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Castellano G, Esposito A, Lella E, Montanaro G, Vessio G. Automated detection of Alzheimer's disease: a multi-modal approach with 3D MRI and amyloid PET. Sci Rep 2024; 14:5210. [PMID: 38433282 PMCID: PMC10909869 DOI: 10.1038/s41598-024-56001-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/28/2024] [Indexed: 03/05/2024] Open
Abstract
Recent advances in deep learning and imaging technologies have revolutionized automated medical image analysis, especially in diagnosing Alzheimer's disease through neuroimaging. Despite the availability of various imaging modalities for the same patient, the development of multi-modal models leveraging these modalities remains underexplored. This paper addresses this gap by proposing and evaluating classification models using 2D and 3D MRI images and amyloid PET scans in uni-modal and multi-modal frameworks. Our findings demonstrate that models using volumetric data learn more effective representations than those using only 2D images. Furthermore, integrating multiple modalities enhances model performance over single-modality approaches significantly. We achieved state-of-the-art performance on the OASIS-3 cohort. Additionally, explainability analyses with Grad-CAM indicate that our model focuses on crucial AD-related regions for its predictions, underscoring its potential to aid in understanding the disease's causes.
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Affiliation(s)
| | - Andrea Esposito
- Department of Computer Science, University of Bari Aldo Moro, Bari, Italy
| | - Eufemia Lella
- Sirio - Research & Innovation, Sidea Group, Bari, Italy
| | | | - Gennaro Vessio
- Department of Computer Science, University of Bari Aldo Moro, Bari, Italy.
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2
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Wu CY, Lin YH, Hsieh HH, Chung YH, Hsu ST, Peng SL. The effect of estrogen therapy on cerebral metabolism in diabetic female rats. Comput Struct Biotechnol J 2023; 21:4769-4776. [PMID: 37841332 PMCID: PMC10570627 DOI: 10.1016/j.csbj.2023.09.031] [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: 04/15/2023] [Revised: 09/20/2023] [Accepted: 09/24/2023] [Indexed: 10/17/2023] Open
Abstract
The impact of estrogen on brain function, especially in individuals with diabetes, remains uncertain. This study aims to compare cerebral glucose metabolism levels in intact rats, ovariectomized (OVX) rats, and 17β-estradiol (E2)-treated OVX diabetic female rats. Sixteen rats were administered a single intraperitoneal injection of 70 mg/kg streptozotocin (STZ) to induce diabetes (intact, n = 6; OVX, n = 6; OVX+E2-treated, n = 4). Additionally, 18 rats received an equivalent solvent dose via intraperitoneal injection (intact, n = 6; OVX, n = 6; OVX+E2-treated, n = 6). After 4 weeks of STZ or solvent administration, positron emission tomography scans with 18F-fluorodeoxyglucose (18F-FDG) injection were employed to assess cerebral glucose metabolism. The diabetic rats exhibited substantial reductions in 18F-FDG uptake across all brain regions (all P < 0.01), in contrast to the control rats. Moreover, intact and OVX + E2-treated diabetic female rats displayed more pronounced decreases in cerebral glucose metabolism in the amygdala and hippocampus compared to OVX diabetic female rats (P < 0.05). These findings suggest that diabetes creates an environment wherein estrogen exacerbates neuropathology and intensifies neuronal activity.
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Affiliation(s)
- Chun-Yi Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei Branch, Taipei, Taiwan
| | - Yu-Hsin Lin
- Department of Pharmacy, National Yang Ming Chiao Tung University, Taipei Branch, Taipei, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Hsin-Hua Hsieh
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei Branch, Taipei, Taiwan
| | - Yi-Hsiu Chung
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Ting Hsu
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
- Neuroscience and Brain Disease Center, China Medical University, Taiwan
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3
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Zhang K, Xu H, Li K. Molecular Imaging for Early-Stage Disease Diagnosis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1199:39-58. [PMID: 37460726 DOI: 10.1007/978-981-32-9902-3_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
With the development of cellular biology, molecular biology, and other subjects, targeted molecular probe was combined with medical imaging technologies to launch a new scientific discipline of molecular imaging that is a research discipline to visualize, characterize, and analyze biological process at the cellular and molecular levels for real-time tracking and precision therapy, also termed as the medical imaging in the twenty-first century. An array of imaging techniques has been developed to image specific targets of living cells or tissues by molecular probes, including optical molecular imaging (OI), magnetic resonance molecular imaging, ultrasound (US) molecular imaging, nuclear medicine molecular imaging, X-ray molecular imaging, and multi-mode molecular imaging. These imaging techniques make the early diagnosis of various diseases possible by means of visualization of gene expression, interactions between proteins, signal transduction, cell metabolism, cell traces, and other physiological or pathological processes in the living system, which bridge the gap between molecular biology and clinical medicine. This chapter will lay the emphasis on the early-stage diagnosis of fatal diseases, such as malignant tumors, cardio- or cerebrovascular diseases, digestive system disease, central nervous system disease, and other diseases employing molecular imaging in a real-time visualized manner.
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Affiliation(s)
- Kuo Zhang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China.
| | - Haiyan Xu
- School of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
| | - Kai Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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4
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Newberg AB, Coble R, Khosravi M, Alavi A. Positron Emission Tomography-Based Assessment of Cognitive Impairment and Dementias, Critical Role of Fluorodeoxyglucose in such Settings. PET Clin 2022; 17:479-494. [PMID: 35717103 DOI: 10.1016/j.cpet.2022.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Positron emission tomography (PET) has been a key component in the diagnostic armamentarium for assessing neurodegenerative diseases such as Alzheimer or Parkinson disease. PET imaging has been useful for diagnosing these disorders, identifying their pathophysiology, and following their treatment. Further, PET imaging has been extensively used for both clinical and research purposes, particularly for helping with potential therapeutic approaches for managing neurodegenerative diseases. This article will review the current literature regarding PET imaging in patients with neurodegenerative disorders. This includes an evaluation of the most commonly used tracer fluorodeoxyglucose that measures cerebral glucose metabolism, tracers that assess neurotransmitter systems, and tracers designed to reveal disease-specific pathophysiological processes. With the continuing development of an expanding variety of radiopharmaceuticals, PET imaging will likely play a prominent role in future research and clinical applications for neurodegenerative diseases.
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Affiliation(s)
- Andrew B Newberg
- Marcus Institute of Integrative Health, Thomas Jefferson University, 789 East Lancaster Avenue, Suite 110, Villanova, PA 19085, USA; Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Roger Coble
- Marcus Institute of Integrative Health, Thomas Jefferson University, 789 East Lancaster Avenue, Suite 110, Villanova, PA 19085, USA; University of California Berkeley, Berkeley, CA, USA
| | - Mohsen Khosravi
- Marcus Institute of Integrative Health, Thomas Jefferson University, 789 East Lancaster Avenue, Suite 110, Villanova, PA 19085, USA
| | - Abass Alavi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
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5
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Boccalini C, Carli G, Tondo G, Polito C, Catricalà E, Berti V, Bessi V, Sorbi S, Iannaccone S, Esposito V, Cappa SF, Perani D. Brain metabolic connectivity reconfiguration in the semantic variant of primary progressive aphasia. Cortex 2022; 154:1-14. [PMID: 35717768 DOI: 10.1016/j.cortex.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/16/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022]
Abstract
Functional network-level alterations in the semantic variant of Primary Progressive Aphasia (sv-PPA) are relevant to understanding the clinical features and the neural spreading of the pathology. We assessed the effect of neurodegeneration on brain systems reorganization in early sv-PPA, using advanced brain metabolic connectivity approaches. Forty-four subjects with sv-PPA and forty-four age-matched healthy controls (HC) were included. We applied two multivariate approaches to [18F]FDG-PET data - i.e., sparse inverse covariance estimation and seed-based interregional correlation analysis - to assess the integrity of (i) the whole-brain metabolic connectivity and (ii) the connectivity of brain regions relevant for cognitive and behavioral functions. Whole-brain analysis revealed a global-scale connectivity reconfiguration in sv-PPA, with widespread changes in metabolic connections of frontal, temporal, and parietal regions. In comparison to HC, the seed-based analysis revealed a) functional isolation of the left anterior temporal lobe (ATL), b) decreases in temporo-occipital connections and contralateral homologous regions, c) connectivity increases to the dorsal parietal cortex from the spared posterior temporal cortex, d) a disruption of the large-scale limbic brain networks. In sv-PPA, the severe functional derangement of the left ATL may lead to an extensive connectivity reconfiguration, encompassing several brain regions, including those not yet affected by neurodegeneration. These findings support the hypothesis that in sv-PPA the focal vulnerability of the core region (i.e., ATL) can potentially drive the widespread cerebral connectivity changes, already present in the early phase.
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Affiliation(s)
- Cecilia Boccalini
- Vita-Salute San Raffaele University, Milan, Italy; In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulia Carli
- Vita-Salute San Raffaele University, Milan, Italy; In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo Tondo
- Vita-Salute San Raffaele University, Milan, Italy; In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Polito
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | - Valentina Berti
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Valentina Bessi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, San Raffaele Hospital, Milan, Italy
| | | | - Stefano F Cappa
- University School for Advanced Studies (IUSS), Pavia, Italy; IRCCS Mondino Foundation, Pavia, Italy
| | - Daniela Perani
- Vita-Salute San Raffaele University, Milan, Italy; In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Nuclear Medicine Unit, San Raffaele Hospital, Milan, Italy.
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6
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Perani D, Cappa SF. The contribution of positron emission tomography to the study of aphasia. HANDBOOK OF CLINICAL NEUROLOGY 2022; 185:151-165. [PMID: 35078596 DOI: 10.1016/b978-0-12-823384-9.00008-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Daniela Perani
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy; In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, Nuclear Medicine Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Stefano F Cappa
- Department of Humanities and Life Sciences, University Institute for Advanced Studies IUSS Pavia, Pavia, Italy; Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy.
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Borghesani V, DeLeon J, Gorno-Tempini ML. Frontotemporal dementia: A unique window on the functional role of the temporal lobes. HANDBOOK OF CLINICAL NEUROLOGY 2022; 187:429-448. [PMID: 35964986 PMCID: PMC9793689 DOI: 10.1016/b978-0-12-823493-8.00011-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Frontotemporal dementia (FTD) is an umbrella term covering a plethora of progressive changes in executive functions, motor abilities, behavior, and/or language. Different clinical syndromes have been described in relation to localized atrophy, informing on the functional networks that underlie these specific cognitive, emotional, and behavioral processes. These functional declines are linked with the underlying neurodegeneration of frontal and/or temporal lobes due to diverse molecular pathologies. Initially, the accumulation of misfolded proteins targets specifically susceptible cell assemblies, leading to relatively focal neurodegeneration that later spreads throughout large-scale cortical networks. Here, we discuss the most recent clinical, neuropathological, imaging, and genetics findings in FTD-spectrum syndromes affecting the temporal lobe. We focus on the semantic variant of primary progressive aphasia and its mirror image, the right temporal variant of FTD. Incipient focal atrophy of the left anterior temporal lobe (ATL) manifests with predominant naming, word comprehension, reading, and object semantic deficits, while cases of predominantly right ATL atrophy present with impairments of socioemotional, nonverbal semantic, and person-specific knowledge. Overall, the observations in FTD allow for crucial clinical-anatomic inferences, shedding light on the role of the temporal lobes in both cognition and complex behaviors. The concerted activity of both ATLs is critical to ensure that percepts are translated into concepts, yet important hemispheric differences should be acknowledged. On one hand, the left ATL attributes meaning to linguistic, external stimuli, thus supporting goal-oriented, action-related behaviors (e.g., integrating sounds and letters into words). On the other hand, the right ATL assigns meaning to emotional, visceral stimuli, thus guiding socially relevant behaviors (e.g., integrating body sensations into feelings of familiarity).
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Affiliation(s)
- Valentina Borghesani
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada; Department of Psychology, Université de Montréal, Montréal, QC, Canada.
| | - Jessica DeLeon
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, United States; Department of Neurology, Dyslexia Center, University of California, San Francisco, CA, United States
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, United States; Department of Neurology, Dyslexia Center, University of California, San Francisco, CA, United States
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8
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Tippett DC, Keser Z. Clinical and neuroimaging characteristics of primary progressive aphasia. HANDBOOK OF CLINICAL NEUROLOGY 2022; 185:81-97. [PMID: 35078612 PMCID: PMC9951770 DOI: 10.1016/b978-0-12-823384-9.00016-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The chapter covers the clinical syndrome of a primary progressive aphasia (PPA), the demographics of this rare neurodegenerative disease, defining clinical and neuroanatomic characteristics of each PPA variant, disease progression, and behavioral features. The chapter begins with a brief introduction that includes references to seminal papers that defined this clinical syndrome and its three variants. The classic PPA subtypes discussed in the chapter are semantic variant PPA (svPPA), nonfluent/agrammatic PPA (nfaPPA), and logopenic variant PPA (lvPPA). The key language and cognitive characteristics, and language tasks that can elicit these language impairments, are detailed. Overlap in the clinical profiles of the PPA variants, which make differential diagnosis challenging, are explained. Disease progression is described, revealing that the PPA variants become more similar over time. Although PPA is language-predominant dementia, there are behavioral manifestations, particularly in svPPA. Changes in behavior in this variant are addressed as well as behavioral changes in nfaPPA and lvPPA that are less well recognized. The patterns of atrophy in the left temporal, parietal, and/or frontal cortices unique to each PPA variant are described. The underlying neuropathologies of the PPA variants are discussed, specifically tauopathies and non-tauopathies associated with svPPA and nfaPPA and Alzheimer's disease pathology in lvPPA.
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Affiliation(s)
- Donna C. Tippett
- Departments of Neurology, Otolaryngology—Head and Neck Surgery, and Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Zafer Keser
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
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Martersteck A, Sridhar J, Coventry C, Weintraub S, Mesulam MM, Rogalski E. Relationships among tau burden, atrophy, age, and naming in the aphasic variant of Alzheimer's disease. Alzheimers Dement 2021; 17:1788-1797. [PMID: 34494711 DOI: 10.1002/alz.12445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Examination of pathologic, anatomic, and cognitive relationships has been limited in primary progressive aphasia (PPA) with underlying Alzheimer's disease (AD) neuropathology. METHODS Spatial relationships between tau positron emission tomography (PET), cortical thickness, age, and naming on the Boston Naming Test (BNT) in PPA with biomarker evidence of AD (PPA-AD) were examined. RESULTS Higher tau PET burden was associated with atrophy and younger age. There was a significant left-lateralized relationship between lower BNT and more atrophy, and between lower BNT and increased tau burden. Variance in naming was primarily shared between tau and atrophy (51%), but naming was uniquely explained more by atrophy (32%) than tau (16%). Higher left anterior temporal tau burden was associated with greater 1-year rate of decline in naming. DISCUSSION PPA-AD has a similar relationship between abnormal biomarkers as first described in amnestic AD, with differing spatial extent, reflecting the left-lateralized nature of the language network.
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Affiliation(s)
- Adam Martersteck
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University (NU) Feinberg School of Medicine, Chicago, Illinois, USA.,NU Feinberg School of Medicine, Department of Radiology, Chicago, Illinois, USA
| | - Jaiashre Sridhar
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University (NU) Feinberg School of Medicine, Chicago, Illinois, USA
| | - Christina Coventry
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University (NU) Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University (NU) Feinberg School of Medicine, Chicago, Illinois, USA.,NU Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, Illinois, USA
| | - M-Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University (NU) Feinberg School of Medicine, Chicago, Illinois, USA.,NU Feinberg School of Medicine, Department of Neurology, Chicago, Illinois, USA
| | - Emily Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University (NU) Feinberg School of Medicine, Chicago, Illinois, USA.,NU Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, Illinois, USA
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Lu J, Huang L, Lv Y, Peng S, Xu Q, Li L, Ge J, Zhang H, Guan Y, Zhao Q, Guo Q, Chen K, Wu P, Ma Y, Zuo C. A disease-specific metabolic imaging marker for diagnosis and progression evaluation of semantic variant primary progressive aphasia. Eur J Neurol 2021; 28:2927-2939. [PMID: 34110063 DOI: 10.1111/ene.14919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE The diagnosis and monitoring of semantic variant primary progressive aphasia (sv-PPA) are clinically challenging. We aimed to establish a distinctive metabolic pattern in sv-PPA for diagnosis and severity evaluation. METHODS Fifteen sv-PPA patients and 15 controls were enrolled to identify sv-PPA-related pattern (sv-PPARP) by principal component analysis of 18 F-fluorodeoxyglucose positron emission tomography. Eighteen Alzheimer disease dementia (AD) and 14 behavioral variant frontotemporal dementia (bv-FTD) patients were enrolled to test the discriminatory power. Correspondingly, regional metabolic activities extracted from the voxelwise analysis were evaluated for the discriminatory power. RESULTS The sv-PPARP was characterized as decreased metabolic activity mainly in the bilateral temporal lobe (left predominance), middle orbitofrontal gyrus, left hippocampus/parahippocampus gyrus, fusiform gyrus, insula, inferior orbitofrontal gyrus, and striatum, with increased activity in the bilateral lingual gyrus, cuneus, calcarine gyrus, and right precentral and postcentral gyrus. The pattern expression had significant discriminatory power (area under the curve [AUC] = 0.98, sensitivity = 100%, specificity = 94.4%) in distinguishing sv-PPA from AD, and the asymmetry index offered complementary discriminatory power (AUC = 0.91, sensitivity = 86.7%, specificity = 92.9%) in distinguishing sv-PPA from bv-FTD. In sv-PPA patients, the pattern expression correlated with Boston Naming Test scores at baseline and showed significant increase in the subset of patients with follow-up. The voxelwise analysis showed similar topography, and the regional metabolic activities had equivalent or better discriminatory power and clinical correlations with Boston Naming Test scores. The ability to reflect disease progression in longitudinal follow-up seemed to be inferior to the pattern expression. CONCLUSIONS The sv-PPARP might serve as an objective biomarker for diagnosis and progression evaluation.
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Affiliation(s)
- Jiaying Lu
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Lin Huang
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yingru Lv
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shichun Peng
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Qian Xu
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ling Li
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jingjie Ge
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Huiwei Zhang
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yihui Guan
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qihao Guo
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Keliang Chen
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ping Wu
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yilong Ma
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Chuantao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,Human Phenome Institute, Fudan University, Shanghai, China.,Institute of Functional and Molecular Medicine Imaging, Fudan University, Shanghai, China
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11
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Borghesani V, Dale CL, Lukic S, Hinkley LBN, Lauricella M, Shwe W, Mizuiri D, Honma S, Miller Z, Miller B, Houde JF, Gorno-Tempini ML, Nagarajan SS. Neural dynamics of semantic categorization in semantic variant of primary progressive aphasia. eLife 2021; 10:e63905. [PMID: 34155973 PMCID: PMC8241439 DOI: 10.7554/elife.63905] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 06/21/2021] [Indexed: 12/28/2022] Open
Abstract
Semantic representations are processed along a posterior-to-anterior gradient reflecting a shift from perceptual (e.g., it has eight legs) to conceptual (e.g., venomous spiders are rare) information. One critical region is the anterior temporal lobe (ATL): patients with semantic variant primary progressive aphasia (svPPA), a clinical syndrome associated with ATL neurodegeneration, manifest a deep loss of semantic knowledge. We test the hypothesis that svPPA patients perform semantic tasks by over-recruiting areas implicated in perceptual processing. We compared MEG recordings of svPPA patients and healthy controls during a categorization task. While behavioral performance did not differ, svPPA patients showed indications of greater activation over bilateral occipital cortices and superior temporal gyrus, and inconsistent engagement of frontal regions. These findings suggest a pervasive reorganization of brain networks in response to ATL neurodegeneration: the loss of this critical hub leads to a dysregulated (semantic) control system, and defective semantic representations are seemingly compensated via enhanced perceptual processing.
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Affiliation(s)
- V Borghesani
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
| | - CL Dale
- Department of Radiology and Biomedical Imaging, University of California, San FranciscoSan FranciscoUnited States
| | - S Lukic
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
| | - LBN Hinkley
- Department of Radiology and Biomedical Imaging, University of California, San FranciscoSan FranciscoUnited States
| | - M Lauricella
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
| | - W Shwe
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
| | - D Mizuiri
- Department of Radiology and Biomedical Imaging, University of California, San FranciscoSan FranciscoUnited States
| | - S Honma
- Department of Radiology and Biomedical Imaging, University of California, San FranciscoSan FranciscoUnited States
| | - Z Miller
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
| | - B Miller
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
| | - JF Houde
- Department of Otolaryngology, University of California, San FranciscoSan FranciscoUnited States
| | - ML Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San FranciscoSan FranciscoUnited States
- Department of Neurology, Dyslexia Center University of California, San FranciscoSan FranciscoUnited States
| | - SS Nagarajan
- Department of Radiology and Biomedical Imaging, University of California, San FranciscoSan FranciscoUnited States
- Department of Otolaryngology, University of California, San FranciscoSan FranciscoUnited States
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12
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Oldan JD, Jewells VL, Pieper B, Wong TZ. Complete Evaluation of Dementia: PET and MRI Correlation and Diagnosis for the Neuroradiologist. AJNR Am J Neuroradiol 2021; 42:998-1007. [PMID: 33926896 DOI: 10.3174/ajnr.a7079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 11/14/2020] [Indexed: 12/12/2022]
Abstract
This article will familiarize neuroradiologists with the pathophysiology, clinical findings, and standard MR imaging and PET imaging features of multiple forms of dementia as well as new emerging techniques. Cases were compiled from multiple institutions with the goal of improved diagnostic accuracy and improved patient care as well as information about biomarkers on the horizon. Dementia topics addressed include the following: Alzheimer disease, frontotemporal dementia, cerebral amyloid angiopathy, Lewy body dementia, Parkinson disease and Parkinson disease variants, amyotrophic lateral sclerosis, multisystem atrophy, Huntington disease vascular dementia, and Creutzfeldt-Jakob disease.
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Affiliation(s)
- J D Oldan
- From the Department of Radiology (J.D.O., V.L.J), University of North Carolina, Chapel Hill, North Carolina
| | - V L Jewells
- From the Department of Radiology (J.D.O., V.L.J), University of North Carolina, Chapel Hill, North Carolina
| | - B Pieper
- Department of Radiology (B.P.), Richard L. Roudebush VA Medical Center, Indianapolis, Indiana
| | - T Z Wong
- Department of Radiology (T.Z.W.), Duke University Hospital, Durham, North Carolina
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Peet BT, Spina S, Mundada N, La Joie R. Neuroimaging in Frontotemporal Dementia: Heterogeneity and Relationships with Underlying Neuropathology. Neurotherapeutics 2021; 18:728-752. [PMID: 34389969 PMCID: PMC8423978 DOI: 10.1007/s13311-021-01101-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 12/11/2022] Open
Abstract
Frontotemporal dementia encompasses a group of clinical syndromes defined pathologically by degeneration of the frontal and temporal lobes. Historically, these syndromes have been challenging to diagnose, with an average of about three years between the time of symptom onset and the initial evaluation and diagnosis. Research in the field of neuroimaging has revealed numerous biomarkers of the various frontotemporal dementia syndromes, which has provided clinicians with a method of narrowing the differential diagnosis and improving diagnostic accuracy. As such, neuroimaging is considered a core investigative tool in the evaluation of neurodegenerative disorders. Furthermore, patterns of neurodegeneration correlate with the underlying neuropathological substrates of the frontotemporal dementia syndromes, which can aid clinicians in determining the underlying etiology and improve prognostication. This review explores the advancements in neuroimaging and discusses the phenotypic and pathologic features of behavioral variant frontotemporal dementia, semantic variant primary progressive aphasia, and nonfluent variant primary progressive aphasia, as seen on structural magnetic resonance imaging and positron emission tomography.
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Affiliation(s)
- Bradley T Peet
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
| | - Salvatore Spina
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Nidhi Mundada
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
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14
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Duignan JA, Haughey A, Kinsella JA, Killeen RP. Molecular and Anatomical Imaging of Dementia With Lewy Bodies and Frontotemporal Lobar Degeneration. Semin Nucl Med 2021; 51:264-274. [PMID: 33402272 DOI: 10.1053/j.semnuclmed.2020.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Dementia with Lewy bodies (DLB) and frontotemporal lobar degeneration (FTLD) are common causes of dementia. Early diagnosis of both conditions is challenging due to clinical and radiological overlap with other forms of dementia, particularly Alzheimer's disease (AD). Structural and functional imaging combined can aid differential diagnosis and help to discriminate DLB or FTLD from other forms of dementia. Imaging of DLB involves the use of 123I-FP-CIT SPECT and 123I-metaiodobenzylguanidine (123I-MIBG), both of which have an established role distinguishing DLB from AD. AD is also characterised by more pronounced atrophy of the medial temporal lobe structures when compared to DLB and these can be assessed at MR using the Medial Temporal Atrophy Scale. 18F-FDG-PET is used as a supportive biomarker for the diagnoses of DLB and can distinguish DLB from AD with high accuracy. Polysomnography and electroencephalography also have established roles in the diagnoses of DLB. FTLD is a heterogenous group of neurodegenerative disorders characterised pathologically by abnormally aggregated proteins. Clinical subtypes include behavioral variant FTD (bvFTD), primary progressive aphasia (PPA), which can be subdivided into semantic variant PPA (svPPA) or nonfluent agrammatic PPA (nfaPPA) and FTD associated with motor neuron disease (FTD-MND). Structural imaging is often the first step in making an image supported diagnoses of FTLD. Regional patterns of atrophy can be assessed on MR and graded according to the global cortical atrophy scale. FTLD is typically associated with atrophy of the frontal and temporal lobes. The patterns of atrophy are associated with the specific clinical subtypes, underlying neuropathology and genetic mutations although there is significant overlap. 18F-FDG-PET is useful for distinguishing FTLD from other forms of dementia and focal areas of hypometabolism can often precede atrophy identified on structural MR imaging. There are currently no biomarkers with which to unambiguously diagnose DLB or FTLD and both conditions demonstrate a wide range of heterogeneity. A combined approach of structural and functional imaging improves diagnostic accuracy in both conditions.
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Affiliation(s)
- John A Duignan
- Department of Radiology, St Vincent's University Hospital, Dublin 4, Ireland; UCD - SVUH PET CT Research Centre, St Vincent's University Hospital, Dublin 4, Ireland
| | - Aoife Haughey
- Department of Radiology, St Vincent's University Hospital, Dublin 4, Ireland; UCD - SVUH PET CT Research Centre, St Vincent's University Hospital, Dublin 4, Ireland
| | - Justin A Kinsella
- Department of Neurology, St Vincent's University Hospital, UCD, Dublin 4, Ireland
| | - Ronan P Killeen
- Department of Radiology, St Vincent's University Hospital, Dublin 4, Ireland; UCD - SVUH PET CT Research Centre, St Vincent's University Hospital, Dublin 4, Ireland.
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15
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Drzezga A, Bischof GN, Giehl K, van Eimeren T. PET and SPECT Imaging of Neurodegenerative Diseases. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00085-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Dave A, Hansen N, Downey R, Johnson C. FDG-PET Imaging of Dementia and Neurodegenerative Disease. Semin Ultrasound CT MR 2020; 41:562-571. [DOI: 10.1053/j.sult.2020.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hedderich DM, Drost R, Goldhardt O, Ortner M, Müller-Sarnowski F, Diehl-Schmid J, Zimmer C, Förstl H, Yakushev I, Jahn T, Grimmer T. Regional Cerebral Associations Between Psychometric Tests and Imaging Biomarkers in Alzheimer's Disease. Front Psychiatry 2020; 11:793. [PMID: 32903760 PMCID: PMC7438836 DOI: 10.3389/fpsyt.2020.00793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 07/23/2020] [Indexed: 11/23/2022] Open
Abstract
Recently, imaging biomarkers have gained importance for the characterization of patients with Alzheimer's disease; however, the relationship between regional biomarker expression and cognitive function remains unclear. In our study, we investigated associations between scores on CERAD neuropsychological assessment battery (CERAD-NAB) subtests with regional glucose metabolism, cortical thickness and amyloid deposition in patients with early Alzheimer's disease (AD) using [18F]-fluorodeoxyglucose (FDG), structural MRI, and 11C-Pittsburgh Compound B (PiB) positron emission tomography (PET), respectively. A total of 76 patients (mean age 68.4 ± 8.5 years, 57.9% male) with early AD (median global clinical dementia rating (CDR) score = 0.5, range: 0.5-2.0) were studied. Associations were investigated by correlation and multiple regression analyses. Scores on cognitive subtests were most closely predicted by regional glucose metabolism with explained variance up to a corrected R² of 0.518, followed by cortical thickness and amyloid deposition. Prediction of cognitive subtest performance was increased up to a corrected R² of 0.622 for Word List-Delayed Recall, when biomarker information from multiple regions and multiple modalities were included. For verbal, visuoconstructive and mnestic domains the closest associations with FDG-PET imaging were found in the left lateral temporal lobe, right parietal lobe, and posterior cingulate cortex, respectively. Decreased cortical thickness in parietal regions was most predictive of impaired subtest performance. Remarkably, cerebral amyloid deposition significantly predicted cognitive function in about half of the subtests but with smaller extent of variance explained (corrected R² ≤ 0.220). We conclude that brain metabolism and atrophy affect cognitive performance in a regionally distinct way. Significant predictions of cognitive function by PiB-PET in half of CERAD-NAB subtests suggest functional relevance even in symptomatic patients with AD, challenging the concept of plateauing cortical amyloid deposition early in the disease course. Our results underscore the complex spatial relationship between different imaging biomarkers.
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Affiliation(s)
- Dennis M. Hedderich
- Department of Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-NIC Neuroimaging Center, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - René Drost
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Oliver Goldhardt
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marion Ortner
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Felix Müller-Sarnowski
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Claus Zimmer
- Department of Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Hans Förstl
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Igor Yakushev
- TUM-NIC Neuroimaging Center, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Nuclear Medicine, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Thomas Jahn
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Zangrandi A, Mioli A, Marti A, Ghidoni E, Gasparini F. Multimodal semantic battery to monitor progressive loss of concepts in the semantic variant of primary progressive aphasia (svPPA): an innovative proposal. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:438-454. [PMID: 32573335 DOI: 10.1080/13825585.2020.1782826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Semantic variant primary progressive aphasia (svPPA) is a rare neurodegenerative disease characterized by a progressive loss of semantic knowledge. Patients with svPPA show anomia, impaired word comprehension, poor object recognition, and difficulties in retrieving semantic information. svPPA is also a unique "natural" model that allows clinicians and cognitive neuroscientists to study the organization of semantic memory because only semantic knowledge is affected in the initial period of the disease, with relative sparing of other cognitive domains. In the clinical practice, semantic memory is commonly tested only with verbal tests. The aim of the present study was to preliminary test a new Multimodal Semantic Battery developed in our laboratory, which comprised 11 subtests designed to assess the semantic knowledge of multiple items via all input modalities. The battery was administered twice, over four years, to a patient diagnosed with svPPA. We found that when extensively tested with multiple tests, in some cases, he was still able to recall semantic features of the items that otherwise would not have emerged with standard semantic tests. These results are discussed for the clinical practice: monitoring semantic memory through all modalities in a practical and reliable way could be useful for both clinicians and experimental researchers to better investigate the breakdown of semantic knowledge.
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Affiliation(s)
- Andrea Zangrandi
- Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia, Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neuro-Motor Diseases , Reggio Emilia, Italy
| | - Alessandro Mioli
- Research Unit of Neurophysiology and Neuroengineering of Human-Technology Interaction, Università Campus Bio-Medico , Rome, Italy
| | - Alessandro Marti
- Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia, Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neuro-Motor Diseases , Reggio Emilia, Italy
| | - Enrico Ghidoni
- Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia, Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neuro-Motor Diseases , Reggio Emilia, Italy
| | - Federico Gasparini
- Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia, Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neuro-Motor Diseases , Reggio Emilia, Italy
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Yeung MK, Chan AS. Functional near-infrared spectroscopy reveals decreased resting oxygenation levels and task-related oxygenation changes in mild cognitive impairment and dementia: A systematic review. J Psychiatr Res 2020; 124:58-76. [PMID: 32120065 DOI: 10.1016/j.jpsychires.2020.02.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 02/06/2023]
Abstract
Nuclear medicine and functional magnetic resonance imaging studies have shown that mild cognitive impairment (MCI) and dementia, including Alzheimer's disease (AD), are characterized by changes in cerebral blood flow. This article reviews the application of an alternative method, functional near-infrared spectroscopy (fNIRS), to the study of cerebral oxygenation changes in MCI and dementia. We synthesized 36 fNIRS studies that examined hemodynamic changes during both the resting state and the execution of tasks of word retrieval, memory, motor control, and visuospatial perception in MCI and dementia. This qualitative review reveals that (amnestic) MCI and AD patients have disrupted frontal and long-range connectivity in the resting state compared to individuals with normal cognition (NC). These patients also exhibit reduced frontal oxygenation changes in various cognitive domains. The review also shows that disrupted connectivity and decreased frontal oxygenation levels/changes are more severe in AD than in (amnestic) MCI, confirming that MCI is an intermediate stage between NC and dementia. Thus, there is reduced resting frontal perfusion, which is greater than expected for age, and a lack of frontal compensatory responses to functional decline across cognitive operations (i.e., word retrieval and memory functioning) in MCI and AD. These indices might potentially serve as perfusion- or oxygenation-based biomarkers for MCI/dementia. To expand the utility of fNIRS for MCI and dementia, further studies that measure tissue oxygenation in a wider range of brain regions and cognitive domains, compare different MCI and dementia types, and correlate changes in cerebral oxygenation over time with disease progression are needed.
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Affiliation(s)
- Michael K Yeung
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, H3A 2B4, Canada
| | - Agnes S Chan
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China; Chanwuyi Research Center for Neuropsychological Well-being, The Chinese University of Hong Kong, Hong Kong SAR, China.
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20
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Nadeau SE. Neural Population Dynamics and Cognitive Function. Front Hum Neurosci 2020; 14:50. [PMID: 32226366 PMCID: PMC7080985 DOI: 10.3389/fnhum.2020.00050] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/04/2020] [Indexed: 12/27/2022] Open
Abstract
Representations in the brain are encoded as patterns of activity of large populations of neurons. The science of population encoded representations, also known as parallel distributed processing (PDP), achieves neurological verisimilitude and has been able to account for a large number of cognitive phenomena in normal people, including reaction times (and reading latencies), stimulus recognition, the effect of stimulus salience on attention, perceptual invariance, simultaneous egocentric and allocentric visual processing, top-down/bottom-up processing, language errors, the effect of statistical regularities of experience, frequency, and age of acquisition, instantiation of rules and symbols, content addressable memory and the capacity for pattern completion, preservation of function in the face of noisy or distorted input, inference, parallel constraint satisfaction, the binding problem and gamma coherence, principles of hippocampal function, the location of knowledge in the brain, limitations in the scope and depth of knowledge acquired through experience, and Piagetian stages of cognitive development. PDP studies have been able to provide a coherent account for impairment in a variety of language functions resulting from stroke or dementia in a large number of languages and the phenomenon of graceful degradation observed in such studies. They have also made important contributions to our understanding of attention (including hemispatial neglect), emotional function, executive function, motor planning, visual processing, decision making, and neuroeconomics. The relationship of neural network population dynamics to electroencephalographic rhythms is starting to emerge. Nevertheless, PDP approaches have scarcely penetrated major areas of study of cognition, including neuropsychology and cognitive neuropsychology, as well as much of cognitive psychology. This article attempts to provide an overview of PDP principles and applications that addresses a broader audience.
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Affiliation(s)
- Stephen E. Nadeau
- Research Service and the Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, United States
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21
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Abstract
Primary progressive aphasia (PPA) is classified into three variants, logopenic variant PPA (lvPPA), nonfluent agrammatic PPA (nfaPPA), and semantic variant PPA (svPPA), based on clinical (syndromic) characteristics with support from neuroimaging and/or underlying neuropathology. Classification of PPA variants provides information valuable to disease management. International consensus criteria are widely employed to identify PPA subtypes; however, classification is complex, and some individuals do not fit neatly into the subtyping scheme. In this review, diagnostic challenges and their implications are discussed, possible explanations for these challenges are explored, and approaches to address PPA classification are considered.
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Affiliation(s)
- Donna C. Tippett
- Departments of Neurology, Otolaryngology - Head and Neck Surgery, and Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21287, USA
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22
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The atrophy pattern in Alzheimer-related PPA is more widespread than that of the frontotemporal lobar degeneration associated variants. NEUROIMAGE-CLINICAL 2019; 24:101994. [PMID: 31505368 PMCID: PMC6734177 DOI: 10.1016/j.nicl.2019.101994] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/16/2019] [Accepted: 08/24/2019] [Indexed: 11/30/2022]
Abstract
Objective The three recognized variants of primary progressive aphasia (PPA) are associated with different loci of degeneration—left posterior perisylvian in logopenic variant (lvPPA), left frontal operculum in non-fluent variant (nfvPPA), and left rostroventral-temporal in semantic variant (svPPA). Meanwhile, it has become apparent that patients with lvPPA, in which Alzheimer pathology is the norm, frequently have more extensive language deficits—namely semantic and grammatical problems—than is captured in the strict diagnostic recommendations for this variant. We hypothesized that this may be because the degeneration in AD-related PPA typically extends beyond the left posterior perisylvian region. Methods Magnetic resonance images from 25 PPA patients (9AD-related PPA, 10 svPPA, 6 nfvPPA) and a healthy control cohort were used to calculate cortical thickness in three regions of interest (ROIs). The three ROIs being the left-hemispheric loci of maximal reported degeneration for each of the three variants of PPA. Results Consistent with past studies, the most severe cortical thinning was in the posterior perisylvian ROI in AD-related PPA; the ventral temporal ROI in svPPA; and the frontal opercular ROI in nfvPPA. Significant cortical thinning in AD-related PPA, however, was evident in all three ROIs. In contrast, thinning in svPPA and nfvPPA was largely restricted to their known peak loci of degeneration. Conclusions Although cortical degeneration in AD-related PPA is maximal in the left posterior perisylvian region, it extends more diffusely throughout the left hemisphere language network offering a plausible explanation for why the linguistic profile of lvPPA so often includes additional semantic and grammatic deficits. lvPPA is associated with AD pathology. AD-PPA present with more extensive deficits than lvPPA. Atrophy in AD-PPA encompasses the peak atrophy sites of the other PPA subtypes. The extended atrophy in AD-PPA explains the heterogeneity of linguistic deficits.
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Kwak K, Yun HJ, Park G, Lee JM. Multi-Modality Sparse Representation for Alzheimer's Disease Classification. J Alzheimers Dis 2019; 65:807-817. [PMID: 29562503 DOI: 10.3233/jad-170338] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) and mild cognitive impairment (MCI) are age-related neurodegenerative diseases characterized by progressive loss of memory and irreversible cognitive functions. The hippocampus, a brain area critical for learning and memory processes, is especially susceptible to damage at early stages of AD. OBJECTIVE We aimed to develop prediction model using a multi-modality sparse representation approach. METHODS We proposed a sparse representation approach to the hippocampus using structural T1-weighted magnetic resonance imaging (MRI) and 18-fluorodeoxyglucose-positron emission tomography (FDG-PET) to distinguish AD/MCI from healthy control subjects (HCs). We considered structural and function information for the hippocampus and applied a sparse patch-based approach to effectively reduce the dimensions of neuroimaging biomarkers. RESULTS In experiments using Alzheimer's Disease Neuroimaging Initiative data, our proposed method demonstrated more reliable than previous classification studies. The effects of different parameters on segmentation accuracy were also evaluated. The mean classification accuracy obtained with our proposed method was 0.94 for AD/HCs, 0.82 for MCI/HCs, and 0.86 for AD/MCI. CONCLUSION We extracted multi-modal features from automatically defined hippocampal regions of training subjects and found this method to be discriminative and robust for AD and MCI classification. The extraction of features in T1 and FDG-PET images is expected to improve classification performance due to the relationship between brain structure and function.
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Affiliation(s)
- Kichang Kwak
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Hyuk Jin Yun
- Fetal Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Gilsoon Park
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
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Lanzoni L, Thompson H, Beintari D, Berwick K, Demnitz-King H, Raspin H, Taha M, Stampacchia S, Smallwood J, Jefferies E. Emotion and location cues bias conceptual retrieval in people with deficient semantic control. Neuropsychologia 2019; 131:294-305. [PMID: 31163176 PMCID: PMC6667741 DOI: 10.1016/j.neuropsychologia.2019.05.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/29/2019] [Accepted: 05/31/2019] [Indexed: 02/02/2023]
Abstract
Visuo-spatial context and emotional valence are powerful cues to episodic retrieval, but the contribution of these inputs to semantic cognition has not been widely investigated. We examined the impact of visuo-spatial, facial emotion and prosody cues and miscues on the retrieval of dominant and subordinate meanings of ambiguous words. Cue photographs provided relevant visuo-spatial or emotional information, consistent with the interpretation of the ambiguous word being probed, while miscues were consistent with an alternative interpretation. We compared the impact of these cues in healthy controls and semantic aphasia patients with deficient control over semantic retrieval following left-hemisphere stroke. Patients showed greater deficits in retrieving the subordinate meanings of ambiguous words, and stronger effects of cueing and miscuing relative to healthy controls. These findings suggest that contextual cues that guide retrieval to the appropriate semantic information reduce the need to constrain semantic retrieval internally, while miscues that are not aligned with the task increase the need for semantic control. Moreover, both valence and visuo-spatial context can prime particular semantic interpretations, in line with theoretical frameworks that argue meaning is computed through the integration of these features. In semantic aphasia, residual comprehension relies heavily on facial expressions and visuospatial cues. This has important implications for patients, their families and clinicians when developing new or more effective modes of communication.
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Affiliation(s)
| | | | | | | | - Harriet Demnitz-King
- Department of Psychology, University of York, UK; Faculty of Brain Sciences, University College London, UK
| | | | - Maria Taha
- Department of Psychology, University of York, UK
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Whitwell JL. FTD spectrum: Neuroimaging across the FTD spectrum. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019; 165:187-223. [PMID: 31481163 DOI: 10.1016/bs.pmbts.2019.05.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Frontotemporal dementia is a complex and heterogeneous neurodegenerative disease that encompasses many clinical syndromes, pathological diseases, and genetic mutations. Neuroimaging has played a critical role in our understanding of the underlying pathophysiology of frontotemporal dementia and provided biomarkers to aid diagnosis. Early studies defined patterns of neurodegeneration and hypometabolism associated with the clinical, pathological and genetic aspects of frontotemporal dementia, with more recent studies highlighting how the breakdown of structural and functional brain networks define frontotemporal dementia. Molecular positron emission tomography ligands allowing the in vivo imaging of tau proteins have also provided important insights, although more work is needed to understand the biology of the currently available ligands.
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Pineault J, Jolicœur P, Grimault S, Lacombe J, Brambati SM, Bier N, Chayer C, Joubert S. A MEG study of the neural substrates of semantic processing in semantic variant primary progressive aphasia. Neurocase 2019; 25:118-129. [PMID: 31256711 DOI: 10.1080/13554794.2019.1631853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Despite a well-documented pattern of semantic impairment, the patterns of brain activation during semantic processing in semantic variant primary progressive aphasia (svPPA) still remain poorly understood. In the current study, one svPPA patient (EC) and six elderly controls carried out a general-level semantic categorization task while their brain activity was recorded using magnetoencephalography (MEG). Despite similar behavioral performance, EC showed hyperactivation of the left inferior temporal gyrus (ITG) and right anterior temporal lobe (ATL) relative to controls. This suggests that periatrophic regions within the ATL region may support preserved semantic abilities in svPPA.
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Affiliation(s)
- Jessica Pineault
- a Département de psychologie , Université de Montréal , Montréal , Canada.,b Centre de Recherche, Institut Universitaire de Gériatrie de Montréal , Université de Montréal , Montréal , Canada
| | - Pierre Jolicœur
- a Département de psychologie , Université de Montréal , Montréal , Canada.,c Centre de Recherche en Neuropsychologie et Cognition , Université de Montréal , Montréal , Canada
| | - Stephan Grimault
- a Département de psychologie , Université de Montréal , Montréal , Canada.,c Centre de Recherche en Neuropsychologie et Cognition , Université de Montréal , Montréal , Canada
| | - Jacinthe Lacombe
- a Département de psychologie , Université de Montréal , Montréal , Canada.,b Centre de Recherche, Institut Universitaire de Gériatrie de Montréal , Université de Montréal , Montréal , Canada
| | - Simona Maria Brambati
- a Département de psychologie , Université de Montréal , Montréal , Canada.,b Centre de Recherche, Institut Universitaire de Gériatrie de Montréal , Université de Montréal , Montréal , Canada
| | - Nathalie Bier
- b Centre de Recherche, Institut Universitaire de Gériatrie de Montréal , Université de Montréal , Montréal , Canada.,d Faculté de médecine , Université de Montréal , Montréal , Canada
| | - Céline Chayer
- d Faculté de médecine , Université de Montréal , Montréal , Canada.,e Service de neurologie , Hôpital Maisonneuve-Rosemont , Montréal , Canada
| | - Sven Joubert
- a Département de psychologie , Université de Montréal , Montréal , Canada.,b Centre de Recherche, Institut Universitaire de Gériatrie de Montréal , Université de Montréal , Montréal , Canada
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27
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Montembeault M, Chapleau M, Jarret J, Boukadi M, Laforce R, Wilson MA, Rouleau I, Brambati SM. Differential language network functional connectivity alterations in Alzheimer's disease and the semantic variant of primary progressive aphasia. Cortex 2019; 117:284-298. [PMID: 31034993 DOI: 10.1016/j.cortex.2019.03.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 01/21/2019] [Accepted: 03/21/2019] [Indexed: 01/18/2023]
Abstract
Patients with Alzheimer's disease (AD) and semantic variant primary progressive aphasia (svPPA) can present with similar language impairments, mainly in naming. It has been hypothesized that these deficits are associated with different brain mechanisms in each disease, but no previous study has used a network approach to explore this hypothesis. The aim of this study was to compare resting-state functional magnetic resonance imaging (rs-fMRI) language network in AD, svPPA patients, and cognitively unimpaired elderly adults (CTRL). Therefore, 10 AD patients, 12 svPPA patients and 11 CTRL underwent rs-fMRI. Seed-based functional connectivity analyses were conducted using regions of interest in the left anterior temporal lobe (ATL), left posterior middle temporal gyrus (pMTG) and left inferior frontal gyrus (IFG), applying a voxelwise correction for gray matter volume. In AD patients, the left pMTG was the only key language region showing functional connectivity changes, mainly a reduced interhemispheric functional connectivity with its right-hemisphere counterpart, in comparison to CTRL. In svPPA patients, we observed a functional isolation of the left ATL, both decreases and increases in functional connectivity from the left pMTG and increased functional connectivity form the left IFG. Post-hoc analyses showed that naming impairments were overall associated with the functional disconnections observed across the language network. In conclusion, AD and svPPA patients present distinct language network functional connectivity profiles. In AD patients, functional connectivity changes were restricted to the left pMTG and were overall less severe in comparison to svPPA patients. Results in svPPA patients suggest decreased functional connectivity along the ventral language pathway and increased functional connectivity along the dorsal language pathway. Finally, the observed connectivity patterns are overall consistent with previously reported structural connectivity and language profiles in these patients.
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Affiliation(s)
- Maxime Montembeault
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada; Département de psychologie, Université de Montréal, Montréal, QC, Canada.
| | - Marianne Chapleau
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada; Département de psychologie, Université de Montréal, Montréal, QC, Canada.
| | - Julien Jarret
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada; Département de psychologie, Université de Montréal, Montréal, QC, Canada.
| | - Mariem Boukadi
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada; Département de psychologie, Université de Montréal, Montréal, QC, Canada.
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire (CIME) du CHU de Québec, QC, Canada; Faculté de médecine, Université Laval, Québec, QC, Canada.
| | - Maximiliano A Wilson
- Faculté de médecine, Université Laval, Québec, QC, Canada; Centre de recherche CERVO, Québec, QC, Canada.
| | - Isabelle Rouleau
- Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada.
| | - Simona M Brambati
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada; Département de psychologie, Université de Montréal, Montréal, QC, Canada.
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Wilson H, Pagano G, Politis M. Dementia spectrum disorders: lessons learnt from decades with PET research. J Neural Transm (Vienna) 2019; 126:233-251. [PMID: 30762136 PMCID: PMC6449308 DOI: 10.1007/s00702-019-01975-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 01/21/2019] [Indexed: 02/07/2023]
Abstract
The dementia spectrum encompasses a range of disorders with complex diagnosis, pathophysiology and limited treatment options. Positron emission tomography (PET) imaging provides insights into specific neurodegenerative processes underlying dementia disorders in vivo. Here we focus on some of the most common dementias: Alzheimer's disease, Parkinsonism dementias including Parkinson's disease with dementia, dementia with Lewy bodies, progressive supranuclear palsy and corticobasal syndrome, and frontotemporal lobe degeneration. PET tracers have been developed to target specific proteinopathies (amyloid, tau and α-synuclein), glucose metabolism, cholinergic system and neuroinflammation. Studies have shown distinct imaging abnormalities can be detected early, in some cases prior to symptom onset, allowing disease progression to be monitored and providing the potential to predict symptom onset. Furthermore, advances in PET imaging have identified potential therapeutic targets and novel methods to accurately discriminate between different types of dementias in vivo. There are promising imaging markers with a clinical application on the horizon, however, further studies are required before they can be implantation into clinical practice.
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Affiliation(s)
- Heather Wilson
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | - Gennaro Pagano
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | - Marios Politis
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK.
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Asghar M, Hinz R, Herholz K, Carter SF. Dual-phase [18F]florbetapir in frontotemporal dementia. Eur J Nucl Med Mol Imaging 2019; 46:304-311. [PMID: 30569187 PMCID: PMC6333719 DOI: 10.1007/s00259-018-4238-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/05/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE The PET tracer [18F]florbetapir is a specific fibrillar amyloid-beta (Aβ) biomarker. During the late scan phase (> 40 min), it provides pathological information about Aβ status. Early scan phase (0-10 min) can provide FDG-'like' information. The current investigation tested the feasibility of using florbetapir as a dual-phase biomarker in behavioural variant frontotemporal dementia (bvFTD). METHODS Eight bvFTD patients underwent [18F]florbetapir and [18]FDG-PET scans. Additionally, ten healthy controls and ten AD patients underwent florbetapir-PET only. PET data were acquired dynamically for 60-min post-injection. The bvFTD PET data were used to define an optimal time window, representing blood flow-related pseudo-metabolism ('pseudo-FDG'), of florbetapir data that maximally correlated with the corresponding real FDG SUVR (40-60 min) in a composite neocortical FTD region. RESULTS A 2 to 5-min time window post-injection of the florbetapir-PET data provided the largest correlation (Pearson's r = 0.79, p = 0.02) to the FDG data. The pseudo-FDG images demonstrated strong internal consistency with actual FDG data and were also visually consistent with the bvFTD patients' hypometabolic profiles. The ability to identify bvFTD from blind visual rating of pseudo-FDG images was consistent with previous reports using FDG data (sensitivity = 75%, specificity = 85%). CONCLUSIONS This investigation demonstrates that early phase florbetapir uptake shows a reduction of frontal lobe perfusion in bvFTD, similar to metabolic findings with FDG. Thus, dynamic florbetapir scans can serve as a dual-phase biomarker in dementia patients to distinguish FTD from AD and cognitively normal elderly, removing the need for a separate FDG-PET scan in challenging dementia cases.
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Affiliation(s)
- Michael Asghar
- Wolfson Molecular Imaging Centre, Faculty of Medicine, Biology and Health, University of Manchester, 27 Palatine Road, Manchester, M20 3LJ, UK
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Rainer Hinz
- Wolfson Molecular Imaging Centre, Faculty of Medicine, Biology and Health, University of Manchester, 27 Palatine Road, Manchester, M20 3LJ, UK
| | - Karl Herholz
- Wolfson Molecular Imaging Centre, Faculty of Medicine, Biology and Health, University of Manchester, 27 Palatine Road, Manchester, M20 3LJ, UK
| | - Stephen F Carter
- Wolfson Molecular Imaging Centre, Faculty of Medicine, Biology and Health, University of Manchester, 27 Palatine Road, Manchester, M20 3LJ, UK.
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30
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Risacher SL, Saykin AJ. Neuroimaging in aging and neurologic diseases. HANDBOOK OF CLINICAL NEUROLOGY 2019; 167:191-227. [PMID: 31753134 DOI: 10.1016/b978-0-12-804766-8.00012-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neuroimaging biomarkers for neurologic diseases are important tools, both for understanding pathology associated with cognitive and clinical symptoms and for differential diagnosis. This chapter explores neuroimaging measures, including structural and functional measures from magnetic resonance imaging (MRI) and molecular measures primarily from positron emission tomography (PET), in healthy aging adults and in a number of neurologic diseases. The spectrum covers neuroimaging measures from normal aging to a variety of dementias: late-onset Alzheimer's disease [AD; including mild cognitive impairment (MCI)], familial and nonfamilial early-onset AD, atypical AD syndromes, posterior cortical atrophy (PCA), logopenic aphasia (lvPPA), cerebral amyloid angiopathy (CAA), vascular dementia (VaD), sporadic and familial behavioral-variant frontotemporal dementia (bvFTD), semantic dementia (SD), progressive nonfluent aphasia (PNFA), frontotemporal dementia with motor neuron disease (FTD-MND), frontotemporal dementia with amyotrophic lateral sclerosis (FTD-ALS), corticobasal degeneration (CBD), progressive supranuclear palsy (PSP), dementia with Lewy bodies (DLB), Parkinson's disease (PD) with and without dementia, and multiple systems atrophy (MSA). We also include a discussion of the appropriate use criteria (AUC) for amyloid imaging and conclude with a discussion of differential diagnosis of neurologic dementia disorders in the context of neuroimaging.
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Affiliation(s)
- Shannon L Risacher
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States.
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31
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Qiao J, Lv Y, Cao C, Wang Z, Li A. Multivariate Deep Learning Classification of Alzheimer's Disease Based on Hierarchical Partner Matching Independent Component Analysis. Front Aging Neurosci 2018; 10:417. [PMID: 30618723 PMCID: PMC6304436 DOI: 10.3389/fnagi.2018.00417] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/03/2018] [Indexed: 12/11/2022] Open
Abstract
Machine learning and pattern recognition have been widely investigated in order to look for the biomarkers of Alzheimer’s disease (AD). However, most existing methods extract features by seed-based correlation, which not only requires prior information but also ignores the relationship between resting state functional magnetic resonance imaging (rs-fMRI) voxels. In this study, we proposed a deep learning classification framework with multivariate data-driven based feature extraction for automatic diagnosis of AD. Specifically, a three-level hierarchical partner matching independent components analysis (3LHPM-ICA) approach was proposed first in order to address the issues in spatial individual ICA, including the uncertainty of the numbers of components, the randomness of initial values, and the correspondence of ICs of multiple subjects, resulting in stable and reliable ICs which were applied as the intrinsic brain functional connectivity (FC) features. Second, Granger causality (GC) was utilized to infer directional interaction between the ICs that were identified by the 3LHPM-ICA method and extract the effective connectivity features. Finally, a deep learning classification framework was developed to distinguish AD from controls by fusing the functional and effective connectivities. A resting state fMRI dataset containing 34 AD patients and 34 normal controls (NCs) was applied to the multivariate deep learning platform, leading to a classification accuracy of 95.59%, with a sensitivity of 97.06% and a specificity of 94.12% with leave-one-out cross validation (LOOCV). The experimental results demonstrated that the measures of neural connectivities of ICA and GC followed by deep learning classification represented the most powerful methods of distinguishing AD clinical data from NCs, and these aberrant brain connectivities might serve as robust brain biomarkers for AD. This approach also allows for expansion of the methodology to classify other psychiatric disorders.
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Affiliation(s)
- Jianping Qiao
- Shandong Province Key Laboratory of Medical Physics and Image Processing Technology, Institute of Data Science and Technology, School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - Yingru Lv
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chongfeng Cao
- Department of Emergency, Jinan Central Hospital Affiliated to Shandong University, Jinan, China
| | - Zhishun Wang
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Anning Li
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
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Zangrandi A, Gasparini F, Imovilli A, Napoli M, Marti A, Angelini D, Barletta-Rodolfi C, Ghidoni E. Atypical non-progressive semantic impairment following allogeneic bone marrow transplantation in a patient with Waldenström’s macroglobulinemia: A case report. Clin Neuropsychol 2018; 33:798-810. [DOI: 10.1080/13854046.2018.1499966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Andrea Zangrandi
- Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neurology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Federico Gasparini
- Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neurology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Annalisa Imovilli
- Department of Haematology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Manuela Napoli
- Neuroradiology Unit, Department of Diagnostic Imaging, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Alessandro Marti
- Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neurology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Damiano Angelini
- Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neurology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Caterina Barletta-Rodolfi
- Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neurology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Enrico Ghidoni
- Clinical Neuropsychology, Cognitive Disorders and Dyslexia Unit, Department of Neurology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
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34
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González-Sánchez M, Puertas-Martín V, Esteban-Pérez J, García-Redondo A, Borrego-Hernández D, Méndez-Guerrero A, Llamas-Velasco S, Herrero-San Martín A, Cordero-Vázquez P, Herrero-Manso MC, Pérez-Martínez DA, Villarejo-Galende A. TARDBP mutation associated with semantic variant primary progressive aphasia, case report and review of the literature. Neurocase 2018; 24:301-305. [PMID: 30773994 DOI: 10.1080/13554794.2019.1581225] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Semantic variant primary progressive aphasia (svPPA) is a clinical syndrome included in the frontotemporal dementia (FTD) spectrum. Unlike other forms of FTD, it is sporadic in the majority of cases and not commonly associated with motor neuron disease (MND). We describe a case of svPPA associated with MND in the same family, due to a mutation of the transactive response DNA binding protein (TARDBP) gene, and review the literature.
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Affiliation(s)
- M González-Sánchez
- a Department of Neurology , Hospital Universitario 12 de Octubre , Madrid , Spain.,b Group of Neurodegenerative Diseases , Hospital 12 de Octubre Research Institute (i+12) , Madrid , Spain.,c Biomedical Research Networking Center in Neurodegenerative Diseases (CIBERNED) , Madrid , Spain
| | - V Puertas-Martín
- a Department of Neurology , Hospital Universitario 12 de Octubre , Madrid , Spain.,b Group of Neurodegenerative Diseases , Hospital 12 de Octubre Research Institute (i+12) , Madrid , Spain
| | - J Esteban-Pérez
- a Department of Neurology , Hospital Universitario 12 de Octubre , Madrid , Spain.,d ALS Unit , Hospital 12 de Octubre Research Institute (i+12) , Madrid , Spain.,e Biomedical Research Networking Centre on Rare Diseases (CIBERER) , Madrid , Spain
| | - A García-Redondo
- d ALS Unit , Hospital 12 de Octubre Research Institute (i+12) , Madrid , Spain.,e Biomedical Research Networking Centre on Rare Diseases (CIBERER) , Madrid , Spain
| | - D Borrego-Hernández
- d ALS Unit , Hospital 12 de Octubre Research Institute (i+12) , Madrid , Spain
| | - A Méndez-Guerrero
- a Department of Neurology , Hospital Universitario 12 de Octubre , Madrid , Spain
| | - S Llamas-Velasco
- a Department of Neurology , Hospital Universitario 12 de Octubre , Madrid , Spain.,b Group of Neurodegenerative Diseases , Hospital 12 de Octubre Research Institute (i+12) , Madrid , Spain.,c Biomedical Research Networking Center in Neurodegenerative Diseases (CIBERNED) , Madrid , Spain
| | - A Herrero-San Martín
- a Department of Neurology , Hospital Universitario 12 de Octubre , Madrid , Spain.,b Group of Neurodegenerative Diseases , Hospital 12 de Octubre Research Institute (i+12) , Madrid , Spain.,c Biomedical Research Networking Center in Neurodegenerative Diseases (CIBERNED) , Madrid , Spain
| | - P Cordero-Vázquez
- a Department of Neurology , Hospital Universitario 12 de Octubre , Madrid , Spain.,d ALS Unit , Hospital 12 de Octubre Research Institute (i+12) , Madrid , Spain
| | - M C Herrero-Manso
- a Department of Neurology , Hospital Universitario 12 de Octubre , Madrid , Spain
| | - D A Pérez-Martínez
- a Department of Neurology , Hospital Universitario 12 de Octubre , Madrid , Spain.,b Group of Neurodegenerative Diseases , Hospital 12 de Octubre Research Institute (i+12) , Madrid , Spain.,c Biomedical Research Networking Center in Neurodegenerative Diseases (CIBERNED) , Madrid , Spain.,f Complutense University of Madrid , Madrid , Spain
| | - A Villarejo-Galende
- a Department of Neurology , Hospital Universitario 12 de Octubre , Madrid , Spain.,b Group of Neurodegenerative Diseases , Hospital 12 de Octubre Research Institute (i+12) , Madrid , Spain.,c Biomedical Research Networking Center in Neurodegenerative Diseases (CIBERNED) , Madrid , Spain.,f Complutense University of Madrid , Madrid , Spain
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Nazem A, Tang CC, Spetsieris P, Dresel C, Gordon ML, Diehl-Schmid J, Grimmer T, Yakushev I, Mattis PJ, Ma Y, Dhawan V, Eidelberg D. A multivariate metabolic imaging marker for behavioral variant frontotemporal dementia. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2018; 10:583-594. [PMID: 30417069 PMCID: PMC6215979 DOI: 10.1016/j.dadm.2018.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction The heterogeneity of behavioral variant frontotemporal dementia (bvFTD) calls for multivariate imaging biomarkers. Methods We studied a total of 148 dementia patients from the Feinstein Institute (Center-A: 25 bvFTD and 10 Alzheimer's disease), Technical University of Munich (Center-B: 44 bvFTD and 29 FTD language variants), and Alzheimer's Disease Neuroimaging Initiative (40 Alzheimer's disease subjects). To identify the covariance pattern of bvFTD (behavioral variant frontotemporal dementia–related pattern [bFDRP]), we applied principal component analysis to combined 18F-fluorodeoxyglucose–positron emission tomography scans from bvFTD and healthy subjects. The phenotypic specificity and clinical correlates of bFDRP expression were assessed in independent testing sets. Results The bFDRP was identified in Center-A data (24.1% of subject × voxel variance; P < .001), reproduced in Center-B data (P < .001), and independently validated using combined testing data (receiver operating characteristics–area under the curve = 0.97; P < .0001). The expression of bFDRP was specifically elevated in bvFTD patients (P < .001) and was significantly higher at more advanced disease stages (P = .035:duration; P < .01:severity). Discussion The bFDRP can be used as a quantitative imaging marker to gauge the underlying disease process and aid in the differential diagnosis of bvFTD.
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Affiliation(s)
- Amir Nazem
- Elmezzi Graduate School of Molecular Medicine, Manhasset, NY, USA.,Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Chris C Tang
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Phoebe Spetsieris
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Christian Dresel
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Marc L Gordon
- Department of Neurology, Northwell Health, Manhasset, NY, USA.,Litwin-Zucker Research Center for the Study of Alzheimer's Disease, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Paul J Mattis
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Yilong Ma
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Vijay Dhawan
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
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Molecular imaging in dementia: Past, present, and future. Alzheimers Dement 2018; 14:1522-1552. [DOI: 10.1016/j.jalz.2018.06.2855] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 06/02/2018] [Accepted: 06/03/2018] [Indexed: 12/14/2022]
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37
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Scheltens NME, van der Weijden K, Adriaanse SM, van Assema D, Oomen PP, Krudop WA, Lammertsma AA, Barkhof F, Koene T, Teunissen CE, Scheltens P, van der Flier WM, Pijnenburg YAL, Yaqub M, Ossenkoppele R, van Berckel BNM. Hypometabolism of the posterior cingulate cortex is not restricted to Alzheimer's disease. NEUROIMAGE-CLINICAL 2018; 19:625-632. [PMID: 29984170 PMCID: PMC6030576 DOI: 10.1016/j.nicl.2018.05.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 04/18/2018] [Accepted: 05/19/2018] [Indexed: 11/15/2022]
Abstract
When differential diagnosis of dementia includes both Alzheimer's disease (AD) and the behavioural variant of frontotemporal dementia (bvFTD), distribution of cerebral glucose metabolism as measured using [18F]‑2‑fluoro‑2‑deoxy‑d‑glucose positron emission tomography ([18F]FDG-PET) may be helpful. One important clue for differentiation is the presence of hypometabolism in the posterior cingulate cortex (PCC), usually associated with AD. PCC hypometabolism however, could also be present in bvFTD. Therefore, the specificity of PCC hypometabolism was examined. Based on visual reading PCC hypometabolism was present in 69–73/81 probable AD patients, in 10–16/33 probable bvFTD patients, and in 0–1/22 cognitive normal (CN) subjects. Findings were validated using a PCC to reference tissue [18F]FDG standard uptake value ratio (SUVr) cut-off, which was derived from the receiver operating characteristic (ROC) separating probable AD from CN, resulting in 9–14/33 bvFTD patients having PCC hypometabolism, depending on the reference tissue used. In conclusion, PCC hypometabolism is not restricted to AD.
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Affiliation(s)
- Nienke M E Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
| | - Kars van der Weijden
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Sofie M Adriaanse
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Danielle van Assema
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Priscilla P Oomen
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Welmoed A Krudop
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Institutes of Neurology and Healthcare Engineering, UCL, London, UK
| | - Teddy Koene
- Alzheimer Center and Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Maqsood Yaqub
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Rik Ossenkoppele
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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Kim J, Lee B. Identification of Alzheimer's disease and mild cognitive impairment using multimodal sparse hierarchical extreme learning machine. Hum Brain Mapp 2018; 39:3728-3741. [PMID: 29736986 DOI: 10.1002/hbm.24207] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/18/2018] [Accepted: 04/25/2018] [Indexed: 01/06/2023] Open
Abstract
Different modalities such as structural MRI, FDG-PET, and CSF have complementary information, which is likely to be very useful for diagnosis of AD and MCI. Therefore, it is possible to develop a more effective and accurate AD/MCI automatic diagnosis method by integrating complementary information of different modalities. In this paper, we propose multi-modal sparse hierarchical extreme leaning machine (MSH-ELM). We used volume and mean intensity extracted from 93 regions of interest (ROIs) as features of MRI and FDG-PET, respectively, and used p-tau, t-tau, and A β 42 as CSF features. In detail, high-level representation was individually extracted from each of MRI, FDG-PET, and CSF using a stacked sparse extreme learning machine auto-encoder (sELM-AE). Then, another stacked sELM-AE was devised to acquire a joint hierarchical feature representation by fusing the high-level representations obtained from each modality. Finally, we classified joint hierarchical feature representation using a kernel-based extreme learning machine (KELM). The results of MSH-ELM were compared with those of conventional ELM, single kernel support vector machine (SK-SVM), multiple kernel support vector machine (MK-SVM) and stacked auto-encoder (SAE). Performance was evaluated through 10-fold cross-validation. In the classification of AD vs. HC and MCI vs. HC problem, the proposed MSH-ELM method showed mean balanced accuracies of 96.10% and 86.46%, respectively, which is much better than those of competing methods. In summary, the proposed algorithm exhibits consistently better performance than SK-SVM, ELM, MK-SVM and SAE in the two binary classification problems (AD vs. HC and MCI vs. HC).
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Affiliation(s)
- Jongin Kim
- Department of Biomedical Science and Engineering (BMSE), Institute of Integrated Technology (IIT), Gwangju Institute of Science and Technology (GIST), Gwangju, 61005, Republic of Korea
| | - Boreom Lee
- Department of Biomedical Science and Engineering (BMSE), Institute of Integrated Technology (IIT), Gwangju Institute of Science and Technology (GIST), Gwangju, 61005, Republic of Korea
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39
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Abstract
Dementia is an important cause of morbidity and mortality worldwide and encompasses a very heterogenous group of disease processes. Positron emission tomography (PET) of the brain using fluorodeoxyglucose (FDG) is a useful modality for differentiating types of dementia. Because FDG does not bind to pathologic proteins, FDG-PET requires that the reader recognize characteristic patterns of glucose hypometabolism to identify pathology. These patterns have been documented in the literature for both primary neurodegenerative disorders and secondary causes of dementia. This article presents an algorithm for organizing these findings and systematically applying them to interpret FDG-PET brain imaging for dementia.
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40
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Cerami C, Dodich A, Greco L, Iannaccone S, Magnani G, Marcone A, Pelagallo E, Santangelo R, Cappa SF, Perani D. The Role of Single-Subject Brain Metabolic Patterns in the Early Differential Diagnosis of Primary Progressive Aphasias and in Prediction of Progression to Dementia. J Alzheimers Dis 2018; 55:183-197. [PMID: 27662315 PMCID: PMC5115609 DOI: 10.3233/jad-160682] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background and Objective: Primary progressive aphasia (PPA) is a clinical syndrome due to different neurodegenerative conditions in which an accurate early diagnosis needs to be supported by a reliable diagnostic tool at the individual level. In this study, we investigated in PPA the FDG-PET brain metabolic patterns at the single-subject level, in order to assess the case-to-case variability and its relationship with clinical-neuropsychological findings. Material and Methods: 55 patients (i.e., 11 semantic variant/sv-PPA, 19 non fluent variant/nfv-PPA, 17 logopenic variant/lv-PPA, 3 slowly progressive anarthria/SPA, and 5 mixed PPA/m-PPA) were included. Clinical-neuropsychological information and FDG-PET data were acquired at baseline. A follow-up of 27.4±12.55 months evaluated the clinical progression. Brain metabolism was analyzed using an optimized and validated voxel-based SPM method at the single-subject level. Results: FDG-PET voxel-wise metabolic assessment revealed specific metabolic signatures characterizing each PPA variant at the individual level, reflecting the underlying neurodegeneration in language networks. Notably, additional dysfunctional patterns predicted clinical progression to specific dementia conditions. In the case of nfv-PPA, a metabolic pattern characterized by involvement of parietal, subcortical and brainstem structures predicted progression to a corticobasal degeneration syndrome or to progressive supranuclear palsy. lv-PPA and sv-PPA cases who progressed to Alzheimer’s disease and frontotemporal dementia at the follow-up presented with extended bilateral patterns at baseline. Discussion: Our results indicate that FDG-PET voxel-wise imaging is a valid biomarker for the early differential diagnosis of PPAs and for the prediction of progression to specific dementia condition. This study supports the use of FDG-PET imaging quantitative assessment in clinical settings for a better characterization of PPA individuals and prognostic definition of possible endo-phenotypes.
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Affiliation(s)
- Chiara Cerami
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.,Department of Clinical Neuroscience, San Raffaele Turro Hospital, Milan, Italy
| | - Alessandra Dodich
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Lucia Greco
- Vita-Salute San Raffaele University, Milan, Italy
| | - Sandro Iannaccone
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.,Department of Clinical Neuroscience, San Raffaele Turro Hospital, Milan, Italy
| | | | - Alessandra Marcone
- Department of Clinical Neuroscience, San Raffaele Turro Hospital, Milan, Italy
| | | | | | - Stefano F Cappa
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.,NEtS Center, Istituto Universitario di Studi Superiori, Pavia, Italy
| | - Daniela Perani
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.,Department of Nuclear Medicine, San Raffaele Hospital, Milan, Italy
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41
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Abstract
We live our lives surrounded by symbols (e.g., road signs, logos, but especially words and numbers), and throughout our life we use them to evoke, communicate and reflect upon ideas and things that are not currently present to our senses. Symbols are represented in our brains at different levels of complexity: at the first and most simple level, as physical entities, in the corresponding primary and secondary sensory cortices. The crucial property of symbols, however, is that, despite the simplicity of their surface forms, they have the power of evoking higher order multifaceted representations that are implemented in distributed neural networks spanning a large portion of the cortex. The rich internal states that reflect our knowledge of the meaning of symbols are what we call semantic representations. In this review paper, we summarize our current knowledge of both the cognitive and neural substrates of semantic representations, focusing on concrete words (i.e., nouns or verbs referring to concrete objects and actions), which, together with numbers, are the most-studied and well defined classes of symbols. Following a systematic descriptive approach, we will organize this literature review around two key questions: what is the content of semantic representations? And, how are semantic representations implemented in the brain, in terms of localization and dynamics? While highlighting the main current opposing perspectives on these topics, we propose that a fruitful way to make substantial progress in this domain would be to adopt a geometrical view of semantic representations as points in high dimensional space, and to operationally partition the space of concrete word meaning into motor-perceptual and conceptual dimensions. By giving concrete examples of the kinds of research that can be done within this perspective, we illustrate how we believe this framework will foster theoretical speculations as well as empirical research.
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Affiliation(s)
- Valentina Borghesani
- École Doctorale Cerveau-Cognition-Comportement, Université Pierre et Marie Curie - Paris 6, 75005 Paris, France; Cognitive Neuroimaging Unit, Institut National de la Santé et de la Recherche Médicale, U992, F-91191 Gif/Yvette, France; Center for Mind/Brain Sciences, University of Trento, 38068 Rovereto, Italy.
| | - Manuela Piazza
- Cognitive Neuroimaging Unit, Institut National de la Santé et de la Recherche Médicale, U992, F-91191 Gif/Yvette, France; Center for Mind/Brain Sciences, University of Trento, 38068 Rovereto, Italy
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42
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Landin-Romero R, Tan R, Hodges JR, Kumfor F. An update on semantic dementia: genetics, imaging, and pathology. ALZHEIMERS RESEARCH & THERAPY 2016; 8:52. [PMID: 27915998 PMCID: PMC5137205 DOI: 10.1186/s13195-016-0219-5] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Progressive and relatively circumscribed loss of semantic knowledge, referred to as semantic dementia (SD) which falls under the broader umbrella of frontotemporal dementia, was officially identified as a clinical syndrome less than 50 years ago. Here, we review recent neuroimaging, pathological, and genetic research in SD. From a neuroimaging perspective, SD is characterised by hallmark asymmetrical atrophy of the anterior temporal pole and anterior fusiform gyrus, which is usually left lateralised. Functional magnetic resonance imaging (fMRI) studies have revealed widespread changes in connectivity, implicating the anterior temporal regions in semantic deficits in SD. Task-related fMRI have also demonstrated the relative preservation of frontal and parietal regions alongside preserved memory performance. In addition, recent longitudinal studies have demonstrated that, with disease progression, atrophy encroaches into the contralateral temporal pole and medial prefrontal cortices, which reflects emerging changes in behaviour and social cognition. Notably, unlike other frontotemporal dementia subtypes, recent research has demonstrated strong clinicopathological concordance in SD, with TDP43 type C as the most common pathological subtype. Moreover, an underlying genetic cause appears to be relatively rare in SD, with the majority of cases having a sporadic form of the disease. The relatively clear diagnosis, clinical course, and pathological homogeneity of SD make this syndrome a promising target for novel disease-modifying interventions. The development of neuroimaging markers of disease progression at the individual level is an important area of research for future studies to address, in order to assist with this endeavour.
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Affiliation(s)
- Ramon Landin-Romero
- Neuroscience Research Australia, PO Box 1165, Randwick, Sydney, NSW, 2031, Australia.,School of Medical Sciences, the University of New South Wales, Sydney, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Rachel Tan
- Neuroscience Research Australia, PO Box 1165, Randwick, Sydney, NSW, 2031, Australia.,School of Medical Sciences, the University of New South Wales, Sydney, Australia
| | - John R Hodges
- Neuroscience Research Australia, PO Box 1165, Randwick, Sydney, NSW, 2031, Australia.,School of Medical Sciences, the University of New South Wales, Sydney, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Fiona Kumfor
- Neuroscience Research Australia, PO Box 1165, Randwick, Sydney, NSW, 2031, Australia. .,School of Medical Sciences, the University of New South Wales, Sydney, Australia. .,ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia.
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43
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Koric L, Guedj E, Habert M, Semah F, Branger P, Payoux P, Le Jeune F. Molecular imaging in the diagnosis of Alzheimer's disease and related disorders. Rev Neurol (Paris) 2016; 172:725-734. [DOI: 10.1016/j.neurol.2016.10.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 07/25/2016] [Accepted: 10/13/2016] [Indexed: 11/29/2022]
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44
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Adenosine A1 receptor antagonist rolofylline alleviates axonopathy caused by human Tau ΔK280. Proc Natl Acad Sci U S A 2016; 113:11597-11602. [PMID: 27671637 DOI: 10.1073/pnas.1603119113] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Accumulation of Tau is a characteristic hallmark of several neurodegenerative diseases but the mode of toxic action of Tau is poorly understood. Here, we show that the Tau protein is toxic due to its aggregation propensity, whereas phosphorylation and/or missorting is not sufficient to cause neuronal dysfunction. Aggregate-prone Tau accumulates, when expressed in vitro at near-endogenous levels, in axons as spindle-shaped grains. These axonal grains contain Tau that is folded in a pathological (MC-1) conformation. Proaggregant Tau induces a reduction of neuronal ATP, concomitant with loss of dendritic spines. Counterintuitively, axonal grains of Tau are not targeted for degradation and do not induce a molecular stress response. Proaggregant Tau causes neuronal and astrocytic hypoactivity and presynaptic dysfunction instead. Here, we show that the adenosine A1 receptor antagonist rolofylline (KW-3902) is alleviating the presynaptic dysfunction and restores neuronal activity as well as dendritic spine levels in vitro. Oral administration of rolofylline for 2-wk to 14-mo-old proaggregant Tau transgenic mice restores the spatial memory deficits and normalizes the basic synaptic transmission. These findings make rolofylline an interesting candidate to combat the hypometabolism and neuronal dysfunction associated with Tau-induced neurodegenerative diseases.
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45
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Kato T, Inui Y, Nakamura A, Ito K. Brain fluorodeoxyglucose (FDG) PET in dementia. Ageing Res Rev 2016; 30:73-84. [PMID: 26876244 DOI: 10.1016/j.arr.2016.02.003] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/08/2016] [Accepted: 02/08/2016] [Indexed: 12/31/2022]
Abstract
The purpose of this article is to present a selective and concise summary of fluorodeoxyglucose (FDG) positron emission tomography (PET) in dementia imaging. FDG PET is used to visualize a downstream topographical marker that indicates the distribution of neural injury or synaptic dysfunction, and can identify distinct phenotypes of dementia due to Alzheimer's disease (AD), Lewy bodies, and frontotemporal lobar degeneration. AD dementia shows hypometabolism in the parietotemporal association area, posterior cingulate, and precuneus. Hypometabolism in the inferior parietal lobe and posterior cingulate/precuneus is a predictor of cognitive decline from mild cognitive impairment (MCI) to AD dementia. FDG PET may also predict conversion of cognitively normal individuals to those with MCI. Age-related hypometabolism is observed mainly in the anterior cingulate and anterior temporal lobe, along with regional atrophy. Voxel-based statistical analyses, such as statistical parametric mapping or three-dimensional stereotactic surface projection, improve the diagnostic performance of imaging of dementias. The potential of FDG PET in future clinical and methodological studies should be exploited further.
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Affiliation(s)
- Takashi Kato
- Department of Radiology, National Center for Geriatrics and Gerontology, Japan; Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Japan.
| | - Yoshitaka Inui
- Department of Radiology, National Center for Geriatrics and Gerontology, Japan
| | - Akinori Nakamura
- Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Japan
| | - Kengo Ito
- Department of Radiology, National Center for Geriatrics and Gerontology, Japan; Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, Japan; Innovation Center for Clinical Research, National Center for Geriatrics and Gerontology, Japan
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46
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Dopper EGP, Chalos V, Ghariq E, den Heijer T, Hafkemeijer A, Jiskoot LC, de Koning I, Seelaar H, van Minkelen R, van Osch MJP, Rombouts SARB, van Swieten JC. Cerebral blood flow in presymptomatic MAPT and GRN mutation carriers: A longitudinal arterial spin labeling study. NEUROIMAGE-CLINICAL 2016; 12:460-5. [PMID: 27625986 PMCID: PMC5011170 DOI: 10.1016/j.nicl.2016.08.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 06/25/2016] [Accepted: 08/01/2016] [Indexed: 12/11/2022]
Abstract
Objective Frontotemporal dementia (FTD) is characterized by behavioral disturbances and language problems. Familial forms can be caused by genetic defects in microtubule-associated protein tau (MAPT), progranulin (GRN), and C9orf72. In light of upcoming clinical trials with potential disease-modifying agents, the development of sensitive biomarkers to evaluate such agents in the earliest stage of FTD is crucial. In the current longitudinal study we used arterial spin labeling MRI (ASL) in presymptomatic carriers of MAPT and GRN mutations to investigate early changes in cerebral blood flow (CBF). Methods Healthy first-degree relatives of patients with a MAPT or GRN mutation underwent ASL at baseline and follow-up after two years. We investigated cross-sectional and longitudinal differences in CBF between mutation carriers (n = 34) and controls without a mutation (n = 31). Results GRN mutation carriers showed significant frontoparietal hypoperfusion compared with controls at follow-up, whereas we found no cross-sectional group differences in the total study group or the MAPT subgroup. Longitudinal analyses revealed a significantly stronger decrease in CBF in frontal, temporal, parietal, and subcortical areas in the total group of mutation carriers and the GRN subgroup, with the strongest decrease in two mutation carriers who converted to clinical FTD during follow-up. Interpretation We demonstrated longitudinal alterations in CBF in presymptomatic FTD independent of grey matter atrophy, with the strongest decrease in individuals that developed symptoms during follow-up. Therefore, ASL could have the potential to serve as a sensitive biomarker of disease progression in the presymptomatic stage of FTD in future clinical trials. Longitudinal alterations in cerebral blood flow in presymptomatic FTD Larger decline in cerebral blood flow during conversion to symptomatic FTD Arterial spin labeling might provide a useful biomarker for therapeutic trials.
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Key Words
- AD, Alzheimer's disease
- ASL, arterial spin labeling
- Arterial spin labeling
- BDI-II, Beck Depression inventory II (BDI-II)
- BNT, Boston Naming Test
- CBF, cerebral blood flow
- Cerebral blood flow
- FDG-PET, positron emission tomography with 18F-fluorodeoxyglucose
- FTD, frontotemporal dementia
- Frontotemporal dementia
- GRN, progranulin
- LDST, Letter Digit Substitution Test
- MAPT, microtubule-associated protein tau
- MMSE, Mini-Mental State Examination
- Presymptomatic
- RAVLT, Rey Auditory Verbal Learning Test
- SAT, Semantic Association Test
- TMT, Trailmaking Test
- VAT, Visual Association Test
- WCST, Wisconsin Card Sorting Test
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Affiliation(s)
- Elise G P Dopper
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, VU Medical Center, Amsterdam, The Netherlands
| | - Vicky Chalos
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Eidrees Ghariq
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tom den Heijer
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Neurology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Anne Hafkemeijer
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Methodology and Statistics, Institute of Psychology, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Lize C Jiskoot
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neuropsychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Inge de Koning
- Department of Neuropsychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Harro Seelaar
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Rick van Minkelen
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Matthias J P van Osch
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Methodology and Statistics, Institute of Psychology, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Clinical Genetics, VU Medical Center, Amsterdam, The Netherlands
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47
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Olm CA, Kandel BM, Avants BB, Detre JA, Gee JC, Grossman M, McMillan CT. Arterial spin labeling perfusion predicts longitudinal decline in semantic variant primary progressive aphasia. J Neurol 2016; 263:1927-38. [PMID: 27379517 DOI: 10.1007/s00415-016-8221-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/22/2016] [Accepted: 06/26/2016] [Indexed: 01/04/2023]
Abstract
The objective of the study was to evaluate the prognostic value of regional cerebral blood flow (CBF) measured by arterial spin labeled (ASL) perfusion MRI in patients with semantic variant primary progressive aphasia (svPPA). We acquired pseudo-continuous ASL (pCASL) MRI and whole-brain T1-weighted structural MRI in svPPA patients (N = 13) with cerebrospinal fluid biomarkers consistent with frontotemporal lobar degeneration pathology. Follow-up T1-weighted MRI was available in a subset of patients (N = 8). We performed whole-brain comparisons of partial volume-corrected CBF and cortical thickness between svPPA and controls, and compared baseline and follow-up cortical thickness in regions of significant hypoperfusion and hyperperfusion. Patients with svPPA showed partial volume-corrected hypoperfusion relative to controls in left temporal lobe and insula. svPPA patients also had typical cortical thinning in anterior temporal, insula, and inferior frontal regions at baseline. Volume-corrected hypoperfusion was seen in areas of significant cortical thinning such as the left temporal lobe and insula. Additional regions of hypoperfusion corresponded to areas without cortical thinning. We also observed regions of hyperperfusion, some associated with cortical thinning and others without cortical thinning, including right superior temporal, inferior parietal, and orbitofrontal cortices. Regions of hypoperfusion and hyperperfusion near cortical thinning at baseline had significant longitudinal thinning between baseline and follow-up scans, but perfusion changes in distant areas did not show progressive thinning. Our findings suggest ASL MRI may be sensitive to functional changes not readily apparent in structural MRI, and specific changes in perfusion may be prognostic markers of disease progression in a manner consistent with cell-to-cell spreading pathology.
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Affiliation(s)
- Christopher A Olm
- Department of Neurology, Penn Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine, 3 West Gates, Philadelphia, PA, 19104, USA
| | - Benjamin M Kandel
- Department of Radiology, Penn Image Computing and Science Lab, Philadelphia, PA, 19104, USA
| | - Brian B Avants
- Department of Radiology, Penn Image Computing and Science Lab, Philadelphia, PA, 19104, USA
| | - John A Detre
- Departments of Neurology and Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - James C Gee
- Department of Radiology, Penn Image Computing and Science Lab, Philadelphia, PA, 19104, USA
| | - Murray Grossman
- Department of Neurology, Penn Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine, 3 West Gates, Philadelphia, PA, 19104, USA
| | - Corey T McMillan
- Department of Neurology, Penn Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine, 3 West Gates, Philadelphia, PA, 19104, USA.
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48
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Birkhoff JM, Garberi C, Re L. The behavioral variant of frontotemporal dementia: An analysis of the literature and a case report. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2016; 47:157-163. [PMID: 27143117 DOI: 10.1016/j.ijlp.2016.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 04/18/2016] [Indexed: 06/05/2023]
Abstract
The aim of this case report is to underline the importance of possible legal consequences of the behavioral variant of frontotemporal dementia (bvFTD). This disease is associated with antisocial behavior, impulse control disorder and cognitive and personality impairment, which are often the earliest manifestations of the bvFTD. One of the antisocial behaviors possibly associated with this neurodegenerative disease is pathological stealing. This case report is about a 50-year-old Italian man who had a regular life until 2010. In 2010 and 2011, some critical events occurred: he lost his job, his father-in-law, to whom he was particularly close, died, and his wife had a serious illness. He began to show symptoms of depression, a significant weight loss, apathy, poor self-care, and lack of interest in the activities of his family. He became disengaged from his prior activities, emotionally detached from his family and developed compulsive hoarding. Moreover, he had uninhibited behaviors, a memory retrieval deficit, executive dysfunctions and impulsive behaviors. In January 2012, the subject began stealing objects, particularly components of computer, without premeditation or concern for resulting legal actions. He was then diagnosed affected by bvFTD. He was charged with theft and attempted theft and the Court asked for a psychiatric evaluation, in order to analyze the effect of the neurodegenerative disease on his behavior. To answer to the Court, the Authors analyzed his history of life and made a mental examination. The subject was considered mentally insane at the time of his crimes. This is an example of the practical application in judicial cases of the latest knowledge and evidence in the literature about the frontotemporal dementia, a disease associated with antisocial behaviors that could create tensions with the criminal law. The focus of the paper is to explain how the behavioral symptoms of bvFTD can have legal implications and how to deal with legal aspects of the behaviors induced by a neuro-psychiatric condition, such as bvFTD.
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Affiliation(s)
- Jutta Maria Birkhoff
- Department of Biotechnologies and Life Sciences, University of Insubria, Varese-Como, Italy
| | - Cesare Garberi
- Department of Biotechnologies and Life Sciences, University of Insubria, Varese-Como, Italy
| | - Laura Re
- Department of Biotechnologies and Life Sciences, University of Insubria, Varese-Como, Italy.
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Chételat G, Ossenkoppele R, Villemagne VL, Perrotin A, Landeau B, Mézenge F, Jagust WJ, Dore V, Miller BL, Egret S, Seeley WW, van der Flier WM, La Joie R, Ames D, van Berckel BNM, Scheltens P, Barkhof F, Rowe CC, Masters CL, de La Sayette V, Bouwman F, Rabinovici GD. Atrophy, hypometabolism and clinical trajectories in patients with amyloid-negative Alzheimer's disease. Brain 2016; 139:2528-39. [PMID: 27357349 DOI: 10.1093/brain/aww159] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 05/16/2016] [Indexed: 11/14/2022] Open
Abstract
See O'Sullivan and Vann (doi:10.1093/aww166) for a scientific commentary on this article.About 15% of patients clinically diagnosed with Alzheimer's disease do not show high tracer retention on amyloid positon emission tomography imaging. The present study investigates clinical and demographic features, patterns of brain atrophy and hypometabolism and longitudinal clinical trajectories of these patients. Forty amyloid-negative patients carrying a pre-scan diagnosis of Alzheimer's disease dementia from four centres were included (11/29 females/males; mean age = 67 ± 9). Detailed clinical histories, including the clinical diagnoses before and after the amyloid scan and at follow-up, were collected. Patients were classified according to their pre-scan clinical phenotype as amnestic (memory predominant), non-amnestic (predominant language, visuospatial or frontal symptoms), or non-specific (diffuse cognitive deficits). Demographic, clinical, neuropsychological, magnetic resonance imaging and (18)F-fluorodeoxyglucose positon emission tomography data were compared to 27 amyloid-positive typical Alzheimer's disease cases (14/13 females/males; mean age = 71 ± 10) and 29 amyloid-negative controls (15/14 females/males; mean age = 69 ± 12) matched for age, gender and education. There were 21 amnestic, 12 non-amnestic, and seven non-specific amyloid-negative Alzheimer's disease cases. Amyloid-negative subgroups did not differ in age, gender or education. After the amyloid scan, clinicians altered the diagnosis in 68% of amyloid-negative patients including 48% of amnestic versus 94% of non-amnestic and non-specific cases. Amnestic amyloid-negative cases were most often reclassified as frontotemporal dementia, non-amnestic as frontotemporal dementia or corticobasal degeneration, and non-specific as dementia with Lewy bodies or unknown diagnosis. The longer-term clinical follow-up was consistent with the post-scan diagnosis in most cases (90%), including in amnestic amyloid-negative cases whose post-positon emission tomography diagnosis remained Alzheimer's disease. While the non-amnestic and non-specific amyloid-negative cases usually showed patterns of atrophy and hypometabolism suggestive of another degenerative disorder, the amnestic amyloid-negative cases had subtle atrophy and hypometabolism, restricted to the retrosplenial/posterior cingulate cortex. Patients with a negative amyloid positon emission tomography scan following an initial clinical diagnosis of Alzheimer's disease have heterogeneous clinical presentations and neuroimaging profiles; a majority showed a clinical progression that was consistent with a neurodegenerative condition. In contrast, in the subgroup of amnestic amyloid-negative cases, the clinical presentation and follow-up usually remained consistent with Alzheimer's disease. An alternative diagnosis was not made in about half of the amnestic amyloid-negative cases, highlighting the need for a clinical framework and terminology to define these patients, who may have underlying limbic-predominant, non-amyloid-related pathologies.
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Affiliation(s)
- Gaël Chételat
- 1 INSERM, U1077, 14074 Caen, France 2 Université de Caen Basse-Normandie UMR-S1077, 14074 Caen, France 3 Ecole Pratique des Hautes Etudes, UMR-S1077, 14074 Caen, France 4 CHU de Caen, U1077, 14000 Caen, France
| | - Rik Ossenkoppele
- 5 VU University Medical Centre, Neuroscience Campus Amsterdam, Department of Neurology and Alzheimer Centre, 1081 HZ Amsterdam, The Netherlands 6 VU University Medical Centre, Department of Radiology and Nuclear Medicine, 1081 HZ Amsterdam, The Netherlands 7 University of California San Francisco, Memory and Aging Centre, Department of Neurology, San Francisco, CA 94720, USA
| | - Victor L Villemagne
- 8 Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, VIC 3084, Australia
| | - Audrey Perrotin
- 1 INSERM, U1077, 14074 Caen, France 2 Université de Caen Basse-Normandie UMR-S1077, 14074 Caen, France 3 Ecole Pratique des Hautes Etudes, UMR-S1077, 14074 Caen, France 4 CHU de Caen, U1077, 14000 Caen, France
| | - Brigitte Landeau
- 1 INSERM, U1077, 14074 Caen, France 2 Université de Caen Basse-Normandie UMR-S1077, 14074 Caen, France 3 Ecole Pratique des Hautes Etudes, UMR-S1077, 14074 Caen, France 4 CHU de Caen, U1077, 14000 Caen, France
| | - Florence Mézenge
- 1 INSERM, U1077, 14074 Caen, France 2 Université de Caen Basse-Normandie UMR-S1077, 14074 Caen, France 3 Ecole Pratique des Hautes Etudes, UMR-S1077, 14074 Caen, France 4 CHU de Caen, U1077, 14000 Caen, France
| | - William J Jagust
- 9 Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley CA 94720, USA; Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - Vincent Dore
- 8 Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, VIC 3084, Australia 10 Commonwealth Scientific Industrial Research Organization Health and Biosecurity Flagship, Brisbane, QLD 4006, Australia
| | - Bruce L Miller
- 7 University of California San Francisco, Memory and Aging Centre, Department of Neurology, San Francisco, CA 94720, USA
| | - Stéphanie Egret
- 1 INSERM, U1077, 14074 Caen, France 2 Université de Caen Basse-Normandie UMR-S1077, 14074 Caen, France 3 Ecole Pratique des Hautes Etudes, UMR-S1077, 14074 Caen, France 4 CHU de Caen, U1077, 14000 Caen, France
| | - William W Seeley
- 7 University of California San Francisco, Memory and Aging Centre, Department of Neurology, San Francisco, CA 94720, USA
| | - Wiesje M van der Flier
- 6 VU University Medical Centre, Department of Radiology and Nuclear Medicine, 1081 HZ Amsterdam, The Netherlands 11 VU University Medical Centre, Department of Epidemiology and Biostatistics, 1081 HZ Amsterdam, The Netherlands
| | - Renaud La Joie
- 1 INSERM, U1077, 14074 Caen, France 2 Université de Caen Basse-Normandie UMR-S1077, 14074 Caen, France 3 Ecole Pratique des Hautes Etudes, UMR-S1077, 14074 Caen, France 4 CHU de Caen, U1077, 14000 Caen, France
| | - David Ames
- 12 Academic Unit for Psychiatry of Old Age, St. Vincent's Health, Department of Psychiatry, The University of Melbourne, Kew, VIC 3101, Australia 13 National Ageing Research Institute, Parkville, VIC 3052, Australia
| | - Bart N M van Berckel
- 6 VU University Medical Centre, Department of Radiology and Nuclear Medicine, 1081 HZ Amsterdam, The Netherlands
| | - Philip Scheltens
- 5 VU University Medical Centre, Neuroscience Campus Amsterdam, Department of Neurology and Alzheimer Centre, 1081 HZ Amsterdam, The Netherlands
| | - Frederik Barkhof
- 6 VU University Medical Centre, Department of Radiology and Nuclear Medicine, 1081 HZ Amsterdam, The Netherlands
| | - Christopher C Rowe
- 8 Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, VIC 3084, Australia
| | - Colin L Masters
- 14 The Florey Institute of Neuroscience and Mental Health, Mental Health, Melbourne, VIC 3010, Australia
| | - Vincent de La Sayette
- 1 INSERM, U1077, 14074 Caen, France 2 Université de Caen Basse-Normandie UMR-S1077, 14074 Caen, France 3 Ecole Pratique des Hautes Etudes, UMR-S1077, 14074 Caen, France 4 CHU de Caen, U1077, 14000 Caen, France 15 CHU de Caen, Service de Neurologie, 14000 Caen, France
| | - Femke Bouwman
- 5 VU University Medical Centre, Neuroscience Campus Amsterdam, Department of Neurology and Alzheimer Centre, 1081 HZ Amsterdam, The Netherlands
| | - Gil D Rabinovici
- 7 University of California San Francisco, Memory and Aging Centre, Department of Neurology, San Francisco, CA 94720, USA 9 Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley CA 94720, USA; Lawrence Berkeley National Laboratory, Berkeley, California, USA
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Abstract
The primary goal of this article is to critically discuss the syndromic overlap that exists between early behavioural variant frontotemporal dementia (bvFTD)--the most common clinical syndrome associated with frontotemporal lobar degeneration (FTLD)--and several primary psychiatric disorders. We begin by summarising the current state of knowledge regarding FTLD, including the recent discovery of FTLD-causative genetic mutations. Clinicopathological correlations in FTLD are subsequently discussed, while emphasising that clinical syndromes of FTD are dictated by the distribution of FTLD pathology in the brain. We then review a large number of cases with suspected and confirmed bvFTD that had previously been diagnosed with a primary psychiatric disorder. The clinical and neuroscientific implications of this overlap are discussed, focusing on the importance of early diagnosis for clinical and therapeutic reasons. We propose that largely due to the paucity of biomarkers for primary psychiatric disorders, and the limited use of FTLD-related biomarkers by psychiatrists at present, it is very difficult to separate patients with early bvFTD from those with primary psychiatric disorders based on clinical grounds. Furthermore, specific limitations of the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 criteria for bvFTD may inadvertently discourage recognition of bvFTD in mental health settings. Clinically, more research is needed to develop tools that allow early differentiation of bvFTD from primary psychiatric disease, as bvFTD therapies will likely be most effective in the earliest stages of disease. From a neuroscience perspective, we argue that bvFTD provides an excellent paradigm for investigating the neural basis of psychiatric disorders.
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Affiliation(s)
- Serggio C Lanata
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, California, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, California, USA
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