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Brumberg J, Blazhenets G, Bühler S, Fostitsch J, Rijntjes M, Ma Y, Eidelberg D, Weiller C, Jost WH, Frings L, Schröter N, Meyer PT. Cerebral Glucose Metabolism Is a Valuable Predictor of Survival in Patients with Lewy Body Diseases. Ann Neurol 2024; 96:539-550. [PMID: 38888141 DOI: 10.1002/ana.27005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/22/2024] [Accepted: 05/17/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE Patients with Lewy body diseases have an increased risk of dementia, which is a significant predictor for survival. Posterior cortical hypometabolism on [18F]fluorodeoxyglucose positron emission tomography (PET) precedes the development of dementia by years. We therefore examined the prognostic value of cerebral glucose metabolism for survival. METHODS We enrolled patients diagnosed with Parkinson's disease (PD), Parkinson's disease with dementia, or dementia with Lewy bodies who underwent [18F]fluorodeoxyglucose PET. Regional cerebral metabolism of each patient was analyzed by determining the expression of the PD-related cognitive pattern (Z-score) and by visual PET rating. We analyzed the predictive value of PET for overall survival using Cox regression analyses (age- and sex-corrected) and calculated prognostic indices for the best model. RESULTS Glucose metabolism was a significant predictor of survival in 259 included patients (n = 118 events; hazard ratio: 1.4 [1.2-1.6] per Z-score; hazard ratio: 1.8 [1.5-2.2] per visual PET rating score; both p < 0.0001). Risk stratification with visual PET rating scores yielded a median survival of 4.8, 6.8, and 12.9 years for patients with severe, moderate, and mild posterior cortical hypometabolism (median survival not reached for normal cortical metabolism). Stratification into 5 groups based on the prognostic index revealed 10-year survival rates of 94.1%, 78.3%, 34.7%, 0.0%, and 0.0%. INTERPRETATION Regional cerebral glucose metabolism is a significant predictor of survival in Lewy body diseases and may allow an earlier survival prediction than the clinical milestone "dementia." Thus, [18F]fluorodeoxyglucose PET may improve the basis for therapy decisions, especially for invasive therapeutic procedures like deep brain stimulation in Parkinson's disease. ANN NEUROL 2024;96:539-550.
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Affiliation(s)
- Joachim Brumberg
- Department of Nuclear Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ganna Blazhenets
- Department of Nuclear Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sabrina Bühler
- Department of Nuclear Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johannes Fostitsch
- Department of Nuclear Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michel Rijntjes
- Department of Neurology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Yilong Ma
- Center for Neurosciences, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
| | - David Eidelberg
- Center for Neurosciences, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Cornelius Weiller
- Department of Neurology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Lars Frings
- Department of Nuclear Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nils Schröter
- Department of Neurology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp T Meyer
- Department of Nuclear Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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2
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Wang J, Huang B, Zhou L, Tang S, Feng H, Chan JWY, Chau SWH, Zhang J, Li SX, Mok V, Wing YK, Liu Y. Visuospatial dysfunction predicts dementia-first phenoconversion in isolated REM sleep behaviour disorder. J Neurol Neurosurg Psychiatry 2024:jnnp-2024-333865. [PMID: 38925912 DOI: 10.1136/jnnp-2024-333865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE While isolated rapid eye movement sleep behaviour disorder (iRBD) is known as a prodrome of α-synucleinopathies, the prediction for its future phenoconversion to parkinsonism-first or dementia-first subtype remains a challenge. This study aimed to investigate whether visuospatial dysfunction predicts dementia-first phenoconversion in iRBD. METHODS Patients with iRBD and control subjects were enrolled in this prospective cohort study. Baseline neuropsychological assessment included the Unified Parkinson's Disease Rating Scale part III, Montreal Cognitive Assessment (MoCA), Rey-Osterrieth complex figure (ROCF), Colour Trails test (CTT), Farnsworth-Munsell 100-hue test and Digit Span test. The anterior and posterior subscores of MoCA as well as their modified versions were explored. A composite score derived from ROCF and CTT was also explored. Regular follow-up was conducted to determine the phenoconversion status of iRBD patients. RESULTS The study included 175 iRBD patients and 98 controls. During a mean follow-up of 5.1 years, 25.7% of patients experienced phenoconversion. Most of the neuropsychological tests could differentiate dementia-first but not parkinsonism-first convertors from non-convertors. The modified posterior subscore of MoCA, by integrating the Alternating Trail Making and Clock Drawing components into original the posterior subscore, which mainly reflects visuospatial function, was the strongest predictor for dementia-first phenoconversion (adjusted HR 5.48, 95% CI 1.67 to 17.98). CONCLUSION Visuospatial dysfunction, as reflected mainly by the modified posterior subscore of MoCA, is a predictive factor for dementia-first phenoconversion in iRBD, suggesting its potential for being a biomarker for clinical prognostic prediction and potential neuroprotective trials aiming to delay or prevent dementia.
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Affiliation(s)
- Jing Wang
- Center for Sleep and Circadian Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Bei Huang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Li Zhou
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Shi Tang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Hongliang Feng
- Center for Sleep and Circadian Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Joey W Y Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Steven W H Chau
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shirley X Li
- Department of Psychology and the State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Vincent Mok
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Yaping Liu
- Center for Sleep and Circadian Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Guangzhou Medical University, Guangzhou, Guangdong, China
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3
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Wyman-Chick KA, Chaudhury P, Bayram E, Abdelnour C, Matar E, Chiu SY, Ferreira D, Hamilton CA, Donaghy PC, Rodriguez-Porcel F, Toledo JB, Habich A, Barrett MJ, Patel B, Jaramillo-Jimenez A, Scott GD, Kane JPM. Differentiating Prodromal Dementia with Lewy Bodies from Prodromal Alzheimer's Disease: A Pragmatic Review for Clinicians. Neurol Ther 2024; 13:885-906. [PMID: 38720013 PMCID: PMC11136939 DOI: 10.1007/s40120-024-00620-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/05/2024] [Indexed: 05/12/2024] Open
Abstract
This pragmatic review synthesises the current understanding of prodromal dementia with Lewy bodies (pDLB) and prodromal Alzheimer's disease (pAD), including clinical presentations, neuropsychological profiles, neuropsychiatric symptoms, biomarkers, and indications for disease management. The core clinical features of dementia with Lewy bodies (DLB)-parkinsonism, complex visual hallucinations, cognitive fluctuations, and REM sleep behaviour disorder are common prodromal symptoms. Supportive clinical features of pDLB include severe neuroleptic sensitivity, as well as autonomic and neuropsychiatric symptoms. The neuropsychological profile in mild cognitive impairment attributable to Lewy body pathology (MCI-LB) tends to include impairment in visuospatial skills and executive functioning, distinguishing it from MCI due to AD, which typically presents with impairment in memory. pDLB may present with cognitive impairment, psychiatric symptoms, and/or recurrent episodes of delirium, indicating that it is not necessarily synonymous with MCI-LB. Imaging, fluid and other biomarkers may play a crucial role in differentiating pDLB from pAD. The current MCI-LB criteria recognise low dopamine transporter uptake using positron emission tomography or single photon emission computed tomography (SPECT), loss of REM atonia on polysomnography, and sympathetic cardiac denervation using meta-iodobenzylguanidine SPECT as indicative biomarkers with slowing of dominant frequency on EEG among others as supportive biomarkers. This review also highlights the emergence of fluid and skin-based biomarkers. There is little research evidence for the treatment of pDLB, but pharmacological and non-pharmacological treatments for DLB may be discussed with patients. Non-pharmacological interventions such as diet, exercise, and cognitive stimulation may provide benefit, while evaluation and management of contributing factors like medications and sleep disturbances are vital. There is a need to expand research across diverse patient populations to address existing disparities in clinical trial participation. In conclusion, an early and accurate diagnosis of pDLB or pAD presents an opportunity for tailored interventions, improved healthcare outcomes, and enhanced quality of life for patients and care partners.
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Affiliation(s)
- Kathryn A Wyman-Chick
- Struthers Parkinson's Center and Center for Memory and Aging, Department of Neurology, HealthPartners/Park Nicollet, Bloomington, USA.
| | - Parichita Chaudhury
- Cleo Roberts Memory and Movement Center, Banner Sun Health Research Institute, Sun City, USA
| | - Ece Bayram
- Parkinson and Other Movement Disorders Center, University of California San Diego, San Diego, USA
| | - Carla Abdelnour
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, USA
| | - Elie Matar
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Shannon Y Chiu
- Department of Neurology, Mayo Clinic Arizona, Phoenix, USA
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Solna, Sweden
- Department of Radiology, Mayo Clinic Rochester, Rochester, USA
- Facultad de Ciencias de la Salud, Universidad Fernando Pessoa Canarias, Las Palmas, Spain
| | - Calum A Hamilton
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Paul C Donaghy
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | | | - Jon B Toledo
- Nantz National Alzheimer Center, Stanley Appel Department of Neurology, Houston Methodist Hospital, Houston, USA
| | - Annegret Habich
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Solna, Sweden
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Matthew J Barrett
- Department of Neurology, Parkinson's and Movement Disorders Center, Virginia Commonwealth University, Richmond, USA
| | - Bhavana Patel
- Department of Neurology, College of Medicine, University of Florida, Gainesville, USA
- Norman Fixel Institute for Neurologic Diseases, University of Florida, Gainesville, USA
| | - Alberto Jaramillo-Jimenez
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
- School of Medicine, Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Gregory D Scott
- Department of Pathology and Laboratory Services, VA Portland Medical Center, Portland, USA
| | - Joseph P M Kane
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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4
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Holtbernd F, Hohenfeld C, Oertel WH, Knake S, Sittig E, Romanzetti S, Heidbreder A, Michels J, Dogan I, Schulz JB, Schiefer J, Janzen A, Reetz K. The functional brain connectome in isolated rapid eye movement sleep behavior disorder and Parkinson's disease. Sleep Med 2024; 117:184-191. [PMID: 38555837 DOI: 10.1016/j.sleep.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/29/2024] [Accepted: 03/10/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Isolated rapid-eye-movement behavior disorder (iRBD) often precedes the development of alpha-synucleinopathies such as Parkinson's disease (PD). Magnetic resonance imaging (MRI) studies have revealed structural brain alterations in iRBD partially resembling those observed in PD. However, relatively little is known about whole-brain functional brain alterations in iRBD. Here, we characterize the functional brain connectome of iRBD compared with PD patients and healthy controls (HC) using resting-state functional MRI (rs-fMRI). METHODS Eighteen iRBD subjects (67.3 ± 6.6 years), 18 subjects with PD (65.4 ± 5.8 years), and 39 age- and sex-matched HC (64.4 ± 9.2 years) underwent rs-fMRI at 3 T. We applied a graph theoretical approach to analyze the brain functional connectome at the global and regional levels. Data were analyzed using both frequentist and Bayesian statistics. RESULTS Global connectivity was largely preserved in iRBD and PD individuals. In contrast, both disease groups displayed altered local connectivity mainly in the motor network, temporal cortical regions including the limbic system, and the visual system. There were some group specific alterations, and connectivity changes were pronounced in PD individuals. Overall, however, there was a good agreement of the connectome changes observed in both disease groups. CONCLUSIONS This study provides evidence for widespread functional brain connectivity alterations in iRBD, including motor circuitry, despite normal motor function. Connectome alterations showed substantial resemblance with those observed in PD, underlining a close pathophysiological relationship of iRBD and PD.
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Affiliation(s)
- Florian Holtbernd
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany; Institute of Neuroscience and Medicine (INM-4/INM-11), Juelich Research Center, Juelich, Germany
| | - Christian Hohenfeld
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Wolfgang H Oertel
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Susanne Knake
- Department of Neurology, Philipps-University Marburg, Marburg, Germany; CMBB, Center for Mind, Brain and Behavior, University Hospital Marburg, Marburg, Germany
| | - Elisabeth Sittig
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Sandro Romanzetti
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Anna Heidbreder
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Muenster, Germany; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Jennifer Michels
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Imis Dogan
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Jörg B Schulz
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | | | - Annette Janzen
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Kathrin Reetz
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany.
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5
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Woyk K, Sahlmann CO, Hansen N, Timäus C, Müller SJ, Khadhraoui E, Wiltfang J, Lange C, Bouter C. Brain 18 F-FDG-PET and an optimized cingulate island ratio to differentiate Lewy body dementia and Alzheimer's disease. J Neuroimaging 2023; 33:256-268. [PMID: 36465027 DOI: 10.1111/jon.13068] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND PURPOSE The diagnosis of Dementia with Lewy Bodies (DLB) is challenging due to various clinical presentations and clinical and neuropathological features that overlap with Alzheimer's disease (AD). The use of 18 F-Fluorodeoxyglucose-PET (18 F-FDG-PET) can be limited due to similar patterns in DLB and AD. However, metabolism in the posterior cingulate cortex is known to be relatively preserved in DLB and visual assessment of the "cingulate island sign" became a helpful tool in the analysis of 18F-FDG-PET. The aim of this study was the evaluation of visual and semiquantitative 18F-FDG-PET analyses in the diagnosis of DLB and the differentiation to AD as well as its relation to other dementia biomarkers. METHODS This retrospective study comprises 81 patients with a clinical diagnosis of DLB or AD that underwent 18 F-FDG-PET/CT. PET scans were analyzed visually and semiquantitatively and results were compared to clinical data, cerebrospinal fluid results, dopamine transporter scintigraphy, and 18F-Florbetaben-PET. Furthermore, different cingulate island ratios were calculated to analyze their diagnostic accuracy. RESULTS Visual assessment of 18F-FDG-PET showed an accuracy of 62%-77% in differentiating between DLB and AD. Standard uptake values were significantly lower in the primary visual cortex and the lateral occipital cortex of DLB patients compared to AD patients. The cingulate island ratio was significantly higher in the DLB group compared to the AD group and the ratio posterior cingulate cortex to visual cortex plus lateral occipital cortex showed the highest diagnostic accuracy to discriminate between DLB and AD at 81%. CONCLUSIONS Semiquantitative 18F-FDG-PET imaging and especially the use of an optimized cingulate island ratio are valuable tools to differentiate between DLB and AD.
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Affiliation(s)
- Katharina Woyk
- Department of Nuclear Medicine, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Carsten Oliver Sahlmann
- Department of Nuclear Medicine, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Niels Hansen
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Charles Timäus
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Sebastian Johannes Müller
- Department of Neuroradiology, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Eya Khadhraoui
- Department of Neuroradiology, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany.,Neurosciences and Signaling Group, Department of Medical Sciences, Institute of Biomedicine, University of Aveiro, Aveiro, Portugal.,German Center for Neurodegenerative Diseases, Göttingen, Germany
| | - Claudia Lange
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Caroline Bouter
- Department of Nuclear Medicine, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
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Ota Y, Kanel P, Bohnen N. Imaging of sleep disorders in pre-Parkinsonian syndromes. Curr Opin Neurol 2022; 35:443-452. [PMID: 35788559 PMCID: PMC9308698 DOI: 10.1097/wco.0000000000001084] [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] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Neuroimaging has been advanced in the last years and enabled clinicians to evaluate sleep disorders, especially isolated rapid eye movement sleep disorder (iRBD), which can be seen in alpha-synucleinopathies. iRBD is the best prodromal clinical marker for phenoconversion to these neurodegenerative diseases. This review aims to provide an update on advanced neuroimaging biomarkers in iRBD. RECENT FINDINGS Advanced structural MRI techniques, such as diffusion tensor imaging and functional MRI, neuromelanin-sensitive MRI, and scintigraphic neuroimaging such as cholinergic PET, dopamine transporter imaging - single-photon emission computerized tomography, perfusional single-photon emission computerized tomography, and cardiac metaiodobenzylguanidine can provide diagnostic and prognostic imaging biomarkers for iRBD, in isolation and more robustly when combined. SUMMARY New advanced neuroimaging can provide imaging biomarkers and aid in the appropriate clinical assessment and future therapeutic trials.
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Affiliation(s)
- Yoshiaki Ota
- The Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Prabesh Kanel
- The Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI, USA
- University of Michigan Parkinson’s Foundation Research Center of Excellence, Ann Arbor, MI, USA
| | - Nicolaas Bohnen
- The Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI, USA
- University of Michigan Parkinson’s Foundation Research Center of Excellence, Ann Arbor, MI, USA
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- GRECC & Neurology Service, VAAAHS, Ann Arbor, MI, USA
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Geng C, Wang S, Li Z, Xu P, Bai Y, Zhou Y, Zhang X, Li Y, Zhang J, Zhang H. Resting-State Functional Network Topology Alterations of the Occipital Lobe Associated With Attention Impairment in Isolated Rapid Eye Movement Behavior Disorder. Front Aging Neurosci 2022; 14:844483. [PMID: 35431890 PMCID: PMC9012114 DOI: 10.3389/fnagi.2022.844483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeThis study investigates the topological properties of brain functional networks in patients with isolated rapid eye movement sleep behavior disorder (iRBD).Participants and MethodsA total of 21 patients with iRBD (iRBD group) and 22 healthy controls (HCs) were evaluated using resting-state functional MRI (rs-fMRI) and neuropsychological measures in cognitive and motor function. Data from rs-fMRI were analyzed using graph theory, which included small-world properties, network efficiency, network local efficiency, nodal shortest path, node efficiency, and network connectivity, as well as the relationship between behavioral characteristics and altered brain topological features.ResultsRey-Osterrieth complex figure test (ROCFT-copy), symbol digital modalities test (SDMT), auditory verbal learning test (AVLT)-N1, AVLT-N2, AVLT-N3, and AVLT-N1-3 scores were significantly lower in patients with iRBD than in HC (P < 0.05), while trail making test A (TMT-A), TMT-B, and Unified Parkinson’s Disease Rating Scale Part-III (UPDRS-III) scores were higher in patients with iRBD (P < 0.05). Compared with the HCs, patients with iRBD had no difference in the small-world attributes (P > 0.05). However, there was a significant decrease in network global efficiency (P = 0.0052) and network local efficiency (P = 0.0146), while an increase in characteristic path length (P = 0.0071). There was lower nodal efficiency in occipital gyrus and nodal shortest path in frontal, parietal, temporal lobe, and cingulate gyrus. Functional connectivities were decreased between the nodes of occipital with the regions where they had declined nodal shortest path. There was a positive correlation between TMT-A scores and the nodal efficiency of the right middle occipital gyrus (R = 0.602, P = 0.014).ConclusionThese results suggest that abnormal behaviors may be associated with disrupted brain network topology and functional connectivity in patients with iRBD and also provide novel insights to understand pathophysiological mechanisms in iRBD.
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Affiliation(s)
- Chaofan Geng
- Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Shenghui Wang
- Department of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Zhonglin Li
- Department of Radiology, Zhengzhou University People’s Hospital, Zhengzhou, China
| | - Pengfei Xu
- Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yingying Bai
- Department of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yao Zhou
- Department of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Xinyu Zhang
- Department of Neurology, Henan Provincial People’s Hospital Affiliated to Xinxiang Medical University, Zhengzhou, China
| | - Yongli Li
- Department of Functional Imaging, Henan Key Laboratory for Medical Imaging of Neurological Diseases, Zhengzhou, China
| | - Jiewen Zhang
- Department of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Hongju Zhang
- Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People’s Hospital Affiliated to Xinxiang Medical University, Zhengzhou, China
- *Correspondence: Hongju Zhang,
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Zhang L, Cao J, Yang H, Pham P, Khan U, Brown B, Wang Y, Zieneldien T, Cao C. Commercial and Instant Coffees Effectively Lower Aβ1-40 and Aβ1-42 in N2a/APPswe Cells. Front Nutr 2022; 9:850523. [PMID: 35369094 PMCID: PMC8965317 DOI: 10.3389/fnut.2022.850523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Alzheimer's disease (AD) is a multifactorial neurological disease with neurofibrillary tangles and neuritic plaques as histopathological markers. Due to this, although AD is the leading cause of dementia worldwide, clinical AD dementia cannot be certainly diagnosed until neuropathological post-mortem evaluation. Coffee has been reported to have neurologically protective factors, particularly against AD, but coffee brand and type have not been taken into consideration in previous studies. We examined the discrepancies among popular commercial and instant coffees in limiting the development and progression through Aβ1-40 and Aβ1-42 production, and hypothesized that coffee consumption, regardless of brand or type, is beneficial for stalling the progression and development of Aβ-related AD. Methods Coffee samples from four commercial coffee brands and four instant coffees were purchased or prepared following given instructions and filtered for the study. 5, 2.5, and 1.25% concentrations of each coffee were used to treat N2a/APPswe cell lines. MTT assay was used to assess cell viability for coffee concentrations, as well as pure caffeine concentrations. Sandwich ELISA assay was used to determine Aβ concentration for Aβ1-40 and Aβ1-42 peptides of coffee-treated cells. Results Caffeine concentrations were significantly varied among all coffees (DC vs. MDC, PC, SB, NIN, MIN p < 0.05). There was no correlation between caffeine concentration and cell toxicity among brands and types of coffee, with no toxicity at 0.5 mg/ml caffeine and lower. Most coffees were toxic to N2a/APPswe cells at 5% (p < 0.05), but not at 2.5%. Most coffees at a 2.5% concentration reduced Aβ1-40 and Aβ1-42 production, with comparable results between commercial and instant coffees. Conclusion All coffees tested have beneficial health effects for AD through lowering Aβ1-40 and Aβ1-42 production, with Dunkin' Donuts® medium roast coffee demonstrating the most consistent and optimal cell survival rates and Aβ concentration. On the other hand, Starbucks® coffee exhibited the highest cell toxicity rates among the tested coffees.
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Affiliation(s)
- Lifang Zhang
- Department of Neurological Rehabilitation, The Affiliated Brain Hospital of Guangzhou Medical University, Guanzhou, China
| | - Jessica Cao
- Department of Kinesiology, Wiess School of Natural Sciences, Rice University, Houston, TX, United States
| | - Haiqiang Yang
- Department of Pharmaceutical Sciences, Taneja College of Pharmacy, University of South Florida, Tampa, FL, United States
| | - Phillip Pham
- Department of Pharmaceutical Sciences, Taneja College of Pharmacy, University of South Florida, Tampa, FL, United States
| | - Umer Khan
- Department of Pharmaceutical Sciences, Taneja College of Pharmacy, University of South Florida, Tampa, FL, United States
| | - Breanna Brown
- Department of Pharmaceutical Sciences, Taneja College of Pharmacy, University of South Florida, Tampa, FL, United States
| | - Yanhong Wang
- Department of Pharmaceutical Sciences, Taneja College of Pharmacy, University of South Florida, Tampa, FL, United States
| | - Tarek Zieneldien
- Department of Pharmaceutical Sciences, Taneja College of Pharmacy, University of South Florida, Tampa, FL, United States
| | - Chuanhai Cao
- Department of Pharmaceutical Sciences, Taneja College of Pharmacy, University of South Florida, Tampa, FL, United States
- Department of Neurology, College of Medicine, University of South Florida, Tampa, FL, United States
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Meles SK, Oertel WH, Leenders KL. Circuit imaging biomarkers in preclinical and prodromal Parkinson's disease. Mol Med 2021; 27:111. [PMID: 34530732 PMCID: PMC8447708 DOI: 10.1186/s10020-021-00327-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/02/2021] [Indexed: 11/10/2022] Open
Abstract
Parkinson's disease (PD) commences several years before the onset of motor features. Pathophysiological understanding of the pre-clinical or early prodromal stages of PD are essential for the development of new therapeutic strategies. Two categories of patients are ideal to study the early disease stages. Idiopathic rapid eye movement sleep behavior disorder (iRBD) represents a well-known prodromal stage of PD in which pathology is presumed to have reached the lower brainstem. The majority of patients with iRBD will develop manifest PD within years to decades. Another category encompasses non-manifest mutation carriers, i.e. subjects without symptoms, but with a known mutation or genetic variant which gives an increased risk of developing PD. The speed of progression from preclinical or prodromal to full clinical stages varies among patients and cannot be reliably predicted on the individual level. Clinical trials will require inclusion of patients with a predictable conversion within a limited time window. Biomarkers are necessary that can confirm pre-motor PD status and can provide information regarding lead time and speed of progression. Neuroimaging changes occur early in the disease process and may provide such a biomarker. Studies have focused on radiotracer imaging of the dopaminergic nigrostriatal system, which can be assessed with dopamine transporter (DAT) single photon emission computed tomography (SPECT). Loss of DAT binding represents an effect of irreversible structural damage to the nigrostriatal system. This marker can be used to monitor disease progression and identify individuals at specific risk for phenoconversion. However, it is known that changes in neuronal activity precede structural changes. Functional neuro-imaging techniques, such as 18F-2-fluoro-2-deoxy-D-glucose Positron Emission Tomography (18F-FDG PET) and functional magnetic resonance imaging (fMRI), can be used to model the effects of disease on brain networks when combined with advanced analytical methods. Because these changes occur early in the disease process, functional imaging studies are of particular interest in prodromal PD diagnosis. In addition, fMRI and 18F-FDG PET may be able to predict a specific future phenotype in prodromal cohorts, which is not possible with DAT SPECT. The goal of the current review is to discuss the network-level brain changes in pre-motor PD.
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Affiliation(s)
- Sanne K Meles
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - Wolfgang H Oertel
- Department of Neurology, Philipps-Universität Marburg, Marburg, Germany.,Institute for Neurogenomics, Helmholtz Center for Health and Environment, Munich, Germany
| | - Klaus L Leenders
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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10
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Fujishiro H, Ota K, Yamagata M, Ito T, Hieda S, Suga H, Fukui T, Nagahama Y. Early diagnosis of prodromal dementia with Lewy bodies using clinical history of probable REM sleep behaviour disorder and cardiac 123 I-MIBG scintigraphy in memory clinics. Psychogeriatrics 2021; 21:288-295. [PMID: 33565213 DOI: 10.1111/psyg.12662] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/16/2021] [Accepted: 01/23/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Rapid eye movement sleep behaviour disorder (RBD) is associated with reduced cardiac 123 I-metaiodobenzylguanidine (MIBG) uptake and often precedes the onset of Lewy body (LB) disorders. We investigated the role of cardiac 123 I-MIBG scintigraphy in relation to probable RBD for the clinical diagnosis of prodromal dementia with Lewy bodies (DLB) in memory clinics. METHODS We reviewed clinical profiles of 60 consecutive patients who underwent cardiac 123 I-MIBG scintigraphy in our memory clinics. The diagnostic threshold of 2.20 was used as the cut-off for the heart-to-mediastinum ratio at the delayed phase. RESULTS Cardiac 123 I-MIBG abnormality was identified in 28 patients at baseline; six were cognitively unimpaired, six had mild cognitive impairment (MCI)-LB, and 16 had probable DLB based on the National Institute on Aging and Alzheimer's Association Research Framework. Although the number of core features increased in accordance with the progression of three cognitive categories, there were no differences in the prevalence of probable RBD and the cardiac MIBG scintigraphy indices among them. During the observation period, two cognitively unimpaired patients with probable RBD progressed to MCI-LB, and three MCI-LB patients with probable RBD developed DLB. The prevalence of final diagnosis of probable MCI-LB or DLB was significantly higher in these patients (85%) than the remaining 32 patients without (9%). Of 25 patients with probable RBD, 22 (88%) had a cardiac 123 I-MIBG abnormality regardless of cognitive conditions. Only one patient consulted a sleep centre for the abnormal sleep behaviour before visiting our memory clinics. Regarding the gender differences, male predominance was not identified and sleep-related injury more frequently occurred in men (7/12, 58%) than in women (1/10, 10%). CONCLUSIONS Proactive detection of probable RBD plus cardiac 123 I-MIBG abnormality provides the opportunity for an early diagnosis of prodromal DLB in memory clinics. This approach warrants further follow-up studies with polysomnographic and pathological verification.
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Affiliation(s)
- Hiroshige Fujishiro
- Department of Psychiatry, Kawasaki Memorial Hospital, Kawasaki, Japan.,Department of Dementia diagnostic Centre, Yokohama Shintoshi Neurosurgery Hospital, Yokohama, Japan
| | - Kazumi Ota
- Department of Dementia diagnostic Centre, Yokohama Shintoshi Neurosurgery Hospital, Yokohama, Japan
| | - Mayumi Yamagata
- Department of Dementia diagnostic Centre, Yokohama Shintoshi Neurosurgery Hospital, Yokohama, Japan
| | - Tatsuya Ito
- Department of Neurology, Kawasaki Memorial Hospital, Kawasaki, Japan
| | - Sotaro Hieda
- Department of Neurology, Kawasaki Memorial Hospital, Kawasaki, Japan.,Department of Neurology, Showa University, Tokyo, Japan
| | - Hiroko Suga
- Department of Psychiatry, Kawasaki Memorial Hospital, Kawasaki, Japan
| | - Toshiya Fukui
- Department of Neurology, Kawasaki Memorial Hospital, Kawasaki, Japan
| | - Yasuhiro Nagahama
- Department of Neurology, Kawasaki Memorial Hospital, Kawasaki, Japan
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11
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Hamilton CA, Matthews FE, Donaghy PC, Taylor JP, O'Brien JT, Barnett N, Olsen K, Lloyd J, Petrides G, McKeith IG, Thomas AJ. Cognitive Decline in Mild Cognitive Impairment With Lewy Bodies or Alzheimer Disease: A Prospective Cohort Study. Am J Geriatr Psychiatry 2021; 29:272-284. [PMID: 32863138 DOI: 10.1016/j.jagp.2020.07.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 04/02/2020] [Accepted: 07/16/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We explored whether the mild cognitive impairment (MCI) stages of dementia with Lewy bodies (DLB) and Alzheimer disease (AD) differ in their cognitive profiles, and longitudinal progression. DESIGN A prospective, longitudinal design was utilized with annual follow-up (Max 5 years, Mean 1.9, standard deviation 1.1) after diagnosis. Participants underwent repeated cognitive testing, and review of their clinical diagnosis and symptoms, including evaluation of core features of DLB. SETTING This was an observational study of independently living individuals, recruited from local healthcare trusts in North East England, UK. PARTICIPANTS An MCI cohort (n = 76) aged ≥60 years was utilized, differentially diagnosed with MCI due to AD (MCI-AD), or possible/probable MCI with Lewy bodies (MCI-LB). MEASUREMENTS A comprehensive clinical and neuropsychological testing battery was administered, including ACE-R, trailmaking tests, FAS verbal fluency, and computerized battery of attention and perception tasks. RESULTS Probable MCI-LB presented with less impaired recognition memory than MCI-AD, greater initial impairments in verbal fluency and perception of line orientation, and thereafter demonstrated an expedited decline in visuo-constructional functions in the ACE-R compared to MCI-AD. No clear diagnostic group differences were found in deterioration speeds for global cognition, language, overall memory, attention or other executive functions. CONCLUSION These findings provide further evidence for differences in severity and decline of visuospatial dysfunctions in DLB compared with AD; further exploration is required to clarify when and how differences in attention, executive, and memory functions emerge, as well as speed of decline to dementia.
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Affiliation(s)
- Calum A Hamilton
- Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University (CAH, PCD, J-PT, NB, KO, IGM, AJT), Newcastle upon Tyne, United Kingdom.
| | - Fiona E Matthews
- Population Health Sciences Institute, Baddiley-Clark Building, Newcastle University (FEM), Newcastle upon Tyne, United Kingdom
| | - Paul C Donaghy
- Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University (CAH, PCD, J-PT, NB, KO, IGM, AJT), Newcastle upon Tyne, United Kingdom
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University (CAH, PCD, J-PT, NB, KO, IGM, AJT), Newcastle upon Tyne, United Kingdom
| | - John T O'Brien
- Department of Psychiatry, Level E4, University of Cambridge School of Clinical Medicine (JTO), Cambridge, United Kingdom
| | - Nicola Barnett
- Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University (CAH, PCD, J-PT, NB, KO, IGM, AJT), Newcastle upon Tyne, United Kingdom
| | - Kirsty Olsen
- Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University (CAH, PCD, J-PT, NB, KO, IGM, AJT), Newcastle upon Tyne, United Kingdom
| | - Jim Lloyd
- Nuclear Medicine Department, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust (JL, GP), Newcastle upon Tyne, United Kingdom
| | - George Petrides
- Nuclear Medicine Department, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust (JL, GP), Newcastle upon Tyne, United Kingdom
| | - Ian G McKeith
- Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University (CAH, PCD, J-PT, NB, KO, IGM, AJT), Newcastle upon Tyne, United Kingdom
| | - Alan J Thomas
- Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University (CAH, PCD, J-PT, NB, KO, IGM, AJT), Newcastle upon Tyne, United Kingdom
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12
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Lee EJ, Oh JS, Moon H, Kim MJ, Kim MS, Chung SJ, Kim JS, Jeon SR. Parkinson Disease-Related Pattern of Glucose Metabolism Associated With the Potential for Motor Improvement After Deep Brain Stimulation. Neurosurgery 2020; 86:492-499. [PMID: 31215629 DOI: 10.1093/neuros/nyz206] [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: 08/02/2018] [Accepted: 02/24/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Motor dysfunctions in Parkinson disease (PD) patients are not completely normalized by deep brain stimulation (DBS), and there is an obvious difference in the degree of symptom improvement after DBS for each patient. OBJECTIVE To test our hypothesis that each patient has their own restoration capacity for motor improvement after DBS, and to investigate whether regional cerebral glucose metabolism in 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scans is associated with the capacity for off-medication motor improvement (MIoff) after DBS. METHODS The MIoff (%) was calculated using the Unified Parkinson's Disease Rating Scale part III in 27 PD patients undergoing DBS in the globus pallidus interna. The standardized uptake value ratios (SUVRs) on FDG-PET were quantitatively measured, and the areas where the SUVR correlated with the MIoff (%) were identified. Also, the areas where the SUVR was significantly different between the 2 MIoff groups (≥60% vs <60%) were determined. RESULTS Ten patients achieved MIoff > 60% at 12 mo after DBS. In general, the MIoff (%) was positively correlated with preoperative SUVR in the temporo-parieto-occipital lobes, while it was inversely correlated with the metabolism in the primary motor cortex. The patients in the MIoff < 60% group showed a significant decrease in SUVR in the parieto-occipital lobes, while parieto-occipital metabolism in those with MIoff ≥ 60% was relatively preserved (Mann-Whitney U test, P = .03). CONCLUSION Our findings suggest that the parieto-occipital lobes may be implicated more generally in the prognosis of motor improvement after DBS in advanced PD than other regions.
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Affiliation(s)
- Eun Jung Lee
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jungsu S Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyojeong Moon
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,System Medical Device Team, Advanced Technology Department, Medical Device Development Center, Daegu-Gyeongbuk Medical Innovation Foundation, Daegu, Republic of Korea
| | - Min-Ju Kim
- Department of Clinical Epidemiology and Biostatics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi Sun Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Ryong Jeon
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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13
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Zhang R, Li Z, Bai Y, Xu P, Zhang J, Zhang H. [Changes of brain structural network properties in patients with rapid eye movement sleep behavior disorder]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:125-130. [PMID: 32376561 DOI: 10.12122/j.issn.1673-4254.2020.01.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the changes in behaviors and brain structural network in patients with idiopathic rapid eye movement sleep behavior disorder (iRBD). METHODS Twenty patients with iRBD (iRBD group) and 22 healthy control subjects were evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn-Yahr staging. Diffusion tensor imaging and graph- theoretical analysis were performed for analyzing the topological characteristics of brain structural networks of the patients, and the correlation between the behavioral changes and the changes in the topological characteristics of the brain networks was analyzed. RESULTS The UPDRS score was significantly higher in iRBD group than in the healthy control group (P < 0.05). No significant difference was found in small-world attributes between the patients with iRBD and the control subjects (P>0.05). The patients with iRBD exhibited significantly shortened characteristic shortest path length Lp (P < 0.05) and significantly increased global efficiency, local efficiency and assortativity (P < 0.05). Examination of regional topological properties of the brain network revealed abnormal node properties in the frontal, temporal, parietal, occipital, and striatal and limbic lobes in patients with iRBD. The patients also had significantly increased degree centrality of the left pallidum and enhanced nodal efficiency in the left thalamus, superior temporal gyrus, temporal pole and bilateral superior occipital gyrus, bilateral putamens as well as the right gyrus rectus, amygdala, supramarginal gyrus, and middle temporal gyrus. The nodal local efficiency was significantly increased in the left superior frontal gyrus, middle cingulate gyrus, superior parietal gyrus, bilateral fusiform gyrus, right superior motor area, postcentral gyrus and angular gyrus of the patients with iRBD. The nodal shortest path was significantly shortened in the left superior motor area, pallidum, thalamus, superior temporal gyrus, temporal pole, bilateral putamens, bilateral superior occipital gyrus, right rectus gyrus, amygdala, supramarginal gyrus and middle temporal gyrus, and the nodal clustering coefficient was significantly lowered in the left superior occipital gyrus of the patients. In patients with iRBD, the UPDRS I score was positively correlated with the nodal efficiency in the right supramarginal gyrus (r=0.50, P < 0.05) and local nodal efficiency in the right fusiform gyrus (r=0.53, P < 0.05), and negatively correlated with the nodal clustering coefficient in the left superior occipital gyrus (r=-0.552, P < 0.05). CONCLUSIONS Patients with iRBD present with abnormal changes in mental condition, behaviors, emotions, activities of daily living and motor functions. The brain structural network of patient with iRBD still has a small-world property with abnormal global topological property and abnormal distribution of local topological property in the cortex, striatum and limbic system.
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Affiliation(s)
- Ruirui Zhang
- Department of Neurology, People's Hospital of Henan University, Zhengzhou 450003, China
| | - Zhonglin Li
- Department of Imaging, People's Hospital of Henan University, Zhengzhou 450003, China
| | - Yingying Bai
- Department of Neurology, People's Hospital of Henan University, Zhengzhou 450003, China
| | - Pengfei Xu
- Department of Neurology, People's Hospital of Henan University, Zhengzhou 450003, China
| | - Jiewen Zhang
- Department of Neurology, People's Hospital of Henan University, Zhengzhou 450003, China
| | - Hongju Zhang
- Department of Neurology, People's Hospital of Henan University, Zhengzhou 450003, China
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14
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Trošt M, Perovnik M, Pirtošek Z. Correlations of Neuropsychological and Metabolic Brain Changes in Parkinson's Disease and Other α-Synucleinopathies. Front Neurol 2019; 10:1204. [PMID: 31798525 PMCID: PMC6868095 DOI: 10.3389/fneur.2019.01204] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/28/2019] [Indexed: 12/14/2022] Open
Abstract
Cognitive impairment is a common feature in Parkinson's disease (PD) and other α-synucleinopathies as 80% of PD patients develop dementia within 20 years. Early cognitive changes in PD patients present as a dysexecutive syndrome, broadly characterized as a disruption of the fronto-striatal dopamine network. Cognitive deficits in other domains (recognition memory, attention processes and visuospatial abilities) become apparent with the progression of PD and development of dementia. In dementia with Lewy bodies (DLB) the cognitive impairment develops early or even precedes parkinsonism and it is more pronounced in visuospatial skills and memory. Cognitive impairment in the rarer α-synucleinopathies (multiple system atrophy and pure autonomic failure) is less well studied. Metabolic brain imaging with positron emission tomography and [18F]-fluorodeoxyglucose (FDG-PET) is a well-established diagnostic method in neurodegenerative diseases, including dementias. Changes in glucose metabolism precede those seen on structural magnetic resonance imaging (MRI). Reduction in glucose metabolism and atrophy have been suggested to represent consecutive changes of neurodegeneration and are linked to specific cognitive disorders (e.g., dysexecutive syndrome, memory impairment, visuospatial deficits etc.). Advances in the statistical analysis of FDG-PET images enabling a network analysis broadened our understanding of neurodegenerative brain processes. A specific cognitive pattern related to PD was identified by applying voxel-based network modeling approach. The magnitude of this pattern correlated significantly with patients' cognitive skills. Specific metabolic brain changes were observed also in patients with DLB as well as in a prodromal phase of α-synucleinopathy: REM sleep behavior disorder. Metabolic brain imaging with FDG-PET is a reliable biomarker of neurodegenerative brain diseases throughout their course, precisely reflecting their topographic distribution, stage and functional impact.
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Affiliation(s)
- Maja Trošt
- Department for Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department for Nuclear Medicine, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Matej Perovnik
- Department for Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Zvezdan Pirtošek
- Department for Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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15
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Durcan R, Donaghy P, Osborne C, Taylor JP, Thomas AJ. Imaging in prodromal dementia with Lewy bodies: Where do we stand? Int J Geriatr Psychiatry 2019; 34:635-646. [PMID: 30714199 DOI: 10.1002/gps.5071] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 01/28/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The aim of this review was to provide an overview of the literature on imaging in prodromal dementia with Lewy bodies (DLB). DESIGN Systematic PubMed search and literature review. RESULTS Diagnostic classification of the prodromal DLB stage remains to be established but is likely to require imaging biomarkers to improve diagnostic accuracy. In subjects with mild cognitive impairment with Lewy body disease (MCI-LB) (here synonymous with prodromal DLB) and REM sleep behaviour disorder, a high risk condition for future conversion to a synucleinopathy, imaging modalities have assessed early structural brain changes, striatal dopaminergic integrity, metabolic brain, and cerebral perfusion alterations. It remains uncertain whether structural brain imaging can differentiate MCI-LB from mild cognitive impairment with Alzheimer disease (MCI-AD), but early right anterior insula thinning has been reported to occur in MCI-LB compared with MCI-AD. Dopaminergic deficits have been observed in a substantial proportion of MCI-LB subjects and have a high specificity for Lewy body disease at the pre-dementia stage. Cardiac sympathetic denervation, occipital hypometabolism, or hypoperfusion is less studied as this pre-dementia stage and it remains to be determined whether any imaging abnormalities antedate DLB. CONCLUSION Imaging studies in prodromal DLB are still in their infancy but offer great potential to study early in vivo structural and functional biological alterations. Future work should focus on longitudinal multimodal imaging studies with postmortem validation of diagnosis in order to develop and then validate criteria for prodromal DLB.
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Affiliation(s)
- Rory Durcan
- Campus for Ageing and Vitality, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Paul Donaghy
- Campus for Ageing and Vitality, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Curtis Osborne
- Campus for Ageing and Vitality, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - John-Paul Taylor
- Campus for Ageing and Vitality, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Alan J Thomas
- Campus for Ageing and Vitality, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
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16
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Tampi RR, Young JJ, Tampi D. Behavioral symptomatology and psychopharmacology of Lewy body dementia. HANDBOOK OF CLINICAL NEUROLOGY 2019; 165:59-70. [PMID: 31727230 DOI: 10.1016/b978-0-444-64012-3.00005-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Lewy body dementia (LBD) is an umbrella term for major neurocognitive disorders caused by Lewy body pathology. Parkinson's disease dementia (PDD) and Dementia with Lewy bodies (DLB) are the two main syndromes in LBD. LBDs typically present with cognitive impairment, cholinergic deficiency, neuropsychiatric symptoms such as visual hallucinations and paranoid delusions, as well as parkinsonian symptoms. Due to the urgency in diagnosing LBD early in the disease course to provide the most optimal management of these syndromes, it is important that clinicians elicit the most clinically significant symptoms during patient encounters. The focus of this chapter is to discuss current LBD classification systems and assessments, neuropathology of LBDs, behavioral symptomatology, contemporary management options, and possible future targets of treatment. PubMed was searched to obtain reviews and studies that pertain to classification, behavioral symptomatology, neurobiology, neuroimaging, and treatment of LBDs. Articles were chosen with a predilection to more recent clinical trials and systematic reviews or meta-analyses. Updates to diagnostic criteria have increased clinical diagnostic sensitivity and specificity. Current therapeutic modalities are limited as there is no current disease-modifying drug available. Cholinesterase inhibitors have been reported to be effective in decreasing neuropsychiatric and cognitive symptoms. Neuroleptics should be avoided unless clinically indicated. There is a paucity of studies investigating treatment options for mood symptoms. Current novel targets of treatment focus on decreasing α-synuclein burden. LBDs are a group of dementia syndromes that affect a significant portion of the elderly population. Early diagnosis and treatment is necessary to improve patient quality of life with current treatment options more focused on alleviating severe symptomatology rather than modifying disease pathology.
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Affiliation(s)
- Rajesh R Tampi
- Department of Psychiatry & Behavioral Sciences, Cleveland Clinic Akron General, Akron, OH, United States; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, United States.
| | - Juan Joseph Young
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Deena Tampi
- Diamond Healthcare, Richmond, VA, United States
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17
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COGEVIS: A New Scale to Evaluate Cognition in Patients with Visual Deficiency. Behav Neurol 2018; 2018:4295184. [PMID: 30046359 PMCID: PMC6036847 DOI: 10.1155/2018/4295184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/15/2018] [Accepted: 02/10/2018] [Indexed: 11/29/2022] Open
Abstract
We evaluated the cognitive status of visually impaired patients referred to low vision rehabilitation (LVR) based on a standard cognitive battery and a new evaluation tool, named the COGEVIS, which can be used to assess patients with severe visual deficits. We studied patients aged 60 and above, referred to the LVR Hospital in Paris. Neurological and cognitive evaluations were performed in an expert memory center. Thirty-eight individuals, 17 women and 21 men with a mean age of 70.3 ± 1.3 years and a mean visual acuity of 0.12 ± 0.02, were recruited over a one-year period. Sixty-three percent of participants had normal cognitive status. Cognitive impairment was diagnosed in 37.5% of participants. The COGEVIS score cutoff point to screen for cognitive impairment was 24 (maximum score of 30) with a sensitivity of 66.7% and a specificity of 95%. Evaluation following 4 months of visual rehabilitation showed an improvement of Instrumental Activities of Daily Living (p = 0.004), National Eye Institute Visual Functioning Questionnaire (p = 0.035), and Montgomery–Åsberg Depression Rating Scale (p = 0.037). This study introduces a new short test to screen for cognitive impairment in visually impaired patients.
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Fujishiro H, Okuda M, Iwamoto K, Miyata S, Torii Y, Iritani S, Ozaki N. Early diagnosis of Lewy body disease in patients with late-onset psychiatric disorders using clinical history of rapid eye movement sleep behavior disorder and [ 123 I]-metaiodobenzylguanidine cardiac scintigraphy. Psychiatry Clin Neurosci 2018. [PMID: 29536584 DOI: 10.1111/pcn.12651] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM Rapid eye movement sleep behavior disorder (RBD) and psychiatric symptoms often antedate the clinical diagnosis of Parkinson's disease or dementia with Lewy bodies. The purpose of this study was to investigate RBD and its relevance to Lewy body disease (LBD) in patients with late-onset psychiatric disorders. METHODS Study subjects included 19 patients with late-onset psychiatric disorders who exhibited REM sleep without atonia (RWA), which is a hallmark of RBD on polysomnography, at our psychiatric ward. Clinical profiles and radiological findings by cardiac [123 I]-metaiodobenzylguanidine ([123 I]-MIBG) scintigraphy and imaging for the dopamine transporter (DAT) were compared between patients with and without RBD symptoms. The correlations between the percentage of RWA in the total rapid eye movement sleep (%RWA) and radiological findings were also investigated. RESULTS Nine patients reported RBD symptoms only on specific questioning, but clinical profiles, including the prevalence of antipsychotropic usage, did not differ when compared to the remaining 10 patients without RBD (incidental RWA group). The median %RWA was significantly higher in the definite RBD group than in the incidental RWA group. Although the cardiac [123 I]-MIBG uptake was significantly lower in the definite RBD group than in the incidental RWA group, there was overlap in the specific binding ratio on DAT scan. CONCLUSION The severity of %RWA was highly correlated with the value of cardiac [123 I]-MIBG uptake, but not with specific binding ratio on DAT scan. Clinical history of RBD and cardiac [123 I]-MIBG scintigraphy are helpful for an early differential diagnosis of LBD from late-onset psychiatric disorders, even before parkinsonism or dementia appears.
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Affiliation(s)
- Hiroshige Fujishiro
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Okuda
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kunihiro Iwamoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Seiko Miyata
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Youta Torii
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shuji Iritani
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Barone DA, Henchcliffe C. Rapid eye movement sleep behavior disorder and the link to alpha-synucleinopathies. Clin Neurophysiol 2018; 129:1551-1564. [PMID: 29883833 DOI: 10.1016/j.clinph.2018.05.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/10/2018] [Accepted: 05/18/2018] [Indexed: 01/09/2023]
Abstract
Rapid eye movement (REM) sleep behavior disorder (RBD) involves REM sleep without atonia in conjunction with a recurrent nocturnal dream enactment behavior, with vocalizations such as shouting and screaming, and motor behaviors such as punching and kicking. Secondary RBD is well described in association with neurological disorders including Parkinson's disease (PD), multiple system atrophy (MSA), and other conditions involving brainstem structures such as tumors. However, RBD alone is now considered to be a potential harbinger of later development of neurodegenerative disorders, in particular PD, MSA, dementia with Lewy bodies (DLB), and pure autonomic failure. These conditions are linked by their underpinning pathology of alpha-synuclein protein aggregation. In RBD, it is therefore important to recognize the potential risk for later development of an alpha-synucleinopathy, and to investigate for other potential causes such as medications. Other signs and symptoms have been described in RBD, such as orthostatic hypotension, or depression. While it is important to recognize these features to improve patient management, they may ultimately provide clinical clues that will lead to risk stratification for phenoconversion. A critical need is to improve our ability to counsel patients, particularly with regard to prognosis. The ability to identify who, of those with RBD, is at high risk for later neurodegenerative disorders will be paramount, and would in addition advance our understanding of the prodromal stages of the alpha-synucleinopathies. Moreover, recognition of at-risk individuals for neurodegenerative disorders may ultimately provide a platform for the testing of possible neuroprotective agents for these neurodegenerative disorders.
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Clinical utility of FDG-PET for the clinical diagnosis in MCI. Eur J Nucl Med Mol Imaging 2018; 45:1497-1508. [DOI: 10.1007/s00259-018-4039-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 04/19/2018] [Indexed: 10/17/2022]
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21
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Caminiti SP, Ballarini T, Sala A, Cerami C, Presotto L, Santangelo R, Fallanca F, Vanoli EG, Gianolli L, Iannaccone S, Magnani G, Perani D. FDG-PET and CSF biomarker accuracy in prediction of conversion to different dementias in a large multicentre MCI cohort. Neuroimage Clin 2018; 18:167-177. [PMID: 29387532 PMCID: PMC5790816 DOI: 10.1016/j.nicl.2018.01.019] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/15/2017] [Accepted: 01/18/2018] [Indexed: 01/29/2023]
Abstract
Background/aims In this multicentre study in clinical settings, we assessed the accuracy of optimized procedures for FDG-PET brain metabolism and CSF classifications in predicting or excluding the conversion to Alzheimer's disease (AD) dementia and non-AD dementias. Methods We included 80 MCI subjects with neurological and neuropsychological assessments, FDG-PET scan and CSF measures at entry, all with clinical follow-up. FDG-PET data were analysed with a validated voxel-based SPM method. Resulting single-subject SPM maps were classified by five imaging experts according to the disease-specific patterns, as "typical-AD", "atypical-AD" (i.e. posterior cortical atrophy, asymmetric logopenic AD variant, frontal-AD variant), "non-AD" (i.e. behavioural variant FTD, corticobasal degeneration, semantic variant FTD; dementia with Lewy bodies) or "negative" patterns. To perform the statistical analyses, the individual patterns were grouped either as "AD dementia vs. non-AD dementia (all diseases)" or as "FTD vs. non-FTD (all diseases)". Aβ42, total and phosphorylated Tau CSF-levels were classified dichotomously, and using the Erlangen Score algorithm. Multivariate logistic models tested the prognostic accuracy of FDG-PET-SPM and CSF dichotomous classifications. Accuracy of Erlangen score and Erlangen Score aided by FDG-PET SPM classification was evaluated. Results The multivariate logistic model identified FDG-PET "AD" SPM classification (Expβ = 19.35, 95% C.I. 4.8-77.8, p < 0.001) and CSF Aβ42 (Expβ = 6.5, 95% C.I. 1.64-25.43, p < 0.05) as the best predictors of conversion from MCI to AD dementia. The "FTD" SPM pattern significantly predicted conversion to FTD dementias at follow-up (Expβ = 14, 95% C.I. 3.1-63, p < 0.001). Overall, FDG-PET-SPM classification was the most accurate biomarker, able to correctly differentiate either the MCI subjects who converted to AD or FTD dementias, and those who remained stable or reverted to normal cognition (Expβ = 17.9, 95% C.I. 4.55-70.46, p < 0.001). Conclusions Our results support the relevant role of FDG-PET-SPM classification in predicting progression to different dementia conditions in prodromal MCI phase, and in the exclusion of progression, outperforming CSF biomarkers.
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Key Words
- AD, Alzheimer's disease
- AUC, area under curve
- Alzheimer's disease dementia
- CBD, corticobasal degeneration
- CDR, Clinical Dementia Rating
- CSF, cerebrospinal fluid
- Clinical setting
- DLB, dementia with Lewy bodies
- EANM, European Association of Nuclear Medicine
- Erlangen Score
- FDG, fluorodeoxyglucose
- FTD, frontotemporal dementia
- Frontotemporal dementia
- LR+, positive likelihood ratio
- LR-, negative likelihood ratio
- MCI, mild cognitive impairment
- PET, positron emission tomography
- PSP, progressive supranuclear palsy
- Prognosis
- aMCI, single-domain amnestic mild cognitive impairment
- bvFTD, behavioral variant of frontotemporal dementia
- md aMCI, multi-domain amnestic mild cognitive impairment
- md naMCI, multi-domain non-amnestic mild cognitive impairment
- naMCI, single-domain non-amnestic mild cognitive impairment
- p-tau, phosphorylated tau
- t-tau, total tau
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Affiliation(s)
- Silvia Paola Caminiti
- Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Tommaso Ballarini
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Arianna Sala
- Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Cerami
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Clinical Neuroscience Department, San Raffaele Turro Hospital, Milan, Italy
| | - Luca Presotto
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Santangelo
- Department of Neurology and INSPE, San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Luigi Gianolli
- Nuclear Medicine Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Sandro Iannaccone
- Clinical Neuroscience Department, San Raffaele Turro Hospital, Milan, Italy
| | - Giuseppe Magnani
- Department of Neurology and INSPE, San Raffaele Scientific Institute, Milan, Italy
| | - Daniela Perani
- Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Nuclear Medicine Unit, IRCCS San Raffaele Hospital, Milan, Italy.
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Génier Marchand D, Montplaisir J, Postuma RB, Rahayel S, Gagnon JF. Detecting the Cognitive Prodrome of Dementia with Lewy Bodies: A Prospective Study of REM Sleep Behavior Disorder. Sleep 2017; 40:2660407. [PMID: 28364450 DOI: 10.1093/sleep/zsw014] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2016] [Indexed: 11/12/2022] Open
Abstract
Study Objectives Long-term studies in REM sleep behavior disorder (RBD) have shown a high rate of conversion into synucleinopathies. We aimed to prospectively follow-up a large cohort of RBD patients to identify cognitive markers for early detection of prodromal dementia. Methods Seventy-six idiopathic RBD patients underwent polysomnography and a complete neuropsychological and neurological assessment and were then followed for a mean of 3.6 years. Cognitive characteristics at baseline were compared between patients who remained disease-free and those who developed a synucleinopathy, and between those who developed dementia first and those who developed parkinsonism first. Receiver operating characteristic curves were calculated to assess the diagnostic value of cognitive tests for detecting prodromal dementia. Results At follow-up, 34 patients developed a neurodegenerative disease: 19 parkinsonism-first and 15 dementia-first. RBD patients who first developed dementia were impaired at baseline in all cognitive domains (attention/executive functions, learning/memory, and visuospatial) compared to patients who developed parkinsonism. Moreover, 93% of patients who first developed dementia had mild cognitive impairment at baseline compared to 42% of patients who developed parkinsonism. RBD patients who developed parkinsonism first were similar at baseline to disease-free RBD patients on cognition. In dementia-first patients, two cognitive tests assessing attention and executive functions (Stroop Color Word Test and Trail Making Test) reliably predicted dementia (area under the curve ≥0.85) compared to parkinsonism-first patients or controls. Conclusions This study shows that cognitive tests assessing attention and executive functions strongly predict conversion to dementia in RBD patients, and may be useful endpoints to determine the effectiveness of interventions to prevent cognitive deterioration in RBD patients.
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Affiliation(s)
- Daphné Génier Marchand
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada.,Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Jacques Montplaisir
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada.,Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada
| | - Ronald B Postuma
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada.,Department of Neurology, Montreal General Hospital, Montreal, Quebec, Canada
| | - Shady Rahayel
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada.,Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Jean-François Gagnon
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada.,Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
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Chimagomedova AS, Vasenina EE, Levin OS. [Diagnostic of prodromal dementia with Levy bodies]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:23-32. [PMID: 28980609 DOI: 10.17116/jnevro20171176223-32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The issues of diagnosis of prodromal dementia with Lewy bodies are considered. Despite numerous studies using international diagnostic criteria, clinical and diagnosis are often inconsistent. Early and more accurate detection of dementia with Lewy bodies is needed for prognosis, optimal management and effective pharmacotherapy.
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Affiliation(s)
- A Sh Chimagomedova
- Russian Medical Academy of Continued Professional Education, Moscow, Russia
| | - E E Vasenina
- Russian Medical Academy of Continued Professional Education, Moscow, Russia
| | - O S Levin
- Russian Medical Academy of Continued Professional Education, Moscow, Russia
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Fujishiro H, Okuda M, Iwamoto K, Miyata S, Otake H, Noda A, Iritani S, Ozaki N. REM sleep without atonia in middle-aged and older psychiatric patients and Lewy body disease: a case series. Int J Geriatr Psychiatry 2017; 32:397-406. [PMID: 27108917 DOI: 10.1002/gps.4477] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 03/05/2016] [Accepted: 03/08/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Rapid eye movement (REM) sleep behavior disorder (RBD) is commonly associated with Lewy body disease, narcolepsy, or depression. In contrast, the relationship between REM sleep without atonia (RWA), which is a hallmark of RBD on polysomnography, and clinical characteristics remains unclear. The purpose of this study is to investigate the clinical features of psychiatric patients exhibiting RWA and its relevance to Lewy body disease. METHODS Of 55 consecutive patients who underwent polysomnography at the psychiatric ward, 25 patients with sleep apnea syndrome were excluded, and 12 patients exhibiting RWA were identified. The clinical profiles were compared between the groups with and without RWA. RESULTS The mean age and the frequency of neurocognitive disorders were significantly higher in 12 patients with RWA than in 18 without. Only five of the 12 patients exhibiting RWA had episodes of dream-enactment behavior, and fulfilled the clinical criteria for RBD. Two young patients were diagnosed with narcolepsy, while the other middle-aged and older patients fulfilled the clinical criteria for Parkinson's disease (n = 1), dementia with Lewy bodies (n = 4), idiopathic RBD (n = 2), and major depressive disorder (MDD) (n = 3). The patients with MDD exhibited constipation and/or olfactory dysfunction. Moreover, neuroimaging examinations in the patients with MDD revealed isolated occipital hypoperfusion in three patients and mild dopamine transporter deficit in one patient. CONCLUSIONS Rapid eye movement sleep without atonia itself may be associated with specific clinical profiles, even when dream-enactment behavior is absent. Continued follow-up of the patients with MDD exhibiting RWA is warranted to determine if they represent the prodromal Parkinson's disease/dementia with Lewy bodies. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Hiroshige Fujishiro
- Department of Sleep Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Okuda
- Department of Sleep Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kunihiro Iwamoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Seiko Miyata
- Department of Sleep Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hironao Otake
- Department of Sleep Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akiko Noda
- Department of Biomedical Science, Chubu University Graduate School of Life and Health Sciences, Kasugai, Japan
| | - Shuji Iritani
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Del Sole A, Malaspina S, Magenta Biasina A. Magnetic resonance imaging and positron emission tomography in the diagnosis of neurodegenerative dementias. FUNCTIONAL NEUROLOGY 2017; 31:205-215. [PMID: 28072381 DOI: 10.11138/fneur/2016.31.4.205] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Neuroimaging, both with magnetic resonance imaging (MRI) and positron emission tomography (PET), has gained a pivotal role in the diagnosis of primary neurodegenerative diseases. These two techniques are used as biomarkers of both pathology and progression of Alzheimer's disease (AD) and to differentiate AD from other neurodegenerative diseases. MRI is able to identify structural changes including patterns of atrophy characterizing neurodegenerative diseases, and to distinguish these from other causes of cognitive impairment, e.g. infarcts, space-occupying lesions and hydrocephalus. PET is widely used to identify regional patterns of glucose utilization, since distinct patterns of distribution of cerebral glucose metabolism are related to different subtypes of neurodegenerative dementia. The use of PET in mild cognitive impairment, though controversial, is deemed helpful for predicting conversion to dementia and the dementia clinical subtype. Recently, new radiopharmaceuticals for the in vivo imaging of amyloid burden have been licensed and more tracers are being developed for the assessment of tauopathies and inflammatory processes, which may underlie the onset of the amyloid cascade. At present, the cerebral amyloid burden, imaged with PET, may help to exclude the presence of AD as well as forecast its possible onset. Finally PET imaging may be particularly useful in ongoing clinical trials for the development of dementia treatments. In the near future, the use of the above methods, in accordance with specific guidelines, along with the use of effective treatments will likely lead to more timely and successful treatment of neurodegenerative dementias.
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26
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Meles SK, Teune LK, de Jong BM, Dierckx RA, Leenders KL. Metabolic Imaging in Parkinson Disease. J Nucl Med 2016; 58:23-28. [DOI: 10.2967/jnumed.116.183152] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 11/18/2016] [Indexed: 01/04/2023] Open
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Kondo D, Ota K, Kasanuki K, Fujishiro H, Chiba Y, Murayama N, Sato K, Hirayasu Y, Arai H, Iseki E. Characteristics of mild cognitive impairment tending to convert into Alzheimer's disease or dementia with Lewy bodies: A follow-up study in a memory clinic. J Neurol Sci 2016; 369:102-108. [PMID: 27653873 DOI: 10.1016/j.jns.2016.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 07/27/2016] [Accepted: 08/03/2016] [Indexed: 11/19/2022]
Abstract
AIM To determine characteristics of MCI that can predict whether patients will go on to develop AD or DLB. METHODS Ninety-three patients diagnosed with MCI underwent neuropsychological and neuroimaging examinations, and were followed-up for a mean of 44.9±19.3months. They were divided into four MCI subtypes (amnestic/non-amnestic MCI, single/multiple domain) according to neuropsychological findings, and into three other MCI categories (AD-type PET, DLB-type PET, and unknown-type PET) based on (18)F-fluorodeoxyglucose PET findings. Patients who were eventually diagnosed with AD, DLB, other dementia, or remained MCI were analyzed in relation to the groups to which they had initially been allocated at the MCI stage. RESULTS Clinical diagnosis after follow-up determined AD in 21 patients (22.6%), DLB in 12 patients (12.9%), other dementia in 2 patients (2.2%), and non-converter in 58 patients (62.3%). Amnestic single-domain MCI and AD-type PET tended to convert into AD. Amnestic multiple-domain MCI and DLB-type PET tended to convert into DLB. A few patients with AD-type PET later developed DLB, and some with DLB-type PET later developed AD. CONCLUSIONS Predicting which type of dementia a person with MCI will later develop might be possible based on early assessment with clinical symptoms in conjunction with neuropsychological and (18)F-fluorodeoxyglucose PET findings.
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Affiliation(s)
- Daizo Kondo
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Japan; Department of Psychiatry, Yokohama City University School of Medicine, Japan
| | - Kazumi Ota
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Japan
| | - Koji Kasanuki
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Japan; Department of Psychiatry, Juntendo University School of Medicine, Japan
| | - Hiroshige Fujishiro
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Japan
| | - Yuhei Chiba
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Japan; Department of Psychiatry, Yokohama City University School of Medicine, Japan
| | - Norio Murayama
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Japan
| | - Kiyoshi Sato
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Japan
| | - Yoshio Hirayasu
- Department of Psychiatry, Yokohama City University School of Medicine, Japan
| | - Heii Arai
- Department of Psychiatry, Juntendo University School of Medicine, Japan
| | - Eizo Iseki
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Japan; Department of Psychiatry, Juntendo University School of Medicine, Japan.
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Kasanuki K, Iseki E, Ota K, Kondo D, Ichimiya Y, Sato K, Arai H. 123I-FP-CIT SPECT findings and its clinical relevance in prodromal dementia with Lewy bodies. Eur J Nucl Med Mol Imaging 2016; 44:358-365. [PMID: 27480759 DOI: 10.1007/s00259-016-3466-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Evidence for the prodromal stage of dementia with Lewy bodies (DLB) is very limited. To address this issue, we investigate the 123I-FP-CIT SPECT measure of dopamine transporter binding finding and its clinical relevance. METHODS We enrolled subjects into a prodromal DLB group (PRD-DLB) (n = 20) and clinical DLB group (CLIN-DLB) (n = 18) and compared these groups with an Alzheimer's disease control group (AD) (n = 10). PRD-DLB was defined as patients having the non-motor symptoms associated with Lewy body disease (LBD) [i.e. REM sleep behavior disorder (RBD), olfactory dysfunction, autonomic dysfunction, and depression] and showing characteristic diffuse occipital hypometabolism in 18F-FDG PET. CLIN-DLB was defined as patients fulfilling the established criteria of probable DLB. Striatal specific binding ratio (SBR) of 123I-FP-CIT SPECT was used for objective group comparisons. The correlations between SBR and cognitive function (MMSE), motor symptoms (UPDRS3), and duration of LBD-associated non-motor symptoms were compared between the two DLB groups. RESULTS Mean SBR scores of both PRD-DLB and CLIN-DLB were significantly lower than those of AD. No correlation was found between SBR and MMSE scores. Both in the CLIN-DLB and total DLB groups, SBR scores were negatively correlated with UPDRS3 scores, whereas no correlation was found in PRD-DLB. Among the LBD-related non-motor symptoms, duration of olfactory dysfunction, and RBD demonstrated negative correlation with SBR scores in PRD-DLB. CONCLUSION 123I-FP-CIT SPECT may play a role for detecting DLB among the subjects in prodromal stage. During this stage, long-term olfactory dysfunction and/or RBD may indicate more severe degeneration of the nigro-striatal dopaminergic pathway.
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Affiliation(s)
- Koji Kasanuki
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan. .,Department of Psychiatry, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan. .,Department of Neuroscience, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL, 32224, USA.
| | - Eizo Iseki
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan.,Department of Psychiatry, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan
| | - Kazumi Ota
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan.,Department of Psychiatry, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan
| | - Daizo Kondo
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan
| | - Yosuke Ichimiya
- Department of Psychiatry, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan
| | - Kiyoshi Sato
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan
| | - Heii Arai
- Department of Psychiatry, Juntendo University School of Medicine, 136-0075, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan
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Cognitive study on Chinese patients with idiopathic REM sleep behavior disorder. J Neurol Sci 2016; 366:82-86. [PMID: 27288781 DOI: 10.1016/j.jns.2016.04.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 04/23/2016] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
Abstract
AIMS We investigated cognitive abnormalities using standard tests in Chinese patients with idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) compared with those in normal controls. METHODS Twenty-three patients with iRBD and 23 normal controls were included in this study. All of the participants underwent one night of video-polysomnography (PSG) monitoring to certify REM sleep without atonia or abnormal behaviors. The cognitive assessments were administered and scored according to a standard procedure, including global cognitive screening and attention/processing speed, executive function, memory, language, and visuospatial ability testing. RESULTS Patients with iRBD had similar scores of the Mini Mental State Examination (MMSE) but lower Montreal Cognitive Assessment (MoCA) scores compared with controls (p>0.05, p=0.013). The iRBD patients performed poorly on verbal memory tests, which included immediate recall (p<0.001), delayed recall (p<0.001), and false recognitions (p=0.002) of the Rey Auditory Verbal Learning Test (RAVLT). The visual memory and visuospatial abilities were also impaired in iRBD patients, as reflected by the copy (p=0.005) and immediate (p=0.004) and delayed (p=0.003) recall of the Rey-Osterrieth complex figure, although no difference was found after Bonferroni correction. The duration of RBD was 6.98±8.10years. After controlling for age, the duration of RBD was only correlated with the Trail Making Test B (r=0.613, p=0.045) and block design (r=-0.667, p=0.025). CONCLUSIONS Impaired verbal memory was observed in iRBD patients who identified as Chinese. MoCA could detect cognitive abnormalities and serve as a screening scale. The present study further confirmed cognitive deficits in iRBD as an early clinical marker in the prodromal stage of synucleinopathy.
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Chiba Y, Iseki E, Fujishiro H, Ota K, Kasanuki K, Suzuki M, Hirayasu Y, Arai H, Sato K. Early differential diagnosis between Alzheimer's disease and dementia with Lewy bodies: Comparison between (18)F-FDG PET and (123)I-IMP SPECT. Psychiatry Res Neuroimaging 2016; 249:105-112. [PMID: 26857415 DOI: 10.1016/j.pscychresns.2015.12.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 10/12/2015] [Accepted: 12/25/2015] [Indexed: 11/21/2022]
Abstract
Both (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and (123)I-iodoamphetamine (IMP) single-photon emission computed tomography (SPECT) have been used for the differential diagnosis of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). Less information is available, however, regarding the differential diagnosis of mild cognitive impairment (MCI) due to AD and MCI due to DLB. We examined nine AD patients (AD group), nine DLB patients (DLB group), eight MCI due to AD patients (MCI-AD group), and nine MCI due to DLB patients (MCI-DLB group) with FDG PET and IMP SPECT using a well-characterized normal database and a stereotactic extraction estimation method. In the AD and DLB groups, receiver operating characteristic (ROC) analysis in the occipital regions showed significant accuracy of both FDG PET and IMP SPECT for the differential diagnosis. In the MCI-AD and MCI-DLB groups, ROC analysis showed significant accuracy of only FDG PET for the differential diagnosis. Both FDG PET and IMP SPECT would be useful for the differential diagnosis between AD and DLB. For the differential diagnosis of MCI-AD versus MCI-DLB, FDG PET would be more useful than IMP SPECT.
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Affiliation(s)
- Yuhei Chiba
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan; Department of Psychiatry, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
| | - Eizo Iseki
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan; Department of Psychiatry, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
| | - Hiroshige Fujishiro
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan; Department of Psychiatry, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; Department of Psychiatry, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya-shi, Aichi 466-8550, Japan
| | - Kazumi Ota
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan
| | - Koji Kasanuki
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan; Department of Psychiatry, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Masaru Suzuki
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan
| | - Yoshio Hirayasu
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa 236-0004, Japan
| | - Heii Arai
- Department of Psychiatry, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Kiyoshi Sato
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan
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Ota K, Fujishiro H, Kasanuki K, Kondo D, Chiba Y, Murayama N, Arai H, Sato K, Iseki E. Prediction of later clinical course by a specific glucose metabolic pattern in non-demented patients with probable REM sleep behavior disorder admitted to a memory clinic: A case study. Psychiatry Res Neuroimaging 2016; 248:151-158. [PMID: 26754469 DOI: 10.1016/j.pscychresns.2015.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 11/09/2015] [Accepted: 12/21/2015] [Indexed: 01/14/2023]
Abstract
The present study is a follow-up study of 11 non-demented patients with probable rapid eye movement (REM) sleep behavior disorder (RBD) at our memory clinic. During the follow-up period (mean±SD of 46.7±6.4 months), all 11 patients exhibited cognitive decline: four (Group A) exhibited core clinical features of dementia with Lewy bodies (DLB), along with severe cognitive decline, and were subsequently diagnosed as having probable DLB; four (Group B) did not exhibit core clinical features of DLB; and the remaining three (Group C) were diagnosed as having Parkinson's disease with dementia (PDD). Positron emission tomography with fluorodeoxyglucose-F18 at baseline revealed that Groups A and B exhibited glucose hypometabolism in the occipital lobe, especially in the primary visual cortex, and Group A tended to present hypometabolism in the parieto-temporal area as well. Group C tended to present hypometabolism in the medial prefrontal area and anterior cingulate gyrus. Neuropsychological examinations indicated poor performance in verbal memory and visuoperception in all groups. This case study suggests that patterns of hypometabolism and neuropsychological examinations at baseline may be indicators of the later clinical course of probable RBD patients.
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Affiliation(s)
- Kazumi Ota
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan
| | - Hiroshige Fujishiro
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan
| | - Koji Kasanuki
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan; Department of Psychiatry, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Daizo Kondo
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan
| | - Yuhei Chiba
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan
| | - Norio Murayama
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan
| | - Heii Arai
- Department of Psychiatry, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kiyoshi Sato
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan
| | - Eizo Iseki
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo 136-0075, Japan; Department of Psychiatry, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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Assessing cerebral glucose metabolism in patients with idiopathic rapid eye movement sleep behavior disorder. J Cereb Blood Flow Metab 2015; 35. [PMID: 26219593 PMCID: PMC4671128 DOI: 10.1038/jcbfm.2015.173] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Idiopathic rapid eye movement sleep behavior disorder (RBD) is a risk marker for subsequent development of neurodegenerative parkinsonism. In this study, we aimed to investigate whether regional cerebral metabolism is altered in patients with RBD and whether regional metabolic activities are associated with clinical measurements in individual patients. Twenty-one patients with polysomnogram-confirmed RBD and 21 age-matched healthy controls were recruited to undertake positron emission tomography imaging with [(18)F]fluorodeoxyglucose. Differences in normalized regional metabolism and correlations between metabolic activity and clinical indices in RBD patients were evaluated on a voxel basis using statistic parametric mapping analysis. Compared with controls, patients with RBD showed increased metabolism in the hippocampus/parahippocampus, cingulate, supplementary motor area, and pons, but decreased metabolism in the occipital cortex/lingual gyrus (P<0.001). RBD duration correlated with metabolism positively in the anterior vermis (r=0.55, P=0.01), but negatively in the medial frontal gyrus (r=-0.59, P=0.005). In addition, chin electromyographic activity presented a positive metabolic correlation in the hippocampus/parahippocampus (r=0.48, P=0.02), but a negative metabolic correlation in the posterior cingulate (r=-0.61, P=0.002). This study has suggested that region-specific metabolic abnormalities exist in RBD patients and regional metabolic activities are associated with clinical measures such as RBD duration and chin electromyographic activity.
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Mackin RS, Insel P, Zhang J, Mohlenhoff B, Galasko D, Weiner M, Mattsson N. Cerebrospinal fluid α-synuclein and Lewy body-like symptoms in normal controls, mild cognitive impairment, and Alzheimer's disease. J Alzheimers Dis 2015; 43:1007-16. [PMID: 25125463 DOI: 10.3233/jad-141287] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Reduced cerebrospinal fluid (CSF) α-synuclein has been described in synucleinopathies, including dementia with Lewy bodies (DLB). Common symptoms of DLB include visual hallucinations and visuospatial and executive deficits. Co-occurrence of Lewy body pathology is common in Alzheimer's disease (AD) patients, but it is unknown if reduced CSF α-synuclein is associated with Lewy body-like symptomatology in AD. OBJECTIVE Determine associations between CSF α-synuclein and Lewy body-like symptomatology. METHODS We included 73 controls (NC), 121 mild cognitive impairment (MCI) patients, and 61 AD patients (median follow-up 3.5 years, range 0.6-7.8). We tested associations between baseline CSF α-synuclein and visual hallucinations and (longitudinal) cognition. Models were tested with and without co-varying for CSF total tau (T-tau), which is elevated in AD patients, and believed to reflect neurodegeneration. RESULTS Hallucinations were reported in 20% of AD patients, 13% of MCI patients, and 8% of NC. In AD, low CSF α-synuclein was associated with hallucinations. When adjusting for CSF T-tau, low CSF α-synuclein was associated with accelerated decline of executive function (NC, MCI, and AD), memory (MCI and AD), and language (MCI). CONCLUSION The associations of low CSF α-synuclein with hallucinations and poor executive function, which are hallmarks of DLB, indirectly suggest that this biomarker may reflect underlying synuclein pathology. The associations with memory and language in MCI and AD suggests either that reduced CSF α-synuclein also partly reflects global impaired neuronal/synaptic function, or that non-specific overall cognitive deterioration is accelerated in the presence of synuclein related pathology. The findings will require autopsy verification.
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Affiliation(s)
- R Scott Mackin
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Philip Insel
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Jing Zhang
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Brian Mohlenhoff
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA Department of Psychiatry, University of California, San Francisco, CA, USA Mental Health Service, Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Douglas Galasko
- Department of Neurosciences, University of California, San Diego, CA, USA
| | - Michael Weiner
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Niklas Mattsson
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
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Hellwig S, Frings L, Amtage F, Buchert R, Spehl TS, Rijntjes M, Tüscher O, Weiller C, Weber WA, Vach W, Meyer PT. 18F-FDG PET Is an Early Predictor of Overall Survival in Suspected Atypical Parkinsonism. J Nucl Med 2015; 56:1541-6. [DOI: 10.2967/jnumed.115.159822] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 07/14/2015] [Indexed: 12/21/2022] Open
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Blanc F, Colloby SJ, Philippi N, de Pétigny X, Jung B, Demuynck C, Phillipps C, Anthony P, Thomas A, Bing F, Lamy J, Martin-Hunyadi C, O'Brien JT, Cretin B, McKeith I, Armspach JP, Taylor JP. Cortical Thickness in Dementia with Lewy Bodies and Alzheimer's Disease: A Comparison of Prodromal and Dementia Stages. PLoS One 2015; 10:e0127396. [PMID: 26061655 PMCID: PMC4489516 DOI: 10.1371/journal.pone.0127396] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/15/2015] [Indexed: 11/18/2022] Open
Abstract
Objectives To assess and compare cortical thickness (CTh) of patients with prodromal Dementia with Lewy bodies (pro-DLB), prodromal Alzheimer's disease (pro-AD), DLB dementia (DLB-d), AD dementia (AD-d) and normal ageing. Methods Study participants(28 pro-DLB, 27 pro-AD, 31 DLB-d, 54 AD-d and 33 elderly controls) underwent 3Tesla T1 3D MRI and detailed clinical and cognitive assessments. We used FreeSurfer analysis package to measure CTh and investigate patterns of cortical thinning across groups. Results Comparison of CTh between pro-DLB and pro-AD (p<0.05, FDR corrected) showed more right anterior insula thinning in pro-DLB, and more bilateral parietal lobe and left parahippocampal gyri thinning in pro-AD. Comparison of prodromal patients to healthy elderly controls showed the involvement of the same regions. In DLB-d (p<0.05, FDR corrected) cortical thinning was found predominantly in the right temporo-parietal junction, and insula, cingulate, orbitofrontal and lateral occipital cortices. In AD-d(p<0.05, FDR corrected),the most significant areas affected included the entorhinal cortices, parahippocampal gyri and parietal lobes. The comparison of AD-d and DLB-d demonstrated more CTh in AD-d in the left entorhinal cortex (p<0.05, FDR corrected). Conclusion Cortical thickness is a sensitive measure for characterising patterns of grey matter atrophy in early stages of DLB distinct from AD. Right anterior insula involvement may be a key region at the prodromal stage of DLB and needs further investigation.
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Affiliation(s)
- Frederic Blanc
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
- * E-mail:
| | - Sean J. Colloby
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Nathalie Philippi
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Xavier de Pétigny
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - Barbara Jung
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - Catherine Demuynck
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - Clélie Phillipps
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - Pierre Anthony
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Alan Thomas
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Fabrice Bing
- University Hospital of Strasbourg, Neuroradiology Service, Strasbourg, France
| | - Julien Lamy
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
| | - Catherine Martin-Hunyadi
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - John T. O'Brien
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Benjamin Cretin
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Ian McKeith
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jean-Paul Armspach
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
| | - John-Paul Taylor
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
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The Relationship Between Atrophy and Hypometabolism: Is It Regionally Dependent in Dementias? Curr Neurol Neurosci Rep 2015; 15:44. [DOI: 10.1007/s11910-015-0562-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Fujishiro H, Nakamura S, Sato K, Iseki E. Prodromal dementia with Lewy bodies. Geriatr Gerontol Int 2015; 15:817-26. [PMID: 25690399 DOI: 10.1111/ggi.12466] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2014] [Indexed: 11/26/2022]
Abstract
Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementing disorder after Alzheimer's disease (AD), but there is limited information regarding the prodromal DLB state compared with that of AD. Parkinson's disease (PD) and DLB share common prodromal symptoms with Lewy body disease (LBD), allowing us to use a common strategy for identifying the individuals with an underlying pathophysiology of LBD. Dysautonomia, olfactory dysfunction, rapid eye movement sleep behavior disorder (RBD) and psychiatric symptoms antedate the onset of dementia by years or even decades in patients with DLB. Although RBD is the most potentially accurate prodromal predictor of DLB, disease progression before the onset of dementia could differ between the prodromal DLB state with and without RBD. Experts who specialize in idiopathic RBD and DLB might need communication in order to clarify the clinical relevance of RBD with the disease progression of DLB. The presence of prodromal LBD symptoms or findings of occipital hypoperfusion/hypometabolism helps us to predict the possible pathophysiological process of LBD in non-demented patients. This approach might provide the opportunity for additional neuroimaging, including cardiac (123) I-metaiodobenzylguanidine scintigraphy and dopamine transporter imaging. Although limited radiological findings in patients with prodromal DLB states have been reported, there is now a need for larger clinical multisite studies with pathological verification. The long prodromal phase of DLB provides a critical opportunity for potential intervention with disease-modifying therapy, but only if we are able to clearly identify the diversity in the clinical courses of DLB. In the present article, we reviewed the limited literature regarding the clinical profiles of prodromal DLB.
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Affiliation(s)
- Hiroshige Fujishiro
- Department of Sleep Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Kiyoshi Sato
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Koto, Japan
| | - Eizo Iseki
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Koto, Japan
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Nasrallah IM, Wolk DA. Multimodality imaging of Alzheimer disease and other neurodegenerative dementias. J Nucl Med 2014; 55:2003-11. [PMID: 25413136 DOI: 10.2967/jnumed.114.141416] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Neurodegenerative diseases, such as Alzheimer disease, result in cognitive decline and dementia and are a leading cause of mortality in the growing elderly population. These progressive diseases typically have an insidious onset, with overlapping clinical features early in the disease course that make diagnosis challenging. The neurodegenerative diseases are associated with characteristic, although not completely understood, changes in the brain: abnormal protein deposition, synaptic dysfunction, neuronal injury, and neuronal death. Neuroimaging biomarkers-principally regional atrophy on structural MR imaging, patterns of hypometabolism on (18)F-FDG PET, and detection of cerebral amyloid plaque on amyloid PET--are able to evaluate the patterns of these abnormalities in the brain to improve early diagnosis and help predict the disease course. These techniques have unique strengths and synergies in multimodality evaluation of the patient with cognitive decline or dementia. This review discusses the key imaging biomarkers from MR imaging, (18)F-FDG PET, and amyloid PET; the imaging features of the most common neurodegenerative dementias; the role of various neuroimaging studies in differential diagnosis and prognosis; and some promising imaging techniques under development.
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Affiliation(s)
- Ilya M Nasrallah
- Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania
| | - David A Wolk
- Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania
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Weisenbach SL, Kassel MT, Rao J, Weldon AL, Avery ET, Briceno EM, Ajilore O, Mann M, Kales HC, Welsh RC, Zubieta JK, Langenecker SA. Differential prefrontal and subcortical circuitry engagement during encoding of semantically related words in patients with late-life depression. Int J Geriatr Psychiatry 2014; 29:1104-15. [PMID: 24948034 PMCID: PMC4337801 DOI: 10.1002/gps.4165] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 05/28/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Verbal memory difficulties are common among individuals with late-life depression (LLD), though there is limited knowledge about disruptions to underlying cerebral circuitry. The purpose of this study is to examine aberrations to cerebral networks implicated in encoding novel verbal semantic material among older adults with LLD. METHODS Twenty-four older adults with early-onset LLD and 23 non-depressed comparisons participated in the study. Participants completed a word list-learning task while undergoing functional magnetic resonance imaging. RESULTS In the context of equivalent recall and recognition of words following scanning and similar hippocampal volumes, patients with LLD exhibited less activation in structures known to be relevant for new learning and memory, including hippocampus, parahippocampal gyrus, insula, and cingulate, relative to non-ill comparisons. An important region in which the LLD group displayed greater activation than the non-depressed comparison group was in left inferior frontal gyrus, an area involved in cognitive control and controlled semantic/phonological retrieval and analysis; this region may be critical for LLD patients to consolidate encoded words into memory. CONCLUSIONS Functional irregularities found in LLD patients may reflect different modes of processing to-be-remembered information and/or early changes predictive of incipient cognitive decline. Future studies might consider mechanisms that could contribute to these functional differences, including hypothalamic-pituitary-adrenal axis functioning and vascular integrity, and utilize longitudinal designs in order to understand whether functional changes are predictive of incipient cognitive decline.
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Affiliation(s)
- Sara L. Weisenbach
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL,University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI,Jesse Brown VA Medical Center, Research & Development, Chicago, IL
| | - Michelle T. Kassel
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL
| | - Julia Rao
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL
| | - Annie L. Weldon
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL
| | - Erich T. Avery
- University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI
| | - Emily M. Briceno
- University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI
| | - Olusala Ajilore
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL
| | - Megan Mann
- University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI
| | - Helen C. Kales
- University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI
| | - Robert C. Welsh
- University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI
| | - Jon-Kar Zubieta
- University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI
| | - Scott A. Langenecker
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL,University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI
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Donaghy PC, McKeith IG. The clinical characteristics of dementia with Lewy bodies and a consideration of prodromal diagnosis. ALZHEIMERS RESEARCH & THERAPY 2014; 6:46. [PMID: 25484925 PMCID: PMC4255387 DOI: 10.1186/alzrt274] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Dementia with Lewy bodies (DLB) is the second most common type of degenerative dementia following Alzheimer’s disease (AD). DLB is clinically and pathologically related to Parkinson's disease (PD) and PD dementia, and the three disorders can be viewed as existing on a spectrum of Lewy body disease. In recent years there has been a concerted effort to establish the phenotypes of AD and PD in the prodromal phase (before the respective syndromes of cognitive and motor impairment are expressed). Evidence for the prodromal presentation of DLB is also emerging. This paper briefly reviews what is known about the clinical presentation of prodromal DLB before discussing the pathology of Lewy body disease and how this relates to potential biomarkers of prodromal DLB. The presenting features of DLB can be broadly placed in three categories: cognitive impairment (particularly nonamnestic cognitive impairments), behavioural/psychiatric phenomena (for example, hallucinations, rapid eye movement sleep behaviour disorder (RBD)) and physical symptoms (for example, parkinsonism, decreased sense of smell, autonomic dysfunction). Some noncognitive symptoms such as constipation, RBD, hyposmia and postural dizziness can predate the onset of memory impairment by several years in DLB. Pathological studies of Lewy body disease have found that the earliest sites of involvement are the olfactory bulb, the dorsal motor nucleus of the vagal nerve, the peripheral autonomic nervous system, including the enteric nervous system, and the brainstem. Some of the most promising early markers for DLB include the presence of RBD, autonomic dysfunction or hyposmia, 123I-metaiodobenzylguanidine cardiac scintigraphy, measures of substantia nigra pathology and skin biopsy for α-synuclein in peripheral autonomic nerves. In the absence of disease-modifying therapies, the diagnosis of prodromal DLB is of limited use in the clinic. That said, knowledge of the prodromal development of DLB could help clinicians identify cases of DLB where the diagnosis is uncertain. Prodromal diagnosis is of great importance in research, where identifying Lewy body disease at an earlier stage may allow researchers to investigate the initial phases of dementia pathophysiology, develop treatments designed to interrupt the development of the dementia syndrome and accurately identify the patients most likely to benefit from these treatments.
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Affiliation(s)
- Paul C Donaghy
- Level 3, Biomedical Research Building, Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle NE4 5PL, UK
| | - Ian G McKeith
- Level 3, Biomedical Research Building, Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle NE4 5PL, UK
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Gonzalez-Lima F, Barksdale BR, Rojas JC. Mitochondrial respiration as a target for neuroprotection and cognitive enhancement. Biochem Pharmacol 2014; 88:584-93. [DOI: 10.1016/j.bcp.2013.11.010] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 11/16/2013] [Accepted: 11/18/2013] [Indexed: 10/25/2022]
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Toledo JB, Cairns NJ, Da X, Chen K, Carter D, Fleisher A, Householder E, Ayutyanont N, Roontiva A, Bauer RJ, Eisen P, Shaw LM, Davatzikos C, Weiner MW, Reiman EM, Morris JC, Trojanowski JQ. Clinical and multimodal biomarker correlates of ADNI neuropathological findings. Acta Neuropathol Commun 2013; 1:65. [PMID: 24252435 PMCID: PMC3893373 DOI: 10.1186/2051-5960-1-65] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 09/23/2013] [Indexed: 12/11/2022] Open
Abstract
Background Autopsy series commonly report a high percentage of coincident pathologies in demented patients, including patients with a clinical diagnosis of dementia of the Alzheimer type (DAT). However many clinical and biomarker studies report cases with a single neurodegenerative disease. We examined multimodal biomarker correlates of the consecutive series of the first 22 Alzheimer’s Disease Neuroimaging Initiative autopsies. Clinical data, neuropsychological measures, cerebrospinal fluid Aβ, total and phosphorylated tau and α-synuclein and MRI and FDG-PET scans. Results Clinical diagnosis was either probable DAT or Alzheimer’s disease (AD)-type mild cognitive impairment (MCI) at last evaluation prior to death. All patients had a pathological diagnosis of AD, but only four had pure AD. A coincident pathological diagnosis of dementia with Lewy bodies (DLB), medial temporal lobe pathology (TDP-43 proteinopathy, argyrophilic grain disease and hippocampal sclerosis), referred to collectively here as MTL, and vascular pathology were present in 45.5%, 40.0% and 22.7% of these patients, respectively. Hallucinations were a strong predictor of coincident DLB (100% specificity) and a more severe dysexecutive profile was also a useful predictor of coincident DLB (80.0% sensitivity and 83.3% specificity). Occipital FDG-PET hypometabolism accurately classified coincident DLB (80% sensitivity and 100% specificity). Subjects with coincident MTL showed lower hippocampal volume. Conclusions Biomarkers can be used to independently predict coincident AD and DLB pathology, a common finding in amnestic MCI and DAT patients. Cohorts with comprehensive neuropathological assessments and multimodal biomarkers are needed to characterize independent predictors for the different neuropathological substrates of cognitive impairment.
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