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Yin JH, Liu YO, Li HL, Burgunder JM, Huang Y. White Matter Microstructure Changes Revealed by Diffusion Kurtosis and Diffusion Tensor Imaging in Mutant Huntingtin Gene Carriers. J Huntingtons Dis 2024:JHD240018. [PMID: 38905054 DOI: 10.3233/jhd-240018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Abstract
Background Diffusion magnetic resonance imaging (dMRI) has revealed microstructural changes in white matter (WM) in Huntington's disease (HD). Objective To compare the validities of different dMRI, i.e., diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI) in HD. Methods 22 mutant huntingtin (mHTT) carriers and 14 controls were enrolled. Clinical assessments and dMRI were conducted. Based on CAG-Age Product (CAP) score, mHTT carriers were categorized into high CAP (hCAP) and medium and low CAP (m& lCAP) groups. Spearman analyses were used to explore correlations between imaging parameters in brain regions and clinical assessments. Receiver operating characteristic (ROC) was used to distinguish mHTT carriers from control, and define the HD patients at advanced stage. Results Compared to controls, mHTT carriers exhibited WM changes in DKI and DTI. There were 22 more regions showing significant differences in HD detected by MK than FA. Only MK in five brain regions showed significantly difference between any two group, and negatively correlated with the disease burden (r = -0.80 to -0.71). ROC analysis revealed that MK was more sensitive and FA was more specific, while Youden index showed that the integration of FA and MK gave rise to higher authenticities, in distinguishing m& lCAP from controls (Youden Index = 0.786), and discerning different phase of HD (Youden Index = 0.804). Conclusions Microstructural changes in WM occur at early stage of HD and deteriorate over the disease progression. Integrating DKI and DTI would provide the best accuracies for differentiating early HD from control and identifying advanced HD.
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Affiliation(s)
- Jin-Hui Yin
- Human Brain & Tissue Bank, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ya-Ou Liu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hong-Liang Li
- Department of Neurology, Aviation General Hospital, Beijing, China
| | - Jean Marc Burgunder
- Department of Neurology, Swiss Huntington's Disease Centre, Siloah, and Department of Neurology, University Hospital, Gümligen (Muri bei Bern), Switzerland
| | - Yue Huang
- Human Brain & Tissue Bank, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Pharmacology Department, School of Biomedical Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
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2
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Müller HP, Kassubek J. Toward diffusion tensor imaging as a biomarker in neurodegenerative diseases: technical considerations to optimize recordings and data processing. Front Hum Neurosci 2024; 18:1378896. [PMID: 38628970 PMCID: PMC11018884 DOI: 10.3389/fnhum.2024.1378896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 02/26/2024] [Indexed: 04/19/2024] Open
Abstract
Neuroimaging biomarkers have shown high potential to map the disease processes in the application to neurodegenerative diseases (NDD), e.g., diffusion tensor imaging (DTI). For DTI, the implementation of a standardized scanning and analysis cascade in clinical trials has potential to be further optimized. Over the last few years, various approaches to improve DTI applications to NDD have been developed. The core issue of this review was to address considerations and limitations of DTI in NDD: we discuss suggestions for improvements of DTI applications to NDD. Based on this technical approach, a set of recommendations was proposed for a standardized DTI scan protocol and an analysis cascade of DTI data pre-and postprocessing and statistical analysis. In summary, considering advantages and limitations of the DTI in NDD we suggest improvements for a standardized framework for a DTI-based protocol to be applied to future imaging studies in NDD, towards the goal to proceed to establish DTI as a biomarker in clinical trials in neurodegeneration.
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Vidas-Guscic N, van Rijswijk J, Van Audekerke J, Jeurissen B, Nnah I, Tang H, Muñoz-Sanjuan I, Pustina D, Cachope R, Van der Linden A, Bertoglio D, Verhoye M. Diffusion MRI marks progressive alterations in fiber integrity in the zQ175DN mouse model of Huntington's disease. Neurobiol Dis 2024; 193:106438. [PMID: 38365045 DOI: 10.1016/j.nbd.2024.106438] [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: 12/04/2023] [Revised: 01/24/2024] [Accepted: 02/13/2024] [Indexed: 02/18/2024] Open
Abstract
Huntington's disease (HD) is a progressive neurodegenerative disease affecting motor and cognitive abilities. Multiple studies have found white matter anomalies in HD-affected humans and animal models of HD. The identification of sensitive white-matter-based biomarkers in HD animal models will be important in understanding disease mechanisms and testing the efficacy of therapeutic interventions. Here we investigated the progression of white matter deficits in the knock-in zQ175DN heterozygous (HET) mouse model of HD at 3, 6 and 11 months of age (M), reflecting different states of phenotypic progression. We compared findings from traditional diffusion tensor imaging (DTI) and advanced fixel-based analysis (FBA) diffusion metrics for their sensitivity in detecting white matter anomalies in the striatum, motor cortex, and segments of the corpus callosum. FBA metrics revealed progressive and widespread reductions of fiber cross-section and fiber density in myelinated bundles of HET mice. The corpus callosum genu was the most affected structure in HET mice at 6 and 11 M based on the DTI and FBA metrics, while the striatum showed the earliest progressive differences starting at 3 M based on the FBA metrics. Overall, FBA metrics detected earlier and more prominent alterations in myelinated fiber bundles compared to the DTI metrics. Luxol fast blue staining showed no loss in myelin density, indicating that diffusion anomalies could not be explained by myelin reduction but diffusion anomalies in HET mice were accompanied by increased levels of neurofilament light chain protein at 11 M. Altogether, our findings reveal progressive alterations in myelinated fiber bundles that can be measured using diffusion MRI, representing a candidate noninvasive imaging biomarker to study phenotype progression and the efficacy of therapeutic interventions in zQ175DN mice. Moreover, our study exposed higher sensitivity of FBA than DTI metrics, suggesting a potential benefit of adopting these advanced metrics in other contexts, including biomarker development in humans.
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Affiliation(s)
- Nicholas Vidas-Guscic
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium; μNeuro Center for Excellence, University of Antwerp, Antwerp, Belgium.
| | - Joëlle van Rijswijk
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium; μNeuro Center for Excellence, University of Antwerp, Antwerp, Belgium
| | - Johan Van Audekerke
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium; μNeuro Center for Excellence, University of Antwerp, Antwerp, Belgium
| | - Ben Jeurissen
- μNeuro Center for Excellence, University of Antwerp, Antwerp, Belgium; Vision Lab, University of Antwerp, Antwerp, Belgium; Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium
| | - Israel Nnah
- Charles River Laboratories, Shrewsbury, MA, United states
| | - Haiying Tang
- CHDI Management, Inc., the company that manages the scientific activities of CHDI Foundation, Inc., Princeton, NJ, United States
| | - Ignacio Muñoz-Sanjuan
- CHDI Management, Inc., the company that manages the scientific activities of CHDI Foundation, Inc., Princeton, NJ, United States
| | - Dorian Pustina
- CHDI Management, Inc., the company that manages the scientific activities of CHDI Foundation, Inc., Princeton, NJ, United States
| | - Roger Cachope
- CHDI Management, Inc., the company that manages the scientific activities of CHDI Foundation, Inc., Princeton, NJ, United States
| | - Annemie Van der Linden
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium; μNeuro Center for Excellence, University of Antwerp, Antwerp, Belgium
| | - Daniele Bertoglio
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium; μNeuro Center for Excellence, University of Antwerp, Antwerp, Belgium
| | - Marleen Verhoye
- Bio-Imaging Lab, University of Antwerp, Antwerp, Belgium; μNeuro Center for Excellence, University of Antwerp, Antwerp, Belgium
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Wilkes FA, Jakabek D, Walterfang M, Velakoulis D, Poudel GR, Stout JC, Chua P, Egan GF, Looi JCL, Georgiou-Karistianis N. The shape of things to come. Mapping spatiotemporal progression of striatal morphology in Huntington disease: The IMAGE-HD study. Psychiatry Res Neuroimaging 2023; 335:111717. [PMID: 37751638 DOI: 10.1016/j.pscychresns.2023.111717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023]
Abstract
Mapping the spatiotemporal progression of neuroanatomical change in Huntington's Disease (HD) is fundamental to the development of bio-measures for prognostication. Statistical shape analysis to measure the striatum has been performed in HD, however there have been a limited number of longitudinal studies. To address these limitations, we utilised the Spherical Harmonic Point Distribution Method (SPHARM-PDM) to generate point distribution models of the striatum in individuals, and used linear mixed models to test for localised shape change over time in pre-manifest HD (pre-HD), symp-HD (symp-HD) and control individuals. Longitudinal MRI scans from the IMAGE-HD study were used (baseline, 18 and 30 months). We found significant differences in the shape of the striatum between groups. Significant group-by-time interaction was observed for the putamen bilaterally, but not for caudate. A differential rate of shape change between groups over time was observed, with more significant deflation in the symp-HD group in comparison with the pre-HD and control groups. CAG repeats were correlated with bilateral striatal shape in pre-HD and symp-HD. Robust statistical analysis of the correlates of striatal shape change in HD has confirmed the suitability of striatal morphology as a potential biomarker correlated with CAG-repeat length, and potentially, an endophenotype.
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Affiliation(s)
- Fiona A Wilkes
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, Australia.
| | | | - Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne Neuropsychiatry Centre, University of Melbourne and Northwestern Mental Health, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Dennis Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne Neuropsychiatry Centre, University of Melbourne and Northwestern Mental Health, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Govinda R Poudel
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Julie C Stout
- School of Psychological Sciences and the Turner Institute of Brain and Mental Health, Monash University, Melbourne, Australia
| | - Phyllis Chua
- Department of Psychiatry, School of Clinical Sciences, Monash University, Monash Medical Centre, Melbourne, Australia
| | - Gary F Egan
- School of Psychological Sciences and the Turner Institute of Brain and Mental Health, Monash University, Melbourne, Australia
| | - Jeffrey C L Looi
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, Australia; Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne Neuropsychiatry Centre, University of Melbourne and Northwestern Mental Health, Melbourne, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences and the Turner Institute of Brain and Mental Health, Monash University, Melbourne, Australia
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Hu B, Younes L, Bu X, Liu CF, Ratnanather JT, Paulsen J, Georgiou-Karistianis N, Miller MI, Ross C, Faria AV. Mixed longitudinal and cross-sectional analyses of deep gray matter and white matter using diffusion weighted images in premanifest and manifest Huntington's disease. Neuroimage Clin 2023; 39:103493. [PMID: 37582307 PMCID: PMC10448214 DOI: 10.1016/j.nicl.2023.103493] [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: 12/01/2022] [Revised: 04/29/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
Changes in the brain of patients with Huntington's disease (HD) begin years before clinical onset, so it remains critical to identify biomarkers to track these early changes. Metrics derived from tensor modeling of diffusion-weighted MRIs (DTI), that indicate the microscopic brain structure, can add important information to regional volumetric measurements. This study uses two large-scale longitudinal, multicenter datasets, PREDICT-HD and IMAGE-HD, to trace changes in DTI of HD participants with a broad range of CAP scores (a product of CAG repeat expansion and age), including those with pre-manifest disease (i.e., prior to clinical onset). Utilizing a fully automated data-driven approach to study the whole brain divided in regions of interest, we traced changes in DTI metrics (diffusivity and fractional anisotropy) versus CAP scores, using sigmoidal and linear regression models. We identified points of inflection in the sigmoidal regression using change-point analysis. The deep gray matter showed more evident and earlier changes in DTI metrics over CAP scores, compared to the deep white matter. In the deep white matter, these changes were more evident and occurred earlier in superior and posterior areas, compared to anterior and inferior areas. The curves of mean diffusivity vs. age of HD participants within a fixed CAP score were different from those of controls, indicating that the disease has an additional effect to age on the microscopic brain structure. These results show the regional and temporal vulnerability of the white matter and deep gray matter in HD, with potential implications for experimental therapeutics.
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Affiliation(s)
- Beini Hu
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Laurent Younes
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA
| | - Xuan Bu
- Department of Radiology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Chin-Fu Liu
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - J Tilak Ratnanather
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Jane Paulsen
- Department of Psychiatry, Neurology, Psychological Brain Sciences, University of Iowa, USA; Department Neurology, University of Wisconsin-Madison, USA
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences and Turner Institute of Brain and Mental Health, Monash University, Australia
| | - Michael I Miller
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Christopher Ross
- Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Andreia V Faria
- Department of Radiology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
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Bocci T, Baloscio D, Ferrucci R, Briscese L, Priori A, Sartucci F. Interhemispheric Connectivity in Idiopathic Cervical Dystonia and Spinocerebellar Ataxias: A Transcranial Magnetic Stimulation Study. Clin EEG Neurosci 2022; 53:460-466. [PMID: 32938220 DOI: 10.1177/1550059420957487] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND RATIONALE Hyperkinetic movement disorders represent a heterogeneous group of diseases, different from a genetic and clinical perspective. In the past, neurophysiological approaches provided different, sometimes contradictory findings, pointing to an impaired cortical inhibition as a common electrophysiological marker. Our aim was to evaluate changes in interhemispheric communication in patients with idiopathic cervical dystonia (ICD) and spinocerebellar ataxias (SCAs). MATERIALS AND METHODS Eleven patients with ICD, 7 with genetically confirmed SCA2 or SCA3, and 10 healthy volunteers were enrolled. The onset latency and duration of the ipsilateral silent period (iSPOL and iSPD, respectively), as well as the so-called transcallosal conduction time (TCT), were then recorded from the abductor pollicis brevis of the right side using an 8-shaped focal coil with wing diameters of 70 mm; all these parameters were evaluated and compared among groups. In SCAs, changes in neurophysiological measures were also correlated to the mutational load. RESULTS iSPD was significantly shorter in patients with SCA2 and SCA3, when compared both to control and ICD (P < .0001); iSPOL and TCT were prolonged in SCAs patients (P < .001). Changes in iSPD, iSPOL, and TCT in SCAs are significantly correlated with the mutational load (P = .01, P = .02, and P = .002, respectively). DISCUSSION This is the first study to assess changes in interhemispheric communication in patients with SCAs and ICD, using a transcranial magnetic stimulation protocol. Together with previous data in Huntington's disease, we suggest that these changes may underlie, at least in part, a common disease mechanism of polyglutamine disorders.
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Affiliation(s)
- Tommaso Bocci
- "Aldo Ravelli" Center for Neurotechnology and Experiental Brain Therapeutics, Department of Health Sciences, University of Milan & ASST Santi Paolo e Carlo, Milan, Italy
| | - Davide Baloscio
- Section of Neurophysiopathology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberta Ferrucci
- "Aldo Ravelli" Center for Neurotechnology and Experiental Brain Therapeutics, Department of Health Sciences, University of Milan & ASST Santi Paolo e Carlo, Milan, Italy
| | - Lucia Briscese
- Severe Acquired Brain Injuries Unit, Cisanello University Hospital, Pisa, Italy
| | - Alberto Priori
- "Aldo Ravelli" Center for Neurotechnology and Experiental Brain Therapeutics, Department of Health Sciences, University of Milan & ASST Santi Paolo e Carlo, Milan, Italy
| | - Ferdinando Sartucci
- Section of Neurophysiopathology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Tan B, Shishegar R, Oldham S, Fornito A, Poudel G, Georgiou-Karistianis N. Investigating longitudinal changes to frontal cortico-striatal tracts in Huntington's disease: the IMAGE-HD study. Brain Imaging Behav 2022; 16:2457-2466. [PMID: 35768755 DOI: 10.1007/s11682-022-00699-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/28/2022]
Abstract
The striatum is the principal site of disease pathology in Huntington's disease and contains neural connections to numerous cortical brain regions. Studies examining abnormalities to neural connections find that white matter integrity is compromised in HD; however, further regional, and longitudinal investigation is required. This paper is the first longitudinal investigation into region-based white-matter integrity changes in Huntington's Disease. The aim of this study was to better understand how disease progression impacts white matter tracts connecting the striatum to the prefrontal and motor cortical regions in HD. We used existing neuroimaging data from IMAGE-HD, comprised of 25 pre-symptomatic, 27 symptomatic, and 25 healthy controls at three separate time points (baseline, 18-months, 30-months). Fractional anisotropy, axial diffusivity and radial diffusivity were derived as measures of white matter microstructure. The anatomical regions of interest were identified using the Desikan-Killiany brain atlas. A Group by Time repeated measures ANCOVA was conducted for each tract of interest and for each measure. We found significantly lower fractional anisotropy and significantly higher radial diffusivity in the symptomatic group, compared to both the pre-symptomatic group and controls (the latter two groups did not differ from each other), in the rostral middle frontal and superior frontal tracts; as well as significantly higher axial diffusivity in the rostral middle tracts only. We did not find a Group by Time interaction for any of the white matter integrity measures. These findings demonstrate that whilst the microstructure of white matter tracts, extending from the striatum to these regions of interest, are compromised during the symptomatic stages of Huntington's disease, 36-month follow-up did not show progressive changes in these measures. Additionally, no correlations were found between clinical measures and tractography changes, indicating further investigations into the relationship between tractography changes and clinical symptoms in Huntington's disease are required.
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Affiliation(s)
- Brendan Tan
- School of Psychological Sciences and The Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton Campus, Melbourne, Victoria, 3800, Australia
| | - Rosita Shishegar
- School of Psychological Sciences and The Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton Campus, Melbourne, Victoria, 3800, Australia.,The Australian E-Health Research Centre, CSIRO, Melbourne, Australia.,Monash Biomedical Imaging, 770 Blackburn Road, Melbourne, Victoria, 3800, Australia
| | - Stuart Oldham
- Monash Biomedical Imaging, 770 Blackburn Road, Melbourne, Victoria, 3800, Australia.,Developmental Imaging, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, VIC, 3052, Australia
| | - Alex Fornito
- School of Psychological Sciences and The Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton Campus, Melbourne, Victoria, 3800, Australia.,Monash Biomedical Imaging, 770 Blackburn Road, Melbourne, Victoria, 3800, Australia
| | - Govinda Poudel
- School of Psychological Sciences and The Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton Campus, Melbourne, Victoria, 3800, Australia.,Sydney Imaging, Brain and Mind Centre, the University of Sydney, Sydney, New South Wales, 2050, Australia.,The Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, 3000, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences and The Turner Institute for Brain and Mental Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton Campus, Melbourne, Victoria, 3800, Australia.
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8
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Barrios-Martinez JV, Fernandes-Cabral DT, Abhinav K, Fernandez-Miranda JC, Chang YF, Suski V, Yeh FC, Friedlander RM. Differential tractography as a dynamic imaging biomarker: A methodological pilot study for Huntington's disease. Neuroimage Clin 2022; 35:103062. [PMID: 35671556 PMCID: PMC9168197 DOI: 10.1016/j.nicl.2022.103062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/05/2022] [Accepted: 05/26/2022] [Indexed: 11/21/2022]
Abstract
Huntington's disease (HD) is a neurodegenerative disorder characterized by motor, psychiatric, and cognitive symptoms. Due to its diverse manifestations, the scientific community has long recognized the need for sensitive, objective, individualized, and dynamic disease assessment tools. We examined the feasibility of Differential Tractography as a biomarker to evaluate correlation of symptom severity and of HD progression at the individual level. Differential tractography is a novel tractography modality that maps pathways with axonal injury characterized by a decrease of anisotropic diffusion pattern. We recruited sixteen patients scanned at 0-, 6-, and 12-month intervals by diffusion MRI scans for differential tractography assessment and correlated its volumetric findings with the Unified Huntington's Disease Rating Scale (UHDRS). Deterministic fiber tracking algorithm was applied. Longitudinal data was modeled using the generalized estimating equation (GEE) model and correlated with UHDRS scores, in addition to Spearman correlation for cross-sectional data. Our results show that volumes of affected pathways revealed by differential tractography significantly correlated with UHDRS scores in longitudinal data (p-value < 0.001), and chronological changes in differential tractography also correlated with the changes in UHDRS (p-value < 0.001). This technique opens new clinical avenues as a clinical translational tool to evaluate presymptomatic and symptomatic gene positive individuals. Our results provide support that differential tractography has the potential to be used as a dynamic imaging biomarker to assess at the individual level in a non-invasive manner, disease progression in HD. Critically important, differential tractography proves to be a quantitative tool for following degeneration in presymptomatic patients, with potential applications in clinical trials.
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Affiliation(s)
| | | | - Kumar Abhinav
- Department of Neurosurgery, University of Bristol, Southmead Hospital, Bristol, UK
| | | | - Yue-Fang Chang
- Department of Neurological Surgery, University of Pittsburgh, UPMC, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Valerie Suski
- Department of Neurology, University of Pittsburgh, UPMC, Pittsburgh, PA, USA
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh, UPMC, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Robert M Friedlander
- Department of Neurological Surgery, University of Pittsburgh, UPMC, Pittsburgh, PA, USA.
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9
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Classification of Huntington's Disease Stage with Features Derived from Structural and Diffusion-Weighted Imaging. J Pers Med 2022; 12:jpm12050704. [PMID: 35629126 PMCID: PMC9143912 DOI: 10.3390/jpm12050704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to classify Huntington’s disease (HD) stage using support vector machines and measures derived from T1- and diffusion-weighted imaging. The effects of feature selection approach and combination of imaging modalities are assessed. Fourteen premanifest-HD individuals (Pre-HD; on average > 20 years from estimated disease onset), eleven early-manifest HD (Early-HD) patients, and eighteen healthy controls (HC) participated in the study. We compared three feature selection approaches: (i) whole-brain segmented grey matter (GM; voxel-based measure) or fractional anisotropy (FA) values; (ii) GM or FA values from subcortical regions-of-interest (caudate, putamen, pallidum); and (iii) automated selection of GM or FA values with the algorithm Relief-F. We assessed single- and multi-kernel approaches to classify combined GM and FA measures. Significant classifications were achieved between Early-HD and Pre-HD or HC individuals (accuracy: generally, 85% to 95%), and between Pre-HD and controls for the feature FA of the caudate ROI (74% accuracy). The combination of GM and FA measures did not result in higher performances. We demonstrate evidence on the high sensitivity of FA for the classification of the earliest Pre-HD stages, and successful distinction between HD stages.
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10
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Zeun P, McColgan P, Dhollander T, Gregory S, Johnson EB, Papoutsi M, Nair A, Scahill RI, Rees G, Tabrizi SJ. Timing of selective basal ganglia white matter loss in premanifest Huntington's disease. Neuroimage Clin 2022; 33:102927. [PMID: 34999565 PMCID: PMC8757039 DOI: 10.1016/j.nicl.2021.102927] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/30/2021] [Accepted: 12/21/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To investigate the timeframe prior to symptom onset when cortico-basal ganglia white matter (white matter) loss begins in premanifest Huntington's disease (preHD), and which striatal and thalamic sub-region white matter tracts are most vulnerable. METHODS We performed fixel-based analysis, which allows resolution of crossing white matter fibres at the voxel level, on diffusion tractography derived white matter tracts of striatal and thalamic sub-regions in two independent cohorts; TrackON-HD, which included 72 preHD (approx. 11 years before disease onset) and 85 controls imaged at three time points over two years; and the HD young adult study (HD-YAS), which included 54 preHD (approx. 25 years before disease onset) and 53 controls, imaged at one time point. Group differences in fibre density and cross section (FDC) were investigated. RESULTS We found no significant group differences in cortico-basal ganglia sub-region FDC in preHD gene carriers 25 years before onset. In gene carriers 11 years before onset, there were reductions in striatal (limbic and caudal motor) and thalamic (premotor, motor and sensory) FDC at baseline, with no significant change over 2 years. Caudal motor-striatal, pre-motor-thalamic, and primary motor-thalamic FDC at baseline, showed significant correlations with the Unified Huntington's disease rating scale (UHDRS) total motor score (TMS). Limbic cortico-striatal FDC and apathy were also significantly correlated. CONCLUSIONS Our findings suggest that limbic and motor white matter tracts to the striatum and thalamus are most susceptible to early degeneration in HD but that approximately 25 years from onset, these tracts appear preserved. These findings may have importance in determining the optimum time to initiate future disease modifying therapies in HD.
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Affiliation(s)
- Paul Zeun
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG, UK
| | - Peter McColgan
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG, UK
| | - Thijs Dhollander
- The Murdoch Children's Research Institute, Parkville Victoria 3052, Australia
| | - Sarah Gregory
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG, UK
| | - Eileanoir B Johnson
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG, UK
| | - Marina Papoutsi
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG, UK
| | - Akshay Nair
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG, UK; Max Planck UCL Centre for Computational Psychiatry and Ageing Research, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG, UK
| | - Rachael I Scahill
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG, UK
| | - Geraint Rees
- UCL Institute of Cognitive Neuroscience, Queen Square, London WC1N 3BG, UK
| | - Sarah J Tabrizi
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG, UK; Dementia Research Institute at UCL, London WC1N 3BG, UK.
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11
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Adanyeguh IM, Branzoli F, Delorme C, Méneret A, Monin ML, Luton MP, Durr A, Sabidussi E, Mochel F. Multiparametric characterization of white matter alterations in early stage Huntington disease. Sci Rep 2021; 11:13101. [PMID: 34162958 PMCID: PMC8222368 DOI: 10.1038/s41598-021-92532-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 05/27/2021] [Indexed: 11/09/2022] Open
Abstract
Huntington's disease (HD) is a monogenic, fully penetrant neurodegenerative disorder. Widespread white matter damage affects the brain of patients with HD at very early stages of the disease. Fixel-based analysis (FBA) is a novel method to investigate the contribution of individual crossing fibers to the white matter damage and to detect possible alterations in both fiber density and fiber-bundle morphology. Diffusion-weighted magnetic resonance spectroscopy (DW-MRS), on the other hand, quantifies the motion of brain metabolites in vivo, thus enabling the investigation of microstructural alteration of specific cell populations. The aim of this study was to identify novel specific microstructural imaging markers of white matter degeneration in HD, by combining FBA and DW-MRS. Twenty patients at an early stage of HD and 20 healthy controls were recruited in a monocentric study. Using diffusion imaging we observed alterations to the brain microstructure and their morphology in patients with HD. Furthermore, FBA revealed specific fiber populations that were affected by the disease. Moreover, the mean diffusivity of the intra-axonal metabolite N-acetylaspartate, co-measured with N-acetylaspartylglutamate (tNAA), was significantly reduced in the corpus callosum of patients compared to controls. FBA and DW-MRS of tNAA provided more specific information about the biological mechanisms underlying HD and showed promise for early investigation of white matter degeneration in HD.
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Affiliation(s)
- Isaac M Adanyeguh
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, 75013, Paris, France
| | - Francesca Branzoli
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, 75013, Paris, France.,Center for NeuroImaging Research (CENIR), Institut du Cerveau Et de La Moelle Épinière, 75013, Paris, France
| | - Cécile Delorme
- Department of Neurology, AP-HP, Pitié-Salpêtrière University Hospital, Paris, France
| | - Aurélie Méneret
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, 75013, Paris, France.,Department of Neurology, AP-HP, Pitié-Salpêtrière University Hospital, Paris, France
| | - Marie-Lorraine Monin
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, 75013, Paris, France
| | - Marie-Pierre Luton
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, 75013, Paris, France
| | - Alexandra Durr
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, 75013, Paris, France
| | - Emanoel Sabidussi
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, 75013, Paris, France
| | - Fanny Mochel
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, 75013, Paris, France. .,Department of Genetics, Center for Neurometabolic Diseases, AP-HP, La Pitié-Salpêtrière University Hospital, 47 Boulevard de l'Hôpital, 75013, Paris, France.
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12
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Altered iron and myelin in premanifest Huntington's Disease more than 20 years before clinical onset: Evidence from the cross-sectional HD Young Adult Study. EBioMedicine 2021; 65:103266. [PMID: 33706250 PMCID: PMC7960938 DOI: 10.1016/j.ebiom.2021.103266] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background Pathological processes in Huntington's disease (HD) begin many years prior to symptom onset. Recently we demonstrated that in a premanifest cohort approximately 24 years from predicted disease onset, despite intact function, there was evidence of subtle neurodegeneration. Here, we use novel imaging techniques to determine whether macro- and micro-structural changes can be detected across the whole-brain in the same cohort. Methods 62 premanifest HD (PreHD) and 61 controls from the HD Young Adult Study (HD-YAS) were included. Grey and white matter volume, diffusion weighted imaging (DWI) measures of white matter microstructure, multiparametric maps (MPM) estimating myelin and iron content from magnetization transfer (MT), proton density (PD), longitudinal relaxation (R1) and effective transverse relaxation (R2*), and myelin g-ratio were examined. Group differences between PreHD and controls were assessed; associations between all imaging metrics and disease burden and CSF neurofilament light (NfL) were also performed. Volumetric and MPM results were corrected at a cluster-wise value of familywise error (FWE) 0.05. Diffusion and g-ratio results were corrected via threshold-free cluster enhancement at FWE 0.05. Findings We showed significantly increased R1 and R2*, suggestive of increased iron, in the putamen, globus pallidum and external capsule of PreHD participants. There was also a significant association between lower cortical R2*, suggestive of reduced myelin or iron, and higher CSF NfL in the frontal lobe and the parieto-occipital cortices. No other results were significant at corrected levels. Interpretation Increased iron in subcortical structures and the surrounding white matter is a feature of very early PreHD. Furthermore, increases in CSF NfL were linked to microstructural changes in the posterior parietal-occipital cortex, a region previously shown to undergo some of the earliest cortical changes in HD. These findings suggest that disease related process are occurring in both subcortical and cortical regions more than 20 years from predicted disease onset.
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13
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Tan B, Shishegar R, Poudel GR, Fornito A, Georgiou-Karistianis N. Cortical morphometry and neural dysfunction in Huntington's disease: a review. Eur J Neurol 2020; 28:1406-1419. [PMID: 33210786 DOI: 10.1111/ene.14648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/22/2020] [Accepted: 11/12/2020] [Indexed: 01/09/2023]
Abstract
Numerous neuroimaging techniques have been used to identify biomarkers of disease progression in Huntington's disease (HD). To date, the earliest and most sensitive of these is caudate volume; however, it is becoming increasingly evident that numerous changes to cortical structures, and their interconnected networks, occur throughout the course of the disease. The mechanisms by which atrophy spreads from the caudate to these cortical regions remains unknown. In this review, the neuroimaging literature specific to T1-weighted and diffusion-weighted magnetic resonance imaging is summarized and new strategies for the investigation of cortical morphometry and the network spread of degeneration in HD are proposed. This new avenue of research may enable further characterization of disease pathology and could add to a suite of biomarker/s of disease progression for patient stratification that will help guide future clinical trials.
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Affiliation(s)
- Brendan Tan
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Rosita Shishegar
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia.,Australian e-Health Research Centre, CSIRO, Melbourne, VIC, Australia.,Monash Biomedical Imaging, Melbourne, VIC, Australia
| | - Govinda R Poudel
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia.,Sydney Imaging, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.,Australian Catholic University, Melbourne, VIC, Australia
| | - Alex Fornito
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia.,Monash Biomedical Imaging, Melbourne, VIC, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
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14
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Gatto RG, Weissmann C. Diffusion Tensor Imaging in Preclinical and Human Studies of Huntington's Disease: What Have we Learned so Far? Curr Med Imaging 2020; 15:521-542. [PMID: 32008561 DOI: 10.2174/1573405614666181115113400] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 10/23/2018] [Accepted: 10/26/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Huntington's Disease is an irreversible neurodegenerative disease characterized by the progressive deterioration of specific brain nerve cells. The current evaluation of cellular and physiological events in patients with HD relies on the development of transgenic animal models. To explore such events in vivo, diffusion tensor imaging has been developed to examine the early macro and microstructural changes in brain tissue. However, the gap in diffusion tensor imaging findings between animal models and clinical studies and the lack of microstructural confirmation by histological methods has questioned the validity of this method. OBJECTIVE This review explores white and grey matter ultrastructural changes associated to diffusion tensor imaging, as well as similarities and differences between preclinical and clinical Huntington's Disease studies. METHODS A comprehensive review of the literature using online-resources was performed (Pub- Med search). RESULTS Similar changes in fractional anisotropy as well as axial, radial and mean diffusivities were observed in white matter tracts across clinical and animal studies. However, comparative diffusion alterations in different grey matter structures were inconsistent between clinical and animal studies. CONCLUSION Diffusion tensor imaging can be related to specific structural anomalies in specific cellular populations. However, some differences between animal and clinical studies could derive from the contrasting neuroanatomy or connectivity across species. Such differences should be considered before generalizing preclinical results into the clinical practice. Moreover, current limitations of this technique to accurately represent complex multicellular events at the single micro scale are real. Future work applying complex diffusion models should be considered.
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Affiliation(s)
- Rodolfo Gabriel Gatto
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, 60607, United States
| | - Carina Weissmann
- Insituto de Fisiología Biologia Molecular y Neurociencias-IFIBYNE-CONICET, University of Buenos Aires, Buenos Aires, Argentina
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15
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Wilton DK, Stevens B. The contribution of glial cells to Huntington's disease pathogenesis. Neurobiol Dis 2020; 143:104963. [PMID: 32593752 DOI: 10.1016/j.nbd.2020.104963] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/07/2020] [Accepted: 06/10/2020] [Indexed: 12/20/2022] Open
Abstract
Glial cells play critical roles in the normal development and function of neural circuits, but in many neurodegenerative diseases, they become dysregulated and may contribute to the development of brain pathology. In Huntington's disease (HD), glial cells both lose normal functions and gain neuropathic phenotypes. In addition, cell-autonomous dysfunction elicited by mutant huntingtin (mHTT) expression in specific glial cell types is sufficient to induce both pathology and Huntington's disease-related impairments in motor and cognitive performance, suggesting that these cells may drive the development of certain aspects of Huntington's disease pathogenesis. In support of this imaging studies in pre-symptomatic HD patients and work on mouse models have suggested that glial cell dysfunction occurs at a very early stage of the disease, prior to the onset of motor and cognitive deficits. Furthermore, selectively ablating mHTT from specific glial cells or correcting for HD-induced changes in their transcriptional profile rescues some HD-related phenotypes, demonstrating the potential of targeting these cells for therapeutic intervention. Here we review emerging research focused on understanding the involvement of different glial cell types in specific aspects of HD pathogenesis. This work is providing new insight into how HD impacts biological functions of glial cells in the healthy brain as well as how HD induced dysfunction in these cells might change the way they integrate into biological circuits.
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Affiliation(s)
- Daniel K Wilton
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Beth Stevens
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA; Stanley Center, Broad Institute, Cambridge, MA 02142, USA; Howard Hughes Medical Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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16
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Waters S, Tedroff J, Ponten H, Klamer D, Sonesson C, Waters N. Pridopidine: Overview of Pharmacology and Rationale for its Use in Huntington's Disease. J Huntingtons Dis 2019; 7:1-16. [PMID: 29480206 PMCID: PMC5836399 DOI: 10.3233/jhd-170267] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Despite advances in understanding the pathophysiology of Huntington’s disease (HD), there are currently no effective pharmacological agents available to treat core symptoms or to stop or prevent the progression of this hereditary neurodegenerative disorder. Pridopidine, a novel small molecule compound, has demonstrated potential for both symptomatic treatment and disease modifying effects in HD. While pridopidine failed to achieve its primary efficacy outcomes (Modified motor score) in two trials (MermaiHD and HART) there were consistent effects on secondary outcomes (TMS). In the most recent study (PrideHD) pridiopidine did not differ from placebo on TMS, possibly due to a large enduring placebo effect. This review describes the process, based on in vivo systems response profiling, by which pridopidine was discovered and discusses its pharmacological profile, aiming to provide a model for the system-level effects, and a rationale for the use of pridopidine in patients affected by HD. Considering the effects on brain neurochemistry, gene expression and behaviour in vivo, pridopidine displays a unique effect profile. A hallmark feature in the behavioural pharmacology of pridopidine is its state-dependent inhibition or activation of dopamine-dependent psychomotor functions. Such effects are paralleled by strengthening of synaptic connectivity in cortico-striatal pathways suggesting pridopidine has potential to modify phenotypic expression as well as progression of HD. The preclinical pharmacological profile is discussed with respect to the clinical results for pridopidine, and proposals are made for further investigation, including preclinical and clinical studies addressing disease progression and effects at different stages of HD.
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Affiliation(s)
- Susanna Waters
- Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden.,Integrative Research Laboratories AB, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Joakim Tedroff
- Department of Clinical Neurosciences, Karolinska Institute, Stockholm, Sweden.,Integrative Research Laboratories AB, Gothenburg, Sweden
| | - Henrik Ponten
- Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden
| | - Daniel Klamer
- Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden
| | - Clas Sonesson
- Integrative Research Laboratories AB, Gothenburg, Sweden
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17
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Petrella LI, Castelhano JM, Ribeiro M, Sereno JV, Gonçalves SI, Laço MN, Hayden MR, Rego AC, Castelo-Branco M. A whole brain longitudinal study in the YAC128 mouse model of Huntington's disease shows distinct trajectories of neurochemical, structural connectivity and volumetric changes. Hum Mol Genet 2019; 27:2125-2137. [PMID: 29668904 DOI: 10.1093/hmg/ddy119] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/26/2018] [Indexed: 12/20/2022] Open
Abstract
Huntington's disease (HD) is a neurodegenerative disorder causing cognitive and motor impairments, evolving to death within 15-20 years after symptom onset. We previously established a mouse model with the entire human HD gene containing 128 CAG repeats (YAC128) which accurately recapitulates the natural history of the human disease. Defined time points in this natural history enable the understanding of longitudinal trajectories from the neurochemical and structural points of view using non-invasive high-resolution multi-modal imaging. Accordingly, we designed a longitudinal structural imaging (MRI and DTI) and spectroscopy (1H-MRS) study in YAC128, at 3, 6, 9 and 12 months of age, at 9.4 T. Structural analysis (MRI/DTI), confirmed that the striatum is the earliest affected brain region, but other regions were also identified through connectivity analysis (pre-frontal cortex, hippocampus, globus pallidus and thalamus), suggesting a striking homology with the human disease. Importantly, we found for the first time, a negative correlation between striatal and hippocampal changes only in YAC128. In fact, the striatum showed accelerated volumetric decay in HD, as opposed to the hippocampus. Neurochemical analysis of the HD striatum suggested early neurometabolic alterations in neurotransmission and metabolism, with a significant increase in striatal GABA levels, and specifically anticorrelated levels of N-acetyl aspartate and taurine, suggesting that the later is homeostatically adjusted for neuroprotection, as neural loss, indicated by the former, is progressing. These results provide novel insights into the natural history of HD and prove a valuable role for longitudinal multi-modal panels of structural and metabolite/neurotransmission in the YAC128 model.
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Affiliation(s)
- Lorena I Petrella
- Institute of Nuclear Science Applied to Health, University of Coimbra, 3000-548 Coimbra, Portugal.,Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal
| | - João M Castelhano
- Institute of Nuclear Science Applied to Health, University of Coimbra, 3000-548 Coimbra, Portugal.,Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Mario Ribeiro
- Institute of Nuclear Science Applied to Health, University of Coimbra, 3000-548 Coimbra, Portugal.,Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal
| | - José V Sereno
- Institute of Nuclear Science Applied to Health, University of Coimbra, 3000-548 Coimbra, Portugal.,Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Sónia I Gonçalves
- Institute of Nuclear Science Applied to Health, University of Coimbra, 3000-548 Coimbra, Portugal.,Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal.,Neuroplasticity and Neural Activity Laboratory, Champalimaud Centre for the Unknown, 1400-038 Lisbon, Portugal
| | - Mário N Laço
- Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Michael R Hayden
- Department of Medical Genetics, Centre for Molecular Medicine and Therapeutics, Child and Family Research Institute, University of British Columbia, Vancouver, BC V5Z 4H4, Canada
| | - A Cristina Rego
- Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Miguel Castelo-Branco
- Institute of Nuclear Science Applied to Health, University of Coimbra, 3000-548 Coimbra, Portugal.,Center for Neuroscience and Cell Biology-Institute of Biomedical Imaging and Life Science (CNC.IBILI), University of Coimbra, 3000-548 Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
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18
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Structural Magnetic Resonance Imaging in Huntington's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 142:335-380. [PMID: 30409258 DOI: 10.1016/bs.irn.2018.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder, caused by expansion of the CAG repeat in the huntingtin gene. HD is characterized clinically by progressive motor, cognitive and neuropsychiatric symptoms. There are currently no disease modifying treatments available for HD, and there is a great need for biomarkers to monitor disease progression and identify new targets for therapeutic intervention. Neuroimaging techniques provide a powerful tool for assessing disease pathology and progression in premanifest stages, before the onset of overt motor symptoms. Structural magnetic resonance imaging (MRI) is non-invasive imaging techniques which have been employed to study structural and microstructural changes in premanifest and manifest HD gene carriers. This chapter described structural imaging techniques and analysis methods employed across HD MRI studies. Current evidence for structural MRI abnormalities in HD, and associations between atrophy, structural white matter changes, iron deposition and clinical performance are discussed; together with the use of structural MRI measures as a diagnostic tool, to assess longitudinal changes, and as potential biomarkers and endpoints for clinical trials.
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19
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Zhang J, Gregory S, Scahill RI, Durr A, Thomas DL, Lehericy S, Rees G, Tabrizi SJ, Zhang H. In vivo characterization of white matter pathology in premanifest huntington's disease. Ann Neurol 2018; 84:497-504. [PMID: 30063250 PMCID: PMC6221120 DOI: 10.1002/ana.25309] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 07/24/2018] [Accepted: 07/28/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Huntington's disease (HD) is a monogenic, fully penetrant neurodegenerative disorder, providing an ideal model for understanding brain changes occurring in the years prior to disease onset. Diffusion tensor imaging (DTI) studies show widespread white matter disorganization in the early premanifest stages (pre-HD). However, although DTI has proved informative, it provides only limited information about underlying changes in tissue properties. Neurite orientation dispersion and density imaging (NODDI) is a novel magnetic resonance imaging (MRI) technique for characterizing axonal pathology more specifically, providing metrics that separately quantify axonal density and axonal organization. Here, we provide the first in vivo characterization of white matter pathology in pre-HD using NODDI. METHODS Diffusion-weighted MRI data that support DTI and NODDI were acquired from 38 pre-HD and 45 control participants. Using whole-brain and region-of-interest analyses, NODDI metrics were compared between groups and correlated with clinical scores of disease progression. Whole-brain changes in DTI metrics were also examined. RESULTS The pre-HD group displayed widespread reductions in axonal density compared with control participants; this correlated with measures of clinical disease progression in the body and genu of the corpus callosum. There was also evidence in the pre-HD group of increased coherence of axonal packing in the white matter surrounding the basal ganglia. INTERPRETATION Our findings suggest that reduced axonal density is one of the major factors underlying white matter pathology in pre-HD, coupled with altered local organization in areas surrounding the basal ganglia. NODDI metrics show promise in providing more specific information about the biological processes underlying HD and neurodegeneration per se. Ann Neurol 2018;84:497-504.
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Affiliation(s)
- Jiaying Zhang
- Department of Computer Science and Centre for Medical Image ComputingUniversity College LondonLondonUnited Kingdom
| | - Sarah Gregory
- Huntington's Disease Research Centre, Institute of NeurologyUniversity College LondonLondonUnited Kingdom
- Wellcome Trust Centre for Neuroimaging, Institute of NeurologyUniversity College LondonLondonUnited Kingdom
| | - Rachael I. Scahill
- Huntington's Disease Research Centre, Institute of NeurologyUniversity College LondonLondonUnited Kingdom
- Department of Neurodegenerative Disease, Institute of NeurologyUniversity College LondonLondonUnited Kingdom
| | - Alexandra Durr
- ICM – Institut du Cerveau et de la Moelle Epinière, INSERM U1127, CNRS UMR7225, Sorbonne Universités – UPMC Université Paris VI UMR_S1127 and APHP, Genetic departmentPitié–Salpêtrière University HospitalParisFrance
| | - David L. Thomas
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of NeurologyUniversity College LondonLondonUnited Kingdom
- Leonard Wolfson Experimental Neurology Centre, Institute of NeurologyUniversity College LondonLondonUnited Kingdom
| | - Stéphane Lehericy
- Neuroimaging Research Center, Brain and Spinal Cord InstitutePierre and Marie Curie University, Inserm UMR1127, CNRS 7225ParisFrance
| | - Geraint Rees
- Wellcome Trust Centre for Neuroimaging, Institute of NeurologyUniversity College LondonLondonUnited Kingdom
| | - Sarah J. Tabrizi
- Huntington's Disease Research Centre, Institute of NeurologyUniversity College LondonLondonUnited Kingdom
- Wellcome Trust Centre for Neuroimaging, Institute of NeurologyUniversity College LondonLondonUnited Kingdom
| | - Hui Zhang
- Department of Computer Science and Centre for Medical Image ComputingUniversity College LondonLondonUnited Kingdom
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20
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Coppen EM, van der Grond J, Hart EP, Lakke EAJF, Roos RAC. The visual cortex and visual cognition in Huntington's disease: An overview of current literature. Behav Brain Res 2018; 351:63-74. [PMID: 29792890 DOI: 10.1016/j.bbr.2018.05.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/01/2018] [Accepted: 05/21/2018] [Indexed: 12/21/2022]
Abstract
The processing of visual stimuli from retina to higher cortical areas has been extensively studied in the human brain. In Huntington's disease (HD), an inherited neurodegenerative disorder, it is suggested that visual processing deficits are present in addition to more characteristic signs such as motor disturbances, cognitive dysfunction, and behavioral changes. Visual deficits are clinically important because they influence overall cognitive performance and have implications for daily functioning. The aim of this review is to summarize current literature on clinical visual deficits, visual cognitive impairment, and underlying visual cortical changes in HD patients. A literature search was conducted using the electronic database of PubMed/Medline. This review shows that changes of the visual system in patients with HD were not the primary focus of currently published studies. Still, early atrophy and alterations of the posterior cerebral cortex was frequently observed, primarily in the associative visual cortical areas such as the lingual and fusiform gyri, and lateral occipital cortex. Changes were even present in the premanifest phase, before clinical onset of motor symptoms, suggesting a primary region for cortical degeneration in HD. Although impairments in visuospatial processing and visual perception were reported in early disease stages, heterogeneous cognitive batteries were used, making a direct comparison between studies difficult. The use of a standardized battery of visual cognitive tasks might therefore provide more detailed information regarding the extent of impairments in specific visual domains. Further research could provide more insight into clinical, functional, and pathophysiological changes of the visual pathway in HD.
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Affiliation(s)
- Emma M Coppen
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Ellen P Hart
- Centre for Human Drug Research, Leiden, The Netherlands.
| | - Egbert A J F Lakke
- Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Raymund A C Roos
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
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21
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Gregory S, Crawford H, Seunarine K, Leavitt B, Durr A, Roos RAC, Scahill RI, Tabrizi SJ, Rees G, Langbehn D, Orth M. Natural biological variation of white matter microstructure is accentuated in Huntington's disease. Hum Brain Mapp 2018; 39:3516-3527. [PMID: 29682858 PMCID: PMC6099203 DOI: 10.1002/hbm.24191] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 03/26/2018] [Accepted: 04/06/2018] [Indexed: 01/11/2023] Open
Abstract
Huntington's disease (HD) is a monogenic neurodegenerative disorder caused by a CAG‐repeat expansion in the Huntingtin gene. Presence of this expansion signifies certainty of disease onset, but only partly explains age at which onset occurs. Genome‐wide association studies have shown that naturally occurring genetic variability influences HD pathogenesis and disease onset. Investigating the influence of biological traits in the normal population, such as variability in white matter properties, on HD pathogenesis could provide a complementary approach to understanding disease modification. We have previously shown that while white matter diffusivity patterns in the left sensorimotor network were similar in controls and HD gene‐carriers, they were more extreme in the HD group. We hypothesized that the influence of natural variation in diffusivity on effects of HD pathogenesis on white matter is not limited to the sensorimotor network but extends to cognitive, limbic, and visual networks. Using tractography, we investigated 32 bilateral pathways within HD‐related networks, including motor, cognitive, and limbic, and examined diffusivity metrics using principal components analysis. We identified three independent patterns of diffusivity common to controls and HD gene‐carriers that predicted HD status. The first pattern involved almost all tracts, the second was limited to sensorimotor tracts, and the third encompassed cognitive network tracts. Each diffusivity pattern was associated with network specific performance. The consistency in diffusivity patterns across both groups coupled with their association with disease status and task performance indicates that naturally‐occurring patterns of diffusivity can become accentuated in the presence of the HD gene mutation to influence clinical brain function.
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Affiliation(s)
- Sarah Gregory
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, United Kingdom
| | - Helen Crawford
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, United Kingdom
| | - Kiran Seunarine
- Developmental Imaging and Biophysics Section, UCL Institute of Child Health, London, WC1N 1EH, United Kingdom
| | - Blair Leavitt
- Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia, Vancouver, BC, V5Z 4H4, Canada
| | - Alexandra Durr
- APHP Department of Genetics, Groupe Hospitalier Pitié-Salpêtrière, and Institut du Cerveau et de la Moelle, INSERM U1127, CNRS UMR7225, Sorbonne Universités - UPMC Université Paris VI UMR_S1127, Paris, France
| | - Raymund A C Roos
- Department of Neurology, Leiden University Medical Centre, Leiden, 2300RC, The Netherlands
| | - Rachael I Scahill
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, United Kingdom
| | - Sarah J Tabrizi
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, United Kingdom
| | - Geraint Rees
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom
| | - Douglas Langbehn
- Departments of Psychiatry and Biostatistics, University of Iowa, Iowa City, Iowa
| | - Michael Orth
- Department of Neurology, Ulm University Hospital, Ulm, Germany
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22
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Abstract
Magnetic resonance imaging (MRI) is a noninvasive technique used routinely to image the body in both clinical and research settings. Through the manipulation of radio waves and static field gradients, MRI uses the principle of nuclear magnetic resonance to produce images with high spatial resolution, appropriate for the investigation of brain structure and function.
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Affiliation(s)
- Sarah Gregory
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, UK.
| | - Rachael I Scahill
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, UK
| | - Geraint Rees
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, UK
| | - Sarah Tabrizi
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, UK
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23
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Garcia‐Gorro C, de Diego‐Balaguer R, Martínez‐Horta S, Pérez‐Pérez J, Kulisevsky J, Rodríguez‐Dechicha N, Vaquer I, Subira S, Calopa M, Muñoz E, Santacruz P, Ruiz‐Idiago J, Mareca C, Caballol N, Camara E. Reduced striato-cortical and inhibitory transcallosal connectivity in the motor circuit of Huntington's disease patients. Hum Brain Mapp 2018; 39:54-71. [PMID: 28990240 PMCID: PMC6866479 DOI: 10.1002/hbm.23813] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 08/25/2017] [Accepted: 09/05/2017] [Indexed: 12/13/2022] Open
Abstract
Huntington's disease (HD) is a neurodegenerative disorder which is primarily associated with striatal degeneration. However, the alterations in connectivity of this structure in HD have been underinvestigated. In this study, we analyzed the functional and structural connectivity of the left putamen, while participants performed a finger-tapping task. Using fMRI and DW-MRI, 30 HD gene expansion carriers (HDGEC) and 29 healthy participants were scanned. Psychophysiological interaction analysis and DTI-based tractography were employed to examine functional and structural connectivity, respectively. Manifest HDGEC exhibited a reduced functional connectivity of the left putamen with the left and the right primary sensorimotor areas (SM1). Based on this result, the inhibitory functional connectivity between the left SM1 and the right SM1 was explored, appearing to be also decreased. In addition, the tract connecting these areas (motor corpus callosum), and the tract connecting the left putamen with the left SM1 appeared disrupted in HDGEC compared to controls. Significant correlations were found between measures of functional and structural connectivity of the motor corpus callosum, showing a coupling of both types of alterations in this tract. The observed reduction of functional and structural connectivity was associated with worse motor scores, which highlights the clinical relevance of these results. Hum Brain Mapp 39:54-71, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Clara Garcia‐Gorro
- Cognition and Brain Plasticity UnitIDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet de LlobregatBarcelonaSpain
- Department of Cognition, Development and Educational PsychologyUniversity of BarcelonaBarcelonaSpain
| | - Ruth de Diego‐Balaguer
- Cognition and Brain Plasticity UnitIDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet de LlobregatBarcelonaSpain
- Department of Cognition, Development and Educational PsychologyUniversity of BarcelonaBarcelonaSpain
- The Institute of Neurosciences of the University of BarcelonaBarcelonaSpain
- ICREA (Catalan Institute for Research and Advanced Studies)BarcelonaSpain
| | - Saul Martínez‐Horta
- Movement Disorders Unit, Department of NeurologyBiomedical Research Institute Sant Pau (IIB‐Sant Pau), Hospital de la Santa Creu i Sant PauBarcelonaSpain
- CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III InstituteMadridSpain
| | - Jesus Pérez‐Pérez
- Movement Disorders Unit, Department of NeurologyBiomedical Research Institute Sant Pau (IIB‐Sant Pau), Hospital de la Santa Creu i Sant PauBarcelonaSpain
- CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III InstituteMadridSpain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Department of NeurologyBiomedical Research Institute Sant Pau (IIB‐Sant Pau), Hospital de la Santa Creu i Sant PauBarcelonaSpain
- CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III InstituteMadridSpain
- Universidad Autónoma de BarcelonaBarcelonaSpain
| | | | - Irene Vaquer
- Hestia Duran i Reynals, Hospital Duran i Reynals, Hospitalet de LlobregatBarcelonaSpain
| | - Susana Subira
- Hestia Duran i Reynals, Hospital Duran i Reynals, Hospitalet de LlobregatBarcelonaSpain
- Department of Clinical and Health PsychologyUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Matilde Calopa
- Movement Disorders Unit, Neurology Service, Hospital Universitari de Bellvitge, L'Hospitalet de LlobregatBarcelonaSpain
| | - Esteban Muñoz
- Movement Disorders Unit, Neurology Service, Hospital ClínicBarcelonaSpain
- IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer)BarcelonaSpain
- Facultat de medicina, University of BarcelonaBarcelonaSpain
| | - Pilar Santacruz
- Movement Disorders Unit, Neurology Service, Hospital ClínicBarcelonaSpain
| | | | | | - Nuria Caballol
- Hospital de Sant Joan Despí Moisès Broggi, Sant Joan DespíBarcelonaSpain
| | - Estela Camara
- Cognition and Brain Plasticity UnitIDIBELL (Institut d'Investigació Biomèdica de Bellvitge), L'Hospitalet de LlobregatBarcelonaSpain
- Department of Cognition, Development and Educational PsychologyUniversity of BarcelonaBarcelonaSpain
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24
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Saba RA, Yared JH, Doring TM, Phys M, Borges V, Ferraz HB. Diffusion tensor imaging of brain white matter in Huntington gene mutation individuals. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 75:503-508. [PMID: 28813079 DOI: 10.1590/0004-282x20170085] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 04/15/2017] [Indexed: 11/21/2022]
Abstract
Objective To evaluate the role of the involvement of white matter tracts in huntingtin gene mutation patients as a potential biomarker of the progression of the disease. Methods We evaluated 34 participants (11 symptomatic huntingtin gene mutation, 12 presymptomatic huntingtin gene mutation, and 11 controls). We performed brain magnetic resonance imaging to assess white matter integrity using diffusion tensor imaging, with measurement of fractional anisotropy. Results We observed a significant decrease of fractional anisotropy in the cortical spinal tracts, corona radiate, corpus callosum, external capsule, thalamic radiations, superior and inferior longitudinal fasciculus, and inferior frontal-occipital fasciculus in the Huntington disease group compared to the control and presymptomatic groups. Reduction of fractional anisotropy is indicative of a degenerative process and axonal loss. There was no statistically significant difference between the presymptomatic and control groups. Conclusion White matter integrity is affected in huntingtin gene mutation symptomatic individuals, but other studies with larger samples are required to assess its usefulness in the progression of the neurodegenerative process.
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Affiliation(s)
- Roberta Arb Saba
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Neurologia, São Paulo SP, Brasil
| | - James H Yared
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Neurologia, São Paulo SP, Brasil
| | | | - Med Phys
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Neurologia, São Paulo SP, Brasil
| | - Vanderci Borges
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Neurologia, São Paulo SP, Brasil
| | - Henrique Ballalai Ferraz
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Neurologia, São Paulo SP, Brasil
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25
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Wu D, Faria AV, Younes L, Mori S, Brown T, Johnson H, Paulsen JS, Ross CA, Miller MI. Mapping the order and pattern of brain structural MRI changes using change-point analysis in premanifest Huntington's disease. Hum Brain Mapp 2017; 38:5035-5050. [PMID: 28657159 PMCID: PMC5766002 DOI: 10.1002/hbm.23713] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/12/2017] [Accepted: 06/19/2017] [Indexed: 02/02/2023] Open
Abstract
Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder that progressively affects motor, cognitive, and emotional functions. Structural MRI studies have demonstrated brain atrophy beginning many years prior to clinical onset ("premanifest" period), but the order and pattern of brain structural changes have not been fully characterized. In this study, we investigated brain regional volumes and diffusion tensor imaging (DTI) measurements in premanifest HD, and we aim to determine (1) the extent of MRI changes in a large number of structures across the brain by atlas-based analysis, and (2) the initiation points of structural MRI changes in these brain regions. We adopted a novel multivariate linear regression model to detect the inflection points at which the MRI changes begin (namely, "change-points"), with respect to the CAG-age product (CAP, an indicator of extent of exposure to the effects of CAG repeat expansion). We used approximately 300 T1-weighted and DTI data from premanifest HD and control subjects in the PREDICT-HD study, with atlas-based whole brain segmentation and change-point analysis. The results indicated a distinct topology of structural MRI changes: the change-points of the volumetric measurements suggested a central-to-peripheral pattern of atrophy from the striatum to the deep white matter; and the change points of DTI measurements indicated the earliest changes in mean diffusivity in the deep white matter and posterior white matter. While interpretation needs to be cautious given the cross-sectional nature of the data, these findings suggest a spatial and temporal pattern of spread of structural changes within the HD brain. Hum Brain Mapp 38:5035-5050, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Dan Wu
- The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreMaryland
| | - Andreia V. Faria
- The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreMaryland
| | - Laurent Younes
- Center for Imaging Science, Johns Hopkins UniversityBaltimoreMaryland
- Institute for Computational Medicine, Johns Hopkins UniversityBaltimoreMaryland
- Department of Applied Mathematics and StatisticsJohns Hopkins UniversityBaltimoreMaryland
| | - Susumu Mori
- The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreMaryland
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger InstituteBaltimoreMaryland
| | - Timothy Brown
- Center for Imaging Science, Johns Hopkins UniversityBaltimoreMaryland
| | - Hans Johnson
- Department of Electrical and Computer EngineeringUniversity of IowaIowa CityIowa
| | - Jane S. Paulsen
- Departments of Psychiatry, Neurology, Psychology and NeurosciencesUniversity of IowaIowa CityIowa
| | - Christopher A. Ross
- Division of Neurobiology, Departments of Psychiatry, Neurology, Neuroscience and Pharmacology, and Program in Cellular and Molecular MedicineJohns Hopkins University School of MedicineBaltimoreMaryland
| | - Michael I. Miller
- Center for Imaging Science, Johns Hopkins UniversityBaltimoreMaryland
- Institute for Computational Medicine, Johns Hopkins UniversityBaltimoreMaryland
- Department of Biomedical EngineeringJohns Hopkins UniversityBaltimoreMaryland
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26
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Birba A, García-Cordero I, Kozono G, Legaz A, Ibáñez A, Sedeño L, García AM. Losing ground: Frontostriatal atrophy disrupts language embodiment in Parkinson’s and Huntington’s disease. Neurosci Biobehav Rev 2017; 80:673-687. [DOI: 10.1016/j.neubiorev.2017.07.011] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 07/25/2017] [Accepted: 07/27/2017] [Indexed: 12/13/2022]
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27
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Vaca-Palomares I, Coe BC, Brien DC, Campos-Romo A, Munoz DP, Fernandez-Ruiz J. Voluntary saccade inhibition deficits correlate with extended white-matter cortico-basal atrophy in Huntington's disease. NEUROIMAGE-CLINICAL 2017. [PMID: 28649493 PMCID: PMC5472191 DOI: 10.1016/j.nicl.2017.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The ability to inhibit automatic versus voluntary saccade commands in demanding situations can be impaired in neurodegenerative diseases such as Huntington's disease (HD). These deficits could result from disruptions in the interaction between basal ganglia and the saccade control system. To investigate voluntary oculomotor control deficits related to the cortico-basal circuitry, we evaluated early HD patients using an interleaved pro- and anti-saccade task that requires flexible executive control to generate either an automatic response (look at a peripheral visual stimulus) or a voluntary response (look away from the stimulus in the opposite direction). The impairments of HD patients in this task are mainly attributed to degeneration in the striatal medium spiny neurons leading to an over-activation of the indirect-pathway thorough the basal ganglia. However, some studies have proposed that damage outside the indirect-pathway also contribute to executive and saccade deficits. We used the interleaved pro- and anti-saccade task to study voluntary saccade inhibition deficits, Voxel-based morphometry and Tract-based spatial statistic to map cortico-basal ganglia circuitry atrophy in HD. HD patients had voluntary saccade inhibition control deficits, including increased regular-latency anti-saccade errors and increased anticipatory saccades. These deficits correlated with white-matter atrophy in the inferior fronto-occipital fasciculus, anterior thalamic radiation, anterior corona radiata and superior longitudinal fasciculus. These findings suggest that cortico-basal ganglia white-matter atrophy in HD, disrupts the normal connectivity in a network controlling voluntary saccade inhibitory behavior beyond the indirect-pathway. This suggests that in vivo measures of white-matter atrophy can be a reliable marker of the progression of cognitive deficits in HD.
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Affiliation(s)
| | - Brian C Coe
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Donald C Brien
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Aurelio Campos-Romo
- Unidad Periférica de Neurociencias, Facultad de Medicina, Universidad Nacional Autónoma de México, en el Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Ciudad de México, Mexico
| | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - Juan Fernandez-Ruiz
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico.
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28
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Sánchez-Castañeda C, de Pasquale F, Caravasso CF, Marano M, Maffi S, Migliore S, Sabatini U, Squitieri F. Resting-state connectivity and modulated somatomotor and default-mode networks in Huntington disease. CNS Neurosci Ther 2017; 23:488-497. [PMID: 28464463 DOI: 10.1111/cns.12701] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 03/10/2017] [Accepted: 03/30/2017] [Indexed: 11/27/2022] Open
Abstract
AIMS To analyze brain functional connectivity in the somatomotor and default-mode networks (DMNs) of patients with Huntington disease (HD), its relationship with gray matter (GM) volume loss, and functional changes after pridopidine treatment. METHODS Ten patients and ten untreated controls underwent T1-weighted imaging and resting-state functional magnetic resonance imaging (fMRI); four patients were also assessed after 3 months of pridopidine treatment (90 mg/d). The seed-based functional connectivity patterns from the posterior cingulate cortex and the supplementary motor area (SMA), considered cortical hubs of the DMN and somatomotor networks, respectively, were computed. FMRIB Software Library voxel-based morphometry measured GM volume. RESULTS Patients had GM volume decrease in all cortical and subcortical areas of the somatomotor network with preservation of the SMA, and increased somatomotor and DMN connectivity. In DMN structures, functional connectivity impairment preceded volume loss. Pridopidine reduced the intensity of these aberrant connections. CONCLUSION The abnormal connectivity of the somatomotor and DMN observed in HD patients may represent an early dysfunction marker, as it preceded volume loss in DMN. Pridopidine reduced connectivity of these networks in all four treated patients, suggesting that connectivity is sensitive to treatment response.
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Affiliation(s)
- Cristina Sánchez-Castañeda
- Department of Medicine, School of Medicine and Health Sciences, IDIBAPS, Neuroscience Institute, University of Barcelona, Barcelona, Spain.,Radiology Department, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Francesco de Pasquale
- Radiology Department, IRCCS Santa Lucia Foundation, Rome, Italy.,Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | | | - Massimo Marano
- Huntington and Rare Diseases Unit, IRCSS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Sabrina Maffi
- Huntington and Rare Diseases Unit, IRCSS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Simone Migliore
- Huntington and Rare Diseases Unit, IRCSS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy.,LIRH Foundation, Rome, Italy
| | - Umberto Sabatini
- Radiology Department, IRCCS Santa Lucia Foundation, Rome, Italy.,Neuroradiology Department, Magna Graecia University, Catanzaro, Italy
| | - Ferdinando Squitieri
- Huntington and Rare Diseases Unit, IRCSS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
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29
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McColgan P, Seunarine KK, Gregory S, Razi A, Papoutsi M, Long JD, Mills JA, Johnson E, Durr A, Roos RA, Leavitt BR, Stout JC, Scahill RI, Clark CA, Rees G, Tabrizi SJ. Topological length of white matter connections predicts their rate of atrophy in premanifest Huntington's disease. JCI Insight 2017; 2:92641. [PMID: 28422761 PMCID: PMC5396531 DOI: 10.1172/jci.insight.92641] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 03/16/2017] [Indexed: 12/11/2022] Open
Abstract
We lack a mechanistic explanation for the stereotyped pattern of white matter loss seen in Huntington’s disease (HD). While the earliest white matter changes are seen around the striatum, within the corpus callosum, and in the posterior white matter tracts, the order in which these changes occur and why these white matter connections are specifically vulnerable is unclear. Here, we use diffusion tractography in a longitudinal cohort of individuals yet to develop clinical symptoms of HD to identify a hierarchy of vulnerability, where the topological length of white matter connections between a brain area and its neighbors predicts the rate of atrophy over 24 months. This demonstrates a new principle underlying neurodegeneration in HD, whereby brain connections with the greatest topological length are the first to suffer damage that can account for the stereotyped pattern of white matter loss observed in premanifest HD. Diffusion tractography in a longitudinal cohort demonstrates that topological length of white matter connections can account for white matter loss patterns in premanifest Huntington’s disease.
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Affiliation(s)
- Peter McColgan
- Huntington's Disease Centre, Department of Neurodegenerative Disease
| | - Kiran K Seunarine
- Developmental Imaging and Biophysics Section, UCL Institute of Child Health, London, United Kingdom
| | - Sarah Gregory
- Huntington's Disease Centre, Department of Neurodegenerative Disease
| | - Adeel Razi
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, United Kingdom.,Department of Electronic Engineering, NED University of Engineering and Technology, Karachi, Pakistan
| | - Marina Papoutsi
- Huntington's Disease Centre, Department of Neurodegenerative Disease
| | - Jeffrey D Long
- Department of Psychiatry.,Department of Biostatistics, University of Iowa, Iowa City, Iowa, USA
| | | | - Eileanoir Johnson
- Huntington's Disease Centre, Department of Neurodegenerative Disease
| | - Alexandra Durr
- APHP Department of Genetics, University Hospital Pitié-Salpêtrière, and ICM (Brain and Spine Institute) INSERM U1127, CNRS UMR7225, Sorbonne Universités - UPMC Paris VI UMR_S1127, Paris, France
| | - Raymund Ac Roos
- Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands
| | - Blair R Leavitt
- Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia, Vancouver British Columbia, Canada
| | - Julie C Stout
- School of Psychological Sciences, Monash University, Australia
| | - Rachael I Scahill
- Huntington's Disease Centre, Department of Neurodegenerative Disease
| | - Chris A Clark
- Developmental Imaging and Biophysics Section, UCL Institute of Child Health, London, United Kingdom
| | - Geraint Rees
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, United Kingdom
| | - Sarah J Tabrizi
- Huntington's Disease Centre, Department of Neurodegenerative Disease.,National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
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- The Track-On HD Investigators are detailed in the Supplemental Acknowledgments
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30
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Meng Y, Jiang J, Bachevalier J, Zhang X, Chan AWS. Developmental Whole Brain White Matter Alterations in Transgenic Huntington's Disease Monkey. Sci Rep 2017; 7:379. [PMID: 28336929 PMCID: PMC5428287 DOI: 10.1038/s41598-017-00381-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 02/23/2017] [Indexed: 11/17/2022] Open
Abstract
Transgenic Huntington’s disease monkey (HD monkey) model provides great opportunity for studying disease progression that could lead to new insight for developing biomarker, early intervention and novel therapeutics. Whole brain white matter integrity of HD-monkeys was examined longitudinally from 6 to 48 months using diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS). Progressive developmental white matter alterations in HD monkeys were widespread and were observed not only in fiber bundles connecting cortical areas to the striatum (e.g. striatal bundle and external capsule), but also in long association fiber pathways, commissural fibers, and subcortical fiber bundle. In all fiber tracts, the data indicate an arrest in white matter development around 23 months followed by slight decline until adulthood in HD monkeys. The microstructural changes parallel the progressive motor, memory and cognitive decline previously reported as HD monkeys aged. The findings revealed the widespread progressive temporal-spatial microstructural changes in HD monkey brains from infancy to adulthood, suggesting differentiated degenerations across different brain areas during brain development.
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Affiliation(s)
- Yuguang Meng
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - Jie Jiang
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA.,Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA
| | - Jocelyne Bachevalier
- Department of Psychology, Emory University School of Medicine, Atlanta, Georgia, USA. .,Division of Developmental and Cognitive Neuroscience, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA.
| | - Xiaodong Zhang
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA. .,Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA.
| | - Anthony W S Chan
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA. .,Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA.
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31
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Puri S, Shaikh AG. Basic and translational neuro-ophthalmology of visually guided saccades: disorders of velocity. EXPERT REVIEW OF OPHTHALMOLOGY 2017; 12:457-473. [PMID: 30774705 DOI: 10.1080/17469899.2017.1395695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Introduction Saccades are rapid, yoked eye movements in an effort to direct a target over fovea. The complex circuitry of saccadic eye movements has been exhaustively described. As a result clinicians can elegantly localize the pathology if it falls on the neuraxis responsible for saccades. Traditionally saccades are studied with their quantitative characteristics such as amplitude, velocity, duration, direction, latency and accuracy. Areas covered Amongst all subtypes, the physiology of the visually guided saccades is most extensively studied. Here we will review the basic and pertinent neuro-anatomy and physiology of visually guided saccade and then discuss common or classic disorders affecting the velocity of visually guided saccades. We will then discuss the basic mechanism for saccade slowing in these disorders. Expert commentary Prompt appreciation of disorders of saccade velocity is critical to reach appropriate diagnosis. Disorders of midbrain, cerebellum, or basal ganglia can lead to prolonged transition time during gaze shift and decreased saccade velocity.
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Affiliation(s)
- Sushant Puri
- Dept. of Neurology, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, Ohio, United States
| | - Aasef G Shaikh
- Dept. of Neurology, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, Ohio, United States.,Daroff-DelOsso Ocular Motility Laboratory, Cleveland VA Medical Center, Cleveland, Ohio, United States
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32
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The Complexity of Clinical Huntington's Disease: Developments in Molecular Genetics, Neuropathology and Neuroimaging Biomarkers. ADVANCES IN NEUROBIOLOGY 2017; 15:129-161. [PMID: 28674980 DOI: 10.1007/978-3-319-57193-5_5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder characterised by extensive neuronal loss in the striatum and cerebral cortex, and a triad of clinical symptoms affecting motor, cognitive/behavioural and mood functioning. The mutation causing HD is an expansion of a CAG tract in exon 1 of the HTT gene. This chapter provides a multifaceted overview of the clinical complexity of HD. We explore recent directions in molecular genetics including the identification of loci that are genetic modifiers of HD that could potentially reveal therapeutic targets beyond the HTT gene transcript and protein. The variability of clinical symptomatology in HD is considered alongside recent findings of variability in cellular and neurochemical changes in the striatum and cerebral cortex in human brain. We review evidence from structural neuroimaging methods of progressive changes of striatum, cerebral cortex and white matter in pre-symptomatic and symptomatic HD, with a particular focus on the potential identification of neuroimaging biomarkers that could be used to test promising disease-specific and modifying treatments. Finally we provide an overview of completed clinical trials in HD and future therapeutic developments.
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Scahill RI, Andre R, Tabrizi SJ, Aylward EH. Structural imaging in premanifest and manifest Huntington disease. HANDBOOK OF CLINICAL NEUROLOGY 2017; 144:247-261. [PMID: 28947121 DOI: 10.1016/b978-0-12-801893-4.00020-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Huntington disease (HD) neuropathology has a devastating effect on brain structure and consequently brain function; neuroimaging provides a means to assess these effects in gene carriers. In this chapter we first outline the unique utility of structural imaging in understanding HD and discuss some of the acquisition and analysis techniques currently available. We review the existing literature to summarize what we know so far about structural brain changes across the spectrum of disease from premanifest through to manifest disease. We then consider how these neuroimaging findings relate to patient function and nonimaging biomarkers, and can be used to predict disease onset. Finally we review the utility of imaging measures for assessment of treatment efficacy in clinical trials.
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Affiliation(s)
- Rachael I Scahill
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Ralph Andre
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Sarah J Tabrizi
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, United Kingdom.
| | - Elizabeth H Aylward
- Center for Integrative Brain Research, Seattle Children's Research Institute, University of Washington, Seattle, WA, United States
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Harrington DL, Long JD, Durgerian S, Mourany L, Koenig K, Bonner-Jackson A, Paulsen JS, Rao SM. Cross-sectional and longitudinal multimodal structural imaging in prodromal Huntington's disease. Mov Disord 2016; 31:1664-1675. [PMID: 27620011 PMCID: PMC5115975 DOI: 10.1002/mds.26803] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 08/17/2016] [Accepted: 08/22/2016] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Diffusivity in white-matter tracts is abnormal throughout the brain in cross-sectional studies of prodromal Huntington's disease. To date, longitudinal changes have not been observed. The present study investigated cross-sectional and longitudinal changes in white-matter diffusivity in relationship to the phase of prodromal Huntington's progression, and compared them with changes in brain volumes and clinical variables that track disease progression. METHODS Diffusion MRI profiles were studied for 2 years in 37 gene-negative controls and 64 prodromal Huntington's disease participants in varied phases of disease progression. To estimate the relative importance of diffusivity metrics in the prodromal phase, group effects were rank ordered relative to those obtained from analyses of brain volumes, motor, cognitive, and sensory variables. RESULTS First, at baseline diffusivity was abnormal throughout all tracts, especially as individuals approached a manifest Huntington's disease diagnosis. Baseline diffusivity metrics in 6 tracts and basal ganglia volumes best distinguished among the groups. Second, group differences in longitudinal change in diffusivity were localized to the superior fronto-occipital fasciculus, most prominently in individuals closer to a diagnosis. Group differences were also observed in longitudinal changes of most brain volumes, but not clinical variables. Last, increases in motor symptoms across time were associated with greater changes in the superior fronto-occipital fasciculus diffusivity and corpus callosum, cerebrospinal fluid, and lateral ventricle volumes. CONCLUSIONS These novel findings provide new insights into changes within 2 years in different facets of brain structure and their clinical relevance to changes in symptomatology that is decisive for a manifest Huntington's diagnosis. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Deborah L Harrington
- Department of Radiology, University of California, San Diego, La Jolla, California, USA
- Research Service, Veteran's Affairs San Diego Healthcare System, San Diego, California, USA
| | - Jeffrey D Long
- Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Sally Durgerian
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Lyla Mourany
- Schey Center for Cognitive Neuroimaging, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Katherine Koenig
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Aaron Bonner-Jackson
- Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, Ohio, USA
| | - Jane S Paulsen
- Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Stephen M Rao
- Schey Center for Cognitive Neuroimaging, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Liu W, Yang J, Burgunder J, Cheng B, Shang H. Diffusion imaging studies of Huntington's disease: A meta-analysis. Parkinsonism Relat Disord 2016; 32:94-101. [PMID: 27624391 DOI: 10.1016/j.parkreldis.2016.09.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/21/2016] [Accepted: 09/05/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) could detect abnormal brain microstructural alterations. DTI studies of Huntington's Disease(HD) have yielded inconsistent results. OBJECTIVE To integrate the existing DTI studies of HD and explore the validity of DTI to detect microstructural damages in HD brain via meta-analysis. METHODS Systematic and comprehensive searches of the databases were performed for DTI studies of HD. The data from the studies that met our inclusion criteria were extracted and analyzed using the CMA2 software. Random effect models were utilized to minimize the potential between-study heterogeneity. One-way sensitivity analysis was conducted to test the robustness of the results. RESULTS The meta-analysis included 140 pre-symptomatic HD (PreHD), 235 symptomatic HD (SymHD) patients and 302 controls, revealing significantly increased fractional anisotropy (FA) in the caudate, putamen, and globus pallidus, while decreased FA in the corpus callosum of both PreHD and SymHD patients compared with controls. In addition, significantly increased mean diffusivity (MD) was identified in the putamen and thalamus of both PreHD and SymHD patients, and in the caudate of SymHD patients, while no significant difference in MD in the caudate of PreHD patients. In the corpus callosum, there was a significant increase of radial diffusivity and axial diffusivity in SymHD patients compared with controls. Meta-regression showed gender-based difference in MD values of the caudate. CONCLUSIONS Our meta-analysis provides further evidence that DTI detects microstructural damage of both white matter and gray matter even in PreHD gene carriers. MD is less sensitive than FA in detecting structural changes in PreHD.
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Affiliation(s)
- Wanglin Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | | | - Bochao Cheng
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huifang Shang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Faria AV, Ratnanather JT, Tward DJ, Lee DS, van den Noort F, Wu D, Brown T, Johnson H, Paulsen JS, Ross CA, Younes L, Miller MI. Linking white matter and deep gray matter alterations in premanifest Huntington disease. Neuroimage Clin 2016; 11:450-460. [PMID: 27104139 PMCID: PMC4827723 DOI: 10.1016/j.nicl.2016.02.014] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 02/17/2016] [Accepted: 02/22/2016] [Indexed: 01/07/2023]
Abstract
Huntington disease (HD) is a fatal progressive neurodegenerative disorder for which only symptomatic treatment is available. A better understanding of the pathology, and identification of biomarkers will facilitate the development of disease-modifying treatments. HD is potentially a good model of a neurodegenerative disease for development of biomarkers because it is an autosomal-dominant disease with complete penetrance, caused by a single gene mutation, in which the neurodegenerative process can be assessed many years before onset of signs and symptoms of manifest disease. Previous MRI studies have detected abnormalities in gray and white matter starting in premanifest stages. However, the understanding of how these abnormalities are related, both in time and space, is still incomplete. In this study, we combined deep gray matter shape diffeomorphometry and white matter DTI analysis in order to provide a better mapping of pathology in the deep gray matter and subcortical white matter in premanifest HD. We used 296 MRI scans from the PREDICT-HD database. Atrophy in the deep gray matter, thalamus, hippocampus, and nucleus accumbens was analyzed by surface based morphometry, and while white matter abnormalities were analyzed in (i) regions of interest surrounding these structures, using (ii) tractography-based analysis, and using (iii) whole brain atlas-based analysis. We detected atrophy in the deep gray matter, particularly in putamen, from early premanifest stages. The atrophy was greater both in extent and effect size in cases with longer exposure to the effects of the CAG expansion mutation (as assessed by greater CAP-scores), and preceded detectible abnormalities in the white matter. Near the predicted onset of manifest HD, the MD increase was widespread, with highest indices in the deep and posterior white matter. This type of in-vivo macroscopic mapping of HD brain abnormalities can potentially indicate when and where therapeutics could be targeted to delay the onset or slow the disease progression.
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Affiliation(s)
- Andreia V Faria
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - J Tilak Ratnanather
- Center for Imaging Science, The Johns Hopkins University, Baltimore, MD, USA; Institute for Computational Medicine, The Johns Hopkins University, Baltimore, MD, USA; Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, MD, USA
| | - Daniel J Tward
- Center for Imaging Science, The Johns Hopkins University, Baltimore, MD, USA; Institute for Computational Medicine, The Johns Hopkins University, Baltimore, MD, USA; Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, MD, USA
| | - David Soobin Lee
- Center for Imaging Science, The Johns Hopkins University, Baltimore, MD, USA; Institute for Computational Medicine, The Johns Hopkins University, Baltimore, MD, USA; Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, MD, USA
| | - Frieda van den Noort
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Dan Wu
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Timothy Brown
- Center for Imaging Science, The Johns Hopkins University, Baltimore, MD, USA
| | - Hans Johnson
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Jane S Paulsen
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Christopher A Ross
- Division of Neurobiology, Department of Psychiatry, and Departments of Neurology, Neuroscience and Pharmacology, Johns Hopkins University, Baltimore, MD, USA
| | - Laurent Younes
- Center for Imaging Science, The Johns Hopkins University, Baltimore, MD, USA; Institute for Computational Medicine, The Johns Hopkins University, Baltimore, MD, USA; Department of Applied Mathematics and Statistics, The Johns Hopkins University, Baltimore, MD, USA
| | - Michael I Miller
- Center for Imaging Science, The Johns Hopkins University, Baltimore, MD, USA; Institute for Computational Medicine, The Johns Hopkins University, Baltimore, MD, USA; Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, MD, USA
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Wiecki TV, Antoniades CA, Stevenson A, Kennard C, Borowsky B, Owen G, Leavitt B, Roos R, Durr A, Tabrizi SJ, Frank MJ. A Computational Cognitive Biomarker for Early-Stage Huntington's Disease. PLoS One 2016; 11:e0148409. [PMID: 26872129 PMCID: PMC4752511 DOI: 10.1371/journal.pone.0148409] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 01/16/2016] [Indexed: 01/18/2023] Open
Abstract
Huntington's disease (HD) is genetically determined but with variability in symptom onset, leading to uncertainty as to when pharmacological intervention should be initiated. Here we take a computational approach based on neurocognitive phenotyping, computational modeling, and classification, in an effort to provide quantitative predictors of HD before symptom onset. A large sample of subjects-consisting of both pre-manifest individuals carrying the HD mutation (pre-HD), and early symptomatic-as well as healthy controls performed the antisaccade conflict task, which requires executive control and response inhibition. While symptomatic HD subjects differed substantially from controls in behavioral measures [reaction time (RT) and error rates], there was no such clear behavioral differences in pre-HD. RT distributions and error rates were fit with an accumulator-based model which summarizes the computational processes involved and which are related to identified mechanisms in more detailed neural models of prefrontal cortex and basal ganglia. Classification based on fitted model parameters revealed a key parameter related to executive control differentiated pre-HD from controls, whereas the response inhibition parameter declined only after symptom onset. These findings demonstrate the utility of computational approaches for classification and prediction of brain disorders, and provide clues as to the underlying neural mechanisms.
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Affiliation(s)
- Thomas V. Wiecki
- Cognitive, Linguistic & Psychological Sciences, Brown, Providence, United States of America
| | - Chrystalina A. Antoniades
- Division of Clinical Neurology, Nuffield Department of Clinical Neurosciences, Level 6 West Wing, John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, United Kingdom
| | - Alexander Stevenson
- Division of Clinical Neurology, Nuffield Department of Clinical Neurosciences, Level 6 West Wing, John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, United Kingdom
| | - Christopher Kennard
- Division of Clinical Neurology, Nuffield Department of Clinical Neurosciences, Level 6 West Wing, John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, United Kingdom
| | - Beth Borowsky
- CHDI Management Inc/CHDI Foundation, 155 Village Boulevard, Suite 200, Princeton, NJ 08540, United States of America
| | - Gail Owen
- Huntington’s Disease Research Centre, UCL Institute of Neurology, 2nd Floor Russell Square House, 10-12 Russell Square, London, WC1B 5EH, United Kingdom
| | - Blair Leavitt
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada
| | - Raymund Roos
- Department of Neurology, Leiden University Medical Centre, 2300RC Leiden, The Netherlands
| | - Alexandra Durr
- Department of Genetics and Cytogenetics, and INSERM UMR S679, APHP Hôpital de la Salpêtrière, 75013 Paris, France
| | - Sarah J. Tabrizi
- Huntington’s Disease Research Centre, UCL Institute of Neurology, 2nd Floor Russell Square House, 10-12 Russell Square, London, WC1B 5EH, United Kingdom
| | - Michael J. Frank
- Cognitive, Linguistic & Psychological Sciences, Brown, Providence, United States of America
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Minkova L, Eickhoff SB, Abdulkadir A, Kaller CP, Peter J, Scheller E, Lahr J, Roos RA, Durr A, Leavitt BR, Tabrizi SJ, Klöppel S. Large-scale brain network abnormalities in Huntington's disease revealed by structural covariance. Hum Brain Mapp 2016; 37:67-80. [PMID: 26453902 PMCID: PMC6867397 DOI: 10.1002/hbm.23014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 08/10/2015] [Accepted: 09/24/2015] [Indexed: 01/05/2023] Open
Abstract
Huntington's disease (HD) is a progressive neurodegenerative disorder that can be diagnosed with certainty decades before symptom onset. Studies using structural MRI have identified grey matter (GM) loss predominantly in the striatum, but also involving various cortical areas. So far, voxel-based morphometric studies have examined each brain region in isolation and are thus unable to assess the changes in the interrelation of brain regions. Here, we examined the structural covariance in GM volumes in pre-specified motor, working memory, cognitive flexibility, and social-affective networks in 99 patients with manifest HD (mHD), 106 presymptomatic gene mutation carriers (pre-HD), and 108 healthy controls (HC). After correction for global differences in brain volume, we found that increased GM volume in one region was associated with increased GM volume in another. When statistically comparing the groups, no differences between HC and pre-HD were observed, but increased positive correlations were evident for mHD, relative to pre-HD and HC. These findings could be explained by a HD-related neuronal loss heterogeneously affecting the examined network at the pre-HD stage, which starts to dominate structural covariance globally at the manifest stage. Follow-up analyses identified structural connections between frontoparietal motor regions to be linearly modified by disease burden score (DBS). Moderator effects of disease load burden became significant at a DBS level typically associated with the onset of unequivocal HD motor signs. Together with existing findings from functional connectivity analyses, our data indicates a critical role of these frontoparietal regions for the onset of HD motor signs.
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Affiliation(s)
- Lora Minkova
- Department of Psychiatry and PsychotherapyUniversity Medical Center FreiburgFreiburgGermany
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
- Department of PsychologyLaboratory for Biological and Personality Psychology, University of FreiburgFreiburgGermany
| | - Simon B. Eickhoff
- Department of Clinical Neuroscience and Medical PsychiatryHeinrich‐Heine UniversityDüsseldorfGermany
- Research Center Jülich, Institute of Neuroscience and Medicine (INM‐1), Department of Psychiatry, Psychotherapy and Psychosomatics, University HospitalJülichGermany
| | - Ahmed Abdulkadir
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
- Department of Computer ScienceUniversity of FreiburgFreiburgGermany
| | - Christoph P. Kaller
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
- Department of NeurologyUniversity Medical Center FreiburgFreiburgGermany
- BrainLinks‐BrainTools Cluster of Excellence, University of FreiburgFreiburgGermany
| | - Jessica Peter
- Department of Psychiatry and PsychotherapyUniversity Medical Center FreiburgFreiburgGermany
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
| | - Elisa Scheller
- Department of Psychiatry and PsychotherapyUniversity Medical Center FreiburgFreiburgGermany
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
| | - Jacob Lahr
- Department of Psychiatry and PsychotherapyUniversity Medical Center FreiburgFreiburgGermany
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
| | - Raymund A. Roos
- Department of NeurologyLeiden University Medical CentreLeidenNetherlands
| | - Alexandra Durr
- Department of Genetics and CytogeneticsPitié‐ Salpêtrière University HospitalParisFrance
| | - Blair R. Leavitt
- Department of Medical GeneticsCentre for Molecular Medicine and Therapeutics, University of British ColumbiaVancouverCanada
| | - Sarah J. Tabrizi
- Department of Neurodegenerative DiseaseUniversity College London, Institute of NeurologyLondonUnited Kingdom
| | - Stefan Klöppel
- Department of Psychiatry and PsychotherapyUniversity Medical Center FreiburgFreiburgGermany
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
- Department of NeurologyUniversity Medical Center FreiburgFreiburgGermany
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Gregory S, Cole JH, Farmer RE, Rees EM, Roos RA, Sprengelmeyer R, Durr A, Landwehrmeyer B, Zhang H, Scahill RI, Tabrizi SJ, Frost C, Hobbs NZ. Longitudinal Diffusion Tensor Imaging Shows Progressive Changes in White Matter in Huntington’s Disease. J Huntingtons Dis 2015; 4:333-46. [DOI: 10.3233/jhd-150173] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Sarah Gregory
- Wellcome Trust Centre for Neuroimaging, UCL, London, WC1N 3BG, UK
| | - James H. Cole
- UCL Institute of Neurology, University College London, UK
- Computational, Cognitive & Clinical Neuroimaging Laboratory, Department of Medicine, Imperial College London, UK
| | - Ruth E. Farmer
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine London, UK
| | - Elin M. Rees
- UCL Institute of Neurology, University College London, UK
| | - Raymund A.C. Roos
- Department of Neurology, Leiden University Medical Centre, 2300RC Leiden, The Netherlands
| | | | - Alexandra Durr
- Department of Genetics and Cytogenetics, INSERM UMR S679, APHP Hôpital de la Salpêtrière, Paris, France
| | | | - Hui Zhang
- Centre for Medical Image Computing, University College London, UK
| | | | | | - Chris Frost
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine London, UK
| | - Nicola Z. Hobbs
- UCL Institute of Neurology, University College London, UK
- IXICO Plc., London, UK
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Minkova L, Scheller E, Peter J, Abdulkadir A, Kaller CP, Roos RA, Durr A, Leavitt BR, Tabrizi SJ, Klöppel S. Detection of Motor Changes in Huntington's Disease Using Dynamic Causal Modeling. Front Hum Neurosci 2015; 9:634. [PMID: 26635585 PMCID: PMC4658414 DOI: 10.3389/fnhum.2015.00634] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/06/2015] [Indexed: 11/17/2022] Open
Abstract
Deficits in motor functioning are one of the hallmarks of Huntington's disease (HD), a genetically caused neurodegenerative disorder. We applied functional magnetic resonance imaging (fMRI) and dynamic causal modeling (DCM) to assess changes that occur with disease progression in the neural circuitry of key areas associated with executive and cognitive aspects of motor control. Seventy-seven healthy controls, 62 pre-symptomatic HD gene carriers (preHD), and 16 patients with manifest HD symptoms (earlyHD) performed a motor finger-tapping fMRI task with systematically varying speed and complexity. DCM was used to assess the causal interactions among seven pre-defined regions of interest, comprising primary motor cortex, supplementary motor area (SMA), dorsal premotor cortex, and superior parietal cortex. To capture heterogeneity among HD gene carriers, DCM parameters were entered into a hierarchical cluster analysis using Ward's method and squared Euclidian distance as a measure of similarity. After applying Bonferroni correction for the number of tests, DCM analysis revealed a group difference that was not present in the conventional fMRI analysis. We found an inhibitory effect of complexity on the connection from parietal to premotor areas in preHD, which became excitatory in earlyHD and correlated with putamen atrophy. While speed of finger movements did not modulate the connection from caudal to pre-SMA in controls and preHD, this connection became strongly negative in earlyHD. This second effect did not survive correction for multiple comparisons. Hierarchical clustering separated the gene mutation carriers into three clusters that also differed significantly between these two connections and thereby confirmed their relevance. DCM proved useful in identifying group differences that would have remained undetected by standard analyses and may aid in the investigation of between-subject heterogeneity.
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Affiliation(s)
- Lora Minkova
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany ; Freiburg Brain Imaging Center, University Medical Center Freiburg Freiburg, Germany ; Laboratory for Biological and Personality Psychology, Department of Psychology, University of Freiburg Freiburg, Germany
| | - Elisa Scheller
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany ; Freiburg Brain Imaging Center, University Medical Center Freiburg Freiburg, Germany
| | - Jessica Peter
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany ; Freiburg Brain Imaging Center, University Medical Center Freiburg Freiburg, Germany
| | - Ahmed Abdulkadir
- Freiburg Brain Imaging Center, University Medical Center Freiburg Freiburg, Germany ; Department of Computer Science, University of Freiburg Freiburg, Germany
| | - Christoph P Kaller
- Freiburg Brain Imaging Center, University Medical Center Freiburg Freiburg, Germany ; Department of Neurology, University Medical Center Freiburg Freiburg, Germany ; BrainLinks-BrainTools Cluster of Excellence, University of Freiburg Freiburg, Germany
| | - Raymund A Roos
- Department of Neurology, Leiden University Medical Centre Leiden, Netherlands
| | - Alexandra Durr
- Department of Genetics and Cytogenetics, Pitié-Salpêtrière University Hospital Paris, France
| | - Blair R Leavitt
- Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia Vancouver, Canada
| | - Sarah J Tabrizi
- Department of Neurodegenerative Disease, Institute of Neurology, University College London London, UK
| | - Stefan Klöppel
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany ; Freiburg Brain Imaging Center, University Medical Center Freiburg Freiburg, Germany ; Department of Neurology, University Medical Center Freiburg Freiburg, Germany
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McColgan P, Seunarine KK, Razi A, Cole JH, Gregory S, Durr A, Roos RAC, Stout JC, Landwehrmeyer B, Scahill RI, Clark CA, Rees G, Tabrizi SJ. Selective vulnerability of Rich Club brain regions is an organizational principle of structural connectivity loss in Huntington's disease. Brain 2015; 138:3327-44. [PMID: 26384928 PMCID: PMC4620513 DOI: 10.1093/brain/awv259] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 07/21/2015] [Accepted: 07/22/2015] [Indexed: 01/05/2023] Open
Abstract
Huntington's disease can be predicted many years before symptom onset, and thus makes an ideal model for studying the earliest mechanisms of neurodegeneration. Diffuse patterns of structural connectivity loss occur in the basal ganglia and cortex early in the disease. However, the organizational principles that underlie these changes are unclear. By understanding such principles we can gain insight into the link between the cellular pathology caused by mutant huntingtin and its downstream effect at the macroscopic level. The 'rich club' is a pattern of organization established in healthy human brains, where specific hub 'rich club' brain regions are more highly connected to each other than other brain regions. We hypothesized that selective loss of rich club connectivity might represent an organizing principle underlying the distributed pattern of structural connectivity loss seen in Huntington's disease. To test this hypothesis we performed diffusion tractography and graph theoretical analysis in a pseudo-longitudinal study of 50 premanifest and 38 manifest Huntington's disease participants compared with 47 healthy controls. Consistent with our hypothesis we found that structural connectivity loss selectively affected rich club brain regions in premanifest and manifest Huntington's disease participants compared with controls. We found progressive network changes across controls, premanifest Huntington's disease and manifest Huntington's disease characterized by increased network segregation in the premanifest stage and loss of network integration in manifest disease. These regional and whole brain network differences were highly correlated with cognitive and motor deficits suggesting they have pathophysiological relevance. We also observed greater reductions in the connectivity of brain regions that have higher network traffic and lower clustering of neighbouring regions. This provides a potential mechanism that results in a characteristic pattern of structural connectivity loss targeting highly connected brain regions with high network traffic and low clustering of neighbouring regions. Our findings highlight the role of the rich club as a substrate for the structural connectivity loss seen in Huntington's disease and have broader implications for understanding the connection between molecular and systems level pathology in neurodegenerative disease.
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Affiliation(s)
- Peter McColgan
- 1 Department of Neurodegenerative Disease, UCL Institute of Neurology, London, WC1N 3BG, UK
| | - Kiran K. Seunarine
- 2 Developmental Imaging and Biophysics Section, UCL Institute of Child Health, London, WC1N 1EH, UK
| | - Adeel Razi
- 3 Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, WC1N 3BG, UK
- 4 Department of Electronic Engineering, NED University of Engineering and Technology, Karachi, Pakistan
| | - James H. Cole
- 5 Computational, Cognitive and Clinical Neuroimaging Laboratory, Department of Medicine, Imperial College London, W12 0HS, UK
| | - Sarah Gregory
- 3 Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, WC1N 3BG, UK
| | - Alexandra Durr
- 6 APHP Department of Genetics, Groupe Hospitalier Pitié-Salpêtrière, and Institut du Cerveau et de la Moelle, INSERM U1127, CNRS UMR7225, Sorbonne Universités – UPMC Université Paris VI UMR_S1127, Paris, France
| | - Raymund A. C. Roos
- 7 Department of Neurology, Leiden University Medical Centre, 2300RC Leiden, The Netherlands
| | - Julie C. Stout
- 8 School of Psychological Sciences, Monash University, VIC, Australia
| | - Bernhard Landwehrmeyer
- 9 Department of Neurology, University of Ulm, Oberer Eselsberg 45-1, D-89081, Ulm, Germany
| | - Rachael I. Scahill
- 1 Department of Neurodegenerative Disease, UCL Institute of Neurology, London, WC1N 3BG, UK
| | - Chris A. Clark
- 2 Developmental Imaging and Biophysics Section, UCL Institute of Child Health, London, WC1N 1EH, UK
| | - Geraint Rees
- 3 Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, WC1N 3BG, UK
| | - Sarah J. Tabrizi
- 1 Department of Neurodegenerative Disease, UCL Institute of Neurology, London, WC1N 3BG, UK
- 10 National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
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Goveas J, O'Dwyer L, Mascalchi M, Cosottini M, Diciotti S, De Santis S, Passamonti L, Tessa C, Toschi N, Giannelli M. Diffusion-MRI in neurodegenerative disorders. Magn Reson Imaging 2015; 33:853-76. [PMID: 25917917 DOI: 10.1016/j.mri.2015.04.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 04/18/2015] [Accepted: 04/19/2015] [Indexed: 12/11/2022]
Abstract
The ability to image the whole brain through ever more subtle and specific methods/contrasts has come to play a key role in understanding the basis of brain abnormalities in several diseases. In magnetic resonance imaging (MRI), "diffusion" (i.e. the random, thermally-induced displacements of water molecules over time) represents an extraordinarily sensitive contrast mechanism, and the exquisite structural detail it affords has proven useful in a vast number of clinical as well as research applications. Since diffusion-MRI is a truly quantitative imaging technique, the indices it provides can serve as potential imaging biomarkers which could allow early detection of pathological alterations as well as tracking and possibly predicting subtle changes in follow-up examinations and clinical trials. Accordingly, diffusion-MRI has proven useful in obtaining information to better understand the microstructural changes and neurophysiological mechanisms underlying various neurodegenerative disorders. In this review article, we summarize and explore the main applications, findings, perspectives as well as challenges and future research of diffusion-MRI in various neurodegenerative disorders including Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, Huntington's disease and degenerative ataxias.
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Affiliation(s)
- Joseph Goveas
- Department of Psychiatry and Behavioral Medicine, and Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Laurence O'Dwyer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Mario Mascalchi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy; Quantitative and Functional Neuroradiology Research Program at Meyer Children and Careggi Hospitals of Florence, Florence, Italy
| | - Mirco Cosottini
- Department of Translational Research and New Surgical and Medical Technologies, University of Pisa, Pisa, Italy; Unit of Neuroradiology, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy
| | - Stefano Diciotti
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Italy
| | - Silvia De Santis
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, Italy; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Carlo Tessa
- Division of Radiology, "Versilia" Hospital, AUSL 12 Viareggio, Lido di Camaiore, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, Medical Physics Section, University of Rome "Tor Vergata", Rome, Italy; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Marco Giannelli
- Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy.
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Fibromyalgia is characterized by altered frontal and cerebellar structural covariance brain networks. NEUROIMAGE-CLINICAL 2015; 7:667-77. [PMID: 25844321 PMCID: PMC4379388 DOI: 10.1016/j.nicl.2015.02.022] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 02/24/2015] [Accepted: 02/27/2015] [Indexed: 01/24/2023]
Abstract
Altered brain morphometry has been widely acknowledged in chronic pain, and recent studies have implicated altered network dynamics, as opposed to properties of individual brain regions, in supporting persistent pain. Structural covariance analysis determines the inter-regional association in morphological metrics, such as gray matter volume, and such structural associations may be altered in chronic pain. In this study, voxel-based morphometry structural covariance networks were compared between fibromyalgia patients (N = 42) and age- and sex-matched pain-free adults (N = 63). We investigated network topology using spectral partitioning, which can delineate local network submodules with consistent structural covariance. We also explored white matter connectivity between regions comprising these submodules and evaluated the association between probabilistic white matter tractography and pain-relevant clinical metrics. Our structural covariance network analysis noted more connections within the cerebellum for fibromyalgia patients, and more connections in the frontal lobe for healthy controls. For fibromyalgia patients, spectral partitioning identified a distinct submodule with cerebellar connections to medial prefrontal and temporal and right inferior parietal lobes, whose gray matter volume was associated with the severity of depression in these patients. Volume for a submodule encompassing lateral orbitofrontal, inferior frontal, postcentral, lateral temporal, and insular cortices was correlated with evoked pain sensitivity. Additionally, the number of white matter fibers between specific submodule regions was also associated with measures of evoked pain sensitivity and clinical pain interference. Hence, altered gray and white matter morphometry in cerebellar and frontal cortical regions may contribute to, or result from, pain-relevant dysfunction in chronic pain patients. We conducted structural covariance and tractography analyses in fibromyalgia. In fibromyalgia, higher correlations between cerebellar ROI volumes were found. In controls, higher correlations between frontal ROI volumes were found. Volume of cerebellum, orbitofrontal and inferior parietal areas correlated with BDI. WM fiber numbers connecting the areas associated with hyperalgesia and clinical pain
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Key Words
- AAL, automated anatomical labeling
- BDI, Beck depression inventory
- BPI, brief pain inventory
- Cerebellum
- DTI, diffusion tensor imaging
- FM, fibromyalgia
- FSL, FMRIB software library
- Fibromyalgia
- HC, healthy controls
- MCP, middle cerebellar peduncle
- MNI, Montreal neurological institute
- MRI, magnetic resonance imaging
- Network
- P40, the pressure level (mm Hg) for a pain intensity rating of 40/100
- Pain
- ROI, region of interest
- SCP, superior cerebellar peduncle
- SPM, statistical parametric mapping
- Tractography
- VBM, voxel-based morphometry
- fMRI, functional MRI
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Novak MJU, Seunarine KK, Gibbard CR, McColgan P, Draganski B, Friston K, Clark CA, Tabrizi SJ. Basal ganglia-cortical structural connectivity in Huntington's disease. Hum Brain Mapp 2015; 36:1728-40. [PMID: 25640796 DOI: 10.1002/hbm.22733] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 11/04/2014] [Accepted: 12/22/2014] [Indexed: 11/07/2022] Open
Abstract
Huntington's disease is an incurable neurodegenerative disease caused by inheritance of an expanded cytosine-adenine-guanine (CAG) trinucleotide repeat within the Huntingtin gene. Extensive volume loss and altered diffusion metrics in the basal ganglia, cortex and white matter are seen when patients with Huntington's disease (HD) undergo structural imaging, suggesting that changes in basal ganglia-cortical structural connectivity occur. The aims of this study were to characterise altered patterns of basal ganglia-cortical structural connectivity with high anatomical precision in premanifest and early manifest HD, and to identify associations between structural connectivity and genetic or clinical markers of HD. 3-Tesla diffusion tensor magnetic resonance images were acquired from 14 early manifest HD subjects, 17 premanifest HD subjects and 18 controls. Voxel-based analyses of probabilistic tractography were used to quantify basal ganglia-cortical structural connections. Canonical variate analysis was used to demonstrate disease-associated patterns of altered connectivity and to test for associations between connectivity and genetic and clinical markers of HD; this is the first study in which such analyses have been used. Widespread changes were seen in basal ganglia-cortical structural connectivity in early manifest HD subjects; this has relevance for development of therapies targeting the striatum. Premanifest HD subjects had a pattern of connectivity more similar to that of controls, suggesting progressive change in connections over time. Associations between structural connectivity patterns and motor and cognitive markers of disease severity were present in early manifest subjects. Our data suggest the clinical phenotype in manifest HD may be at least partly a result of altered connectivity.
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Affiliation(s)
- Marianne J U Novak
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, United Kingdom; Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom
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Jin J, Peng Q, Hou Z, Jiang M, Wang X, Langseth AJ, Tao M, Barker PB, Mori S, Bergles DE, Ross CA, Detloff PJ, Zhang J, Duan W. Early white matter abnormalities, progressive brain pathology and motor deficits in a novel knock-in mouse model of Huntington's disease. Hum Mol Genet 2015; 24:2508-27. [PMID: 25609071 DOI: 10.1093/hmg/ddv016] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 01/19/2015] [Indexed: 12/21/2022] Open
Abstract
White matter abnormalities have been reported in premanifest Huntington's disease (HD) subjects before overt striatal neuronal loss, but whether the white matter changes represent a necessary step towards further pathology and the underlying mechanism of these changes remains unknown. Here, we characterized a novel knock-in mouse model that expresses mouse HD gene homolog (Hdh) with extended CAG repeat- HdhQ250, which was derived from the selective breeding of HdhQ150 mice. HdhQ250 mice manifest an accelerated and robust phenotype compared with its parent line. HdhQ250 mice exhibit progressive motor deficits, reduction in striatal and cortical volume, accumulation of mutant huntingtin aggregation, decreased levels of DARPP32 and BDNF and altered striatal metabolites. The abnormalities detected in this mouse model are reminiscent of several aspects of human HD. In addition, disturbed myelination was evident in postnatal Day 14 HdhQ250 mouse brain, including reduced levels of myelin regulatory factor and myelin basic protein, and decreased numbers of myelinated axons in the corpus callosum. Thinner myelin sheaths, indicated by increased G-ratio of myelin, were also detected in the corpus callosum of adult HdhQ250 mice. Moreover, proliferation of oligodendrocyte precursor cells is altered by mutant huntingtin both in vitro and in vivo. Our data indicate that this model is suitable for understanding comprehensive pathogenesis of HD in white matter and gray matter as well as developing therapeutics for HD.
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Affiliation(s)
- Jing Jin
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences
| | - Qi Peng
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences
| | | | - Mali Jiang
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences
| | - Xin Wang
- Department of Radiation Oncology, Weill Cornell Medical College, New York, NY 10065, USA
| | | | - Michael Tao
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences
| | | | | | | | - Christopher A Ross
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences, Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA, Department of Neuroscience, Department of Neurology and Pharmacology and Molecular Sciences and
| | - Peter J Detloff
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, AL 35242, USA
| | | | - Wenzhen Duan
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences, Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA, Department of Neuroscience,
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46
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Poudel GR, Stout JC, Domínguez D JF, Churchyard A, Chua P, Egan GF, Georgiou-Karistianis N. Longitudinal change in white matter microstructure in Huntington's disease: The IMAGE-HD study. Neurobiol Dis 2014; 74:406-12. [PMID: 25497085 DOI: 10.1016/j.nbd.2014.12.009] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 11/14/2014] [Accepted: 12/08/2014] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To quantify 18-month changes in white matter microstructure in premanifest (pre-HD) and symptomatic Huntington's disease (symp-HD). To investigate baseline clinical, cognitive and motor symptoms that are predictive of white matter microstructural change over 18months. METHOD Diffusion tensor imaging (DTI) data were analyzed for 28 pre-HD, 25 symp-HD, and 27 controls scanned at baseline and after 18months. Unbiased tract-based spatial statistics (TBSS) methods were used to identify longitudinal changes in fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) of white matter. Stepwise linear regression models were used to identify baseline clinical, cognitive, and motor measures that are predictive of longitudinal diffusion changes. RESULTS Symp-HD compared to controls showed 18-month reductions in FA in the corpus callosum and cingulum white matter. Symp-HD compared to pre-HD showed increased RD in the corpus callosum and striatal projection pathways. FA in the body, genu, and splenium of the corpus callosum was significantly associated with a baseline clinical motor measure (Unified Huntington's Disease Rating Scale: total motor scores: UHDRS-TMS) across both HD groups. This measure was also the only independent predictor of longitudinal decline in FA in all parts of the corpus callosum across both HD groups. CONCLUSIONS We provide direct evidence of longitudinal decline in white matter microstructure in symp-HD. Although pre-HD did not show longitudinal change, clinical symptoms and motor function predicted white matter microstructural changes for all gene positive subjects. These findings suggest that loss of axonal integrity is an early hallmark of neurodegenerative changes which are clinically relevant.
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Affiliation(s)
- Govinda R Poudel
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia; VLSCI Life Sciences Computation Centre, Melbourne, Victoria, Australia
| | - Julie C Stout
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Juan F Domínguez D
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Andrew Churchyard
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Calvary Health Care Bethlehem Hospital, Caulfield, Victoria, Australia
| | - Phyllis Chua
- Department of Psychiatry, School of Clinical Sciences, Monash University, Victoria, Australia; Calvary Health Care Bethlehem Hospital, Caulfield, Victoria, Australia
| | - Gary F Egan
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Monash Biomedical Imaging (MBI), Monash University, Melbourne, Victoria, Australia; ARC Centre of Excellence for Integrative Brain Function, Monash University, Clayton, Victoria, Australia; VLSCI Life Sciences Computation Centre, Melbourne, Victoria, Australia
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Phillips O, Squitieri F, Sanchez-Castaneda C, Elifani F, Caltagirone C, Sabatini U, Di Paola M. Deep white matter in Huntington's disease. PLoS One 2014; 9:e109676. [PMID: 25340651 PMCID: PMC4207674 DOI: 10.1371/journal.pone.0109676] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/03/2014] [Indexed: 11/19/2022] Open
Abstract
White matter (WM) abnormalities have already been shown in presymptomatic (Pre-HD) and symptomatic HD subjects using Magnetic Resonance Imaging (MRI). In the present study, we examined the microstructure of the long-range large deep WM tracts by applying two different MRI approaches: Diffusion Tensor Imaging (DTI) -based tractography, and T2*weighted (iron sensitive) imaging. We collected Pre-HD subjects (n = 25), HD patients (n = 25) and healthy control subjects (n = 50). Results revealed increased axial (AD) and radial diffusivity (RD) and iron levels in Pre-HD subjects compared to controls. Fractional anisotropy decreased between the Pre-HD and HD phase and AD/RD increased and although impairment was pervasive in HD, degeneration occurred in a pattern in Pre-HD. Furthermore, iron levels dropped for HD patients. As increased iron levels are associated with remyelination, the data suggests that Pre-HD subjects attempt to repair damaged deep WM years before symptoms occur but this process fails with disease progression.
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Affiliation(s)
- Owen Phillips
- Clinical and Behavioural Neurology Dept, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | | | | | - Carlo Caltagirone
- Clinical and Behavioural Neurology Dept, IRCCS Santa Lucia Foundation, Rome, Italy
- Neuroscience Dept, University of Rome “Tor Vergata”, Rome, Italy
| | | | - Margherita Di Paola
- Clinical and Behavioural Neurology Dept, IRCCS Santa Lucia Foundation, Rome, Italy
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Kargieman L, Herrera E, Baez S, García AM, Dottori M, Gelormini C, Manes F, Gershanik O, Ibáñez A. Motor-Language Coupling in Huntington's Disease Families. Front Aging Neurosci 2014; 6:122. [PMID: 24971062 PMCID: PMC4054328 DOI: 10.3389/fnagi.2014.00122] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 05/27/2014] [Indexed: 11/24/2022] Open
Abstract
Traditionally, Huntington’s disease (HD) has been known as a movement disorder, characterized by motor, psychiatric, and cognitive impairments. Recent studies have shown that motor and action–language processes are neurally associated. The cognitive mechanisms underlying this interaction have been investigated through the action compatibility effect (ACE) paradigm, which induces a contextual coupling of ongoing motor actions and verbal processing. The present study is the first to use the ACE paradigm to evaluate action–word processing in HD patients (HDP) and their families. Specifically, we tested three groups: HDP, healthy first-degree relatives (HDR), and non-relative healthy controls. The results showed that ACE was abolished in HDP as well as HDR, but not in controls. Furthermore, we found that the processing deficits were primarily linguistic, given that they did not correlate executive function measurements. Our overall results underscore the role of cortico-basal ganglia circuits in action–word processing and indicate that the ACE task is a sensitive and robust early biomarker of HD and familial vulnerability.
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Affiliation(s)
- Lucila Kargieman
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University , Buenos Aires , Argentina ; National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina ; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University , Santiago , Chile
| | - Eduar Herrera
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University , Buenos Aires , Argentina ; National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina ; Universidad Autónoma del Caribe , Barranquilla , Colombia
| | - Sandra Baez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University , Buenos Aires , Argentina ; National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina ; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University , Santiago , Chile
| | - Adolfo M García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University , Buenos Aires , Argentina ; National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina ; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University , Santiago , Chile ; School of Languages, National University of Córdoba (UNC) , Córdoba , Argentina
| | - Martin Dottori
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University , Buenos Aires , Argentina
| | - Carlos Gelormini
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University , Buenos Aires , Argentina
| | - Facundo Manes
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University , Buenos Aires , Argentina ; National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina ; Australian Research Council (ARC) Centre of Excellence in Cognition and its Disorders , Sydney, NSW , Australia
| | - Oscar Gershanik
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University , Buenos Aires , Argentina ; National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina
| | - Agustín Ibáñez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University , Buenos Aires , Argentina ; National Scientific and Technical Research Council (CONICET) , Buenos Aires , Argentina ; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University , Santiago , Chile ; Universidad Autónoma del Caribe , Barranquilla , Colombia
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Ferraro S, Nanetti L, Piacentini S, Mandelli ML, Bertolino N, Ghielmetti F, Epifani F, Nigri A, Taroni F, Bruzzone MG, Di Donato S, Savoiardo M, Mariotti C, Grisoli M. Frontal cortex BOLD signal changes in premanifest Huntington disease: a possible fMRI biomarker. Neurology 2014; 83:65-72. [PMID: 24898924 DOI: 10.1212/wnl.0000000000000538] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To identify a possible functional imaging biomarker sensitive to the earliest neural changes in premanifest Huntington disease (preHD), allowing early therapeutic approaches aimed at preventing or delaying clinical onset. METHODS Sixteen preHD and 18 healthy participants were submitted to anatomical acquisitions and functional MRI (fMRI) acquisitions during the execution of the exogenous covert orienting of attention task. Due to strong a priori hypothesis, all fMRI correlation analyses were restricted to the following: (1) the frontal oculomotor cortex identified by the means of a prosaccadic task, comprising frontal eye fields and supplementary frontal eye fields; and (2) the data collected during inhibition of return, a phenomenon occurring during the executed task. In preHD, multiple regression analysis was performed between fMRI data and the probability to develop the disease in the next 5 years (p5HD). Moreover, mean blood oxygen level-dependent (BOLD) signal changes in the frontal oculomotor cortex and striatal volumes were linearly correlated with p5HD. RESULTS In preHD, multiple regression analysis showed that clusters of activity strongly correlated with p5HD in the right frontal oculomotor cortex. Importantly, mean BOLD signal changes of this region correlated with p5HD (r(2) = 0.52). Among the considered striatal volumes, a modest correlation (r(2) = 0.29) was observed in the right putamen and p5HD. CONCLUSION fMRI activations in the right-frontal oculomotor cortex during inhibition of return can be considered a possible functional imaging biomarker in preHD.
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Affiliation(s)
- Stefania Ferraro
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Lorenzo Nanetti
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco.
| | - Sylvie Piacentini
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Maria L Mandelli
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Nicola Bertolino
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Francesco Ghielmetti
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Francesca Epifani
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Anna Nigri
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Franco Taroni
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Maria G Bruzzone
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Stefano Di Donato
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Mario Savoiardo
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Caterina Mariotti
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Marina Grisoli
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
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Alterations of eye movement control in neurodegenerative movement disorders. J Ophthalmol 2014; 2014:658243. [PMID: 24955249 PMCID: PMC4052189 DOI: 10.1155/2014/658243] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 03/27/2014] [Accepted: 04/14/2014] [Indexed: 01/21/2023] Open
Abstract
The evolution of the fovea centralis, the most central part of the retina and the area of the highest visual accuracy, requires humans to shift their gaze rapidly (saccades) to bring some object of interest within the visual field onto the fovea. In addition, humans are equipped with the ability to rotate the eye ball continuously in a highly predicting manner (smooth pursuit) to hold a moving target steadily upon the retina. The functional deficits in neurodegenerative movement disorders (e.g., Parkinsonian syndromes) involve the basal ganglia that are critical in all aspects of movement control. Moreover, neocortical structures, the cerebellum, and the midbrain may become affected by the pathological process. A broad spectrum of eye movement alterations may result, comprising smooth pursuit disturbance (e.g., interrupting saccades), saccadic dysfunction (e.g., hypometric saccades), and abnormal attempted fixation (e.g., pathological nystagmus and square wave jerks). On clinical grounds, videooculography is a sensitive noninvasive in vivo technique to classify oculomotion function alterations. Eye movements are a valuable window into the integrity of central nervous system structures and their changes in defined neurodegenerative conditions, that is, the oculomotor nuclei in the brainstem together with their directly activating supranuclear centers and the basal ganglia as well as cortical areas of higher cognitive control of attention.
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