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Park M, Kim HJ, Baik K, Na HK, Lee YG, Yoon SH, Jeong SH, Chung SJ, Shin HW, Lyoo CH, Sohn YH, Lee PH. Association between striatal amyloid deposition and motor prognosis in Parkinson's disease. Eur J Neurol 2024:e16364. [PMID: 39034046 DOI: 10.1111/ene.16364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/18/2024] [Accepted: 05/12/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND AND PURPOSE The co-occurrence of amyloid-β pathology in Parkinson's disease (PD) is common; however, the role of amyloid-β deposition in motor prognosis remains elusive. This study aimed to investigate the association between striatal amyloid deposition, motor complications and motor prognosis in patients with PD. METHODS Ninety-six patients with PD who underwent 18F florbetaben (FBB) positron emission tomography were retrospectively assessed. The ratio of the striatum to global (STG) FBB uptake was obtained for each individual, and patients were allotted into low and high STG groups according to the median value. The effect of STG group on regional amyloid deposition, the occurrence of motor complications and longitudinal change in levodopa equivalent dose (LED) requirement were investigated after controlling for age, sex, LED and disease duration at FBB scan. RESULTS The high STG group was associated with lower cortical FBB uptake in the parietal, occipital and posterior cingulate cortices and higher striatal FBB uptake compared to the low STG group. Patients in the high STG group had a higher risk of developing wearing off and levodopa-induced dyskinesia than those in the low STG group, whereas the risk for freezing of gait was comparable between the two groups. The high STG group showed a more rapid increase in LED requirements over time than the low STG group. CONCLUSIONS These findings suggest that relatively high striatal amyloid deposition is associated with poor motor outcomes in patients with PD.
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Affiliation(s)
- Mincheol Park
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Neurology, Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea
| | - Hyun Joo Kim
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Kyoungwon Baik
- Department of Neurology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Han Kyu Na
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Gun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - So Hoon Yoon
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Neurology, Catholic Kwandong University International St. Mary's Hospital, Incheon, Republic of Korea
| | - Seong Ho Jeong
- Department of Neurology, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hae-Won Shin
- Department of Neurology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
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Kang S, Jeon S, Lee YG, Ye BS. Alteration of medial temporal lobe metabolism related to Alzheimer's disease and dementia with lewy bodies. Alzheimers Res Ther 2024; 16:89. [PMID: 38654300 PMCID: PMC11036684 DOI: 10.1186/s13195-024-01429-4] [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: 10/10/2023] [Accepted: 03/11/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Association of medial temporal lobe (MTL) metabolism with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) has not been evaluated considering their mixed disease (MD). METHODS 131 patients with AD, 133 with DLB, 122 with MD, and 28 normal controls (NCs) underwent neuropsychological tests, assessments for parkinsonism, cognitive fluctuation (CF), and visual hallucinations (VH), and 18F-fluorodeoxyglucose PET to quantify MTL metabolism in the amygdala, hippocampus, and entorhinal cortex. The effects of AD and DLB on MTL metabolism were evaluated using general linear models (GLMs). Associations between MTL metabolism, cognition, and clinical features were evaluated using GLMs or logistic regression models separately performed for the AD spectrum (NC + AD + MD), DLB spectrum (NC + DLB + MD), and disease groups (AD + DLB + MD). Covariates included age, sex, and education. RESULTS AD was associated with hippocampal/entorhinal hypometabolism, whereas DLB was associated with relative amygdalar/hippocampal hypermetabolism. Relative MTL hypermetabolism was associated with lower attention/visuospatial/executive scores and severe parkinsonism in both the AD and DLB spectra and disease groups. Left hippocampal/entorhinal hypometabolism was associated with lower verbal memory scores, whereas right hippocampal hypometabolism was associated with lower visual memory scores in both the AD spectrum and disease groups. Relative MTL hypermetabolism was associated with an increased risk of CF and VH in the disease group, and relative amygdalar hypermetabolism was associated with an increased risk of VH in the DLB spectrum. CONCLUSIONS Entorhinal-hippocampal hypometabolism and relative amygdala-hippocampal hypermetabolism could be characteristics of AD- and DLB-related neurodegeneration, respectively.
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Affiliation(s)
- Sungwoo Kang
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Seun Jeon
- Metabolism-Dementia Research Institute , Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Gun Lee
- Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Kang S, Jeon S, Lee YG, Ye BS. Dopamine transporter positron emission tomography in patients with Alzheimer's disease with Lewy body disease features. Neurobiol Aging 2024; 134:57-65. [PMID: 37992545 DOI: 10.1016/j.neurobiolaging.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/24/2023]
Abstract
In 36 normal controls (NC), 37 patients with Alzheimer's disease (AD) without parkinsonism (ADP-), 31 AD with parkinsonism (ADP+), and 40 AD with dementia with Lewy bodies (ADDLB), dual-phase dopamine transporter (DAT) positron emission tomography (PET) were performed to evaluate the diagnostic performance of DAT and early-to-delayed uptake ratios (E/Ds) in the anterior caudate (AC), posterior caudate (PC), anterior putamen (AP), posterior putamen (PP), and substantia nigra (SN) to differentiate ADP+/ADDLB from NC, and their effects on parkinsonism and cognition. DAT-SN and E/D-PP showed higher accuracies to differentiate ADP+/ADDLB from NC than DAT-PP. Among AD patients, lower DAT in the putamen and PC and higher E/Ds in the striatum were associated with severe parkinsonism, while higher E/Ds in the putamen, PC, and SN were associated with executive dysfunction. Our results suggest that decreased DAT-SN and increased E/D-PP could be biomarkers differentiating ADP+/ADDLB from pure AD and controls. Meanwhile, increased E/Ds in the putamen could reflect the severity of DLB presenting with parkinsonism and executive dysfunction among AD patients.
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Affiliation(s)
- Sungwoo Kang
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seun Jeon
- Brain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Gun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Han JH, Lee S, Bae SH, Yun M, Ye BS, Jung J. Distinct changes in brain metabolism in patients with dementia and hearing loss. Brain Behav 2024; 14:e3374. [PMID: 38376024 PMCID: PMC10771228 DOI: 10.1002/brb3.3374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 02/21/2024] Open
Abstract
INTRODUCTION Previous studies have reported that hearing loss (HL) is associated with dementia, although the mechanistic underpinnings remain elusive. This study aimed to evaluate the changes in brain metabolism in patients with HL and different types of dementia. METHODS Patients with cognitive impairment (CI) and HL treated at the university-based memory clinic from May 2016 to October 2021 were included. In total, 108 patients with CI and HL prospectively underwent audiometry, neuropsychological test, magnetic resonance imaging, and 18 F-fluorodeoxyglucose positron emission tomography. Twenty-seven individuals without cognitive impairment and hearing loss were enrolled as a control group. Multivariable regression was performed to evaluate brain regions correlated with each pathology type after adjusting for confounding factors. RESULTS Multivariable regression analyses revealed that Alzheimer's disease-related CI (ADCI) was associated with hypometabolic changes in the right superior temporal gyrus (STG), right middle temporal gyrus (MTG), and bilateral medial temporal lobe. Lewy body disease-related CI (LBDCI) and vascular CI were associated with hypermetabolic and hypometabolic changes in the ascending auditory pathway, respectively. In the pure ADCI group, the degree of HL was positively associated with abnormal increase of brain metabolism in the right MTG, whereas it was negatively associated with decreased brain metabolism in the right STG in the pure LBDCI group. CONCLUSION Each dementia type is associated with distinct changes in brain metabolism in patients with HL.
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Affiliation(s)
- Ji Hyuk Han
- Department of OtorhinolaryngologyYonsei University College of MedicineSeoulRepublic of Korea
| | - Sangwon Lee
- Department of Nuclear MedicineYonsei University College of MedicineSeoulRepublic of Korea
| | - Seong Hoon Bae
- Department of OtorhinolaryngologyYonsei University College of MedicineSeoulRepublic of Korea
| | - Mijin Yun
- Department of Nuclear MedicineYonsei University College of MedicineSeoulRepublic of Korea
| | - Byung Seok Ye
- Department of NeurologyYonsei University College of MedicineSeoulRepublic of Korea
| | - Jinsei Jung
- Department of OtorhinolaryngologyYonsei University College of MedicineSeoulRepublic of Korea
- Graduate School of Medical ScienceYonsei University College of MedicineSeoulRepublic of Korea
- Brain Korea 21 ProjectYonsei University College of MedicineSeoulRepublic of Korea
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Lee YG, Jeon S, Kang SW, Ye BS. Effects of amyloid beta and dopaminergic depletion on perfusion and clinical symptoms. Alzheimers Dement 2023; 19:5719-5729. [PMID: 37422287 DOI: 10.1002/alz.13379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/23/2023] [Accepted: 06/07/2023] [Indexed: 07/10/2023]
Abstract
INTRODUCTION Although mixed pathologies are common in Alzheimer's disease (AD) and dementia with Lewy bodies (DLB), the effects of amyloid beta and dopaminergic depletion on brain perfusion and clinical symptoms have not been elucidated. METHODS In 99 cognitive impairment patients due to AD and/or DLB and 32 controls, 18F-florbetaben (FBB) and dual-phase dopamine transporter (DAT) positron emission tomography (PET) were performed to measure the FBB standardized uptake value ratio (SUVR), striatal DAT uptakes, and brain perfusion. RESULTS Higher FBB-SUVR and lower ventral striatal DAT uptake were intercorrelated and, respectively, associated with left entorhinal/temporo-parietal-centered hypoperfusion and vermis/hippocampal-centered hyperperfusion, whereas regional perfusion mediated clinical symptoms and cognition. DISCUSSION Amyloid beta deposition and striatal dopaminergic depletion contribute to regional perfusion changes, clinical symptoms, and cognition in the spectrum of normal aging and cognitive impairment due to AD and/or LBD. HIGHLIGHTS Amyloid beta (Aβ) deposition was associated with ventral striatal dopaminergic depletion. Aβ deposition and dopaminergic depletion correlated with perfusion. Aβ deposition correlated with hypoperfusion centered in the left entorhinal cortex. Dopaminergic depletion correlated with hyperperfusion centered in the vermis. Perfusion mediated the Aβ deposition/dopaminergic depletion's effects on cognition.
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Affiliation(s)
- Young-Gun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Seun Jeon
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
- Metabolism-Dementia Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Woo Kang
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Metabolism-Dementia Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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Kang S, Jeon S, Lee YG, Ye BS. Striatal dopamine transporter uptake, parkinsonism and cognition in Alzheimer's disease. Eur J Neurol 2023; 30:3105-3113. [PMID: 37493955 DOI: 10.1111/ene.15995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND AND PURPOSE The correlates of motor parkinsonism in Alzheimer's disease (AD) remain controversial. The effects of nigrostriatal dopaminergic degeneration on parkinsonism and cognition in biomarker-validated patients with AD were evaluated. METHODS This study recruited 116 patients with AD who underwent dual-phase 18 F-N-(3-fluoropropyl)-2β-carbon ethoxy-3β-(4-iodophenyl) nortropane positron emission tomography, 18 F-florbetaben positron emission tomography, 3 T brain magnetic resonance imaging, and Unified Parkinson's Disease Rating Scale (UPDRS) and neuropsychological tests. The mean cortical thickness in the frontal, temporal, parietal and occipital cortices, and the dopamine transporter (DAT) uptake in the caudate, anterior/posterior putamen and substantia nigra were quantified. The relationship between DAT uptake, mean lobar cortical thickness, UPDRS motor score and cognition was investigated using general linear models (GLMs) after controlling for age, sex, education, intracranial volume, and deep and periventricular white matter hyperintensities. A path analysis was performed for the UPDRS motor score with the same covariates. RESULTS Path analysis and multivariable GLMs for UPDRS motor score showed that lower caudate DAT uptake was directly associated with a higher UPDRS motor score, whereas caudate DAT uptake confounded the association between mean frontal/parietal thickness and UPDRS motor score. Multivariable GLMs for cognitive scores showed that lower caudate DAT uptake was associated with visuospatial/executive dysfunction independent of mean frontal or parietal thickness. CONCLUSIONS Nigrostriatal dopaminergic dysfunction is associated with parkinsonism and visuospatial/executive dysfunction in patients with AD.
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Affiliation(s)
- Sungwoo Kang
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seun Jeon
- Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young-Gun Lee
- Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
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Baik K, Cha J, Park M, Lee Y, Chung SJ, Yoo HS, Sohn YH, Lee PH. Distinct amyloid-dependent patterns of nigra dopamine depletion in Lewy body diseases. Front Aging Neurosci 2023; 15:1196602. [PMID: 37614472 PMCID: PMC10442581 DOI: 10.3389/fnagi.2023.1196602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/14/2023] [Indexed: 08/25/2023] Open
Abstract
Introduction Concomitant amyloid pathology is not uncommon and contributes to the clinical characteristics of Lewy body disease (LBD). We investigated the effect of amyloid on striatal18F-FP-CIT uptake patterns in LBD, including Parkinson's disease (PD) and dementia with Lewy bodies. Methods We enrolled 125 patients with LBD who underwent18F-florbetaben positron emission tomography (PET) and18F-FP-CIT PET. Patients were divided into amyloid-positive and amyloid-negative groups. We investigated the effect of amyloid on striatal dopamine transporter (DAT) availability, depending on the type of LBD, using general linear models with interaction analysis after controlling for age, sex, education, deep white matter hyperintensity (WMH), periventricular WMH, and cognitive status. Results There was a significant interaction effect between the disease group and the presence of amyloid on DAT availability in the anterior putamen, posterior putamen, caudate, and ventral striatum. In the presence of amyloid, only the PD group exhibited decreased DAT availability in the anterior and posterior putamen. In both groups, the presence of amyloid was not associated with DAT availability in the caudate and ventral striatum. The presence of amyloid was not directly related to the worse parkinsonian motor symptoms in both groups. However, there was a significant indirect effect of amyloid on parkinsonian motor symptoms, which was mediated by anterior and posterior putaminal DAT availability in the PD group alone. Discussion This study demonstrates different amyloid-dependent or amyloid-independent18F-FP-CIT PET patterns in patients with LBD, suggesting distinctive interactions between α-synuclein and amyloid pathology based on the type of LBD.
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Affiliation(s)
- Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jungho Cha
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Mincheol Park
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Neurology, Chung-Ang University College of Medicine and Graduate School of Medicine, Gwangmyeong Hospital, Gwangmyeong, Republic of Korea
| | - Younggun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young H. Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
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Lee YG, Jeon S, Baik K, Kang SW, Ye BS. Substantia nigral dopamine transporter uptake in dementia with Lewy bodies. NPJ Parkinsons Dis 2023; 9:88. [PMID: 37296236 PMCID: PMC10256694 DOI: 10.1038/s41531-023-00534-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Nigrostriatal dopaminergic degeneration is a pathological hallmark of dementia with Lewy bodies (DLB). To identify the subregional dopamine transporter (DAT) uptake patterns that improve the diagnostic accuracy of DLB, we analyzed N-(3-[18F] fluoropropyl)-2β-carbomethoxy-3β-(4-iodophenyl)-nortropane (FP-CIT) PET in 51 patients with DLB, in 36 patients with mild cognitive impairment with Lewy body (MCI-LB), and in 40 healthy controls (HCs). In addition to a high affinity for DAT, FP-CIT show a modest affinity to serotonin or norepinephrine transporters. Specific binding ratios (SBRs) of the nigrostriatal subregions were transformed to age-adjusted z-scores (zSBR) based on HCs. The diagnostic accuracy of subregional zSBRs were tested using receiver operating characteristic (ROC) curve analyses separately for MCI-LB and DLB versus HCs. Then, the effect of subregional zSBRs on the presence of clinical features and gray matter (GM) density were evaluated in all patients with MCI-LB or DLB as a group. ROC curve analyses showed that the diagnostic accuracy of DLB based on the zSBR of substantia nigra (area under the curve [AUC], 0.90) or those for MCI-LB (AUC, 0.87) were significantly higher than that based on the zSBR of posterior putamen for DLB (AUC, 0.72) or MCI-LB (AUC, 0.65). Lower zSBRs in nigrostriatal regions were associated with visual hallucination, severe parkinsonism, and cognitive dysfunction, while lower zSBR of substantia nigra was associated with widespread GM atrophy in DLB and MCI-LB patients. Taken together, our results suggest that evaluation of nigral DAT uptake may increase the diagnostic accuracy of DLB and MCI-LB than other striatal regions.
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Affiliation(s)
- Young-Gun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Seun Jeon
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Woo Kang
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
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Chin KS, Gajamange S, Desmond PM, Villemagne VL, Rowe CC, Churilov L, Yassi N, Watson R. Association between amyloid-beta deposition and cortical thickness in dementia with Lewy bodies. Aust N Z J Psychiatry 2023; 57:594-602. [PMID: 35196886 DOI: 10.1177/00048674221081773] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Amyloid-beta often co-exists in dementia with Lewy bodies, but its clinical relevance in dementia with Lewy bodies remains unclear. This study aimed to investigate the clinical and imaging correlates of amyloid-beta deposition in dementia with Lewy bodies, particularly its relationship with cortical thickness in Alzheimer's disease-prone regions and hippocampal volume. METHODS Twenty-four participants with probable dementia with Lewy bodies underwent high-resolution magnetic resonance imaging and amyloid-beta positron emission tomography imaging using the radiotracer 18F-NAV4694. Amyloid-beta deposition was quantified and reported using the Centiloid method. RESULTS Amyloid-beta positivity, defined as Centiloid > 50, was present in 45.8% of dementia with Lewy bodies participants. There were no statistically significant differences in clinical characteristics between Aβ+ and Aβ- dementia with Lewy bodies. Compared with the Aβ- group, Aβ+ dementia with Lewy bodies exhibited greater global cortical thinning as well as in the Alzheimer's disease-prone region of interest, adjusted for age, sex and years of education. A mean cortical thickness of 5.12 mm across a combined meta-region of interest has a sensitivity of 88.9% and specificity of 90.0% in discriminating Aβ+ from Aβ- dementia with Lewy bodies. Hippocampal volume was not different between groups. CONCLUSION Early structural changes in cortical thickness, but not hippocampal volume, were observed in dementia with Lewy bodies with significant amyloid-beta burden. This may represent an early Alzheimer's disease-related neurodegenerative process.
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Affiliation(s)
- Kai Sin Chin
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Department of Aged Care, The Royal Melbourne Hospital, Parkville, VIC, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Sanuji Gajamange
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Patricia M Desmond
- Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Victor L Villemagne
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Molecular Imaging & Therapy, Austin Health, The University of Melbourne, Heidelberg, VIC, Australia
| | - Christopher C Rowe
- Department of Molecular Imaging & Therapy, Austin Health, The University of Melbourne, Heidelberg, VIC, Australia
| | - Leonid Churilov
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Nawaf Yassi
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Rosie Watson
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Department of Aged Care, The Royal Melbourne Hospital, Parkville, VIC, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
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Baik K, Jeon S, Yang SJ, Na Y, Chung SJ, Yoo HS, Yun M, Lee PH, Sohn YH, Ye BS. Cortical Thickness and Brain Glucose Metabolism in Healthy Aging. J Clin Neurol 2023; 19:138-146. [PMID: 36647225 PMCID: PMC9982173 DOI: 10.3988/jcn.2022.0021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 08/04/2022] [Accepted: 08/07/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND AND PURPOSE We aimed to determine the effect of demographic factors on cortical thickness and brain glucose metabolism in healthy aging subjects. METHODS The following tests were performed on 71 subjects with normal cognition: neurological examination, 3-tesla magnetic resonance imaging, 18F-fluorodeoxyglucose positron-emission tomography, and neuropsychological tests. Cortical thickness and brain metabolism were measured using vertex- and voxelwise analyses, respectively. General linear models (GLMs) were used to determine the effects of age, sex, and education on cortical thickness and brain glucose metabolism. The effects of mean lobar cortical thickness and mean lobar metabolism on neuropsychological test scores were evaluated using GLMs after controlling for age, sex, and education. The intracranial volume (ICV) was further included as a predictor or covariate for the cortical thickness analyses. RESULTS Age was negatively correlated with the mean cortical thickness in all lobes (frontal and parietal lobes, p=0.001; temporal and occipital lobes, p<0.001) and with the mean temporal metabolism (p=0.005). Education was not associated with cortical thickness or brain metabolism in any lobe. Male subjects had a lower mean parietal metabolism than did female subjects (p<0.001), while their mean cortical thicknesses were comparable. ICV was positively correlated with mean cortical thickness in the frontal (p=0.016), temporal (p=0.009), and occipital (p=0.007) lobes. The mean lobar cortical thickness was not associated with cognition scores, while the mean temporal metabolism was positively correlated with verbal memory test scores. CONCLUSIONS Age and sex affect cortical thickness and brain glucose metabolism in different ways. Demographic factors must therefore be considered in analyses of cortical thickness and brain metabolism.
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Affiliation(s)
- Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seun Jeon
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Soh-Jeong Yang
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Yeona Na
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Young H. Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
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Baik K, Jeon S, Park M, Lee YG, Lee PH, Sohn YH, Ye BS. Comparison Between 18F-Florapronol and 18F-Florbetaben Imaging in Patients With Cognitive Impairment. J Clin Neurol 2023; 19:260-269. [PMID: 36775276 PMCID: PMC10169926 DOI: 10.3988/jcn.2022.0207] [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: 05/29/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND AND PURPOSE To determine the imaging characteristics and cutoff value of 18F-florapronol (FC119S) quantitative analysis for detecting β-amyloid positivity and Alzheimer's disease (AD), we compared the findings of FC119S and 18F-florbetaben (FBB) positron- emission tomography (PET) in patients with cognitive impairment. METHODS We prospectively enrolled 35 patients with cognitive impairment who underwent FBB-PET, FC119S-PET, and brain magnetic resonance imaging. We measured global and vertex-wise standardized uptake value ratios (SUVRs) using a surface-based method with the cerebellar gray matter as reference. Optimal global FC119S SUVR cutoffs were determined using receiver operating characteristic curves for β-amyloid positivity based on the global FBB SUVR of 1.478 and presence of AD, respectively. We evaluated the global and vertex-wise SUVR correlations between the two tracers. In addition, we performed correlation analysis for global or vertex-wise SUVR of each tracer with the vertex-wise cortical thicknesses. RESULTS The optimal global FC119S SUVR cutoff value was 1.385 both for detecting β-amyloid positivity and for detecting AD. Based on the global SUVR cutoff value of each tracer, 32 (91.4%) patients had concordant β-amyloid positivity. The SUVRs of FC119S and FBB had strong global (r=0.72) and vertex-wise (r>0.7) correlations in the overall cortices, except for the parietal and temporal cortices (0.4<r<0.7). The FC119S SUVR had significant negative vertex-wise correlations with cortical thicknesses in the posterior cingulate, anterior cingulate, parietal, posterior temporal, and occipital cortices. CONCLUSIONS Quantitative FC119S-PET analysis provided reliable information for detecting β-amyloid deposition and the presence of AD.
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Affiliation(s)
- Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seun Jeon
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.,Brain Research Institute, Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea
| | - Mincheol Park
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.,Department of Neurology, Chung-Ang University College of Medicine and Graduate School of Medicine, Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Young-Gun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
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12
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Baik K, Kim HR, Park M, Lee Y, Na HK, Sohn YH, Seong JK, Lee PH. Effect of Amyloid on Cognitive Performance in Parkinson's Disease and Dementia with Lewy Bodies. Mov Disord 2023; 38:278-285. [PMID: 36527414 DOI: 10.1002/mds.29295] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/07/2022] [Accepted: 11/27/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Concomitant amyloid pathology contributes to the clinical heterogeneity of Lewy body diseases (LBDs). OBJECTIVE The objective of this study was to investigate the pattern and effect of amyloid accumulation on cognitive dysfunction in Parkinson's disease (PD) and dementia with Lewy bodies (DLB). METHODS We retrospectively assessed 205 patients with LBD (91 with DLB and 114 with PD) who underwent 18 F-florbetaben positron emission tomography and divided them into amyloid-positive and amyloid-negative groups depending on global standardized uptake value ratios (SUVRs). We investigated the effect of group on the regional and global SUVRs using general linear models (GLMs) after controlling for age, sex, cognitive status, and score on the Korean version of the Mini-Mental State Examination. Moreover, the effect of amyloid on cognitive function, depending on the type of LBD, was evaluated using GLMs with interaction analysis. RESULTS In all evaluated regions including the striatum, the DLB group showed a higher SUVR than the PD group. Among amyloid-positive patients, the DLB group had a higher regional SUVR than the PD group in the frontal and parietal cortices. There was a significant interaction effect between amyloid and disease groups in language and memory function. In patients with PD, global amyloid load was negatively associated with language (B = -2.03; P = 0.010) and memory functions (B = -1.96; P < 0.001). However, amyloid load was not significantly associated with cognitive performance in the DLB group. CONCLUSIONS Although the burden of amyloid was higher in the DLB group, amyloid accumulation was negatively associated with the memory and language functions in the PD group only. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Ryun Kim
- Interdisciplinary Studies for Emerging Industries Research Institute, Department of Software Convergence, Seoul Women's University, Seoul, South Korea
| | - Mincheol Park
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Department of Neurology, Chung-Ang University College of Medicine and Graduate School of Medicine, Gwangmyeong Hospital, Gwangmyeong, South Korea
| | - Younggun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Han Kyu Na
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Joon-Kyung Seong
- School of Biomedical Engineering, Korea University, Seoul, South Korea.,Department of Artificial Intelligence, Korea University, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
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13
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Perovnik M, Tomše P, Jamšek J, Tang C, Eidelberg D, Trošt M. Metabolic brain pattern in dementia with Lewy bodies: Relationship to Alzheimer's disease topography. Neuroimage Clin 2022; 35:103080. [PMID: 35709556 PMCID: PMC9207351 DOI: 10.1016/j.nicl.2022.103080] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/26/2022] [Accepted: 06/05/2022] [Indexed: 10/28/2022]
Abstract
PURPOSE Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia, that shares clinical and metabolic similarities with both Alzheimer's and Parkinson's disease. In this study we aimed to identify a DLB-related pattern (DLBRP), study its relationship with other metabolic brain patterns and explore its diagnostic and prognostic value. METHODS A cohort of 79 participants with DLB, 63 with dementia due to Alzheimer's disease (AD) and 41 normal controls (NCs) and their 2-[18F]FDG PET scans were analysed for identification and validation of DLBRP. Voxel-wise correlation and multiple linear regression were used to study the relation between DLBRP and Alzheimer's disease-related pattern (ADRP), Parkinson's disease-related pattern (PDRP) and PD-related cognitive pattern (PDCP). Diagnostic and prognostic value of DLBRP and of modified DLBRP after accounting for ADRP overlap (DLBRP ⊥ ADRP), were explored. RESULTS The newly identified DLBRP shared topographic similarities with ADRP (R2 = 24%) and PDRP (R2 = 37%), but not with PDCP. We could accurately discriminate between DLB and NC (AUC = 0.99) based on DLBRP expression, and between DLB and AD (AUC = 0.87) based on DLBRP ⊥ ADRP expression. DLBRP expression correlated with cognitive impairment, but the correlation was lost after accounting for ADRP overlap. DLBRP and DLBRP ⊥ ADRP correlated with patients' survival time. CONCLUSION DLBRP has proven to be a specific metabolic brain biomarker of DLB, sharing similarities with ADRP and PDRP, but not PDCP. We observed a similar metabolic mechanism underlying cognitive impairment in DLB and AD. DLB-specific metabolic changes were more detrimental for overall survival.
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Affiliation(s)
- Matej Perovnik
- Department of Neurology, University Medical Center Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia.
| | - Petra Tomše
- Department of Nuclear Medicine, University Medical Center Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia
| | - Jan Jamšek
- Department of Nuclear Medicine, University Medical Center Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia
| | - Chris Tang
- Center for Neurosciences, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
| | - Maja Trošt
- Department of Neurology, University Medical Center Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia; Department of Nuclear Medicine, University Medical Center Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia
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14
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Braverman ER, Dennen CA, Gold MS, Bowirrat A, Gupta A, Baron D, Roy AK, Smith DE, Cadet JL, Blum K. Proposing a “Brain Health Checkup (BHC)” as a Global Potential “Standard of Care” to Overcome Reward Dysregulation in Primary Care Medicine: Coupling Genetic Risk Testing and Induction of “Dopamine Homeostasis”. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095480. [PMID: 35564876 PMCID: PMC9099927 DOI: 10.3390/ijerph19095480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 12/27/2022]
Abstract
In 2021, over 100,000 people died prematurely from opioid overdoses. Neuropsychiatric and cognitive impairments are underreported comorbidities of reward dysregulation due to genetic antecedents and epigenetic insults. Recent genome-wide association studies involving millions of subjects revealed frequent comorbidity with substance use disorder (SUD) in a sizeable meta-analysis of depression. It found significant associations with the expression of NEGR1 in the hypothalamus and DRD2 in the nucleus accumbens, among others. However, despite the rise in SUD and neuropsychiatric illness, there are currently no standard objective brain assessments being performed on a routine basis. The rationale for encouraging a standard objective Brain Health Check (BHC) is to have extensive data available to treat clinical syndromes in psychiatric patients. The BHC would consist of a group of reliable, accurate, cost-effective, objective assessments involving the following domains: Memory, Attention, Neuropsychiatry, and Neurological Imaging. Utilizing primarily PUBMED, over 36 years of virtually all the computerized and written-based assessments of Memory, Attention, Psychiatric, and Neurological imaging were reviewed, and the following assessments are recommended for use in the BHC: Central Nervous System Vital Signs (Memory), Test of Variables of Attention (Attention), Millon Clinical Multiaxial Inventory III (Neuropsychiatric), and Quantitative Electroencephalogram/P300/Evoked Potential (Neurological Imaging). Finally, we suggest continuing research into incorporating a new standard BHC coupled with qEEG/P300/Evoked Potentials and genetically guided precision induction of “dopamine homeostasis” to diagnose and treat reward dysregulation to prevent the consequences of dopamine dysregulation from being epigenetically passed on to generations of our children.
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Affiliation(s)
- Eric R. Braverman
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA; (E.R.B.); (C.A.D.)
| | - Catherine A. Dennen
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA; (E.R.B.); (C.A.D.)
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA;
- Department of Psychiatry, Tulane School of Medicine, New Orleans, LA 70112, USA;
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA;
| | - David Baron
- Division of Addiction Research & Education, Center for Psychiatry, Medicine & Primary Care (Office of Provost), Western University Health Sciences, Pomona, CA 91766, USA;
| | - A. Kenison Roy
- Department of Psychiatry, Tulane School of Medicine, New Orleans, LA 70112, USA;
| | - David E. Smith
- Department of Cellular and Molecular Pharmacology, University of California San Francisco, San Francisco, CA 94158, USA;
| | - Jean Lud Cadet
- The Molecular Neuropsychiatry Research Branch, NIH National Institute on Drug Abuse, Baltimore, MD 21224, USA;
| | - Kenneth Blum
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA; (E.R.B.); (C.A.D.)
- Division of Addiction Research & Education, Center for Psychiatry, Medicine & Primary Care (Office of Provost), Western University Health Sciences, Pomona, CA 91766, USA;
- Correspondence:
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15
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Lee YG, Jeon S, Park M, Kang SW, Yoon SH, Baik K, Lee PH, Sohn YH, Ye BS. Effects of Alzheimer and Lewy Body Disease Pathologies on Brain Metabolism. Ann Neurol 2022; 91:853-863. [PMID: 35307860 DOI: 10.1002/ana.26355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to determine the pattern of 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) related to postmortem Lewy body disease (LBD) pathology in clinical Alzheimer disease (AD). METHODS FDG-PET scans were analyzed in 62 autopsy-confirmed patients and 110 controls in the Alzheimer's Disease Neuroimaging Initiative. Based on neuropathologic evaluations on Braak stage for neurofibrillary tangle, Consortium to Establish a Registry for AD score for neuritic plaque, and Lewy-related pathology, subjects were classified into AD(-)/LBD(-), AD(-)/LBD(+), AD(+)/LBD(-), and AD(+)/LBD(+) groups. The association between postmortem LBD and AD pathologies and antemortem brain metabolism was evaluated. RESULTS AD and LBD pathologies had significant interaction effects to decrease metabolism in the cerebellar vermis, bilateral caudate, putamen, basal frontal cortex, and anterior cingulate cortex in addition to the left side of the entorhinal cortex and amygdala, and significant interaction effects to increase metabolism in the bilateral parietal and occipital cortices. LBD pathology was associated with hypermetabolism in the cerebellar vermis, bilateral putamen, anterior cingulate cortex, and basal frontal cortex, corresponding to the Lewy body-related hypermetabolic patterns. AD pathology was associated with hypometabolism in the bilateral hippocampus, entorhinal cortex, and posterior cingulate cortex regardless of LBD pathology, whereas LBD pathology was associated with hypermetabolism in the bilateral putamen and anterior cingulate cortex regardless of AD pathology. INTERPRETATION Postmortem LBD and AD pathologies had significant interaction effects on the antemortem brain metabolism in clinical AD patients. Specific metabolic patterns related to AD and LBD pathologies could be elucidated when simultaneously considering the two pathologies. ANN NEUROL 2022.
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Affiliation(s)
- Young-Gun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seun Jeon
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Mincheol Park
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Woo Kang
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - So Hoon Yoon
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Ho Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
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16
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Yoo HS, Jeon S, Cavedo E, Ko M, Yun M, Lee PH, Sohn YH, Grothe MJ, Teipel S, Hampel H, Evans AC, Ye BS. Association of β-Amyloid and Basal Forebrain With Cortical Thickness and Cognition in Alzheimer and Lewy Body Disease Spectra. Neurology 2022; 98:e947-e957. [PMID: 34969939 PMCID: PMC8901177 DOI: 10.1212/wnl.0000000000013277] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 12/21/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Cholinergic degeneration and β-amyloid contribute to brain atrophy and cognitive dysfunction in Alzheimer disease (AD) and Lewy body disease (LBD), but their relationship has not been comparatively evaluated. METHODS In this cross-sectional study, we recruited 28 normal controls (NC), 55 patients with AD mild cognitive impairment (MCI), 34 patients with AD dementia, 28 patients with LBD MCI, and 51 patients with LBD dementia. Participants underwent cognitive evaluation, brain MRI to measure the basal forebrain (BF) volume and global cortical thickness (CTh), and 18F-florbetaben (FBB) PET to measure the standardized uptake value ratio (SUVR). Using general linear models and path analyses, we evaluated the association of FBB-SUVR and BF volume with CTh or cognitive dysfunction in the AD spectrum (AD and NC) and LBD spectrum (LBD and NC), respectively. Covariates included age, sex, education, deep and periventricular white matter hyperintensities, intracranial volume, hypertension, diabetes, and hyperlipidemia. RESULTS BF volume mediated the association between FBB-SUVR and CTh in both the AD and LBD spectra, while FBB-SUVR was associated with CTh independently of BF volume only in the LBD spectrum. Significant correlation between voxel-wise FBB-SUVR and CTh was observed only in the LBD group. FBB-SUVR was independently associated with widespread cognitive dysfunction in both the AD and LBD spectra, especially in the memory domain (standardized beta [B] for AD spectrum = -0.60, B for LBD spectrum = -0.33). In the AD spectrum, BF volume was associated with memory dysfunction (B = 0.18), and CTh was associated with language (B = 0.21) and executive (B = 0.23) dysfunction. In the LBD spectrum, however, BF volume and CTh were independently associated with widespread cognitive dysfunction. CONCLUSIONS There is a common β-amyloid-related degenerative mechanism with or without the mediation of BF in the AD and LBD spectra, while the association of BF atrophy with cognitive dysfunction is more profound and there is localized β-amyloid-cortical atrophy interaction in the LBD spectrum.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Byoung Seok Ye
- From the Department of Neurology (H.S.Y., S.J., P.H.L., Y.H.S., B.S.Y.), Brain Research Institute (S.J.), Severance Biomedical Science Institute (M.J.K.), and Department of Nuclear Medicine (M.Y.), Yonsei University College of Medicine, Seoul, South Korea; Sorbonne University (E.C., H.H.), GRC N0. 21, Alzheimer Precision Medicine, AP-HP, Pitié-Salpêtrière Hospital; Qynapse (E.C.), Paris, France; German Center for Neurodegenerative Diseases (DZNE)-Rostock/Greifswald (M.J.G., S.T.), Rostock, Germany; Unidad de Trastornos del Movimiento (M.J.G.), Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Spain; Department of Psychosomatic Medicine (S.T.), University Medicine Rostock, Germany; and McGill Center for Integrative Neuroscience (A.C.E.), Montreal Neurological Institute, McGill University, Quebec, Canada.
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17
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Tu H, Zhang ZW, Qiu L, Lin Y, Jiang M, Chia SY, Wei Y, Ng ASL, Reynolds R, Tan EK, Zeng L. Increased expression of pathological markers in Parkinson's disease dementia post-mortem brains compared to dementia with Lewy bodies. BMC Neurosci 2022; 23:3. [PMID: 34983390 PMCID: PMC8725407 DOI: 10.1186/s12868-021-00687-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/22/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) and dementia with Lewy bodies (DLB) are common age-related neurodegenerative diseases comprising Lewy body spectrum disorders associated with cortical and subcortical Lewy body pathology. Over 30% of PD patients develop PD dementia (PDD), which describes dementia arising in the context of established idiopathic PD. Furthermore, Lewy bodies frequently accompany the amyloid plaque and neurofibrillary tangle pathology of Alzheimer's disease (AD), where they are observed in the amygdala of approximately 60% of sporadic and familial AD. While PDD and DLB share similar pathological substrates, they differ in the temporal onset of motor and cognitive symptoms; however, protein markers to distinguish them are still lacking. METHODS Here, we systematically studied a series of AD and PD pathogenesis markers, as well as mitochondria, mitophagy, and neuroinflammation-related indicators, in the substantia nigra (SN), temporal cortex (TC), and caudate and putamen (CP) regions of human post-mortem brain samples from individuals with PDD and DLB and condition-matched controls. RESULTS We found that p-APPT668 (TC), α-synuclein (CP), and LC3II (CP) are all increased while the tyrosine hydroxylase (TH) (CP) is decreased in both PDD and DLB compared to control. Also, the levels of Aβ42 and DD2R, IBA1, and p-LRRK2S935 are all elevated in PDD compared to control. Interestingly, protein levels of p-TauS199/202 in CP and DD2R, DRP1, and VPS35 in TC are all increased in PDD compared to DLB. CONCLUSIONS Together, our comprehensive and systematic study identified a set of signature proteins that will help to understand the pathology and etiology of PDD and DLB at the molecular level.
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Affiliation(s)
- Haitao Tu
- Neural Stem Cell Research Lab, Research Department, National Neuroscience Institute, Singapore, 308433, Singapore
| | - Zhi Wei Zhang
- Neural Stem Cell Research Lab, Research Department, National Neuroscience Institute, Singapore, 308433, Singapore
| | - Lifeng Qiu
- Neural Stem Cell Research Lab, Research Department, National Neuroscience Institute, Singapore, 308433, Singapore
| | - Yuning Lin
- Guangxi University of Chinese Medicine, 179 Mingxiu Dong Rd., Nanning, 530001, Guangxi, China
| | - Mei Jiang
- Neural Stem Cell Research Lab, Research Department, National Neuroscience Institute, Singapore, 308433, Singapore
- Department of Anatomy and Neurobiology, Zhongshan School of Medicine, Sun Yat-Sen University, #74, Zhongshan No. 2 Road, Guangzhou, 510080, China
- Department of Human Anatomy, Institute of Stem Cell and Regenerative Medicine, Dongguan Campus, Guangdong Medical University, Dongguan, China
| | - Sook-Yoong Chia
- Neural Stem Cell Research Lab, Research Department, National Neuroscience Institute, Singapore, 308433, Singapore
| | - Yanfei Wei
- Guangxi University of Chinese Medicine, 179 Mingxiu Dong Rd., Nanning, 530001, Guangxi, China
| | - Adeline S L Ng
- Department of Neurology, National Neuroscience Institute, Singapore, 308433, Singapore
- DUKE-NUS Graduate Medical School, Neuroscience & Behavioral Disorders Program, Singapore, 169857, Singapore
| | - Richard Reynolds
- Division of Neuroscience, Imperial College London, Hammersmith Hospital, London, W12 0NN, UK
- Centre for Molecular Neuropathology, Lee Kong Chian School of Medicine, Nanyang Technological University, Novena Campus, 11 Mandalay Road, Singapore, 308232, Singapore
| | - Eng-King Tan
- Department of Neurology, National Neuroscience Institute, Singapore, 308433, Singapore
- DUKE-NUS Graduate Medical School, Neuroscience & Behavioral Disorders Program, Singapore, 169857, Singapore
| | - Li Zeng
- Neural Stem Cell Research Lab, Research Department, National Neuroscience Institute, Singapore, 308433, Singapore.
- DUKE-NUS Graduate Medical School, Neuroscience & Behavioral Disorders Program, Singapore, 169857, Singapore.
- Centre for Molecular Neuropathology, Lee Kong Chian School of Medicine, Nanyang Technological University, Novena Campus, 11 Mandalay Road, Singapore, 308232, Singapore.
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18
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Lee YH, Jeon S, Yoo HS, Chung SJ, Jung JH, Baik K, Sohn YH, Lee PH, Yun M, Evans AC, Ye BS. Effect of Alzheimer's Disease and Lewy Body Disease on Metabolic Changes. J Alzheimers Dis 2021; 79:1471-1487. [PMID: 33459638 DOI: 10.3233/jad-201094] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND The relationship among amyloid-β (Aβ) deposition on amyloid positron emission tomography (PET), cortical metabolism on 18F-fluoro-2-deoxy-D-glucose (FDG)-PET, and clinical diagnosis has not been elucidated for both Alzheimer's disease (AD) and Lewy body disease (LBD). OBJECTIVE We investigated the patterns of cerebral metabolism according to the presence of AD and LBD. METHODS A total of 178 subjects were enrolled including 42 pure AD, 32 pure LBD, 34 Lewy body variant AD (LBVAD), 15 LBD with amyloid, 26 AD with dementia with Lewy bodies (DLB), and 29 control subjects. Pure AD, LBVAD, and AD with DLB groups had biomarker-supported diagnoses of typical AD, while pure LBD, LBD with amyloid, and AD with DLB groups had biomarker-supported diagnoses of typical LBD. Typical AD and LBD with amyloid showed amyloid-positivity on 18F-florbetaben (FBB) PET, while typical LBD and LBVAD had abnormalities on dopamine transporter PET. We measured regional patterns of glucose metabolism using FDG-PET and evaluated their relationship with AD and LBD. RESULTS Compared with control group, typical AD and typical LBD commonly exhibited hypometabolism in the bilateral temporo-parietal junction, precuneus, and posterior cingulate cortex. Typical AD showed an additional hypometabolism in the entorhinal cortex, while patients with dopamine transporter abnormality-supported diagnosis of LBD showed diffuse hypometabolism that spared the sensory-motor cortex. Although the diffuse hypometabolism in LBD also involved the occipital cortex, prominent occipital hypometabolism was only seen in LBD with amyloid group. CONCLUSION Combining clinical and metabolic evaluations may enhance the diagnostic accuracy of AD, LBD, and mixed disease cases.
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Affiliation(s)
- Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seun Jeon
- McGill Center for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Ho Jung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Alan C Evans
- McGill Center for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
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19
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Kang SW, Jeon S, Lee YG, Park M, Baik K, Jung JH, Chung SJ, Yoo HS, Jeong SH, Yun M, Lee PH, Sohn YH, Evans AC, Ye BS. Implication of metabolic and dopamine transporter PET in dementia with Lewy bodies. Sci Rep 2021; 11:14394. [PMID: 34257349 PMCID: PMC8277897 DOI: 10.1038/s41598-021-93442-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/24/2021] [Indexed: 11/08/2022] Open
Abstract
To evaluate the implication of 18F-fluorodeoxyglucose (FDG)- and dopamine transporter (DAT)-positron emission tomography (PET) in the diagnosis and clinical symptoms of dementia with Lewy bodies (DLB), 55 DLB patients and 49 controls underwent neuropsychological evaluation and FDG-, DAT-, and 18F-Florbetaben (FBB) PET. DAT- and FDG-uptake and FDG/DAT ratio were measured in the anterior and posterior striatum. The first principal component (PC1) of FDG subject residual profiles was identified for each subject. Receiver operating characteristic curve analyses for the diagnosis of DLB were performed using FDG- and DAT-PET biomarkers as predictors, and general linear models for motor severity and cognitive scores were performed adding FBB standardized uptake value ratio as a predictor. Increased metabolism in the bilateral putamen, vermis, and somato-motor cortices, which characterized PC1, was observed in the DLB group, compared to the control group. A combination of posterior putamen FDG/DAT ratio and PC1 showed the highest diagnostic accuracy (91.8% sensitivity and 96.4% specificity), which was significantly greater than that obtained by DAT uptake alone. Striatal DAT uptake and PC1 independently contributed to motor severity and language, memory, frontal/executive, and general cognitive dysfunction in DLB patients, while only PC1 contributed to attention and visuospatial dysfunction.
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Affiliation(s)
- Sung Woo Kang
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Seun Jeon
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
- Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young-Gun Lee
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Mincheol Park
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Jin Ho Jung
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Seok Jong Chung
- Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Seong Ho Jeong
- Department of Neurology, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Alan C Evans
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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Jung JH, Jeon S, Baik K, Lee YH, Chung SJ, Yoo HS, Jeong SH, Sohn YH, Lee PH, Ye BS. Apolipoprotein E4, amyloid, and cognition in Alzheimer's and Lewy body disease. Neurobiol Aging 2021; 106:45-54. [PMID: 34242895 DOI: 10.1016/j.neurobiolaging.2021.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/14/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022]
Abstract
The role of apolipoprotein E4 (APOE4) in the risk of Alzheimer's disease (AD) and Lewy body disease (LBD), and their relationship with β-amyloid deposition and cognitive dysfunction, remain unclear. Using amyloid and dopamine transporter imaging, we enrolled 126 controls and 208 patients with typical AD (pure AD and Lewy body variant of AD), AD with dementia with Lewy bodies, or typical LBD (dementia with Lewy bodies with amyloid deposition and pure LBD). APOE4 was associated with an increased risk of all disease subtypes except pure LBD. APOE4 was associated with increased frontal β-amyloid burden, and typical LBD was associated with increased occipital β-amyloid levels through its interaction with APOE4. APOE4 was associated with deteriorated general cognition and memory dysfunction via its interaction with typical LBD and AD, respectively. In conclusion, the impact of APOE4 on disease risk depends on its effects on β-amyloid deposition, and APOE4 is associated with β-amyloid deposition regardless of the clinical diagnosis. However, it interacts with typical LBD to cause occipital β-amyloid deposition.
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Affiliation(s)
- Jin Ho Jung
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Seun Jeon
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seong Ho Jeong
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
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21
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Baik K, Yang JJ, Jung JH, Lee YH, Chung SJ, Yoo HS, Sohn YH, Lee PH, Lee JM, Ye BS. Structural connectivity networks in Alzheimer's disease and Lewy body disease. Brain Behav 2021; 11:e02112. [PMID: 33792194 PMCID: PMC8119831 DOI: 10.1002/brb3.2112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 02/14/2021] [Accepted: 02/17/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE We evaluated disruption of the white matter (WM) network related with Alzheimer's disease (AD) and Lewy body disease (LBD), which includes Parkinson's disease and dementia with Lewy bodies. METHODS We consecutively recruited 37 controls and 77 patients with AD-related cognitive impairment (ADCI) and/or LBD-related cognitive impairment (LBCI). Diagnoses of ADCI and LBCI were supported by amyloid PET and dopamine transporter PET, respectively. There were 22 patients with ADCI, 19 patients with LBCI, and 36 patients with mixed ADCI/LBCI. We investigated the relationship between ADCI, LBCI, graph theory-based network measures on diffusion tensor images, and cognitive dysfunction using general linear models after controlling for age, sex, education, deep WM hyperintensities (WMH), periventricular WMH, and intracranial volume. RESULTS LBCI, especially mixed with ADCI, was associated with increased normalized path length and decreased normalized global efficiency. LBCI was related to the decreased nodal degree of left caudate, which was further associated with broad cognitive dysfunction. Decreased left caudate nodal degree was associated with decreased fractional anisotropy (FA) in the brain regions vulnerable to LBD. Compared with the control group, the LBCI group had an increased betweenness centrality in the occipital nodes, which was associated with decreased FA in the WM adjacent to the striatum and visuospatial dysfunction. CONCLUSION Concomitant ADCI and LBCI are associated with the accentuation of LBCI-related WM network disruption centered in the left caudate nucleus. The increase of occipital betweenness centrality could be a characteristic biologic change associated with visuospatial dysfunction in LBCI.
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Affiliation(s)
- Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Jin-Ju Yang
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Jin Ho Jung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
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22
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Jung J, Bae SH, Han JH, Kwak SH, Nam GS, Lee PH, Sohn YH, Yun M, Ye BS. Relationship between Hearing Loss and Dementia Differs According to the Underlying Mechanism. J Clin Neurol 2021; 17:290-299. [PMID: 33835751 PMCID: PMC8053549 DOI: 10.3988/jcn.2021.17.2.290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 01/23/2023] Open
Abstract
Background and Purpose The associations between hearing loss (HL) and the mechanisms underlying cognitive impairment (CI) remain unclear. We evaluated the effects of clinical factors, vascular magnetic resonance imaging (MRI) markers, and CI mechanisms on HL. Methods In total, 112 patients with CI (59% demented) and subjective HL prospectively underwent MRI, amyloid positron-emission tomography (PET), hearing evaluations, and neuropsychological tests including a language comprehension test. Patients were categorized into pure-Alzheimer's disease-related CI (ADCI), pure-Lewy-body disease-related CI (LBCI), mixed-ADCI/LBCI, and non-ADCI/LBCI groups based on clinical features and PET biomarkers. Results The risk of peripheral HL [defined as a pure-tone average (PTA) threshold >40 dB] was higher in the pure-LBCI group than in the pure-ADCI and mixed-ADCI/LBCI groups, and lower in the presence of ADCI. The non-ADCI/LBCI group had the most-severe vascular MRI markers and showed a higher risk of peripheral HL than did the pure-ADCI and mixed-ADCI/LBCI groups. While the pure-LBCI group had a higher risk of comprehension dysfunction than the pure-ADCI group regardless of the PTA and the score on the Korean version of the Mini Mental State Examination (K-MMSE), those in the pure-LBCI group even with a better K-MMSE score had a risk of comprehension dysfunction comparable to that in the mixed-ADCI/LBCI group due to a worse PTA. Conclusions Peripheral HL could be associated with the absence of significant β-amyloid deposition in patients with CI and characteristic of the pure-LBCI and non-ADCI/LBCI groups.
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Affiliation(s)
- Jinsei Jung
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.,Graduate school of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Korea
| | - Seong Hoon Bae
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hyuk Han
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hyun Kwak
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Gi Sung Nam
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Ho Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea.
| | - Byung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
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23
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Chung SJ, Kim HR, Jung JH, Lee PH, Jeong Y, Sohn YH. Identifying the Functional Brain Network of Motor Reserve in Early Parkinson's Disease. Mov Disord 2020; 35:577-586. [PMID: 32096277 DOI: 10.1002/mds.28012] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/09/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The severity of motor symptoms in Parkinson's disease (PD) does not always correlate with the degree of nigral dopaminergic neuronal loss. Individuals with greater motor reserve may have milder motor signs than their striatal dopamine loss. In this study, we explored the functional brain network associated with motor reserve in early-stage PD. METHODS We analyzed 134 patients with de novo PD who underwent dopamine transporter scans and resting-state functional magnetic resonance imaging. We estimated individual motor reserve based on initial motor deficits and striatal dopamine depletion using a residual model. We applied network-based statistic analysis to identify the functional brain network associated with the measure of motor reserve (ie, motor reserve network). We also assessed the effect of motor reserve network connectivity strength on the longitudinal increase in levodopa-equivalent dose during the 2-year follow-up period. RESULTS Network-based statistic analysis identified the motor reserve network composed of the basal ganglia, inferior frontal cortex, insula, and cerebellar vermis at a primary threshold of P value 0.001. Patients with an increased degree of functional connectivity within the motor reserve network had greater motor reserve. There was a significant interaction between the motor reserve network strength and time in the linear mixed model, indicating that higher motor reserve network strength was associated with slower longitudinal increase in levodopa-equivalent dose. CONCLUSIONS The present study revealed the functional brain network associated with motor reserve in patients with early-stage PD. Functional connections within the motor reserve network are associated with the individual's capacity to cope with PD-related pathologies. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Hang-Rai Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.,KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Jin Ho Jung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Jeong
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.,KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.,Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
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24
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Yoo HS, Lee S, Chung SJ, Lee YH, Ye BS, Sohn YH, Yun M, Lee PH. Clinical and striatal dopamine transporter predictors of β-amyloid in dementia with Lewy bodies. Neurology 2020; 94:e1344-e1352. [PMID: 32086384 DOI: 10.1212/wnl.0000000000009168] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 11/06/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the relationship between β-amyloid (Aβ) deposition and striatal dopamine depletion, cognitive functions, and neuropsychiatric symptoms in dementia with Lewy bodies (DLB). METHODS We consecutively recruited 51 patients with DLB who had undergone a neuropsychological test, Neuropsychiatric Inventory assessment, brain MRI, N-(3-[18F]fluoropropyl)-2β-carbon ethoxy-3β-(4-iodophenyl) PET, and 18F-florbetaben PET within 6 months. The patients were divided into Aβ-negative (DLB-Aβ-, n = 20) and Aβ-positive (DLB-Aβ+, n = 31) groups according to the brain amyloid plaque load score. We performed comparative analyses of dopamine transporter (DAT) activity, neuropsychological profile, and neuropsychiatric symptoms between the 2 groups. RESULTS Compared to the DLB-Aβ- group, the DLB-Aβ+ group had a younger age at diagnosis (p = 0.017), poorer performance in attention (p = 0.028) and visuospatial (p = 0.006) functions, and higher proportion of anxiety (p = 0.006) and total neuropsychiatric burden (p = 0.013). Those in the DLB-Aβ+ group also had lower DAT activity in the anterior putamen (p = 0.015) and ventral striatum (p = 0.006) regardless of age, sex, and years of education. In addition, lower DAT activity in the ventral striatum was significantly associated with anxiety and total neuropsychiatric burden in DLB. CONCLUSIONS This study demonstrated that Aβ deposition in DLB is associated with diagnosis at a younger age, higher cognitive and neuropsychiatric burden, and decreased DAT activity, suggesting that evaluation of clinical features and DAT activity can predict the presence of Aβ in DLB.
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Affiliation(s)
- Han Soo Yoo
- From the Department of Neurology (H.S.Y., S.J.C., Y.H.L., B.S.Y., Y.H.S., P.H.L.), the Department of Nuclear Medicine (S.L., M.Y.), and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea
| | - Sangwon Lee
- From the Department of Neurology (H.S.Y., S.J.C., Y.H.L., B.S.Y., Y.H.S., P.H.L.), the Department of Nuclear Medicine (S.L., M.Y.), and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea.
| | - Seok Jong Chung
- From the Department of Neurology (H.S.Y., S.J.C., Y.H.L., B.S.Y., Y.H.S., P.H.L.), the Department of Nuclear Medicine (S.L., M.Y.), and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea
| | - Yang Hyun Lee
- From the Department of Neurology (H.S.Y., S.J.C., Y.H.L., B.S.Y., Y.H.S., P.H.L.), the Department of Nuclear Medicine (S.L., M.Y.), and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea.
| | - Byoung Seok Ye
- From the Department of Neurology (H.S.Y., S.J.C., Y.H.L., B.S.Y., Y.H.S., P.H.L.), the Department of Nuclear Medicine (S.L., M.Y.), and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- From the Department of Neurology (H.S.Y., S.J.C., Y.H.L., B.S.Y., Y.H.S., P.H.L.), the Department of Nuclear Medicine (S.L., M.Y.), and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea
| | - Mijin Yun
- From the Department of Neurology (H.S.Y., S.J.C., Y.H.L., B.S.Y., Y.H.S., P.H.L.), the Department of Nuclear Medicine (S.L., M.Y.), and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea.
| | - Phil Hyu Lee
- From the Department of Neurology (H.S.Y., S.J.C., Y.H.L., B.S.Y., Y.H.S., P.H.L.), the Department of Nuclear Medicine (S.L., M.Y.), and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea.
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25
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Ye R, Touroutoglou A, Brickhouse M, Katz S, Growdon JH, Johnson KA, Dickerson BC, Gomperts SN. Topography of cortical thinning in the Lewy body diseases. NEUROIMAGE-CLINICAL 2020; 26:102196. [PMID: 32059167 PMCID: PMC7016450 DOI: 10.1016/j.nicl.2020.102196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 11/15/2022]
Abstract
Objective Regional cortical thinning in dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD) may underlie some aspect of their clinical impairments; cortical atrophy likely reflects extensive Lewy body pathology with alpha-synuclein deposits, as well as associated Alzheimer's disease co-pathologies, when present. Here we investigated the topographic distribution of cortical thinning in these Lewy body diseases compared to cognitively normal PD and healthy non-PD control subjects, explored the association of regional thinning with clinical features and evaluated the impact of amyloid deposition. Methods Twenty-one participants with dementia with Lewy bodies (DLB), 16 with Parkinson disease (PD) - associated cognitive impairment (PD-MCI and PDD), and 24 cognitively normal participants with PD underwent MRI, PiB PET, and clinical evaluation. Cortical thickness across the brain and in regions of interest (ROIs) was compared across diagnostic groups and across subgroups stratified by amyloid status, and was related to clinical and cognitive measures. Results DLB and PD-impaired groups shared a similar distribution of cortical thinning that included regions characteristic of AD, as well as the fusiform, precentral, and paracentral gyri. Elevated PiB retention in DLB and PD-impaired but not in PD-normal participants was associated with more extensive and severe cortical thinning, in an overlapping topography that selectively affected the medial temporal lobe in DLB participants. In DLB, greater thinning in AD signature and fusiform regions was associated with greater cognitive impairment. Conclusions The pattern of cortical thinning is similar in DLB and PD-associated cognitive impairment, overlapping with and extending beyond AD signature regions to involve fusiform, precentral, and paracentral regions. Cortical thinning in AD signature and fusiform regions in these diseases reflects cognitive impairment and is markedly accentuated by amyloid co-pathology. Further work will be required to determine whether the distinct topography of cortical thinning in DLB and PD-associated cognitive impairment might have value as a diagnostic and/ or outcome biomarker in clinical trials.
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Affiliation(s)
- Rong Ye
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Alexandra Touroutoglou
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Michael Brickhouse
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Samantha Katz
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - John H Growdon
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Stephen N Gomperts
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA.
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26
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Ye BS, Lee S, Yoo H, Chung SJ, Lee YH, Choi Y, Lee PH, Sohn YH, Yun M. Distinguishing between dementia with Lewy bodies and Alzheimer's disease using metabolic patterns. Neurobiol Aging 2019; 87:11-17. [PMID: 31791660 DOI: 10.1016/j.neurobiolaging.2019.10.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 10/25/2019] [Accepted: 10/29/2019] [Indexed: 10/25/2022]
Abstract
Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) are the 2 most common causes of dementia. We compared the regional metabolism on 18F-fluorodeoxyglucose positron emission tomography (PET) among 21 control subjects and cognitively impaired patients due to DLB (N = 63) and AD (N = 38). All participants underwent 18F-Florbetaben (FBB) PET, and all DLB patients had abnormality on dopamine transporter PET. Both the FBB-positive DLB (N = 38) and FBB-negative DLB (N = 25) groups had increased metabolism in the bilateral central cerebellum, posterior putamen, and somatomotor cortices compared with the control and AD groups. Compared with the control group, the DLB and AD groups commonly exhibited hypometabolism in the bilateral lateral temporal, temporo-parietal junction, posterior cingulate, and precuneus cortices. Both DLB groups had additional hypometabolism in the bilateral thalami and dorsolateral prefrontal cortices, whereas the AD group did in the bilateral entorhinal cortices and hippocampi. Our results suggest that hypermetabolism in the somatomotor cortex, posterior putamen, or central cerebellum could be a useful imaging biomarker for detecting DLB patients, while entorhinal/hippocampal hypometabolism could be a specific biomarker for AD.
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Affiliation(s)
- Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Sangwon Lee
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hansoo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yonghoon Choi
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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Kang SW, Jeon S, Yoo HS, Chung SJ, Lee PH, Sohn YH, Yun M, Evans AC, Ye BS. Effects of Lewy body disease and Alzheimer disease on brain atrophy and cognitive dysfunction. Neurology 2019; 92:e2015-e2026. [PMID: 30944239 DOI: 10.1212/wnl.0000000000007373] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 01/07/2019] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To investigate the independent and interaction effects of Alzheimer disease (AD) and Lewy body disease (LBD) on cognition and brain atrophy. METHODS We consecutively recruited 38 controls and 108 patients with AD-related cognitive impairment (ADCI) and/or LBD-related cognitive impairment (LBCI) from university-based dementia and movement clinics. Diagnoses of ADCI and LBCI were supported by 18F-florbetaben PET and 18F-N-(3-fluoropropyl)-2β-carbon ethoxy-3β-(4-iodophenyl) nortropane-PET, respectively. There were 38 controls, 26 patients with pure ADCI (18 mild cognitive impairment [MCI] and 8 dementia), 28 patients with pure LBCI (13 MCI and 15 dementia), and 54 patients with mixed ADCI and LBCI (17 MCI and 37 dementia). We performed group-wise comparisons for neuropsychological z scores and regional cortical thickness. We also evaluated the effects of ADCI and LBCI using general linear models. RESULTS Compared to the controls, patients in the pure ADCI group and pure LBCI group had focused cortical thinning in the bilateral entorhinal/right anterior temporal cortices and bilateral anteromedial temporal/basal frontal cortices, respectively, while the mixed disease group had additional cortical thinning in the widespread association cortices. The independent effects of ADCI and LBCI on regional cortical thinning overlapped in the widespread association cortices, especially at the bilateral temporoparietal junction and parietal cortices. ADCI and LBCI had independent detrimental effects on the copying item of the Rey-Osterrieth Complex Figure Test. CONCLUSIONS Concomitant ADCI and LBCI are associated with the accentuation of neurodegeneration to widespread association cortices, and both diseases contribute to visuospatial dysfunction.
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Affiliation(s)
- Sung Woo Kang
- From the Departments of Neurology (S.W.K., H.S.Y., S.J.C., P.H.L., Y.H.S., B.S.Y.) and Nuclear Medicine (M.Y.), Yonsei University College of Medicine, Seoul, Korea; and McGill Centre for Integrative Neuroscience (S.J., A.C.E.), Montreal Neurological Institute, McGill University, Quebec, Canada
| | - Seun Jeon
- From the Departments of Neurology (S.W.K., H.S.Y., S.J.C., P.H.L., Y.H.S., B.S.Y.) and Nuclear Medicine (M.Y.), Yonsei University College of Medicine, Seoul, Korea; and McGill Centre for Integrative Neuroscience (S.J., A.C.E.), Montreal Neurological Institute, McGill University, Quebec, Canada
| | - Han Soo Yoo
- From the Departments of Neurology (S.W.K., H.S.Y., S.J.C., P.H.L., Y.H.S., B.S.Y.) and Nuclear Medicine (M.Y.), Yonsei University College of Medicine, Seoul, Korea; and McGill Centre for Integrative Neuroscience (S.J., A.C.E.), Montreal Neurological Institute, McGill University, Quebec, Canada
| | - Seok Jong Chung
- From the Departments of Neurology (S.W.K., H.S.Y., S.J.C., P.H.L., Y.H.S., B.S.Y.) and Nuclear Medicine (M.Y.), Yonsei University College of Medicine, Seoul, Korea; and McGill Centre for Integrative Neuroscience (S.J., A.C.E.), Montreal Neurological Institute, McGill University, Quebec, Canada
| | - Phil Hyu Lee
- From the Departments of Neurology (S.W.K., H.S.Y., S.J.C., P.H.L., Y.H.S., B.S.Y.) and Nuclear Medicine (M.Y.), Yonsei University College of Medicine, Seoul, Korea; and McGill Centre for Integrative Neuroscience (S.J., A.C.E.), Montreal Neurological Institute, McGill University, Quebec, Canada
| | - Young H Sohn
- From the Departments of Neurology (S.W.K., H.S.Y., S.J.C., P.H.L., Y.H.S., B.S.Y.) and Nuclear Medicine (M.Y.), Yonsei University College of Medicine, Seoul, Korea; and McGill Centre for Integrative Neuroscience (S.J., A.C.E.), Montreal Neurological Institute, McGill University, Quebec, Canada
| | - Mijin Yun
- From the Departments of Neurology (S.W.K., H.S.Y., S.J.C., P.H.L., Y.H.S., B.S.Y.) and Nuclear Medicine (M.Y.), Yonsei University College of Medicine, Seoul, Korea; and McGill Centre for Integrative Neuroscience (S.J., A.C.E.), Montreal Neurological Institute, McGill University, Quebec, Canada
| | - Alan C Evans
- From the Departments of Neurology (S.W.K., H.S.Y., S.J.C., P.H.L., Y.H.S., B.S.Y.) and Nuclear Medicine (M.Y.), Yonsei University College of Medicine, Seoul, Korea; and McGill Centre for Integrative Neuroscience (S.J., A.C.E.), Montreal Neurological Institute, McGill University, Quebec, Canada
| | - Byoung Seok Ye
- From the Departments of Neurology (S.W.K., H.S.Y., S.J.C., P.H.L., Y.H.S., B.S.Y.) and Nuclear Medicine (M.Y.), Yonsei University College of Medicine, Seoul, Korea; and McGill Centre for Integrative Neuroscience (S.J., A.C.E.), Montreal Neurological Institute, McGill University, Quebec, Canada.
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