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Baset A, Huang F. Shedding light on subiculum's role in human brain disorders. Brain Res Bull 2024; 214:110993. [PMID: 38825254 DOI: 10.1016/j.brainresbull.2024.110993] [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: 04/09/2024] [Revised: 05/17/2024] [Accepted: 05/30/2024] [Indexed: 06/04/2024]
Abstract
Subiculum is a pivotal output component of the hippocampal formation, a structure often overlooked in neuroscientific research. Here, this review aims to explore the role of the subiculum in various brain disorders, shedding light on its significance within the functional-neuroanatomical perspective on neurological diseases. The subiculum's involvement in multiple brain disorders was thoroughly examined. In Alzheimer's disease, subiculum alterations precede cognitive decline, while in epilepsy, the subiculum plays a critical role in seizure initiation. Stress involves the subiculum's impact on the hypothalamic-pituitary-adrenocortical axis. Moreover, the subiculum exhibits structural and functional changes in anxiety, schizophrenia, and Parkinson's disease, contributing to cognitive deficits. Bipolar disorder is linked to subiculum structural abnormalities, while autism spectrum disorder reveals an alteration of inward deformation in the subiculum. Lastly, frontotemporal dementia shows volumetric differences in the subiculum, emphasizing its contribution to the disorder's complexity. Taken together, this review consolidates existing knowledge on the subiculum's role in brain disorders, and may facilitate future research, diagnostic strategies, and therapeutic interventions for various neurological conditions.
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Affiliation(s)
- Abdul Baset
- Department of Neuroscience, City University of Hong Kong, Hong Kong Special Administrative Region of China; Centre for Regenerative Medicine and Health, Hong Kong Institute of Science & Innovation, Chinese Academy of Sciences, Hong Kong Special Administrative Region of China
| | - Fengwen Huang
- Department of Neuroscience, City University of Hong Kong, Hong Kong Special Administrative Region of China; Centre for Regenerative Medicine and Health, Hong Kong Institute of Science & Innovation, Chinese Academy of Sciences, Hong Kong Special Administrative Region of China.
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Urso D, Giannoni-Luza S, Mondello S, Logroscino G. Accuracy of clinical diagnosis of behavioural variant frontotemporal dementia: a protocol for a systematic review and meta-analysis. BMJ Open 2024; 14:e081935. [PMID: 38977370 PMCID: PMC11256028 DOI: 10.1136/bmjopen-2023-081935] [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: 11/09/2023] [Accepted: 05/10/2024] [Indexed: 07/10/2024] Open
Abstract
INTRODUCTION Behavioural variant frontotemporal dementia (bvFTD) characterisation has evolved, but diagnosis remains challenging, relying on clinical diagnostic criteria that have undergone revisions over time. In this systematic review, our aims are to evaluate the accuracy of clinical diagnostic criteria for bvFTD by comparing them against pathological diagnoses and determine potential improvement in performance over the years. METHODS AND ANALYSIS This systematic review protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 guidelines and is registered on PROSPERO. We will search four databases (MEDLINE-PubMed, Web of Science, Embase and LILACS) using tailored search terms on May 1st 2024. Inclusion criteria encompass peer-reviewed articles reporting diagnostic parameters or raw data regarding bvFTD clinical diagnosis based on well-defined criteria. Screening and selection of relevant articles will be independently performed by two reviewers using the Covidence systematic review manager. Discrepancies will be resolved by a third researcher. Pathologic and genetic diagnosis will be the main gold standard, but we will also consider refined diagnoses after a follow-up period. Data will be collected on study design, baseline demographics and sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. Study quality will be assessed with Quality Assessment of Diagnostic Accuracy Studies-2. If possible, we will conduct a meta-analysis using bivariate random-effect models. Subgroup analyses will consider study settings, gold standards, disease stages and bias. ETHICS AND DISSEMINATION Ethics approval will not be needed because the data used in this systematic review will be extracted from published studies. Findings will be disseminated through peer-reviewed publications and presentations at relevant scientific conferences, potentially enhancing our understanding of bvFTD clinical diagnosis reliability and guiding future criteria refinements. PROSPERO REGISTRATION NUMBER CRD42023389063.
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Affiliation(s)
- Daniele Urso
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Puglia, Italy
- Department of Neurosciences, Institute of Psychiatry Psychology and Neuroscience, London, London, UK
| | - Stefano Giannoni-Luza
- Sensory-Motor Lab (SeMoLa), Department of Ophthalmology, Fondation Asile des Aveugles, Lausanne, Vaud, Switzerland
| | - Stefania Mondello
- Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Messina, Sicily, Italy
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Puglia, Italy
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari, Bari, Italy
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Santamaría-García H, Migeot J, Medel V, Hazelton JL, Teckentrup V, Romero-Ortuno R, Piguet O, Lawor B, Northoff G, Ibanez A. Allostatic Interoceptive Overload Across Psychiatric and Neurological Conditions. Biol Psychiatry 2024:S0006-3223(24)01428-8. [PMID: 38964530 DOI: 10.1016/j.biopsych.2024.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 06/10/2024] [Accepted: 06/19/2024] [Indexed: 07/06/2024]
Abstract
Emerging theories emphasize the crucial role of allostasis (anticipatory and adaptive regulation of the body's biological processes) and interoception (integration, anticipation, and regulation of internal bodily states) in adjusting physiological responses to environmental and bodily demands. In this review, we explore the disruptions in integrated allostatic interoceptive mechanisms in psychiatric and neurological disorders, including anxiety, depression, Alzheimer's disease, and frontotemporal dementia. We assess the biological mechanisms associated with allostatic interoception, including whole-body cascades, brain structure and function of the allostatic interoceptive network, heart-brain interactions, respiratory-brain interactions, the gut-brain-microbiota axis, peripheral biological processes (inflammatory, immune), and epigenetic pathways. These processes span psychiatric and neurological conditions and call for developing dimensional and transnosological frameworks. We synthesize new pathways to understand how allostatic interoceptive processes modulate interactions between environmental demands and biological functions in brain disorders. We discuss current limitations of the framework and future transdisciplinary developments. This review opens a new research agenda for understanding how allostatic interoception involves brain predictive coding in psychiatry and neurology, allowing for better clinical application and the development of new therapeutic interventions.
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Affiliation(s)
- Hernando Santamaría-García
- Pontificia Universidad Javeriana, PhD program of Neuroscience, Bogotá, Colombia; Hospital Universitario San Ignacio, Centro de Memoria y Cognición Intellectus, Bogotá, Colombia
| | - Joaquin Migeot
- Global Brain Health Institute, University California of San Francisco, San Francisco, California; Global Brain Health Institute, Trinity College of Dublin, Dublin, Ireland; Latin American Brain Health Institute, Universidad Adolfo Ibanez, Santiago, Chile
| | - Vicente Medel
- Latin American Brain Health Institute, Universidad Adolfo Ibanez, Santiago, Chile
| | - Jessica L Hazelton
- Latin American Brain Health Institute, Universidad Adolfo Ibanez, Santiago, Chile; School of Psychology and Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Vanessa Teckentrup
- School of Psychology and Trinity Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Roman Romero-Ortuno
- Pontificia Universidad Javeriana, PhD program of Neuroscience, Bogotá, Colombia; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Olivier Piguet
- School of Psychology and Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Brian Lawor
- Pontificia Universidad Javeriana, PhD program of Neuroscience, Bogotá, Colombia
| | - George Northoff
- Institute of Mental Health Research, Mind, Brain Imaging and Neuroethics Research Unit, University of Ottawa, Ottawa, Ontario, Canada
| | - Agustin Ibanez
- Global Brain Health Institute, University California of San Francisco, San Francisco, California; Global Brain Health Institute, Trinity College of Dublin, Dublin, Ireland; Latin American Brain Health Institute, Universidad Adolfo Ibanez, Santiago, Chile; School of Psychology and Trinity Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
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4
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Rossi-Harries S, Harrison CR, Camic PM, Sullivan MP, Grillo A, Crutch SJ, Harding E. 'Talking lines': the stories of diagnosis and support as told by those with lived experience of rare forms of dementia. BMC Geriatr 2024; 24:504. [PMID: 38849735 PMCID: PMC11157747 DOI: 10.1186/s12877-024-04988-1] [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: 09/07/2023] [Accepted: 04/17/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND People living with, or caring for someone with, rare forms of dementia can encounter issues while obtaining a diagnosis and trying to access appropriate support. This can affect their wellbeing, quality of life, social relationships and employment status. This study makes use of an arts-based narrative approach to explore individual accounts of these experiences whilst also exploring how, in telling their stories, those affected by rare forms of dementia might invoke, and situate their stories in relation to, broader cultural narratives around dementia and illness. METHODS Semi-structured interviews were conducted via video-conferencing software with participants (N = 27), living with, or caring for someone with, a rare forms of dementia. Participants used line drawings to depict their journey from initial symptoms to the present day, followed by prompts to verbally narrate their experiences. All interview transcripts and line drawings were subjected to narrative analysis. Four sets of transcripts and drawings were then subjected to more in-depth analysis. RESULTS Analysis shed light on the struggles encountered by both care-partners and people with a diagnosis, while navigating a health and social care system that does not always understand their needs. This often led to individuals feeling isolated and unsupported. Accounts also depicted challenges to identity brought on by the process. The moment of diagnosis was also drawn in a complicated light. Individuals found comfort in gaining understanding, but felt fear at recognising upcoming challenges. Participants situated their own accounts against mainstream cultural narratives around what good support for cognitive impairment and dementia might look like, whilst also demonstrating the influential role they took on in pursuing the right care. CONCLUSIONS The use of line drawing, alongside narrative interviews, allowed participants to tell complicated, sometimes anachronistic, stories about difficult experiences, whilst also reflecting on, and attaching meaning to, them. These stories highlighted pressing gaps in healthcare services and shone a light on the various pieces of collective action individuals were engaged in in order to improve them. Finally, in modelling some elements of the participants' service provision which were working, the narratives pointed to future directions services might move in.
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Affiliation(s)
- Samuel Rossi-Harries
- Dementia Research Centre, UCL Queen Square Institute of Neurology, box 16, 8-11 Queen Square, London, WC1N 3BG, UK.
| | - Charles R Harrison
- Dementia Research Centre, UCL Queen Square Institute of Neurology, box 16, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Paul M Camic
- Dementia Research Centre, UCL Queen Square Institute of Neurology, box 16, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Mary Pat Sullivan
- School of Social Work, Faculty of Education and Professional Studies, Nipissing University, Nipissing, ON, Canada
| | - Adetola Grillo
- School of Social Work, Faculty of Education and Professional Studies, Nipissing University, Nipissing, ON, Canada
| | - Sebastian James Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, box 16, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Emma Harding
- Dementia Research Centre, UCL Queen Square Institute of Neurology, box 16, 8-11 Queen Square, London, WC1N 3BG, UK
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Huang M, Landin-Romero R, Matis S, Dalton MA, Piguet O. Longitudinal volumetric changes in amygdala subregions in frontotemporal dementia. J Neurol 2024; 271:2509-2520. [PMID: 38265470 PMCID: PMC11055736 DOI: 10.1007/s00415-023-12172-5] [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] [Received: 12/07/2023] [Revised: 12/20/2023] [Accepted: 12/23/2023] [Indexed: 01/25/2024]
Abstract
Amygdala atrophy has been found in frontotemporal dementia (FTD), yet the specific changes of its subregions across different FTD phenotypes remain unclear. The aim of this study was to investigate the volumetric alterations of the amygdala subregions in FTD phenotypes and how they evolve with disease progression. Patients clinically diagnosed with behavioral variant FTD (bvFTD) (n = 20), semantic dementia (SD) (n = 20), primary nonfluent aphasia (PNFA) (n = 20), Alzheimer's disease (AD) (n = 20), and 20 matched healthy controls underwent whole brain structural MRI. The patient groups were followed up annually for up to 3.5 years. Amygdala nuclei were segmented using FreeSurfer, corrected by total intracranial volumes, and grouped into the basolateral, superficial, and centromedial subregions. Linear mixed effects models were applied to identify changes in amygdala subregional volumes over time. At baseline, bvFTD, SD, and AD displayed global amygdala volume reduction, whereas amygdala volume appeared to be preserved in PNFA. Asymmetrical amygdala atrophy (left > right) was most pronounced in SD. Longitudinally, SD and PNFA showed greater rates of annual decline in the right basolateral and superficial subregions compared to bvFTD and AD. The findings provide comprehensive insights into the differential impact of FTD pathology on amygdala subregions, revealing distinct atrophy patterns that evolve over disease progression. The characterization of amygdala subregional involvement in FTD and their potential role as biomarkers carry substantial clinical implications.
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Affiliation(s)
- Mengjie Huang
- School of Psychology, The University of Sydney, Camperdown, NSW, 2050, Australia
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Ramon Landin-Romero
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, 2050, Australia
- School of Health Sciences, The University of Sydney, Camperdown, NSW, 2050, Australia
| | - Sophie Matis
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, 2050, Australia
- School of Health Sciences, The University of Sydney, Camperdown, NSW, 2050, Australia
| | - Marshall A Dalton
- School of Psychology, The University of Sydney, Camperdown, NSW, 2050, Australia
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Olivier Piguet
- School of Psychology, The University of Sydney, Camperdown, NSW, 2050, Australia.
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, 2050, Australia.
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Kim YA, Mellen M, Kizil C, Santa-Maria I. Mechanisms linking cerebrovascular dysfunction and tauopathy: Adding a layer of epiregulatory complexity. Br J Pharmacol 2024; 181:879-895. [PMID: 37926507 DOI: 10.1111/bph.16280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 09/11/2023] [Accepted: 09/30/2023] [Indexed: 11/07/2023] Open
Abstract
Intracellular accumulation of hyperphosphorylated misfolded tau proteins are found in many neurodegenerative tauopathies, including Alzheimer's disease (AD). Tau pathology can impact cerebrovascular physiology and function through multiple mechanisms. In vitro and in vivo studies have shown that alterations in the blood-brain barrier (BBB) integrity and function can result in synaptic abnormalities and neuronal damage. In the present review, we will summarize how tau proteostasis dysregulation contributes to vascular dysfunction and, conversely, we will examine the factors and pathways leading to tau pathological alterations triggered by cerebrovascular dysfunction. Finally, we will highlight the role epigenetic and epitranscriptomic factors play in regulating the integrity of the cerebrovascular system and the progression of tauopathy including a few observartions on potential therapeutic interventions. LINKED ARTICLES: This article is part of a themed issue From Alzheimer's Disease to Vascular Dementia: Different Roads Leading to Cognitive Decline. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v181.6/issuetoc.
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Affiliation(s)
- Yoon A Kim
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
- Department of Pathology and Cell Biology, Columbia University, New York, New York, USA
| | - Marian Mellen
- Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Pozuelo de Alarcon, Madrid, Spain
| | - Caghan Kizil
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Ismael Santa-Maria
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
- Department of Pathology and Cell Biology, Columbia University, New York, New York, USA
- Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Pozuelo de Alarcon, Madrid, Spain
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Das S, van Engelen MPE, Goossens J, Jacobs D, Bongers B, Fieldhouse JLP, Pijnenburg YAL, Teunissen CE, Vanmechelen E, Verberk IMW. The use of synaptic biomarkers in cerebrospinal fluid to differentiate behavioral variant of frontotemporal dementia from primary psychiatric disorders and Alzheimer's disease. Alzheimers Res Ther 2024; 16:34. [PMID: 38355535 PMCID: PMC10865562 DOI: 10.1186/s13195-024-01409-8] [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: 09/22/2023] [Accepted: 02/04/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Lack of early molecular biomarkers in sporadic behavioral variants of frontotemporal dementia (bvFTD) and its clinical overlap with primary psychiatric disorders (PPD) hampers its diagnostic distinction. Synaptic dysfunction is an early feature in bvFTD and identification of specific biomarkers might improve its diagnostic accuracy. Our goal was to understand the differential diagnostic potential of cerebrospinal fluid (CSF) synaptic biomarkers in bvFTD versus PPD and their specificity towards bvFTD compared with Alzheimer's disease (AD) and controls. Additionally, we explored the association of CSF synaptic biomarkers with social cognition, cognitive performance, and disease severity in these clinical groups. METHODS Participants with probable bvFTD (n = 57), PPD (n = 71), AD (n = 60), and cognitively normal controls (n = 39) with available CSF, cognitive tests, and disease severity as frontotemporal lobar degeneration-modified clinical dementia rating scale (FTLD-CDR) were included. In a subset of bvFTD and PPD cases, Ekman 60 faces test scores for social cognition were available. CSF synaptosomal-associated protein 25 (SNAP25), neurogranin (Ng), neuronal pentraxin 2 (NPTX2), and glutamate receptor 4 (GluR4) were measured, along with neurofilament light (NfL), and compared between groups using analysis of covariance (ANCOVA) and logistic regression. Diagnostic accuracy was assessed using ROC analyses, and biomarker panels were selected using Wald's backward selection. Correlations with cognitive measures were performed using Pearson's partial correlation analysis. RESULTS NPTX2 concentrations were lower in the bvFTD group compared with PPD (p < 0.001) and controls (p = 0.003) but not compared with AD. Concentrations of SNAP25 (p < 0.001) and Ng (p < 0.001) were elevated in patients with AD versus those with bvFTD and controls. The modeled panel for differential diagnosis of bvFTD versus PPD consisted of NfL and NPTX2 (AUC = 0.96, CI: 0.93-0.99, p < 0.001). In bvFTD versus AD, the modeled panel consisted of NfL, SNAP25, Ng, and GluR4 (AUC = 0.86, CI: 0.79-0.92, p < 0.001). In bvFTD, lower NPTX2 (Pearson's r = 0.29, p = 0.036) and GluR4 (Pearson's r = 0.34, p = 0.014) concentrations were weakly associated with worse performance of total cognitive score. Lower GluR4 concentrations were also associated with worse MMSE scores (Pearson's r = 0.41, p = 0.002) as well as with worse executive functioning (Pearson's r = 0.36, p = 0.011) in bvFTD. There were no associations between synaptic markers and social cognition or disease severity in bvFTD. CONCLUSION Our findings of involvement of NTPX2 in bvFTD but not PPD contribute towards better understanding of bvFTD disease pathology.
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Affiliation(s)
- Shreyasee Das
- Department of Laboratory Medicine, Neurochemistry Laboratory, Amsterdam, UMC location VrijeUniversiteit Amsterdam, Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
- ADx NeuroSciences, Technologiepark-Zwijnaarde 6, 9052, Gent, Belgium
| | - Marie-Paule E van Engelen
- Neurology, Amsterdam UMC location VUmc, Alzheimer Center Amsterdam, VrijeUniversiteit Amsterdam, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, De Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands
| | - Julie Goossens
- ADx NeuroSciences, Technologiepark-Zwijnaarde 6, 9052, Gent, Belgium
| | - Dirk Jacobs
- ADx NeuroSciences, Technologiepark-Zwijnaarde 6, 9052, Gent, Belgium
| | - Bram Bongers
- Department of Laboratory Medicine, Neurochemistry Laboratory, Amsterdam, UMC location VrijeUniversiteit Amsterdam, Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
| | - Jay L P Fieldhouse
- Neurology, Amsterdam UMC location VUmc, Alzheimer Center Amsterdam, VrijeUniversiteit Amsterdam, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, De Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands
| | - Yolande A L Pijnenburg
- Neurology, Amsterdam UMC location VUmc, Alzheimer Center Amsterdam, VrijeUniversiteit Amsterdam, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, De Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands
| | - Charlotte E Teunissen
- Department of Laboratory Medicine, Neurochemistry Laboratory, Amsterdam, UMC location VrijeUniversiteit Amsterdam, Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
- Neurology, Amsterdam UMC location VUmc, Alzheimer Center Amsterdam, VrijeUniversiteit Amsterdam, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, De Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands
| | | | - Inge M W Verberk
- Department of Laboratory Medicine, Neurochemistry Laboratory, Amsterdam, UMC location VrijeUniversiteit Amsterdam, Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands.
- Neurology, Amsterdam UMC location VUmc, Alzheimer Center Amsterdam, VrijeUniversiteit Amsterdam, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, De Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands.
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Wang Z, Liu A, Yu J, Wang P, Bi Y, Xue S, Zhang J, Guo H, Zhang W. The effect of aperiodic components in distinguishing Alzheimer's disease from frontotemporal dementia. GeroScience 2024; 46:751-768. [PMID: 38110590 PMCID: PMC10828513 DOI: 10.1007/s11357-023-01041-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/07/2023] [Indexed: 12/20/2023] Open
Abstract
Distinguishing between Alzheimer's disease (AD) and frontotemporal dementia (FTD) presents a clinical challenge. Inexpensive and accessible techniques such as electroencephalography (EEG) are increasingly being used to address this challenge. In particular, the potential relevance between aperiodic components of EEG activity and these disorders has gained interest as our understanding evolves. This study aims to determine the differences in aperiodic activity between AD and FTD and evaluate its potential for distinguishing between the two disorders. A total of 88 participants, including 36 patients with AD, 23 patients with FTD, and 29 healthy controls (CN) underwent cognitive assessment and scalp EEG acquisition. Neuronal power spectra were parameterized to decompose the EEG spectrum, enabling comparison of group differences in different components. A support vector machine was employed to assess the impact of aperiodic parameters on the differential diagnosis. Compared with the CN group, both the AD and FTD groups showed varying degrees of increased alpha power (both periodic and raw power) and theta alpha power ratio. At the channel level, theta power (both periodic and raw power) in the frontal regions was higher in the AD group compared to the FTD group, and aperiodic parameters (both exponents and offsets) in the frontal, temporal, central, and parietal regions were higher in the AD group than in the FTD group. Importantly, the inclusion of aperiodic parameters led to improved performance in distinguishing between the two disorders. These findings highlight the significance of aperiodic components in discriminating dementia-related diseases.
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Affiliation(s)
- Zhuyong Wang
- Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China On Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory On Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, 510280, People's Republic of China
| | - Anyang Liu
- Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China On Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory On Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, 510280, People's Republic of China
| | - Jianshen Yu
- Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China On Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory On Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, 510280, People's Republic of China
| | - Pengfei Wang
- Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China On Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory On Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, 510280, People's Republic of China
| | - Yuewei Bi
- Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China On Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory On Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, 510280, People's Republic of China
| | - Sha Xue
- Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China On Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory On Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, 510280, People's Republic of China
| | - Jiajun Zhang
- Guangdong Province Key Laboratory of Computational Science, School of Mathematics, Sun Yat-Sen University, No. 135, Xingang Xi Road, Guangzhou, People's Republic of China.
| | - Hongbo Guo
- Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China On Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory On Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, 510280, People's Republic of China.
| | - Wangming Zhang
- Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China On Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory On Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, 510280, People's Republic of China.
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Ferrante FJ, Migeot J, Birba A, Amoruso L, Pérez G, Hesse E, Tagliazucchi E, Estienne C, Serrano C, Slachevsky A, Matallana D, Reyes P, Ibáñez A, Fittipaldi S, Campo CG, García AM. Multivariate word properties in fluency tasks reveal markers of Alzheimer's dementia. Alzheimers Dement 2024; 20:925-940. [PMID: 37823470 PMCID: PMC10916979 DOI: 10.1002/alz.13472] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/15/2023] [Accepted: 08/20/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Verbal fluency tasks are common in Alzheimer's disease (AD) assessments. Yet, standard valid response counts fail to reveal disease-specific semantic memory patterns. Here, we leveraged automated word-property analysis to capture neurocognitive markers of AD vis-à-vis behavioral variant frontotemporal dementia (bvFTD). METHODS Patients and healthy controls completed two fluency tasks. We counted valid responses and computed each word's frequency, granularity, neighborhood, length, familiarity, and imageability. These features were used for group-level discrimination, patient-level identification, and correlations with executive and neural (magnetic resonanance imaging [MRI], functional MRI [fMRI], electroencephalography [EEG]) patterns. RESULTS Valid responses revealed deficits in both disorders. Conversely, frequency, granularity, and neighborhood yielded robust group- and subject-level discrimination only in AD, also predicting executive outcomes. Disease-specific cortical thickness patterns were predicted by frequency in both disorders. Default-mode and salience network hypoconnectivity, and EEG beta hypoconnectivity, were predicted by frequency and granularity only in AD. DISCUSSION Word-property analysis of fluency can boost AD characterization and diagnosis. HIGHLIGHTS We report novel word-property analyses of verbal fluency in AD and bvFTD. Standard valid response counts captured deficits and brain patterns in both groups. Specific word properties (e.g., frequency, granularity) were altered only in AD. Such properties predicted cognitive and neural (MRI, fMRI, EEG) patterns in AD. Word-property analysis of fluency can boost AD characterization and diagnosis.
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Affiliation(s)
- Franco J. Ferrante
- Centro de Neurociencias CognitivasUniversidad de San AndrésVictoriaProvincia de Buenos AiresArgentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)Ciudad Autónoma de Buenos AiresArgentina
- Facultad de IngenieríaUniversidad de Buenos Aires (FIUBA)CABAArgentina
| | - Joaquín Migeot
- Latin American Brain Health (BrainLat) InstituteUniversidad Adolfo IbáñezPeñalolénRegión MetropolitanaChile
- Center for Social and Cognitive Neuroscience (CSCN)School of PsychologyUniversidad Adolfo IbáñezLas CondesChile
| | - Agustina Birba
- Centro de Neurociencias CognitivasUniversidad de San AndrésVictoriaProvincia de Buenos AiresArgentina
- Instituto Universitario de NeurocienciaUniversidad de La LagunaLa LagunaTenerifeEspaña
- Cognitive Department of PsychologyUniversidad de La LagunaLa LagunaTenerifeEspaña
| | - Lucía Amoruso
- Centro de Neurociencias CognitivasUniversidad de San AndrésVictoriaProvincia de Buenos AiresArgentina
- Basque Center on Cognition Brain and Language (BCBL)San SebastiánGipuzkoaEspaña
- IkerbasqueBasque Foundation for ScienceBilbaoSpain
| | - Gonzalo Pérez
- Centro de Neurociencias CognitivasUniversidad de San AndrésVictoriaProvincia de Buenos AiresArgentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)Ciudad Autónoma de Buenos AiresArgentina
- Facultad de IngenieríaUniversidad de Buenos Aires (FIUBA)CABAArgentina
| | - Eugenia Hesse
- Centro de Neurociencias CognitivasUniversidad de San AndrésVictoriaProvincia de Buenos AiresArgentina
- Departamento de Matemática y CienciasUniversidad de San AndrésVictoriaProvincia de Buenos AiresArgentina
| | - Enzo Tagliazucchi
- Latin American Brain Health (BrainLat) InstituteUniversidad Adolfo IbáñezPeñalolénRegión MetropolitanaChile
- Departamento de FísicaUniversidad de Buenos Aires and Instituto de Física de Buenos Aires (IFIBA‐CONICET)CABAArgentina
| | - Claudio Estienne
- Instituto de Ingeniería BiomédicaUniversidad de Buenos AiresBuenos AiresArgentina
| | - Cecilia Serrano
- Unidad de Neurología CognitivaHospital César MilsteinCABAArgentina
| | - Andrea Slachevsky
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC)Physiopathology Department ‐ ICBMNeurocience and East Neuroscience DepartmentsFaculty of MedicineUniversity of ChileProvidenciaSantiagoChile
- Geroscience Center for Brain Health and Metabolism (GERO)Faculty of MedicineUniversity of ChileProvidenciaSantiagoChile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology DepartmentHospital del Salvador and Faculty of MedicineUniversity of ChileProvidenciaSantiagoChile
- Servicio de NeurologíaDepartamento de MedicinaClínica Alemana‐Universidad del DesarrolloLas CondesRegión MetropolitanaChile
| | - Diana Matallana
- Instituto de EnvejecimientoDepartment of PsychiatrySchool of MedicinePontifical Xaverian UniversityBogotáColombia
- Department of Mental HealthHospital Universitario Santa Fe de BogotáBogotáColombia
| | - Pablo Reyes
- Centro de Memoria y CogniciónIntellectus‐Hospital Universitario San IgnacioBogotáColombia
- Pontificia Universidad JaverianaDepartments of PhysiologyPsychiatry and Aging InstituteBogotáColombia
| | - Agustín Ibáñez
- Centro de Neurociencias CognitivasUniversidad de San AndrésVictoriaProvincia de Buenos AiresArgentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)Ciudad Autónoma de Buenos AiresArgentina
- Latin American Brain Health (BrainLat) InstituteUniversidad Adolfo IbáñezPeñalolénRegión MetropolitanaChile
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USATrinity College DublinDublinIreland
| | - Sol Fittipaldi
- Centro de Neurociencias CognitivasUniversidad de San AndrésVictoriaProvincia de Buenos AiresArgentina
- Latin American Brain Health (BrainLat) InstituteUniversidad Adolfo IbáñezPeñalolénRegión MetropolitanaChile
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USATrinity College DublinDublinIreland
| | - Cecilia Gonzalez Campo
- Centro de Neurociencias CognitivasUniversidad de San AndrésVictoriaProvincia de Buenos AiresArgentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)Ciudad Autónoma de Buenos AiresArgentina
| | - Adolfo M. García
- Centro de Neurociencias CognitivasUniversidad de San AndrésVictoriaProvincia de Buenos AiresArgentina
- Latin American Brain Health (BrainLat) InstituteUniversidad Adolfo IbáñezPeñalolénRegión MetropolitanaChile
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USATrinity College DublinDublinIreland
- Departamento de Lingüística y LiteraturaFacultad de HumanidadesUniversidad de Santiago de ChileEstación CentralSantiagoChile
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10
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Toro-Hernández FD, Migeot J, Marchant N, Olivares D, Ferrante F, González-Gómez R, González Campo C, Fittipaldi S, Rojas-Costa GM, Moguilner S, Slachevsky A, Chaná Cuevas P, Ibáñez A, Chaigneau S, García AM. Neurocognitive correlates of semantic memory navigation in Parkinson's disease. NPJ Parkinsons Dis 2024; 10:15. [PMID: 38195756 PMCID: PMC10776628 DOI: 10.1038/s41531-024-00630-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/29/2023] [Indexed: 01/11/2024] Open
Abstract
Cognitive studies on Parkinson's disease (PD) reveal abnormal semantic processing. Most research, however, fails to indicate which conceptual properties are most affected and capture patients' neurocognitive profiles. Here, we asked persons with PD, healthy controls, and individuals with behavioral variant frontotemporal dementia (bvFTD, as a disease control group) to read concepts (e.g., 'sun') and list their features (e.g., hot). Responses were analyzed in terms of ten word properties (including concreteness, imageability, and semantic variability), used for group-level comparisons, subject-level classification, and brain-behavior correlations. PD (but not bvFTD) patients produced more concrete and imageable words than controls, both patterns being associated with overall cognitive status. PD and bvFTD patients showed reduced semantic variability, an anomaly which predicted semantic inhibition outcomes. Word-property patterns robustly classified PD (but not bvFTD) patients and correlated with disease-specific hypoconnectivity along the sensorimotor and salience networks. Fine-grained semantic assessments, then, can reveal distinct neurocognitive signatures of PD.
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Affiliation(s)
- Felipe Diego Toro-Hernández
- Graduate Program in Neuroscience and Cognition, Federal University of ABC, São Paulo, Brazil
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Joaquín Migeot
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Nicolás Marchant
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Daniela Olivares
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Laboratorio de Neuropsicología y Neurociencias Clínicas, Universidad de Chile, Santiago, Chile
| | - Franco Ferrante
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council, Buenos Aires, Argentina
- Facultad de Ingeniería, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Raúl González-Gómez
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Cecilia González Campo
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Sol Fittipaldi
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- Global Brain Health Institute, University of California, San Francisco, California, USA; & Trinity College, Dublin, Ireland
| | - Gonzalo M Rojas-Costa
- Department of Radiology, Clínica las Condes, Santiago, Chile
- Advanced Epilepsy Center, Clínica las Condes, Santiago, Chile
- Join Unit FISABIO-CIPF, Valencia, Spain
- School of Medicine, Finis Terrae University, Santiago, Chile
- Health Innovation Center, Clínica Las Condes, Santiago, Chile
| | - Sebastian Moguilner
- Global Brain Health Institute, University of California, San Francisco, California, USA; & Trinity College, Dublin, Ireland
| | - Andrea Slachevsky
- Memory and Neuropsychiatric Center (CMYN), Neurology Department, Hospital del Salvador & Faculty of Medicine, University of Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopatology Program - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Neurology and Psychiatry Department, Clínica Alemana-Universidad Desarrollo, Santiago, Chile
| | - Pedro Chaná Cuevas
- Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Chile
| | - Agustín Ibáñez
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- Global Brain Health Institute, University of California, San Francisco, California, USA; & Trinity College, Dublin, Ireland
| | - Sergio Chaigneau
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Center for Cognition Research, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Adolfo M García
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile.
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina.
- Global Brain Health Institute, University of California, San Francisco, California, USA; & Trinity College, Dublin, Ireland.
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile.
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11
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Shen T, Vogel JW, Duda J, Phillips JS, Cook PA, Gee J, Elman L, Quinn C, Amado DA, Baer M, Massimo L, Grossman M, Irwin DJ, McMillan CT. Novel data-driven subtypes and stages of brain atrophy in the ALS-FTD spectrum. Transl Neurodegener 2023; 12:57. [PMID: 38062485 PMCID: PMC10701950 DOI: 10.1186/s40035-023-00389-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND TDP-43 proteinopathies represent a spectrum of neurological disorders, anchored clinically on either end by amyotrophic lateral sclerosis (ALS) and frontotemporal degeneration (FTD). The ALS-FTD spectrum exhibits a diverse range of clinical presentations with overlapping phenotypes, highlighting its heterogeneity. This study was aimed to use disease progression modeling to identify novel data-driven spatial and temporal subtypes of brain atrophy and its progression in the ALS-FTD spectrum. METHODS We used a data-driven procedure to identify 13 anatomic clusters of brain volume for 57 behavioral variant FTD (bvFTD; with either autopsy-confirmed TDP-43 or TDP-43 proteinopathy-associated genetic variants), 103 ALS, and 47 ALS-FTD patients with likely TDP-43. A Subtype and Stage Inference (SuStaIn) model was trained to identify subtypes of individuals along the ALS-FTD spectrum with distinct brain atrophy patterns, and we related subtypes and stages to clinical, genetic, and neuropathological features of disease. RESULTS SuStaIn identified three novel subtypes: two disease subtypes with predominant brain atrophy in either prefrontal/somatomotor regions or limbic-related regions, and a normal-appearing group without obvious brain atrophy. The limbic-predominant subtype tended to present with more impaired cognition, higher frequencies of pathogenic variants in TBK1 and TARDBP genes, and a higher proportion of TDP-43 types B, E and C. In contrast, the prefrontal/somatomotor-predominant subtype had higher frequencies of pathogenic variants in C9orf72 and GRN genes and higher proportion of TDP-43 type A. The normal-appearing brain group showed higher frequency of ALS relative to ALS-FTD and bvFTD patients, higher cognitive capacity, higher proportion of lower motor neuron onset, milder motor symptoms, and lower frequencies of genetic pathogenic variants. The overall SuStaIn stages also correlated with evidence for clinical progression including longer disease duration, higher King's stage, and cognitive decline. Additionally, SuStaIn stages differed across clinical phenotypes, genotypes and types of TDP-43 pathology. CONCLUSIONS Our findings suggest distinct neurodegenerative subtypes of disease along the ALS-FTD spectrum that can be identified in vivo, each with distinct brain atrophy, clinical, genetic and pathological patterns.
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Affiliation(s)
- Ting Shen
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jacob W Vogel
- Department of Clinical Sciences, SciLifeLab, Lund University, 222 42, Lund, Sweden
| | - Jeffrey Duda
- Penn Image Computing and Science Lab (PICSL), Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jeffrey S Phillips
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Philip A Cook
- Penn Image Computing and Science Lab (PICSL), Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - James Gee
- Penn Image Computing and Science Lab (PICSL), Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Lauren Elman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Colin Quinn
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Defne A Amado
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Michael Baer
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Lauren Massimo
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - David J Irwin
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Digital Neuropathology Laboratory, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Corey T McMillan
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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12
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Harding E, Rossi-Harries S, Alterkawi S, Waddington C, Grillo A, Wood O, Brotherhood EV, Windle G, Sullivan MP, Camic PM, Stott J, Crutch SJ. 'The oxygen of shared experience': exploring social support processes within peer support groups for carers of people with non-memory-led and inherited dementias. Aging Ment Health 2023; 27:1912-1928. [PMID: 36999880 DOI: 10.1080/13607863.2023.2194848] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/18/2023] [Indexed: 04/01/2023]
Abstract
OBJECTIVES To explore support processes and behaviours taking place during online peer support groups for family carers of people living with rare, non-memory-led and inherited dementias (PLWRD). METHODS Twenty-five family carers of PLWRD participated in a series of ongoing online peer support groups on the theme of 'Independence and Identity'. Transcripts from 16 sessions were analysed using qualitative directed content analysis with a coding framework informed by Cutrona & Suhr's (2004) Social Support Behaviour Code (SSBC). RESULTS Most of the social support behaviours outlined in the SSBC were identified within the sessions, along with two novel social support categories - 'Experiential Support' and 'Community Support' - and novel support behaviours including 'Advocacy and Collective Action' and 'Uses Humour'. The SSBC code 'Relationship' appeared to be of central importance. CONCLUSIONS This study sheds light on the unique challenges of the caring context for those affected by non-memory-led and inherited dementias and the significant contributions carers can offer to, and receive from, peers in similar situations. It highlights the importance of services which recognise the value of the informational and emotional expertise of carers of PLWRD and encourages the continued development and delivery of tailored support for these populations.
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Affiliation(s)
- Emma Harding
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Samuel Rossi-Harries
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Shaima Alterkawi
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Claire Waddington
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Adetola Grillo
- School of Social Work, Faculty of Education and Professional Studies, Nipissing University, Nipissing, Ontario, Canada
| | - Olivia Wood
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Emilie V Brotherhood
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Gill Windle
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - Mary Pat Sullivan
- School of Social Work, Faculty of Education and Professional Studies, Nipissing University, Nipissing, Ontario, Canada
| | - Paul M Camic
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Joshua Stott
- Department of Clinical, Educational, and Health Psychology, UCL Division of Psychology and Language Sciences, UCL, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
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13
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Shen T, Vogel JW, Duda J, Phillips JS, Cook PA, Gee J, Elman L, Quinn C, Amado DA, Baer M, Massimo L, Grossman M, Irwin DJ, McMillan CT. Novel data-driven subtypes and stages of brain atrophy in the ALS-FTD spectrum. RESEARCH SQUARE 2023:rs.3.rs-3183113. [PMID: 37609205 PMCID: PMC10441467 DOI: 10.21203/rs.3.rs-3183113/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Background TDP-43 proteinopathies represents a spectrum of neurological disorders, anchored clinically on either end by amyotrophic lateral sclerosis (ALS) and frontotemporal degeneration (FTD). The ALS-FTD spectrum exhibits a diverse range of clinical presentations with overlapping phenotypes, highlighting its heterogeneity. This study aimed to use disease progression modeling to identify novel data-driven spatial and temporal subtypes of brain atrophy and its progression in the ALS-FTD spectrum. Methods We used a data-driven procedure to identify 13 anatomic clusters of brain volumes for 57 behavioral variant FTD (bvFTD; with either autopsy-confirmed TDP-43 or TDP-43 proteinopathy-associated genetic variants), 103 ALS, and 47 ALS-FTD patients with likely TDP-43. A Subtype and Stage Inference (SuStaIn) model was trained to identify subtypes of individuals along the ALS-FTD spectrum with distinct brain atrophy patterns, and we related subtypes and stages to clinical, genetic, and neuropathological features of disease. Results SuStaIn identified three novel subtypes: two disease subtypes with predominant brain atrophy either in prefrontal/somatomotor regions or limbic-related regions, and a normal-appearing group without obvious brain atrophy. The Limbic-predominant subtype tended to present with more impaired cognition, higher frequencies of pathogenic variants in TBK1 and TARDBP genes, and a higher proportion of TDP-43 type B, E and C. In contrast, the Prefrontal/Somatomotor-predominant subtype had higher frequencies of pathogenic variants in C9orf72 and GRN genes and higher proportion of TDP-43 type A. The normal-appearing brain group showed higher frequency of ALS relative to ALS-FTD and bvFTD patients, higher cognitive capacity, higher proportion of lower motor neuron onset, milder motor symptoms, and lower frequencies of genetic pathogenic variants. Overall SuStaIn stages also correlated with evidence for clinical progression including longer disease duration, higher King's stage, and cognitive decline. Additionally, SuStaIn stages differed across clinical phenotypes, genotypes and types of TDP-43 pathology. Conclusions Our findings suggest distinct neurodegenerative subtypes of disease along the ALS-FTD spectrum that can be identified in vivo, each with distinct brain atrophy, clinical, genetic and pathological patterns.
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Affiliation(s)
- Ting Shen
- University of Pennsylvania Perelman School of Medicine
| | | | - Jeffrey Duda
- University of Pennsylvania Perelman School of Medicine
| | | | - Philip A Cook
- University of Pennsylvania Perelman School of Medicine
| | - James Gee
- University of Pennsylvania Perelman School of Medicine
| | - Lauren Elman
- University of Pennsylvania Perelman School of Medicine
| | - Colin Quinn
- University of Pennsylvania Perelman School of Medicine
| | - Defne A Amado
- University of Pennsylvania Perelman School of Medicine
| | - Michael Baer
- University of Pennsylvania Perelman School of Medicine
| | | | | | - David J Irwin
- University of Pennsylvania Perelman School of Medicine
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14
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van Engelen MPE, Verfaillie SCJ, Dols A, Oudega ML, Boellaard R, Golla SSV, den Hollander M, Ossenkoppele R, Scheltens P, van Berckel BNM, Pijnenburg YAL, Vijverberg EGB. Altered brain metabolism in frontotemporal dementia and psychiatric disorders: involvement of the anterior cingulate cortex. EJNMMI Res 2023; 13:71. [PMID: 37493827 PMCID: PMC10371967 DOI: 10.1186/s13550-023-01020-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Behavioural symptoms and frontotemporal hypometabolism overlap between behavioural variant of frontotemporal dementia (bvFTD) and primary psychiatric disorders (PPD), hampering diagnostic distinction. Voxel-wise comparisons of brain metabolism might identify specific frontotemporal-(hypo)metabolic regions between bvFTD and PPD. We investigated brain metabolism in bvFTD and PPD and its relationship with behavioural symptoms, social cognition, severity of depressive symptoms and cognitive functioning. RESULTS Compared to controls, bvFTD showed decreased metabolism in the dorsal anterior cingulate cortex (dACC) (p < 0.001), orbitofrontal cortex (OFC), temporal pole, dorsolateral prefrontal cortex (dlPFC) and caudate, whereas PPD showed no hypometabolism. Compared to PPD, bvFTD showed decreased metabolism in the dACC (p < 0.001, p < 0.05FWE), insula, Broca's area, caudate, thalamus, OFC and temporal cortex (p < 0.001), whereas PPD showed decreased metabolism in the motor cortex (p < 0.001). Across bvFTD and PPD, decreased metabolism in the temporal cortex (p < 0.001, p < 0.05FWE), dACC and frontal cortex was associated with worse social cognition. Decreased metabolism in the dlPFC was associated with compulsiveness (p < 0.001). Across bvFTD, PPD and controls, decreased metabolism in the PFC and motor cortex was associated with executive dysfunctioning (p < 0.001). CONCLUSIONS Our findings indicate subtle but distinct metabolic patterns in bvFTD and PPD, most strongly in the dACC. The degree of frontotemporal and cingulate hypometabolism was related to impaired social cognition, compulsiveness and executive dysfunctioning. Our findings suggest that the dACC might be an important region to differentiate between bvFTD and PPD but needs further validation.
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Affiliation(s)
- Marie-Paule E van Engelen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Sander C J Verfaillie
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Annemieke Dols
- Department of Psychiatry, UMC Utrecht Brain Center, University of Utrecht, Utrecht, The Netherlands
| | - Mardien L Oudega
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, The Netherlands
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Sandeep S V Golla
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marijke den Hollander
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- EQT Life Sciences Partners, Amsterdam, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Everard G B Vijverberg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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15
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Legaz A, Prado P, Moguilner S, Báez S, Santamaría-García H, Birba A, Barttfeld P, García AM, Fittipaldi S, Ibañez A. Social and non-social working memory in neurodegeneration. Neurobiol Dis 2023; 183:106171. [PMID: 37257663 PMCID: PMC11177282 DOI: 10.1016/j.nbd.2023.106171] [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: 04/05/2023] [Revised: 05/08/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023] Open
Abstract
Although social functioning relies on working memory, whether a social-specific mechanism exists remains unclear. This undermines the characterization of neurodegenerative conditions with both working memory and social deficits. We assessed working memory domain-specificity across behavioral, electrophysiological, and neuroimaging dimensions in 245 participants. A novel working memory task involving social and non-social stimuli with three load levels was assessed across controls and different neurodegenerative conditions with recognized impairments in: working memory and social cognition (behavioral-variant frontotemporal dementia); general cognition (Alzheimer's disease); and unspecific patterns (Parkinson's disease). We also examined resting-state theta oscillations and functional connectivity correlates of working memory domain-specificity. Results in controls and all groups together evidenced increased working memory demands for social stimuli associated with frontocinguloparietal theta oscillations and salience network connectivity. Canonical frontal theta oscillations and executive-default mode network anticorrelation indexed non-social stimuli. Behavioral-variant frontotemporal dementia presented generalized working memory deficits related to posterior theta oscillations, with social stimuli linked to salience network connectivity. In Alzheimer's disease, generalized working memory impairments were related to temporoparietal theta oscillations, with non-social stimuli linked to the executive network. Parkinson's disease showed spared working memory performance and canonical brain correlates. Findings support a social-specific working memory and related disease-selective pathophysiological mechanisms.
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Affiliation(s)
- Agustina Legaz
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Universidad Nacional de Córdoba, Facultad de Psicología, Córdoba, Argentina
| | - Pavel Prado
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile; Escuela de Fonoaudiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
| | - Sebastián Moguilner
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile; Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, United States; Trinity College Dublin (TCD), Dublin, Ireland
| | | | - Hernando Santamaría-García
- Pontificia Universidad Javeriana, Medical School, Physiology and Psychiatry Departments, Memory and Cognition Center Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Agustina Birba
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina; Facultad de Psicología, Universidad de La Laguna, Tenerife, Spain; Instituto Universitario de Neurociencia, Universidad de La Laguna, Tenerife, Spain
| | - Pablo Barttfeld
- Cognitive Science Group. Instituto de Investigaciones Psicológicas (IIPsi), CONICET UNC, Facultad de Psicología, Universidad Nacional de Córdoba, Boulevard de la Reforma esquina Enfermera Gordillo, CP 5000. Córdoba, Argentina
| | - Adolfo M García
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina; Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, United States; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile; Trinity College Dublin (TCD), Dublin, Ireland
| | - Sol Fittipaldi
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile; Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, United States; Trinity College Dublin (TCD), Dublin, Ireland.
| | - Agustín Ibañez
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile; Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, United States; Trinity College Dublin (TCD), Dublin, Ireland.
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16
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Wang JY, Ma GM, Tang XQ, Shi QL, Yu MC, Lou MM, He KW, Wang WY. Brain region-specific synaptic function of FUS underlies the FTLD-linked behavioural disinhibition. Brain 2023; 146:2107-2119. [PMID: 36345573 DOI: 10.1093/brain/awac411] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 08/10/2022] [Accepted: 09/19/2022] [Indexed: 11/09/2022] Open
Abstract
Synaptic dysfunction is one of the earliest pathological processes that contribute to the development of many neurological disorders, including Alzheimer's disease and frontotemporal lobar degeneration. However, the synaptic function of many disease-causative genes and their contribution to the pathogenesis of the related diseases remain unclear. In this study, we investigated the synaptic role of fused in sarcoma, an RNA-binding protein linked to frontotemporal lobar degeneration and amyotrophic lateral sclerosis, and its potential pathological role in frontotemporal lobar degeneration using pyramidal neuron-specific conditional knockout mice (FuscKO). We found that FUS regulates the expression of many genes associated with synaptic function in a hippocampal subregion-specific manner, concomitant with the frontotemporal lobar degeneration-linked behavioural disinhibition. Electrophysiological study and molecular pathway analyses further reveal that fused in sarcoma differentially regulates synaptic and neuronal properties in the ventral hippocampus and medial prefrontal cortex, respectively. Moreover, fused in sarcoma selectively modulates the ventral hippocampus-prefrontal cortex projection, which is known to mediate the anxiety-like behaviour. Our findings unveil the brain region- and synapse-specific role of fused in sarcoma, whose impairment might lead to the emotional symptoms associated with frontotemporal lobar degeneration.
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Affiliation(s)
- Jun-Ying Wang
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Science, Shanghai 201210, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Guo-Ming Ma
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Science, Shanghai 201210, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xiao-Qiang Tang
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Science, Shanghai 201210, China
| | - Qi-Li Shi
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Science, Shanghai 201210, China
| | - Ming-Can Yu
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Science, Shanghai 201210, China
| | - Min-Min Lou
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Science, Shanghai 201210, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Kai-Wen He
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Science, Shanghai 201210, China
| | - Wen-Yuan Wang
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Science, Shanghai 201210, China
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- Animal Center of Zoology, Institute of Neuroscience, Kunming Medical University, Kunming 650500, China
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17
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Sanz Perl Y, Fittipaldi S, Gonzalez Campo C, Moguilner S, Cruzat J, Fraile-Vazquez ME, Herzog R, Kringelbach ML, Deco G, Prado P, Ibanez A, Tagliazucchi E. Model-based whole-brain perturbational landscape of neurodegenerative diseases. eLife 2023; 12:e83970. [PMID: 36995213 PMCID: PMC10063230 DOI: 10.7554/elife.83970] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 03/15/2023] [Indexed: 03/31/2023] Open
Abstract
The treatment of neurodegenerative diseases is hindered by lack of interventions capable of steering multimodal whole-brain dynamics towards patterns indicative of preserved brain health. To address this problem, we combined deep learning with a model capable of reproducing whole-brain functional connectivity in patients diagnosed with Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). These models included disease-specific atrophy maps as priors to modulate local parameters, revealing increased stability of hippocampal and insular dynamics as signatures of brain atrophy in AD and bvFTD, respectively. Using variational autoencoders, we visualized different pathologies and their severity as the evolution of trajectories in a low-dimensional latent space. Finally, we perturbed the model to reveal key AD- and bvFTD-specific regions to induce transitions from pathological to healthy brain states. Overall, we obtained novel insights on disease progression and control by means of external stimulation, while identifying dynamical mechanisms that underlie functional alterations in neurodegeneration.
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Affiliation(s)
- Yonatan Sanz Perl
- Department of Physics, University of Buenos AiresBuenos AiresArgentina
- National Scientific and Technical Research Council (CONICET), CABABuenos AiresArgentina
- Cognitive Neuroscience Center (CNC), Universidad de San AndrésBuenos AiresArgentina
- Center for Brain and Cognition, Computational Neuroscience Group, Universitat Pompeu FabraBarcelonaSpain
| | - Sol Fittipaldi
- National Scientific and Technical Research Council (CONICET), CABABuenos AiresArgentina
- Cognitive Neuroscience Center (CNC), Universidad de San AndrésBuenos AiresArgentina
| | - Cecilia Gonzalez Campo
- National Scientific and Technical Research Council (CONICET), CABABuenos AiresArgentina
- Cognitive Neuroscience Center (CNC), Universidad de San AndrésBuenos AiresArgentina
| | - Sebastián Moguilner
- Global Brain Health Institute, University of California, San FranciscoSan FranciscoUnited States
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo IbáñezSantiagoChile
| | - Josephine Cruzat
- Center for Brain and Cognition, Computational Neuroscience Group, Universitat Pompeu FabraBarcelonaSpain
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo IbáñezSantiagoChile
| | | | - Rubén Herzog
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo IbáñezSantiagoChile
| | - Morten L Kringelbach
- Department of Psychiatry, University of OxfordOxfordUnited Kingdom
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus UniversityÅrhusDenmark
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of MinhoBragaPortugal
- Centre for Eudaimonia and Human Flourishing, University of OxfordOxfordUnited Kingdom
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Universitat Pompeu FabraBarcelonaSpain
- Department of Information and Communication Technologies, Universitat Pompeu FabraBarcelonaSpain
- Institució Catalana de la Recerca i Estudis Avancats (ICREA)BarcelonaSpain
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
- School of Psychological Sciences, Monash UniversityClaytonAustralia
| | - Pavel Prado
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo IbáñezSantiagoChile
- Escuela de Fonoaudiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San SebastiánSantiagoChile
| | - Agustin Ibanez
- National Scientific and Technical Research Council (CONICET), CABABuenos AiresArgentina
- Cognitive Neuroscience Center (CNC), Universidad de San AndrésBuenos AiresArgentina
- Global Brain Health Institute, University of California, San FranciscoSan FranciscoUnited States
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo IbáñezSantiagoChile
- Trinity College Institute of Neuroscience (TCIN), Trinity College DublinDublinIreland
| | - Enzo Tagliazucchi
- Department of Physics, University of Buenos AiresBuenos AiresArgentina
- National Scientific and Technical Research Council (CONICET), CABABuenos AiresArgentina
- Cognitive Neuroscience Center (CNC), Universidad de San AndrésBuenos AiresArgentina
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo IbáñezSantiagoChile
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18
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Cruzat J, Herzog R, Prado P, Sanz-Perl Y, Gonzalez-Gomez R, Moguilner S, Kringelbach ML, Deco G, Tagliazucchi E, Ibañez A. Temporal Irreversibility of Large-Scale Brain Dynamics in Alzheimer's Disease. J Neurosci 2023; 43:1643-1656. [PMID: 36732071 PMCID: PMC10008060 DOI: 10.1523/jneurosci.1312-22.2022] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/12/2022] [Accepted: 12/25/2022] [Indexed: 02/04/2023] Open
Abstract
Healthy brain dynamics can be understood as the emergence of a complex system far from thermodynamic equilibrium. Brain dynamics are temporally irreversible and thus establish a preferred direction in time (i.e., arrow of time). However, little is known about how the time-reversal symmetry of spontaneous brain activity is affected by Alzheimer's disease (AD). We hypothesized that the level of irreversibility would be compromised in AD, signaling a fundamental shift in the collective properties of brain activity toward equilibrium dynamics. We investigated the irreversibility from resting-state fMRI and EEG data in male and female human patients with AD and elderly healthy control subjects (HCs). We quantified the level of irreversibility and, thus, proximity to nonequilibrium dynamics by comparing forward and backward time series through time-shifted correlations. AD was associated with a breakdown of temporal irreversibility at the global, local, and network levels, and at multiple oscillatory frequency bands. At the local level, temporoparietal and frontal regions were affected by AD. The limbic, frontoparietal, default mode, and salience networks were the most compromised at the network level. The temporal reversibility was associated with cognitive decline in AD and gray matter volume in HCs. The irreversibility of brain dynamics provided higher accuracy and more distinctive information than classical neurocognitive measures when differentiating AD from control subjects. Findings were validated using an out-of-sample cohort. Present results offer new evidence regarding pathophysiological links between the entropy generation rate of brain dynamics and the clinical presentation of AD, opening new avenues for dementia characterization at different levels.SIGNIFICANCE STATEMENT By assessing the irreversibility of large-scale dynamics across multiple brain signals, we provide a precise signature capable of distinguishing Alzheimer's disease (AD) at the global, local, and network levels and different oscillatory regimes. Irreversibility of limbic, frontoparietal, default-mode, and salience networks was the most compromised by AD compared with more sensory-motor networks. Moreover, the time-irreversibility properties associated with cognitive decline and atrophy outperformed and complemented classical neurocognitive markers of AD in predictive classification performance. Findings were generalized and replicated with an out-of-sample validation procedure. We provide novel multilevel evidence of reduced irreversibility in AD brain dynamics that has the potential to open new avenues for understating neurodegeneration in terms of the temporal asymmetry of brain dynamics.
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Affiliation(s)
- Josephine Cruzat
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, 7911328, Santiago, Chile
- Fundación para el Estudio de la Conciencia Humana (ECoH), 7550000, Santiago, Chile
| | - Ruben Herzog
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, 7911328, Santiago, Chile
- Fundación para el Estudio de la Conciencia Humana (ECoH), 7550000, Santiago, Chile
| | - Pavel Prado
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, 7911328, Santiago, Chile
- Escuela de Fonoaudiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
| | - Yonatan Sanz-Perl
- Department of Physics, University of Buenos Aires, C1428EGA, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), C1033AAJ, Buenos Aires, Argentina
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, C116ABJ, Buenos Aires, Argentina
- Center for Brain and Cognition, Computational Neuroscience Group, Universitat Pompeu Fabra, 08005 Barcelona, Spain
| | - Raul Gonzalez-Gomez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, 7911328, Santiago, Chile
| | - Sebastian Moguilner
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, 7911328, Santiago, Chile
- Global Brain Health Institute, University of California, San Francisco, San Francisco, California 94143
- Global Brain Health Institute, Trinity College, Dublin 2, Ireland
| | - Morten L Kringelbach
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, 8000 Århus, Denmark
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford OX3 9BX, United Kingdom
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Universitat Pompeu Fabra, 08005 Barcelona, Spain
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, 08018 Barcelona, Spain
- Institució Catalana de la Recerca i Estudis Avancats (ICREA), 08010 Barcelona, Spain
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, D-04303 Leipzig, Germany
- School of Psychological Sciences, Monash University, Melbourne 3168, Australia
| | - Enzo Tagliazucchi
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, 7911328, Santiago, Chile
- Department of Physics, University of Buenos Aires, C1428EGA, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), C1033AAJ, Buenos Aires, Argentina
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, C116ABJ, Buenos Aires, Argentina
| | - Agustín Ibañez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, 7911328, Santiago, Chile
- National Scientific and Technical Research Council (CONICET), C1033AAJ, Buenos Aires, Argentina
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, C116ABJ, Buenos Aires, Argentina
- Global Brain Health Institute, University of California, San Francisco, San Francisco, California 94143
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
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19
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Sabatini S, Martyr A, Gamble LD, Collins R, Matthews FE, Morris RG, Rusted JM, Pentecost C, Quinn C, Clare L. Longitudinal Predictors of Informant-Rated Involvement of People with Dementia in Everyday Decision-Making: Findings from the IDEAL Program. J Appl Gerontol 2023; 42:290-301. [PMID: 36193737 PMCID: PMC9841822 DOI: 10.1177/07334648221128558] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The extent to which people with dementia are involved in everyday decision-making is unclear. We explored informant-rated involvement of people with dementia in everyday decision-making over 2 years and whether functional, behavioral, and psychological factors related to the person with dementia and the caregiver explain variability in involvement of people with dementia in everyday decision-making. We used IDEAL data for 1182 people with dementia and their caregivers. Baseline mean score on the decision-making involvement scale was 31/45; it minimally declined over time. People with dementia who were female, single, and/or whose caregiver was younger had greater involvement in everyday decision-making than those without these characteristics. Better cognition, fewer functional difficulties, fewer neuropsychiatric symptoms, less caregiver stress, and better informant-rated relationship quality were associated with higher involvement in everyday decision-making. Cognitive and functional rehabilitation, and educational resources for caregivers, could prolong involvement of people with dementia in everyday decision-making.
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Affiliation(s)
- Serena Sabatini
- Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland
| | - Anthony Martyr
- Centre for Research in Ageing and Cognitive Health, Faculty of Health and Life Sciences, University of Exeter Medical School, Exeter, UK
| | - Laura D. Gamble
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Rachel Collins
- Centre for Research in Ageing and Cognitive Health, Faculty of Health and Life Sciences, University of Exeter Medical School, Exeter, UK
| | - Fiona E. Matthews
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Robin G. Morris
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | | | - Claire Pentecost
- Centre for Research in Ageing and Cognitive Health, Faculty of Health and Life Sciences, University of Exeter Medical School, Exeter, UK
| | - Catherine Quinn
- Centre for Applied Dementia Studies, Bradford University, Bradford, UK,Wolfson Centre for Applied Health Research, Bradford, UK
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, Faculty of Health and Life Sciences, University of Exeter Medical School, Exeter, UK,Linda Clare, Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter EX1 2LU, UK.
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20
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Ramanan S, El-Omar H, Roquet D, Ahmed RM, Hodges JR, Piguet O, Lambon Ralph MA, Irish M. Mapping behavioural, cognitive and affective transdiagnostic dimensions in frontotemporal dementia. Brain Commun 2023; 5:fcac344. [PMID: 36687395 PMCID: PMC9847565 DOI: 10.1093/braincomms/fcac344] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 09/26/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
Two common clinical variants of frontotemporal dementia are the behavioural variant frontotemporal dementia, presenting with behavioural and personality changes attributable to prefrontal atrophy, and semantic dementia, displaying early semantic dysfunction primarily due to anterior temporal degeneration. Despite representing independent diagnostic entities, mounting evidence indicates overlapping cognitive-behavioural profiles in these syndromes, particularly with disease progression. Why such overlap occurs remains unclear. Understanding the nature of this overlap, however, is essential to improve early diagnosis, characterization and management of those affected. Here, we explored common cognitive-behavioural and neural mechanisms contributing to heterogeneous frontotemporal dementia presentations, irrespective of clinical diagnosis. This transdiagnostic approach allowed us to ascertain whether symptoms not currently considered core to these two syndromes are present in a significant proportion of cases and to explore the neural basis of clinical heterogeneity. Sixty-two frontotemporal dementia patients (31 behavioural variant frontotemporal dementia and 31 semantic dementia) underwent comprehensive neuropsychological, behavioural and structural neuroimaging assessments. Orthogonally rotated principal component analysis of neuropsychological and behavioural data uncovered eight statistically independent factors explaining the majority of cognitive-behavioural performance variation in behavioural variant frontotemporal dementia and semantic dementia. These factors included Behavioural changes, Semantic dysfunction, General Cognition, Executive function, Initiation, Disinhibition, Visuospatial function and Affective changes. Marked individual-level overlap between behavioural variant frontotemporal dementia and semantic dementia was evident on the Behavioural changes, General Cognition, Initiation, Disinhibition and Affective changes factors. Compared to behavioural variant frontotemporal dementia, semantic dementia patients displayed disproportionate impairment on the Semantic dysfunction factor, whereas greater impairment on Executive and Visuospatial function factors was noted in behavioural variant frontotemporal dementia. Both patient groups showed comparable magnitude of atrophy to frontal regions, whereas severe temporal lobe atrophy was characteristic of semantic dementia. Whole-brain voxel-based morphometry correlations with emergent factors revealed associations between fronto-insular and striatal grey matter changes with Behavioural, Executive and Initiation factor performance, bilateral temporal atrophy with Semantic dysfunction factor scores, parietal-subcortical regions with General Cognitive performance and ventral temporal atrophy associated with Visuospatial factor scores. Together, these findings indicate that cognitive-behavioural overlap (i) occurs systematically in frontotemporal dementia; (ii) varies in a graded manner between individuals and (iii) is associated with degeneration of different neural systems. Our findings suggest that phenotypic heterogeneity in frontotemporal dementia syndromes can be captured along continuous, multidimensional spectra of cognitive-behavioural changes. This has implications for the diagnosis of both syndromes amidst overlapping features as well as the design of symptomatic treatments applicable to multiple syndromes.
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Affiliation(s)
- Siddharth Ramanan
- Medical Research Council Cognition and Brain Sciences Unit, The University of Cambridge, Cambridge CB3 1AU, UK
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Psychology, The University of Sydney, Sydney, NSW 2050, Australia
| | - Hashim El-Omar
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
| | - Daniel Roquet
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Psychology, The University of Sydney, Sydney, NSW 2050, Australia
| | - Rebekah M Ahmed
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- Memory and Cognition Clinic, Department of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - John R Hodges
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Psychology, The University of Sydney, Sydney, NSW 2050, Australia
- School of Medical Sciences, The University of Sydney, Sydney, NSW 2050, Australia
| | - Olivier Piguet
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Psychology, The University of Sydney, Sydney, NSW 2050, Australia
| | - Matthew A Lambon Ralph
- Medical Research Council Cognition and Brain Sciences Unit, The University of Cambridge, Cambridge CB3 1AU, UK
| | - Muireann Irish
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Psychology, The University of Sydney, Sydney, NSW 2050, Australia
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21
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Fieldhouse JLP, van Dijk G, Gillissen F, van Engelen MPE, de Boer SCM, Dols A, van der Waal HJ, Regeer BJ, Vijverberg EGB, Pijnenburg YAL. A caregiver's perspective on clinically relevant symptoms in behavioural variant frontotemporal dementia: tools for disease management and trial design. Psychogeriatrics 2023; 23:11-22. [PMID: 36314055 PMCID: PMC10092374 DOI: 10.1111/psyg.12898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/29/2022] [Accepted: 10/10/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Adequate detection of symptoms and disease progression in behavioural variant frontotemporal dementia (bvFTD) is complex. Dementia cohorts usually utilize cognitive and functional measures, which fail to detect dominant behavioural and social cognitive deficits in bvFTD. Moreover, since patients typically have a loss of insight, caregivers are important informants. This is the first qualitative study to investigate caregiver relevant symptoms during the disease course of bvFTD, aiming to improve tools for diagnosis, progression, and future clinical trials. METHODS Informal caregivers of patients in different disease stages of bvFTD (N = 20) were recruited from the neurology outpatient clinic of the Amsterdam UMC and a patient organization for peer support in the Netherlands. Their perspectives on clinical relevance were thoroughly explored during individual semi-structured interviews. Inductive content analysis with open coding was performed by two researchers independently to establish overarching themes and patterns. RESULTS Caregivers reported a variety of symptoms, in which (i) loss of emotional connection, (ii) preoccupation and restlessness, and (iii) apathy and dependency compose major themes of relevance for diagnosis and treatment. Within heterogeneous disease trajectories, symptom presence differed between stages and among individuals, which is relevant in the context of progression and outcome measures. Significant socio-emotional changes dominated in early stages, while severe cognitive, behavioural, and physical deterioration shifted focus from predominant personality change to quality of life in later stages. CONCLUSIONS Caregiver perspectives on target symptoms in bvFTD differ according to clinical stage and patient-caregiver characteristics, with significant socio-emotional changes characterizing early stages. These findings call for more appropriate tools and symptomatic treatments, as well as a personalized approach in treatment of bvFTD and a focus on early stage interventions in clinical trial design.
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Affiliation(s)
- Jay L P Fieldhouse
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Gaby van Dijk
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Freek Gillissen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Marie-Paule E van Engelen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Sterre C M de Boer
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Annemiek Dols
- Department of Old Age Psychiatry, GGZ InGeest, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | | | - Barbara J Regeer
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Everard G B Vijverberg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands
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22
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Díaz-Rivera MN, Birba A, Fittipaldi S, Mola D, Morera Y, de Vega M, Moguilner S, Lillo P, Slachevsky A, González Campo C, Ibáñez A, García AM. Multidimensional inhibitory signatures of sentential negation in behavioral variant frontotemporal dementia. Cereb Cortex 2022; 33:403-420. [PMID: 35253864 PMCID: PMC9837611 DOI: 10.1093/cercor/bhac074] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Processing of linguistic negation has been associated to inhibitory brain mechanisms. However, no study has tapped this link via multimodal measures in patients with core inhibitory alterations, a critical approach to reveal direct neural correlates and potential disease markers. METHODS Here we examined oscillatory, neuroanatomical, and functional connectivity signatures of a recently reported Go/No-go negation task in healthy controls and behavioral variant frontotemporal dementia (bvFTD) patients, typified by primary and generalized inhibitory disruptions. To test for specificity, we also recruited persons with Alzheimer's disease (AD), a disease involving frequent but nonprimary inhibitory deficits. RESULTS In controls, negative sentences in the No-go condition distinctly involved frontocentral delta (2-3 Hz) suppression, a canonical inhibitory marker. In bvFTD patients, this modulation was selectively abolished and significantly correlated with the volume and functional connectivity of regions supporting inhibition (e.g. precentral gyrus, caudate nucleus, and cerebellum). Such canonical delta suppression was preserved in the AD group and associated with widespread anatomo-functional patterns across non-inhibitory regions. DISCUSSION These findings suggest that negation hinges on the integrity and interaction of spatiotemporal inhibitory mechanisms. Moreover, our results reveal potential neurocognitive markers of bvFTD, opening a new agenda at the crossing of cognitive neuroscience and behavioral neurology.
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Affiliation(s)
- Mariano N Díaz-Rivera
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,Agencia Nacional de Promoción Científica y Tecnológica (ANPCyT), C1425FQD, Godoy Cruz 2370, Buenos Aires, Argentina
| | - Agustina Birba
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina
| | - Sol Fittipaldi
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina
| | - Débora Mola
- Instituto de Investigaciones Psicológicas, CONICET, 5000, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Yurena Morera
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, Campus de Guajara, 38205 La Laguna, Santa Cruz de Tenerife, Spain
| | - Manuel de Vega
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, Campus de Guajara, 38205 La Laguna, Santa Cruz de Tenerife, Spain
| | - Sebastian Moguilner
- Global Brain Health Institute, University of California, San Francisco, CA94158, US; and Trinity College, Dublin D02DP21, , Ireland.,Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, 8320000, Santiago, Chile
| | - Patricia Lillo
- Departamento de Neurología Sur, Facultad de Medicina, Universidad de Chile, 8380000, Santiago, Chile.,Unidad de Neurología, Hospital San José, 8380000, Santiago, Chile.,Geroscience Center for Brain Health and Metabolism (GERO), 7800003, Santiago, Chile
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), 7800003, Santiago, Chile.,Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, Neuroscience and East Neuroscience Departments, Faculty of Medicine, Institute of Biomedical Sciences (ICBM), University of Chile, 8380000, Santiago, Chile.,Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, 7500000, Santiago, Chile.,Departamento de Medicina, Servicio de Neurología, Clínica Alemana-Universidad del Desarrollo, 7550000, Santiago, Chile
| | - Cecilia González Campo
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina
| | - Agustín Ibáñez
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina.,Global Brain Health Institute, University of California, San Francisco, CA94158, US; and Trinity College, Dublin D02DP21, , Ireland.,Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, 8320000, Santiago, Chile
| | - Adolfo M García
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, Vito Dumas 284, Buenos Aires B1644BID, Argentina.,National Scientific and Technical Research Council (CONICET), C1425FQD, Godoy Cruz 2290, Buenos Aires, Argentina.,Global Brain Health Institute, University of California, San Francisco, CA94158, US; and Trinity College, Dublin D02DP21, , Ireland.,Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, 7550000, Santiago, Chile
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23
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Schievink WI, Maya M, Barnard Z, Taché RB, Prasad RS, Wadhwa VS, Moser FG, Nuño M. The reversible impairment of behavioral variant frontotemporal brain sagging syndrome: Challenges and opportunities. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12367. [PMID: 36544987 PMCID: PMC9760785 DOI: 10.1002/trc2.12367] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 12/23/2022]
Abstract
Introduction Due to loss of brain buoyancy, spontaneous spinal cerebrospinal fluid (CSF) leaks cause orthostatic headaches but also can cause symptoms indistinguishable from behavioral variant frontotemporal dementia (bvFTD) due to severe brain sagging (including the frontal and temporal lobes), as visualized on brain magnetic resonance imaging. However, the detection of these CSF leaks may require specialized spinal imaging techniques, such as digital subtraction myelography (DSM). Methods We performed DSM in the lateral decubitus position under general anesthesia in 21 consecutive patients with frontotemporal dementia brain sagging syndrome (4 women and 17 men; mean age 56.2 years [range: 31-70 years]). Results Nine patients (42.8%) were found to have a CSF-venous fistula, a recently discovered type of CSF leak that cannot be detected on conventional spinal imaging. All nine patients underwent uneventful surgical ligation of the fistula. Complete or near-complete and sustained resolution of bvFTD symptoms was obtained by all nine patients, accompanied by reversal of brain sagging, but in only three (25.0%) of the twelve patients in whom no CSF-venous fistula could be detected (P = 0.0011), and who were treated with non-targeted therapies. Discussion Concerns about a spinal CSF leak should not be dismissed in patients with frontotemporal brain sagging syndrome, even when conventional spinal imaging is normal. However, even with this specialized imaging the source of the loss of spinal CSF remains elusive in more than half of patients.
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Affiliation(s)
- Wouter I. Schievink
- Department of NeurosurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Marcel Maya
- Department of ImagingCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Zachary Barnard
- Department of NeurosurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Rachelle B. Taché
- Department of NeurosurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Ravi S. Prasad
- Department of ImagingCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Vikram S. Wadhwa
- Department of ImagingCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Franklin G. Moser
- Department of ImagingCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Miriam Nuño
- Department of Public Health SciencesUniversity of CaliforniaDavisCaliforniaUSA
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24
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Santamaría-García H, Ogonowsky N, Baez S, Palacio N, Reyes P, Schulte M, López A, Matallana D, Ibanez A. Neurocognitive patterns across genetic levels in behavioral variant frontotemporal dementia: a multiple single cases study. BMC Neurol 2022; 22:454. [PMID: 36474176 PMCID: PMC9724347 DOI: 10.1186/s12883-022-02954-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/06/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Behavioral variant frontotemporal dementia (bvFTD) has been related to different genetic factors. Identifying multimodal phenotypic heterogeneity triggered by various genetic influences is critical for improving diagnosis, prognosis, and treatments. However, the specific impact of different genetic levels (mutations vs. risk variants vs. sporadic presentations) on clinical and neurocognitive phenotypes is not entirely understood, specially in patites from underrepresented regions such as Colombia. METHODS Here, in a multiple single cases study, we provide systematic comparisons regarding cognitive, neuropsychiatric, brain atrophy, and gene expression-atrophy overlap in a novel cohort of FTD patients (n = 42) from Colombia with different genetic levels, including patients with known genetic influences (G-FTD) such as those with genetic mutations (GR1) in particular genes (MAPT, TARDBP, and TREM2); patients with risk variants (GR2) in genes associated with FTD (tau Haplotypes H1 and H2 and APOE variants including ε2, ε3, ε4); and sporadic FTD patients (S-FTD (GR3)). RESULTS We found that patients from GR1 and GR2 exhibited earlier disease onset, pervasive cognitive impairments (cognitive screening, executive functioning, ToM), and increased brain atrophy (prefrontal areas, cingulated cortices, basal ganglia, and inferior temporal gyrus) than S-FTD patients (GR3). No differences in disease duration were observed across groups. Additionally, significant neuropsychiatric symptoms were observed in the GR1. The GR1 also presented more clinical and neurocognitive compromise than GR2 patients; these groups, however, did not display differences in disease onset or duration. APOE and tau patients showed more neuropsychiatric symptoms and primary atrophy in parietal and temporal cortices than GR1 patients. The gene-atrophy overlap analysis revealed atrophy in regions with specific genetic overexpression in all G-FTD patients. A differential family presentation did not explain the results. CONCLUSIONS Our results support the existence of genetic levels affecting the clinical, neurocognitive, and, to a lesser extent, neuropsychiatric presentation of bvFTD in the present underrepresented sample. These results support tailored assessments characterization based on the parallels of genetic levels and neurocognitive profiles in bvFTD.
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Affiliation(s)
- Hernando Santamaría-García
- PhD program in Neuroscience, Pontificia Universidad Javeriana, Bogotá, Colombia.
- Memory and cognition Center, Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia.
- Department of Neurology, Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA.
| | - Natalia Ogonowsky
- CONICET & Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - Sandra Baez
- Faculty of Psychology, Universidad de los Andes, Bogotá, Colombia
| | - Nicole Palacio
- Integrated Program in Neuroscience, McGill University, Montreal, Canada
| | - Pablo Reyes
- PhD program in Neuroscience, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Michael Schulte
- CONICET & Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - Andrea López
- Pontificia Universidad Javeriana, Bogotá, Colombia
- Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Agustín Ibanez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago de Chile, Chile.
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, & National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
- Trinity Collegue of Dublin, Dublin, Irland.
- Global Brain Health Insititute, Universidad California San Francisco-Trinity College of Dublin, San Francisco, USA.
- Global Brain Health Insititute, Universidad California San Francisco-Trinity College of Dublin, Dublin, Irland.
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25
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Herzog R, Rosas FE, Whelan R, Fittipaldi S, Santamaria-Garcia H, Cruzat J, Birba A, Moguilner S, Tagliazucchi E, Prado P, Ibanez A. Genuine high-order interactions in brain networks and neurodegeneration. Neurobiol Dis 2022; 175:105918. [PMID: 36375407 PMCID: PMC11195446 DOI: 10.1016/j.nbd.2022.105918] [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: 08/13/2022] [Revised: 10/18/2022] [Accepted: 11/03/2022] [Indexed: 11/13/2022] Open
Abstract
Brain functional networks have been traditionally studied considering only interactions between pairs of regions, neglecting the richer information encoded in higher orders of interactions. In consequence, most of the connectivity studies in neurodegeneration and dementia use standard pairwise metrics. Here, we developed a genuine high-order functional connectivity (HOFC) approach that captures interactions between 3 or more regions across spatiotemporal scales, delivering a more biologically plausible characterization of the pathophysiology of neurodegeneration. We applied HOFC to multimodal (electroencephalography [EEG], and functional magnetic resonance imaging [fMRI]) data from patients diagnosed with behavioral variant of frontotemporal dementia (bvFTD), Alzheimer's disease (AD), and healthy controls. HOFC revealed large effect sizes, which, in comparison to standard pairwise metrics, provided a more accurate and parsimonious characterization of neurodegeneration. The multimodal characterization of neurodegeneration revealed hypo and hyperconnectivity on medium to large-scale brain networks, with a larger contribution of the former. Regions as the amygdala, the insula, and frontal gyrus were associated with both effects, suggesting potential compensatory processes in hub regions. fMRI revealed hypoconnectivity in AD between regions of the default mode, salience, visual, and auditory networks, while in bvFTD between regions of the default mode, salience, and somatomotor networks. EEG revealed hypoconnectivity in the γ band between frontal, limbic, and sensory regions in AD, and in the δ band between frontal, temporal, parietal and posterior areas in bvFTD, suggesting additional pathophysiological processes that fMRI alone can not capture. Classification accuracy was comparable with standard biomarkers and robust against confounders such as sample size, age, education, and motor artifacts (from fMRI and EEG). We conclude that high-order interactions provide a detailed, EEG- and fMRI compatible, biologically plausible, and psychopathological-specific characterization of different neurodegenerative conditions.
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Affiliation(s)
- Rubén Herzog
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Fundación para el Estudio de la Conciencia Humana (EcoH), Chile
| | - Fernando E Rosas
- Fundación para el Estudio de la Conciencia Humana (EcoH), Chile; Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, UK; Data Science Institute, Imperial College London, UK; Centre for Complexity Science, Imperial College London, UK; Department of Informatics, University of Sussex, Brighton, UK
| | - Robert Whelan
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin 2, Ireland
| | - Sol Fittipaldi
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin 2, Ireland; Cognitive Neuroscience Center (CNC), Universidad de San Andrés & CONICET, Buenos Aires, Argentina
| | | | - Josephine Cruzat
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Fundación para el Estudio de la Conciencia Humana (EcoH), Chile
| | - Agustina Birba
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés & CONICET, Buenos Aires, Argentina
| | - Sebastian Moguilner
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Enzo Tagliazucchi
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Buenos Aires Physics Institute and Physics Department, University of Buenos Aires, Buenos Aires, Argentina
| | - Pavel Prado
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile.
| | - Agustin Ibanez
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin 2, Ireland; Cognitive Neuroscience Center (CNC), Universidad de San Andrés & CONICET, Buenos Aires, Argentina; Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), CA, USA.
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26
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Chen Z, Chu M, Liu L, Zhang J, Kong Y, Xie K, Cui Y, Ye H, Li J, Wang L, Wu L. Genetic prion diseases presenting as frontotemporal dementia: clinical features and diagnostic challenge. Alzheimers Res Ther 2022; 14:90. [PMID: 35768878 PMCID: PMC9245249 DOI: 10.1186/s13195-022-01033-4] [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: 01/02/2022] [Accepted: 06/22/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
To elucidate the clinical and ancillary features of genetic prion diseases (gPrDs) presenting with frontotemporal dementia (FTD) to aid early identification.
Methods
Global data of gPrDs presenting with FTD caused by prion protein gene mutations were collected from literature review and our records. Fifty-one cases of typical FTD and 136 cases of prion diseases admitted to our institution were included as controls. Clinical and ancillary data of the different groups were compared.
Results
Forty-nine cases of gPrDs presenting with FTD were identified. Compared to FTD or prion diseases, gPrDs presenting with FTD were characterized by earlier onset age (median 45 vs. 61/60 years, P < 0.001, P < 0.001) and higher incidence of positive family history (81.6% vs. 27.5/13.2%, P < 0.001, P < 0.001). Furthermore, GPrDs presenting with FTD exhibited shorter duration (median 5 vs. 8 years) and a higher rate of parkinsonism (63.7% vs. 9.8%, P < 0.001), pyramidal signs (39.1% vs. 7.8%, P = 0.001), mutism (35.9% vs. 0%, P < 0.001), seizures (25.8% vs. 0%, P < 0.001), myoclonus (22.5% vs. 0%, P < 0.001), and hyperintensity on MRI (25.0% vs. 0, P < 0.001) compared to FTD. Compared to prion diseases, gPrDs presenting with FTD had a longer duration of symptoms (median 5 vs. 1.1 years, P < 0.001), higher rates of frontotemporal atrophy (89.7% vs. 3.3%, P < 0.001), lower rates of periodic short-wave complexes on EEG (0% vs. 30.3%, P = 0.001), and hyperintensity on MRI (25.0% vs. 83.0%, P < 0.001). The frequency of codon 129 Val allele in gPrDs presenting with FTD was significantly higher than that reported in the literature for gPrDs in the Caucasian and East Asian populations (33.3% vs. 19.2%/8.0%, P = 0.005, P < 0.001).
Conclusions
GPrDs presenting with FTD are characterized by early-onset, high incidence of positive family history, high frequency of the Val allele at codon 129, overlapping symptoms with prion disease and FTD, and ancillary features closer to FTD. PRNP mutations may be a rare cause in the FTD spectrum, and PRNP genotyping should be considered in patients with these features.
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27
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Tirigay R, Moltrasio J, Rubinstein W. Dissociations between musical semantic memory and verbal memory in a patient with behavioral variant frontotemporal dementia. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-10. [PMID: 36416413 DOI: 10.1080/23279095.2022.2148105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Patients with dementia show dissociations between musical semantic memory (i.e., spared musical lexicon) and other memory modalities, except in some severe cases. We aim to study, from a neuropsychological point of view, the dissociation between musical semantic memory compared to language and verbal memory in a patient with severe Behavioral Variant Frontotemporal Dementia (bvFTD). We hypothesize a single dissociation between these domains will be found, with sparing of musical semantic memory. METHODS LC, a patient with severe bvFTD, and three matched controls were assessed through language, semantic, and episodic memory, and musical semantic memory tasks. The control group had similar music taste as LC: to participate as controls, tango must be one of their favorite musical genres. RESULTS LC showed impairment in all Verbal Memory tasks, but not in musical tasks. There was a dissociation between musical semantic memory, and language and verbal semantic memory. CONCLUSIONS The musical lexicon can be preserved in advanced stages of dementia, which supports the idea that music can be a therapeutic tool in patients with severe dementia.
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Affiliation(s)
- Romina Tirigay
- Departamento de Neurociencias, Universidad de Palermo, Buenos Aires, Argentina
- Residencia Manantial, Buenos Aires, Argentina
| | - Julieta Moltrasio
- Facultad de Psicología; Instituto de Investigaciones, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Wanda Rubinstein
- Departamento de Neurociencias, Universidad de Palermo, Buenos Aires, Argentina
- Facultad de Psicología; Instituto de Investigaciones, Universidad de Buenos Aires, Buenos Aires, Argentina
- HIGA "Eva Perón", CONICET, Laboratorio de Deterioro Cognitivo. San Martín, Buenos Aires, Argentina
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28
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O'Connor CMC, Fisher A, Cheung SC, Caga J, Piguet O. Supporting behaviour change in younger-onset dementia: mapping the needs of family carers in the community. Aging Ment Health 2022; 26:2252-2261. [PMID: 34424808 DOI: 10.1080/13607863.2021.1966744] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Almost 10% of people with dementia experience a younger-onset of disease (before 65 years). Changes in behaviour are common, as are delays in diagnosis and limited access to appropriate support and services. This study aimed to explore the specific behaviour support needs of families living with younger-onset dementia. METHODS Seventy-one families of people with younger-onset dementia were surveyed to understand the experience of family carers regarding difficult-to-manage behaviour changes, confidence in identifying and implementing behaviour support strategies, use of specific behaviour support strategies, and use of formal and informal support services regarding behaviour changes. RESULTS Survey responses were received from family members of people living with behavioural variant frontotemporal dementia (n = 28), semantic dementia (n = 17), and Alzheimer's disease (n = 23). Over 90% of family carers reported difficult-to-manage behaviours which fell into four main domains: (1) aggression, (2) compulsive behaviour, (3) disinhibition and inappropriate social behaviour, and (4) apathy. A range of preventative and responsive strategies, with an emphasis on de-escalation strategies were identified and carers reported variable confidence in managing behaviour changes or in accessing formal support strategies. CONCLUSIONS Difficult-to-manage behaviour changes in community-dwelling people with younger-onset dementia are common. The existing agency of families should be recognised and built upon with better access to specific behaviour support services to increase competence and confidence in providing behaviour support and ultimately improve quality of life for them and their family member with dementia.
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Affiliation(s)
- Claire M C O'Connor
- Centre for Positive Ageing, HammondCare, Sydney, Australia.,School of Population Health, The University of New South Wales, Sydney, Australia
| | - Alinka Fisher
- College of Nursing and Health Sciences Adelaide, Flinders University, Adelaide, Australia
| | - Sau Chi Cheung
- School of Psychology and Brain & Mind Centre, The University of Sydney, Sydney, Australia
| | - Jashelle Caga
- Sydney Medical School and Brain & Mind Centre, The University of Sydney, Sydney, Australia
| | - Olivier Piguet
- School of Psychology and Brain & Mind Centre, The University of Sydney, Sydney, Australia
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29
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Migeot JA, Duran-Aniotz CA, Signorelli CM, Piguet O, Ibáñez A. A predictive coding framework of allostatic-interoceptive overload in frontotemporal dementia. Trends Neurosci 2022; 45:838-853. [PMID: 36057473 PMCID: PMC11286203 DOI: 10.1016/j.tins.2022.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/27/2022] [Accepted: 08/09/2022] [Indexed: 10/31/2022]
Abstract
Recent allostatic-interoceptive explanations using predictive coding models propose that efficient regulation of the body's internal milieu is necessary to correctly anticipate environmental needs. We review this framework applied to understanding behavioral variant frontotemporal dementia (bvFTD) considering both allostatic overload and interoceptive deficits. First, we show how this framework could explain divergent deficits in bvFTD (cognitive impairments, behavioral maladjustment, brain atrophy, fronto-insular-temporal network atypicality, aberrant interoceptive electrophysiological activity, and autonomic disbalance). We develop a set of theory-driven predictions based on levels of allostatic interoception associated with bvFTD phenomenology and related physiopathological mechanisms. This approach may help further understand the disparate behavioral and physiopathological dysregulations of bvFTD, suggesting targeted interventions and strengthening clinical models of neurological and psychiatric disorders.
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Affiliation(s)
- Joaquin A Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Claudia A Duran-Aniotz
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Camilo M Signorelli
- Department of Computer Science, University of Oxford, Oxford, UK; Physiology of Cognition, GIGA-CRC In Vivo Imaging, University of Liège, Liège, Belgium; Cognitive Neuroimaging Unit, INSERM, Saclay, France
| | - Olivier Piguet
- The University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, Australia
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Global Brain Health Institute, University of California-San Francisco, San Francisco, CA, USA, and Trinity College Dublin, Dublin, Ireland.
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30
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Magrath Guimet N, Zapata-Restrepo LM, Miller BL. Advances in Treatment of Frontotemporal Dementia. J Neuropsychiatry Clin Neurosci 2022; 34:316-327. [PMID: 35578801 DOI: 10.1176/appi.neuropsych.21060166] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this review, the authors explored the clinical features of frontotemporal dementia (FTD), focusing on treatment. The clinical features of FTD are unique, with disinhibition, apathy, loss of empathy, and compulsions common. Motor changes occur later in the illness. The two major proteins that aggregate in the brain with FTD are tau and TDP-43, whereas a minority of patients aggregate FET proteins, primarily the FUS protein. Genetic causes include mutations in MAPT, GRN, and C9orf72. There are no medications that can slow FTD progression, although new therapies for the genetic forms of FTD are moving into clinical trials. Once a diagnosis is made, therapies should begin, focusing on the family and the patient. In the setting of FTD, families experience a severe burden associated with caregiving, and the clinician should focus on alleviating this burden. Advice around legal and financial issues is usually helpful. Careful consideration of environmental changes to cope with abnormal behaviors is essential. Most compounds that have been used to treat dementia of the Alzheimer's disease type are not effective in FTD, and cholinesterase inhibitors and memantine should be avoided. Although the data are scant, there is some evidence that antidepressants and second-generation antipsychotics may help individual patients.
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Affiliation(s)
- Nahuel Magrath Guimet
- Global Brain Health Institute, University of California, San Francisco (all authors); Institute of Neuroscience, Trinity College, Dublin (all authors); Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires (Magrath Guimet); Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco (Miller); and Department of Medical Sciences, Pontifical Xaverian University Cali, Cali, Colombia (Zapata-Restrepo), Department of Psychiatry, Fundación Valle del Lili, Cali, Colombia (Zapata-Restrepo)
| | - Lina M Zapata-Restrepo
- Global Brain Health Institute, University of California, San Francisco (all authors); Institute of Neuroscience, Trinity College, Dublin (all authors); Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires (Magrath Guimet); Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco (Miller); and Department of Medical Sciences, Pontifical Xaverian University Cali, Cali, Colombia (Zapata-Restrepo), Department of Psychiatry, Fundación Valle del Lili, Cali, Colombia (Zapata-Restrepo)
| | - Bruce L Miller
- Global Brain Health Institute, University of California, San Francisco (all authors); Institute of Neuroscience, Trinity College, Dublin (all authors); Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires (Magrath Guimet); Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco (Miller); and Department of Medical Sciences, Pontifical Xaverian University Cali, Cali, Colombia (Zapata-Restrepo), Department of Psychiatry, Fundación Valle del Lili, Cali, Colombia (Zapata-Restrepo)
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Ooi S, Patel SK, Eratne D, Kyndt C, Reidy N, Lewis C, Lee SC, Darby D, Brodtmann A. Plasma Neurofilament Light Chain and Clinical Diagnosis in Frontotemporal Dementia Syndromes. J Alzheimers Dis 2022; 89:1221-1231. [DOI: 10.3233/jad-220272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Frontotemporal dementia (FTD) syndromes, mimics, phenocopy (phFTD), and slowly progressive behavioral variant FTD (bvFTD) can be difficult to distinguish clinically. Biomarkers such as neurofilament light chain (NfL) may be helpful. Objective: To study plasma NfL levels in people with FTD syndromes and determine if plasma NfL can distinguish between FTD syndromes and phFTD. Methods: Plasma NfL levels were estimated using both Simoa ® Quanterix HD-X™ and SR-X™ machines grouped via final diagnosis after investigation and review. Results: Fifty participants were studied: bvFTD = 20, semantic variant FTD (svFTD) = 11, non-fluent variant FTD (nfvFTD) = 9, FTD with motor neuron disease (MND) = 4, phFTD = 2, slow progressors = 3, FTD mimic = 1, mean age 67.2 (SD 8.4) years. NfL levels were significantly higher in the FTD group compared to phenocopy group (p = 0.003). Median NfL (IQR) pg/mL was comparable in the FTD syndromes: bvFTD 41.10 (50.72), svFTD 44.38 (16.61), and nfvFTD 42.61 (22.93), highest in FTD with MND 79.67 (45.32) and lowest in both phFTD 13.99 (0.79) and slow progressors 17.97 (3.62). Conclusion: Plasma NfL appears to differentiate FTD syndromes and mimics. However, a lower NfL may predict a slower, but not necessarily lack of, neurodegeneration and therefore appears limited distinguishing slow progressors from FTD phenocopies. Larger numbers of patients from all clinical groups are required to strengthen diagnostic utility.
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Affiliation(s)
- Suyi Ooi
- Eastern Cognitive Disorders Clinic, Eastern Health, Box Hill, VIC, Australia
- Eastern Clinical Research Unit, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, Australia
- Royal Melbourne Hospital, Department of Neurology, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Sheila K Patel
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Dhamidhu Eratne
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Neuropsychiatry and Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital and University of Melbourne, Parkville, VIC, Australia
| | - Christopher Kyndt
- Eastern Cognitive Disorders Clinic, Eastern Health, Box Hill, VIC, Australia
- Eastern Clinical Research Unit, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, Australia
- Royal Melbourne Hospital, Department of Neurology, Parkville, VIC, Australia
| | - Natalie Reidy
- Eastern Cognitive Disorders Clinic, Eastern Health, Box Hill, VIC, Australia
| | - Courtney Lewis
- Eastern Cognitive Disorders Clinic, Eastern Health, Box Hill, VIC, Australia
- Neuropsychiatry and Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital and University of Melbourne, Parkville, VIC, Australia
| | - Sarah C.M. Lee
- Eastern Clinical Research Unit, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, Australia
- Calvary Health Care Bethlehem, Parkdale, VIC, Australia
| | - David Darby
- Eastern Cognitive Disorders Clinic, Eastern Health, Box Hill, VIC, Australia
- Eastern Clinical Research Unit, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, Australia
- Royal Melbourne Hospital, Department of Neurology, Parkville, VIC, Australia
- Alfred Health, Department of Neurology, Prahran, Australia
| | - Amy Brodtmann
- Eastern Cognitive Disorders Clinic, Eastern Health, Box Hill, VIC, Australia
- Eastern Clinical Research Unit, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, Australia
- Royal Melbourne Hospital, Department of Neurology, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
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32
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Birba A, Fittipaldi S, Cediel Escobar JC, Gonzalez Campo C, Legaz A, Galiani A, Díaz Rivera MN, Martorell Caro M, Alifano F, Piña-Escudero SD, Cardona JF, Neely A, Forno G, Carpinella M, Slachevsky A, Serrano C, Sedeño L, Ibáñez A, García AM. Multimodal Neurocognitive Markers of Naturalistic Discourse Typify Diverse Neurodegenerative Diseases. Cereb Cortex 2022; 32:3377-3391. [PMID: 34875690 PMCID: PMC9376869 DOI: 10.1093/cercor/bhab421] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/05/2021] [Accepted: 10/28/2021] [Indexed: 02/07/2023] Open
Abstract
Neurodegeneration has multiscalar impacts, including behavioral, neuroanatomical, and neurofunctional disruptions. Can disease-differential alterations be captured across such dimensions using naturalistic stimuli? To address this question, we assessed comprehension of four naturalistic stories, highlighting action, nonaction, social, and nonsocial events, in Parkinson's disease (PD) and behavioral variant frontotemporal dementia (bvFTD) relative to Alzheimer's disease patients and healthy controls. Text-specific correlates were evaluated via voxel-based morphometry, spatial (fMRI), and temporal (hd-EEG) functional connectivity. PD patients presented action-text deficits related to the volume of action-observation regions, connectivity across motor-related and multimodal-semantic hubs, and frontal hd-EEG hypoconnectivity. BvFTD patients exhibited social-text deficits, associated with atrophy and spatial connectivity patterns along social-network hubs, alongside right frontotemporal hd-EEG hypoconnectivity. Alzheimer's disease patients showed impairments in all stories, widespread atrophy and spatial connectivity patterns, and heightened occipitotemporal hd-EEG connectivity. Our framework revealed disease-specific signatures across behavioral, neuroanatomical, and neurofunctional dimensions, highlighting the sensitivity and specificity of a single naturalistic task. This investigation opens a translational agenda combining ecological approaches and multimodal cognitive neuroscience for the study of neurodegeneration.
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Affiliation(s)
- Agustina Birba
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, B1644BID Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), C1425FQD Buenos Aires, Argentina
| | - Sol Fittipaldi
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, B1644BID Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), C1425FQD Buenos Aires, Argentina
| | - Judith C Cediel Escobar
- Facultad de Psicología, Universidad del Valle, Santiago de Cali 76001, Colombia
- Departamento de Estudios Psicológicos, Facultad de Derecho y Ciencias Sociales, Universidad Icesi, Cali 1234567, Colombia
| | - Cecilia Gonzalez Campo
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, B1644BID Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), C1425FQD Buenos Aires, Argentina
| | - Agustina Legaz
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, B1644BID Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), C1425FQD Buenos Aires, Argentina
| | - Agostina Galiani
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, CONICET, C1060AAF Buenos Aires, Argentina
| | - Mariano N Díaz Rivera
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, B1644BID Buenos Aires, Argentina
- National Agency of Scientific and Technological Promotion, C1425FQD Buenos Aires, Argentina
| | - Miquel Martorell Caro
- National Scientific and Technical Research Council (CONICET), C1425FQD Buenos Aires, Argentina
| | - Florencia Alifano
- National Scientific and Technical Research Council (CONICET), C1425FQD Buenos Aires, Argentina
| | | | - Juan Felipe Cardona
- Facultad de Psicología, Universidad del Valle, Santiago de Cali 76001, Colombia
| | - Alejandra Neely
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, 8320000 Santiago, Chile
| | - Gonzalo Forno
- Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, ICBM, Neurosciences Department, Faculty of Medicine, University of Chile, 8380000 Santiago, Chile
- School of Psychology, Universidad de los Andes, 7620001 Santiago, Chile
- Alzheimer's and other cognitive disorders group, Institute of Neurosciences, University of Barcelona, 8007 Barcelona, Spain
| | - Mariela Carpinella
- Unidad de Neurociencias, Instituto Conci Carpinella, 5000 Córdoba, Argentina
- Facultad de Medicina, Universidad Católica de Cuyo Sede San Luis, 5700 San Luis, Argentina
| | - Andrea Slachevsky
- Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, ICBM, Neurosciences Department, Faculty of Medicine, University of Chile, 8380000 Santiago, Chile
- Gerosciences Center for Brain Health and Metabolism, 7800003 Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador & University of Chile, 7500000 Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, 7690000 Santiago, Chile
| | - Cecilia Serrano
- Unidad de Neurología Cognitiva, Hospital César Milstein, C1221AC Buenos Aires, Argentina
| | - Lucas Sedeño
- National Scientific and Technical Research Council (CONICET), C1425FQD Buenos Aires, Argentina
| | - Agustín Ibáñez
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, B1644BID Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), C1425FQD Buenos Aires, Argentina
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, 8320000 Santiago, Chile
- Global Brain Health Institute, University of California, San Francisco, CA 94158, US; and Trinity College, Dublin D02 DP21, Ireland
| | - Adolfo M García
- Centro de Neurociencias Cognitivas, Universidad de San Andrés, B1644BID Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), C1425FQD Buenos Aires, Argentina
- Global Brain Health Institute, University of California, San Francisco, CA 94158, US; and Trinity College, Dublin D02 DP21, Ireland
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, 8431166 Santiago, Chile
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Birba A, Santamaría-García H, Prado P, Cruzat J, Ballesteros AS, Legaz A, Fittipaldi S, Duran-Aniotz C, Slachevsky A, Santibañez R, Sigman M, García AM, Whelan R, Moguilner S, Ibáñez A. Allostatic-Interoceptive Overload in Frontotemporal Dementia. Biol Psychiatry 2022; 92:54-67. [PMID: 35491275 PMCID: PMC11184918 DOI: 10.1016/j.biopsych.2022.02.955] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND The predictive coding theory of allostatic-interoceptive load states that brain networks mediating autonomic regulation and interoceptive-exteroceptive balance regulate the internal milieu to anticipate future needs and environmental demands. These functions seem to be distinctly compromised in behavioral variant frontotemporal dementia (bvFTD), including alterations of the allostatic-interoceptive network (AIN). Here, we hypothesize that bvFTD is typified by an allostatic-interoceptive overload. METHODS We assessed resting-state heartbeat evoked potential (rsHEP) modulation as well as its behavioral and multimodal neuroimaging correlates in patients with bvFTD relative to healthy control subjects and patients with Alzheimer's disease (N = 94). We measured 1) resting-state electroencephalography (to assess the rsHEP, prompted by visceral inputs and modulated by internal body sensing), 2) associations between rsHEP and its neural generators (source location), 3) cognitive disturbances (cognitive state, executive functions, facial emotion recognition), 4) brain atrophy, and 5) resting-state functional magnetic resonance imaging functional connectivity (AIN vs. control networks). RESULTS Relative to healthy control subjects and patients with Alzheimer's disease, patients with bvFTD presented more negative rsHEP amplitudes with sources in critical hubs of the AIN (insula, amygdala, somatosensory cortex, hippocampus, anterior cingulate cortex). This exacerbated rsHEP modulation selectively predicted the patients' cognitive profile (including cognitive decline, executive dysfunction, and emotional impairments). In addition, increased rsHEP modulation in bvFTD was associated with decreased brain volume and connectivity of the AIN. Machine learning results confirmed AIN specificity in predicting the bvFTD group. CONCLUSIONS Altogether, these results suggest that bvFTD may be characterized by an allostatic-interoceptive overload manifested in ongoing electrophysiological markers, brain atrophy, functional networks, and cognition.
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Affiliation(s)
- Agustina Birba
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Hernando Santamaría-García
- PhD Neuroscience Program, Physiology and Psychiatry Departments, Pontificia Universidad Javeriana, Bogotá, Colombia; Memory and Cognition Center Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland
| | - Pavel Prado
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Josefina Cruzat
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
| | | | - Agustina Legaz
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Sol Fittipaldi
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Claudia Duran-Aniotz
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Andrea Slachevsky
- Center for Geroscience, Brain Health and Metabolism, Santiago, Chile; Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Institute of Biomedical Sciences, Santiago, Chile; Memory and Neuropsychiatric Clinic, Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile; Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Rodrigo Santibañez
- Neurology Service, Hospital Dr. Sótero del Río, Santiago, Chile; Neurology Department, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mariano Sigman
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Laboratorio de Neurociencia, Universidad Torcuato Di Tella, Buenos Aires, Argentina; Facultad de Lenguas y Educación, Universidad Nebrija, Madrid, Spain
| | - Adolfo M García
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland
| | - Robert Whelan
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Sebastián Moguilner
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Agustín Ibáñez
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
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Khoshnood B, Ullgren A, Laffita-Mesa J, Öijerstedt L, Patra K, Nennesmo I, Graff C. TBK1 haploinsufficiency results in changes in the K63-ubiquitination profiles in brain and fibroblasts from affected and presymptomatic mutation carriers. J Neurol 2022; 269:3037-3049. [PMID: 34800171 PMCID: PMC9120096 DOI: 10.1007/s00415-021-10887-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Frontotemporal dementia (FTD) is a neurodegenerative disease, resulting in progressive problems in language and/or behaviour and is often diagnosed before 65 years of age. Ubiquitin positive protein aggregates in the brain are among the key pathologic hallmarks of frontotemporal lobar degeneration (FTLD) postmortem. The TANK-binding kinase 1 gene (TBK1) is on the list of genes that can contribute to the development of FTD as well as the related neurodegenerative disease amyotrophic lateral sclerosis (ALS). METHODS In this study, using an array of clinical and neuropathological data combined with biochemical and proteomics assays, we analyze the TBK1 splice-mutation (c.1340 + 1G > A) in a Swedish family with a history of FTD and ALS. We also explore the K63 ubiquitination landscape in post-mortem brain tissue and fibroblast cultures. RESULTS The intronic (c.1340 + 1G > A) mutation in TBK1 results in haploinsufficiency and affects the activity of the protein in symptomatic and pre-symptomatic mutation carriers. CONCLUSION Our results suggest that the mutation leads to a significant reduction of TBK1 activity and induce alterations in K63 ubiquitination profile of the cell already in the presymptomatic stages.
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Affiliation(s)
- Behzad Khoshnood
- Division for Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Unit for Hereditary Dementias, Karolinska University Hospital Solna, Stockholm, Sweden
- Swedish FTD Initiative, Stockholm, Sweden
| | - Abbe Ullgren
- Division for Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Unit for Hereditary Dementias, Karolinska University Hospital Solna, Stockholm, Sweden
- Swedish FTD Initiative, Stockholm, Sweden
| | - Jose Laffita-Mesa
- Division for Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Unit for Hereditary Dementias, Karolinska University Hospital Solna, Stockholm, Sweden
- Swedish FTD Initiative, Stockholm, Sweden
| | - Linn Öijerstedt
- Division for Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Unit for Hereditary Dementias, Karolinska University Hospital Solna, Stockholm, Sweden
- Swedish FTD Initiative, Stockholm, Sweden
| | - Kalicharan Patra
- Division for Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Unit for Hereditary Dementias, Karolinska University Hospital Solna, Stockholm, Sweden
- Swedish FTD Initiative, Stockholm, Sweden
| | - Inger Nennesmo
- Department of Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Caroline Graff
- Division for Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Unit for Hereditary Dementias, Karolinska University Hospital Solna, Stockholm, Sweden
- Swedish FTD Initiative, Stockholm, Sweden
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Disentangling Reversal-learning Impairments in Frontotemporal Dementia and Alzheimer Disease. Cogn Behav Neurol 2022; 35:110-122. [PMID: 35486540 DOI: 10.1097/wnn.0000000000000303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/09/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Individuals with frontotemporal dementia (FTD) often present with poor decision-making, which can affect both their financial and social situations. Delineation of the specific cognitive impairments giving rise to impaired decision-making in individuals with FTD may inform treatment strategies, as different neurotransmitter systems have been associated with distinct patterns of altered decision-making. OBJECTIVE To use a reversal-learning paradigm to identify the specific cognitive components of reversal learning that are most impaired in individuals with FTD and those with Alzheimer disease (AD) in order to inform future approaches to treatment for symptoms related to poor decision-making and behavioral inflexibility. METHOD We gave 30 individuals with either the behavioral variant of FTD or AD and 18 healthy controls a stimulus-discrimination reversal-learning task to complete. We then compared performance in each phase between the groups. RESULTS The FTD group demonstrated impairments in initial stimulus-association learning, though to a lesser degree than the AD group. The FTD group also performed poorly in classic reversal learning, with the greatest impairments being observed in individuals with frontal-predominant atrophy during trials requiring inhibition of a previously advantageous response. CONCLUSION Taken together, these results and the reversal-learning paradigm used in this study may inform the development and screening of behavioral, neurostimulatory, or pharmacologic interventions aiming to address behavioral symptoms related to stimulus-reinforcement learning and response inhibition impairments in individuals with FTD.
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Jenkins LM, Wang L, Rosen H, Weintraub S. A transdiagnostic review of neuroimaging studies of apathy and disinhibition in dementia. Brain 2022; 145:1886-1905. [PMID: 35388419 PMCID: PMC9630876 DOI: 10.1093/brain/awac133] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/18/2022] [Accepted: 03/13/2022] [Indexed: 11/12/2022] Open
Abstract
Apathy and disinhibition are common and highly distressing neuropsychiatric symptoms associated with negative outcomes in persons with dementia. This paper is a critical review of functional and structural neuroimaging studies of these symptoms transdiagnostically in dementia of the Alzheimer type, which is characterized by prominent amnesia early in the disease course, and behavioural variant frontotemporal dementia, characterized by early social-comportmental deficits. We describe the prevalence and clinical correlates of these symptoms and describe methodological issues, including difficulties with symptom definition and different measurement instruments. We highlight the heterogeneity of findings, noting however, a striking similarity of the set of brain regions implicated across clinical diagnoses and symptoms. These regions involve several key nodes of the salience network, and we describe the functions and anatomical connectivity of these brain areas, as well as present a new theoretical account of disinhibition in dementia. Future avenues for research are discussed, including the importance of transdiagnostic studies, measuring subdomains of apathy and disinhibition, and examining different units of analysis for deepening our understanding of the networks and mechanisms underlying these extremely distressing symptoms.
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Affiliation(s)
- Lisanne M Jenkins
- Correspondence to: Lisanne Jenkins 710 N Lakeshore Drive, Suite 1315 Chicago, IL 60611, USA E-mail:
| | - Lei Wang
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, OH 43210, USA
| | - Howie Rosen
- Weill Institute for Neurosciences, School of Medicine, University of California, San Francisco, CA, USA 94158
| | - Sandra Weintraub
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA,Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA 60611
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Lashkarivand A, Eide PK. Brain Sagging Dementia -- Diagnosis, Treatment, and Outcome: A Review. Neurology 2022; 98:798-805. [PMID: 35338080 DOI: 10.1212/wnl.0000000000200511] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 02/28/2022] [Indexed: 11/15/2022] Open
Abstract
Brain sagging dementia (BSD), caused by spontaneous intracranial hypotension (SIH), is a rare syndrome that is only recently recognized, mimicking the clinical findings of behavioral variant frontotemporal dementia (bvFTD). Being aware of its signs and symptoms is essential for early diagnosis and treatment in this potentially reversible form of dementia. Our objective was to identify cases with BSD in the literature and present its clinical characteristics, diagnostic workup, treatment options, and outcome.The review was reported according to PRISMA guidelines and registered with the PROSPERO database (CRD42020150709). MEDLINE, EMBASE, PsychINFO, and Cochrane Library were searched. There was no date restriction. The search was updated in April 2021.A total of 983 articles were screened and assessed for eligibility. Twenty-nine articles (25 case reports and four series) and 70 patients were selected for inclusion. No cranial leak cases were identified. BSD diagnosis should be made based on clinical signs and symptoms and radiological findings. There is a male predominance (F: M ratio 1:4) and a peak incidence in the 6th decade of life. The main clinical manifestation is insidious onset, gradually progressive cognitive and behavioral changes characteristic for bvFTD. Headache is present in the majority of patients (89%). The presence of brain sagging and absence of frontotemporal atrophy is an absolute criterion for the diagnosis. The CSF leak is identified with myelography and digital subtraction myelography. The treatment and repair depend on the etiology and extent of the dural defect, although an epidural blood patch is the first-line treatment in most cases. With treatment, 81% experienced partial and 67% complete resolution of their symptoms. This review highlights the most important clinical aspects of BSD. Due to the sparse evidence and lack of BSD awareness, many patients are most likely left undiagnosed. Recognizing this condition is essential to provide early treatment to reverse the cognitive and behavioral changes that may otherwise progress and fully impair the patient. Moreover, patients with longstanding SIH must be carefully assessed for cognitive and behavioral changes.
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Affiliation(s)
- Aslan Lashkarivand
- Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Per Kristian Eide
- Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Ozzoude M, Varriano B, Beaton D, Ramirez J, Holmes MF, Scott CJM, Gao F, Sunderland KM, McLaughlin P, Rabin J, Goubran M, Kwan D, Roberts A, Bartha R, Symons S, Tan B, Swartz RH, Abrahao A, Saposnik G, Masellis M, Lang AE, Marras C, Zinman L, Shoesmith C, Borrie M, Fischer CE, Frank A, Freedman M, Montero-Odasso M, Kumar S, Pasternak S, Strother SC, Pollock BG, Rajji TK, Seitz D, Tang-Wai DF, Turnbull J, Dowlatshahi D, Hassan A, Casaubon L, Mandzia J, Sahlas D, Breen DP, Grimes D, Jog M, Steeves TDL, Arnott SR, Black SE, Finger E, Tartaglia MC. Investigating the contribution of white matter hyperintensities and cortical thickness to empathy in neurodegenerative and cerebrovascular diseases. GeroScience 2022; 44:1575-1598. [PMID: 35294697 DOI: 10.1007/s11357-022-00539-x] [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: 08/17/2021] [Accepted: 02/22/2022] [Indexed: 11/24/2022] Open
Abstract
Change in empathy is an increasingly recognised symptom of neurodegenerative diseases and contributes to caregiver burden and patient distress. Empathy impairment has been associated with brain atrophy but its relationship to white matter hyperintensities (WMH) is unknown. We aimed to investigate the relationships amongst WMH, brain atrophy, and empathy deficits in neurodegenerative and cerebrovascular diseases. Five hundred thirteen participants with Alzheimer's disease/mild cognitive impairment, amyotrophic lateral sclerosis, frontotemporal dementia (FTD), Parkinson's disease, or cerebrovascular disease (CVD) were included. Empathy was assessed using the Interpersonal Reactivity Index. WMH were measured using a semi-automatic segmentation and FreeSurfer was used to measure cortical thickness. A heterogeneous pattern of cortical thinning was found between groups, with FTD showing thinning in frontotemporal regions and CVD in left superior parietal, left insula, and left postcentral. Results from both univariate and multivariate analyses revealed that several variables were associated with empathy, particularly cortical thickness in the fronto-insulo-temporal and cingulate regions, sex (female), global cognition, and right parietal and occipital WMH. Our results suggest that cortical atrophy and WMH may be associated with empathy deficits in neurodegenerative and cerebrovascular diseases. Future work should consider investigating the longitudinal effects of WMH and atrophy on empathy deficits in neurodegenerative and cerebrovascular diseases.
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Affiliation(s)
- Miracle Ozzoude
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Avenue, 6th floor 6KD-407, Toronto, ON, M5T 0S8, Canada.,L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Brenda Varriano
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Avenue, 6th floor 6KD-407, Toronto, ON, M5T 0S8, Canada
| | - Derek Beaton
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
| | - Joel Ramirez
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Melissa F Holmes
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Christopher J M Scott
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Fuqiang Gao
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | | | - Paula McLaughlin
- Nova Scotia Health and Dalhousie University, Halifax, NS, Canada
| | - Jennifer Rabin
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Maged Goubran
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,Queen's University, Kingston, ON, Canada
| | - Angela Roberts
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA.,School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Robert Bartha
- Robarts Research Institute, Western University, London, ON, Canada
| | - Sean Symons
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Brian Tan
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
| | - Richard H Swartz
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Heart & Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Agessandro Abrahao
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Gustavo Saposnik
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Mario Masellis
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Anthony E Lang
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Edmond J Safra Program for Parkinson Disease, Movement Disorder Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Connie Marras
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Edmond J Safra Program for Parkinson Disease, Movement Disorder Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Lorne Zinman
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Christen Shoesmith
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Michael Borrie
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,St. Joseph's Healthcare Centre, London, ON, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Andrew Frank
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Morris Freedman
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Baycrest Health Sciences, Toronto, ON, Canada
| | - Manuel Montero-Odasso
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada.,Gait and Brain Lab, Parkwood Institute, London, ON, Canada
| | - Sanjeev Kumar
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Stephen Pasternak
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Stephen C Strother
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Bruce G Pollock
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Tarek K Rajji
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Dallas Seitz
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - David F Tang-Wai
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Memory Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - John Turnbull
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Dar Dowlatshahi
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Ayman Hassan
- Thunder Bay Regional Health Research Institute, Thunder Bay, ON, Canada
| | - Leanne Casaubon
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jennifer Mandzia
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada.,Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Demetrios Sahlas
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK.,Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - David Grimes
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada.,Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,London Health Sciences Centre, London, ON, Canada
| | - Thomas D L Steeves
- Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Stephen R Arnott
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
| | - Sandra E Black
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Heart & Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada.,Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | | | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Avenue, 6th floor 6KD-407, Toronto, ON, M5T 0S8, Canada. .,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada. .,Memory Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
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Tsoukra P, Velakoulis D, Wibawa P, Malpas CB, Walterfang M, Evans A, Farrand S, Kelso W, Eratne D, Loi SM. The Diagnostic Challenge of Young-Onset Dementia Syndromes and Primary Psychiatric Diseases: Results From a Retrospective 20-Year Cross-Sectional Study. J Neuropsychiatry Clin Neurosci 2022; 34:44-52. [PMID: 34538074 DOI: 10.1176/appi.neuropsych.20100266] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Distinguishing a dementia syndrome from a primary psychiatric disease in younger patients can be challenging and may lead to diagnostic change over time. The investigators aimed to examine diagnostic stability in a cohort of patients with younger-onset neurocognitive disorders. METHODS A retrospective review of records was conducted for patients who were admitted to an inpatient neuropsychiatry service unit between 2000 and 2019, who were followed up for at least 12 months, and who received a diagnosis of young-onset dementia at any time point. Initial diagnosis included Alzheimer's disease-type dementia (N=30), frontotemporal dementia (FTD) syndromes (N=44), vascular dementia (N=7), mild cognitive impairment (N=10), primary psychiatric diseases (N=6), and other conditions, such as Lewy body dementia (N=30). RESULTS Among 127 patients, 49 (39%) had a change in their initial diagnoses during the follow-up period. Behavioral variant FTD (bvFTD) was the least stable diagnosis, followed by dementia not otherwise specified and mild cognitive impairment. Compared with patients with a stable diagnosis, those who changed exhibited a higher cognitive score at baseline, a longer follow-up period, greater delay to final diagnosis, and no family history of dementia. Patients whose diagnosis changed from a neurodegenerative to a psychiatric diagnosis were more likely to have a long psychiatric history, while those whose diagnosis changed from a psychiatric to a neurodegenerative one had a recent manifestation of psychiatric symptoms. CONCLUSIONS Misdiagnosis of younger patients with neurocognitive disorders is not uncommon, especially in cases of bvFTD. Late-onset psychiatric symptoms may be the harbinger to a neurodegenerative disease. Close follow-up and monitoring of these patients are necessary.
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Affiliation(s)
- Paraskevi Tsoukra
- Department of Neurology, Evaggelismos Hospital, Athens, Greece (Tsoukra); Neuropsychiatry Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Melbourne Neuropsychiatry Centre, University of Melbourne and Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Department of Medicine, Clinical Outcomes Research Unit, Royal Melbourne Hospital, Parkville, Australia (Malpas); Department of Neurology, Royal Melbourne Hospital, Parkville, Australia (Malpas); and Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia (Malpas)
| | - Dennis Velakoulis
- Department of Neurology, Evaggelismos Hospital, Athens, Greece (Tsoukra); Neuropsychiatry Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Melbourne Neuropsychiatry Centre, University of Melbourne and Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Department of Medicine, Clinical Outcomes Research Unit, Royal Melbourne Hospital, Parkville, Australia (Malpas); Department of Neurology, Royal Melbourne Hospital, Parkville, Australia (Malpas); and Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia (Malpas)
| | - Pierre Wibawa
- Department of Neurology, Evaggelismos Hospital, Athens, Greece (Tsoukra); Neuropsychiatry Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Melbourne Neuropsychiatry Centre, University of Melbourne and Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Department of Medicine, Clinical Outcomes Research Unit, Royal Melbourne Hospital, Parkville, Australia (Malpas); Department of Neurology, Royal Melbourne Hospital, Parkville, Australia (Malpas); and Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia (Malpas)
| | - Charles B Malpas
- Department of Neurology, Evaggelismos Hospital, Athens, Greece (Tsoukra); Neuropsychiatry Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Melbourne Neuropsychiatry Centre, University of Melbourne and Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Department of Medicine, Clinical Outcomes Research Unit, Royal Melbourne Hospital, Parkville, Australia (Malpas); Department of Neurology, Royal Melbourne Hospital, Parkville, Australia (Malpas); and Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia (Malpas)
| | - Mark Walterfang
- Department of Neurology, Evaggelismos Hospital, Athens, Greece (Tsoukra); Neuropsychiatry Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Melbourne Neuropsychiatry Centre, University of Melbourne and Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Department of Medicine, Clinical Outcomes Research Unit, Royal Melbourne Hospital, Parkville, Australia (Malpas); Department of Neurology, Royal Melbourne Hospital, Parkville, Australia (Malpas); and Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia (Malpas)
| | - Andrew Evans
- Department of Neurology, Evaggelismos Hospital, Athens, Greece (Tsoukra); Neuropsychiatry Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Melbourne Neuropsychiatry Centre, University of Melbourne and Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Department of Medicine, Clinical Outcomes Research Unit, Royal Melbourne Hospital, Parkville, Australia (Malpas); Department of Neurology, Royal Melbourne Hospital, Parkville, Australia (Malpas); and Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia (Malpas)
| | - Sarah Farrand
- Department of Neurology, Evaggelismos Hospital, Athens, Greece (Tsoukra); Neuropsychiatry Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Melbourne Neuropsychiatry Centre, University of Melbourne and Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Department of Medicine, Clinical Outcomes Research Unit, Royal Melbourne Hospital, Parkville, Australia (Malpas); Department of Neurology, Royal Melbourne Hospital, Parkville, Australia (Malpas); and Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia (Malpas)
| | - Wendy Kelso
- Department of Neurology, Evaggelismos Hospital, Athens, Greece (Tsoukra); Neuropsychiatry Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Melbourne Neuropsychiatry Centre, University of Melbourne and Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Department of Medicine, Clinical Outcomes Research Unit, Royal Melbourne Hospital, Parkville, Australia (Malpas); Department of Neurology, Royal Melbourne Hospital, Parkville, Australia (Malpas); and Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia (Malpas)
| | - Dhamidhu Eratne
- Department of Neurology, Evaggelismos Hospital, Athens, Greece (Tsoukra); Neuropsychiatry Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Melbourne Neuropsychiatry Centre, University of Melbourne and Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Department of Medicine, Clinical Outcomes Research Unit, Royal Melbourne Hospital, Parkville, Australia (Malpas); Department of Neurology, Royal Melbourne Hospital, Parkville, Australia (Malpas); and Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia (Malpas)
| | - Samantha M Loi
- Department of Neurology, Evaggelismos Hospital, Athens, Greece (Tsoukra); Neuropsychiatry Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Melbourne Neuropsychiatry Centre, University of Melbourne and Royal Melbourne Hospital, Parkville, Australia (Velakoulis, Wibawa, Walterfang, Evans, Farrand, Kelso, Eratne, Loi); Department of Medicine, Clinical Outcomes Research Unit, Royal Melbourne Hospital, Parkville, Australia (Malpas); Department of Neurology, Royal Melbourne Hospital, Parkville, Australia (Malpas); and Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia (Malpas)
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Savard M, Pascoal TA, Servaes S, Dhollander T, Iturria-Medina Y, Kang MS, Vitali P, Therriault J, Mathotaarachchi S, Benedet AL, Gauthier S, Rosa-Neto P. Impact of long- and short-range fiber depletion on the cognitive deficits of fronto-temporal dementia. eLife 2022; 11:73510. [PMID: 35073256 PMCID: PMC8824472 DOI: 10.7554/elife.73510] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/23/2022] [Indexed: 11/21/2022] Open
Abstract
Recent studies suggest a framework where white-matter (WM) atrophy plays an important role in fronto-temporal dementia (FTD) pathophysiology. However, these studies often overlook the fact that WM tracts bridging different brain regions may have different vulnerabilities to the disease and the relative contribution of grey-matter (GM) atrophy to this WM model, resulting in a less comprehensive understanding of the relationship between clinical symptoms and pathology. Using a common factor analysis to extract a semantic and an executive factor, we aimed to test the relative contribution of WM and GM of specific tracts in predicting cognition in the Frontotemporal Lobar Degeneration Neuroimaging Initiative (FTLDNI). We found that semantic symptoms were mainly dependent on short-range WM fibre disruption, while damage to long-range WM fibres was preferentially associated to executive dysfunction with the GM contribution to cognition being predominant for local processing. These results support the importance of the disruption of specific WM tracts to the core cognitive symptoms associated with FTD. As large-scale WM tracts, which are particularly vulnerable to vascular disease, were highly associated with executive dysfunction, our findings highlight the importance of controlling for risk factors associated with deep WM disease, such as vascular risk factors, in patients with FTD in order not to potentiate underlying executive dysfunction.
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Affiliation(s)
- Melissa Savard
- Translational Neuroimaging Laboratory, McGill University
| | | | - Stijn Servaes
- Translational Neuroimaging Laboratory, McGill University
| | | | | | - Min Su Kang
- Translational Neuroimaging Laboratory, McGill University
| | - Paolo Vitali
- Department of Neurology and Neurosurgery, McGill University
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Musa Salech G, Lillo P, van der Hiele K, Méndez-Orellana C, Ibáñez A, Slachevsky A. Apathy, Executive Function, and Emotion Recognition Are the Main Drivers of Functional Impairment in Behavioral Variant of Frontotemporal Dementia. Front Neurol 2022; 12:734251. [PMID: 35095710 PMCID: PMC8792989 DOI: 10.3389/fneur.2021.734251] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The cognitive and neuropsychiatric deficits present in patients with behavioral variant frontotemporal dementia (bvFTD) are associated with loss of functionality in the activities of daily living (ADLs). The main purpose of this study was to examine and explore the association between the cognitive and neuropsychiatric features that might prompt functional impairment of basic, instrumental, and advanced ADL domains in patients with bvFTD. Methods: A retrospective cross-sectional study was conducted with 27 patients with bvFTD in its early stage (<2 years of evolution) and 32 healthy control subjects. A neuropsychological assessment was carried out wherein measures of cognitive function and neuropsychiatric symptoms were obtained. The informant-report Technology-Activities of Daily Living Questionnaire was used to assess the percentage of functional impairment in the different ADL domains. To identify the best determinants, three separate multiple regression analyses were performed, considering each functional impairment as the dependent variable and executive function, emotion recognition, disinhibition, and apathy as independent variables. Results: For the basic ADLs, a model that explains 28.2% of the variability was found, in which the presence of apathy (β = 0.33, p = 0.02) and disinhibition (β = 0.29, p = 0.04) were significant factors. Concerning instrumental ADLs, the model produced accounted for 63.7% of the functional variability, with the presence of apathy (β = 0.71, p < 0.001), deficits in executive function (β = -0.36, p = 0.002), and lack of emotion recognition (β = 0.28, p = 0.017) as the main contributors. Finally, in terms of advanced ADLs, the model found explained 52.6% of the variance, wherein only the presence of apathy acted as a significant factor (β = 0.59, p < 0.001). Conclusions: The results of this study show the prominent and transverse effect of apathy in the loss of functionality throughout all the ADL domains. Apart from that, this is the first study that shows that the factors associated with loss of functionality differ according to the functional domain in patients with bvFTD in its early stage. Finally, no other study has analyzed the impact of the lack of emotion recognition in the functionality of ADLs. These results could guide the planning of tailored interventions that might enhance everyday activities and the improvement of quality of life.
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Affiliation(s)
- Gada Musa Salech
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Institute of Biomedical Sciences (ICBM), Neurosciences Department, East Neuroscience Department, Faculty of Medicine, University of Chile, Santiago, Chile
- Departamento de Neurología, Clínica Universidad de los Andes, Santiago, Chile
| | - Patricia Lillo
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Department of Neurology South, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Unidad de Neurología, Hospital San José, Santiago, Chile
| | - Karin van der Hiele
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, Netherlands
| | | | - Agustín Ibáñez
- Cognitive Neuroscience Center (CNC), National Scientific and Technical Research Council (CONICET), Universidad de San Andrés, Buenos Aires, Argentina
- The Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Andrea Slachevsky
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Institute of Biomedical Sciences (ICBM), Neurosciences Department, East Neuroscience Department, Faculty of Medicine, University of Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN), Department of Neurology, Hospital del Salvador & University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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Gossink F, Dols A, Stek ML, Scheltens P, Nijmeijer B, Cohn Hokke P, Dijkstra A, Van Ruissen F, Aalfs C, Pijnenburg YAL. Early life involvement in C9orf72 repeat expansion carriers. J Neurol Neurosurg Psychiatry 2022; 93:93-100. [PMID: 33906932 DOI: 10.1136/jnnp-2020-325994] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/12/2021] [Accepted: 04/12/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The chromosome 9 open reading frame 72 gene (C9orf72) hexanucleotide repeat expansion (C9orf72RE) is the most common genetic cause of behavioural variant frontotemporal dementia (bvFTD). Since the onset of the C9orf72RE-associated disease is sometimes hard to define, we hypothesise that C9orf72RE may cause a lifelong neuropsychiatric vulnerability. The first aim of our study was to explore lifelong behavioural and personality characteristics in C9orf72RE. Second, we aimed to describe distinctive characteristics of C9orf72RE during disease course. METHODS Out of 183 patients from the Amsterdam Dementia Cohort that underwent genetic testing between 2011 and 2018, 20 C9orf72RE bvFTD patients and 23 C9orf72RE negative bvFTD patients were included. Patients and their relatives were interviewed extensively to chart their biography. Data analysis was performed through a mixed-methods approach including qualitative and quantitative analyses. RESULTS Education, type of professional career and number of intimate partners were not different between carriers and non-carriers. Carriers were more often described by their relatives as having 'fixed behavioural patterns in daily life' and with limited empathy already years before onset of bvFTD symptoms. In carriers, disease course was more often characterised by excessive buying and obsessive physical exercise than in non-carriers. CONCLUSION This is the first study thoroughly exploring biographies of bvFTD patients with C9orf72RE, revealing that subtle personality traits may be present early in life. Our study suggests that C9orf72RE exerts a lifelong neuropsychiatric vulnerability. This may strengthen hypotheses of links between neurodevelopmental and neurodegenerative diseases. Moreover, the presence of a distinct C9orf72RE -associated syndrome within the FTD spectrum opens doors for investigation of vulnerable neuronal networks.
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Affiliation(s)
- Flora Gossink
- Alzheimer Center, Department of Neurology, Location VU University Medical Center, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Annemiek Dols
- Department of Old Age psychiatry, GGZ inGeest Amsterdam locatie De Nieuwe Valerius, Amsterdam, The Netherlands
| | - Max L Stek
- Department of Old Age psychiatry, GGZ inGeest Amsterdam locatie De Nieuwe Valerius, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center, Department of Neurology, Location VU University Medical Center, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Bas Nijmeijer
- Clinical Genetics, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
| | | | - Anke Dijkstra
- Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
| | - Fred Van Ruissen
- Department of Clinical Genetics, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | | | - Yolande A L Pijnenburg
- Alzheimer Center, Department of Neurology, Location VU University Medical Center, Amsterdam University Medical Centres, Amsterdam, The Netherlands
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Salminen LE, Tubi MA, Bright J, Thomopoulos SI, Wieand A, Thompson PM. Sex is a defining feature of neuroimaging phenotypes in major brain disorders. Hum Brain Mapp 2022; 43:500-542. [PMID: 33949018 PMCID: PMC8805690 DOI: 10.1002/hbm.25438] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 12/12/2022] Open
Abstract
Sex is a biological variable that contributes to individual variability in brain structure and behavior. Neuroimaging studies of population-based samples have identified normative differences in brain structure between males and females, many of which are exacerbated in psychiatric and neurological conditions. Still, sex differences in MRI outcomes are understudied, particularly in clinical samples with known sex differences in disease risk, prevalence, and expression of clinical symptoms. Here we review the existing literature on sex differences in adult brain structure in normative samples and in 14 distinct psychiatric and neurological disorders. We discuss commonalities and sources of variance in study designs, analysis procedures, disease subtype effects, and the impact of these factors on MRI interpretation. Lastly, we identify key problems in the neuroimaging literature on sex differences and offer potential recommendations to address current barriers and optimize rigor and reproducibility. In particular, we emphasize the importance of large-scale neuroimaging initiatives such as the Enhancing NeuroImaging Genetics through Meta-Analyses consortium, the UK Biobank, Human Connectome Project, and others to provide unprecedented power to evaluate sex-specific phenotypes in major brain diseases.
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Affiliation(s)
- Lauren E. Salminen
- Imaging Genetics CenterMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
| | - Meral A. Tubi
- Imaging Genetics CenterMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
| | - Joanna Bright
- Imaging Genetics CenterMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
| | - Sophia I. Thomopoulos
- Imaging Genetics CenterMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
| | - Alyssa Wieand
- Imaging Genetics CenterMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
| | - Paul M. Thompson
- Imaging Genetics CenterMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USCMarina del ReyCaliforniaUSA
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44
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Gonzalez-Gomez R, Rodríguez-Villagra OA, Schulte M, Torralva T, Ibáñez A, Huepe D, Fittipaldi S. Neurocognitive factorial structure of executive functions: Evidence from neurotypicals and frontotemporal dementia. Cortex 2021; 145:79-96. [PMID: 34689034 PMCID: PMC11168581 DOI: 10.1016/j.cortex.2021.08.015] [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: 12/17/2020] [Revised: 06/01/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
The latent structure of executive functions (EFs) remains controversial. Confirmatory factorial analysis (CFA) has provided support for both multidimensional (assumes EFs to be functionally separable but related components) and bifactor (proposes all components are nested within a common factor) models. However, these CFA models have never been compared in patient samples, nor regarding their neuroanatomical correlates. Here, we systematically contrast both approaches in neurotypicals and in a neurodegenerative lesion model (patients with the behavioral variant frontotemporal dementia, bvFTD), characterized by executive deficits associated with frontal neurodegeneration. First, CFA was used to test the models' fit in a sample of 341 neurotypicals and 29 bvFTD patients based on performance in an executive frontal screening battery which assesses working memory, motor inhibition, verbal inhibition, and abstraction capacity. Second, we compared EFs factor and observed scores between patients and matched controls. Finally, we used voxel-based morphometry (VBM) to compare the grey matter correlates of factor and observed scores. CFA results showed that both models fit the data well. The multidimensional model, however, was more sensitive than the bifactor model and the observed scores to detect EFs impairments in bvFTD patients. VBM results for the multidimensional model revealed common and unique grey matter correlates for EFs components across prefrontal-insular, posterior, and temporal cortices. Regarding the bifactor model, only the common factor was associated with prefrontal-insular hubs. Observed scores presented scant, non-frontal grey matter associations. Converging behavioral and neuroanatomical evidence from healthy populations and a neurodegenerative model of EFs supports an underlying multidimensional structure.
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Affiliation(s)
- Raul Gonzalez-Gomez
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Chile
| | - Odir Antonio Rodríguez-Villagra
- Institute for Psychological Research, University of Costa Rica, Sabanilla, Costa Rica; Neuroscience Research Center, University of Costa Rica, San Pedro, Costa Rica
| | - Michael Schulte
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - Teresa Torralva
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Chile; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco (UCSF), US and Trinity College Dublin (TCD), Ireland
| | - David Huepe
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Chile.
| | - Sol Fittipaldi
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Facultad de Psicología, Universidad Nacional de Córdoba, Argentina.
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45
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Measuring social cognition in frontotemporal lobar degeneration: a clinical approach. J Neurol 2021; 269:2227-2244. [PMID: 34797433 DOI: 10.1007/s00415-021-10889-9] [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: 08/18/2021] [Revised: 10/14/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
Alterations in social cognition, a broad term indicating our ability to understand others and adapt our behavior accordingly, have been the focus of growing attention in the past years. Some neurological conditions, such as those belonging to the frontotemporal lobar degeneration (FTLD) spectrum, are associated to varying degrees with social cognition deficits, encompassing problems with theory of mind (ToM), empathy, perception of social stimuli, and social behavior. In this review, we outline a clinical framework for the evaluation of social cognition and discuss its role in the assessment of patients affected by a range of FTLD conditions.
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46
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Magno MA, Canu E, Filippi M, Agosta F. Social cognition in the FTLD spectrum: evidence from MRI. J Neurol 2021; 269:2245-2258. [PMID: 34797434 DOI: 10.1007/s00415-021-10892-0] [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: 08/18/2021] [Revised: 10/14/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
Over the past few years, there has been great interest in social cognition, a wide term referring to the human ability of understanding others' emotions, thoughts, and intentions, to empathize with them and to behave accordingly. While there is no agreement on the classification of social cognitive processes, they can broadly be categorized as consisting of theory of mind, empathy, social perception, and social behavior. The study of social cognition and its relative deficits is increasingly assuming clinical relevance. However, the clinical and neuroanatomical correlates of social cognitive alterations in neurodegenerative conditions, such as those belonging to the frontotemporal lobar (FTLD) spectrum, are not fully established. In this review, we describe the current understanding of social cognition impairments in different FTLD conditions with respect to MRI.
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Affiliation(s)
- Maria Antonietta Magno
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy. .,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy.
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47
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Ssali T, Anazodo UC, Narciso L, Liu L, Jesso S, Richardson L, Günther M, Konstandin S, Eickel K, Prato F, Finger E, St Lawrence K. Sensitivity of arterial Spin labeling for characterization of longitudinal perfusion changes in Frontotemporal dementia and related disorders. NEUROIMAGE-CLINICAL 2021; 35:102853. [PMID: 34697009 PMCID: PMC9421452 DOI: 10.1016/j.nicl.2021.102853] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/24/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
This study demonstrates the value of ASL for longitudinal monitoring of perfusion in FTD patients. Good agreement was found in repeat measures of CBF in patients and controls. Transit times were not a significant source of error for the selected post labeling delay (2 s).
Background Advances in the understanding of the pathophysiology of frontotemporal dementia (FTD) and related disorders, along with the development of novel candidate disease modifying treatments, have stimulated the need for tools to assess the efficacy of new therapies. While perfusion imaging by arterial spin labeling (ASL) is an attractive approach for longitudinal imaging biomarkers of neurodegeneration, sources of variability between sessions including arterial transit times (ATT) and fluctuations in resting perfusion can reduce its sensitivity. Establishing the magnitude of perfusion changes that can be reliably detected is necessary to delineate longitudinal perfusion changes related to disease processes from the effects of these sources of error. Purpose To assess the feasibility of ASL for longitudinal monitoring of patients with FTD by quantifying between-session variability of perfusion on a voxel-by-voxel basis. Methods and materials ASL data were collected in 13 healthy controls and 8 patients with FTD or progressive supra-nuclear palsy. Variability in cerebral blood flow (CBF) by single delay pseudo-continuous ASL (SD-pCASL) acquired one month apart were quantified by the coefficient of variation (CV) and intraclass correlation coefficient (ICC). Additionally, CBF by SD-pCASL and ATT by low-resolution multiple inversion time ASL (LowRes-pCASL) were compared to Hadamard encoded sequences which are able to simultaneously measure CBF and ATT with improved time-efficiency. Results Agreement of grey-matter perfusion between sessions was found for both patients and controls (CV = 10.8% and 8.3% respectively) with good reliability for both groups (ICC > 0.6). Intensity normalization to remove day-to-day fluctuations in resting perfusion reduced the CV by 28%. Less than 5% of voxels had ATTs above the chosen post labelling delay (2 s), indicating that the ATT was not a significant source of error. Hadamard-encoded perfusion imaging yielded systematically higher CBF compared to SD-pCASL, but produced similar transit-time measurements. Power analysis revealed that SD-pCASL has the sensitivity to detect longitudinal changes as low as 10% with as few as 10 patient participants. Conclusion With the appropriate labeling parameters, SD-pCASL is a promising approach for assessing longitudinal changes in CBF associated with FTD.
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Affiliation(s)
- Tracy Ssali
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada.
| | - Udunna C Anazodo
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Lucas Narciso
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Linshan Liu
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Sarah Jesso
- Lawson Health Research Institute, London, Canada; St. Joseph's Health Care, London, Canada
| | - Lauryn Richardson
- Lawson Health Research Institute, London, Canada; St. Joseph's Health Care, London, Canada
| | - Matthias Günther
- Fraunhofer Institute for Medical Image Computing MEVIS, Bremen, Germany; University Bremen, Bremen, Germany
| | - Simon Konstandin
- Fraunhofer Institute for Medical Image Computing MEVIS, Bremen, Germany; Mediri GmbH, Heidelberg, Germany
| | | | - Frank Prato
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Elizabeth Finger
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada; Department of Clinical Neurological Sciences, Western University, London, Canada
| | - Keith St Lawrence
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
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48
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Stamatelos P, Kontokostas K, Liantinioti C, Giavasi C, Ioakeimidis M, Antonelou R, Papathanasiou M, Arvaniti C, Bonakis A, Tsivgoulis G, Voumvourakis K, Stefanis L, Papageorgiou SG. Evolving Causes of Rapidly Progressive Dementia: A 5-Year Comparative Study. Alzheimer Dis Assoc Disord 2021; 35:315-320. [PMID: 34654042 DOI: 10.1097/wad.0000000000000472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 06/05/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Rapidly progressive dementia (RPD) is a clinical syndrome developing in <1 to 2 years. Recent progress in RPD evaluation is significant, so RPD's prevalence may change over time. The aim of our new case series was to estimate the relative frequency of RPDs' causative entities, considering the recent advances in RPDs' diagnosis, and compare the results with those of our previous report. PATIENTS AND METHODS We retrospectively reviewed the medical records of 47 patients who were referred to Attikon University Hospital during a 5-year period for a suspected RPD. RESULTS Neurodegenerative diseases were the most frequent causes (38%), followed by prion disease (19%) and autoimmune encephalopathy (AE, 17%). AE cases were by far more common than in our previous report, while other than AE secondary causes were significantly decreased. Mean time to dementia was 9 months in neurodegenerative diseases and 5 months in non-neurodegenerative. Main clinical findings across all patients were memory impairment (66%) and behavioral-emotional disturbances (48%). CONCLUSIONS Neurodegenerative diseases are common causes of RPD and have a slower evolution than non-neurodegenerative. Diagnostic novelties enabled the recognition of AE, whereas more common secondary causes are probably now diagnosed in primary settings since the recognition of RPD as distinct clinical entity is continually increasing.
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Affiliation(s)
| | | | | | - Christina Giavasi
- Neurology Department, Nottingham University Hospital, Nottingham, UK
| | | | | | - Matilda Papathanasiou
- 2nd Department of Radiology, Attikon University General Hospital, National and Kapodistrian University of Athens
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49
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Legaz A, Abrevaya S, Dottori M, Campo CG, Birba A, Caro MM, Aguirre J, Slachevsky A, Aranguiz R, Serrano C, Gillan CM, Leroi I, García AM, Fittipaldi S, Ibañez A. Multimodal mechanisms of human socially reinforced learning across neurodegenerative diseases. Brain 2021; 145:1052-1068. [PMID: 34529034 PMCID: PMC9128375 DOI: 10.1093/brain/awab345] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/17/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Social feedback can selectively enhance learning in diverse domains. Relevant
neurocognitive mechanisms have been studied mainly in healthy persons, yielding
correlational findings. Neurodegenerative lesion models, coupled with multimodal
brain measures, can complement standard approaches by revealing direct
multidimensional correlates of the phenomenon. To this end, we assessed socially reinforced and non-socially reinforced learning
in 40 healthy participants as well as persons with behavioural variant
frontotemporal dementia (n = 21), Parkinson’s
disease (n = 31) and Alzheimer’s disease
(n = 20). These conditions are typified by
predominant deficits in social cognition, feedback-based learning and
associative learning, respectively, although all three domains may be partly
compromised in the other conditions. We combined a validated behavioural task
with ongoing EEG signatures of implicit learning (medial frontal negativity) and
offline MRI measures (voxel-based morphometry). In healthy participants, learning was facilitated by social feedback relative to
non-social feedback. In comparison with controls, this effect was specifically
impaired in behavioural variant frontotemporal dementia and Parkinson’s
disease, while unspecific learning deficits (across social and non-social
conditions) were observed in Alzheimer’s disease. EEG results showed
increased medial frontal negativity in healthy controls during social feedback
and learning. Such a modulation was selectively disrupted in behavioural variant
frontotemporal dementia. Neuroanatomical results revealed extended
temporo-parietal and fronto-limbic correlates of socially reinforced learning,
with specific temporo-parietal associations in behavioural variant
frontotemporal dementia and predominantly fronto-limbic regions in
Alzheimer’s disease. In contrast, non-socially reinforced learning was
consistently linked to medial temporal/hippocampal regions. No associations with
cortical volume were found in Parkinson’s disease. Results are consistent
with core social deficits in behavioural variant frontotemporal dementia, subtle
disruptions in ongoing feedback-mechanisms and social processes in
Parkinson’s disease and generalized learning alterations in
Alzheimer’s disease. This multimodal approach highlights the impact of
different neurodegenerative profiles on learning and social feedback. Our findings inform a promising theoretical and clinical agenda in the fields of
social learning, socially reinforced learning and neurodegeneration.
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Affiliation(s)
- Agustina Legaz
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina.,Universidad Nacional de Córdoba. Facultad de Psicología, Córdoba, CU320, Argentina
| | - Sofía Abrevaya
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina.,Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, CONICET, Buenos Aires, C1021, Argentina
| | - Martín Dottori
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina
| | - Cecilia González Campo
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
| | - Agustina Birba
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
| | - Miguel Martorell Caro
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina.,Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, CONICET, Buenos Aires, C1021, Argentina
| | - Julieta Aguirre
- Instituto de Investigaciones Psicológicas (IIPsi), CONICET, Universidad Nacional de Córdoba, Córdoba, CB5000, Argentina
| | - Andrea Slachevsky
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital delSalvador, SSMO & Faculty of Medicine, University of Chile, Santiago, Chile.,Gerosciences Center for Brain Health and Metabolism, Santiago, Chile.,Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, ICBM, Neurosciences Department, Faculty of Medicine, University of Chile, Chile.,Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Chile
| | | | - Cecilia Serrano
- Neurología Cognitiva, Hospital Cesar Milstein, Buenos Aires, C1221, Argentina
| | - Claire M Gillan
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA 94158, USA.,Department of Psychology, Trinity College Dublin, Dublin, Ireland.,Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Iracema Leroi
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA 94158, USA
| | - Adolfo M García
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina.,Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA 94158, USA.,Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), Dublin, Dublin 2, Ireland.,Faculty of Education, National University of Cuyo, Mendoza, M5502JMA, Argentina.,Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Sol Fittipaldi
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina.,Universidad Nacional de Córdoba. Facultad de Psicología, Córdoba, CU320, Argentina
| | - Agustín Ibañez
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, C1011ACC, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina.,Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA 94158, USA.,Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
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50
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Macfarlane S, Atee M, Morris T, Cunningham C. When responsive and reactive meet organic? Treatment implications of language use in the era of #BanBPSD. Int J Geriatr Psychiatry 2021; 36:1299-1303. [PMID: 33779007 PMCID: PMC8453926 DOI: 10.1002/gps.5545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/16/2021] [Accepted: 03/21/2021] [Indexed: 11/09/2022]
Abstract
The aetiopathogenesis of behaviours and psychological symptoms of dementia (BPSD) is often subjective, complex and multifaceted, produced by an array of contributing factors, including biomedical, psychological, environmental and/or social factors. Alongside other contributing factors, organic aetiology of BPSD should be considered when devising therapeutic management plans. Although considered last resort, time‐limited antipsychotic treatment (≤3 months) may have a vital adjunct role in managing intractable, refractory, distressing and/or life‐threatening BPSD, such as delusions and hallucinations; but only after person‐centred psychosocial interventions are exhausted and fail to deliver any therapeutic response. If prescribed, careful monitoring of therapeutic responses and adverse effects of antipsychotics with de‐prescribing plans should be a top priority, as these agents have limited efficacies and serious adverse outcomes (e.g., mortality).
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Affiliation(s)
- Stephen Macfarlane
- The Dementia CentreHammondCareSt LeonardsNew South WalesAustralia,Faculty of Medicine, Nursing & Health SciencesMonash UniversityClaytonVictoriaAustralia
| | - Mustafa Atee
- The Dementia CentreHammondCareWembleyWestern AustraliaAustralia,Curtin Medical SchoolFaculty of Health SciencesCurtin UniversityBentleyWestern AustraliaAustralia
| | - Thomas Morris
- The Dementia CentreHammondCareSt LeonardsNew South WalesAustralia
| | - Colm Cunningham
- The Dementia CentreHammondCareSt LeonardsNew South WalesAustralia,School of Public Health & Community MedicineUniversity of New South WalesSydneyNew South WalesAustralia
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