1
|
Zhu P, Gao S, Wu S, Li X, Huang C, Chen Y, Liu G. Causal relationships between dyslexia and the risk of eight dementias. Transl Psychiatry 2024; 14:371. [PMID: 39266518 PMCID: PMC11393330 DOI: 10.1038/s41398-024-03082-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/20/2024] [Accepted: 08/30/2024] [Indexed: 09/14/2024] Open
Abstract
Observational and genetic studies have reported the relationship between dyslexia and Alzheimer's disease (AD). Until now, the causal effect of dyslexia on AD risk has remained unclear. We conducted a two-sample univariable Mendelian randomization (MR) analysis to determine the causal association between dyslexia and the risk of AD, vascular dementia (VD), Lewy body dementia (LBD), and frontotemporal dementia (FTD) and its four subtypes. First, we selected 42 dyslexia genetic variants from a large-scale genome-wide association studies (GWAS) dataset and extracted their corresponding GWAS summary statistics from AD, VD, LBD, and FTD. Second, we selected four MR methods, including inverse-variance weighted (IVW), weighted median, MR-Egger, and MR-PRESSO. Heterogeneity, horizontal pleiotropy, and leave-one-out sensitivity analysis were then used to evaluate the reliability of all causal estimates. We also conducted multivariable MR (MVMR) and mediation analysis to assess the potential mediating role of cognitive performance (CP) or educational achievement (EA) on the causal association between dyslexia and AD. Two MVMR methods, including MV IVW and MV-Egger, and two-step MR were used to perform the analysis. Using IVW, we found a significant causal association between increased dyslexia and increased risk of AD (OR = 1.15, 95% CI: 1.04-1.28, P = 0.006), but not VD, LBD, FTD, or its four subtypes. MR-PRESSO further supported the statistically significant association between dyslexia and AD (OR = 1.15, 95% CI: 1.05-1.27, P = 0.006). All sensitivity analyses confirmed the reliability of causal estimates. Using MV IVW and mediation analysis, we found no causal relationship between dyslexia and AD after adjusting for CP but not EA, CP mediated the total effect of dyslexia on AD with a proportion of 46.32%. We provide genetic evidence to support a causal effect of increased dyslexia on increased risk of AD, which was largely mediated by CP. Reading activity may be a potential intervention strategy for AD by improving cognitive function.
Collapse
Affiliation(s)
- Ping Zhu
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, 100069, Beijing, China
| | - Shan Gao
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, 100069, Beijing, China
| | - Shiyang Wu
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, 100069, Beijing, China
| | - Xuan Li
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, 100069, Beijing, China
| | - Chen Huang
- Dr. Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, 999078, Macao SAR, China
| | - Yan Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Wannan Medical College, No. 22, Wenchang Road, 241002, Wuhu, Anhui, China.
| | - Guiyou Liu
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, 100069, Beijing, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Wannan Medical College, No. 22, Wenchang Road, 241002, Wuhu, Anhui, China.
- Brain Hospital, Shengli Oilfield Central Hospital, Dongying, China.
- Beijing Key Laboratory of Hypoxia Translational Medicine, National Engineering Laboratory of Internet Medical Diagnosis and Treatment Technology, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China.
| |
Collapse
|
2
|
Baqué L, Machuca MJ. Dysfluency in primary progressive aphasia: Temporal speech parameters. CLINICAL LINGUISTICS & PHONETICS 2024:1-34. [PMID: 39104133 DOI: 10.1080/02699206.2024.2378345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 08/07/2024]
Abstract
Analysing spontaneous speech in individuals experiencing fluency difficulties holds potential for diagnosing speech and language disorders, including Primary Progressive Aphasia (PPA). Dysfluency in the spontaneous speech of patients with PPA has mostly been described in terms of abnormal pausing behaviour, but the temporal features related to speech have drawn little attention. This study compares speech-related fluency parameters in the three main variants of PPA and in typical speech. Forty-three adults participated in this research, thirteen with the logopenic variant of PPA (lvPPA), ten with the non-fluent variant (nfvPPA), nine with the semantic variant (svPPA), and eleven who were healthy age-matched adults. Participants' fluency was assessed through a picture description task from which 42 parameters were computed including syllable duration, speaking pace, the duration of speech chunks (i.e. interpausal units, IPU), and the number of linguistic units per IPU and per second. The results showed that each PPA variant exhibited abnormal speech characteristics reflecting various underlying factors, from motor speech deficits to higher-level issues. Out of the 42 parameters considered, 37 proved useful for characterising dysfluency in the three main PPA variants and 35 in distinguishing among them. Therefore, taking into account not only pausing behaviour but also temporal speech parameters can provide a fuller understanding of dysfluency in PPA. However, no single parameter by itself sufficed to distinguish one PPA group from the other two, further evidence that dysfluency is not dichotomous but rather multidimensional, and that complementary multiparametric analyses are needed.
Collapse
Affiliation(s)
- Lorraine Baqué
- Departament de Filologia Francesa i Romànica, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - María-Jesús Machuca
- Departament de Filologia Espanyola, Universitat Autònoma de Barcelona, Bellaterra, Spain
| |
Collapse
|
3
|
Singh-Reilly N, Botha H, Duffy JR, Clark HM, Utianski RL, Machulda MM, Graff-Radford J, Schwarz CG, Petersen RC, Lowe VJ, Jack CR, Josephs KA, Whitwell JL. Speech-language within and between network disruptions in primary progressive aphasia variants. Neuroimage Clin 2024; 43:103639. [PMID: 38991435 PMCID: PMC11296005 DOI: 10.1016/j.nicl.2024.103639] [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: 12/08/2023] [Revised: 05/20/2024] [Accepted: 06/30/2024] [Indexed: 07/13/2024]
Abstract
Primary progressive aphasia (PPA) variants present with distinct disruptions in speech-language functions with little known about the interplay between affected and spared regions within the speech-language network and their interaction with other functional networks. The Neurodegenerative Research Group, Mayo Clinic, recruited 123 patients with PPA (55 logopenic (lvPPA), 44 non-fluent (nfvPPA) and 24 semantic (svPPA)) who were matched to 60 healthy controls. We investigated functional connectivity disruptions between regions within the left-speech-language network (Broca, Wernicke, anterior middle temporal gyrus (aMTG), supplementary motor area (SMA), planum temporale (PT) and parietal operculum (PO)), and disruptions to other networks (visual association, dorsal-attention, frontoparietal and default mode networks (DMN)). Within the speech-language network, multivariate linear regression models showed reduced aMTG-Broca connectivity in all variants, with lvPPA and nfvPPA findings remaining significant after Bonferroni correction. Additional loss in Wernicke-Broca connectivity in nfvPPA, Wernicke-PT connectivity in lvPPA and greater aMTG-PT connectivity in svPPA were also noted. Between-network connectivity findings in all variants showed reduced aMTG-DMN and increased aMTG-dorsal-attention connectivity, with additional disruptions between aMTG-visual association in both lvPPA and svPPA, aMTG-frontoparietal in lvPPA, and Wernicke-DMN breakdown in svPPA. These findings suggest that aMTG connectivity breakdown is a shared feature in all PPA variants, with lvPPA showing more extensive connectivity disruptions with other networks.
Collapse
Affiliation(s)
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Joseph R Duffy
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Mary M Machulda
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | | | | |
Collapse
|
4
|
Hurley RS, Lapin B, Jones SE, Crawford A, Leverenz JB, Bonner-Jackson A, Pillai JA. Hemispheric asymmetries in hippocampal volume related to memory in left and right temporal variants of frontotemporal degeneration. Front Neurol 2024; 15:1374827. [PMID: 38742046 PMCID: PMC11089209 DOI: 10.3389/fneur.2024.1374827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
In addition to Alzheimer's disease (AD), the hippocampus is now known to be affected in variants of frontotemporal degeneration (FTD). In semantic variant primary progressive aphasia (svPPA), characterized by language impairments, hippocampal atrophy is greater in the left hemisphere. Nonverbal impairments (e.g., visual object recognition) are prominent in the right temporal variant of FTD (rtvFTD), and hippocampal atrophy may be greater in the right hemisphere. In this study we examined the hypothesis that leftward hippocampal asymmetry (predicted in svPPA) would be associated with selective verbal memory impairments (with relative preservation of visual memory), while rightward asymmetry (predicted in rtvFTD) would be associated with the opposite pattern (greater visual memory impairment). In contrast, we predicted that controls and individuals in the amnestic mild cognitive impairment stage of AD (aMCI), both of whom were expected to show symmetrical hippocampal volumes, would show roughly equivalent scores in verbal and visual memory. Participants completed delayed recall tests with words and geometric shapes, and hippocampal volumes were assessed with MRI. The aMCI sample showed symmetrical hippocampal atrophy, and similar degree of verbal and visual memory impairment. The svPPA sample showed greater left hippocampal atrophy and verbal memory impairment, while rtvFTD showed greater right hippocampal atrophy and visual memory impairment. Greater asymmetry in hippocampal volumes was associated with larger differences between verbal and visual memory in the FTD samples. Unlike AD, asymmetry is a core feature of brain-memory relationships in temporal variants of FTD.
Collapse
Affiliation(s)
- Robert S. Hurley
- Department of Psychology, Cleveland State University, Cleveland, OH, United States
| | - Brittany Lapin
- Department of Quantitative Health Sciences, Lerner Research Institute Cleveland Clinic, Cleveland, OH, United States
- Center for Outcomes Research and Evaluation, Neurological Institute Cleveland Clinic, Cleveland, OH, United States
| | - Stephen E. Jones
- Department of Diagnostic Radiology, Imaging Institute Cleveland Clinic, Cleveland, OH, United States
| | - Anna Crawford
- Department of Diagnostic Radiology, Imaging Institute Cleveland Clinic, Cleveland, OH, United States
| | - James B. Leverenz
- Lou Ruvo Center for Brain Health, Neurological Institute Cleveland Clinic, Cleveland, OH, United States
| | - Aaron Bonner-Jackson
- Lou Ruvo Center for Brain Health, Neurological Institute Cleveland Clinic, Cleveland, OH, United States
| | - Jagan A. Pillai
- Lou Ruvo Center for Brain Health, Neurological Institute Cleveland Clinic, Cleveland, OH, United States
| |
Collapse
|
5
|
Maldonado-Díaz C, Hiya S, Yokoda RT, Farrell K, Marx GA, Kauffman J, Daoud EV, Gonzales MM, Parker AS, Canbeldek L, Kulumani Mahadevan LS, Crary JF, White CL, Walker JM, Richardson TE. Disentangling and quantifying the relative cognitive impact of concurrent mixed neurodegenerative pathologies. Acta Neuropathol 2024; 147:58. [PMID: 38520489 PMCID: PMC10960766 DOI: 10.1007/s00401-024-02716-y] [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: 01/12/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/25/2024]
Abstract
Neurodegenerative pathologies such as Alzheimer disease neuropathologic change (ADNC), Lewy body disease (LBD), limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC), and cerebrovascular disease (CVD) frequently coexist, but little is known about the exact contribution of each pathology to cognitive decline and dementia in subjects with mixed pathologies. We explored the relative cognitive impact of concurrent common and rare neurodegenerative pathologies employing multivariate logistic regression analysis adjusted for age, gender, and level of education. We analyzed a cohort of 6,262 subjects from the National Alzheimer's Coordinating Center database, ranging from 0 to 6 comorbid neuropathologic findings per individual, where 95.7% of individuals had at least 1 neurodegenerative finding at autopsy and 75.5% had at least 2 neurodegenerative findings. We identified which neuropathologic entities correlate most frequently with one another and demonstrated that the total number of pathologies per individual was directly correlated with cognitive performance as assessed by Clinical Dementia Rating (CDR®) and Mini-Mental State Examination (MMSE). We show that ADNC, LBD, LATE-NC, CVD, hippocampal sclerosis, Pick disease, and FTLD-TDP significantly impact overall cognition as independent variables. More specifically, ADNC significantly affected all assessed cognitive domains, LBD affected attention, processing speed, and language, LATE-NC primarily affected tests related to logical memory and language, while CVD and other less common pathologies (including Pick disease, progressive supranuclear palsy, and corticobasal degeneration) had more variable neurocognitive effects. Additionally, ADNC, LBD, and higher numbers of comorbid neuropathologies were associated with the presence of at least one APOE ε4 allele, and ADNC and higher numbers of neuropathologies were inversely correlated with APOE ε2 alleles. Understanding the mechanisms by which individual and concomitant neuropathologies affect cognition and the degree to which each contributes is an imperative step in the development of biomarkers and disease-modifying therapeutics, particularly as these medical interventions become more targeted and personalized.
Collapse
Affiliation(s)
- Carolina Maldonado-Díaz
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15.238, 1468 Madison Avenue, New York, NY, 10029, USA
| | - Satomi Hiya
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15.238, 1468 Madison Avenue, New York, NY, 10029, USA
| | - Raquel T Yokoda
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15.238, 1468 Madison Avenue, New York, NY, 10029, USA
| | - Kurt Farrell
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15.238, 1468 Madison Avenue, New York, NY, 10029, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Neuropathology Brain Bank and Research CoRE, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Ronal M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Gabriel A Marx
- Neuropathology Brain Bank and Research CoRE, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Ronal M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Justin Kauffman
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15.238, 1468 Madison Avenue, New York, NY, 10029, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Neuropathology Brain Bank and Research CoRE, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Ronal M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Elena V Daoud
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Mitzi M Gonzales
- Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA, 90048, USA
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Alicia S Parker
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Leyla Canbeldek
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15.238, 1468 Madison Avenue, New York, NY, 10029, USA
| | - Lakshmi Shree Kulumani Mahadevan
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15.238, 1468 Madison Avenue, New York, NY, 10029, USA
| | - John F Crary
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15.238, 1468 Madison Avenue, New York, NY, 10029, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Neuropathology Brain Bank and Research CoRE, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Ronal M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Charles L White
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Jamie M Walker
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15.238, 1468 Madison Avenue, New York, NY, 10029, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Neuropathology Brain Bank and Research CoRE, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Timothy E Richardson
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, Annenberg Building, 15.238, 1468 Madison Avenue, New York, NY, 10029, USA.
| |
Collapse
|
6
|
Kawles A, Keszycki R, Minogue G, Zouridakis A, Ayala I, Gill N, Macomber A, Lubbat V, Coventry C, Rogalski E, Weintraub S, Mao Q, Flanagan ME, Zhang H, Castellani R, Bigio EH, Mesulam MM, Geula C, Gefen T. Phenotypically concordant distribution of pick bodies in aphasic versus behavioral dementias. Acta Neuropathol Commun 2024; 12:31. [PMID: 38389095 PMCID: PMC10885488 DOI: 10.1186/s40478-024-01738-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 02/04/2024] [Indexed: 02/24/2024] Open
Abstract
Pick's disease (PiD) is a subtype of the tauopathy form of frontotemporal lobar degeneration (FTLD-tau) characterized by intraneuronal 3R-tau inclusions. PiD can underly various dementia syndromes, including primary progressive aphasia (PPA), characterized by an isolated and progressive impairment of language and left-predominant atrophy, and behavioral variant frontotemporal dementia (bvFTD), characterized by progressive dysfunction in personality and bilateral frontotemporal atrophy. In this study, we investigated the neocortical and hippocampal distributions of Pick bodies in bvFTD and PPA to establish clinicopathologic concordance between PiD and the salience of the aphasic versus behavioral phenotype. Eighteen right-handed cases with PiD as the primary pathologic diagnosis were identified from the Northwestern University Alzheimer's Disease Research Center brain bank (bvFTD, N = 9; PPA, N = 9). Paraffin-embedded sections were stained immunohistochemically with AT8 to visualize Pick bodies, and unbiased stereological analysis was performed in up to six regions bilaterally [middle frontal gyrus (MFG), superior temporal gyrus (STG), inferior parietal lobule (IPL), anterior temporal lobe (ATL), dentate gyrus (DG) and CA1 of the hippocampus], and unilateral occipital cortex (OCC). In bvFTD, peak neocortical densities of Pick bodies were in the MFG, while the ATL was the most affected in PPA. Both the IPL and STG had greater leftward pathology in PPA, with the latter reaching significance (p < 0.01). In bvFTD, Pick body densities were significantly right-asymmetric in the STG (p < 0.05). Hippocampal burden was not clinicopathologically concordant, as both bvFTD and PPA cases demonstrated significant hippocampal pathology compared to neocortical densities (p < 0.0001). Inclusion-to-neuron analyses in a subset of PPA cases confirmed that neurons in the DG are disproportionately burdened with inclusions compared to neocortical areas. Overall, stereological quantitation suggests that the distribution of neocortical Pick body pathology is concordant with salient clinical features unique to PPA vs. bvFTD while raising intriguing questions about the selective vulnerability of the hippocampus to 3R-tauopathies.
Collapse
Affiliation(s)
- Allegra Kawles
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rachel Keszycki
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Grace Minogue
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Antonia Zouridakis
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ivan Ayala
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nathan Gill
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alyssa Macomber
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Vivienne Lubbat
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christina Coventry
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily Rogalski
- Department of Neurology, University of Chicago School of Medicine, Chicago, IL, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Qinwen Mao
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Margaret E Flanagan
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hui Zhang
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rudolph Castellani
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Eileen H Bigio
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - M-Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Changiz Geula
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Cell and Developmental Biology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Tamar Gefen
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| |
Collapse
|
7
|
Liu F, Shi Y, Wu Q, Chen H, Wang Y, Cai L, Zhang N. The value of FDG combined with PiB PET in the diagnosis of patients with cognitive impairment in a memory clinic. CNS Neurosci Ther 2024; 30:e14418. [PMID: 37602885 PMCID: PMC10848040 DOI: 10.1111/cns.14418] [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: 06/05/2023] [Revised: 07/12/2023] [Accepted: 08/07/2023] [Indexed: 08/22/2023] Open
Abstract
AIMS To analyze the value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) combined with amyloid PET in cognitive impairment diagnosis. METHODS A total of 187 patients with dementia or mild cognitive impairment (MCI) who underwent 11 C-Pittsburgh compound B (PiB) and FDG PET scans in a memory clinic were included in the final analysis. RESULTS Amyloid-positive and amyloid-negative dementia patient groups showed a significant difference in the proportion of individuals presenting temporoparietal cortex (p < 0.001) and posterior cingulate/precuneus cortex (p < 0.001) hypometabolism. The sensitivity and specificity of this hypometabolic pattern for identifying amyloid pathology were 72.61% and 77.97%, respectively, in patients clinically diagnosed with AD and 60.87% and 76.19%, respectively, in patients with MCI. The initial diagnosis was changed in 32.17% of patients with dementia after considering both PiB and FDG results. There was a significant difference in both the proportion of patients showing the hypometabolic pattern and PiB positivity between dementia conversion patients and patients with a stable diagnosis of MCI (p < 0.05). CONCLUSION Temporoparietal and posterior cingulate/precuneus cortex hypometabolism on FDG PET suggested amyloid pathology in patients with cognitive impairment and is helpful in diagnostic decision-making and predicting AD dementia conversion from MCI, particularly when combined with amyloid PET.
Collapse
Affiliation(s)
- Fang Liu
- Department of NeurologyTianjin Neurological Institute, Tianjin Medical University General HospitalTianjinChina
| | - Yudi Shi
- Department of NeurologyTianjin Neurological Institute, Tianjin Medical University General HospitalTianjinChina
- Health Management CenterTianjin Medical University General Hospital Airport SiteTianjinChina
| | - Qiuyan Wu
- Department of NeurologyTianjin Neurological Institute, Tianjin Medical University General HospitalTianjinChina
| | - Huifeng Chen
- Department of NeurologyTianjin Neurological Institute, Tianjin Medical University General HospitalTianjinChina
- Department of NeurologyTianjin Medical University General Hospital Airport SiteTianjinChina
| | - Ying Wang
- PET/CT CenterTianjin Medical University General HospitalTianjinChina
| | - Li Cai
- PET/CT CenterTianjin Medical University General HospitalTianjinChina
| | - Nan Zhang
- Department of NeurologyTianjin Neurological Institute, Tianjin Medical University General HospitalTianjinChina
- Department of NeurologyTianjin Medical University General Hospital Airport SiteTianjinChina
| |
Collapse
|
8
|
Robinson CG, Coleman T, Buciuc M, Singh NA, Pham NTT, Machulda MM, Graff-Radford J, Whitwell JL, Josephs KA. Behavioral and Neuropsychiatric Differences Across Two Atypical Alzheimer's Disease Variants: Logopenic Progressive Aphasia and Posterior Cortical Atrophy. J Alzheimers Dis 2024; 97:895-908. [PMID: 38143349 PMCID: PMC10842893 DOI: 10.3233/jad-230652] [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] [Indexed: 12/26/2023]
Abstract
BACKGROUND Posterior cortical atrophy (PCA) and logopenic progressive aphasia (LPA) are two common atypical Alzheimer's disease (AD) variants. Little is known about behavioral and neuropsychiatric symptoms or activities of daily living (ADLs) in PCA and LPA, and whether they differ across syndromes. OBJECTIVE To characterize the behavioral and neuropsychiatric profiles and ADLs of PCA and LPA and compare presence/absence and severity of symptoms between syndromes. METHODS Seventy-eight atypical AD patients, 46 with PCA and 32 with LPA, completed the Neuropsychiatric Inventory Questionnaire (NPI-Q) and Cambridge Behavioral Inventory-Revised (CBI-R) at baseline and longitudinally over-time. Mann-Whitney U and Fisher's Exact Tests assessed for differences in symptoms between the two syndromes with significance set at p≤0.01. To eliminate demographic differences as confounders the groups were matched, and differences reanalyzed. RESULTS PCA were younger at onset (p = 0.006), at time of baseline assessment (p = 0.02) and had longer disease duration (p = 0.01). Neuropsychiatric symptoms were common in PCA and LPA, although more common and severe in PCA. At baseline, PCA had a higher NPI-Q total score (p = 0.01) and depression subscore (p = 0.01) than LPA. Baseline total CBI-R scores were also higher in PCA than LPA (p = 0.001) with PCA having worse scores in all 10 CBI-R categories. Longitudinally, there was no difference between groups on the NPI-Q. However, on the CBI-R, PCA had faster rates of worsening on self-grooming (p = 0.01) and self-dressing (p = 0.01) compared to LPA. CONCLUSIONS Behavioral and neuropsychiatric symptoms are common in PCA and LPA although these symptoms are more common and severe in PCA.
Collapse
Affiliation(s)
| | - Tia Coleman
- Department of Neurology, Mayo Clinic, Rochester, MN
| | - Marina Buciuc
- Department of Neurology, Medical University of South Carolina, Charleston, SC
| | | | | | - Mary M. Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | | | | |
Collapse
|
9
|
García AM, de Leon J, Tee BL, Blasi DE, Gorno-Tempini ML. Speech and language markers of neurodegeneration: a call for global equity. Brain 2023; 146:4870-4879. [PMID: 37497623 PMCID: PMC10690018 DOI: 10.1093/brain/awad253] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/29/2023] [Accepted: 07/15/2023] [Indexed: 07/28/2023] Open
Abstract
In the field of neurodegeneration, speech and language assessments are useful for diagnosing aphasic syndromes and for characterizing other disorders. As a complement to classic tests, scalable and low-cost digital tools can capture relevant anomalies automatically, potentially supporting the quest for globally equitable markers of brain health. However, this promise remains unfulfilled due to limited linguistic diversity in scientific works and clinical instruments. Here we argue for cross-linguistic research as a core strategy to counter this problem. First, we survey the contributions of linguistic assessments in the study of primary progressive aphasia and the three most prevalent neurodegenerative disorders worldwide-Alzheimer's disease, Parkinson's disease, and behavioural variant frontotemporal dementia. Second, we address two forms of linguistic unfairness in the literature: the neglect of most of the world's 7000 languages and the preponderance of English-speaking cohorts. Third, we review studies showing that linguistic dysfunctions in a given disorder may vary depending on the patient's language and that English speakers offer a suboptimal benchmark for other language groups. Finally, we highlight different approaches, tools and initiatives for cross-linguistic research, identifying core challenges for their deployment. Overall, we seek to inspire timely actions to counter a looming source of inequity in behavioural neurology.
Collapse
Affiliation(s)
- Adolfo M García
- Global Brain Health Institute, University of California, San Francisco, CA 94143, USA
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires B1644BID, Argentina
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago 9160000, Chile
- Latin American Brain Health (BrainLat) Institute, Universidad Adolfo Ibáñez, Avenida Diagonal Las Torres 2640 (7941169), Santiago, Peñalolén, Región Metropolitana, Chile
| | - Jessica de Leon
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Boon Lead Tee
- Global Brain Health Institute, University of California, San Francisco, CA 94143, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Damián E Blasi
- Data Science Initiative, Harvard University, Cambridge, MA 02138, USA
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
- Department of Linguistic and Cultural Evolution, Max Planck Institute for the Science of Human History, Jena 07745, Germany
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143, USA
| |
Collapse
|
10
|
Ohm DT, Rhodes E, Bahena A, Capp N, Lowe M, Sabatini P, Trotman W, Olm CA, Phillips J, Prabhakaran K, Rascovsky K, Massimo L, McMillan C, Gee J, Tisdall MD, Yushkevich PA, Lee EB, Grossman M, Irwin DJ. Neuroanatomical and cellular degeneration associated with a social disorder characterized by new ritualistic belief systems in a TDP-C patient vs. a Pick patient. Front Neurol 2023; 14:1245886. [PMID: 37900607 PMCID: PMC10600461 DOI: 10.3389/fneur.2023.1245886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/15/2023] [Indexed: 10/31/2023] Open
Abstract
Frontotemporal dementia (FTD) is a spectrum of clinically and pathologically heterogenous neurodegenerative dementias. Clinical and anatomical variants of FTD have been described and associated with underlying frontotemporal lobar degeneration (FTLD) pathology, including tauopathies (FTLD-tau) or TDP-43 proteinopathies (FTLD-TDP). FTD patients with predominant degeneration of anterior temporal cortices often develop a language disorder of semantic knowledge loss and/or a social disorder often characterized by compulsive rituals and belief systems corresponding to predominant left or right hemisphere involvement, respectively. The neural substrates of these complex social disorders remain unclear. Here, we present a comparative imaging and postmortem study of two patients, one with FTLD-TDP (subtype C) and one with FTLD-tau (subtype Pick disease), who both developed new rigid belief systems. The FTLD-TDP patient developed a complex set of values centered on positivity and associated with specific physical and behavioral features of pigs, while the FTLD-tau patient developed compulsive, goal-directed behaviors related to general themes of positivity and spirituality. Neuroimaging showed left-predominant temporal atrophy in the FTLD-TDP patient and right-predominant frontotemporal atrophy in the FTLD-tau patient. Consistent with antemortem cortical atrophy, histopathologic examinations revealed severe loss of neurons and myelin predominantly in the anterior temporal lobes of both patients, but the FTLD-tau patient showed more bilateral, dorsolateral involvement featuring greater pathology and loss of projection neurons and deep white matter. These findings highlight that the regions within and connected to anterior temporal lobes may have differential vulnerability to distinct FTLD proteinopathies and serve important roles in human belief systems.
Collapse
Affiliation(s)
- Daniel T. Ohm
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Emma Rhodes
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Alejandra Bahena
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Noah Capp
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - MaKayla Lowe
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Philip Sabatini
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Winifred Trotman
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher A. Olm
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Jeffrey Phillips
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Karthik Prabhakaran
- Penn Image Computing and Science Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Lauren Massimo
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Corey McMillan
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - James Gee
- Penn Image Computing and Science Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - M. Dylan Tisdall
- Center for Advanced Magnetic Resonance Imaging and Spectroscopy, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Paul A. Yushkevich
- Penn Image Computing and Science Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Edward B. Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - David J. Irwin
- Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
11
|
Higashi S, Koshibe Y, Miyazaki T, Watanabe R, Nakanome H, Inoue T, Asada T, Arai T. Feasibility study of Internet video-based speech-language activity for outpatients with primary progressive aphasia. PLoS One 2023; 18:e0288468. [PMID: 37440500 DOI: 10.1371/journal.pone.0288468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Primary progressive aphasia is a clinical dementia syndrome secondary to neurodegenerative disease characterized by language-related difficulties. Currently, there is no effective treatment for language impairment in primary progressive aphasia. In the present study, we investigated the feasibility of Internet video-based speech-language activities for this condition. METHODS Twenty-three people with primary progressive aphasia (pwPPA) participated in the study and were provided with twelve speech-language activity videos on a dedicated website, with three sessions per week. The group that chose to continue with participation after three months of intervention received Internet activities for one year. Cognitive domains associated with persistence, treatment motivation, and video difficulty settings were statistically analyzed. RESULTS After three months, 17 out of 23 participants opted to continue with the activities. The ability to follow oral commands which was measured pre intervention was higher in the group that continued compared with those participants who discontinued activity. The scores of two Standard Language Test of Aphasia subtests, sentence repetition and narrative writing-associated with the ability to comprehend and produce sentence structure-were highly correlated with motivation, interest and concentration in activity. Participants with different levels of primary progressive aphasia progression could participate in the same video-based activities when high-frequency words were used in the video. CONCLUSIONS Internet video-based speech-language activity at home has potential as a useful tool for future primary progressive aphasia treatment because it provides a cost-effective approach to intensive intervention and overcomes barriers associated with traditional therapy approaches.
Collapse
Affiliation(s)
- Shinji Higashi
- Department of Psychiatry, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
| | - Yuko Koshibe
- Department of Psychiatry, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
- Memory Clinic Ochanomizu, Bunkyo-ku, Tokyo, Japan
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takehiro Miyazaki
- Department of Psychiatry, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
| | - Ryohei Watanabe
- Department of Psychiatry, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
| | - Hanako Nakanome
- Department of Psychiatry, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
- Memory Clinic Ochanomizu, Bunkyo-ku, Tokyo, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | | | - Tetsuaki Arai
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| |
Collapse
|
12
|
Dávila G, Torres-Prioris MJ, López-Barroso D, Berthier ML. Turning the Spotlight to Cholinergic Pharmacotherapy of the Human Language System. CNS Drugs 2023; 37:599-637. [PMID: 37341896 PMCID: PMC10374790 DOI: 10.1007/s40263-023-01017-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/22/2023]
Abstract
Even though language is essential in human communication, research on pharmacological therapies for language deficits in highly prevalent neurodegenerative and vascular brain diseases has received little attention. Emerging scientific evidence suggests that disruption of the cholinergic system may play an essential role in language deficits associated with Alzheimer's disease and vascular cognitive impairment, including post-stroke aphasia. Therefore, current models of cognitive processing are beginning to appraise the implications of the brain modulator acetylcholine in human language functions. Future work should be directed further to analyze the interplay between the cholinergic system and language, focusing on identifying brain regions receiving cholinergic innervation susceptible to modulation with pharmacotherapy to improve affected language domains. The evaluation of language deficits in pharmacological cholinergic trials for Alzheimer's disease and vascular cognitive impairment has thus far been limited to coarse-grained methods. More precise, fine-grained language testing is needed to refine patient selection for pharmacotherapy to detect subtle deficits in the initial phases of cognitive decline. Additionally, noninvasive biomarkers can help identify cholinergic depletion. However, despite the investigation of cholinergic treatment for language deficits in Alzheimer's disease and vascular cognitive impairment, data on its effectiveness are insufficient and controversial. In the case of post-stroke aphasia, cholinergic agents are showing promise, particularly when combined with speech-language therapy to promote trained-dependent neural plasticity. Future research should explore the potential benefits of cholinergic pharmacotherapy in language deficits and investigate optimal strategies for combining these agents with other therapeutic approaches.
Collapse
Affiliation(s)
- Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain.
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain.
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.
| |
Collapse
|
13
|
Ash S, Nevler N, Irwin DJ, Shellikeri S, Rascovsky K, Shaw L, Lee EB, Trojanowski JQ, Grossman M. Apraxia of Speech in the Spontaneous Speech of Nonfluent/Agrammatic Primary Progressive Aphasia. J Alzheimers Dis Rep 2023; 7:589-604. [PMID: 37313492 PMCID: PMC10259074 DOI: 10.3233/adr-220089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 05/13/2023] [Indexed: 06/15/2023] Open
Abstract
Background Apraxia of speech (AOS) is a core feature of nonfluent/agrammatic primary progressive aphasia (naPPA), but its precise characteristics and the prevalence of AOS features in spontaneous speech are debated. Objective To assess the frequency of features of AOS in the spontaneous, connected speech of individuals with naPPA and to evaluate whether these features are associated with an underlying motor disorder such as corticobasal syndrome or progressive supranuclear palsy. Methods We examined features of AOS in 30 patients with naPPA using a picture description task. We compared these patients to 22 individuals with behavioral variant frontotemporal dementia and 30 healthy controls. Each speech sample was evaluated perceptually for lengthened speech segments and quantitatively for speech sound distortions, pauses between and within words, and articulatory groping. We compared subgroups of naPPA with and without at least two features of AOS to assess the possible contribution of a motor impairment to speech production deficits. Results naPPA patients produced both speech sound distortions and other speech sound errors. Speech segmentation was found in 27/30 (90%) of individuals. Distortions were identified in 8/30 (27%) of individuals, and other speech sound errors occurred in 18/30 (60%) of individuals. Frequent articulatory groping was observed in 6/30 (20%) of individuals. Lengthened segments were observed rarely. There were no differences in the frequencies of AOS features among naPPA subgroups as a function of extrapyramidal disease. Conclusion Features of AOS occur with varying frequency in the spontaneous speech of individuals with naPPA, independently of an underlying motor disorder.
Collapse
Affiliation(s)
- Sharon Ash
- Penn Frontotemporal Degeneration Center and Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - Naomi Nevler
- Penn Frontotemporal Degeneration Center and Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - David J. Irwin
- Penn Frontotemporal Degeneration Center and Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - Sanjana Shellikeri
- Penn Frontotemporal Degeneration Center and Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center and Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - Leslie Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - Edward B. Lee
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | | | | |
Collapse
|
14
|
Stephen TL, Korobkova L, Breningstall B, Nguyen K, Mehta S, Pachicano M, Jones KT, Hawes D, Cabeen RP, Bienkowski MS. Machine Learning Classification of Alzheimer's Disease Pathology Reveals Diffuse Amyloid as a Major Predictor of Cognitive Impairment in Human Hippocampal Subregions. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.31.543117. [PMID: 37333119 PMCID: PMC10274752 DOI: 10.1101/2023.05.31.543117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Analyzing Alzheimer's disease (AD) pathology within anatomical subregions is a significant challenge, often carried out by pathologists using a standardized, semi-quantitative approach. To augment traditional methods, a high-throughput, high-resolution pipeline was created to classify the distribution of AD pathology within hippocampal subregions. USC ADRC post-mortem tissue sections from 51 patients were stained with 4G8 for amyloid, Gallyas for neurofibrillary tangles (NFTs) and Iba1 for microglia. Machine learning (ML) techniques were utilized to identify and classify amyloid pathology (dense, diffuse and APP (amyloid precursor protein)), NFTs, neuritic plaques and microglia. These classifications were overlaid within manually segmented regions (aligned with the Allen Human Brain Atlas) to create detailed pathology maps. Cases were separated into low, intermediate, or high AD stages. Further data extraction enabled quantification of plaque size and pathology density alongside ApoE genotype, sex, and cognitive status. Our findings revealed that the increase in pathology burden across AD stages was driven mainly by diffuse amyloid. The pre and para-subiculum had the highest levels of diffuse amyloid while NFTs were highest in the A36 region in high AD cases. Moreover, different pathology types had distinct trajectories across disease stages. In a subset of AD cases, microglia were elevated in intermediate and high compared to low AD. Microglia also correlated with amyloid pathology in the Dentate Gyrus. The size of dense plaques, which may represent microglial function, was lower in ApoE4 carriers. In addition, individuals with memory impairment had higher levels of both dense and diffuse amyloid. Taken together, our findings integrating ML classification approaches with anatomical segmentation maps provide new insights on the complexity of disease pathology in AD progression. Specifically, we identified diffuse amyloid pathology as being a major driver of AD in our cohort, regions of interest and microglial responses that might advance AD diagnosis and treatment.
Collapse
|
15
|
Meyer AM, Snider SF, Tippett DC, Saloma R, Turkeltaub PE, Hillis AE, Friedman RB. Baseline Conceptual-Semantic Impairment Predicts Longitudinal Treatment Effects for Anomia in Primary Progressive Aphasia and Alzheimer's Disease. APHASIOLOGY 2023; 38:205-236. [PMID: 38283767 PMCID: PMC10809875 DOI: 10.1080/02687038.2023.2183075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 02/16/2023] [Indexed: 01/30/2024]
Abstract
Background An individual's diagnostic subtype may fail to predict the efficacy of a given type of treatment for anomia. Classification by conceptual-semantic impairment may be more informative. Aims This study examined the effects of conceptual-semantic impairment and diagnostic subtype on anomia treatment effects in primary progressive aphasia (PPA) and Alzheimer's disease (AD). Methods & Procedures At baseline, the picture and word versions of the Pyramids and Palm Trees and Kissing and Dancing tests were used to measure conceptual-semantic processing. Based on norming that was conducted with unimpaired older adults, participants were classified as being impaired on both the picture and word versions (i.e., modality-general conceptual-semantic impairment), the picture version (Objects or Actions) only (i.e., visual-conceptual impairment), the word version (Nouns or Verbs) only (i.e., lexical-semantic impairment), or neither the picture nor the word version (i.e., no impairment). Following baseline testing, a lexical treatment and a semantic treatment were administered to all participants. The treatment stimuli consisted of nouns and verbs that were consistently named correctly at baseline (Prophylaxis items) and/or nouns and verbs that were consistently named incorrectly at baseline (Remediation items). Naming accuracy was measured at baseline, and it was measured at three, seven, eleven, fourteen, eighteen, and twenty-one months. Outcomes & Results Compared to baseline naming performance, lexical and semantic treatments both improved naming accuracy for treated Remediation nouns and verbs. For Prophylaxis items, lexical treatment was effective for both nouns and verbs, and semantic treatment was effective for verbs, but the pattern of results was different for nouns -- the effect of semantic treatment was initially nonsignificant or marginally significant, but it was significant beginning at 11 Months, suggesting that the effects of prophylactic semantic treatment may become more apparent as the disorder progresses. Furthermore, the interaction between baseline Conceptual-Semantic Impairment and the Treatment Condition (Lexical vs. Semantic) was significant for verb Prophylaxis items at 3 and 18 Months, and it was significant for noun Prophylaxis items at 14 and 18 Months. Conclusions The pattern of results suggested that individuals who have modality-general conceptual-semantic impairment at baseline are more likely to benefit from lexical treatment, while individuals who have unimpaired conceptual-semantic processing at baseline are more likely to benefit from semantic treatment as the disorder progresses. In contrast to conceptual-semantic impairment, diagnostic subtype did not typically predict the treatment effects.
Collapse
Affiliation(s)
- Aaron M. Meyer
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | - Sarah F. Snider
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | | | - Ryan Saloma
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | - Peter E. Turkeltaub
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | | | - Rhonda B. Friedman
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| |
Collapse
|
16
|
Martínez-Pernía D, Olavarría L, Fernández-Manjón B, Cabello V, Henríquez F, Robert P, Alvarado L, Barría S, Antivilo A, Velasquez J, Cerda M, Farías G, Torralva T, Ibáñez A, Parra MA, Gilbert S, Slachevsky A. The limitations and challenges in the assessment of executive dysfunction associated with real-world functioning: The opportunity of serious games. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-17. [PMID: 36827177 PMCID: PMC11177293 DOI: 10.1080/23279095.2023.2174438] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Nowadays, there is a broad range of methods for detecting and evaluating executive dysfunction ranging from clinical interview to neuropsychological evaluation. Nevertheless, a critical issue of these assessments is the lack of correspondence of the neuropsychological test's results with real-world functioning. This paper proposes serious games as a new framework to improve the neuropsychological assessment of real-world functioning. We briefly discuss the contribution and limitations of current methods of evaluation of executive dysfunction (paper-and-pencil tests, naturalistic observation methods, and Information and Communications Technologies) to inform on daily life functioning. Then, we analyze what are the limitations of these methods to predict real-world performance: (1) A lack of appropriate instruments to investigate the complexity of real-world functioning, (2) the vast majority of neuropsychological tests assess well-structured tasks, and (3) measurement of behaviors are based on simplistic data collection and statistical analysis. This work shows how serious games offer an opportunity to develop more efficient tools to detect executive dysfunction in everyday life contexts. Serious games provide meaningful narrative stories and virtual or real environments that immerse the user in natural and social environments with social interactions. In those highly interactive game environments, the player needs to adapt his/her behavioral performance to novel and ill-structured tasks which are suited for collecting user interaction evidence. Serious games offer a novel opportunity to develop better tools to improve diagnosis of the executive dysfunction in everyday life contexts. However, more research is still needed to implement serious games in everyday clinical practice.
Collapse
Affiliation(s)
- David Martínez-Pernía
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Loreto Olavarría
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Victoria Cabello
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Biomedical Science Institute, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Fernando Henríquez
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Biomedical Science Institute, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Laboratory for Cognitive and Evolutionary Neuroscience (LaNCE), Department of Psychiatry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Philippe Robert
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d'Azur, Nice, France
| | - Luís Alvarado
- Departamento de Psiquiatría y Salud Mental Norte, Universidad de Chile, Santiago, Chile
| | - Silvia Barría
- Departamento de Ciencias Neurologicas Oriente, Facultad de Medicina, Universidad de Chile, and Servicio de Neurología, Hospital del Salvador, Santiago, Chile
| | - Andrés Antivilo
- Departamento de Ciencias Neurologicas Oriente, Facultad de Medicina, Universidad de Chile, and Servicio de Neurología, Hospital del Salvador, Santiago, Chile
| | - Juan Velasquez
- Facultad de Ciencias Físicas y Matemáticas, Web Intelligence Center, Universidad de Chile, Santiago, Chile
- Department of Industrial Engineering, Faculty of Physical and Mathematical Sciences, Instituto Sistemas Complejos de Ingeniería (ISCI), University of Chile, Santiago, Chile
| | - Mauricio Cerda
- Integrative Biology Program, Institute of Biomedical Sciences, and Center for Medical Informatics and Telemedicine, Faculty of Medicine, and Biomedical Neuroscience Institute, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Gonzalo Farías
- Department of Neurology North, Faculty of Medicine, University of Chile, Santiago, Chile
- Center for advanced clinical research (CICA), Hospital Clínico Universidad de Chile, Chile
| | - Teresa Torralva
- Institute of Cognitive and Translational Neuroscience (INCYT), Instituto de Neurología Cognitiva Foundation, Favaloro University, Buenos Aires, Argentina
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
- Trinity College Dublin (TCD), Dublin, Ireland
| | - Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Sam Gilbert
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Biomedical Science Institute, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| |
Collapse
|
17
|
Ishihara K, Fukui T, Kawamura M, Shiota JI, Nakano I. Symptomatology and Neuropathology of patients presenting with focal cortical signs. Neuropathology 2023; 43:27-43. [PMID: 36328774 DOI: 10.1111/neup.12854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/05/2022] [Accepted: 07/10/2022] [Indexed: 11/06/2022]
Abstract
Here, we describe two patients who presented with focal cortical signs and underwent neuropathological examination. Case 1 was a 73-year-old woman with progressive speech disorder and abnormal behavior. She showed agraphia of the frontal lobe type, featured by the omission of kana letters when writing, other than pyramidal tract signs, pseudobulbar palsy, and frontal lobe dementia. Neuropathological examination, including TAR DNA-binding protein 43 (TDP-43) immunohistochemistry, revealed bilateral frontal and anterior temporal lobe lesions accentuated in the precentral gyrus and posterior part of the middle frontal gyrus. Both upper and lower motor neurons showed pathological changes compatible with amyotrophic lateral sclerosis. Case 2 was a 62-year-old man with progressive speech disorder and hand clumsiness. He had a motor speech disorder, compatible with apraxia of speech, and limb apraxia of the limb-kinetic and ideomotor type. Neuropathological examination revealed degeneration in the left frontal lobe, including the precentral gyrus, anterior temporal, and parietal lobe cortices. Moreover, numerous argyrophilic neuronal intracytoplasmic inclusions (Pick body) and ballooned neurons were observed in these lesions and the limbic system. The pathological diagnosis was Pick disease involving the peri-Rolandic area and parietal lobe. In these two cases, the distribution of neuropathological changes in the cerebral cortices correlated with the clinical symptoms observed.
Collapse
Affiliation(s)
- Kenji Ishihara
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan.,Asahi Hospital of Neurology and Rehabilitation, Chiba, Japan
| | - Toshiya Fukui
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan.,Kawasaki Memorial Hospital, Kawasaki, Japan
| | - Mitsuru Kawamura
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan.,Okusawa Hospital, Tokyo, Japan
| | - Jun-Ichi Shiota
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan.,Ushioda Home Clinic, Yokohama, Japan
| | - Imaharu Nakano
- Department of Neurology, Jichi Medical University, Tochigi, Japan
| |
Collapse
|
18
|
Shimazaki R, Sunami Y, Bando M, Harada A, Takahashi K. [A case of non-fluent/agrammatic variant of primary progressive aphasia with logoclonia]. Rinsho Shinkeigaku 2023; 63:7-14. [PMID: 36567100 DOI: 10.5692/clinicalneurol.cn-001628] [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: 12/24/2022]
Abstract
We report a case of non-fluent/agrammatic variant of primary progressive aphasia in a 79-year-old right-handed man who was admitted with a 5-year history of non-fluent speech and apraxia of speech. He also presented with agrammatism and logoclonia (the meaningless repetition of the middle or final syllable of a word). Furthermore, brain MRI revealed atrophy of the bilateral frontal and temporal lobes, while N-isopropyl-p-123I-iodoamphetamine single-photon emission computed tomography (SPECT) revealed relative hypoperfusion in the right basal ganglia. In addition, dopamine transporter SPECT revealed a decrease in specific binding ratio values, indicating neural dopamine dysfunction, which led to his diagnosis of progressive non-fluent aphasia with logoclonia. Logoclonia is a severe linguistic dysfunction usually observed in the advanced stages of Alzheimer's disease. However, based on the clinical course and cerebrospinal fluid evaluation results, our patient did not show any features of Alzheimer's disease. Thus, logoclonia might be associated with lesions involving the basal ganglia, right hemisphere, and left frontotemporal lobe.
Collapse
Affiliation(s)
- Rui Shimazaki
- Department of Neurology, Tokyo Metropolitan Neurological Hospital
| | - Yoko Sunami
- Department of Neurology, Tokyo Metropolitan Neurological Hospital
| | - Mitsuaki Bando
- Department of Neurology, Tokyo Metropolitan Neurological Hospital
| | - Akiko Harada
- Department of rehabilitation, Tokyo Metropolitan Neurological Hospital
| | | |
Collapse
|
19
|
Kawles A, Minogue G, Zouridakis A, Keszycki R, Gill N, Nassif C, Coventry C, Zhang H, Rogalski E, Flanagan ME, Castellani R, Bigio EH, Mesulam MM, Geula C, Gefen T. Differential vulnerability of the dentate gyrus to tauopathies in dementias. Acta Neuropathol Commun 2023; 11:1. [PMID: 36597124 PMCID: PMC9811688 DOI: 10.1186/s40478-022-01485-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 01/05/2023] Open
Abstract
The dentate gyrus (DG), a key hippocampal subregion in memory processing, generally resists phosphorylated tau accumulation in the amnestic dementia of the Alzheimer's type due to Alzheimer's disease (DAT-AD), but less is known about the susceptibility of the DG to other tauopathies. Here, we report stereologic densities of total DG neurons and tau inclusions in thirty-two brains of human participants with autopsy-confirmed tauopathies with distinct isoform profiles-3R Pick's disease (PiD, N = 8), 4R corticobasal degeneration (CBD, N = 8), 4R progressive supranuclear palsy (PSP, N = 8), and 3/4R AD (N = 8). All participants were diagnosed during life with primary progressive aphasia (PPA), an aphasic clinical dementia syndrome characterized by progressive deterioration of language abilities with spared non-language cognitive abilities in early stages, except for five patients with DAT-AD as a comparison group. 51% of total participants were female. All specimens were stained immunohistochemically with AT8 to visualize tau pathology, and PPA cases were stained for Nissl substance to visualize neurons. Unbiased stereological analysis was performed in granule and hilar DG cells, and inclusion-to-neuron ratios were calculated. In the PPA group, PiD had highest mean total (granule + hilar) densities of DG tau pathology (p < 0.001), followed by CBD, AD, then PSP. PPA-AD cases showed more inclusions in hilar cells compared to granule cells, while the opposite was true in PiD and CBD. Inclusion-to-neuron ratios revealed, on average, 33% of all DG neurons in PiD cases contained a tau inclusion, compared to ~ 7% in CBD, 2% in AD, and 0.4% in PSP. There was no significant difference between DAT-AD and PPA-AD pathologic tau burden, suggesting that differences in DG burden are not specific to clinical phenotype. We conclude that the DG is differentially vulnerable to pathologic tau accumulation, raising intriguing questions about the structural integrity and functional significance of hippocampal circuits in neurodegenerative dementias.
Collapse
Affiliation(s)
- Allegra Kawles
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Grace Minogue
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
| | - Antonia Zouridakis
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
| | - Rachel Keszycki
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Nathan Gill
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Caren Nassif
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
| | - Christina Coventry
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
| | - Hui Zhang
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Emily Rogalski
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Margaret E. Flanagan
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Rudolph Castellani
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Eileen H. Bigio
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - M. Marsel Mesulam
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Changiz Geula
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
- Department of Cell and Developmental Biology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Tamar Gefen
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, 300 E. Superior Street, Tarry Building, 8th Floor, Chicago, IL 60611 USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| |
Collapse
|
20
|
Tafuri B, Filardi M, Urso D, Gnoni V, De Blasi R, Nigro S, Logroscino G. Asymmetry of radiomics features in the white matter of patients with primary progressive aphasia. Front Aging Neurosci 2023; 15:1120935. [PMID: 37213534 PMCID: PMC10196268 DOI: 10.3389/fnagi.2023.1120935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 04/17/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction Primary Progressive Aphasia (PPA) is a neurological disease characterized by linguistic deficits. Semantic (svPPA) and non-fluent/agrammatic (nfvPPA) variants are the two main clinical subtypes. We applied a novel analytical framework, based on radiomic analysis, to investigate White Matter (WM) asymmetry and to examine whether asymmetry is associated with verbal fluency performance. Methods Analyses were performed on T1-weighted images including 56 patients with PPA (31 svPPA and 25 nfvPPA) and 53 age- and sex-matched controls. Asymmetry Index (AI) was computed for 86 radiomics features in 34 white matter regions. The relationships between AI, verbal fluency performance (semantic and phonemic) and Boston Naming Test score (BNT) were explored through Spearman correlation analysis. Results Relative to controls, WM asymmetry in svPPA patients involved regions adjacent to middle temporal cortex as part of the inferior longitudinal (ILF), fronto-occipital (IFOF) and superior longitudinal fasciculi. Conversely, nfvPPA patients showed an asymmetry of WM in lateral occipital regions (ILF/IFOF). A higher lateralization involving IFOF, cingulum and forceps minor was found in nfvPPA compared to svPPA patients. In nfvPPA patients, semantic fluency was positively correlated to asymmetry in ILF/IFOF tracts. Performances at BNT were associated with AI values of the middle temporal (ILF/SLF) and parahippocampal (ILF/IFOF) gyri in svPPA patients. Discussion Radiomics features depicted distinct pathways of asymmetry in svPPA and nfvPPA involving damage of principal fiber tracts associated with speech and language. Assessing asymmetry of radiomics in PPA allows achieving a deeper insight into the neuroanatomical damage and may represent a candidate severity marker for language impairments in PPA patients.
Collapse
Affiliation(s)
- Benedetta Tafuri
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Lecce, Italy
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy
- *Correspondence: Benedetta Tafuri,
| | - Marco Filardi
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Lecce, Italy
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy
| | - Daniele Urso
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Lecce, Italy
- Department of Neurosciences, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Valentina Gnoni
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Lecce, Italy
- Department of Neurosciences, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- Sleep and Brain Plasticity Centre, CNS, IoPPN, King’s College London, London, United Kingdom
| | - Roberto De Blasi
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Lecce, Italy
- Department of Diagnostic Imaging, Pia Fondazione di Culto e Religione “Card. G. Panico”, Tricase, Italy
| | - Salvatore Nigro
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Lecce, Italy
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Lecce, Italy
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy
| | | |
Collapse
|
21
|
Arezoumandan S, Xie SX, Cousins KAQ, Mechanic-Hamilton DJ, Peterson CS, Huang CY, Ohm DT, Ittyerah R, McMillan CT, Wolk DA, Yushkevich P, Trojanowski JQ, Lee EB, Grossman M, Phillips JS, Irwin DJ. Regional distribution and maturation of tau pathology among phenotypic variants of Alzheimer's disease. Acta Neuropathol 2022; 144:1103-1116. [PMID: 35871112 PMCID: PMC9936795 DOI: 10.1007/s00401-022-02472-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/02/2022] [Accepted: 07/14/2022] [Indexed: 01/26/2023]
Abstract
Alzheimer's disease neuropathologic change (ADNC) is clinically heterogenous and can present with a classic multidomain amnestic syndrome or focal non-amnestic syndromes. Here, we investigated the distribution and burden of phosphorylated and C-terminally cleaved tau pathologies across hippocampal subfields and cortical regions among phenotypic variants of Alzheimer's disease (AD). In this study, autopsy-confirmed patients with ADNC, were classified into amnestic (aAD, N = 40) and non-amnestic (naAD, N = 39) groups based on clinical criteria. We performed digital assessment of tissue sections immunostained for phosphorylated-tau (AT8 detects pretangles and mature tangles), D421-truncated tau (TauC3, a marker for mature tangles and ghost tangles), and E391-truncated tau (MN423, a marker that primarily detects ghost tangles), in hippocampal subfields and three cortical regions. Linear mixed-effect models were used to test regional and group differences while adjusting for demographics. Both groups showed AT8-reactivity across hippocampal subfields that mirrored traditional Braak staging with higher burden of phosphorylated-tau in subregions implicated as affected early in Braak staging. The burden of phosphorylated-tau and TauC3-immunoreactive tau in the hippocampus was largely similar between the aAD and naAD groups. In contrast, the naAD group had lower relative distribution of MN423-reactive tangles in CA1 (β = - 0.2, SE = 0.09, p = 0.001) and CA2 (β = - 0.25, SE = 0.09, p = 0.005) compared to the aAD. While the two groups had similar levels of phosphorylated-tau pathology in cortical regions, there was higher burden of TauC3 reactivity in sup/mid temporal cortex (β = 0.16, SE = 0.07, p = 0.02) and MN423 reactivity in all cortical regions (β = 0.4-0.43, SE = 0.09, p < 0.001) in the naAD compared to aAD. In conclusion, AD clinical variants may have a signature distribution of overall phosphorylated-tau pathology within the hippocampus reflecting traditional Braak staging; however, non-amnestic AD has greater relative mature tangle pathology in the neocortex compared to patients with clinical amnestic AD, where the hippocampus had greatest relative burden of C-terminally cleaved tau reactivity. Thus, varying neuronal susceptibility to tau-mediated neurodegeneration may influence the clinical expression of ADNC.
Collapse
Affiliation(s)
- Sanaz Arezoumandan
- Digital Neuropathology Laboratory, Department of Neurology, Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Penn Frontotemporal Degeneration Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Sharon X Xie
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Katheryn A Q Cousins
- Penn Frontotemporal Degeneration Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Dawn J Mechanic-Hamilton
- Department of Neurology, Penn Memory Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Department of Neurology, Penn Alzheimer's Disease Research Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Claire S Peterson
- Digital Neuropathology Laboratory, Department of Neurology, Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Penn Frontotemporal Degeneration Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Camille Y Huang
- Digital Neuropathology Laboratory, Department of Neurology, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Daniel T Ohm
- Digital Neuropathology Laboratory, Department of Neurology, Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Penn Frontotemporal Degeneration Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Ranjit Ittyerah
- Penn Image Computing and Science Lab, Department of Radiology, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Corey T McMillan
- Penn Frontotemporal Degeneration Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Department of Neurology, Penn Alzheimer's Disease Research Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - David A Wolk
- Department of Neurology, Penn Memory Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Department of Neurology, Penn Alzheimer's Disease Research Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Paul Yushkevich
- Department of Neurology, Penn Alzheimer's Disease Research Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Penn Image Computing and Science Lab, Department of Radiology, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - John Q Trojanowski
- Department of Neurology, Penn Alzheimer's Disease Research Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Edward B Lee
- Department of Neurology, Penn Alzheimer's Disease Research Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Translational Neuropathology Research Laboratory, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Jeffrey S Phillips
- Penn Frontotemporal Degeneration Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - David J Irwin
- Digital Neuropathology Laboratory, Department of Neurology, Perelman School of Medicine, Philadelphia, PA, 19104, USA.
- Penn Frontotemporal Degeneration Center, Perelman School of Medicine, Philadelphia, PA, 19104, USA.
| |
Collapse
|
22
|
Momota Y, Konishi M, Takahata K, Kishimoto T, Tezuka T, Bun S, Tabuchi H, Ito D, Mimura M. Case report: Non-Alzheimer's disease tauopathy with logopenic variant primary progressive aphasia diagnosed using amyloid and tau PET. Front Neurol 2022; 13:1049113. [DOI: 10.3389/fneur.2022.1049113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022] Open
Abstract
We report a patient with logopenic variant primary progressive aphasia (lv-PPA) who was diagnosed as having non-Alzheimer's disease (AD) tauopathy after multiple biophysical/biological examinations, including amyloid and 18F-florzolotau tau positron emission tomography (PET), had been performed. A woman in her late 60s who had previously been diagnosed as having AD was referred to us for a further, detailed examination. She had been unaware of any symptoms at the time of AD diagnosis, but she subsequently became gradually aware of a speech impairment. She talked nearly completely and fluently, although she occasionally exhibited word-finding difficulty and made phonological errors during naming, word fluency testing, and sentence repetition; these findings met the criteria for the diagnosis of lv-PPA, which is known to be observed more commonly in AD than in other proteinopathies. Magnetic resonance imaging, single photon emission computed tomography, and plasma phosphorylated tau and plasma neurofilament light chain measurements showed an AD-like pattern. However, both 11C-Pittsburgh compound-B and 18F-florbetaben amyloid PET showed negative results, whereas 18F-florzolotau tau PET yielded positive results, with radio signals predominantly in the left superior temporal gyrus, middle temporal gyrus, supramarginal gyrus, and frontal operculum. Whole-genome sequencing revealed no known dominantly inherited mutations in AD or frontotemporal lobar degeneration genes, including the genes encoding amyloid precursor protein, microtubule-associated protein tau, presenilin 1 and 2. To the best of our knowledge, this patient was a rare case of lv-PPA who was diagnosed as having non-AD tauopathy based on the results of multiple examinations, including whole-genome sequencing, plasma measurement, and amyloid and 18F-florzolotau tau PET. This case underscores the clinicopathologically heterogeneous nature of this syndrome.
Collapse
|
23
|
Kannappan B, te Nijenhuis J, Choi YY, Lee JJ, Choi KY, Balzekas I, Jung HY, Choe Y, Song MK, Chung JY, Ha JM, Choi SM, Kim H, Kim BC, Jo HJ, Lee KH. Can hippocampal subfield measures supply information that could be used to improve the diagnosis of Alzheimer's disease? PLoS One 2022; 17:e0275233. [PMID: 36327265 PMCID: PMC9632892 DOI: 10.1371/journal.pone.0275233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 09/12/2022] [Indexed: 11/05/2022] Open
Abstract
The diagnosis of Alzheimer's disease (AD) needs to be improved. We investigated if hippocampal subfield volume measured by structural imaging, could supply information, so that the diagnosis of AD could be improved. In this study, subjects were classified based on clinical, neuropsychological, and amyloid positivity or negativity using PET scans. Data from 478 elderly Korean subjects grouped as cognitively unimpaired β-amyloid-negative (NC), cognitively unimpaired β-amyloid-positive (aAD), mild cognitively impaired β-amyloid-positive (pAD), mild cognitively impaired-specific variations not due to dementia β-amyloid-negative (CIND), severe cognitive impairment β-amyloid-positive (ADD+) and severe cognitive impairment β-amyloid-negative (ADD-) were used. NC and aAD groups did not show significant volume differences in any subfields. The CIND did not show significant volume differences when compared with either the NC or the aAD (except L-HATA). However, pAD showed significant volume differences in Sub, PrS, ML, Tail, GCMLDG, CA1, CA4, HATA, and CA3 when compared with the NC and aAD. The pAD group also showed significant differences in the hippocampal tail, CA1, CA4, molecular layer, granule cells/molecular layer/dentate gyrus, and CA3 when compared with the CIND group. The ADD- group had significantly larger volumes than the ADD+ group in the bilateral tail, SUB, PrS, and left ML. The results suggest that early amyloid depositions in cognitive normal stages are not accompanied by significant bilateral subfield volume atrophy. There might be intense and accelerated subfield volume atrophy in the later stages associated with the cognitive impairment in the pAD stage, which subsequently could drive the progression to AD dementia. Early subfield volume atrophy associated with the β-amyloid burden may be characterized by more symmetrical atrophy in CA regions than in other subfields. We conclude that the hippocampal subfield volumetric differences from structural imaging show promise for improving the diagnosis of Alzheimer's disease.
Collapse
Affiliation(s)
- Balaji Kannappan
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
| | - Jan te Nijenhuis
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
| | - Yu Yong Choi
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
| | - Jang Jae Lee
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
| | - Kyu Yeong Choi
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
| | - Irena Balzekas
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Ho Yub Jung
- Department of Computer Engineering, Chosun University, Gwangju, South Korea
| | | | - Min Kyung Song
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Ji Yeon Chung
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Neurology, Chosun University Hospital, Gwangju, South Korea
| | - Jung-Min Ha
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Nuclear Medicine, Chosun University Hospital, Gwangju, South Korea
| | - Seong-Min Choi
- Department of Neurology, Chonnam National University Medical School, Gwangju, South Korea
| | - Hoowon Kim
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Neurology, Chosun University Hospital, Gwangju, South Korea
| | - Byeong C. Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, South Korea
| | - Hang Joon Jo
- Department of Physiology, College of Medicine, Hanyang University, Seoul, South Korea
| | - Kun Ho Lee
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
- Korea Brain Research Institute, Daegu, South Korea
| |
Collapse
|
24
|
Dunlop SR, Ayala I, Spencer C, Flanagan ME, Mesulam MM, Gefen T, Geula C. Resistance of Basal Forebrain Cholinergic Neurons to TDP-43 Proteinopathy in Primary Progressive Aphasia. J Neuropathol Exp Neurol 2022; 81:910-919. [PMID: 36111818 PMCID: PMC9582786 DOI: 10.1093/jnen/nlac079] [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] [Indexed: 11/14/2022] Open
Abstract
Basal forebrain cholinergic neurons (BFCN) display accumulation of neurofibrillary tangles and degeneration in Alzheimer disease and are targets of therapeutic intervention. This study determined vulnerability of BFCN to accumulation of TDP-43 in primary progressive aphasia with TDP-43 proteinopathy (PPA-TDP). Brains from 16 PPA participants with pathologically confirmed TDP-43 proteinopathy, with available paraffin-embedded sections (Group 1), or systematically sampled frozen sections (Group 2), were studied. Immunohistochemistry was performed with an antibody against phosphorylated TDP-43. BFCN were identified by their magnocellular appearance in Nissl preparations. Presence of TDP-43 inclusions and preinclusions in BFCN was determined and quantitative analysis was performed in Group 2. In Group 1, BFCN were completely free of inclusions except for occasional dystrophic neurites. Sparse TDP-43 preinclusions with smooth or granular staining in BFCN were detected. In Group 2, extremely rare TDP-43 intranuclear inclusions were detected in 0.1% of BFCN per section, along with occasional dystrophic neurites. Although sparse, significantly more preinclusions (1.4% of BFCN) were present when compared with inclusions. No hemispheric differences were noted. Small neurons near BFCN contained more preinclusions compared with BFCN. Thus, BFCN in PPA-TDP are resistant to TDP-43 proteinopathy and degeneration, suggesting that cholinergic therapy is unlikely to be effective in this disorder.
Collapse
Affiliation(s)
- Sara Rose Dunlop
- From the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ivan Ayala
- From the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Callen Spencer
- From the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Margaret E Flanagan
- From the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Marek-Marsel Mesulam
- From the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tamar Gefen
- From the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Changiz Geula
- From the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
25
|
Potagas C, Nikitopoulou Z, Angelopoulou G, Kasselimis D, Laskaris N, Kourtidou E, Constantinides VC, Bougea A, Paraskevas GP, Papageorgiou G, Tsolakopoulos D, Papageorgiou SG, Kapaki E. Silent Pauses and Speech Indices as Biomarkers for Primary Progressive Aphasia. Medicina (B Aires) 2022; 58:medicina58101352. [PMID: 36295513 PMCID: PMC9611099 DOI: 10.3390/medicina58101352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 12/30/2022] Open
Abstract
Background and Objectives: Recent studies highlight the importance of investigating biomarkers for diagnosing and classifying patients with primary progressive aphasia (PPA). Even though there is ongoing research on pathophysiological indices in this field, the use of behavioral variables, and especially speech-derived factors, has drawn little attention in the relevant literature. The present study aims to investigate the possible utility of speech-derived indices, particularly silent pauses, as biomarkers for primary progressive aphasia (PPA). Materials and Methods: We recruited 22 PPA patients and 17 healthy controls, from whom we obtained speech samples based on two elicitation tasks, i.e., cookie theft picture description (CTP) and the patients’ personal narration of the disease onset and course. Results: Four main indices were derived from these speech samples: speech rate, articulation rate, pause frequency, and pause duration. In order to investigate whether these indices could be used to discriminate between the four groups of participants (healthy individuals and the three patient subgroups corresponding to the three variants of PPA), we conducted three sets of analyses: a series of ANOVAs, two principal component analyses (PCAs), and two hierarchical cluster analyses (HCAs). The ANOVAs revealed significant differences between the four subgroups for all four variables, with the CTP results being more robust. The subsequent PCAs and HCAs were in accordance with the initial statistical comparisons, revealing that the speech-derived indices for CTP provided a clearer classification and were especially useful for distinguishing the non-fluent variant from healthy participants as well as from the two other PPA taxonomic categories. Conclusions: In sum, we argue that speech-derived indices, and especially silent pauses, could be used as complementary biomarkers to efficiently discriminate between PPA and healthy speakers, as well as between the three variants of the disease.
Collapse
Affiliation(s)
- Constantin Potagas
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Correspondence:
| | - Zoi Nikitopoulou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Georgia Angelopoulou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Department of Speech and Language Therapy, School of Health Sciences, University of Peloponnese, 241 00 Kalamata, Greece
| | - Dimitrios Kasselimis
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Department of Psychology, Panteion University of Social and Political Sciences, 176 71 Athens, Greece
| | - Nikolaos Laskaris
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Department of Industrial Design and Production Engineering, School of Engineering, University of West Attica, 122 43 Athens, Greece
| | - Evie Kourtidou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Vasilios C. Constantinides
- 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Anastasia Bougea
- 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - George P. Paraskevas
- 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 115 28 Athens, Greece
| | - Georgios Papageorgiou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Dimitrios Tsolakopoulos
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Sokratis G. Papageorgiou
- 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| |
Collapse
|
26
|
Comorbid Neurodegeneration in Primary Progressive Aphasia: Clinicopathological Correlations in a Single-Center Study. Behav Neurol 2022; 2022:6075511. [PMID: 36120397 PMCID: PMC9477586 DOI: 10.1155/2022/6075511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 08/05/2022] [Accepted: 08/10/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction. Primary progressive aphasia (PPA) is a clinically variable syndrome manifesting as slow progressive loss of speech and language with multiple underlying neurodegenerative pathologies. Materials and Methods. We included data from nine PPA patients with available autopsies. We then retrospectively reviewed all available medical records, neuropsychology, and MRI results to confirm the corresponding subtypes of PPA and compared them with postmortem neuropathological results. Results. Clinical presentations corresponded to the nonfluent/agrammatic variant in six cases, the semantic variant in one case, the logopenic variant in one case, and the mixed variant (concomitant nonfluent/agrammatic plus semantic variant) in one case. Patients with a broader clinical presentation, i.e., combining manifestations of one PPA subtype and symptoms of another PPA variant, had autopsy comorbidities showing multiple neurodegenerative disorders. Of the nine subjects enrolled in the study, Alzheimer’s disease (AD) was found in eight cases; however, in only one case, AD was detected as an isolated neuropathological substrate of PPA. In eight brain samples, different comorbid neuropathologies were detected: three cases with comorbid AD and dementia with Lewy bodies, two cases with comorbid AD and TDP-43 pathology, one case with comorbid AD and complex tauopathies, and one case with comorbid AD with both tau and TDP-43 deposits. Finally, one case had comorbid tau and TDP-43 pathology but without comorbid AD pathology. Conclusions. Our observation suggests that PPA cases could be more heterogeneous in their etiology than previously thought and underlying neurodegenerative comorbidities should be considered in routine practice, especially if the clinical presentation of PPA is atypical.
Collapse
|
27
|
Karpouzian-Rogers T, Hurley R, Seckin M, Moeller S, Gill N, Zhang H, Coventry C, Nelson M, Weintraub S, Rogalski E, Marsel Mesulam M. Eye movements as a measure of word comprehension deficits in primary progressive aphasia. BRAIN AND LANGUAGE 2022; 232:105165. [PMID: 35908339 PMCID: PMC9428830 DOI: 10.1016/j.bandl.2022.105165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 03/11/2022] [Accepted: 07/24/2022] [Indexed: 05/09/2023]
Abstract
INTRODUCTION Eye movement studies can uncover subtle aspects of language processing impairment in individuals with primary progressive aphasia (PPA), who may have difficulty understanding words. This study examined eye movement patterns on a word-object matching task in response to varying levels of word-knowledge in PPA. METHODS Participants with semantic and non-semantic PPA completed an object-matching task, where a word was presented and participants then selected the corresponding pictured object from an array. Afterwards, participants defined words for trials to which they incorrectly pointed. Linear mixed-effects analyses examined fixation differences on targets and related and unrelated foils. RESULTS On incorrectly-pointed trials, participants demonstrated greater fixation duration on related foils, demonstrating intra-category blurring. For words that could not be defined, there was similar fixation duration on related and unrelated foils, demonstrating inter-category semantic blurring. DISCUSSION This study demonstrated that fixation patterns reflect varying levels of word knowledge in PPA.
Collapse
Affiliation(s)
- Tatiana Karpouzian-Rogers
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Rob Hurley
- Department of Psychology, Cleveland State University Cleveland, OH, USA
| | - Mustafa Seckin
- Department of Neurology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Stacey Moeller
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Nathan Gill
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Division of Biostatistics, Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hui Zhang
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Division of Biostatistics, Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christina Coventry
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Matthew Nelson
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - M Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
28
|
Therriault J, Pascoal TA, Savard M, Mathotaarachchi S, Benedet AL, Chamoun M, Tissot C, Lussier FZ, Rahmouni N, Stevenson J, Qureshi MNI, Kang MS, Thomas É, Vitali P, Soucy JP, Massarweh G, Saha-Chaudhuri P, Gauthier S, Rosa-Neto P. Intrinsic connectivity of the human brain provides scaffold for tau aggregation in clinical variants of Alzheimer's disease. Sci Transl Med 2022; 14:eabc8693. [PMID: 36001678 DOI: 10.1126/scitranslmed.abc8693] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Alzheimer's disease (AD) phenotypes might result from differences in selective vulnerability. Evidence from preclinical models suggests that tau pathology has cell-to-cell propagation properties. Therefore, here, we tested the cell-to-cell propagation framework in the amnestic, visuospatial, language, and behavioral/dysexecutive phenotypes of AD. We report that each AD phenotype is associated with a distinct network-specific pattern of tau aggregation, where tau aggregation is concentrated in brain network hubs. In all AD phenotypes, regional tau load could be predicted by connectivity patterns of the human brain. Furthermore, regions with greater connectivity displayed similar rates of longitudinal tau accumulation in an independent cohort. Connectivity-based tau deposition was not restricted to a specific vulnerable network but was rather a general property of brain organization, linking selective vulnerability and transneuronal spreading models of neurodegeneration. Together, this study indicates that intrinsic brain connectivity provides a framework for tau aggregation across diverse phenotypic manifestations of AD.
Collapse
Affiliation(s)
- Joseph Therriault
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada.,Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Tharick A Pascoal
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada.,Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Mélissa Savard
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada
| | - Sulantha Mathotaarachchi
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada
| | - Andréa L Benedet
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada.,Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Mira Chamoun
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada
| | - Cécile Tissot
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada.,Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Firoza Z Lussier
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada.,Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Nesrine Rahmouni
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada.,Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Jenna Stevenson
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada.,Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Muhammad Naveed Iqbal Qureshi
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada.,Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Min Su Kang
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada.,Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Émilie Thomas
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada
| | - Paolo Vitali
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada
| | - Jean-Paul Soucy
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada.,Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Gassan Massarweh
- Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada.,Department of Radiochemistry, McGill University, Montreal, Quebec H3A 2B4, Canada
| | | | - Serge Gauthier
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec H3A 1G1, Canada
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada.,Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec H3A 1G1, Canada
| |
Collapse
|
29
|
Singh NA, Graff-Radford J, Machulda MM, Schwarz CG, Baker MC, Rademakers R, Ertekin-Taner N, Lowe VJ, Josephs KA, Whitwell JL. Atypical Alzheimer's disease phenotypes with normal or borderline PET biomarker profiles. J Neurol 2022; 269:6613-6626. [PMID: 36001141 DOI: 10.1007/s00415-022-11330-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/05/2022] [Accepted: 08/07/2022] [Indexed: 01/01/2023]
Abstract
Posterior cortical atrophy (PCA) and logopenic progressive aphasia (LPA) are clinical syndromes that commonly have underlying Alzheimer's disease (AD), although non-AD pathologies have also been reported. PET imaging allows for identification of beta-amyloid (Aβ) and tau in AD, so we aimed to assess these in a large cohort to identify patients that do not have evidence for biomarker-defined AD. Eight-one patients, 47 PCA and 34 LPA, underwent extensive neurological and neuropsychological testing, [11C] Pittsburgh compound B, [18F] flortaucipir and [18F] fluorodeoxyglucose PETs. Global Aβ and tau-PET standardized uptake value ratios (SUVRs) were plotted for all patients and outliers, and patients with abnormally low SUVRs compared to the biomarker-classic cohort were identified. Six (7.4%) biomarker-outlier cases were identified, and three patterns were observed: (i) negative/borderline Aβ-PET and striking widespread tau-PET uptake (two LPA); (ii) negative/borderline Aβ-PET and low tau-PET uptake (three PCA) and (iii) elevated Aβ-PET uptake but mild focal tau-PET uptake (one LPA). Among the unusual patients in group ii, two patients showed no abnormal tau uptake suggesting non-AD pathology, with one developing features of cortico-basal syndrome and the other dementia with Lewy bodies. The remaining patient showed very mild focal tau uptake. This study demonstrates that a small minority (~ 8%) of PCA and LPA patients do not show the typical striking patterns of Aβ and tau PET uptake, with only 2% showing absence of both proteins. These findings will help inform the use of molecular PET in clinical treatment trials that include patients with atypical phenotypes of AD.
Collapse
Affiliation(s)
| | | | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Matthew C Baker
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | | | - Jennifer L Whitwell
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.
| |
Collapse
|
30
|
Focal amyloid and asymmetric tau in an imaging-to-autopsy case of clinical primary progressive aphasia with Alzheimer disease neuropathology. Acta Neuropathol Commun 2022; 10:111. [PMID: 35945628 PMCID: PMC9361632 DOI: 10.1186/s40478-022-01412-w] [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: 05/24/2022] [Accepted: 07/17/2022] [Indexed: 01/21/2023] Open
Abstract
Quantification of in vivo amyloid and tau PET imaging relationships with postmortem measurements are critical for validating the sensitivity and specificity imaging biomarkers across clinical phenotypes with Alzheimer disease neuropathologic change (ADNC). This study examined the quantitative relationship between regional binding of in vivo 18F-florbetapir amyloid PET and 18F-flortaucipir tau PET with postmortem stereological counts of amyloid plaques and neurofibrillary tangles (NFT) in a case of primary progressive aphasia (PPA) with ADNC, where neurodegeneration asymmetrically targets the left hemisphere. Beginning 2 years prior to death, a 63-year-old right-handed man presenting with agrammatic variant PPA underwent a florbetapir and flortaucpir PET scan, and neuropsychological assessments and magnetic resonance imaging sessions every 6 months. Florbetapir and flortaucpir PET standard uptake value ratios (SUVRs) were quantified from 8 left and right hemisphere brain regions with stereological quantification of amyloid plaques and NFTs from corresponding postmortem sections. Pearson's correlations and measures of asymmetry were used to examine relationships between imaging and autopsy measurements. The three visits prior to death revealed decline of language measures, with marked progression of atrophy. Florbetapir PET presented with an atypical focal pattern of uptake and showed a significant positive correlation with postmortem amyloid plaque density across the 8 regions (r = 0.92; p = 0.001). Flortaucipir PET had a left-lateralized distribution and showed a significant positive correlation with NFT density (r = 0.78; p = 0.023). Flortaucipir PET and NFT density indicated a medial temporal lobe sparing presentation of ADNC, demonstrating that AD does not always target the medial temporal lobe. This study adds additional evidence, in a non-amnestic phenotype of ADNC, that there is a strong correlation between AD PET biomarkers, florbetapir and flortaucipir, with quantitative neuropathology. The atypical and focal presentation of plaque density and florbetapir PET uptake suggests not all amyloid pathology presents as diffuse across neocortex.
Collapse
|
31
|
Dong L, Wang J, Liu C, Li J, Mao C, Huang X, Chu S, Peng B, Cui L, Gao J. Genetic Spectrum and Clinical Heterogeneity of Chinese Frontotemporal Dementia Patients: Data from PUMCH Dementia Cohort. J Alzheimers Dis 2022; 89:893-901. [PMID: 35964197 PMCID: PMC9535560 DOI: 10.3233/jad-220594] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: There are relatively few data on the genetic spectrum of Chinese frontotemporal dementia (FTD) population. Objective: With the dementia cohort of Peking Union Medical College Hospital, we aim to illustrate the genetic spectrum of FTD patients, as well as the phenotypic heterogeneity of FTD-gene variant carriers. Methods: 204 unrelated, clinically diagnosed FTD patients of Chinese ancestry were enrolled. All the participants received demographic survey, history inquiry, physical examination, cognitive assessment, blood biochemical test, brain CT/MRI, and gene sequencing. Results: 56.4% (115/204) participants were clinically diagnosed with behavioral variant of FTD, 20.6% (42/204) with nonfluent/agrammatic variant primary progressive aphasia (PPA), 20.1% (41/204) with semantic variant PPA, and 2.9% (6/204) with mixed variant PPA. 11.8% (24/204) subjects harbored the potential causative variants in FTD-related genes, including the MAPT (n = 7), TBK1 (n = 7), GRN (n = 2), TBK1+GRN (n = 1), VCP (n = 1), TARDBP (n = 1), UBQLN2 (n = 1), SQSTM1 (n = 1), DCTN1 (n = 1), HNRNPA1 (n = 1), and C9orf72 GGGGCC repeats (n = 1). The TBK1 T31fs, T457fs, K622fs, c.359-1G>A, the VCP P188T, and the GRN P50fs, P439fs were novel pathogenic/likely pathogenic variants. The TBK1 carriers showed a later disease onset and a higher incidence of parietal atrophy relative to the MAPTcarriers. Conclusion: There is genetic and clinical heterogeneity among Chinese FTD population. The TBK1 has a high mutation frequency in Chinese FTD patients.
Collapse
Affiliation(s)
- Liling Dong
- Neurology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Wang
- Neurology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Caiyan Liu
- Neurology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Li
- Neurology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chenhui Mao
- Neurology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinying Huang
- Neurology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shanshan Chu
- Neurology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bin Peng
- Neurology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liying Cui
- Neurology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Gao
- Neurology Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
32
|
Thurin K, Patel V, Perez DL, Dickerson BC, Hochberg D, Quimby M, Miller MB, Feany M, Silbersweig D, McGinnis SM, Daffner KR, Gale SA. Case Study 2: A 60-Year-Old Man With Progressive Deficits in Language Output. J Neuropsychiatry Clin Neurosci 2022; 34:196-203. [PMID: 35921620 DOI: 10.1176/appi.neuropsych.22010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kristina Thurin
- Department of Psychiatry and Department of Neurology, Center for Cognitive and Memory Disorders, Ohio State University Wexner Medical Center, Columbus, Ohio (Thurin); Departments of Psychiatry (Thurin, Silbersweig) and Neurology (Thurin, McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Pathology, Division of Neuropathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Departments of Neurology and Psychiatry, Divisions of Behavioral Neurology and Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School (Perez); Departments of Neurology and Psychiatry, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School (Dickerson, Hochberg, Quimby)
| | - Viharkumar Patel
- Department of Psychiatry and Department of Neurology, Center for Cognitive and Memory Disorders, Ohio State University Wexner Medical Center, Columbus, Ohio (Thurin); Departments of Psychiatry (Thurin, Silbersweig) and Neurology (Thurin, McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Pathology, Division of Neuropathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Departments of Neurology and Psychiatry, Divisions of Behavioral Neurology and Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School (Perez); Departments of Neurology and Psychiatry, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School (Dickerson, Hochberg, Quimby)
| | - David L Perez
- Department of Psychiatry and Department of Neurology, Center for Cognitive and Memory Disorders, Ohio State University Wexner Medical Center, Columbus, Ohio (Thurin); Departments of Psychiatry (Thurin, Silbersweig) and Neurology (Thurin, McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Pathology, Division of Neuropathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Departments of Neurology and Psychiatry, Divisions of Behavioral Neurology and Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School (Perez); Departments of Neurology and Psychiatry, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School (Dickerson, Hochberg, Quimby)
| | - Bradford C Dickerson
- Department of Psychiatry and Department of Neurology, Center for Cognitive and Memory Disorders, Ohio State University Wexner Medical Center, Columbus, Ohio (Thurin); Departments of Psychiatry (Thurin, Silbersweig) and Neurology (Thurin, McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Pathology, Division of Neuropathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Departments of Neurology and Psychiatry, Divisions of Behavioral Neurology and Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School (Perez); Departments of Neurology and Psychiatry, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School (Dickerson, Hochberg, Quimby)
| | - Daisy Hochberg
- Department of Psychiatry and Department of Neurology, Center for Cognitive and Memory Disorders, Ohio State University Wexner Medical Center, Columbus, Ohio (Thurin); Departments of Psychiatry (Thurin, Silbersweig) and Neurology (Thurin, McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Pathology, Division of Neuropathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Departments of Neurology and Psychiatry, Divisions of Behavioral Neurology and Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School (Perez); Departments of Neurology and Psychiatry, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School (Dickerson, Hochberg, Quimby)
| | - Megan Quimby
- Department of Psychiatry and Department of Neurology, Center for Cognitive and Memory Disorders, Ohio State University Wexner Medical Center, Columbus, Ohio (Thurin); Departments of Psychiatry (Thurin, Silbersweig) and Neurology (Thurin, McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Pathology, Division of Neuropathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Departments of Neurology and Psychiatry, Divisions of Behavioral Neurology and Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School (Perez); Departments of Neurology and Psychiatry, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School (Dickerson, Hochberg, Quimby)
| | - Michael B Miller
- Department of Psychiatry and Department of Neurology, Center for Cognitive and Memory Disorders, Ohio State University Wexner Medical Center, Columbus, Ohio (Thurin); Departments of Psychiatry (Thurin, Silbersweig) and Neurology (Thurin, McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Pathology, Division of Neuropathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Departments of Neurology and Psychiatry, Divisions of Behavioral Neurology and Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School (Perez); Departments of Neurology and Psychiatry, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School (Dickerson, Hochberg, Quimby)
| | - Mel Feany
- Department of Psychiatry and Department of Neurology, Center for Cognitive and Memory Disorders, Ohio State University Wexner Medical Center, Columbus, Ohio (Thurin); Departments of Psychiatry (Thurin, Silbersweig) and Neurology (Thurin, McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Pathology, Division of Neuropathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Departments of Neurology and Psychiatry, Divisions of Behavioral Neurology and Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School (Perez); Departments of Neurology and Psychiatry, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School (Dickerson, Hochberg, Quimby)
| | - David Silbersweig
- Department of Psychiatry and Department of Neurology, Center for Cognitive and Memory Disorders, Ohio State University Wexner Medical Center, Columbus, Ohio (Thurin); Departments of Psychiatry (Thurin, Silbersweig) and Neurology (Thurin, McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Pathology, Division of Neuropathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Departments of Neurology and Psychiatry, Divisions of Behavioral Neurology and Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School (Perez); Departments of Neurology and Psychiatry, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School (Dickerson, Hochberg, Quimby)
| | - Scott M McGinnis
- Department of Psychiatry and Department of Neurology, Center for Cognitive and Memory Disorders, Ohio State University Wexner Medical Center, Columbus, Ohio (Thurin); Departments of Psychiatry (Thurin, Silbersweig) and Neurology (Thurin, McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Pathology, Division of Neuropathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Departments of Neurology and Psychiatry, Divisions of Behavioral Neurology and Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School (Perez); Departments of Neurology and Psychiatry, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School (Dickerson, Hochberg, Quimby)
| | - Kirk R Daffner
- Department of Psychiatry and Department of Neurology, Center for Cognitive and Memory Disorders, Ohio State University Wexner Medical Center, Columbus, Ohio (Thurin); Departments of Psychiatry (Thurin, Silbersweig) and Neurology (Thurin, McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Pathology, Division of Neuropathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Departments of Neurology and Psychiatry, Divisions of Behavioral Neurology and Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School (Perez); Departments of Neurology and Psychiatry, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School (Dickerson, Hochberg, Quimby)
| | - Seth A Gale
- Department of Psychiatry and Department of Neurology, Center for Cognitive and Memory Disorders, Ohio State University Wexner Medical Center, Columbus, Ohio (Thurin); Departments of Psychiatry (Thurin, Silbersweig) and Neurology (Thurin, McGinnis, Daffner, Gale), Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston; Department of Pathology, Division of Neuropathology, Brigham and Women's Hospital, Harvard Medical School (Patel, Miller, Feany); Departments of Neurology and Psychiatry, Divisions of Behavioral Neurology and Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School (Perez); Departments of Neurology and Psychiatry, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School (Dickerson, Hochberg, Quimby)
| |
Collapse
|
33
|
Serpente M, Ghezzi L, Fenoglio C, Buccellato FR, Fumagalli GG, Rotondo E, Arcaro M, Arighi A, Galimberti D. miRNA Expression Is Increased in Serum from Patients with Semantic Variant Primary Progressive Aphasia. Int J Mol Sci 2022; 23:ijms23158487. [PMID: 35955622 PMCID: PMC9368911 DOI: 10.3390/ijms23158487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 02/04/2023] Open
Abstract
Primary progressive aphasia (PPA) damages the parts of the brain that control speech and language. There are three clinical PPA variants: nonfluent/agrammatic (nfvPPA), logopenic (lvPPA) and semantic (svPPA). The pathophysiology underlying PPA variants is not fully understood, including the role of micro (mi)RNAs which were previously shown to play a role in several neurodegenerative diseases. Using a two-step analysis (array and validation through real-time PCR), we investigated the miRNA expression pattern in serum from 54 PPA patients and 18 controls. In the svPPA cohort, we observed a generalized upregulation of miRNAs with miR-106b-5p and miR-133a-3p reaching statistical significance (miR-106b-5p: 2.69 ± 0.89 mean ± SD vs. 1.18 ± 0.28, p < 0.0001; miR-133a-3p: 2.09 ± 0.10 vs. 0.74 ± 0.11 mean ± SD, p = 0.0002). Conversely, in lvPPA, the majority of miRNAs were downregulated. GO enrichment and KEGG pathway analyses revealed that target genes of both miRNAs are involved in pathways potentially relevant for the pathogenesis of neurodegenerative diseases. This is the first study that investigates the expression profile of circulating miRNAs in PPA variant patients. We identified a specific miRNA expression profile in svPPA that could differentiate this pathological condition from other PPA variants. Nevertheless, these preliminary results need to be confirmed in a larger independent cohort.
Collapse
Affiliation(s)
- Maria Serpente
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.R.B.); (G.G.F.); (E.R.); (M.A.); (A.A.); (D.G.)
- Correspondence: ; Tel.: +39-02-55033858; Fax: +39-02-550336580
| | - Laura Ghezzi
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Chiara Fenoglio
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, University of Milan, 20122 Milan, Italy;
| | - Francesca R. Buccellato
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.R.B.); (G.G.F.); (E.R.); (M.A.); (A.A.); (D.G.)
- Department of Biomedical, Surgical and Dental Sciences, Dino Ferrari Center, University of Milan, 20122 Milan, Italy
| | - Giorgio G. Fumagalli
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.R.B.); (G.G.F.); (E.R.); (M.A.); (A.A.); (D.G.)
| | - Emanuela Rotondo
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.R.B.); (G.G.F.); (E.R.); (M.A.); (A.A.); (D.G.)
| | - Marina Arcaro
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.R.B.); (G.G.F.); (E.R.); (M.A.); (A.A.); (D.G.)
| | - Andrea Arighi
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.R.B.); (G.G.F.); (E.R.); (M.A.); (A.A.); (D.G.)
| | - Daniela Galimberti
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.R.B.); (G.G.F.); (E.R.); (M.A.); (A.A.); (D.G.)
- Department of Biomedical, Surgical and Dental Sciences, Dino Ferrari Center, University of Milan, 20122 Milan, Italy
| |
Collapse
|
34
|
Heywood A, Stocks J, Schneider JA, Arfanakis K, Bennett DA, Beg MF, Wang L. The unique effect of TDP-43 on hippocampal subfield morphometry and cognition. Neuroimage Clin 2022; 35:103125. [PMID: 36002965 PMCID: PMC9421500 DOI: 10.1016/j.nicl.2022.103125] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 01/18/2023]
Abstract
•We explored postmortem TDP-43 burden and antemortem hippocampal surface deformation. •TDP-43 was uniquely associated with inward deformation in the hippocampus. •Deformation patterns account for co-existing disease showing TDP-43′s unique effect. •Deformation was significantly correlated with cognition scores.
Collapse
Affiliation(s)
- Ashley Heywood
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Jane Stocks
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | | | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
35
|
Huang J, Cao Y, Zhang D, Lei X, Chang J. Research trends of the neuroimaging in aphasia: A bibliometric analysis and visualization analysis from 2004 to 2021. Front Hum Neurosci 2022; 16:945160. [PMID: 35911602 PMCID: PMC9334888 DOI: 10.3389/fnhum.2022.945160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives To review the current research status of the neuroimaging of aphasia, and reveal the hotspots and frontiers of research in this field. Methods We searched articles related to the neuroimaging research on aphasia since Web of Science (WOS) database construction and extracted the data. CiteSpace and VOSviewer were used for the country/institution analysis, journal analysis, discipline analysis, burst keyword analysis and cited-reference cluster analysis. Results Of the studies retrieved from WOS, 2922 studies that related to the neuroimaging of aphasia were screened and finally included 2799 articles for research. The United States of America and University of California San Francisco were the main countries and institutions in this field. Brain had the highest impact factor in both published and cited journals. Through the discipline and topic analysis of this field, the most common category was Neurosciences and Neurology. The keyword with the strongest citation strength was “functional connectivity,” and the recent burst keywords were “functional connectivity” and “network.” The co-citation network showed seven clusters greater than 100. Among the top 5 clusters, the most recently formed cluster, Cluster #2 (progressive supranuclear palsy), had an average year of 2017. The literature in the top 5 clusters mainly focused on 3 aspects, specifically, the discovery of language processing models, injury and recovery mechanisms of post-stroke aphasia (PSA), and diagnosis of primary progressive aphasia (PPA) variants. Conclusion The results of this bibliometric study revealed the following three research hotspots in the neuroimaging of aphasia: clarifying the connotation of the most recognized language processing model, the dual-stream model, exploring the injury mechanism based on the dual-stream model and the recovery mechanism involving the left and right hemispheres of PSA, and determining the diagnostic criteria for PPA variants. A major research trend is to combine new neuroimaging technology, such as PET tracer technology, to realize the visual presentation of disease-specific proteins to improve the pathological diagnostic criteria of PPA variants. Accordingly, a visualized analysis of literature that uses CiteSpace provides a more rapid, repeatable and flexible method, which is more conducive to capturing research hotspots and emerging trends.
Collapse
|
36
|
Nissim NR, Harvey DY, Haslam C, Friedman L, Bharne P, Litz G, Phillips JS, Cousins KAQ, Xie SX, Grossman M, Hamilton RH. Through Thick and Thin: Baseline Cortical Volume and Thickness Predict Performance and Response to Transcranial Direct Current Stimulation in Primary Progressive Aphasia. Front Hum Neurosci 2022; 16:907425. [PMID: 35874157 PMCID: PMC9302040 DOI: 10.3389/fnhum.2022.907425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives We hypothesized that measures of cortical thickness and volume in language areas would correlate with response to treatment with high-definition transcranial direct current stimulation (HD-tDCS) in persons with primary progressive aphasia (PPA). Materials and Methods In a blinded, within-group crossover study, PPA patients (N = 12) underwent a 2-week intervention HD-tDCS paired with constraint-induced language therapy (CILT). Multi-level linear regression (backward-fitted models) were performed to assess cortical measures as predictors of tDCS-induced naming improvements, measured by the Western Aphasia Battery-naming subtest, from baseline to immediately after and 6 weeks post-intervention. Results Greater baseline thickness of the pars opercularis significantly predicted naming gains (p = 0.03) immediately following intervention, while greater thickness of the middle temporal gyrus (MTG) and lower thickness of the superior temporal gyrus (STG) significantly predicted 6-week naming gains (p's < 0.02). Thickness did not predict naming gains in sham. Volume did not predict immediate gains for active stimulation. Greater volume of the pars triangularis and MTG, but lower STG volume significantly predicted 6-week naming gains in active stimulation. Greater pars orbitalis and MTG volume, and lower STG volume predicted immediate naming gains in sham (p's < 0.05). Volume did not predict 6-week naming gains in sham. Conclusion Cortical thickness and volume were predictive of tDCS-induced naming improvement in PPA patients. The finding that frontal thickness predicted immediate active tDCS-induced naming gains while temporal areas predicted naming changes at 6-week suggests that a broader network of regions may be important for long-term maintenance of treatment gains. The finding that volume predicted immediate naming performance in the sham condition may reflect the benefits of behavioral speech language therapy and neural correlates of its short-lived treatment gains. Collectively, thickness and volume were predictive of treatment gains in the active condition but not sham, suggesting that pairing HD-tDCS with CILT may be important for maintaining treatment effects.
Collapse
Affiliation(s)
- Nicole R. Nissim
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Moss Rehabilitation Research Institute, Elkins Park, PA, United States
| | - Denise Y. Harvey
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher Haslam
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Leah Friedman
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Pandurang Bharne
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Geneva Litz
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Jeffrey S. Phillips
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Katheryn A. Q. Cousins
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Sharon X. Xie
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Murray Grossman
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Roy H. Hamilton
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
37
|
Mesulam MM, Coventry CA, Bigio EH, Sridhar J, Gill N, Fought AJ, Zhang H, Thompson CK, Geula C, Gefen T, Flanagan M, Mao Q, Weintraub S, Rogalski EJ. Neuropathological fingerprints of survival, atrophy and language in primary progressive aphasia. Brain 2022; 145:2133-2148. [PMID: 35441216 PMCID: PMC9246707 DOI: 10.1093/brain/awab410] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/25/2021] [Accepted: 10/19/2021] [Indexed: 01/21/2023] Open
Abstract
Primary progressive aphasia is a neurodegenerative disease that selectively impairs language without equivalent impairment of speech, memory or comportment. In 118 consecutive autopsies on patients with primary progressive aphasia, primary diagnosis was Alzheimer's disease neuropathological changes (ADNC) in 42%, corticobasal degeneration or progressive supranuclear palsy neuropathology in 24%, Pick's disease neuropathology in 10%, transactive response DNA binding proteinopathy type A [TDP(A)] in 10%, TDP(C) in 11% and infrequent entities in 3%. Survival was longest in TDP(C) (13.2 ± 2.6 years) and shortest in TDP(A) (7.1 ± 2.4 years). A subset of 68 right-handed participants entered longitudinal investigations. They were classified as logopenic, agrammatic/non-fluent or semantic by quantitative algorithms. Each variant had a preferred but not invariant neuropathological correlate. Seventy-seven per cent of logopenics had ADNC, 56% of agrammatics had corticobasal degeneration/progressive supranuclear palsy or Pick's disease and 89% of semantics had TDP(C). Word comprehension impairments had strong predictive power for determining underlying neuropathology positively for TDP(C) and negatively for ADNC. Cortical atrophy was smallest in corticobasal degeneration/progressive supranuclear palsy and largest in TDP(A). Atrophy encompassed posterior frontal but not temporoparietal cortex in corticobasal degeneration/progressive supranuclear palsy, anterior temporal but not frontoparietal cortex in TDP(C), temporofrontal but not parietal cortex in Pick's disease and all three lobes with ADNC or TDP(A). There were individual deviations from these group patterns, accounting for less frequent clinicopathologic associations. The one common denominator was progressive asymmetric atrophy overwhelmingly favouring the left hemisphere language network. Comparisons of ADNC in typical amnestic versus atypical aphasic dementia and of TDP in type A versus type C revealed fundamental biological and clinical differences, suggesting that members of each pair may constitute distinct clinicopathologic entities despite identical downstream proteinopathies. Individual TDP(C) participants with unilateral left temporal atrophy displayed word comprehension impairments without additional object recognition deficits, helping to dissociate semantic primary progressive aphasia from semantic dementia. When common and uncommon associations were considered in the set of 68 participants, one neuropathology was found to cause multiple clinical subtypes, and one subtype of primary progressive aphasia to be caused by multiple neuropathologies, but with different probabilities. Occasionally, expected clinical manifestations of atrophy sites were absent, probably reflecting individual peculiarities of language organization. The hemispheric asymmetry of neurodegeneration and resultant language impairment in primary progressive aphasia reflect complex interactions among the cellular affinities of the degenerative disease, the constitutive biology of language cortex, familial or developmental vulnerabilities of this network and potential idiosyncrasies of functional anatomy in the affected individual.
Collapse
Affiliation(s)
- M Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Chicago, IL 60611, USA
- Davee Department of Neurology, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Christina A Coventry
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Eileen H Bigio
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Pathology, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Jaiashre Sridhar
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Nathan Gill
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Preventive Medicine, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Angela J Fought
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Hui Zhang
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Preventive Medicine, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Cynthia K Thompson
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Chicago, IL 60611, USA
- School of Communication, Northwestern University, Evanston, IL 60208, USA
| | - Changiz Geula
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Tamar Gefen
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Margaret Flanagan
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Pathology, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Qinwen Mao
- Department of Pathology, University of Utah, Salt Lake City, UT 84112, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Emily J Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Chicago, IL 60611, USA
| |
Collapse
|
38
|
Roberts AC, Rademaker AW, Salley EA, Mooney A, Morhardt D, Fried-Oken M, Weintraub S, Mesulam M, Rogalski E. Communication Bridge™-2 (CB2): an NIH Stage 2 randomized control trial of a speech-language intervention for communication impairments in individuals with mild to moderate primary progressive aphasia. Trials 2022; 23:487. [PMID: 35698099 PMCID: PMC9190461 DOI: 10.1186/s13063-022-06162-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 03/07/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Primary progressive aphasia (PPA) is a clinical dementia syndrome. Impairments in language (speaking, reading, writing, and understanding) are the primary and persistent symptoms. These impairments progress insidiously and devastate communication confidence, participation, and quality of life for persons living with PPA. Currently, there are no effective disease modifying treatments for PPA. Speech-language interventions hold promise for mitigating communication challenges and language symptoms. However, evidence regarding their efficacy in PPA is of low quality and there are currently no rigorous randomized trials. METHOD Communication Bridge™-2 (CB2) is a Stage 2, superiority, single-blind, randomized, parallel group, active-control, behavioral clinical trial delivered virtually within a telehealth service delivery model to individuals with PPA. Ninety carefully characterized participants with clinically confirmed PPA will be randomized to one of two speech-language intervention arms: (1) Communication Bridge™ a dyadic intervention based in communication participation therapy models that incorporates salient training stimuli or (2) the control intervention a non-dyadic intervention based in impairment therapy models addressing word retrieval and language production that incorporates fixed stimuli. The superiority of Communication Bridge™ over the Control arm will be evaluated using primary outcomes of communication confidence and participation. Other outcomes include accuracy for trained words and scripts. Participants complete two therapy blocks over a 12-month period. Outcomes will be measured at baseline, at each therapy block, and at 12 months post enrollment. DISCUSSION The CB2 trial will supply Level 2 evidence regarding the efficacy of the Communication Bridge™ intervention delivered in a telehealth service delivery model for individuals with mild to moderate PPA. An important by-product of the CB2 trial is that these data can be used to evaluate the efficacy of speech-language interventions delivered in both trial arms for persons with PPA. The impact of these data should not be overlooked as they will yield important insights examining why interventions work and for whom, which will advance effectiveness trials for speech-language interventions in PPA. TRIAL REGISTRATION ClinicalTrials.gov NCT03371706 . Registered prospectively on December 13, 2017.
Collapse
Affiliation(s)
- Angela C Roberts
- Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, USA.
- University of Western Ontario, School of Communication Sciences and Disorders and Department of Computer Science, Ontario, Canada.
| | - Alfred W Rademaker
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, USA
| | - Elizabeth Ann Salley
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, USA
| | - Aimee Mooney
- Oregon Health & Science University, Portland, USA
| | - Darby Morhardt
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, USA
| | - Melanie Fried-Oken
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, USA
| | - Sandra Weintraub
- Mesulam Center for Alzheimer's Disease and Cognitive Neurology and Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, USA
| | - Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, USA
| | - Emily Rogalski
- Mesulam Center for Alzheimer's Disease and Cognitive Neurology and Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, USA
| |
Collapse
|
39
|
Effect of Rehabilitation on Brain Functional Connectivity in a Stroke Patient Affected by Conduction Aphasia. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12125991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Stroke is a medical condition that affects the brain and represents a leading cause of death and disability. Associated with drug therapy, rehabilitative treatment is essential for promoting recovery. In the present work, we report an EEG-based study concerning a left ischemic stroke patient affected by conduction aphasia. Specifically, the objective is to compare the brain functional connectivity before and after an intensive rehabilitative treatment. The analysis was performed by means of local and global efficiency measures related to the execution of three tasks: naming, repetition and reading. As expected, the results showed that the treatment led to a balancing of the values of both parameters between the two hemispheres since the rehabilitation contributed to the creation of new neural patterns to compensate for the disrupted ones. Moreover, we observed that for both name and repetition tasks, shortly after the stroke, the global and local connectivity are lower in the affected lobe (left hemisphere) than in the unaffected one (right hemisphere). Conversely, for the reading task, global and local connectivity are higher in the impaired lobe. This apparently contrasting trend can be due to the effects of stroke, which affect not only the site of structural damage but also brain regions belonging to a functional network. Moreover, changes in network connectivity can be task-dependent. This work can be considered a first step for future EEG-based studies to establish the most suitable connectivity measures for supporting the treatment of stroke and monitoring the recovery process.
Collapse
|
40
|
Stockbridge MD, Tippett DC, Breining BL, Hillis AE. When words first fail: Predicting the emergence of primary progressive aphasia variants from unclassifiable anomic performance in early disease. APHASIOLOGY 2022; 37:1173-1185. [PMID: 37377938 PMCID: PMC10292722 DOI: 10.1080/02687038.2022.2084706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Background The majority of patients with primary progressive aphasia (PPA) can be distinguished into one of three variants: semantic, non-fluent/agrammatic, or logopenic. However, many do not meet criteria for any one variant. Aim To identify aspects of cognitive-linguistic performance that yield an early unclassifiable PPA designation that predicted the later emergence of a given variant. Methods & Procedures Of 256 individuals with PPA evaluated, 19 initially were unclassifiable and later met criteria for a variant. Receiver operating characteristic curves were used to evaluate the binary ability of a given task to predict eventual classification as a given variant. Tasks with a high area under the curve were examined using regression analyses to determine their ability to predict variant. Outcomes & Results High mean predictive value was observed for multiple naming assessments targeting nouns and verbs. The Boston Naming Test (BNT) was the only test that, in isolation, resulted in a significant model and high classification accuracy. Conclusions Although naming impairment is common across PPA variants, very low initial BNT scores emerged as a uniquely accurate basis for predicting eventual semantic variant, and normal BNT scores predicted eventual nonfluent/agrammatic variant. High performance on picture-verb verification was useful in identifying future lvPPA.
Collapse
Affiliation(s)
- Melissa D. Stockbridge
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Donna C. Tippett
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Bonnie L. Breining
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218
| |
Collapse
|
41
|
Kawles A, Nishihira Y, Feldman A, Gill N, Minogue G, Keszycki R, Coventry C, Spencer C, Lilek J, Ajroud K, Coppola G, Rademakers R, Rogalski E, Weintraub S, Zhang H, Flanagan ME, Bigio EH, Mesulam MM, Geula C, Mao Q, Gefen T. Cortical and subcortical pathological burden and neuronal loss in an autopsy series of FTLD-TDP-type C. Brain 2022; 145:1069-1078. [PMID: 34919645 PMCID: PMC9050539 DOI: 10.1093/brain/awab368] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/11/2021] [Accepted: 08/29/2021] [Indexed: 10/31/2023] Open
Abstract
The TDP-43 type C pathological form of frontotemporal lobar degeneration is characterized by the presence of immunoreactive TDP-43 short and long dystrophic neurites, neuronal cytoplasmic inclusions, neuronal loss and gliosis and the absence of neuronal intranuclear inclusions. Frontotemporal lobar degeneration-TDP-type C cases are commonly associated with the semantic variant of primary progressive aphasia or behavioural variant frontotemporal dementia. Here, we provide detailed characterization of regional distributions of pathological TDP-43 and neuronal loss and gliosis in cortical and subcortical regions in 10 TDP-type C cases and investigate the relationship between inclusions and neuronal loss and gliosis. Specimens were obtained from the first 10 TDP-type C cases accessioned from the Northwestern Alzheimer's Disease Research Center (semantic variant of primary progressive aphasia, n = 7; behavioural variant frontotemporal dementia, n = 3). A total of 42 cortical (majority bilateral) and subcortical regions were immunostained with a phosphorylated TDP-43 antibody and/or stained with haematoxylin-eosin. Regions were evaluated for atrophy, and for long dystrophic neurites, short dystrophic neurites, neuronal cytoplasmic inclusions, and neuronal loss and gliosis using a semiquantitative 5-point scale. We calculated a 'neuron-to-inclusion' score (TDP-type C mean score - neuronal loss and gliosis mean score) for each region per case to assess the relationship between TDP-type C inclusions and neuronal loss and gliosis. Primary progressive aphasia cases demonstrated leftward asymmetry of cortical atrophy consistent with the aphasic phenotype. We also observed abundant inclusions and neurodegeneration in both cortical and subcortical regions, with certain subcortical regions emerging as particularly vulnerable to dystrophic neurites (e.g. amygdala, caudate and putamen). Interestingly, linear mixed models showed that regions with lowest TDP-type C pathology had high neuronal dropout, and conversely, regions with abundant pathology displayed relatively preserved neuronal densities (P < 0.05). This inverse relationship between the extent of TDP-positive inclusions and neuronal loss may reflect a process whereby inclusions disappear as their associated neurons are lost. Together, these findings offer insight into the putative substrates of neurodegeneration in unique dementia syndromes.
Collapse
Affiliation(s)
- Allegra Kawles
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Yasushi Nishihira
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Alex Feldman
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Nathan Gill
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Grace Minogue
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Rachel Keszycki
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Christina Coventry
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Callen Spencer
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Jaclyn Lilek
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Kaouther Ajroud
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Giovanni Coppola
- Department of Psychiatry and Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Emily Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Hui Zhang
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Margaret E Flanagan
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Eileen H Bigio
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - M -Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Changiz Geula
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Cell and Developmental Biology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Qinwen Mao
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Tamar Gefen
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| |
Collapse
|
42
|
Hashizume Y. Macroscopic findings of brain with dementia. Neuropathology 2022; 42:353-366. [PMID: 35451141 DOI: 10.1111/neup.12785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 11/29/2022]
Abstract
In this paper, we have described the points to be noted when examining the macroscopic findings of the brain of patients with dementia. The characteristics of the macroscopic findings of the brain of patients with dementia are shown in the figure of the outer surface and the cut surface. Gross findings in the brain of patients with Alzheimer's disease should consider, in addition to the degree of limbic changes, whether the atrophy is diffuse, the degree of ventricular enlargement, and the complications of vascular changes. The macroscopic findings of the brain of patients with dementia with Lewy bodies are characterized by the absence of notable abnormal findings other than the depigmentation of the substantia nigra and locus coeruleus. In dementia with Lewy bodies, other types of dementia complications should be considered if abnormal findings are present. It should be noted that accurate diagnosis of argyrophilic grain dementia and senile dementia of neurofibrillary tangle type by macroscopic findings alone is often difficult to distinguish from a mild case of Alzheimer's disease and change by physiological aging in particular. In frontotemporal lobar degeneration, changes in the basal ganglia, brain stem, cerebellum and motor neurons should be observed to make a differential diagnosis of various types of frontotemporal lobar degeneration. It is important to understand the areas that are often damaged in different types of dementia and the extent of lesions, and to distinguish each type of dementia. Care should be taken as macroscopic findings are more complex when several types of dementia are mixed. It was shown that accurate understanding of macroscopic findings is essential for understanding clinical symptoms, imaging findings, differential diagnosis of dementia and disease pathogenesis.
Collapse
Affiliation(s)
- Yoshio Hashizume
- Institute of Neuropathology, Fukushimura Hospital, Toyohashi, Japan
| |
Collapse
|
43
|
Verbal and Nonverbal Memory in Neurodegenerative and Stroke Aphasia: Evidence From the Turkish Version of the Three Words Three Shapes Test. Cogn Behav Neurol 2022; 35:49-65. [PMID: 35239599 DOI: 10.1097/wnn.0000000000000294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although language impairment is the most salient feature of cognitive impairment in both primary progressive aphasia (PPA) and stroke aphasia (SA), memory can also be impaired in both patient populations. OBJECTIVE To identify distinctive features of verbal and nonverbal memory processing in individuals with PPA and those with SA. METHOD We gave individuals with PPA (n = 14), those with SA (n = 8), and healthy controls (HC; n = 13) a comprehensive neuropsychological test battery and the Turkish version of the Three Words Three Shapes Test (3W3S-Turkish). The 3W3S-Turkish Test includes five subtests: Copy, Incidental Recall, Acquisition, Delayed Recall, and Recognition. High-resolution brain scans were performed in a subset of individuals with PPA and those with SA. Lesion distribution was limited to the dorsal language areas in the SA group, whereas peak atrophy areas in the PPA group extended beyond the language network, including the medial temporal lobe, precuneus, and posterior/medial portions of the cingulate cortex. RESULTS Both the PPA and SA groups showed impairment in incidental recall, and the PPA group showed additional impairment in delayed recall. Greater impairment for verbal stimuli suggestive of material-specific memory impairment was evident in the PPA group's scores on the Incidental Recall and Delayed Recall subtests. Both aphasia groups retained the acquired information regardless of material type. CONCLUSION Although both aphasia groups shared similarities in the involvement of the dorsal prefrontal working memory/attention network, the PPA group showed greater impairment in delayed recall compared with the SA group.
Collapse
|
44
|
Signature laminar distributions of pathology in frontotemporal lobar degeneration. Acta Neuropathol 2022; 143:363-382. [PMID: 34997851 PMCID: PMC8858288 DOI: 10.1007/s00401-021-02402-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/11/2021] [Accepted: 12/28/2021] [Indexed: 12/24/2022]
Abstract
Frontotemporal lobar degeneration (FTLD) with either tau (FTLD-tau) or TDP-43 (FTLD-TDP) inclusions are distinct proteinopathies that frequently cause similar frontotemporal dementia (FTD) clinical syndromes. FTD syndromes often display macroscopic signatures of neurodegeneration at the level of regions and networks, but it is unclear if subregional laminar pathology display patterns unique to proteinopathy or clinical syndrome. We hypothesized that FTLD-tau and FTLD-TDP accumulate pathology in relatively distinct cortical layers independent of clinical syndrome, with greater involvement of lower layers in FTLD-tau. The current study examined 170 patients with either FTLD-tau (n = 73) or FTLD-TDP (n = 97) spanning dementia and motor phenotypes in the FTD spectrum. We digitally measured the percent area occupied by tau and TDP-43 pathology in upper layers (I-III), lower layers (IV-VI), and juxtacortical white matter (WM) from isocortical regions in both hemispheres where available. Linear mixed-effects models compared ratios of upper to lower layer pathology between FTLD groups and investigated relationships with regions, WM pathology, and global cognitive impairment while adjusting for demographics. We found lower ratios of layer pathology in FTLD-tau and higher ratios of layer pathology in FTLD-TDP, reflecting lower layer-predominant tau pathology and upper layer-predominant TDP-43 pathology, respectively (p < 0.001). FTLD-tau displayed lower ratios of layer pathology related to greater WM tau pathology (p = 0.002) and to earlier involved/severe pathology regions (p = 0.007). In contrast, FTLD-TDP displayed higher ratios of layer pathology not related to either WM pathology or regional severity. Greater cognitive impairment was associated with higher ratios of layer pathology in FTLD-tau (p = 0.018), but was not related to ratios of layer pathology in FTLD-TDP. Lower layer-predominant tau pathology and upper layer-predominant TDP-43 pathology are proteinopathy-specific, regardless of clinical syndromes or regional networks that define these syndromes. Thus, patterns of laminar change may provide a useful anatomical framework for investigating how degeneration of select cells and corresponding laminar circuits influence large-scale networks and clinical symptomology in FTLD.
Collapse
|
45
|
Boeve BF, Boxer AL, Kumfor F, Pijnenburg Y, Rohrer JD. Advances and controversies in frontotemporal dementia: diagnosis, biomarkers, and therapeutic considerations. Lancet Neurol 2022; 21:258-272. [DOI: 10.1016/s1474-4422(21)00341-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 08/16/2021] [Accepted: 09/28/2021] [Indexed: 12/13/2022]
|
46
|
Tremblay C, Serrano GE, Intorcia AJ, Curry J, Sue LI, Nelson CM, Walker JE, Glass MJ, Arce RA, Fleisher AS, Pontecorvo MJ, Atri A, Montine TJ, Chen K, Beach TG. Hemispheric Asymmetry and Atypical Lobar Progression of Alzheimer-Type Tauopathy. J Neuropathol Exp Neurol 2022; 81:158-171. [PMID: 35191506 DOI: 10.1093/jnen/nlac008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The spread of neurofibrillary tau pathology in Alzheimer disease (AD) mostly follows a stereotypical pattern of topographical progression but atypical patterns associated with interhemispheric asymmetry have been described. Because histopathological studies that used bilateral sampling are limited, this study aimed to assess interhemispheric tau pathology differences and the presence of topographically atypical cortical spreading patterns. Immunohistochemical staining for detection of tau pathology was performed in 23 regions of interest in 57 autopsy cases comparing bilateral cortical regions and hemispheres. Frequent mild (82% of cases) and occasional moderate (32%) interhemispheric density discrepancies were observed, whereas marked discrepancies were uncommon (7%) and restricted to occipital regions. Left and right hemispheric tau pathology dominance was observed with similar frequencies, except in Braak Stage VI that favored a left dominance. Interhemispheric Braak stage differences were observed in 16% of cases and were more frequent in advanced (IV-VI) versus early (I-III) stages. One atypical lobar topographical pattern in which occipital tau pathology density exceeded frontal lobe scores was identified in 4 cases favoring a left dominant asymmetry. We speculate that asymmetry and atypical topographical progression patterns may be associated with atypical AD clinical presentations and progression characteristics, which should be tested by comprehensive clinicopathological correlations.
Collapse
Affiliation(s)
- Cécilia Tremblay
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Geidy E Serrano
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Jasmine Curry
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Lucia I Sue
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Courtney M Nelson
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Jessica E Walker
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Michael J Glass
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Richard A Arce
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | - Alireza Atri
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA.,Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas J Montine
- Department of Pathology, Stanford University, Stanford, California, USA
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, Arizona, USA.,School of Mathematics and Statistics, Arizona State University, Tempe, Arizona, USA.,Department of Neurology, College of Medicine Phoenix, University of Arizona, Tucson, Arizona, USA
| | - Thomas G Beach
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| |
Collapse
|
47
|
Tuckute G, Paunov A, Kean H, Small H, Mineroff Z, Blank I, Fedorenko E. Frontal language areas do not emerge in the absence of temporal language areas: A case study of an individual born without a left temporal lobe. Neuropsychologia 2022; 169:108184. [DOI: 10.1016/j.neuropsychologia.2022.108184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/07/2021] [Accepted: 02/15/2022] [Indexed: 10/19/2022]
|
48
|
Paranhos T, Lucas T, de Salles A, Moll J, de Oliveira-Souza R. A presumptive association between obsessive compulsions and asymmetric temporal lobe atrophy: a case report. J Med Case Rep 2022; 16:21. [PMID: 35045865 PMCID: PMC8772087 DOI: 10.1186/s13256-021-03228-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background The relatively isolated atrophy of the temporal lobes leads to a clinical radiological pattern, referred to as the temporal variant of frontotemporal dementia. While semantic dementia and behavioral variant frontotemporal dementia are classically related to this syndrome, the logopenic variant of primary progressive aphasia has been less commonly reported. This case report aims to give a pictorial description of a case in which a patient with asymmetric temporal lobe atrophy presented with the logopenic variant of primary progressive aphasia and complex rituals of cleanliness. Case presentation We report on the case of a 68-year-old, right-handed White woman with complex rituals and progressive speech impairment. The obsessive–compulsive rituals represented an exacerbation of lifelong preoccupations with cleanliness and orderliness that were praised by her relatives. Neuropsychological assessment revealed a striking impairment of language and memory, with relative sparing of tool-use praxis and visuospatial skills. Magnetic resonance imaging and 18fluorodeoxyglucose-positron emission tomography scans showed bilateral asymmetrical temporal lobe atrophy and hypometabolism. A year later, she was still able to entertain conversation for a short while, but her vocabulary and fluency had further declined. Praxis and visuospatial skills remained intact. She did not experience pathological elation, delusions, or hallucinations. The disease followed a relentless progression into a partial Klüver–Bucy syndrome, abulia, and terminal dementia. She died from acute myocardial infarction 8 years after the onset of aphasia. The symptoms and their temporal course supported a diagnosis of logopenic variant of primary progressive aphasia due to asymmetric temporal variant frontotemporal lobar degeneration. Conclusions This report gives a pictorial description of a temporal variant of frontotemporal dementia in a patient who presented with worsening of a lifelong obsessive–compulsive disorder and logopenic variant of primary progressive aphasia. Supplementary Information The online version contains supplementary material available at 10.1186/s13256-021-03228-z.
Collapse
|
49
|
Seckin M, Ricard I, Raiser T, Heitkamp N, Ebert A, Prix C, Levin J, Diehl-Schmid J, Riedl L, Roßmeier C, Hoen N, Schroeter ML, Marschhauser A, Obrig H, Benke T, Kornhuber J, Fliessbach K, Schneider A, Wiltfang J, Jahn H, Fassbender K, Prudlo J, Lauer M, Duning T, Wilke C, Synofzik M, Anderl-Straub S, Semler E, Lombardi J, Landwehrmeyer B, Ludolph A, Otto M, Danek A. Utility of the Repeat and Point Test for Subtyping Patients With Primary Progressive Aphasia. Alzheimer Dis Assoc Disord 2022; 36:44-51. [PMID: 35001030 DOI: 10.1097/wad.0000000000000482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 11/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Primary progressive aphasia (PPA) may present with three distinct clinical sybtypes: semantic variant PPA (svPPA), nonfluent/agrammatic variant PPA (nfvPPA), and logopenic variant PPA (lvPPA). OBJECTIVE The aim was to examine the utility of the German version of the Repeat and Point (R&P) Test for subtyping patients with PPA. METHOD During the R&P Test, the examiner reads out aloud a noun and the participants are asked to repeat the word and subsequently point to the corresponding picture. Data from 204 patients (68 svPPA, 85 nfvPPA, and 51 lvPPA) and 33 healthy controls were analyzed. RESULTS Controls completed both tasks with >90% accuracy. Patients with svPPA had high scores in repetition (mean=9.2±1.32) but low scores in pointing (mean=6±2.52). In contrast, patients with nfvPPA and lvPPA performed comparably in both tasks with lower scores in repetition (mean=7.4±2.7 for nfvPPA and 8.2±2.34 for lvPPA) but higher scores in pointing (mean=8.9±1.41 for nfvPPA and 8.6±1.62 for lvPPA). The R&P Test had high accuracy discriminating svPPA from nfvPPA (83% accuracy) and lvPPA (79% accuracy). However, there was low accuracy discriminating nfvPPA from lvPPA (<60%). CONCLUSION The R&P Test helps to differentiate svPPA from 2 nonsemantic variants (nfvPPA and lvPPA). However, additional tests are required for the differentiation of nfvPPA and lvPPA.
Collapse
Affiliation(s)
- Mustafa Seckin
- Neurologische Klinik und Poliklinik
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Department of Neurology, İstanbul, Turkey
| | - Ingrid Ricard
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Unversität München
| | | | | | - Anne Ebert
- Neurologische Klinik, Universitätsmedizin Mannheim, Mannheim
| | | | - Johannes Levin
- Neurologische Klinik und Poliklinik
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)
- Munich Cluster for Systems Neurology (SyNergy)
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich
| | - Lina Riedl
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich
| | - Carola Roßmeier
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich
| | - Nora Hoen
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Neurology, and Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig
| | - Anke Marschhauser
- Max Planck Institute for Human Cognitive and Brain Sciences, Neurology, and Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig
| | - Hellmuth Obrig
- Max Planck Institute for Human Cognitive and Brain Sciences, Neurology, and Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig
| | - Thomas Benke
- Universitätsklinik für Neurologie, Kognitive Neurologie und Neuropsychologie, Innsbruck, Austria
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen
| | - Klaus Fliessbach
- Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Universitätsklinikum Bonn & Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn
| | - Anja Schneider
- Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Universitätsklinikum Bonn & Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn
| | - Jens Wiltfang
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Göttingen
| | - Holger Jahn
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Klaus Fassbender
- Neurologische Klinik und Poliklinik, Universität des Saarlandes, KirrbergerStraße, Homburg
| | - Johannes Prudlo
- Klinik für Neurologie und Poliklinik, Universitätsklinikum Rostock, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock
| | - Martin Lauer
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie, Universität Würzburg, Würzburg
| | - Thomas Duning
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Westfälische-Wilhelms-Universität, Münster
| | - Carlo Wilke
- Department of Neurodegenerative Diseases, Centre for Neurology and Hertie-Institute for Clinical Brain Research, University Hospital
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Tübingen
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Centre for Neurology and Hertie-Institute for Clinical Brain Research, University Hospital
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Tübingen
| | | | - Elisa Semler
- Neurologische Klinik und Poliklinik, Universität Ulm
| | | | | | - Albert Ludolph
- Neurologische Klinik und Poliklinik, Universität Ulm
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Ulm
| | - Markus Otto
- Neurologische Klinik und Poliklinik, Universität Ulm
| | | |
Collapse
|
50
|
McGinnis SM, Stern AM, Woods JK, Torre M, Feany MB, Miller MB, Silbersweig DA, Gale SA, Daffner KR. Case Study 1: A 55-Year-Old Woman With Progressive Cognitive, Perceptual, and Motor Impairments. J Neuropsychiatry Clin Neurosci 2022; 34:8-15. [PMID: 34763525 PMCID: PMC8813898 DOI: 10.1176/appi.neuropsych.21040114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Scott M. McGinnis
- Department of Neurology, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Andrew M. Stern
- Department of Neurology, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Jared K. Woods
- Department of Pathology, Division of Neuropathology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Matthew Torre
- Department of Pathology, Division of Neuropathology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Mel B. Feany
- Department of Pathology, Division of Neuropathology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Michael B. Miller
- Department of Pathology, Division of Neuropathology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - David A. Silbersweig
- Department of Psychiatry, Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Seth A. Gale
- Department of Neurology, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Kirk R. Daffner
- Department of Neurology, Division of Cognitive and Behavioral Neurology, Center for Brain/Mind Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston
| |
Collapse
|