will be necessary to establish the causal nature of this relationship.
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fMRI in Neurodegenerative Diseases: From Scientific Insights to Clinical Applications. NEUROMETHODS 2016. [DOI: 10.1007/978-1-4939-5611-1_23] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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36
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Poudel GR, Driscoll S, Domínguez D JF, Stout JC, Churchyard A, Chua P, Egan GF, Georgiou-Karistianis N. Functional Brain Correlates of Neuropsychiatric Symptoms in Presymptomatic Huntington’s Disease: The IMAGE-HD Study. J Huntingtons Dis 2015; 4:325-32. [DOI: 10.3233/jhd-150154] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Govinda R. Poudel
- Monash Institute of Cognitive and Clinical Neurosciences/School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Life Sciences Computation Centre, Victorian Life Sciences Computation Initiative (VLSCI), Melbourne, Victoria, Australia
| | - Shannon Driscoll
- Monash Institute of Cognitive and Clinical Neurosciences/School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Juan F. Domínguez D
- Monash Institute of Cognitive and Clinical Neurosciences/School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Julie C. Stout
- Monash Institute of Cognitive and Clinical Neurosciences/School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Andrew Churchyard
- Department of Neurology, Monash Medical Centre, Clayton, Victoria, Australia
| | - Phyllis Chua
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Gary F. Egan
- Monash Institute of Cognitive and Clinical Neurosciences/School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Nellie Georgiou-Karistianis
- Monash Institute of Cognitive and Clinical Neurosciences/School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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37
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Stout JC, Glikmann-Johnston Y, Andrews SC. Cognitive assessment strategies in Huntington's disease research. J Neurosci Methods 2015; 265:19-24. [PMID: 26719240 DOI: 10.1016/j.jneumeth.2015.12.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 12/10/2015] [Accepted: 12/12/2015] [Indexed: 01/26/2023]
Abstract
The number of studies examining cognition in Huntington's disease (HD) has increased dramatically in recent decades, and cognitive research methods in HD have become much more sophisticated. In this review, we provide a summary of the advances in cognitive research in HD to date, and outline the key considerations for researchers planning to include cognitive assessment in their studies of HD. In particular, we discuss consideration of structure-function relationships, selection of tests appropriate to the population, choice of materials and issues of intellectual property, consideration of variables which can confound studies of cognition in HD, practice effects, and specific issues for multi-site research. Finally, we discuss future directions for cognitive assessment in HD research.
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Affiliation(s)
- Julie C Stout
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University 18 Innovation Walk, Clayton 3800, VIC, Australia.
| | - Yifat Glikmann-Johnston
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University 18 Innovation Walk, Clayton 3800, VIC, Australia.
| | - Sophie C Andrews
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University 18 Innovation Walk, Clayton 3800, VIC, Australia.
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Klöppel S, Gregory S, Scheller E, Minkova L, Razi A, Durr A, Roos RA, Leavitt BR, Papoutsi M, Landwehrmeyer GB, Reilmann R, Borowsky B, Johnson H, Mills JA, Owen G, Stout J, Scahill RI, Long JD, Rees G, Tabrizi SJ. Compensation in Preclinical Huntington's Disease: Evidence From the Track-On HD Study. EBioMedicine 2015; 2:1420-9. [PMID: 26629536 PMCID: PMC4634199 DOI: 10.1016/j.ebiom.2015.08.002] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 07/31/2015] [Accepted: 08/02/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cognitive and motor task performance in premanifest Huntington's disease (HD) gene-carriers is often within normal ranges prior to clinical diagnosis, despite loss of brain volume in regions involved in these tasks. This indicates ongoing compensation, with the brain maintaining function in the presence of neuronal loss. However, thus far, compensatory processes in HD have not been modeled explicitly. Using a new model, which incorporates individual variability related to structural change and behavior, we sought to identify functional correlates of compensation in premanifest-HD gene-carriers. METHODS We investigated the modulatory effects of regional brain atrophy, indexed by structural measures of disease load, on the relationship between performance and brain activity (or connectivity) using task-based and resting-state functional MRI. FINDINGS Consistent with compensation, as atrophy increased performance-related activity increased in the right parietal cortex during a working memory task. Similarly, increased functional coupling between the right dorsolateral prefrontal cortex and a left hemisphere network in the resting-state predicted better cognitive performance as atrophy increased. Such patterns were not detectable for the left hemisphere or for motor tasks. INTERPRETATION Our findings provide evidence for active compensatory processes in premanifest-HD for cognitive demands and suggest a higher vulnerability of the left hemisphere to the effects of regional atrophy.
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Affiliation(s)
- Stefan Klöppel
- Albert-Ludwigs-University Freiburg, University Medical Center, Division Freiburg Brain Imaging, Freiburg, Germany
- Albert-Ludwigs-University Freiburg, University Medical Center, Department of Psychiatry and Psychotherapy, Freiburg, Germany
- Albert-Ludwigs-University Freiburg, University Medical Center, Department of Neurology, Freiburg, Germany
| | - Sarah Gregory
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
| | - Elisa Scheller
- Albert-Ludwigs-University Freiburg, University Medical Center, Division Freiburg Brain Imaging, Freiburg, Germany
- Albert-Ludwigs-University Freiburg, University Medical Center, Department of Psychiatry and Psychotherapy, Freiburg, Germany
- Albert-Ludwigs-University Freiburg, Department of Psychology, Laboratory for Biological and Personality Psychology, Freiburg, Germany
| | - Lora Minkova
- Albert-Ludwigs-University Freiburg, University Medical Center, Division Freiburg Brain Imaging, Freiburg, Germany
- Albert-Ludwigs-University Freiburg, University Medical Center, Department of Psychiatry and Psychotherapy, Freiburg, Germany
- Albert-Ludwigs-University Freiburg, Department of Psychology, Laboratory for Biological and Personality Psychology, Freiburg, Germany
| | - Adeel Razi
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
- Department of Electronic Engineering, N.E.D University of Engineering & Technology, Karachi, Pakistan
| | - Alexandra Durr
- APHP Department of Genetics, Groupe Hospitalier Pitié-Salpêtrière, UPMC Université Paris VI UMR_S1127, Paris France
- Institut du Cerveau et de la Moelle, INSERM U1127, CNRS UMR7225, UPMC Université Paris VI UMR_S1127, Paris France
| | - Raymund A.C. Roos
- Leiden University Medical Center, Department of Neurology, Leiden, The Netherlands
| | - Blair R. Leavitt
- Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia, Canada
| | - Marina Papoutsi
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | | | - Ralf Reilmann
- George-Huntington-Institute, Muenster, Germany
- University of Tuebingen, Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, Tuebingen, Germany
| | | | - Hans Johnson
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IA, USA
| | - James A. Mills
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Gail Owen
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Julie Stout
- School of Psychological Sciences and Institute of Clinical and Cognitive Neuroscience, Monash University, Melbourne, Australia
| | - Rachael I. Scahill
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Jeffrey D. Long
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Geraint Rees
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Sarah J. Tabrizi
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
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Turner LM, Croft RJ, Churchyard A, Looi JCL, Apthorp D, Georgiou-Karistianis N. Abnormal Electrophysiological Motor Responses in Huntington's Disease: Evidence of Premanifest Compensation. PLoS One 2015; 10:e0138563. [PMID: 26406226 PMCID: PMC4583227 DOI: 10.1371/journal.pone.0138563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 08/31/2015] [Indexed: 01/15/2023] Open
Abstract
Background Huntington's disease (HD) causes progressive motor dysfunction through characteristic atrophy. Changes to neural structure begin in premanifest stages yet individuals are able to maintain a high degree of function, suggesting involvement of supportive processing during motor performance. Electroencephalography (EEG) enables the investigation of subtle impairments at the neuronal level, and possible compensatory strategies, by examining differential activation patterns. We aimed to use EEG to investigate neural motor processing (via the Readiness Potential; RP), premotor processing and sensorimotor integration (Contingent Negative Variation; CNV) during simple motor performance in HD. Methods We assessed neural activity associated with motor preparation and processing in 20 premanifest (pre-HD), 14 symptomatic HD (symp-HD), and 17 healthy controls. Participants performed sequential tapping within two experimental paradigms (simple tapping; Go/No-Go). RP and CNV potentials were calculated separately for each group. Results Motor components and behavioural measures did not distinguish pre-HD from controls. Compared to controls and pre-HD, symp-HD demonstrated significantly reduced relative amplitude and latency of the RP, whereas controls and pre-HD did not differ. However, early CNV was found to significantly differ between control and pre-HD groups, due to enhanced early CNV in pre-HD. Conclusions For the first time, we provide evidence of atypical activation during preparatory processing in pre-HD. The increased activation during this early stage of the disease may reflect ancillary processing in the form of recruitment of additional neural resources for adequate motor preparation, despite atrophic disruption to structure and circuitry. We propose an early adaptive compensation mechanism in pre-HD during motor preparation.
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Affiliation(s)
- Lauren M. Turner
- Research School of Psychology, College of Medicine, Biology, & Environment, Australian National University, Canberra, Australia
- * E-mail:
| | - Rodney J. Croft
- School of Psychology & Illawarra Health & Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Andrew Churchyard
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Calvary Health Care Bethlehem Hospital, Caulfield, Victoria, Australia
| | - Jeffrey C. L. Looi
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Deborah Apthorp
- Research School of Psychology, College of Medicine, Biology, & Environment, Australian National University, Canberra, Australia
- School of Psychology & Illawarra Health & Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
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Mason SL, Zhang J, Begeti F, Guzman NV, Lazar AS, Rowe JB, Barker RA, Hampshire A. The role of the amygdala during emotional processing in Huntington's disease: from pre-manifest to late stage disease. Neuropsychologia 2015; 70:80-9. [PMID: 25700742 PMCID: PMC4415907 DOI: 10.1016/j.neuropsychologia.2015.02.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 01/15/2015] [Accepted: 02/13/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Deficits in emotional processing can be detected in the pre-manifest stage of Huntington's disease and negative emotion recognition has been identified as a predictor of clinical diagnosis. The underlying neuropathological correlates of such deficits are typically established using correlative structural MRI studies. This approach does not take into consideration the impact of disruption to the complex interactions between multiple brain circuits on emotional processing. Therefore, exploration of the neural substrates of emotional processing in pre-manifest HD using fMRI connectivity analysis may be a useful way of evaluating the way brain regions interrelate in the period prior to diagnosis. METHODS We investigated the impact of predicted time to disease onset on brain activation when participants were exposed to pictures of faces with angry and neutral expressions, in 20 pre-manifest HD gene carriers and 23 healthy controls. On the basis of the results of this initial study went on to look at amygdala dependent cognitive performance in 79 Huntington's disease patients from a cross-section of disease stages (pre-manifest to late disease) and 26 healthy controls, using a validated theory of mind task: "the Reading the Mind in the Eyes Test" which has been previously been shown to be amygdala dependent. RESULTS Psychophysiological interaction analysis identified reduced connectivity between the left amygdala and right fusiform facial area in pre-manifest HD gene carriers compared to controls when viewing angry compared to neutral faces. Change in PPI connectivity scores correlated with predicted time to disease onset (r=0.45, p<0.05). Furthermore, performance on the "Reading the Mind in the Eyes Test" correlated negatively with proximity to disease onset and became progressively worse with each stage of disease. CONCLUSION Abnormalities in the neural networks underlying social cognition and emotional processing can be detected prior to clinical diagnosis in Huntington's disease. Connectivity between the amygdala and other brain regions is impacted by the disease process in pre-manifest HD and may therefore be a useful way of identifying participants who are approaching a clinical diagnosis. Furthermore, the "Reading the Mind in the Eyes Test" is a surrogate measure of amygdala function that is clinically useful across the entire cross-section of disease stages in HD.
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Affiliation(s)
- Sarah L Mason
- John Van Geest Centre for Brain Repair, University of Cambridge, UK.
| | - Jiaxiang Zhang
- MRC Cognition and Brian Sciences Unit, University of Cambridge, UK
| | - Faye Begeti
- John Van Geest Centre for Brain Repair, University of Cambridge, UK
| | | | - Alpar S Lazar
- John Van Geest Centre for Brain Repair, University of Cambridge, UK
| | - James B Rowe
- Department of Clinical Neuroscience, University of Cambridge, UK; MRC Cognition and Brian Sciences Unit, University of Cambridge, UK
| | - Roger A Barker
- Department of Clinical Neuroscience, University of Cambridge, UK; MRC Cognition and Brian Sciences Unit, University of Cambridge, UK
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Recent imaging advances in neurology. J Neurol 2015; 262:2182-94. [PMID: 25808503 DOI: 10.1007/s00415-015-7711-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/13/2015] [Accepted: 03/14/2015] [Indexed: 01/08/2023]
Abstract
Over the recent years, the application of neuroimaging techniques such as magnetic resonance imaging (MRI) and positron emission tomography (PET) has considerably advanced the understanding of complex neurological disorders. PET is a powerful molecular imaging tool, which investigates the distribution and binding of radiochemicals attached to biologically relevant molecules; as such, this technique is able to give information on biochemistry and metabolism of the brain in health and disease. MRI uses high intensity magnetic fields and radiofrequency pulses to provide structural and functional information on tissues and organs in intact or diseased individuals, including the evaluation of white matter integrity, grey matter thickness and brain perfusion. The aim of this article is to review the most recent advances in neuroimaging research in common neurological disorders such as movement disorders, dementia, epilepsy, traumatic brain injury and multiple sclerosis, and to evaluate their contribution in the diagnosis and management of patients.
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Dogan I, Eickhoff CR, Fox PT, Laird AR, Schulz JB, Eickhoff SB, Reetz K. Functional connectivity modeling of consistent cortico-striatal degeneration in Huntington's disease. NEUROIMAGE-CLINICAL 2015; 7:640-52. [PMID: 25844318 PMCID: PMC4375786 DOI: 10.1016/j.nicl.2015.02.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/19/2015] [Accepted: 02/23/2015] [Indexed: 11/25/2022]
Abstract
Huntington's disease (HD) is a progressive neurodegenerative disorder characterized by a complex neuropsychiatric phenotype. In a recent meta-analysis we identified core regions of consistent neurodegeneration in premanifest HD in the striatum and middle occipital gyrus (MOG). For early manifest HD convergent evidence of atrophy was most prominent in the striatum, motor cortex (M1) and inferior frontal junction (IFJ). The aim of the present study was to functionally characterize this topography of brain atrophy and to investigate differential connectivity patterns formed by consistent cortico-striatal atrophy regions in HD. Using areas of striatal and cortical atrophy at different disease stages as seeds, we performed task-free resting-state and task-based meta-analytic connectivity modeling (MACM). MACM utilizes the large data source of the BrainMap database and identifies significant areas of above-chance co-activation with the seed-region via the activation-likelihood-estimation approach. In order to delineate functional networks formed by cortical as well as striatal atrophy regions we computed the conjunction between the co-activation profiles of striatal and cortical seeds in the premanifest and manifest stages of HD, respectively. Functional characterization of the seeds was obtained using the behavioral meta-data of BrainMap. Cortico-striatal atrophy seeds of the premanifest stage of HD showed common co-activation with a rather cognitive network including the striatum, anterior insula, lateral prefrontal, premotor, supplementary motor and parietal regions. A similar but more pronounced co-activation pattern, additionally including the medial prefrontal cortex and thalamic nuclei was found with striatal and IFJ seeds at the manifest HD stage. The striatum and M1 were functionally connected mainly to premotor and sensorimotor areas, posterior insula, putamen and thalamus. Behavioral characterization of the seeds confirmed that experiments activating the MOG or IFJ in conjunction with the striatum were associated with cognitive functions, while the network formed by M1 and the striatum was driven by motor-related tasks. Thus, based on morphological changes in HD, we identified functionally distinct cortico-striatal networks resembling a cognitive and motor loop, which may be prone to early disruptions in different stages of the disease and underlie HD-related cognitive and motor symptom profiles. Our findings provide an important link between morphometrically defined seed-regions and corresponding functional circuits highlighting the functional and ensuing clinical relevance of structural damage in HD. Pre-HD atrophy seeds showed common functional co-activation with a cognitive network. Modeling of manifest-HD seeds delineated a segregation of a cognitive and motor loop. Behavioral decoding of atrophy seeds confirmed functional segregation of networks. Based on morphometric changes in HD distinct corticostriatal networks were identified. Findings depict functional and ensuing clinical relevance of structural damage in HD.
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Affiliation(s)
- Imis Dogan
- Department of Neurology, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany ; Institute of Neuroscience and Medicine (INM-1, INM-4), Research Center Jülich GmbH, 52425 Jülich, Germany ; JARA - Translational Brain Medicine, Aachen, Jülich, Germany
| | - Claudia R Eickhoff
- Institute of Neuroscience and Medicine (INM-1, INM-4), Research Center Jülich GmbH, 52425 Jülich, Germany ; Department of Psychiatry, Psychotherapy and Psychosomatic, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - Peter T Fox
- Research Imaging Center, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78284-7801, USA
| | - Angela R Laird
- Department of Physics, Florida International University, Modesto A. Maidique Campus, CP 204, 11200 SW 8th Street, Miami, FL 33199, USA
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany ; JARA - Translational Brain Medicine, Aachen, Jülich, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine (INM-1, INM-4), Research Center Jülich GmbH, 52425 Jülich, Germany ; Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany ; Institute of Neuroscience and Medicine (INM-1, INM-4), Research Center Jülich GmbH, 52425 Jülich, Germany ; JARA - Translational Brain Medicine, Aachen, Jülich, Germany
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Gabery S, Georgiou-Karistianis N, Lundh SH, Cheong RY, Churchyard A, Chua P, Stout JC, Egan GF, Kirik D, Petersén Å. Volumetric analysis of the hypothalamus in Huntington Disease using 3T MRI: the IMAGE-HD Study. PLoS One 2015; 10:e0117593. [PMID: 25659157 PMCID: PMC4319930 DOI: 10.1371/journal.pone.0117593] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 12/29/2014] [Indexed: 12/25/2022] Open
Abstract
Huntington disease (HD) is a fatal neurodegenerative disorder caused by an expanded CAG repeat in the huntingtin gene. Non-motor symptoms and signs such as psychiatric disturbances, sleep problems and metabolic dysfunction are part of the disease manifestation. These aspects may relate to changes in the hypothalamus, an area of the brain involved in the regulation of emotion, sleep and metabolism. Neuropathological and imaging studies using both voxel-based morphometry (VBM) of magnetic resonance imaging (MRI) as well as positron emission tomography (PET) have demonstrated pathological changes in the hypothalamic region during early stages in symptomatic HD. In this investigation, we aimed to establish a robust method for measurements of the hypothalamic volume in MRI in order to determine whether the hypothalamic dysfunction in HD is associated with the volume of this region. Using T1-weighted imaging, we describe a reproducible delineation procedure to estimate the hypothalamic volume which was based on the same landmarks used in histologically processed postmortem hypothalamic tissue. Participants included 36 prodromal HD (pre-HD), 33 symptomatic HD (symp-HD) and 33 control participants who underwent MRI scanning at baseline and 18 months follow-up as part of the IMAGE-HD study. We found no evidence of cross-sectional or longitudinal changes between groups in hypothalamic volume. Our results suggest that hypothalamic pathology in HD is not associated with volume changes.
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Affiliation(s)
- Sanaz Gabery
- Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | | | - Sofia Hult Lundh
- Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Rachel Y. Cheong
- Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Andrew Churchyard
- School of Psychological Sciences, Monash University, Clayton, Victoria, 3180, Australia
- Huntington’s Disease Unit, Bethlehem Hospital, Kooyong Rd, Caulfield, Victoria, 3162, Australia
| | - Phyllis Chua
- Huntington’s Disease Unit, Bethlehem Hospital, Kooyong Rd, Caulfield, Victoria, 3162, Australia
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, 3168, Australia
| | - Julie C. Stout
- School of Psychological Sciences, Monash University, Clayton, Victoria, 3180, Australia
| | - Gary F. Egan
- School of Psychological Sciences, Monash University, Clayton, Victoria, 3180, Australia
- Monash Biomedical Imaging (MBI), Monash University, Clayton, Victoria, 3180, Australia
- Life Sciences Computation Centre, Victorian Life Sciences Computation Initiative (VLSCI), Melbourne, Victoria, Australia
| | - Deniz Kirik
- Brain Repair and Imaging in Neural Systems (B.R.A.I.N.S) Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
- Lund University Bioimaging Center, Lund, Sweden
| | - Åsa Petersén
- Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
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Cruickshank TM, Thompson JA, Domínguez D JF, Reyes AP, Bynevelt M, Georgiou-Karistianis N, Barker RA, Ziman MR. The effect of multidisciplinary rehabilitation on brain structure and cognition in Huntington's disease: an exploratory study. Brain Behav 2015; 5:e00312. [PMID: 25642394 PMCID: PMC4309878 DOI: 10.1002/brb3.312] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 12/05/2014] [Accepted: 12/08/2014] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND There is a wealth of evidence detailing gray matter degeneration and loss of cognitive function over time in individuals with Huntington's disease (HD). Efforts to attenuate disease-related brain and cognitive changes have been unsuccessful to date. Multidisciplinary rehabilitation, comprising motor and cognitive intervention, has been shown to positively impact on functional capacity, depression, quality of life and some aspects of cognition in individuals with HD. This exploratory study aimed to evaluate, for the first time, whether multidisciplinary rehabilitation can slow further deterioration of disease-related brain changes and related cognitive deficits in individuals with manifest HD. METHODS Fifteen participants who manifest HD undertook a multidisciplinary rehabilitation intervention spanning 9 months. The intervention consisted of once-weekly supervised clinical exercise, thrice-weekly self-directed home based exercise and fortnightly occupational therapy. Participants were assessed using MR imaging and validated cognitive measures at baseline and after 9 months. RESULTS Participants displayed significantly increased gray matter volume in the right caudate and bilaterally in the dorsolateral prefrontal cortex after 9 months of multidisciplinary rehabilitation. Volumetric increases in gray matter were accompanied by significant improvements in verbal learning and memory (Hopkins Verbal Learning-Test). A significant association was found between gray matter volume increases in the dorsolateral prefrontal cortex and performance on verbal learning and memory. CONCLUSIONS This study provides preliminary evidence that multidisciplinary rehabilitation positively impacts on gray matter changes and cognitive functions relating to verbal learning and memory in individuals with manifest HD. Larger controlled trials are required to confirm these preliminary findings.
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Affiliation(s)
- Travis M Cruickshank
- School of Medical Sciences, Edith Cowan UniversityPerth, Western Australia, Australia
| | - Jennifer A Thompson
- School of Medical Sciences, Edith Cowan UniversityPerth, Western Australia, Australia
| | - Juan F Domínguez D
- School of Psychological Sciences, Monash UniversityMelbourne, Victoria, Australia
| | - Alvaro P Reyes
- School of Medical Sciences, Edith Cowan UniversityPerth, Western Australia, Australia
| | - Mike Bynevelt
- Department of Surgery, UWA and Neurological Intervention and Imaging Service of Western AustraliaPerth, Western Australia, Australia
| | | | | | - Mel R Ziman
- School of Medical Sciences, Edith Cowan UniversityPerth, Western Australia, Australia
- School of Pathology and Laboratory Medicine, University of Western AustraliaPerth, Western Australia, Australia
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Poudel GR, Stout JC, Domínguez D JF, Churchyard A, Chua P, Egan GF, Georgiou-Karistianis N. Longitudinal change in white matter microstructure in Huntington's disease: The IMAGE-HD study. Neurobiol Dis 2014; 74:406-12. [PMID: 25497085 DOI: 10.1016/j.nbd.2014.12.009] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 11/14/2014] [Accepted: 12/08/2014] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To quantify 18-month changes in white matter microstructure in premanifest (pre-HD) and symptomatic Huntington's disease (symp-HD). To investigate baseline clinical, cognitive and motor symptoms that are predictive of white matter microstructural change over 18months. METHOD Diffusion tensor imaging (DTI) data were analyzed for 28 pre-HD, 25 symp-HD, and 27 controls scanned at baseline and after 18months. Unbiased tract-based spatial statistics (TBSS) methods were used to identify longitudinal changes in fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) of white matter. Stepwise linear regression models were used to identify baseline clinical, cognitive, and motor measures that are predictive of longitudinal diffusion changes. RESULTS Symp-HD compared to controls showed 18-month reductions in FA in the corpus callosum and cingulum white matter. Symp-HD compared to pre-HD showed increased RD in the corpus callosum and striatal projection pathways. FA in the body, genu, and splenium of the corpus callosum was significantly associated with a baseline clinical motor measure (Unified Huntington's Disease Rating Scale: total motor scores: UHDRS-TMS) across both HD groups. This measure was also the only independent predictor of longitudinal decline in FA in all parts of the corpus callosum across both HD groups. CONCLUSIONS We provide direct evidence of longitudinal decline in white matter microstructure in symp-HD. Although pre-HD did not show longitudinal change, clinical symptoms and motor function predicted white matter microstructural changes for all gene positive subjects. These findings suggest that loss of axonal integrity is an early hallmark of neurodegenerative changes which are clinically relevant.
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Affiliation(s)
- Govinda R Poudel
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia; VLSCI Life Sciences Computation Centre, Melbourne, Victoria, Australia
| | - Julie C Stout
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Juan F Domínguez D
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Andrew Churchyard
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Calvary Health Care Bethlehem Hospital, Caulfield, Victoria, Australia
| | - Phyllis Chua
- Department of Psychiatry, School of Clinical Sciences, Monash University, Victoria, Australia; Calvary Health Care Bethlehem Hospital, Caulfield, Victoria, Australia
| | - Gary F Egan
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia; ARC Centre of Excellence for Integrative Brain Function, Monash University, Clayton, Victoria, Australia; VLSCI Life Sciences Computation Centre, Melbourne, Victoria, Australia
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46
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Scheller E, Minkova L, Leitner M, Klöppel S. Attempted and successful compensation in preclinical and early manifest neurodegeneration - a review of task FMRI studies. Front Psychiatry 2014; 5:132. [PMID: 25324786 PMCID: PMC4179340 DOI: 10.3389/fpsyt.2014.00132] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 09/08/2014] [Indexed: 01/20/2023] Open
Abstract
Several models of neural compensation in healthy aging have been suggested to explain brain activity that aids to sustain cognitive function. Applying recently suggested criteria of "attempted" and "successful" compensation, we reviewed existing literature on compensatory mechanisms in preclinical Huntington's disease (HD) and amnestic mild cognitive impairment (aMCI). Both disorders constitute early stages of neurodegeneration ideal for examining compensatory mechanisms and developing targeted interventions. We strived to clarify whether compensation criteria derived from healthy aging populations can be applied to early neurodegeneration. To concentrate on the close coupling of cognitive performance and brain activity, we exclusively addressed task fMRI studies. First, we found evidence for parallels in compensatory mechanisms between healthy aging and neurodegenerative disease. Several studies fulfilled criteria of attempted compensation, while reports of successful compensation were largely absent, which made it difficult to conclude on. Second, comparing working memory studies in preclinical HD and aMCI, we identified similar compensatory patterns across neurodegenerative disorders in lateral and medial prefrontal cortex. Such patterns included an inverted U-shaped relationship of neurodegeneration and compensatory activity spanning from preclinical to manifest disease. Due to the lack of studies systematically targeting all criteria of compensation, we propose an exemplary study design, including the manipulation of compensating brain areas by brain stimulation. Furthermore, we delineate the benefits of targeted interventions by non-invasive brain stimulation, as well as of unspecific interventions such as physical activity or cognitive training. Unambiguously detecting compensation in early neurodegenerative disease will help tailor interventions aiming at sustained overall functioning and delayed clinical disease onset.
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Affiliation(s)
- Elisa Scheller
- Section of Gerontopsychiatry and Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center (FBI), University Medical Center Freiburg, Freiburg, Germany
- Laboratory for Biological and Personality Psychology, Department of Psychology, University of Freiburg, Freiburg, Germany
| | - Lora Minkova
- Section of Gerontopsychiatry and Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center (FBI), University Medical Center Freiburg, Freiburg, Germany
- Laboratory for Biological and Personality Psychology, Department of Psychology, University of Freiburg, Freiburg, Germany
| | - Mathias Leitner
- Section of Gerontopsychiatry and Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center (FBI), University Medical Center Freiburg, Freiburg, Germany
| | - Stefan Klöppel
- Section of Gerontopsychiatry and Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Freiburg Brain Imaging Center (FBI), University Medical Center Freiburg, Freiburg, Germany
- Department of Neurology, University Medical Center Freiburg, Freiburg, Germany
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Papoutsi M, Labuschagne I, Tabrizi SJ, Stout JC. The cognitive burden in Huntington's disease: pathology, phenotype, and mechanisms of compensation. Mov Disord 2014; 29:673-83. [PMID: 24757115 DOI: 10.1002/mds.25864] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 02/14/2014] [Accepted: 02/17/2014] [Indexed: 02/02/2023] Open
Abstract
Huntington's disease (HD) is an inherited autosomal dominant neurodegenerative disorder. The most prominent sign of HD is the presence of involuntary motor movements. However, HD is also characterized by marked cognitive decline, which often precedes the onset of motor symptoms and is generally considered to be more debilitating to the patients and their families, compared to motor symptoms. Cognitive decline is widespread across most faculties of cognition in later stages of the disease, but seems to be selective in preclinical and early stages of the disease, with deficits in the HD patients' ability to multitask, their speed of processing, and executive function. It is now well established that preceding clinical diagnosis there is a preclinical stage, during which HD gene mutation carriers are relatively symptom free, despite disease pathological onset and the presence of neurodegeneration. Evidence from functional brain imaging studies suggests the presence of neural compensation in preclinical stages of HD, whereby the brain undergoes functional reorganization in response to neurodegeneration to preserve motor and cognitive performance. In this review, we will describe the underlying HD pathology with a focus on how it links to the cognitive phenotype. We will also present evidence regarding the presence of neural compensation in HD and the possible mechanisms supporting it. Finally, we will discuss current research in the field of cognitive interventions that aim to support and enhance neural compensation in HD. These research efforts could, one day, prolong the preclinical stage and assist with symptom management of those affected with HD.
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Affiliation(s)
- Marina Papoutsi
- Institute of Neurology, University College London, London, United Kingdom
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48
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Krishna SH, McKinney AM, Lucato LT. Congenital Genetic Inborn Errors of Metabolism Presenting as an Adult or Persisting Into Adulthood: Neuroimaging in the More Common or Recognizable Disorders. Semin Ultrasound CT MR 2014; 35:160-91. [DOI: 10.1053/j.sult.2013.10.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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