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Imokawa T, Yokoyama K, Takahashi K, Oyama J, Tsuchiya J, Sanjo N, Tateishi U. Brain perfusion SPECT in dementia: what radiologists should know. Jpn J Radiol 2024:10.1007/s11604-024-01612-5. [PMID: 38888851 DOI: 10.1007/s11604-024-01612-5] [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: 03/25/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024]
Abstract
The findings of brain perfusion single-photon emission computed tomography (SPECT), which detects abnormalities often before changes manifest in morphological imaging, mainly reflect neurodegeneration and contribute to dementia evaluation. A major shift is about to occur in dementia practice to the approach of diagnosing based on biomarkers and treating with disease-modifying drugs. Accordingly, brain perfusion SPECT will be required to serve as a biomarker of neurodegeneration. Hypoperfusion in Alzheimer's disease (AD) is typically seen in the posterior cingulate cortex and precuneus early in the disease, followed by the temporoparietal cortices. On the other hand, atypical presentations of AD such as the posterior variant, logopenic variant, frontal variant, and corticobasal syndrome exhibit hypoperfusion in areas related to symptoms. Additionally, hypoperfusion especially in the precuneus and parietal association cortex can serve as a predictor of progression from mild cognitive impairment to AD. In dementia with Lewy bodies (DLB), the differentiating feature is the presence of hypoperfusion in the occipital lobes in addition to that observed in AD. Hypoperfusion of the occipital lobe is not a remarkable finding, as it is assumed to reflect functional loss due to impairment of the cholinergic and dopaminergic systems rather than degeneration per se. Moreover, the cingulate island sign reflects the degree of AD pathology comorbid in DLB. Frontotemporal dementia is characterized by regional hypoperfusion according to the three clinical types, and the background pathology is diverse. Idiopathic normal pressure hydrocephalus shows apparent hypoperfusion around the Sylvian fissure and corpus callosum and apparent hyperperfusion in high-convexity areas. The cortex or striatum with diffusion restriction on magnetic resonance imaging in prion diseases reflects spongiform degeneration and brain perfusion SPECT reveals hypoperfusion in the same areas. Brain perfusion SPECT findings in dementia should be carefully interpreted considering background pathology.
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Affiliation(s)
- Tomoki Imokawa
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
- Department of Radiology, Japanese Red Cross Omori Hospital, Ota-Ku, Tokyo, Japan
| | - Kota Yokoyama
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan.
| | - Kanae Takahashi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Jun Oyama
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Junichi Tsuchiya
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Nobuo Sanjo
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
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Metabolomics Deciphering the Potential Biomarkers of Hengqing I Prescription against Vascular Dementia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1636145. [PMID: 35399642 PMCID: PMC8986386 DOI: 10.1155/2022/1636145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 11/17/2022]
Abstract
With the aging of population, vascular dementia (VaD) seriously threatens people's health and quality of life. It is of great significance to explore biomarkers of VaD from the perspective of metabolomics and traditional Chinese medicine (TCM). Therefore, VaD was divided into kidney deficiency and blood stasis syndrome (KDBS) and non-KDBS according to TCM. Then, some patients received the treatment of Hengqing I (HQI) prescription. The urine of six groups (VaD group, normal group, KDBS group, non-KDBS group, HQI group, and control group) was detected on LC-MS/MS. Multivariate statistical analysis showed that the metabolic profiles of the three comparisons were significantly different. The top analysis-ready molecules of downregulated histamine and upregulated biotin, methionine, pantothenic acid, SAH, histidine, and kaempferol may be the most related metabolites. These putative biomarkers play an important role in the regulation of key metabolic processes linked to VaD. Additionally, pathway analysis showed aminoacyl-tRNA biosynthesis, and amino acids metabolic pathways were highly correlated with the occurrence of VaD. In this present paper, vitamins, amino acids, and their derivatives were selected as the basis for VaD diagnosis and treatment monitoring, and the significance of TCM classification and Hengqing I prescription in the treatment of VaD was discussed.
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Ferrando R, Damian A. Brain SPECT as a Biomarker of Neurodegeneration in Dementia in the Era of Molecular Imaging: Still a Valid Option? Front Neurol 2021; 12:629442. [PMID: 34040574 PMCID: PMC8141564 DOI: 10.3389/fneur.2021.629442] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 04/06/2021] [Indexed: 12/21/2022] Open
Abstract
Biomarkers are playing a progressively leading role in both clinical practice and scientific research in dementia. Although amyloid and tau biomarkers have gained ground in the clinical community in recent years, neurodegeneration biomarkers continue to play a key role due to their ability to identify different patterns of brain involvement that sign the transition between asymptomatic and symptomatic stages of the disease with high sensitivity and specificity. Both 18F-FDG positron emission tomography (PET) and perfusion single photon emission computed tomography (SPECT) have proved useful to reveal the functional alterations underlying various neurodegenerative diseases. Although the focus of nuclear neuroimaging has shifted to PET, the lower cost and wider availability of SPECT make it a still valid alternative for the study of patients with dementia. This review discusses the principles of both techniques, compares their diagnostic performance for the diagnosis of neurodegenerative diseases and highlights the role of SPECT to characterize patients from low- and middle-income countries, where special care of additional costs is particularly needed to meet the new recommendations for the diagnosis and characterization of patients with dementia.
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Affiliation(s)
- Rodolfo Ferrando
- Centro de Medicina Nuclear e Imagenología Molecular, Hospital de Clínicas, Universidad de la República (UdelaR), Montevideo, Uruguay.,Centro Uruguayo de Imagenología Molecular (CUDIM), Montevideo, Uruguay
| | - Andres Damian
- Centro de Medicina Nuclear e Imagenología Molecular, Hospital de Clínicas, Universidad de la República (UdelaR), Montevideo, Uruguay.,Centro Uruguayo de Imagenología Molecular (CUDIM), Montevideo, Uruguay
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Kim JH, Ko PW, Lee HW, Jeong JY, Lee MG, Kim JH, Lee WH, Yu R, Oh WJ, Suk K. Astrocyte-derived lipocalin-2 mediates hippocampal damage and cognitive deficits in experimental models of vascular dementia. Glia 2017; 65:1471-1490. [DOI: 10.1002/glia.23174] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 05/10/2017] [Accepted: 05/11/2017] [Indexed: 02/06/2023]
Affiliation(s)
- Jae-Hong Kim
- Department of Pharmacology; Kyungpook National University we of Medicine; Daegu Republic of Korea
- BK21 Plus KNU Biomedical Convergence Program, Department of Biomedical Sciences; Kyungpook National University School of Medicine; Daegu Republic of Korea
| | - Pan-Woo Ko
- Department of Neurology; Kyungpook National University School of Medicine; Daegu Republic of Korea
- Brain Science & Engineering Institute; Kyungpook National University; Daegu Republic of Korea
| | - Ho-Won Lee
- Department of Neurology; Kyungpook National University School of Medicine; Daegu Republic of Korea
- Brain Science & Engineering Institute; Kyungpook National University; Daegu Republic of Korea
| | - Ji-Young Jeong
- Department of Pharmacology; Kyungpook National University we of Medicine; Daegu Republic of Korea
| | - Maan-Gee Lee
- Department of Pharmacology; Kyungpook National University we of Medicine; Daegu Republic of Korea
- Brain Science & Engineering Institute; Kyungpook National University; Daegu Republic of Korea
| | - Jong-Heon Kim
- Department of Pharmacology; Kyungpook National University we of Medicine; Daegu Republic of Korea
- Brain Science & Engineering Institute; Kyungpook National University; Daegu Republic of Korea
- BK21 Plus KNU Biomedical Convergence Program, Department of Biomedical Sciences; Kyungpook National University School of Medicine; Daegu Republic of Korea
| | - Won-Ha Lee
- Department of Genetic Engineering; Kyungpook National University; Daegu Republic of Korea
| | - Ri Yu
- Korea Brain Research Institute; Daegu Republic of Korea
| | - Won-Jong Oh
- Korea Brain Research Institute; Daegu Republic of Korea
| | - Kyoungho Suk
- Department of Pharmacology; Kyungpook National University we of Medicine; Daegu Republic of Korea
- Brain Science & Engineering Institute; Kyungpook National University; Daegu Republic of Korea
- BK21 Plus KNU Biomedical Convergence Program, Department of Biomedical Sciences; Kyungpook National University School of Medicine; Daegu Republic of Korea
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Gallaway PJ, Miyake H, Buchowski MS, Shimada M, Yoshitake Y, Kim AS, Hongu N. Physical Activity: A Viable Way to Reduce the Risks of Mild Cognitive Impairment, Alzheimer's Disease, and Vascular Dementia in Older Adults. Brain Sci 2017; 7:E22. [PMID: 28230730 PMCID: PMC5332965 DOI: 10.3390/brainsci7020022] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/23/2017] [Accepted: 02/03/2017] [Indexed: 11/17/2022] Open
Abstract
A recent alarming rise of neurodegenerative diseases in the developed world is one of the major medical issues affecting older adults. In this review, we provide information about the associations of physical activity (PA) with major age-related neurodegenerative diseases and syndromes, including Alzheimer's disease, vascular dementia, and mild cognitive impairment. We also provide evidence of PA's role in reducing the risks of these diseases and helping to improve cognitive outcomes in older adults. Finally, we describe some potential mechanisms by which this protective effect occurs, providing guidelines for future research.
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Affiliation(s)
- Patrick J Gallaway
- Department of Nutritional Sciences, The University of Arizona, Tucson, AZ 85721-0038, USA.
| | - Hiroji Miyake
- Nishinomiya Kyoritsu Neurosurgical Hospital, Hyogo 663-8211, Japan.
| | - Maciej S Buchowski
- Department of Medicine, Vanderbilt University, Nashville, TN 37232-5280, USA.
| | - Mieko Shimada
- Chiba Prefectural University of Health Sciences, Chiba 261-0014, Japan.
| | - Yutaka Yoshitake
- National Institute of Fitness & Sport in Kanoya, Kagoshima 891-2311, Japan.
| | - Angela S Kim
- Department of Nutritional Sciences, The University of Arizona, Tucson, AZ 85721-0038, USA.
| | - Nobuko Hongu
- Department of Nutritional Sciences, The University of Arizona, Tucson, AZ 85721-0038, USA.
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Nagata K, Yamazaki T, Takano D, Maeda T, Fujimaki Y, Nakase T, Sato Y. Cerebral circulation in aging. Ageing Res Rev 2016; 30:49-60. [PMID: 27484894 DOI: 10.1016/j.arr.2016.06.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 12/20/2022]
Abstract
Cerebral circulation is known to be protected by the regulatory function against the hypoperfusion that will affect the cognitive function as a result of brain ischemia and energy failure. The regulatory function includes cerebrovascular autoregulation, chemical control, metabolic control, and neurogenic control, and those compensatory mechanisms can be influenced by hypertension, atherosclerosis, cardiac diseases, cerebrovascular diseases and aging. On the other hand, large and/or small infarction, intracranial hemorrhage, subarachnoid hemorrhage, atherosclerosis, amylod angiopathy are also more directly associated with cognitive decline not only in those with vascular cognitive impairment or vascular dementia but also those with Alzheimer's disease.
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Affiliation(s)
- Ken Nagata
- Department of Neurology, Clinical Research Institute, Yokohama General Hospital, Yokohama, Japan.
| | - Takashi Yamazaki
- Department of Neurology, Clinical Research Institute, Yokohama General Hospital, Yokohama, Japan
| | - Daiki Takano
- Department of Neurology, Clinical Research Institute, Yokohama General Hospital, Yokohama, Japan
| | - Tetsuya Maeda
- Department of Neurology and Gerontology, Iwate Medical University, Morioka, Japan
| | - Yumi Fujimaki
- Department of Neurology, Research Institute for Brain and Blood Vessels, Akita, Japan
| | - Taizen Nakase
- Department of Neurology, Research Institute for Brain and Blood Vessels, Akita, Japan
| | - Yuichi Sato
- Department of Neurology, Noshiro Yamamoto Medical Association Hospital, Noshiro, Japan
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Rodríguez García P, Rodríguez García D. Diagnosis of vascular cognitive impairment and its main categories. NEUROLOGÍA (ENGLISH EDITION) 2015. [DOI: 10.1016/j.nrleng.2011.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Li F, Yan CQ, Lin LT, Li H, Zeng XH, Liu Y, Du SQ, Zhu W, Liu CZ. Acupuncture attenuates cognitive deficits and increases pyramidal neuron number in hippocampal CA1 area of vascular dementia rats. Altern Ther Health Med 2015; 15:133. [PMID: 25928206 PMCID: PMC4426171 DOI: 10.1186/s12906-015-0656-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 04/20/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Decreased cognition is recognized as one of the most severe and consistent behavioral impairments in dementia. Experimental studies have reported that acupuncture may improve cognitive deficits, relieve vascular dementia (VD) symptoms, and increase cerebral perfusion and electrical activity. METHODS Multi-infarction dementia was modeled in rats with 3% microemboli saline suspension. Two weeks after acupuncture at Zusanli (ST36), all rats were subjected to a hidden platform trial to test their 3-day spatial memory using the Morris water maze test. To estimate the numbers of pyramidal neuron, astrocytes, and synaptic boutons in hippocampal CA1 area, we adopted an unbiased stereology method to accurately sample and measure the size of cells. RESULTS We found that acupuncture at ST36 significantly decreased the escape latency of VD rats. In addition, acupuncture significantly increased the pyramidal neuron number in hippocampal CA1 area (P < 0.05) and tended to decrease the number of astrocytes (P = 0.063). However, there was no significant change in the synaptic bouton number of hippocampal CA1 area in any of the groups (P > 0.05). CONCLUSIONS These findings suggest that acupuncture may improve cognitive deficits and increase pyramidal neuron number of hippocampal CA1 area in VD rats.
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Huai Y, Dong Y, Xu J, Meng N, Song C, Li W, Lv P. L-3-n-butylphthalide protects against vascular dementia via activation of the Akt kinase pathway. Neural Regen Res 2014; 8:1733-42. [PMID: 25206470 PMCID: PMC4145956 DOI: 10.3969/j.issn.1673-5374.2013.19.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 05/27/2013] [Indexed: 12/25/2022] Open
Abstract
As a neuroprotective drug for the treatment of ischemic stroke, 3-n-butylphthalide, a celery seed extract, has been approved by the State Food and Drug Administration of China as a clinical therapeutic drug for ischemic stroke patients. L-3-n-butylphthalide possesses significant efficacy in the treatment of acute ischemic stroke. The activated Akt kinase pathway can prevent the death of nerve cells and exhibit neuroprotective effects in the brain after stroke. This study provides the hypothesis that l-3-n-butylphthalide has a certain therapeutic effect on vascular dementia, and its mechanism depends on the activation of the Akt kinase pathway. A vascular dementia mouse model was established by cerebral repetitive ischemia/reperfusion, and intragastrically administered l-3-n-butylphthalide daily for 28 consecutive days after ischemia/reperfusion, or 7 consecutive days before ischemia/reperfusion. The Morris water maze test showed significant impairment of spatial learning and memory at 4 weeks after operation, but intragastric administration of l-3-n-butylphthalide, especially pretreatment with l-3-n-butylphthalide, significantly reversed these changes. Thionine staining and western blot analylsis showed that preventive and therapeutic application of l-3-n-butylphthalide can reduce loss of pyramidal neurons in the hippocampal CA1 region and alleviate nerve damage in mice with vascular dementia. In addition, phosphorylated Akt expression in hippocampal tissue increased significantly after l-3-n- butylphthalide treatment. Experimental findings demonstrate that l-3-n-butylphthalide has preventive and therapeutic effects on vascular dementia, and its mechanism may be mediated by upregulation of phosphorylated Akt in the hippocampus.
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Affiliation(s)
- Yaping Huai
- Department of Neurology, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
| | - Yanhong Dong
- Department of Neurology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Jing Xu
- Department of Neurology, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
| | - Nan Meng
- Department of Neurology, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
| | - Chunfeng Song
- Electron Microscope Center, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
| | - Wenbin Li
- Department of Pathophysiology, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
| | - Peiyuan Lv
- Department of Neurology, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China ; Department of Neurology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
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Pathophysiological rat model of vascular dementia: magnetic resonance spectroscopy, microimaging and behavioral study. Brain Res 2014; 1568:10-20. [PMID: 24792309 DOI: 10.1016/j.brainres.2014.04.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 04/09/2014] [Accepted: 04/23/2014] [Indexed: 12/19/2022]
Abstract
Chronic cerebral hypoperfusion and aging can be related to vascular dementia manifested by the decline in cognitive abilities and memory impairment. The identification of specific biomarkers of vascular disorder in early stages is important for the development of neuroprotective agents. In the present study, a three-vessel occlusion (3-VO) rat model of vascular dementia in the middle-aged rat brain was used to investigate the effect of global cerebral hypoperfusion. A multimodal study was performed using magnetic resonance spectroscopy, MR-microimaging, histology and behavioral tests. Our measurements showed a signal alteration in T2-weighted MR images, the elevation of T2 relaxation times and histologically proven neural cell death in the hippocampal area, as well as mild changes in concentration of proton and phosphorus metabolites. These changes were accompanied by mild behavioral alterations in the open field and slightly decreased habituation. The analysis of the effects of vascular pathology on cognitive functions and neurodegeneration can contribute to the development of new treatment strategies for early stages of neurodegeneration.
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Dobson-Stone C, Luty AA, Thompson EM, Blumbergs P, Brooks WS, Short CL, Field CD, Panegyres PK, Hecker J, Solski JA, Blair IP, Fullerton JM, Halliday GM, Schofield PR, Kwok JBJ. Frontotemporal dementia-amyotrophic lateral sclerosis syndrome locus on chromosome 16p12.1-q12.2: genetic, clinical and neuropathological analysis. Acta Neuropathol 2013; 125:523-33. [PMID: 23338750 PMCID: PMC3611035 DOI: 10.1007/s00401-013-1078-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 01/07/2013] [Accepted: 01/08/2013] [Indexed: 12/13/2022]
Abstract
Numerous families exhibiting both frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) have been described, and although many of these have been shown to harbour a repeat expansion in C9ORF72, several C9ORF72-negative FTD-ALS families remain. We performed neuropathological and genetic analysis of a large European Australian kindred (Aus-12) with autosomal dominant inheritance of dementia and/or ALS. Affected Aus-12 members developed either ALS or dementia; some of those with dementia also had ALS and/or extrapyramidal features. Neuropathology was most consistent with frontotemporal lobar degeneration with type B TDP pathology, but with additional phosphorylated tau pathology consistent with corticobasal degeneration. Aus-12 DNA samples were negative for mutations in all known dementia and ALS genes, including C9ORF72 and FUS. Genome-wide linkage analysis provided highly suggestive evidence (maximum multipoint LOD score of 2.9) of a locus on chromosome 16p12.1-16q12.2. Affected individuals shared a chromosome 16 haplotype flanked by D16S3103 and D16S489, spanning 37.9 Mb, with a smaller suggestive disease haplotype spanning 24.4 Mb defined by recombination in an elderly unaffected individual. Importantly, this smaller region does not overlap with FUS. Whole-exome sequencing identified four variants present in the maximal critical region that segregate with disease. Linkage analysis incorporating these variants generated a maximum multipoint LOD score of 3.0. These results support the identification of a locus on chromosome 16p12.1-16q12.2 responsible for an unusual cluster of neurodegenerative phenotypes. This region overlaps with a separate locus on 16q12.1-q12.2 reported in an independent ALS family, indicating that this region may harbour a second major locus for FTD-ALS.
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Affiliation(s)
- Carol Dobson-Stone
- Neuroscience Research Australia, Barker St, Randwick, Sydney, NSW 2031 Australia
- University of New South Wales, Sydney, Australia
| | - Agnes A. Luty
- Neuroscience Research Australia, Barker St, Randwick, Sydney, NSW 2031 Australia
- University of New South Wales, Sydney, Australia
| | - Elizabeth M. Thompson
- SA Clinical Genetics Service, SA Pathology, Women’s and Children’s Hospital, Adelaide, Australia
- Department of Paediatrics, University of Adelaide, North Terrace, Adelaide, Australia
| | - Peter Blumbergs
- Institute of Medical and Veterinary Science, Adelaide, Australia
| | - William S. Brooks
- Neuroscience Research Australia, Barker St, Randwick, Sydney, NSW 2031 Australia
- University of New South Wales, Sydney, Australia
| | - Cathy L. Short
- Department of Neurology, The Queen Elizabeth Hospital, Woodville, Adelaide, Australia
| | - Colin D. Field
- Division of Rehabilitation and Aged Care, Memory Clinic, Repatriation General Hospital, Daw Park, Adelaide, Australia
- Present Address: Adelaide Dementia Driving Clinic, North Adelaide, Australia
| | | | - Jane Hecker
- Department of General Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - Jennifer A. Solski
- Northcott Neuroscience Laboratory, ANZAC Research Institute, Concord Hospital, Sydney, Australia
| | - Ian P. Blair
- Northcott Neuroscience Laboratory, ANZAC Research Institute, Concord Hospital, Sydney, Australia
| | - Janice M. Fullerton
- Neuroscience Research Australia, Barker St, Randwick, Sydney, NSW 2031 Australia
- University of New South Wales, Sydney, Australia
| | - Glenda M. Halliday
- Neuroscience Research Australia, Barker St, Randwick, Sydney, NSW 2031 Australia
- University of New South Wales, Sydney, Australia
| | - Peter R. Schofield
- Neuroscience Research Australia, Barker St, Randwick, Sydney, NSW 2031 Australia
- University of New South Wales, Sydney, Australia
| | - John B. J. Kwok
- Neuroscience Research Australia, Barker St, Randwick, Sydney, NSW 2031 Australia
- University of New South Wales, Sydney, Australia
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Rodríguez García PL, Rodríguez García D. Diagnosis of vascular cognitive impairment and its main categories. Neurologia 2012; 30:223-39. [PMID: 22739039 DOI: 10.1016/j.nrl.2011.12.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 11/21/2011] [Accepted: 12/20/2011] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE A review of current criteria for the diagnosis of categories related with vascular cognitive impairment, in particular the nomenclature, diagnostic criteria, and differential clinical-radiological findings. DEVELOPMENT The criteria for the diagnosis of vascular cognitive impairment have evolved, but available criteria were designed basically for differentiating between vascular dementia and dementia due to Alzheimer disease, and for research purposes. Nevertheless, in clinical practice precise elements are required for: 1) Clinical diagnosis of dementia and mild cognitive impairment; 2) Clinical and neuroimaging criteria for identification of the various cerebrovascular lesions associated with cognitive dysfunction, and 3) A formulation of the aetiogenic-pathogenic relationship between cognitive impairment and cerebrovascular lesions. For this reason, a review was carried out on the diagnostic elements of vascular cognitive impairment categories, classification, and their most relevant characteristics. It highlights the characteristic for the diagnosis of multi-infarction dementia, strategic single infarct dementia, small vessel disease with dementia, mixed dementia, and vascular mild cognitive impairment. CONCLUSIONS Standardisation is required, by a multidisciplinary expert team, as regards nomenclature and criteria for the diagnosis of the full spectrum associated with vascular cognitive impairment and especially for vascular dementia and its categories.
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Affiliation(s)
| | - D Rodríguez García
- Hospital General Docente Dr. Ernesto Guevara de la Serna, Las Tunas, Cuba
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Alafuzoff I, Gelpi E, Al-Sarraj S, Arzberger T, Attems J, Bodi I, Bogdanovic N, Budka H, Bugiani O, Englund E, Ferrer I, Gentleman S, Giaccone G, Graeber MB, Hortobagyi T, Höftberger R, Ironside JW, Jellinger K, Kavantzas N, King A, Korkolopoulou P, Kovács GG, Meyronet D, Monoranu C, Parchi P, Patsouris E, Roggendorf W, Rozemuller A, Seilhean D, Streichenberger N, Thal DR, Wharton SB, Kretzschmar H. The need to unify neuropathological assessments of vascular alterations in the ageing brain: multicentre survey by the BrainNet Europe consortium. Exp Gerontol 2012; 47:825-33. [PMID: 22705312 DOI: 10.1016/j.exger.2012.06.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 06/03/2012] [Accepted: 06/05/2012] [Indexed: 12/12/2022]
Abstract
Here, we summarise the results after carrying out a large survey regarding the assessment of vascular alterations, both vessel changes and vascular lesions in an inter-laboratory setting. In total, 32 neuropathologists from 22 centres, most being members of BrainNet Europe (BNE), participated by filling out a questionnaire with emphasis on assessment of common vascular alterations seen in the brains of aged subjects. A certain level of harmonisation has been reached among BNE members regarding sectioning of the brain, harvesting of brain tissue for histology and staining used when compared to the survey carried out in 2006 by Pantoni and colleagues. The most significant variability was seen regarding the assessment of severity and of clinical significance of vascular alterations. Two strategies have recently been recommended regarding the assessment of vascular alterations in aged and demented subjects. The National Institute on Aging - Alzheimer's Association (NIA-AA) recommends the assessment of hippocampal sclerosis, vascular brain injury and microvascular lesions in 12 regions. Although this strategy will be easy to follow, the recommendations do not inform how the load of observed alterations should be assessed and when the observed lesions are of significance. Deramecourt and his colleagues recommend an assessment and semiquantitative grading of various pathologies in 4 brain regions. This strategy yielded a total score of 0 to 20 as an estimate of pathology load. It is, however, not clear which score is considered to be of clinical significance. Furthermore, in several BNE trials the semiquantitative assessment has yielded poor agreement rates; an observation that might negatively influence the strategy proposed by Deramecourt and his colleagues. In line with NIA-AA, a dichotomised approach of easily recognisable lesions in a standardised set of brain regions harvested for neuropathological assessment and applying reproducible sampling and staining strategies is recommended by BNE. However, a simple strategy regarding assessment of load of alteration is urgently needed to yield reproducible, and at the same time, comparable results between centres.
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Affiliation(s)
- Irina Alafuzoff
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
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Nordlund A, Göthlin M, Wallin A. Vascular disease, Alzheimer's disease biomarkers and cognition in mild cognitive impairment: additive or synergetic effects? Dement Geriatr Cogn Disord 2012; 32:250-6. [PMID: 22179302 DOI: 10.1159/000334653] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS To study how vascular disease and Alzheimer-typical biomarkers relate to cognitive performance in mild cognitive impairment (MCI). METHODS Three groups diagnosed with MCI, one with vascular disease (MCI-vas, n = 61), one with Alzheimer-typical biomarkers (MCI-bio, n = 99) and one with both vascular disease and Alzheimer-typical biomarkers (MCI-vasbio, n = 56), were examined with a comprehensive neuropsychological test battery. RESULTS The MCI-vas and MCI-bio groups performed quite similarly on the test battery, whereas the MCI-vasbio group tended to perform worse than the other groups. MCI-vasbio patients performed significantly worse on tests within all cognitive domains, with the most clear-cut differences on an executive test. CONCLUSIONS Considering the small differences between MCI-vas and MCI-bio, vascular disease or biomarkers alone do not seem to be associated with a specific cognitive profile. The combination of vascular disease and Alzheimer-typical biomarkers, on the other hand, seems to be associated with more severe cognitive deficits. The difference in an aspect of executive functioning is interpreted as a synergetic effect.
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Affiliation(s)
- Arto Nordlund
- Sahlgrenska Academy, Institute of Neuroscience and Physiology, Göteborg University, Mölndal, Sweden.
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Xin J, Zhang J, Gao Y, Xiong L. Association of estrogen receptor β gene polymorphisms with vascular dementia in women. Neurol Sci 2011; 33:1029-35. [PMID: 22183267 DOI: 10.1007/s10072-011-0885-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Accepted: 12/06/2011] [Indexed: 12/31/2022]
Abstract
The objective of the present study was to explore a potential association between the estrogen receptor β (ERβ) gene polymorphisms and vascular dementia (VaD) in women. The relationship of two polymorphisms (rs944050 and rs4986938) and their associated haplotypes in the ERβ gene with VaD were examined in 121 Chinese Han women (>50 years of age) including 61 with VaD and 60 healthy age-matched controls. The potential associations were evaluated using unconditional logistic regression. The variant allele G of rs944050 in the ERβ gene increased the risk of VaD (odds ratio = 2.02, 95% confidence interval = 1.08-3.77). In haplotype analyses, the ERβ haplotype containing the polymorphism rs944050 variant allele and the polymorphism rs4986938 wild-type allele was associated with VaD (odds ratio = 1.70, 95% confidence interval = 1.03-2.84). The polymorphism rs944050 in the ERβ gene was associated with an increased risk of VaD in Chinese Han women. Further studies regarding the association between the ERβ gene polymorphisms and VaD are needed to confirm these findings.
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Affiliation(s)
- Jiawei Xin
- Department of Neurology, Zhongnan Hospital, Wuhan University, No.169, Donghu Road, Wuhan 430071, Hubei, China
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Luty AA, Kwok JBJ, Thompson EM, Blumbergs P, Brooks WS, Loy CT, Dobson-Stone C, Panegyres PK, Hecker J, Nicholson GA, Halliday GM, Schofield PR. Pedigree with frontotemporal lobar degeneration--motor neuron disease and Tar DNA binding protein-43 positive neuropathology: genetic linkage to chromosome 9. BMC Neurol 2008; 8:32. [PMID: 18755042 PMCID: PMC2553097 DOI: 10.1186/1471-2377-8-32] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Accepted: 08/29/2008] [Indexed: 12/12/2022] Open
Abstract
Background Frontotemporal lobar degeneration (FTLD) represents a clinically, pathologically and genetically heterogenous neurodegenerative disorder, often complicated by neurological signs such as motor neuron-related limb weakness, spasticity and paralysis, parkinsonism and gait disturbances. Linkage to chromosome 9p had been reported for pedigrees with the neurodegenerative disorder, frontotemporal lobar degeneration (FTLD) and motor neuron disease (MND). The objective in this study is to identify the genetic locus in a multi-generational Australian family with FTLD-MND. Methods Clinical review and standard neuropathological analysis of brain sections from affected pedigree members. Genome-wide scan using microsatellite markers and single nucleotide polymorphism fine mapping. Examination of candidate genes by direct DNA sequencing. Results Neuropathological examination revealed cytoplasmic deposition of the TDP-43 protein in three affected individuals. Moreover, we identify a family member with clinical Alzheimer's disease, and FTLD-Ubiquitin neuropathology. Genetic linkage and haplotype analyses, defined a critical region between markers D9S169 and D9S1845 on chromosome 9p21. Screening of all candidate genes within this region did not reveal any novel genetic alterations that co-segregate with disease haplotype, suggesting that one individual carrying a meiotic recombination may represent a phenocopy. Re-analysis of linkage data using the new affection status revealed a maximal two-point LOD score of 3.24 and a multipoint LOD score of 3.41 at marker D9S1817. This provides the highest reported LOD scores from a single FTLD-MND pedigree. Conclusion Our reported increase in the minimal disease region should inform other researchers that the chromosome 9 locus may be more telomeric than predicted by published recombination boundaries. Moreover, the existence of a family member with clinical Alzheimer's disease, and who shares the disease haplotype, highlights the possibility that late-onset AD patients in the other linked pedigrees may be mis-classified as sporadic dementia cases.
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Affiliation(s)
- Agnes A Luty
- Prince of Wales Medical Research Institute, Sydney, NSW, Australia.
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Gackowski D, Rozalski R, Siomek A, Dziaman T, Nicpon K, Klimarczyk M, Araszkiewicz A, Olinski R. Oxidative stress and oxidative DNA damage is characteristic for mixed Alzheimer disease/vascular dementia. J Neurol Sci 2007; 266:57-62. [PMID: 17888453 DOI: 10.1016/j.jns.2007.08.041] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2007] [Revised: 08/29/2007] [Accepted: 08/30/2007] [Indexed: 12/01/2022]
Abstract
Oxidative DNA damage may contribute to neuronal cell loss and may be involved in pathogenesis of some neurodegenerative diseases. We assessed the broad spectrum of oxidative DNA damage biomarkers and antioxidants in mixed Alzheimer disease/vascular dementia (MD) and in control patients. The amount of the products of oxidative DNA damage repair (8-oxo-2'-deoxyguanosine and 8-oxoguanine) excreted into urine and cerebrospinal fluid (CSF) was measured by gas chromatography/mass spectrometry with HPLC pre-purification. The level of 8-oxo-2'-deoxyguanosine in leukocytes' DNA, antioxidant vitamins and uric acid concentrations in blood plasma were analyzed by the mean of HPLC technique. For the first time we demonstrated oxidative DNA damage on the level of whole organism and in CSF of MD patients. Urinary excretion of oxidative DNA damage repair products were higher in patients with MD than in the control group. The level 8-oxoguanine in cerebrospinal fluid of MD patients almost doubled the level found in the control group. Also the concentrations of ascorbic acid and retinol in plasma were reduced in MD patients. Oxidative stress/DNA damage is an important factor that may be involved in pathogenesis of mixed dementia. It is likely that treatment of these patients with antioxidants may slow down the progression of the disease.
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Affiliation(s)
- Daniel Gackowski
- Department of Clinical Biochemistry, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Karlowicza 24, 85-092 Bydgoszcz, Poland
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