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Nakatani N, Ono D, Hirata K, Yoshioka K, Endo H, Ono K, Higuchi M, Yokota T. [A case of left posterior cortical atrophy presenting with kana-predominant reading impairment]. Rinsho Shinkeigaku 2024; 64:557-563. [PMID: 39069492 DOI: 10.5692/clinicalneurol.cn-001907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
The patient was an 85-year-old man with a one-year history of difficulty reading kana. Neuropsychological evaluation revealed kana (phonogram)-selective reading impairment and kanji (ideogram)-dominant writing impairment. MRI revealed significant cerebral atrophy in the left occipital cortex, leading to the clinical diagnosis of posterior cortical atrophy (PCA). Cerebrospinal fluid amyloid β1-42 levels were reduced, and amyloid PET showed accumulation in the posterior cingulate cortex, precuneus, and frontal lobe. In contrast, tau PET showed no accumulation in the atrophied brain areas. Episodes of REM sleep behavior disorder and decreased uptake on meta-iodobenzylguanidine (MIBG) myocardial scintigraphy suggested the involvement of Lewy body pathology. PCA with distinct laterality has been rarely reported, and this is the first case to present Kana-selective reading impairment and Kanji-dominant writing impairment with neurodegenerative background.
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Affiliation(s)
- Natsuki Nakatani
- Department of Neurology, Tokyo Medical and Dental University Hospital
| | - Daisuke Ono
- Department of Neurology, Tokyo Medical and Dental University Hospital
- Department of Neuroscience, Mayo Clinic
| | - Kosei Hirata
- Department of Neurology, Tokyo Medical and Dental University Hospital
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology
| | - Kotaro Yoshioka
- Department of Neurology, Tokyo Medical and Dental University Hospital
| | - Hironobu Endo
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology
| | - Kenjiro Ono
- Department of Neurology, Kanazawa University
| | - Makoto Higuchi
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology
| | - Takanori Yokota
- Department of Neurology, Tokyo Medical and Dental University Hospital
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2
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Pelak VS, Krishnan V, Serva S, Pressman P, Mahmood A, Noteboom L, Bettcher BM, Sillau SH, Callen AL, Thaker AA. Lobar Microbleeds in the Posterior Cortical Atrophy Syndrome: A Comparison to Typical Alzheimer's Disease. Curr Neurol Neurosci Rep 2024; 24:27-33. [PMID: 38261145 DOI: 10.1007/s11910-024-01330-5] [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] [Accepted: 12/14/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE OF THE STUDY Posterior cortical atrophy is a clinico-radiographical syndrome that presents with higher-order visual dysfunction and is most commonly due to Alzheimer's disease. Understanding factors associated with atypical presentations of Alzheimer's disease, such as posterior cortical atrophy (PCA), holds promise to shape our understanding of AD pathophysiology. Thus, we aimed to compare MRI evidence of lobar microbleeds (LMBs) in posterior cortical atrophy (PCA) syndrome to typical AD (tAD) and to assess and compare MRI evidence of cerebral amyloid angiopathy (CAA) in each group. FINDINGS We retrospectively collected clinical and MRI data from participants with PCA (n = 26), identified from an institutional PCA registry, and participants with tAD (n = 46) identified from electronic health records from a single institution. LMBs were identified on susceptibility-weighted imaging (SWI); the Fazekas grade of white matter disease was assessed using FLAIR images, and Boston criteria version 2.0 for cerebral amyloid angiopathy were applied to all data. The proportion of participants with PCA and LMB (7.7%) was lower than for tAD (47.8%) (p = 0.005). The frequency of "probable" CAA was similar in both groups, while "possible" CAA was more frequent in tAD (30.4%) than PCA (0%) (p = 0.001). The Fazekas grades were not different between groups. Lobar microbleeds on SWI were not more common in PCA than in typical AD. Clinicopathological investigations are necessary to confirm these findings. The factors that contribute to the posterior cortical atrophy phenotype are unknown.
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Affiliation(s)
- Victoria S Pelak
- Department of Neurology, University of Colorado School of Medicine, 12631 East 17 Avenue, Mail Stop B185, Aurora, CO, 80045, USA.
| | - Vishal Krishnan
- Department of Neurology, University of Colorado School of Medicine, 12631 East 17 Avenue, Mail Stop B185, Aurora, CO, 80045, USA
| | - Stephanie Serva
- Department of Neurology, University of Colorado School of Medicine, 12631 East 17 Avenue, Mail Stop B185, Aurora, CO, 80045, USA
| | - Peter Pressman
- Department of Neurology, University of Colorado School of Medicine, 12631 East 17 Avenue, Mail Stop B185, Aurora, CO, 80045, USA
| | - Asher Mahmood
- Department of Neurology, University of Colorado School of Medicine, 12631 East 17 Avenue, Mail Stop B185, Aurora, CO, 80045, USA
| | - Lily Noteboom
- Department of Neurology, University of Colorado School of Medicine, 12631 East 17 Avenue, Mail Stop B185, Aurora, CO, 80045, USA
| | - Brianne M Bettcher
- Department of Neurology, University of Colorado School of Medicine, 12631 East 17 Avenue, Mail Stop B185, Aurora, CO, 80045, USA
| | - Stefan H Sillau
- Department of Neurology, University of Colorado School of Medicine, 12631 East 17 Avenue, Mail Stop B185, Aurora, CO, 80045, USA
| | - Andrew L Callen
- Department of Radiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Ashesh A Thaker
- Department of Radiology, University of Colorado School of Medicine, Aurora, CO, USA
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3
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Cotta Ramusino M, Scanu L, Gritti L, Imbimbo C, Farina LM, Cosentino G, Perini G, Costa A. Neurophysiological Alterations of the Visual Pathway in Posterior Cortical Atrophy: Systematic Review and a Case Series. J Alzheimers Dis 2024; 98:53-67. [PMID: 38363610 DOI: 10.3233/jad-231123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Background The clinical features of posterior cortical atrophy (PCA), a rare condition often caused by Alzheimer's disease, have been recently defined, while little is known about its neurophysiological correlates. Objective To describe neurophysiological alterations of the visual pathway as assessed using visual field test (VF), visual evoked potentials (VEP), and electroretinogram (ERG) in PCA patients. Methods Studies reporting VF, VEPs, and ERG in PCA patients were selected according PRISMA method. Of the 323 articles that emerged from the literature, 17 included the outcomes of interest. To these data, we added those derived from a patient cohort enrolled at our clinic. Results The literature review included 140 patients, half of them (50%) presented with homonymous hemianopia or quadrantanopia. VEPs were available in 4 patients (2 normal findings, 1 decreased amplitude, and 1 increased latency) and ERG in 3 patients (substantially normal findings). Our case series included 6 patients, presenting with homonymous lateral hemianopia in 50% and contralateral cortical atrophy. VEPs showed normal amplitude in 66-83% according to the stimulation check, and increased latency in 67% in absence of myelin damage on MRI. Latency was increased in both eyes in 50% and only on one side in the other 50%. Such alterations were observed in patients with more severe and symmetric atrophy. ERG showed normal findings. Conclusions Neurophysiological investigations of the visual pathway in PCA are almost absent in literature. Alterations involve both amplitude and latency and can be also monocular. A multiple-point involvement of the optical pathway can be hypothesized.
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Affiliation(s)
- Matteo Cotta Ramusino
- Clinical Neuroscience Unit of Dementia, Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Lucia Scanu
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Linda Gritti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Camillo Imbimbo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Lisa Maria Farina
- Neuroradiology Department, Advanced Imaging and Radiomics Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Giuseppe Cosentino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Clinical Neurophysiology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Giulia Perini
- Clinical Neuroscience Unit of Dementia, Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Alfredo Costa
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Unit of Behavioral Neurology and Center for Cognitive Disorders and Dementia (CDCD), IRCCS Mondino Foundation, Pavia, Italy
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4
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Beh A, McGraw PV, Webb BS, Schluppeck D. Linking Multi-Modal MRI to Clinical Measures of Visual Field Loss After Stroke. Front Neurosci 2022; 15:737215. [PMID: 35069094 PMCID: PMC8766758 DOI: 10.3389/fnins.2021.737215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Loss of vision across large parts of the visual field is a common and devastating complication of cerebral strokes. In the clinic, this loss is quantified by measuring the sensitivity threshold across the field of vision using static perimetry. These methods rely on the ability of the patient to report the presence of lights in particular locations. While perimetry provides important information about the intactness of the visual field, the approach has some shortcomings. For example, it cannot distinguish where in the visual pathway the key processing deficit is located. In contrast, brain imaging can provide important information about anatomy, connectivity, and function of the visual pathway following stroke. In particular, functional magnetic resonance imaging (fMRI) and analysis of population receptive fields (pRF) can reveal mismatches between clinical perimetry and maps of cortical areas that still respond to visual stimuli after stroke. Here, we demonstrate how information from different brain imaging modalities-visual field maps derived from fMRI, lesion definitions from anatomical scans, and white matter tracts from diffusion weighted MRI data-provides a more complete picture of vision loss. For any given location in the visual field, the combination of anatomical and functional information can help identify whether vision loss is due to absence of gray matter tissue or likely due to white matter disconnection from other cortical areas. We present a combined imaging acquisition and visual stimulus protocol, together with a description of the analysis methodology, and apply it to datasets from four stroke survivors with homonymous field loss (two with hemianopia, two with quadrantanopia). For researchers trying to understand recovery of vision after stroke and clinicians seeking to stratify patients into different treatment pathways, this approach combines multiple, convergent sources of data to characterize the extent of the stroke damage. We show that such an approach gives a more comprehensive measure of residual visual capacity-in two particular respects: which locations in the visual field should be targeted and what kind of visual attributes are most suited for rehabilitation.
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Affiliation(s)
| | | | | | - Denis Schluppeck
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
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5
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Saionz EL, Busza A, Huxlin KR. Rehabilitation of visual perception in cortical blindness. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:357-373. [PMID: 35034749 PMCID: PMC9682408 DOI: 10.1016/b978-0-12-819410-2.00030-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Blindness is a common sequela after stroke affecting the primary visual cortex, presenting as a contralesional, homonymous, visual field cut. This can occur unilaterally or, less commonly, bilaterally. While it has been widely assumed that after a brief period of spontaneous improvement, vision loss becomes stable and permanent, accumulating data show that visual training can recover some of the vision loss, even long after the stroke. Here, we review the different approaches to rehabilitation employed in adult-onset cortical blindness (CB), focusing on visual restoration methods. Most of this work was conducted in chronic stroke patients, partially restoring visual discrimination and luminance detection. However, to achieve this, patients had to train for extended periods (usually many months), and the vision restored was not entirely normal. Several adjuvants to training such as noninvasive, transcranial brain stimulation, and pharmacology are starting to be investigated for their potential to increase the efficacy of training in CB patients. However, these approaches are still exploratory and require considerably more research before being adopted. Nonetheless, having established that the adult visual system retains the capacity for restorative plasticity, attention recently turned toward the subacute poststroke period. Drawing inspiration from sensorimotor stroke rehabilitation, visual training was recently attempted for the first time in subacute poststroke patients. It improved vision faster, over larger portions of the blind field, and for a larger number of visual discrimination abilities than identical training initiated more than 6 months poststroke (i.e., in the chronic period). In conclusion, evidence now suggests that visual neuroplasticity after occipital stroke can be reliably recruited by a range of visual training approaches. In addition, it appears that poststroke visual plasticity is dynamic, with a critical window of opportunity in the early postdamage period to attain more rapid, more extensive recovery of a larger set of visual perceptual abilities.
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Affiliation(s)
- Elizabeth L Saionz
- Medical Scientist Training Program, University of Rochester, Rochester, NY, United States
| | - Ania Busza
- Department of Neurology, University of Rochester, Rochester, NY, United States
| | - Krystel R Huxlin
- Flaum Eye Institute, University of Rochester, Rochester, NY, United States.
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6
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Liu S, Hou B, You H, Zhang Y, Zhu Y, Ma C, Zuo Z, Feng F. The Association Between Perivascular Spaces and Cerebral Blood Flow, Brain Volume, and Cardiovascular Risk. Front Aging Neurosci 2021; 13:599724. [PMID: 34531732 PMCID: PMC8438293 DOI: 10.3389/fnagi.2021.599724] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Basal ganglia perivascular spaces are associated with cognitive decline and cardiovascular risk factors. There is a lack of studies on the cardiovascular risk burden of basal ganglia perivascular spaces (BG-PVS) and their relationship with gray matter volume (GMV) and GM cerebral blood flow (CBF) in the aging brain. Here, we investigated these two issues in a large sample of cognitively intact older adults. Methods: A total of 734 volunteers were recruited. MRI was performed with 3.0 T using a pseudo-continuous arterial spin labeling (pCASL) sequence and a sagittal isotropic T1-weighted sequence for CBF and GMV analysis. The images obtained from 406 participants were analyzed to investigate the relationship between the severity of BG-PVS and GMV/CBF. False discovery rate-corrected P-values (PFDR) of <0.05 were considered significant. The images obtained from 254 participants were used to study the relationship between the severity of BG-PVS and cardiovascular risk burden. BG-PVS were rated using a 5-grade score. The severity of BG-PVS was classified as mild (grade <3) and severe (grade ≥3). Cardiovascular risk burden was assessed with the Framingham General Cardiovascular Risk Score (FGCRS). Results: Severe basal ganglia perivascular spaces were associated with significantly smaller GMV and CBF in multiple cortical regions (PFDR <0.05), and were associated with significantly larger volume in the bilateral caudate nucleus, pallidum, and putamen (PFDR <0.05). The participants with severe BG-PVS were more likely to have a higher cardiovascular risk burden than the participants with mild BG-PVS (60.71% vs. 42.93%; P =0.02). Conclusion: In cognitively intact older adults, severe BG-PVS are associated with smaller cortical GMV and CBF, larger subcortical GMV, and higher cardiovascular risk burden.
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Affiliation(s)
- Sirui Liu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Hou
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui You
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiwei Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yicheng Zhu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chao Ma
- Department of Human Anatomy, Histology and Embryology, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Zhentao Zuo
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,Sino-Danish College, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Beijing, China
| | - Feng Feng
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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7
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Clinical and radiological profile of posterior cortical atrophy and comparison with a group of typical Alzheimer disease and amnestic mild cognitive impairment. Acta Neurol Belg 2021; 121:1009-1018. [PMID: 33230741 DOI: 10.1007/s13760-020-01547-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/08/2020] [Indexed: 12/21/2022]
Abstract
Posterior cortical atrophy (PCA) is a rare dementia affecting higher visual processing and other posterior cortical functions with atrophy and hypometabolism in occipito-parieto-temporal areas, more on right side. The objective of the study was to explore the clinical, neuropsychological, and radiological features of PCA patients and to compare them with typical multi-domain amnestic Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) patients. Four out of 9 patients of PCA fulfilling the criteria of Tang-Wai et al. (2004), 10 patients each of AD and aMCI fulfilling NIA-AA criteria were chosen. Patients were assessed clinically by experienced neurologists. Neuropsychological assessment was performed with standardized validated tests. Each patient underwent an MRI. FDG-PET was done for all PCA and six AD patients. PCA patients were younger, cognitively more impaired with rapid progression showing predominant visuospatial deficits consistent with the damage to the upstream of visual processing. AD patients presented predominantly with amnestic symptoms, with visuospatial dysfunction in some and aMCI had mild memory loss. Marked atrophy and hypometabolism in occipital, parietal and temporal areas in PCA, atrophy and hypometabolism in medial temporal areas in AD and minimal non-localized atrophy in MRI in aMCI were seen. Two PCA patients showed hypometabolism extending to the medial temporal and one to the frontal cortex. The clinical and imaging features of PCA are consistent with the damage predominantly to the upstream of visual processing. The difference between PCA and typical AD suggests involvement of AD pathology at different sites within a common disease-relevant network of brain regions.
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8
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Mendez MF, Khattab YI, Yerstein O. Impaired visual search in posterior cortical atrophy vs. typical Alzheimer's disease. J Neurol Sci 2021; 428:117574. [PMID: 34271285 DOI: 10.1016/j.jns.2021.117574] [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: 06/11/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Posterior cortical atrophy (PCA) is a neurocognitive disorder characterized by difficulty localizing in space. Recognizing PCA is important because it is usually missed early in its course and may result from a number of neurological disorders other than Alzheimer's disease (AD). OBJECTIVE This study aimed to clarify whether impaired visual search tasks of spatial localization distinguished patients with PCA from those with other more typical dementias as well as from healthy control (HC) subjects. METHODS Twelve patients meeting neuroimaging-supported Consensus Criteria for PCA, 12 comparably advanced patients with amnestic-predominant typical AD (tAD), and 24 HC participants were compared on tests of untimed and timed visual search, spatial neglect, mental rotation, environmental orientation, visuospatial construction, and face recognition. RESULTS Only abnormalities in untimed and timed visual search and environmental orientation distinguished the PCA patients from both the tAD group and the HC group without also distinguishing the tAD patients from HC's. The PCA patients also had a tendency to greater difficulty scanning left hemispace compared to HC's. Visuospatial constructions, although worse in PCA, and face recognition were impaired in both dementia groups. CONCLUSIONS These findings support the concept of PCA as a disorder of spatial processing and localization, indicating that visual search tasks are particularly sensitive and specific for detecting PCA and distinguishing it from more typical dementia syndromes.
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Affiliation(s)
- Mario F Mendez
- Departments of Neurology, David Geffen School of Medicine, University of California Los Angeles (UCLA), USA; Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), USA; Neurology Service, Neurobehavior Unit, V.A. Greater Los Angeles Healthcare System, USA.
| | - Youssef I Khattab
- Departments of Neurology, David Geffen School of Medicine, University of California Los Angeles (UCLA), USA
| | - Oleg Yerstein
- Department of Neurology, Lahey Hospital and Medical Center, USA.
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Overman MJ, Zamboni G, Butler C, Ahmed S. Splenial white matter integrity is associated with memory impairments in posterior cortical atrophy. Brain Commun 2021; 3:fcab060. [PMID: 34007964 PMCID: PMC8112963 DOI: 10.1093/braincomms/fcab060] [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: 09/29/2020] [Revised: 12/09/2020] [Accepted: 02/23/2021] [Indexed: 11/22/2022] Open
Abstract
Posterior cortical atrophy is an atypical form of Alzheimer’s disease characterized by visuospatial impairments and predominant tissue loss in the posterior parieto-occipital and temporo-occipital cortex. Whilst episodic memory is traditionally thought to be relatively preserved in posterior cortical atrophy, recent work indicates that memory impairments form a common clinical symptom in the early stages of the disease. Neuroimaging studies suggest that memory dysfunction in posterior cortical atrophy may originate from atrophy and functional hypoconnectivity of parietal cortex. The structural connectivity patterns underpinning these memory impairments, however, have not been investigated. This line of inquiry is of particular interest, as changes in white matter tracts of posterior cortical atrophy patients have been shown to be more extensive than expected based on posterior atrophy of grey matter. In this cross-sectional diffusion tensor imaging MRI study, we examine the relationship between white matter microstructure and verbal episodic memory in posterior cortical atrophy. We assessed episodic memory performance in a group of posterior cortical atrophy patients (n = 14) and a group of matched healthy control participants (n = 19) using the Free and Cued Selective Reminding Test with Immediate Recall. Diffusion tensor imaging measures were obtained for 13 of the posterior cortical atrophy patients and a second control group of 18 healthy adults. Patients and healthy controls demonstrated similar memory encoding performance, indicating that learning of verbal information was preserved in posterior cortical atrophy. However, retrieval of verbal items was significantly impaired in the patient group compared with control participants. As expected, tract-based spatial statistics analyses showed widespread reductions of white matter integrity in posterior cortical regions of patients compared with healthy adults. Correlation analyses indicated that poor verbal retrieval in the patient group was specifically associated with microstructural damage of the splenium of the corpus callosum. Post-hoc tractography analyses in healthy controls demonstrated that this splenial region was connected to thalamic radiations and the retrolenticular part of the internal capsule. These results provide insight into the brain circuits that underlie memory impairments in posterior cortical atrophy. From a cognitive perspective, we propose that the association between splenial integrity and memory dysfunction could arise indirectly via disruption of attentional processes. We discuss implications for the clinical phenotype and development of therapeutic aids for cognitive impairment in posterior cortical atrophy.
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Affiliation(s)
- Margot Juliëtte Overman
- Research Institute for the Care of Older People (RICE), Bath BA1 3NG, UK.,MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
| | - Giovanna Zamboni
- Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena, Italy.,Center for Neuroscience and Neurotechnology, Università di Modena e Reggio Emilia, Modena, Italy.,Nuffield Department of Clinical Neuroscience, University of Oxford, Oxfordshire OX3 9DU, UK
| | - Christopher Butler
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxfordshire OX3 9DU, UK.,Department of Brain Sciences, Imperial College London, London SW7 2AZ, UK.,Departamento de Neurología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Samrah Ahmed
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxfordshire OX3 9DU, UK.,School of Psychology and Clinical Language Sciences, University of Reading, Reading RG6 6ES, UK
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10
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Pini L, Geroldi C, Galluzzi S, Baruzzi R, Bertocchi M, Chitò E, Orini S, Romano M, Cotelli M, Rosini S, Magnaldi S, Morassi M, Cobelli M, Bonvicini C, Archetti S, Zanetti O, Frisoni GB, Pievani M. Age at onset reveals different functional connectivity abnormalities in prodromal Alzheimer's disease. Brain Imaging Behav 2021; 14:2594-2605. [PMID: 31903525 DOI: 10.1007/s11682-019-00212-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Age at symptom onset (AAO) underlies different Alzheimer's disease (AD) clinical variants: late-onset AD (LOAD) is characterized by memory deficits, while early-onset AD (EOAD) presents predominantly with non-memory symptoms. The involvement of different neural networks may explain these distinct clinical phenotypes. In this study, we tested the hypothesis of an early and selective involvement of neural networks based on AAO in AD. Twenty memory clinic patients with prodromal AD (i.e., mild cognitive impairment with an AD-like cerebrospinal fluid profile) and 30 healthy controls underwent a cognitive evaluation and a resting state functional MRI exam. Independent component analysis was performed to assess functional connectivity (FC) in the following networks: default mode, frontoparietal, limbic, visual, and sensorimotor. Patients were stratified into late-onset (pLOAD) and early-onset (pEOAD) prodromal AD according to the AAO and controls were stratified into younger and older groups accordingly. Decreased FC within the default mode and the limbic networks was observed in pLOAD, while pEOAD showed lower FC in the frontoparietal and visual networks. The sensorimotor network did not show differences between groups. A significant association was found between memory and limbic network FC in pLOAD, and between executive functions and frontoparietal network FC in pEOAD, although the latter association did not survive multiple comparison correction. Our findings indicate that aberrant connectivity in memory networks is associated with pLOAD, while networks underlying executive and visuo-spatial functions are affected in pEOAD. These findings are in line with the hypothesis that the pathophysiological mechanisms underlying EOAD and LOAD are distinct.
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Affiliation(s)
- Lorenzo Pini
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, 25125, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Cristina Geroldi
- Alzheimer's Unit - Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Samantha Galluzzi
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, 25125, Brescia, Italy
| | - Roberta Baruzzi
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, 25125, Brescia, Italy
| | - Monica Bertocchi
- Alzheimer's Unit - Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Eugenia Chitò
- Alzheimer's Unit - Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Stefania Orini
- Alzheimer's Unit - Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Melissa Romano
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, 25125, Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Sandra Rosini
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Silvia Magnaldi
- Radiology, Department of Health Services, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Mauro Morassi
- Department of Radiology, Fondazione Poliambulanza, Brescia, Italy
| | - Milena Cobelli
- Department of Radiology, Fondazione Poliambulanza, Brescia, Italy
| | - Cristian Bonvicini
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Silvana Archetti
- Department of Laboratory Diagnostic, Biotechnology Laboratory, ASST Spedali Civili Brescia, Brescia, Italy
| | - Orazio Zanetti
- Alzheimer's Unit - Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giovanni B Frisoni
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, 25125, Brescia, Italy.,Memory Clinic and LANVIE Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Michela Pievani
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, 25125, Brescia, Italy.
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11
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Yerstein O, Parand L, Liang LJ, Isaac A, Mendez MF. Benson's Disease or Posterior Cortical Atrophy, Revisited. J Alzheimers Dis 2021; 82:493-502. [PMID: 34057092 PMCID: PMC8316293 DOI: 10.3233/jad-210368] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND D. Frank Benson and colleagues first described the clinical and neuropathological features of posterior cortical atrophy (PCA) from patients in the UCLA Neurobehavior Program. OBJECTIVE We reviewed the Program's subsequent clinical experience with PCA, and its potential for clarifying this relatively rare syndrome in comparison to the accumulated literature on PCA. METHODS Using the original criteria derived from this clinic, 65 patients with neuroimaging-supported PCA were diagnosed between 1995 and 2020. RESULTS On presentation, most had visual localization complaints and related visuospatial symptoms, but nearly half had memory complaints followed by symptoms of depression. Neurobehavioral testing showed predominant difficulty with visuospatial constructions, Gerstmann's syndrome, and Balint's syndrome, but also impaired memory and naming. On retrospective application of the current Consensus Criteria for PCA, 59 (91%) met PCA criteria with a modification allowing for "significantly greater visuospatial over memory and naming deficits." There were 37 deaths (56.9%) with the median overall survival of 10.3 years (95% CI: 9.6-13.6 years), consistent with a slow neurodegenerative disorder in most patients. CONCLUSION Together, these findings recommend modifying the PCA criteria for "relatively spared" memory, language, and behavior to include secondary memory and naming difficulty and depression, with increased emphasis on the presence of Gerstmann's and Balint's syndromes.
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Affiliation(s)
- Oleg Yerstein
- Department of Neurology, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Leila Parand
- Department of Neurology, Behavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
- Neurology Service, Neurobehavior Unit, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Li-Jung Liang
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Adrienne Isaac
- Department of Linguistics, Georgetown University, Washington, DC, USA
| | - Mario F. Mendez
- Department of Neurology, Behavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
- Neurology Service, Neurobehavior Unit, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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12
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de Best PB, Abulafia R, McKyton A, Levin N. Convergence Along the Visual Hierarchy Is Altered in Posterior Cortical Atrophy. Invest Ophthalmol Vis Sci 2020; 61:8. [PMID: 32897377 PMCID: PMC7488212 DOI: 10.1167/iovs.61.11.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 08/17/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose Posterior cortical atrophy (PCA) is a rare neurodegenerative syndrome manifesting with visuospatial processing impairment. We recently suggested that abnormal population receptive field properties are associated with the symptoms of PCA patients. Specifically, simultanagnosia, the inability to perceive multiple items simultaneously, can be explained by smaller peripheral population receptive fields, and foveal crowding, in which nearby distractors interfere with object perception, may result from larger foveal population receptive fields. These effects occurred predominantly in V1, even though atrophy mainly involves high-order areas. In this study, we used connective field modeling to better understand these inter-area interactions. Methods We used functional magnetic resonance imaging to scan six PCA patients and eight controls while they viewed drifting bar stimuli. Resting-state data were also collected. Connective field modeling was applied for both conditions: once when the source was V1 and the targets were extrastriate areas and once for the opposite direction. The difference between the two was defined as convergence magnitude. Results With stimulus, the convergence magnitude of the controls increased along the visual pathway, suggesting that spatial integration from V1 becomes larger up the visual hierarchy. No such slope was found in the PCA patients. The difference between the groups originated mainly from the dorsal pathway. Without stimulus, the convergence magnitude was negative, slightly more so for the PCA patients, with no slope, suggesting constant divergence along the visual hierarchy. Conclusions Atrophy in one part of the visual system can affect other areas within the network through complex intervisual area interactions, resulting in modulation of population receptive field properties and an ensemble of visuocognitive function impairments.
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Affiliation(s)
- Pieter B. de Best
- fMRI Unit, Neurology Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ruth Abulafia
- fMRI Unit, Neurology Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ayelet McKyton
- fMRI Unit, Neurology Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Netta Levin
- fMRI Unit, Neurology Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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13
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Glick-Shames H, Keadan T, Backner Y, Bick A, Levin N. Global Brain Involvement in Posterior Cortical Atrophy: Multimodal MR Imaging Investigation. Brain Topogr 2020; 33:600-612. [PMID: 32761400 DOI: 10.1007/s10548-020-00788-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 07/23/2020] [Indexed: 02/04/2023]
Abstract
Posterior cortical atrophy (PCA), considered a visual variant of Alzheimer's disease, has similar pathological characteristics yet shows a selective visual manifestation with relative preservation of other cortical areas, at least at early stages of disease. Using a gamut of imaging methods, we aim to evaluate the global aspect of this relatively local disease and describe the interplay of the involvement of the different brain components. Ten PCA patients and 14 age-matched controls underwent MRI scans. Cortical thickness was examined to identify areas of cortical thinning. Hippocampal volume was assessed using voxel-based morphometry. The integrity of 20 fiber tracts was assessed by Diffusion Tensor Imaging. Regions of difference in global functional connectivity were identified by resting-state fMRI, using multi-variant pattern analysis. Correlations were examined to evaluate the connection between grey matter atrophy, the network changes and the disease load. The patients presented bilateral cortical thinning, primarily in their brains' posterior segments. Impaired segments of white matter integrity were evident only within three fiber tracts in the left hemisphere. Four areas were identified as different in their global connectivity pattern. The visual network-related areas showed reduced connectivity and was correlated to atrophy. Right Broadman area 39 showed in addition increased connectivity to the frontal areas. Global structural and functional imaging pointed to the highly localized nature of PCA. Functional connectivity followed grey matter atrophy in visual regions. White matter involvement seemed less prominent, however damage is directly related to presence of disease and not mediated only by grey matter damage.
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Affiliation(s)
- Haya Glick-Shames
- fMRI Lab, Neurology Department, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, 91120, Israel
| | - Tarek Keadan
- fMRI Lab, Neurology Department, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, 91120, Israel
| | - Yael Backner
- fMRI Lab, Neurology Department, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, 91120, Israel
| | - Atira Bick
- fMRI Lab, Neurology Department, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, 91120, Israel
| | - Netta Levin
- fMRI Lab, Neurology Department, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, 91120, Israel.
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14
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Olds JJ, Hills WL, Warner J, Falardeau J, Alasantro LH, Moster ML, Egan RA, Cornblath WT, Lee AG, Frishberg BM, Turbin RE, Katz DM, Charley JA, Pelak VS. Posterior Cortical Atrophy: Characteristics From a Clinical Data Registry. Front Neurol 2020; 11:358. [PMID: 32581988 PMCID: PMC7297208 DOI: 10.3389/fneur.2020.00358] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/14/2020] [Indexed: 12/02/2022] Open
Abstract
Background: Posterior cortical atrophy (PCA) is a neurodegenerative syndrome that presents with higher-order visual dysfunction with relative sparing of memory and other cognitive domains, and it is most commonly associated with Alzheimer's disease pathology. There is a lack of data regarding the presentation of PCA to non-cognitive specialists. Therefore, we collected clinical data from neuro-ophthalmologists regarding the presentation of PCA to their practices and compared data to published cohorts and a published survey of cognitive specialists. Methods: Members of the North American Neuro-Ophthalmology Society Listserv (NANOSnet) were invited to complete an online, retrospective, chart-review data-entry survey regarding their patients with PCA, and REDCap was used for data collection. Results: Data for 38 patients were entered by 12 neuro-ophthalmologists. Patient mean age at presentation was 67.8 years, and 74% of patients were women. Difficulty reading was reported at presentation by 91% of patients, and poor performance on color vision, stereopsis, and visual field testing (performed reliably by 36/38 patients) were common findings. Most patients who were treated were treated with donepezil and/or memantine. Conclusions: Compared to published data from cognitive specialists, patients presenting to neuro-ophthalmology with PCA were more likely to be older and female and have a reading complaint. Reliable visual field testing was the norm with homonymous defects in the majority of patients. The neuro-ophthalmologist plays an important role in diagnosing PCA in older adults with unexplained visual signs and symptoms, and future studies of PCA should involve multiple specialists in order to advance our understanding of PCA and develop effective treatments.
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Affiliation(s)
- Jennifer J Olds
- Department of Ophthalmology, Keesler Air Force Base, Biloxi, MS, United States
| | - William L Hills
- Department of Neurology & Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, United States
| | - Judith Warner
- Department of Ophthalmology & Neurology, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, United States
| | - Julie Falardeau
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, United States
| | - Lori Haase Alasantro
- Department of Neuroscience, The Neurology Center of Southern California, University of California San Diego School of Medicine, Carlsbad, CA, United States
| | - Mark L Moster
- Department of Neurology and Ophthalmology, Wills Eye Hospital and Thomas Jefferson University, Philadelphia, PA, United States
| | - Robert A Egan
- Eye & Vascular Neurology, LLC, Carlton, OR, United States
| | - Wayne T Cornblath
- Department of Ophthalmology, Visual Sciences & Neurology, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI, United States
| | - Andrew G Lee
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, United States
| | - Benjamin M Frishberg
- Department of Neuroscience, The Neurology Center of Southern California, University of California San Diego School of Medicine, Carlsbad, CA, United States
| | - Roger E Turbin
- Division of Neuro-ophthalmology and Orbital Surgery, Rutgers New Jersey Medical School, Institute of Ophthalmology and Visual Sciences, Newark, NJ, United States
| | - David M Katz
- Bethesda Neurology, LLC, Department of Ophthalmology & Neurology, Howard University Hospital, Georgetown University Hospital, Washington, DC, United States
| | - John A Charley
- Retired Private Practice Ophthalmologist, Pittsburgh, PA, United States
| | - Victoria S Pelak
- Department of Neurology & Ophthalmology, UCHealth Sue Anschutz-Rodgers Eye Center and the Neurosciences Center, University of Colorado School of Medicine, Aurora, CO, United States
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15
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Loganovsky KN, Marazziti D, Fedirko PA, Kuts KV, Antypchuk KY, Perchuk IV, Babenko TF, Loganovska TK, Kolosynska OO, Kreinis GY, Gresko MV, Masiuk SV, Mucci F, Zdorenko LL, Della Vecchia A, Zdanevich NA, Garkava NA, Dorichevska RY, Vasilenko ZL, Kravchenko VI, Drosdova NV. Radiation-Induced Cerebro-Ophthalmic Effects in Humans. Life (Basel) 2020; 10:E41. [PMID: 32316206 PMCID: PMC7235763 DOI: 10.3390/life10040041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/08/2020] [Accepted: 04/12/2020] [Indexed: 12/15/2022] Open
Abstract
Exposure to ionizing radiation (IR) could affect the human brain and eyes leading to both cognitive and visual impairments. The aim of this paper was to review and analyze the current literature, and to comment on the ensuing findings in the light of our personal contributions in this field. The review was carried out according to the PRISMA guidelines by searching PubMed, Scopus, Embase, PsycINFO and Google Scholar English papers published from January 2000 to January 2020. The results showed that prenatally or childhood-exposed individuals are a particular target group with a higher risk for possible radiation effects and neurodegenerative diseases. In adulthood and medical/interventional radiologists, the most frequent IR-induced ophthalmic effects include cataracts, glaucoma, optic neuropathy, retinopathy and angiopathy, sometimes associated with specific neurocognitive deficits. According to available information that eye alterations may induce or may be associated with brain dysfunctions and vice versa, we propose to label this relationship "eye-brain axis", as well as to deepen the diagnosis of eye pathologies as early and easily obtainable markers of possible low dose IR-induced brain damage.
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Affiliation(s)
- Konstantin N. Loganovsky
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Donatella Marazziti
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry, University of Pisa, Via Roma, 67, I 56100 Pisa, Italy; (F.M.); (A.D.V.)
| | - Pavlo A. Fedirko
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Kostiantyn V. Kuts
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Katerina Y. Antypchuk
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Iryna V. Perchuk
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Tetyana F. Babenko
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Tetyana K. Loganovska
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Olena O. Kolosynska
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - George Y. Kreinis
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Marina V. Gresko
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Sergii V. Masiuk
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Federico Mucci
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry, University of Pisa, Via Roma, 67, I 56100 Pisa, Italy; (F.M.); (A.D.V.)
- Dipartimento di Biochimica Biologia Molecolare, University of Siena, 53100 Siena, Italy
| | - Leonid L. Zdorenko
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Alessandra Della Vecchia
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry, University of Pisa, Via Roma, 67, I 56100 Pisa, Italy; (F.M.); (A.D.V.)
| | - Natalia A. Zdanevich
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Natalia A. Garkava
- Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine, 9 Vernadsky Street, 49044 Dnipro, Ukraine;
| | - Raisa Y. Dorichevska
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Zlata L. Vasilenko
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Victor I. Kravchenko
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
| | - Nataliya V. Drosdova
- National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine, 53 Illyenko Street, 04050 Kyiv, Ukraine; (K.N.L.); (P.A.F.); (K.V.K.); (K.Y.A.); (I.V.P.); (T.F.B.); (T.K.L.); (O.O.K.); (G.Y.K.); (M.V.G.); (S.V.M.); (L.L.Z.); (N.A.Z.); (R.Y.D.); (Z.L.V.); (V.I.K.); (N.V.D.)
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16
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Li S, Lv P, He M, Zhang W, Liu J, Gong Y, Wang T, Gong Q, Ji Y, Lui S. Cerebral regional and network characteristics in asthma patients: a resting-state fMRI study. Front Med 2020; 14:792-801. [PMID: 32270434 DOI: 10.1007/s11684-020-0745-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/18/2019] [Indexed: 02/08/2023]
Abstract
Asthma is a serious health problem that involves not only the respiratory system but also the central nervous system. Previous studies identified either regional or network alterations in patients with asthma, but inconsistent results were obtained. A key question remains unclear: are the regional and neural network deficits related or are they two independent characteristics in asthma? Answering this question is the aim of this study. By collecting resting-state functional magnetic resonance imaging from 39 patients with asthma and 40 matched health controls, brain functional measures including regional activity (amplitude of low-frequency fluctuations) and neural network function (degree centrality (DC) and functional connectivity) were calculated to systematically characterize the functional alterations. Patients exhibited regional abnormities in the left angular gyrus, right precuneus, and inferior temporal gyrus within the default mode network. Network abnormalities involved both the sensorimotor network and visual network with key regions including the superior frontal gyrus and occipital lobes. Altered DC in the lingual gyrus was correlated with the degree of airway obstruction. This study elucidated different patterns of regional and network changes, thereby suggesting that the two parameters reflect different brain characteristics of asthma. These findings provide evidence for further understanding the potential cerebral alterations in the pathophysiology of asthma.
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Affiliation(s)
- Siyi Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Peilin Lv
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Min He
- Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wenjing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Jieke Liu
- Department of Radiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Yao Gong
- Department of Geriatric Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, 610036, China
| | - Ting Wang
- Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yulin Ji
- Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China.
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17
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Abstract
PURPOSE OF REVIEW This article presents an overview of the clinical syndrome of posterior cortical atrophy (PCA), including its pathologic underpinnings, clinical presentation, investigation findings, diagnostic criteria, and management. RECENT FINDINGS PCA is usually an atypical form of Alzheimer disease with relatively young age at onset. New diagnostic criteria allow patients to be diagnosed on a syndromic basis as having a primary visual (pure) form or more complex (plus) form of PCA and, when possible, on a disease-specific basis using biomarkers or underlying pathology. Imaging techniques have demonstrated that some pathologic processes are concordant (atrophy, hypometabolism, tau deposition) with clinical symptoms and some are discordant (widespread amyloid deposition). International efforts are under way to establish the genetic underpinnings of this typically sporadic form of Alzheimer disease. In the absence of specific disease-modifying therapies, a number of practical suggestions can be offered to patients and their families to facilitate reading and activities of daily living, promote independence, and improve quality of life SUMMARY: While rare, PCA is an important diagnostic entity for neurologists, ophthalmologists, and optometrists to recognize to allow for early accurate diagnosis and appropriate patient management. PCA provides an important opportunity to investigate the causes of selective vulnerability in Alzheimer disease.
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18
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Loganovsky KN, Fedirko PA, Kuts KV, Marazziti D, Antypchuk KY, Perchuk IV, Babenko TF, Loganovska TK, Kolosynska OO, Kreinis GY, Gresko MV, Masiuk SV, Zdorenko LL, Zdanevich NA, Garkava NA, Dorichevska RY, Vasilenko ZL, Kravchenko VI, Drosdova NV, Yefimova YV. BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT. Part І. THE CONSEQUENCES OF IRRADIATION OF THE PARTICIPANTS OF THE LIQUIDATION OF THE CHORNOBYL ACCIDENT. PROBLEMY RADIAT︠S︡IĬNOÏ MEDYT︠S︡YNY TA RADIOBIOLOHIÏ 2020; 25:90-129. [PMID: 33361831 DOI: 10.33145/2304-8336-2020-25-90-129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Exposure to ionizing radiation could affect the brain and eyes leading to cognitive and vision impairment, behavior disorders and performance decrement during professional irradiation at medical radiology, includinginterventional radiological procedures, long-term space flights, and radiation accidents. OBJECTIVE The objective was to analyze the current experimental, epidemiological, and clinical data on the radiation cerebro-ophthalmic effects. MATERIALS AND METHODS In our analytical review peer-reviewed publications via the bibliographic and scientometric bases PubMed / MEDLINE, Scopus, Web of Science, and selected papers from the library catalog of NRCRM - theleading institution in the field of studying the medical effects of ionizing radiation - were used. RESULTS The probable radiation-induced cerebro-ophthalmic effects in human adults comprise radiation cataracts,radiation glaucoma, radiation-induced optic neuropathy, retinopathies, angiopathies as well as specific neurocognitive deficit in the various neuropsychiatric pathology including cerebrovascular pathology and neurodegenerativediseases. Specific attention is paid to the likely stochastic nature of many of those effects. Those prenatally and inchildhood exposed are a particular target group with a higher risk for possible radiation effects and neurodegenerative diseases. CONCLUSIONS The experimental, clinical, epidemiological, anatomical and pathophysiological rationale for visualsystem and central nervous system (CNS) radiosensitivity is given. The necessity for further international studieswith adequate dosimetric support and the follow-up medical and biophysical monitoring of high radiation riskcohorts is justified. The first part of the study currently being published presents the results of the study of theeffects of irradiation in the participants of emergency works at the Chornobyl Nuclear Power Plant (ChNPP).
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Affiliation(s)
- K N Loganovsky
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - P A Fedirko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - K V Kuts
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - D Marazziti
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry, University of Pisa, Via Roma, 67, I 56100, Pisa, Italy
| | - K Yu Antypchuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - I V Perchuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - T F Babenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - T K Loganovska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - O O Kolosynska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - G Yu Kreinis
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - M V Gresko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - S V Masiuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - L L Zdorenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - N A Zdanevich
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - N A Garkava
- State Institution «Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine», 9 Vernadsky Street, Dnipro, 49044, Ukraine
| | - R Yu Dorichevska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - Z L Vasilenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - V I Kravchenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - N V Drosdova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
| | - Yu V Yefimova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Illyenko Street, Kyiv, 04050, Ukraine
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19
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Li Z, Li C, Liang Y, Wang K, Zhang W, Chen R, Wu Q, Zhang X. Altered Functional Connectivity and Brain Network Property in Pregnant Women With Cleft Fetuses. Front Psychol 2019; 10:2235. [PMID: 31649585 PMCID: PMC6795235 DOI: 10.3389/fpsyg.2019.02235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 09/17/2019] [Indexed: 12/31/2022] Open
Abstract
Non-syndromic clefts of the lip and/or palate (NSCLP) is the most common congenital anomaly in the craniofacial region. NSCLP is a highly gene-associated malformation. We speculate that pregnant women with NSCLP fetuses (pregnancies with NSCLP) may have specific brain changes during pregnancy. To explore characteristic brain function changes of pregnancies with NSCLP, we analyzed resting-state fMRI (rs-fMRI) data of 42 pregnant women (21 pregnancies with NSCLP and 21 pregnancies with normal fetuses) to compare intergroup differences of (fractional) amplitude of low frequency fluctuations (fALFF/ALFF), regional homogeneity (Reho), functional connectivity (FC) and network topological properties. Compared with the control group, increased ALFF in the left hippocampus, the right fusiform and the left anterior cingulate (ACG), increased Reho in left middle occipital gyrus (MOG) and right medial frontal gyrus (MFG) were found for pregnancies with NSCLP. Meanwhile, FC between the left supramarginal gyrus (SMG) and bilateral olfactory cortex (OLF), FC between left precentral gyrus (PreCG) and right MFG, FC between right inferior frontal gyrus (IFG) and left inferior temporal gyrus (ITG) were enhanced in pregnancies with NSCLP. Besides, FC between left PreCG and left amygdala, bilateral para-hippocampal gyrus, FC between left amygdala and left MFG, right IFG were decreased. Graph theory-based analysis explored increased degree centrality (DC), betweenness centrality (BC) and nodal efficiency (Ne) in the left ITG and left SMG for pregnancies with NSCLP. Pregnancies with NSCLP has widespread decreased FC within neural networks of speech and language, which indicated that they were more likely to be associated with defects in speech and language skills. At the same time, increased topological indices showed that speech and language related regions played dominant role in their brain networks. These findings may provide clues for early detection of NSCLP fetuses.
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Affiliation(s)
- Zhen Li
- School of Biomedical Engineering, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Chunlin Li
- School of Biomedical Engineering, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Yuting Liang
- Department of Radiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Keyang Wang
- Department of Radiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Wenjing Zhang
- Department of Oral and Maxillofacial Plastic and Trauma Surgery, Center of Cleft Lip and Palate Treatment, Beijing Stomatological Hospital, Beijing, China
| | - Renji Chen
- Department of Oral and Maxillofacial Plastic and Trauma Surgery, Center of Cleft Lip and Palate Treatment, Beijing Stomatological Hospital, Beijing, China
| | - Qingqing Wu
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Xu Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
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20
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Alvarez I, Parker AJ, Bridge H. Normative cerebral cortical thickness for human visual areas. Neuroimage 2019; 201:116057. [PMID: 31352123 PMCID: PMC6892250 DOI: 10.1016/j.neuroimage.2019.116057] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/20/2019] [Accepted: 07/24/2019] [Indexed: 12/31/2022] Open
Abstract
Studies of changes in cerebral neocortical thickness often rely on small control samples for comparison with specific populations with abnormal visual systems. We present a normative dataset for FreeSurfer-derived cortical thickness across 25 human visual areas derived from 960 participants in the Human Connectome Project. Cortical thickness varies systematically across visual areas, in broad agreement with canonical visual system hierarchies in the dorsal and ventral pathways. In addition, cortical thickness estimates show consistent within-subject variability and reliability. Importantly, cortical thickness estimates in visual areas are well described by a normal distribution, making them amenable to direct statistical comparison. Normative neocortical thickness values for human visual areas measured with FreeSurfer. A gradient of increasing neocortical thickness with visual area hierarchy. Consistent within- and between-subject variability in neocortical thickness across visual areas.
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Affiliation(s)
- Ivan Alvarez
- Oxford Centre for Functional MRI of the Brain (FMRIB), Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
| | - Andrew J Parker
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Holly Bridge
- Oxford Centre for Functional MRI of the Brain (FMRIB), Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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21
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Chen Y, Liu P, Wang Y, Peng G. Neural Mechanisms of Visual Dysfunction in Posterior Cortical Atrophy. Front Neurol 2019; 10:670. [PMID: 31293507 PMCID: PMC6603128 DOI: 10.3389/fneur.2019.00670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 06/07/2019] [Indexed: 11/13/2022] Open
Abstract
Posterior cortical atrophy (PCA) is characterized predominantly by visual dysfunction that arises from bilateral impairments in occipital, parietal, and temporal regions of the brain. PCA is clinically identified based primarily on visual symptoms and neuroimaging findings. Region-specific gray and white matter deficits have been discussed in detail, and are associated with clinical manifestations that present with similar patterns of perfusion and metabolic findings. Here, we discuss both structural and functional changes in the ventral and dorsal visual streams along with their underlying relationships. We also discuss the most recent developments in neuroimaging characteristics and summarize correlations between distinct neuroimaging presentations.
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Affiliation(s)
- Yi Chen
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ping Liu
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yunyun Wang
- Department of Neurology, Shengzhou People's Hospital, Shengzhou, China
| | - Guoping Peng
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Guoping Peng
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22
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Foster Z, Kini A, Al Othman B, Lee AG, Vaphiades M. Seeing is not believing. Surv Ophthalmol 2019; 65:386-390. [PMID: 30953621 DOI: 10.1016/j.survophthal.2019.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 03/29/2019] [Indexed: 01/01/2023]
Abstract
An 84-year-old woman with a history of dry age-related macular degeneration presented with an acute inability to read, but intact writing ability (pure alexia or alexia without agraphia). She denied any difficulty speaking, paresthesias, or hemiparesis. Her visual acuity was 20/20 in each eye. Macular examination, optical coherence tomography, and fluorescein angiography demonstrated the previously diagnosed macular drusen and geographic atrophy of the retinal pigment epithelium consistent with the dry form of age-related macular degeneration both eyes. Automated perimetry revealed a right homonymous hemianopsia. Neuroimaging confirmed a left occipital ischemic infarction with involvement of the splenium of the corpus callosum producing the classic disconnection syndrome of alexia without agraphia.
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Affiliation(s)
- Zane Foster
- Baylor College of Medicine, Houston, Texas, USA
| | - Ashwini Kini
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Bayan Al Othman
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Andrew G Lee
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA; Department of Ophthalmology, UTMB, Galveston, Texas, USA; UT MD Anderson Cancer Center, Texas A and M College of Medicine, Texas, USA.
| | - Michael Vaphiades
- Departments of Ophthalmology, Neurology, and Neurosurgery, University of Alabama, Birmingham, Alabama, USA
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23
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24
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Pelak VS, Hills W. Vision in Alzheimer's disease: a focus on the anterior afferent pathway. Neurodegener Dis Manag 2018; 8:49-67. [PMID: 29359625 DOI: 10.2217/nmt-2017-0030] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Visual dysfunction has long been recognized as a manifestation of Alzheimer's disease (AD), particularly in the form of visuospatial impairment during all stages of disease. However, investigations have revealed findings within the anterior (i.e., pregeniculate) afferent visual pathways that rely on retinal imaging and electrophysiologic methodologies for detection. Here we focus on the anterior afferent visual pathways in AD and the measures used for assessment, including optical coherence tomography, electrophysiology, color vision testing and threshold visual field perimetry. A brief summary of higher order visual dysfunction is also included to allow the reader to keep in context the broader findings of afferent visual dysfunction in AD.
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Affiliation(s)
- Victoria S Pelak
- Departments of Neurology & Ophthalmology, The Rocky Mountain Lions Eye Institute, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - William Hills
- Departments of Ophthalmology & Neurology, Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
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25
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Hayashi R, Yamaguchi S, Narimatsu T, Miyata H, Katsumata Y, Mimura M. Statokinetic Dissociation (Riddoch Phenomenon) in a Patient with Homonymous Hemianopsia as the First Sign of Posterior Cortical Atrophy. Case Rep Neurol 2017; 9:256-260. [PMID: 29422846 PMCID: PMC5803707 DOI: 10.1159/000481304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 11/19/2022] Open
Abstract
We report a 60-year-old woman with posterior cortical atrophy (PCA) who presented with left homonymous hemianopsia persisting for 5 years; the patient's condition was observed using static, but not kinetic, perimetry. This statokinetic dissociation of hemianopsia, which is often called Riddoch syndrome, might have been caused by a dysfunction of the right primary visual and visual association cortices, representing a functional imbalance within a disturbed visual cortex. In patients with PCA and visual field defects, both static and kinetic perimetry may be useful for understanding the extent of degeneration in the visual cortex, in addition to examinations of unilateral neglect.
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Affiliation(s)
- Ryuichiro Hayashi
- Department of Neurology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Shigeki Yamaguchi
- Department of Neurology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Toshio Narimatsu
- Department of Ophthalmology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Hiroshi Miyata
- Department of Ophthalmology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Yasushi Katsumata
- Department of Radiology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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26
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Maia da Silva MN, Millington RS, Bridge H, James-Galton M, Plant GT. Visual Dysfunction in Posterior Cortical Atrophy. Front Neurol 2017; 8:389. [PMID: 28861031 PMCID: PMC5561011 DOI: 10.3389/fneur.2017.00389] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/21/2017] [Indexed: 01/08/2023] Open
Abstract
Posterior cortical atrophy (PCA) is a syndromic diagnosis. It is characterized by progressive impairment of higher (cortical) visual function with imaging evidence of degeneration affecting the occipital, parietal, and posterior temporal lobes bilaterally. Most cases will prove to have Alzheimer pathology. The aim of this review is to summarize the development of the concept of this disorder since it was first introduced. A critical discussion of the evolving diagnostic criteria is presented and the differential diagnosis with regard to the underlying pathology is reviewed. Emphasis is given to the visual dysfunction that defines the disorder, and the classical deficits, such as simultanagnosia and visual agnosia, as well as the more recently recognized visual field defects, are reviewed, along with the evidence on their neural correlates. The latest developments on the imaging of PCA are summarized, with special attention to its role on the differential diagnosis with related conditions.
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Affiliation(s)
- Mari N Maia da Silva
- The National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Cognitive and Behavioural Neurology Unit, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - Rebecca S Millington
- Oxford Centre for fMRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Holly Bridge
- Oxford Centre for fMRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Merle James-Galton
- The National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Gordon T Plant
- The National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom.,St. Thomas' Hospital, London, United Kingdom
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