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Jellinger KA. Pathomechanisms of cognitive and behavioral impairment in corticobasal degeneration. J Neural Transm (Vienna) 2023; 130:1509-1522. [PMID: 37659990 DOI: 10.1007/s00702-023-02691-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/23/2023] [Indexed: 09/04/2023]
Abstract
Corticobasal degeneration (CBD) is a rare, sporadic, late-onset progressive neurodegenerative disorder of unknown etiology, clinically characterized by an akinetic-rigid syndrome, behavior and personality disorders, language problems (aphasias), apraxia, executive and cognitive abnormalities and limb dystonia. The syndrome is not specific, as clinical features of pathologically proven CBD include several phenotypes. This 4-repeat (4R) tauopathy is morphologically featured by often asymmetric frontoparietal atrophy, ballooned/achromatic neurons containing filamentous 4R-tau aggregates in cortex and striatum, thread-like processes that are more widespread than in progressive supranuclear palsy (PSP), pathognomonic "astroglial plaques", and numerous inclusions in both astrocytes and oligodendroglia ("coiled bodies") in the white matter. Cognitive deficits in CBD are frequent initial presentations before onset of motor symptoms, depending on the phenotypic variant. They predominantly include executive and visuospatial dysfunction, sleep disorders and language deficits with usually preserved memory domains. Neuroimaging studies showed heterogenous locations of brain atrophy, particularly contralateral to the dominant symptoms, with disruption of striatal connections to prefrontal cortex and basal ganglia circuitry. Asymmetric hypometabolism, mainly involving frontal and parietal regions, is associated with brain cholinergic deficits, and dopaminergic nigrostriatal degeneration. Widespread alteration of cortical and subcortical structures causing heterogenous changes in various brain functional networks support the concept that CBD, similar to PSP, is a brain network disruption disorder. Putative pathogenic factors are hyperphosphorylated tau-pathology, neuroinflammation and oxidative injury, but the basic mechanisms of cognitive impairment in CBD, as in other degenerative movement disorders, are complex and deserve further elucidation as a basis for early diagnosis and adequate treatment of this fatal disorder.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
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El Ouartassi A, Giordana C, Schiazza A, Chardin D, Darcourt J. [ 18F]-FDopa positron emission tomography imaging in corticobasal syndrome. Brain Imaging Behav 2023; 17:619-627. [PMID: 37474673 DOI: 10.1007/s11682-023-00789-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE First, to investigate the patterns of [18F]-FDOPA positron emission tomography imaging in corticobasal syndrome using visual and semi-quantitative analysis and to compare them with patterns found in Parkinson's disease and progressive supranuclear palsy. Then, to search for correlations with clinical features and [18F]-FDG positron emission tomography imaging. METHODS 27 corticobasal syndrome patients who underwent [18F]-FDOPA positron emission tomography imaging were retrospectively studied. They were compared to 27 matched Parkinson's disease patients, 12 progressive supranuclear palsy patients and 53 normal controls. Scans were visually assigned to one of the following patterns: normal; unilateral homogeneous striatal uptake reduction; putamen uptake reduction with putamen-caudate gradient. A semi-quantitative analysis of striatal regional uptake and asymmetry was performed and correlated to clinical features and [18F]-FDG positron emission tomography patterns. RESULTS [18F]-FDOPA positron emission tomography appeared visually abnormal in only 33.5% of corticobasal syndrome patients. However, semi-quantitative analysis found putaminal asymmetry in 63%. Striatal uptake was homogeneously reduced in both putamen and caudate nucleus in corticobasal syndrome patients unlike in Parkinson's disease and progressive supranuclear palsy. No correlation was found between [18F]-FDOPA positron emission tomography and clinical features. Half of corticobasal syndrome patients presented a corticobasal degeneration pattern on [18F]-FDG positron emission tomography. CONCLUSION: [18F]-FDOPA positron emission tomography can often be normal in corticobasal syndrome patients. Semi-quantitative analysis is useful to unmask a significant asymmetry in many of them. Homogeneous striatal uptake reduction contralateral to the clinical signs is highly suggestive of corticobasal syndrome. This finding can be helpful to better characterize this syndrome with respect to Parkinson's disease and progressive supranuclear palsy.
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Affiliation(s)
- Anaïs El Ouartassi
- Movement Disorders Unit, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France.
- Neurology Department, Centre Hospitalier d'Antibes, 107 Avenue de Nice, Antibes, France.
| | - Caroline Giordana
- Movement Disorders Unit, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Aurélie Schiazza
- Nuclear Medicine Department, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
- Research Group, UMR 4320, CEA-Université Côte d'Azur, Nice, France
| | - David Chardin
- Nuclear Medicine Department, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
- Research Group, UMR 4320, CEA-Université Côte d'Azur, Nice, France
| | - Jacques Darcourt
- Nuclear Medicine Department, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
- Research Group, UMR 4320, CEA-Université Côte d'Azur, Nice, France
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Rau A, Schröter N, Blazhenets G, Maurer C, Urbach H, Meyer PT, Frings L. The metabolic spatial covariance pattern of definite idiopathic normal pressure hydrocephalus: an FDG PET study with principal components analysis. Alzheimers Res Ther 2023; 15:202. [PMID: 37980531 PMCID: PMC10657637 DOI: 10.1186/s13195-023-01339-x] [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: 06/28/2023] [Accepted: 10/24/2023] [Indexed: 11/20/2023]
Abstract
Identification of patients with idiopathic normal pressure hydrocephalus (iNPH) in a collective with suspected neurodegenerative disease is essential. This study aimed to determine the metabolic spatial covariance pattern of iNPH on FDG PET using an established technique based on scaled subprofile model principal components analysis (SSM-PCA).We identified 11 patients with definite iNPH. By applying SSM-PCA to the FDG PET data, they were compared to 48 age-matched healthy controls to determine the whole-brain voxel-wise metabolic spatial covariance pattern of definite iNPH (iNPH-related pattern, iNPHRP). The iNPHRP score was compared between groups of patients with definite iNPH, possible iNPH (N = 34), Alzheimer's (AD, N = 38), and Parkinson's disease (PD, N = 35) applying pairwise Mann-Whitney U tests and correction for multiple comparisons.SSM-PCA of FDG PET revealed an iNPHRP that is characterized by relative negative voxel weights at the vicinity of the lateral ventricles and relative positive weights in the paracentral midline region. The iNPHRP scores of patients with definite iNPH were substantially higher than in patients with AD and PD (both p < 0.05) and non-significantly higher than those of patients with possible iNPH. Subject scores of the iNPHRP discriminated definite iNPH from AD and PD with 96% and 100% accuracy and possible iNPH from AD and PD with 83% and 86% accuracy.We defined a novel metabolic spatial covariance pattern of iNPH that might facilitate the differential diagnosis of iNPH versus other neurodegenerative disorders. The knowledge of iNPH-associated alterations in the cerebral glucose metabolism is of high relevance as iNPH constitutes an important differential diagnosis to dementia and movement disorders.
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Affiliation(s)
- Alexander Rau
- Department of Neuroradiology, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nils Schröter
- Department of Neurology, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ganna Blazhenets
- Department of Nuclear Medicine, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Maurer
- Center for Geriatrics and Gerontology, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Horst Urbach
- Department of Neuroradiology, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp T Meyer
- Department of Nuclear Medicine, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lars Frings
- Department of Nuclear Medicine, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- Center for Geriatrics and Gerontology, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Yoshida Y, Yokoi T, Hara K, Watanabe H, Yamaguchi H, Bagarinao E, Masuda M, Kato T, Ogura A, Ohdake R, Kawabata K, Katsuno M, Kato K, Naganawa S, Okamura N, Yanai K, Sobue G. <Editors' Choice> Pattern of THK 5351 retention in normal aging involves core regions of resting state networks associated with higher cognitive function. NAGOYA JOURNAL OF MEDICAL SCIENCE 2023; 85:758-771. [PMID: 38155624 PMCID: PMC10751491 DOI: 10.18999/nagjms.85.4.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 12/22/2022] [Indexed: 12/30/2023]
Abstract
We aimed to elucidate the distribution pattern of the positron emission tomography probe [18F]THK 5351, a marker for astrogliosis and tau accumulation, in healthy aging. We also assessed the relationship between THK5351 retention and resting state networks. We enrolled 62 healthy participants in this study. All participants underwent magnetic resonance imaging/positron emission tomography scanning consisting of T1-weighted images, resting state functional magnetic resonance imaging, Pittsburgh Compound-B and THK positron emission tomography. The preprocessed THK images were entered into a scaled subprofile modeling/principal component analysis to extract THK distribution patterns. Using the most significant THK pattern, we generated regions of interest, and performed seed-based functional connectivity analyses. We also evaluated the functional connectivity overlap ratio to identify regions with high between-network connectivity. The most significant THK distributions were observed in the medial prefrontal cortex and bilateral putamen. The seed regions of interest in the medial prefrontal cortex had a functional connectivity map that significantly overlapped with regions of the dorsal default mode network. The seed regions of interest in the putamen showed strong overlap with the basal ganglia and anterior salience networks. The functional connectivity overlap ratio also showed that three peak regions had the characteristics of connector hubs. We have identified an age-related spatial distribution of THK in the medial prefrontal cortex and basal ganglia in normal aging. Interestingly, the distribution's peaks are located in regions of connector hubs that are strongly connected to large-scale resting state networks associated with higher cognitive function.
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Affiliation(s)
- Yusuke Yoshida
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takamasa Yokoi
- Department of Neurology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Kazuhiro Hara
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hirohisa Watanabe
- Brain and Mind Research Center, Nagoya University, Nagoya, Japan
- Department of Neurology, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hiroshi Yamaguchi
- Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Michihito Masuda
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshiyasu Kato
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Aya Ogura
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Reiko Ohdake
- Brain and Mind Research Center, Nagoya University, Nagoya, Japan
| | - Kazuya Kawabata
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsuhiko Kato
- Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Kazuhiko Yanai
- Department of Pharmacology, Tohoku University School of Medicine, Sendai, Japan
| | - Gen Sobue
- Brain and Mind Research Center, Nagoya University, Nagoya, Japan
- Aichi Medical University, Nagakute, Japan
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5
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Barbero JA, Unadkat P, Choi YY, Eidelberg D. Functional Brain Networks to Evaluate Treatment Responses in Parkinson's Disease. Neurotherapeutics 2023; 20:1653-1668. [PMID: 37684533 PMCID: PMC10684458 DOI: 10.1007/s13311-023-01433-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Network analysis of functional brain scans acquired with [18F]-fluorodeoxyglucose positron emission tomography (FDG PET, to map cerebral glucose metabolism), or resting-state functional magnetic resonance imaging (rs-fMRI, to map blood oxygen level-dependent brain activity) has increasingly been used to identify and validate reproducible circuit abnormalities associated with neurodegenerative disorders such as Parkinson's disease (PD). In addition to serving as imaging markers of the underlying disease process, these networks can be used singly or in combination as an adjunct to clinical diagnosis and as a screening tool for therapeutics trials. Disease networks can also be used to measure rates of progression in natural history studies and to assess treatment responses in individual subjects. Recent imaging studies in PD subjects scanned before and after treatment have revealed therapeutic effects beyond the modulation of established disease networks. Rather, other mechanisms of action may be at play, such as the induction of novel functional brain networks directly by treatment. To date, specific treatment-induced networks have been described in association with novel interventions for PD such as subthalamic adeno-associated virus glutamic acid decarboxylase (AAV2-GAD) gene therapy, as well as sham surgery or oral placebo under blinded conditions. Indeed, changes in the expression of these networks with treatment have been found to correlate consistently with clinical outcome. In aggregate, these attributes suggest a role for functional brain networks as biomarkers in future clinical trials.
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Affiliation(s)
- János A Barbero
- Center for Neurosciences, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11549, USA
| | - Prashin Unadkat
- Center for Neurosciences, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11549, USA
- Elmezzi Graduate School of Molecular Medicine, Manhasset, NY, 11030, USA
| | - Yoon Young Choi
- Center for Neurosciences, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA.
- Molecular Medicine and Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11549, USA.
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6
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Buchert R, Wegner F, Huppertz HJ, Berding G, Brendel M, Apostolova I, Buhmann C, Dierks A, Katzdobler S, Klietz M, Levin J, Mahmoudi N, Rinscheid A, Rogozinski S, Rumpf JJ, Schneider C, Stöcklein S, Spetsieris PG, Eidelberg D, Wattjes MP, Sabri O, Barthel H, Höglinger G. Automatic covariance pattern analysis outperforms visual reading of 18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET) in variant progressive supranuclear palsy. Mov Disord 2023; 38:1901-1913. [PMID: 37655363 DOI: 10.1002/mds.29581] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND To date, studies on positron emission tomography (PET) with 18 F-fluorodeoxyglucose (FDG) in progressive supranuclear palsy (PSP) usually included PSP cohorts overrepresenting patients with Richardson's syndrome (PSP-RS). OBJECTIVES To evaluate FDG-PET in a patient sample representing the broad phenotypic PSP spectrum typically encountered in routine clinical practice. METHODS This retrospective, multicenter study included 41 PSP patients, 21 (51%) with RS and 20 (49%) with non-RS variants of PSP (vPSP), and 46 age-matched healthy controls. Two state-of-the art methods for the interpretation of FDG-PET were compared: visual analysis supported by voxel-based statistical testing (five readers) and automatic covariance pattern analysis using a predefined PSP-related pattern. RESULTS Sensitivity and specificity of the majority visual read for the detection of PSP in the whole cohort were 74% and 72%, respectively. The percentage of false-negative cases was 10% in the PSP-RS subsample and 43% in the vPSP subsample. Automatic covariance pattern analysis provided sensitivity and specificity of 93% and 83% in the whole cohort. The percentage of false-negative cases was 0% in the PSP-RS subsample and 15% in the vPSP subsample. CONCLUSIONS Visual interpretation of FDG-PET supported by voxel-based testing provides good accuracy for the detection of PSP-RS, but only fair sensitivity for vPSP. Automatic covariance pattern analysis outperforms visual interpretation in the detection of PSP-RS, provides clinically useful sensitivity for vPSP, and reduces the rate of false-positive findings. Thus, pattern expression analysis is clinically useful to complement visual reading and voxel-based testing of FDG-PET in suspected PSP. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Wegner
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | | | - Georg Berding
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Ivayla Apostolova
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Dierks
- Department of Nuclear Medicine, University Hospital Augsburg, Augsburg, Germany
| | - Sabrina Katzdobler
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU, Munich, Germany
| | - Martin Klietz
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU, Munich, Germany
| | - Nima Mahmoudi
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Andreas Rinscheid
- Medical Physics and Radiation Protection, University Hospital Augsburg, Augsburg, Germany
| | | | | | - Christine Schneider
- Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany
| | - Sophia Stöcklein
- Department of Radiology, University Hospital of Munich, LMU, Munich, Germany
| | - Phoebe G Spetsieris
- The Feinstein Institutes for Medical Research Manhasset, Manhasset, New York, USA
| | - David Eidelberg
- The Feinstein Institutes for Medical Research Manhasset, Manhasset, New York, USA
| | - Mike P Wattjes
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Günter Höglinger
- Department of Neurology, Hannover Medical School, Hannover, Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU, Munich, Germany
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7
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Carli G, Meles SK, Reesink FE, de Jong BM, Pilotto A, Padovani A, Galbiati A, Ferini-Strambi L, Leenders KL, Perani D. Comparison of univariate and multivariate analyses for brain [18F]FDG PET data in α-synucleinopathies. Neuroimage Clin 2023; 39:103475. [PMID: 37494757 PMCID: PMC10394024 DOI: 10.1016/j.nicl.2023.103475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/18/2023] [Accepted: 07/09/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Brain imaging with [18F]FDG-PET can support the diagnostic work-up of patients with α-synucleinopathies. Validated data analysis approaches are necessary to evaluate disease-specific brain metabolism patterns in neurodegenerative disorders. This study compared the univariate Statistical Parametric Mapping (SPM) single-subject procedure and the multivariate Scaled Subprofile Model/Principal Component Analysis (SSM/PCA) in a cohort of patients with α-synucleinopathies. METHODS We included [18F]FDG-PET scans of 122 subjects within the α-synucleinopathy spectrum: Parkinson's Disease (PD) normal cognition on long-term follow-up (PD - low risk to dementia (LDR); n = 28), PD who developed dementia on clinical follow-up (PD - high risk of dementia (HDR); n = 16), Dementia with Lewy Bodies (DLB; n = 67), and Multiple System Atrophy (MSA; n = 11). We also included [18F]FDG-PET scans of isolated REM sleep behaviour disorder (iRBD; n = 51) subjects with a high risk of developing a manifest α-synucleinopathy. Each [18F]FDG-PET scan was compared with 112 healthy controls using SPM procedures. In the SSM/PCA approach, we computed the individual scores of previously identified patterns for PD, DLB, and MSA: PD-related patterns (PDRP), DLBRP, and MSARP. We used ROC curves to compare the diagnostic performances of SPM t-maps (visual rating) and SSM/PCA individual pattern scores in identifying each clinical condition across the spectrum. Specifically, we used the clinical diagnoses ("gold standard") as our reference in ROC curves to evaluate the accuracy of the two methods. Experts in movement disorders and dementia made all the diagnoses according to the current clinical criteria of each disease (PD, DLB and MSA). RESULTS The visual rating of SPM t-maps showed higher performance (AUC: 0.995, specificity: 0.989, sensitivity 1.000) than PDRP z-scores (AUC: 0.818, specificity: 0.734, sensitivity 1.000) in differentiating PD-LDR from other α-synucleinopathies (PD-HDR, DLB and MSA). This result was mainly driven by the ability of SPM t-maps to reveal the limited or absent brain hypometabolism characteristics of PD-LDR. Both SPM t-maps visual rating and SSM/PCA z-scores showed high performance in identifying DLB (DLBRP = AUC: 0.909, specificity: 0.873, sensitivity 0.866; SPM t-maps = AUC: 0.892, specificity: 0.872, sensitivity 0.910) and MSA (MSARP: AUC: 0.921, specificity: 0.811, sensitivity 1.000; SPM t-maps: AUC: 1.000, specificity: 1.000, sensitivity 1.000) from other α-synucleinopathies. PD-HDR and DLB were comparable for the brain hypo and hypermetabolism patterns, thus not allowing differentiation by SPM t-maps or SSM/PCA. Of note, we found a gradual increase of PDRP and DLBRP expression in the continuum from iRBD to PD-HDR and DLB, where the DLB patients had the highest scores. SSM/PCA could differentiate iRBD from DLB, reflecting specifically the differences in disease staging and severity (AUC: 0.938, specificity: 0.821, sensitivity 0.941). CONCLUSIONS SPM-single subject maps and SSM/PCA are both valid methods in supporting diagnosis within the α-synucleinopathy spectrum, with different strengths and pitfalls. The former reveals dysfunctional brain topographies at the individual level with high accuracy for all the specific subtype patterns, and particularly also the normal maps; the latter provides a reliable quantification, independent from the rater experience, particularly in tracking the disease severity and staging. Thus, our findings suggest that differences in data analysis approaches exist and should be considered in clinical settings. However, combining both methods might offer the best diagnostic performance.
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Affiliation(s)
- Giulia Carli
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sanne K Meles
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Fransje E Reesink
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bauke M de Jong
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Andrea Galbiati
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neuroscience, Sleep Disorders Center, San Raffaele Hospital, Milan, Italy
| | - Luigi Ferini-Strambi
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neuroscience, Sleep Disorders Center, San Raffaele Hospital, Milan, Italy
| | - Klaus L Leenders
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Daniela Perani
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy; In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan; Nuclear Medicine Unit, San Raffaele Hospital, Milan, Italy.
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8
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O'Dell RS, Higgins-Chen A, Gupta D, Chen MK, Naganawa M, Toyonaga T, Lu Y, Ni G, Chupak A, Zhao W, Salardini E, Nabulsi NB, Huang Y, Arnsten AFT, Carson RE, van Dyck CH, Mecca AP. Principal component analysis of synaptic density measured with [ 11C]UCB-J PET in early Alzheimer's disease. Neuroimage Clin 2023; 39:103457. [PMID: 37422964 PMCID: PMC10338149 DOI: 10.1016/j.nicl.2023.103457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 05/01/2023] [Accepted: 06/19/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Synaptic loss is considered an early pathological event and major structural correlate of cognitive impairment in Alzheimer's disease (AD). We used principal component analysis (PCA) to identify regional patterns of covariance in synaptic density using [11C]UCB-J PET and assessed the association between principal components (PC) subject scores with cognitive performance. METHODS [11C]UCB-J binding was measured in 45 amyloid + participants with AD and 19 amyloid- cognitively normal participants aged 55-85. A validated neuropsychological battery assessed performance across five cognitive domains. PCA was applied to the pooled sample using distribution volume ratios (DVR) standardized (z-scored) by region from 42 bilateral regions of interest (ROI). RESULTS Parallel analysis determined three significant PCs explaining 70.2% of the total variance. PC1 was characterized by positive loadings with similar contributions across the majority of ROIs. PC2 was characterized by positive and negative loadings with strongest contributions from subcortical and parietooccipital cortical regions, respectively, while PC3 was characterized by positive and negative loadings with strongest contributions from rostral and caudal cortical regions, respectively. Within the AD group, PC1 subject scores were positively correlated with performance across all cognitive domains (Pearson r = 0.24-0.40, P = 0.06-0.006), PC2 subject scores were inversely correlated with age (Pearson r = -0.45, P = 0.002) and PC3 subject scores were significantly correlated with CDR-sb (Pearson r = 0.46, P = 0.04). No significant correlations were observed between cognitive performance and PC subject scores in CN participants. CONCLUSIONS This data-driven approach defined specific spatial patterns of synaptic density correlated with unique participant characteristics within the AD group. Our findings reinforce synaptic density as a robust biomarker of disease presence and severity in the early stages of AD.
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Affiliation(s)
- Ryan S O'Dell
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA.
| | - Albert Higgins-Chen
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA; Pain Research, Informatics, Multi-morbidities, and Education Center, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Dhruva Gupta
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA
| | - Ming-Kai Chen
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Mika Naganawa
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Takuya Toyonaga
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Yihuan Lu
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Gessica Ni
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA
| | - Anna Chupak
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA
| | - Wenzhen Zhao
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA
| | - Elaheh Salardini
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA
| | - Nabeel B Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Amy F T Arnsten
- Department of Neuroscience, Yale University School of Medicine, P.O. Box 208001, New Haven, CT 06520, USA
| | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Christopher H van Dyck
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA; Department of Neuroscience, Yale University School of Medicine, P.O. Box 208001, New Haven, CT 06520, USA; Department of Neurology, Yale University School of Medicine, P.O. Box 208018, New Haven, CT 06520, USA
| | - Adam P Mecca
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA.
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9
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Sasikumar S, Strafella AP. Structural and Molecular Imaging for Clinically Uncertain Parkinsonism. Semin Neurol 2023; 43:95-105. [PMID: 36878467 DOI: 10.1055/s-0043-1764228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Neuroimaging is an important adjunct to the clinical assessment of Parkinson disease (PD). Parkinsonism can be challenging to differentiate, especially in early disease stages, when it mimics other movement disorders or when there is a poor response to dopaminergic therapies. There is also a discrepancy between the phenotypic presentation of degenerative parkinsonism and the pathological outcome. The emergence of more sophisticated and accessible neuroimaging can identify molecular mechanisms of PD, the variation between clinical phenotypes, and the compensatory mechanisms that occur with disease progression. Ultra-high-field imaging techniques have improved spatial resolution and contrast that can detect microstructural changes, disruptions in neural pathways, and metabolic and blood flow alterations. We highlight the imaging modalities that can be accessed in clinical practice and recommend an approach to the diagnosis of clinically uncertain parkinsonism.
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Affiliation(s)
- Sanskriti Sasikumar
- Morton and Gloria Shulman Movement Disorder Unit and Edmond J. Safra Parkinson Disease Program, Neurology Division, Department of Medicine, University of Toronto, Toronto Western Hospital, UHN, Ontario, Canada
| | - Antonio P Strafella
- Morton and Gloria Shulman Movement Disorder Unit and Edmond J. Safra Parkinson Disease Program, Neurology Division, Department of Medicine, University of Toronto, Toronto Western Hospital, UHN, Ontario, Canada.,Krembil Brain Institute, University Health Network and Brain Health Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
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10
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Schröter N, Blazhenets G, Meyer PT, Rijntjes M, Brumberg J. [ 18F]PM-PBB3-PET Reveals Clinical and [ 18F]FDG-PET Mimics of 4-Repeat Tauopathy Caused by Creutzfeld-Jakob Disease. Mov Disord Clin Pract 2023; 10:531-532. [PMID: 36949786 PMCID: PMC10026304 DOI: 10.1002/mdc3.13683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/12/2022] [Accepted: 01/23/2023] [Indexed: 02/09/2023] Open
Affiliation(s)
- Nils Schröter
- Department of Neurology, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburg im BreisgauGermany
| | - Ganna Blazhenets
- Department of Nuclear Medicine, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburg im BreisgauGermany
| | - Philipp T. Meyer
- Department of Nuclear Medicine, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburg im BreisgauGermany
| | - Michel Rijntjes
- Department of Neurology, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburg im BreisgauGermany
| | - Joachim Brumberg
- Department of Nuclear Medicine, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburg im BreisgauGermany
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11
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The challenging quest of neuroimaging: From clinical to molecular-based subtyping of Parkinson disease and atypical parkinsonisms. HANDBOOK OF CLINICAL NEUROLOGY 2023; 192:231-258. [PMID: 36796945 DOI: 10.1016/b978-0-323-85538-9.00004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The current framework of Parkinson disease (PD) focuses on phenotypic classification despite its considerable heterogeneity. We argue that this method of classification has restricted therapeutic advances and therefore limited our ability to develop disease-modifying interventions in PD. Advances in neuroimaging have identified several molecular mechanisms relevant to PD, variation within and between clinical phenotypes, and potential compensatory mechanisms with disease progression. Magnetic resonance imaging (MRI) techniques can detect microstructural changes, disruptions in neural pathways, and metabolic and blood flow alterations. Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging have informed the neurotransmitter, metabolic, and inflammatory dysfunctions that could potentially distinguish disease phenotypes and predict response to therapy and clinical outcomes. However, rapid advancements in imaging techniques make it challenging to assess the significance of newer studies in the context of new theoretical frameworks. As such, there needs to not only be a standardization of practice criteria in molecular imaging but also a rethinking of target approaches. In order to harness precision medicine, a coordinated shift is needed toward divergent rather than convergent diagnostic approaches that account for interindividual differences rather than similarities within an affected population, and focus on predictive patterns rather than already lost neural activity.
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12
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Perovnik M, Rus T, Schindlbeck KA, Eidelberg D. Functional brain networks in the evaluation of patients with neurodegenerative disorders. Nat Rev Neurol 2023; 19:73-90. [PMID: 36539533 DOI: 10.1038/s41582-022-00753-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 12/24/2022]
Abstract
Network analytical tools are increasingly being applied to brain imaging maps of resting metabolic activity (PET) or blood oxygenation-dependent signals (functional MRI) to characterize the abnormal neural circuitry that underlies brain diseases. This approach is particularly valuable for the study of neurodegenerative disorders, which are characterized by stereotyped spread of pathology along discrete neural pathways. Identification and validation of disease-specific brain networks facilitate the quantitative assessment of pathway changes over time and during the course of treatment. Network abnormalities can often be identified before symptom onset and can be used to track disease progression even in the preclinical period. Likewise, network activity can be modulated by treatment and might therefore be used as a marker of efficacy in clinical trials. Finally, early differential diagnosis can be achieved by simultaneously measuring the activity levels of multiple disease networks in an individual patient's scans. Although these techniques were originally developed for PET, over the past several years analogous methods have been introduced for functional MRI, a more accessible non-invasive imaging modality. This advance is expected to broaden the application of network tools to large and diverse patient populations.
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Affiliation(s)
- Matej Perovnik
- Department of Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Tomaž Rus
- Department of Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | | | - David Eidelberg
- Center for Neurosciences, The Feinstein Institutes for Medical Research, Manhasset, NY, USA.
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13
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Katzdobler S, Nitschmann A, Barthel H, Bischof G, Beyer L, Marek K, Song M, Wagemann O, Palleis C, Weidinger E, Nack A, Fietzek U, Kurz C, Häckert J, Stapf T, Ferschmann C, Scheifele M, Eckenweber F, Biechele G, Franzmeier N, Dewenter A, Schönecker S, Saur D, Schroeter ML, Rumpf JJ, Rullmann M, Schildan A, Patt M, Stephens AW, van Eimeren T, Neumaier B, Drzezga A, Danek A, Classen J, Bürger K, Janowitz D, Rauchmann BS, Stöcklein S, Perneczky R, Schöberl F, Zwergal A, Höglinger GU, Bartenstein P, Villemagne V, Seibyl J, Sabri O, Levin J, Brendel M. Additive value of [ 18F]PI-2620 perfusion imaging in progressive supranuclear palsy and corticobasal syndrome. Eur J Nucl Med Mol Imaging 2023; 50:423-434. [PMID: 36102964 PMCID: PMC9816230 DOI: 10.1007/s00259-022-05964-w] [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: 01/17/2022] [Accepted: 09/01/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Early after [18F]PI-2620 PET tracer administration, perfusion imaging has potential for regional assessment of neuronal injury in neurodegenerative diseases. This is while standard late-phase [18F]PI-2620 tau-PET is able to discriminate the 4-repeat tauopathies progressive supranuclear palsy and corticobasal syndrome (4RTs) from disease controls and healthy controls. Here, we investigated whether early-phase [18F]PI-2620 PET has an additive value for biomarker based evaluation of 4RTs. METHODS Seventy-eight patients with 4RTs (71 ± 7 years, 39 female), 79 patients with other neurodegenerative diseases (67 ± 12 years, 35 female) and twelve age-matched controls (69 ± 8 years, 8 female) underwent dynamic (0-60 min) [18F]PI-2620 PET imaging. Regional perfusion (0.5-2.5 min p.i.) and tau load (20-40 min p.i.) were measured in 246 predefined brain regions [standardized-uptake-value ratios (SUVr), cerebellar reference]. Regional SUVr were compared between 4RTs and controls by an ANOVA including false-discovery-rate (FDR, p < 0.01) correction. Hypoperfusion in resulting 4RT target regions was evaluated at the patient level in all patients (mean value - 2SD threshold). Additionally, perfusion and tau pattern expression levels were explored regarding their potential discriminatory value of 4RTs against other neurodegenerative disorders, including validation in an independent external dataset (n = 37), and correlated with clinical severity in 4RTs (PSP rating scale, MoCA, activities of daily living). RESULTS Patients with 4RTs had significant hypoperfusion in 21/246 brain regions, most dominant in thalamus, caudate nucleus, and anterior cingulate cortex, fitting to the topology of the 4RT disease spectrum. However, single region hypoperfusion was not specific regarding the discrimination of patients with 4RTs against patients with other neurodegenerative diseases. In contrast, perfusion pattern expression showed promise for discrimination of patients with 4RTs from other neurodegenerative diseases (AUC: 0.850). Discrimination by the combined perfusion-tau pattern expression (AUC: 0.903) exceeded that of the sole tau pattern expression (AUC: 0.864) and the discriminatory power of the combined perfusion-tau pattern expression was replicated in the external dataset (AUC: 0.917). Perfusion but not tau pattern expression was associated with PSP rating scale (R = 0.402; p = 0.0012) and activities of daily living (R = - 0.431; p = 0.0005). CONCLUSION [18F]PI-2620 perfusion imaging mirrors known topology of regional hypoperfusion in 4RTs. Single region hypoperfusion is not specific for 4RTs, but perfusion pattern expression may provide an additive value for the discrimination of 4RTs from other neurodegenerative diseases and correlates closer with clinical severity than tau pattern expression.
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Affiliation(s)
- Sabrina Katzdobler
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Alexander Nitschmann
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Henryk Barthel
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Gerard Bischof
- grid.411097.a0000 0000 8852 305XDepartment of Nuclear Medicine, University Hospital Cologne, Cologne, Germany ,Molecular Organization of the Brain, Institute for Neuroscience and Medicine, INM-2), Jülich, Germany
| | - Leonie Beyer
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Ken Marek
- grid.452597.8InviCRO, LLC, Boston, MA USA ,grid.452597.8Molecular Neuroimaging, A Division of inviCRO, New Haven, CT USA
| | - Mengmeng Song
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Olivia Wagemann
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Carla Palleis
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Endy Weidinger
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Anne Nack
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Urban Fietzek
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Carolin Kurz
- grid.411095.80000 0004 0477 2585Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Jan Häckert
- grid.411095.80000 0004 0477 2585Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,grid.7307.30000 0001 2108 9006Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany
| | - Theresa Stapf
- grid.411095.80000 0004 0477 2585Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Christian Ferschmann
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Maximilian Scheifele
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Florian Eckenweber
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Gloria Biechele
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Nicolai Franzmeier
- grid.411095.80000 0004 0477 2585Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Anna Dewenter
- grid.411095.80000 0004 0477 2585Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sonja Schönecker
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Dorothee Saur
- grid.9647.c0000 0004 7669 9786Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Matthias L. Schroeter
- grid.9647.c0000 0004 7669 9786Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany ,grid.9647.c0000 0004 7669 9786LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany ,grid.419524.f0000 0001 0041 5028Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jost-Julian Rumpf
- grid.9647.c0000 0004 7669 9786Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Michael Rullmann
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Andreas Schildan
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Marianne Patt
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | | | - Thilo van Eimeren
- grid.411097.a0000 0000 8852 305XDepartment of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Bernd Neumaier
- grid.411097.a0000 0000 8852 305XDepartment of Nuclear Medicine, University Hospital Cologne, Cologne, Germany ,grid.8385.60000 0001 2297 375XInstitute for Neuroscience and Medicine (INM-3), Cognitive Neuroscience, Research Centre Juelich, Juelich, Germany
| | - Alexander Drzezga
- grid.411097.a0000 0000 8852 305XDepartment of Nuclear Medicine, University Hospital Cologne, Cologne, Germany ,Molecular Organization of the Brain, Institute for Neuroscience and Medicine, INM-2), Jülich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Adrian Danek
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Joseph Classen
- grid.9647.c0000 0004 7669 9786Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Katharina Bürger
- grid.411095.80000 0004 0477 2585Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Daniel Janowitz
- grid.411095.80000 0004 0477 2585Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- grid.7307.30000 0001 2108 9006Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany ,grid.411095.80000 0004 0477 2585Department of Radiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sophia Stöcklein
- grid.411095.80000 0004 0477 2585Department of Radiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Robert Perneczky
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ,grid.7307.30000 0001 2108 9006Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany ,grid.7445.20000 0001 2113 8111Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College, London, UK
| | - Florian Schöberl
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Andreas Zwergal
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Günter U. Höglinger
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ,grid.10423.340000 0000 9529 9877Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Peter Bartenstein
- grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ,grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Victor Villemagne
- grid.410678.c0000 0000 9374 3516Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, VIC Australia ,grid.1008.90000 0001 2179 088XDepartment of Medicine, Austin Health, The University of Melbourne, Melbourne, VIC Australia ,grid.21925.3d0000 0004 1936 9000Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA USA
| | - John Seibyl
- grid.452597.8InviCRO, LLC, Boston, MA USA ,grid.452597.8Molecular Neuroimaging, A Division of inviCRO, New Haven, CT USA
| | - Osama Sabri
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Johannes Levin
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Matthias Brendel
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ,grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
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14
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Parmera JB, de Oliveira MCB, Rodrigues RD, Coutinho AM. Progressive supranuclear palsy and corticobasal degeneration: novel clinical concepts and advances in biomarkers. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:126-136. [PMID: 35976324 PMCID: PMC9491415 DOI: 10.1590/0004-282x-anp-2022-s134] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are sporadic adult-onset primary tauopathies clinically classified among the atypical parkinsonian syndromes. They are intrinsically related with regard to their clinical features, pathology, biochemistry, and genetic risk factors. OBJECTIVES This review highlights the current knowledge on PSP and CBD, focusing on evolving clinical concepts, new diagnostic criteria, and advances in biomarkers. METHODS We performed a non-systematic literature review through the PubMed database. The search was restricted to articles written in English, published from 1964 to date. RESULTS Clinicopathologic and in vivo biomarkers studies have broadened PSP and CBD clinical phenotypes. They are now recognized as a range of motor and behavioral syndromes associated with underlying 4R-tauopathy neuropathology. The Movement Disorders Society PSP diagnostic criteria included clinical variants apart from the classical description, increasing diagnostic sensitivity. Meanwhile, imaging biomarkers have explored the complexity of symptoms and pathological processes related to corticobasal syndrome and CBD. CONCLUSIONS In recent years, several prospective or clinicopathologic studies have assessed clinical, radiological, and fluid biomarkers that have helped us gain a better understanding of the complexity of the 4R-tauopathies, mainly PSP and CBD.
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Affiliation(s)
- Jacy Bezerra Parmera
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo, SP, Brazil
| | | | - Roberta Diehl Rodrigues
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo, SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Radiologia, Laboratório de Medicina Nuclear (LIM 44), São Paulo, SP, Brazil
| | - Artur Martins Coutinho
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Radiologia, Centro de Medicina Nuclear, Laboratório de Medicina Nuclear (LIM 43), São Paulo, SP, Brazil
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15
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Riley KJ, Graner BD, Veronesi MC. The tauopathies: Neuroimaging characteristics and emerging experimental therapies. J Neuroimaging 2022; 32:565-581. [PMID: 35470528 PMCID: PMC9545715 DOI: 10.1111/jon.13001] [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: 01/10/2022] [Revised: 03/10/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022] Open
Abstract
The tauopathies are a heterogeneous group of neurodegenerative disorders in which the prevailing underlying disease process is intracellular deposition of abnormal misfolded tau protein. Diseases often categorized as tauopathies include progressive supranuclear palsy, chronic traumatic encephalopathy, corticobasal degeneration, and frontotemporal lobar degeneration. Tauopathies can be classified through clinical assessment, imaging findings, histologic validation, or molecular biomarkers tied to the underlying disease mechanism. Many tauopathies vary in their clinical presentation and overlap substantially in presentation, making clinical diagnosis of a specific primary tauopathy difficult. Anatomic imaging findings are also rarely specific to a single tauopathy, and when present may not manifest until well after the point at which therapy may be most impactful. Molecular biomarkers hold the most promise for patient care and form a platform upon which emerging diagnostic and therapeutic applications could be developed. One of the most exciting developments utilizing these molecular biomarkers for assessment of tau deposition within the brain is tau‐PET imaging utilizing novel ligands that specifically target tau protein. This review will discuss the background, significance, and clinical presentation of each tauopathy with additional attention to the pathologic mechanisms at the protein level. The imaging characteristics will be outlined with select examples of emerging imaging techniques. Finally, current treatment options and emerging therapies will be discussed. This is by no means a comprehensive review of the literature but is instead intended for the practicing radiologist as an overview of a rapidly evolving topic.
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Affiliation(s)
- Kalen J Riley
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Brian D Graner
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Michael C Veronesi
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
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16
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Arterial spin labeling imaging for the detection of cerebral blood flow asymmetry in patients with corticobasal syndrome. Neuroradiology 2022; 64:1829-1837. [DOI: 10.1007/s00234-022-02942-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
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17
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Fucoxanthin Prevents Long-Term Administration l-DOPA-Induced Neurotoxicity through the ERK/JNK-c-Jun System in 6-OHDA-Lesioned Mice and PC12 Cells. Mar Drugs 2022; 20:md20040245. [PMID: 35447917 PMCID: PMC9025159 DOI: 10.3390/md20040245] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 02/04/2023] Open
Abstract
As the most abundant marine carotenoid extracted from seaweeds, fucoxanthin is considered to have neuroprotective activity via its excellent antioxidant properties. Oxidative stress is regarded as an important starting factor for neuronal cell loss and necrosis, is one of the causes of Parkinson’s disease (PD), and is considered to be the cause of adverse reactions caused by the current PD commonly used treatment drug levodopa (l-DA). Supplementation with antioxidants early in PD can effectively prevent neurodegeneration and inhibit apoptosis in dopaminergic neurons. At present, the effect of fucoxanthin in improving the adverse effects triggered by long-term l-DA administration in PD patients is unclear. In the present study, we found that fucoxanthin can reduce cytotoxicity and suppress the high concentration of l-DA (200 μM)-mediated cell apoptosis in the 6-OHDA-induced PC12 cells through improving the reduction in mitochondrial membrane potential, suppressing ROS over-expression, and inhibiting active of ERK/JNK-c-Jun system and expression of caspase-3 protein. These results were demonstrated by PD mice with long-term administration of l-DA showing enhanced motor ability after intervention with fucoxanthin. Our data indicate that fucoxanthin may prove useful in the treatment of PD patients with long-term l-DA administration.
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18
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A replication study, systematic review and meta-analysis of automated image-based diagnosis in parkinsonism. Sci Rep 2022; 12:2763. [PMID: 35177751 PMCID: PMC8854576 DOI: 10.1038/s41598-022-06663-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 02/02/2022] [Indexed: 12/28/2022] Open
Abstract
Differential diagnosis of parkinsonism early upon symptom onset is often challenging for clinicians and stressful for patients. Several neuroimaging methods have been previously evaluated; however specific routines remain to be established. The aim of this study was to systematically assess the diagnostic accuracy of a previously developed 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) based automated algorithm in the diagnosis of parkinsonian syndromes, including unpublished data from a prospective cohort. A series of 35 patients prospectively recruited in a movement disorder clinic in Stockholm were assessed, followed by systematic literature review and meta-analysis. In our cohort, automated image-based classification method showed excellent sensitivity and specificity for Parkinson Disease (PD) vs. atypical parkinsonian syndromes (APS), in line with the results of the meta-analysis (pooled sensitivity and specificity 0.84; 95% CI 0.79-0.88 and 0.96; 95% CI 0.91 -0.98, respectively). In conclusion, FDG-PET automated analysis has an excellent potential to distinguish between PD and APS early in the disease course and may be a valuable tool in clinical routine as well as in research applications.
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19
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Abstract
Positron emission tomography greatly advanced our understanding on the underlying neural mechanisms of movement disorders. PET with flurodeoxyglucose (FDG) is especially useful as it depicts regional metabolic activity level that can predict patients' symptoms. Multivariate pattern analysis has been used to determine and quantify the co-varying brain networks associated with specific clinical traits of neurodegenerative disease. The result is a biomarker, useful for diagnosis, treatments, and follow up studies. Parkinsonian traits and parkinsonisms are associated with specific spatial pattern of metabolic abnormality useful for differential diagnosis. This approach has also been used for monitoring disease progression and novel treatment responses mostly in Parkinson's disease. In this book chapter, we, illustrate and discuss the significance of the brain networks associated with disease and their modification with neuroplastic changes.
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20
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Ezura M, Kikuchi A, Okamura N, Ishiki A, Hasegawa T, Harada R, Watanuki S, Funaki Y, Hiraoka K, Baba T, Sugeno N, Yoshida S, Kobayashi J, Kobayashi M, Tano O, Ishiyama S, Nakamura T, Nakashima I, Mugikura S, Iwata R, Taki Y, Furukawa K, Arai H, Furumoto S, Tashiro M, Yanai K, Kudo Y, Takeda A, Aoki M. 18F-THK5351 Positron Emission Tomography Imaging in Neurodegenerative Tauopathies. Front Aging Neurosci 2021; 13:761010. [PMID: 34912209 PMCID: PMC8668184 DOI: 10.3389/fnagi.2021.761010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: We aimed to determine whether in vivo tau deposits and monoamine oxidase B (MAO-B) detection using 18F-THK5351 positron emission tomography (PET) can assist in the differential distribution in patients with corticobasal syndrome (CBS), progressive supranuclear palsy (PSP), and Alzheimer's disease (AD) and whether 18F-THK5351 retention of lesion sites in CBS and PSP can correlate with clinical parameters. Methods: 18F-THK5351 PET was performed in 35 participants, including 7, 9, and 10 patients with CBS, PSP, and AD, respectively, and 9 age-matched normal controls. In CBS and PSP, cognitive and motor functions were assessed using the Montreal Cognitive Assessment, Addenbrooke's Cognitive Examination-Revised, and Frontal Assessment Battery, Unified Parkinson's Disease Rating Scale Motor Score, and PSP Rating Scale. Results: 18F-THK5351 retention was observed in sites susceptible to disease-related pathologies in CBS, PSP, and AD. 18F-THK5351 uptake in the precentral gyrus clearly differentiated patients with CBS from those with PSP and AD. Furthermore, 18F-THK5351 uptake in the inferior temporal gyrus clearly differentiated patients with AD from those with CBS and PSP. Regional 18F-THK5351 retention was associated with the cognitive function in CBS and PSP. Conclusion: Measurement of the tau deposits and MAO-B density in the brain using 18F-THK5351 may be helpful for the differential diagnosis of tauopathies and for understanding disease stages.
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Affiliation(s)
- Michinori Ezura
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akio Kikuchi
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Occupational Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Nobuyuki Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.,Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Aiko Ishiki
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Division of Community of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takafumi Hasegawa
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryuichi Harada
- Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shoichi Watanuki
- Division of Cyclotron Nuclear Medicine, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Yoshihito Funaki
- Division of Radiopharmaceutical Chemistry, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Kotaro Hiraoka
- Division of Cyclotron Nuclear Medicine, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Toru Baba
- Department of Neurology, National Hospital Organization Sendai Nishitaga Hospital, Sendai, Japan
| | - Naoto Sugeno
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shun Yoshida
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Junpei Kobayashi
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Michiko Kobayashi
- Division of Neurology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Ohito Tano
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shun Ishiyama
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takaaki Nakamura
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ichiro Nakashima
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Division of Neurology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Shunji Mugikura
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ren Iwata
- Division of Radiopharmaceutical Chemistry, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Yasuyuki Taki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Katsutoshi Furukawa
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Division of Community of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Hiroyuki Arai
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Shozo Furumoto
- Division of Radiopharmaceutical Chemistry, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Manabu Tashiro
- Division of Cyclotron Nuclear Medicine, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Kazuhiko Yanai
- Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yukitsuka Kudo
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Atsushi Takeda
- Department of Neurology, National Hospital Organization Sendai Nishitaga Hospital, Sendai, Japan
| | - Masashi Aoki
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
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21
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Guedj E, Varrone A, Boellaard R, Albert NL, Barthel H, van Berckel B, Brendel M, Cecchin D, Ekmekcioglu O, Garibotto V, Lammertsma AA, Law I, Peñuelas I, Semah F, Traub-Weidinger T, van de Giessen E, Van Weehaeghe D, Morbelli S. EANM procedure guidelines for brain PET imaging using [ 18F]FDG, version 3. Eur J Nucl Med Mol Imaging 2021; 49:632-651. [PMID: 34882261 PMCID: PMC8803744 DOI: 10.1007/s00259-021-05603-w] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 10/21/2021] [Indexed: 12/13/2022]
Abstract
The present procedural guidelines summarize the current views of the EANM Neuro-Imaging Committee (NIC). The purpose of these guidelines is to assist nuclear medicine practitioners in making recommendations, performing, interpreting, and reporting results of [18F]FDG-PET imaging of the brain. The aim is to help achieve a high-quality standard of [18F]FDG brain imaging and to further increase the diagnostic impact of this technique in neurological, neurosurgical, and psychiatric practice. The present document replaces a former version of the guidelines that have been published in 2009. These new guidelines include an update in the light of advances in PET technology such as the introduction of digital PET and hybrid PET/MR systems, advances in individual PET semiquantitative analysis, and current broadening clinical indications (e.g., for encephalitis and brain lymphoma). Further insight has also become available about hyperglycemia effects in patients who undergo brain [18F]FDG-PET. Accordingly, the patient preparation procedure has been updated. Finally, most typical brain patterns of metabolic changes are summarized for neurodegenerative diseases. The present guidelines are specifically intended to present information related to the European practice. The information provided should be taken in the context of local conditions and regulations.
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Affiliation(s)
- Eric Guedj
- APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, Nuclear Medicine Department, Aix Marseille Univ, Marseille, France. .,Service Central de Biophysique et Médecine Nucléaire, Hôpital de la Timone, 264 rue Saint Pierre, 13005, Marseille, France.
| | - Andrea Varrone
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Healthcare Services, Stockholm, Sweden
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands.,Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Nathalie L Albert
- Department of Nuclear Medicine, Ludwig Maximilians-University of Munich, Munich, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University, Leipzig, Germany
| | - Bart van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Matthias Brendel
- Department of Nuclear Medicine, Ludwig Maximilians-University of Munich, Munich, Germany.,German Centre of Neurodegenerative Diseases (DZNE), Site Munich, Bonn, Germany
| | - Diego Cecchin
- Nuclear Medicine Unit, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Ozgul Ekmekcioglu
- Sisli Hamidiye Etfal Education and Research Hospital, Nuclear Medicine Dept., University of Health Sciences, Istanbul, Turkey
| | - Valentina Garibotto
- NIMTLab, Faculty of Medicine, Geneva University, Geneva, Switzerland.,Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands.,Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Iván Peñuelas
- Department of Nuclear Medicine, Clinica Universidad de Navarra, IdiSNA, University of Navarra, Pamplona, Spain
| | - Franck Semah
- Nuclear Medicine Department, University Hospital, Lille, France
| | - Tatjana Traub-Weidinger
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Elsmarieke van de Giessen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands.,Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, Meibergdreef 9, Amsterdam, The Netherlands
| | | | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Nuclear Medicine Unit, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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22
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Implication of metabolic and dopamine transporter PET in dementia with Lewy bodies. Sci Rep 2021; 11:14394. [PMID: 34257349 PMCID: PMC8277897 DOI: 10.1038/s41598-021-93442-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/24/2021] [Indexed: 11/08/2022] Open
Abstract
To evaluate the implication of 18F-fluorodeoxyglucose (FDG)- and dopamine transporter (DAT)-positron emission tomography (PET) in the diagnosis and clinical symptoms of dementia with Lewy bodies (DLB), 55 DLB patients and 49 controls underwent neuropsychological evaluation and FDG-, DAT-, and 18F-Florbetaben (FBB) PET. DAT- and FDG-uptake and FDG/DAT ratio were measured in the anterior and posterior striatum. The first principal component (PC1) of FDG subject residual profiles was identified for each subject. Receiver operating characteristic curve analyses for the diagnosis of DLB were performed using FDG- and DAT-PET biomarkers as predictors, and general linear models for motor severity and cognitive scores were performed adding FBB standardized uptake value ratio as a predictor. Increased metabolism in the bilateral putamen, vermis, and somato-motor cortices, which characterized PC1, was observed in the DLB group, compared to the control group. A combination of posterior putamen FDG/DAT ratio and PC1 showed the highest diagnostic accuracy (91.8% sensitivity and 96.4% specificity), which was significantly greater than that obtained by DAT uptake alone. Striatal DAT uptake and PC1 independently contributed to motor severity and language, memory, frontal/executive, and general cognitive dysfunction in DLB patients, while only PC1 contributed to attention and visuospatial dysfunction.
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23
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Lu J, Huang L, Lv Y, Peng S, Xu Q, Li L, Ge J, Zhang H, Guan Y, Zhao Q, Guo Q, Chen K, Wu P, Ma Y, Zuo C. A disease-specific metabolic imaging marker for diagnosis and progression evaluation of semantic variant primary progressive aphasia. Eur J Neurol 2021; 28:2927-2939. [PMID: 34110063 DOI: 10.1111/ene.14919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE The diagnosis and monitoring of semantic variant primary progressive aphasia (sv-PPA) are clinically challenging. We aimed to establish a distinctive metabolic pattern in sv-PPA for diagnosis and severity evaluation. METHODS Fifteen sv-PPA patients and 15 controls were enrolled to identify sv-PPA-related pattern (sv-PPARP) by principal component analysis of 18 F-fluorodeoxyglucose positron emission tomography. Eighteen Alzheimer disease dementia (AD) and 14 behavioral variant frontotemporal dementia (bv-FTD) patients were enrolled to test the discriminatory power. Correspondingly, regional metabolic activities extracted from the voxelwise analysis were evaluated for the discriminatory power. RESULTS The sv-PPARP was characterized as decreased metabolic activity mainly in the bilateral temporal lobe (left predominance), middle orbitofrontal gyrus, left hippocampus/parahippocampus gyrus, fusiform gyrus, insula, inferior orbitofrontal gyrus, and striatum, with increased activity in the bilateral lingual gyrus, cuneus, calcarine gyrus, and right precentral and postcentral gyrus. The pattern expression had significant discriminatory power (area under the curve [AUC] = 0.98, sensitivity = 100%, specificity = 94.4%) in distinguishing sv-PPA from AD, and the asymmetry index offered complementary discriminatory power (AUC = 0.91, sensitivity = 86.7%, specificity = 92.9%) in distinguishing sv-PPA from bv-FTD. In sv-PPA patients, the pattern expression correlated with Boston Naming Test scores at baseline and showed significant increase in the subset of patients with follow-up. The voxelwise analysis showed similar topography, and the regional metabolic activities had equivalent or better discriminatory power and clinical correlations with Boston Naming Test scores. The ability to reflect disease progression in longitudinal follow-up seemed to be inferior to the pattern expression. CONCLUSIONS The sv-PPARP might serve as an objective biomarker for diagnosis and progression evaluation.
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Affiliation(s)
- Jiaying Lu
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Lin Huang
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yingru Lv
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shichun Peng
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Qian Xu
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ling Li
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jingjie Ge
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Huiwei Zhang
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yihui Guan
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qihao Guo
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Keliang Chen
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ping Wu
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yilong Ma
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Chuantao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,Human Phenome Institute, Fudan University, Shanghai, China.,Institute of Functional and Molecular Medicine Imaging, Fudan University, Shanghai, China
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24
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Cerami C, Dodich A, Iannaccone S, Magnani G, Marcone A, Guglielmo P, Vanoli G, Cappa SF, Perani D. Individual Brain Metabolic Signatures in Corticobasal Syndrome. J Alzheimers Dis 2021; 76:517-528. [PMID: 32538847 DOI: 10.3233/jad-200153] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Corticobasal syndrome (CBS) is the usual clinical presentation of patients with corticobasal degeneration pathology. Nevertheless, there are CBS individuals with postmortem neuropathology typical of Alzheimer's disease (AD). OBJECTIVE In this study, we aim to detect FDG-PET metabolic signatures at the single-subject level in a CBS sample, also evaluated with cerebrospinal fluid (CSF) markers for AD pathology. METHODS 21 patients (68.9±6.4 years; MMSE score = 21.7±6.3) fulfilling current criteria for CBS were enrolled. All underwent a clinical-neuropsychological assessment and an instrumental evaluation for biomarkers of neurodegeneration, amyloid and tau pathology (i.e., FDG-PET imaging and CSF Aβ42 and tau levels) at close intervals. CBS subjects were classified according to the presence or absence of CSF markers of AD pathology (i.e., low Aβ42 and high phosphorylated tau levels). Optimized voxel-based SPM procedures provided FDG-PET metabolic patterns at the single-subject and group levels. RESULTS Eight CBS had an AD-like CSF profile (CBS-AD), while thirteen were negative (CBS-noAD). The two subgroups did not differ in demographic characteristics or global cognitive impairment. FDG-PET SPM t-maps identified different metabolic signatures. Namely, all CBS-AD patients showed the typical AD-like hypometabolic pattern involving posterior cingulate cortex, precuneus and temporo-parietal cortex, whereas CBS-noAD cases showed bilateral hypometabolism in fronto-insular cortex and basal ganglia that is typical of the frontotemporal lobar degeneration spectrum. DISCUSSION These results strongly suggest the inclusion of FDG-PET imaging in the diagnostic algorithm of individuals with CBS clinical phenotype in order to early identify functional metabolic signatures due to different neuropathological substrates, thus improving the diagnostic accuracy.
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Affiliation(s)
- Chiara Cerami
- Dipartimento di Scienze Umane e della Vita, Scuola Universitaria di Studi Superiori IUSS Pavia, Pavia, Italy.,IRCCS Mondino Foundation, Pavia, Italy
| | - Alessandra Dodich
- CeRiN, Centre for Mind/Brain Sciences, University of Trento, Rovereto, Italy
| | | | | | | | | | | | - Stefano F Cappa
- Dipartimento di Scienze Umane e della Vita, Scuola Universitaria di Studi Superiori IUSS Pavia, Pavia, Italy.,IRCCS Mondino Foundation, Pavia, Italy
| | - Daniela Perani
- Nuclear Medicine Unit, San Raffaele Hospital, Milan, Italy.,Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
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25
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Peng S, Dhawan V, Eidelberg D, Ma Y. Neuroimaging evaluation of deep brain stimulation in the treatment of representative neurodegenerative and neuropsychiatric disorders. Bioelectron Med 2021; 7:4. [PMID: 33781350 PMCID: PMC8008578 DOI: 10.1186/s42234-021-00065-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/02/2021] [Indexed: 01/16/2023] Open
Abstract
Brain stimulation technology has become a viable modality of reversible interventions in the effective treatment of many neurological and psychiatric disorders. It is aimed to restore brain dysfunction by the targeted delivery of specific electronic signal within or outside the brain to modulate neural activity on local and circuit levels. Development of therapeutic approaches with brain stimulation goes in tandem with the use of neuroimaging methodology in every step of the way. Indeed, multimodality neuroimaging tools have played important roles in target identification, neurosurgical planning, placement of stimulators and post-operative confirmation. They have also been indispensable in pre-treatment screen to identify potential responders and in post-treatment to assess the modulation of brain circuitry in relation to clinical outcome measures. Studies in patients to date have elucidated novel neurobiological mechanisms underlying the neuropathogenesis, action of stimulations, brain responses and therapeutic efficacy. In this article, we review some applications of deep brain stimulation for the treatment of several diseases in the field of neurology and psychiatry. We highlight how the synergistic combination of brain stimulation and neuroimaging technology is posed to accelerate the development of symptomatic therapies and bring revolutionary advances in the domain of bioelectronic medicine.
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Affiliation(s)
- Shichun Peng
- Center for Neurosciences, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, New York, 11030, USA
| | - Vijay Dhawan
- Center for Neurosciences, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, New York, 11030, USA
| | - David Eidelberg
- Center for Neurosciences, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, New York, 11030, USA
| | - Yilong Ma
- Center for Neurosciences, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, New York, 11030, USA.
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26
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Peng S, Tang C, Schindlbeck K, Rydzinski Y, Dhawan V, Spetsieris PG, Ma Y, Eidelberg D. Dynamic 18F-FPCIT PET: Quantification of Parkinson's disease metabolic networks and nigrostriatal dopaminergic dysfunction in a single imaging session. J Nucl Med 2021; 62:jnumed.120.257345. [PMID: 33741649 PMCID: PMC8612203 DOI: 10.2967/jnumed.120.257345] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/09/2021] [Accepted: 03/09/2021] [Indexed: 11/16/2022] Open
Abstract
Previous multi-center imaging studies with 18F-FDG PET have established the presence of Parkinson's disease motor- and cognition-related metabolic patterns termed PDRP and PDCP in patients with this disorder. Given that in PD cerebral perfusion and glucose metabolism are typically coupled in the absence of medication, we determined whether subject expression of these disease networks can be quantified in early-phase images from dynamic 18F-FPCIT PET scans acquired to assess striatal dopamine transporter (DAT) binding. Methods: We studied a cohort of early-stage PD patients and age-matched healthy control subjects who underwent 18F-FPCIT at baseline; scans were repeated 4 years later in a smaller subset of patients. The early 18F-FPCIT frames, which reflect cerebral perfusion, were used to compute PDRP and PDCP expression (subject scores) in each subject, and compared to analogous measures computed based on 18F-FDG PET scan when additionally available. The late 18F-FPCIT frames were used to measure caudate and putamen DAT binding in the same individuals. Results: PDRP subject scores from early-phase 18F-FPCIT and 18F-FDG scans were elevated and striatal DAT binding reduced in PD versus healthy subjects. The PDRP scores from 18F-FPCIT correlated with clinical motor ratings, disease duration, and with corresponding measures from 18F-FDG PET. In addition to correlating with disease duration and analogous 18F-FDG PET values, PDCP scores correlated with DAT binding in the caudate/anterior putamen. PDRP and PDCP subject scores using either method rose over 4 years whereas striatal DAT binding declined over the same time period. Conclusion: Early-phase images obtained with 18F-FPCIT PET can provide an alternative to 18F-FDG PET for PD network quantification. This technique therefore allows PDRP/PDCP expression and caudate/putamen DAT binding to be evaluated with a single tracer in one scanning session.
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Affiliation(s)
- Shichun Peng
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York; and
| | - Chris Tang
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York; and
| | - Katharina Schindlbeck
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York; and
| | - Yaacov Rydzinski
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Vijay Dhawan
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York; and
| | - Phoebe G. Spetsieris
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York; and
| | - Yilong Ma
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York; and
| | - David Eidelberg
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York; and
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Frey KA. Molecular Imaging of Extrapyramidal Movement Disorders With Dementia: The 4R Tauopathies. Semin Nucl Med 2021; 51:275-285. [PMID: 33431202 DOI: 10.1053/j.semnuclmed.2020.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Two pathologically distinct neurodegenerative conditions, progressive supranuclear palsy and corticobasal degeneration, share in common deposits of tau proteins that differ both molecularly and ultrastructurally from the common tau deposits diagnostic of Alzheimer disease. The proteinopathy in these disorders is characterized by fibrillary aggregates of 4R tau proteins. The clinical presentations of progressive supranuclear palsy and of corticobasal degeneration are often confused with more common disorders such as Parkinson disease or subtypes of frontotemporal lobar degeneration. Neither of these 4R tau disorders has effective therapy, and while there are emerging molecular imaging approaches to identify patients earlier in the course of disease, there are as yet no reliably sensitive and specific approaches to diagnoses in life. In this review, aspects of the clinical syndromes, neuropathology, and molecular biomarker imaging studies applicable to progressive supranuclear palsy and to corticobasal degeneration will be presented. Future development of more accurate molecular imaging approaches is proposed.
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Affiliation(s)
- Kirk A Frey
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, The University of Michigan Health System, Ann Arbor, MI.
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van Veen R, Gurvits V, Kogan RV, Meles SK, de Vries GJ, Renken RJ, Rodriguez-Oroz MC, Rodriguez-Rojas R, Arnaldi D, Raffa S, de Jong BM, Leenders KL, Biehl M. An application of generalized matrix learning vector quantization in neuroimaging. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 197:105708. [PMID: 32977181 DOI: 10.1016/j.cmpb.2020.105708] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 08/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Neurodegenerative diseases like Parkinson's disease often take several years before they can be diagnosed reliably based on clinical grounds. Imaging techniques such as MRI are used to detect anatomical (structural) pathological changes. However, these kinds of changes are usually seen only late in the development. The measurement of functional brain activity by means of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) can provide useful information, but its interpretation is more difficult. The scaled sub-profile model principal component analysis (SSM/PCA) was shown to provide more useful information than other statistical techniques. Our objective is to improve the performance further by combining SSM/PCA and prototype-based generalized matrix learning vector quantization (GMLVQ). METHODS We apply a combination of SSM/PCA and GMLVQ as a classifier. In order to demonstrate the combination's validity, we analyze FDG-PET data of Parkinson's disease (PD) patients collected at three different neuroimaging centers in Europe. We determine the diagnostic performance by performing a ten times repeated ten fold cross validation. Additionally, discriminant visualizations of the data are included. The prototypes and relevance of GMLVQ are transformed back to the original voxel space by exploiting the linearity of SSM/PCA. The resulting prototypes and relevance profiles have then been assessed by three neurologists. RESULTS One important finding is that discriminative visualization can help to identify disease-related properties as well as differences which are due to center-specific factors. Secondly, the neurologist assessed the interpretability of the method and confirmed that prototypes are similar to known activity profiles of PD patients. CONCLUSION We have shown that the presented combination of SSM/PCA and GMLVQ can provide useful means to assess and better understand characteristic differences in FDG-PET data from PD patients and HCs. Based on the assessments by medical experts and the results of our computational analysis we conclude that the first steps towards a diagnostic support system have been taken successfully.
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Affiliation(s)
- Rick van Veen
- Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, the Netherlands.
| | - Vita Gurvits
- Department of Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, the Netherlands
| | - Rosalie V Kogan
- Department of Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, the Netherlands
| | - Sanne K Meles
- Department of Neurology, University Medical Centre Groningen, the Netherlands
| | | | - Remco J Renken
- Department of Biomedical Sciences of Cells & Systems, Cognitive Neuroscience Center, University Medical Center Groningen, the Netherlands
| | | | | | - Dario Arnaldi
- Department of Neuroscience, University of Genoa, Italy; Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Stefano Raffa
- Department of Health Sciences, University of Genoa, Italy; Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Bauke M de Jong
- Department of Neurology, University Medical Centre Groningen, the Netherlands
| | - Klaus L Leenders
- Department of Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, the Netherlands
| | - Michael Biehl
- Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, the Netherlands
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29
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Dave A, Hansen N, Downey R, Johnson C. FDG-PET Imaging of Dementia and Neurodegenerative Disease. Semin Ultrasound CT MR 2020; 41:562-571. [DOI: 10.1053/j.sult.2020.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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30
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Parmera JB, Coutinho AM, Aranha MR, Studart-Neto A, de Godoi Carneiro C, de Almeida IJ, Fontoura Solla DJ, Ono CR, Barbosa ER, Nitrini R, Buchpiguel CA, Brucki SMD. FDG-PET Patterns Predict Amyloid Deposition and Clinical Profile in Corticobasal Syndrome. Mov Disord 2020; 36:651-661. [PMID: 33206389 DOI: 10.1002/mds.28373] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/13/2020] [Accepted: 10/19/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Corticobasal syndrome (CBS) is an atypical parkinsonian syndrome related to multiple underlying pathologies. OBJECTIVE To investigate if individual brain [18 F]fluorodeoxyglucose-positron emission tomography (FDG-PET) patterns could distinguish CBS due to Alzheimer's disease (AD) from other pathologies based on [11 C]Pittsburgh Compound-B (PIB)-PET. METHODS Forty-five patients with probable CBS were prospectively evaluated regarding cognitive and movement disorders profile. They underwent FDG-PET and were distributed into groups: likely related to AD (CBS FDG-AD) or likely non-AD (CBS FDG-nonAD) pathology. Thirty patients underwent PIB-PET on a hybrid PET-magnetic resonance imaging equipment to assess their amyloid status. FDG and PIB-PET images were classified individually based on visual and semi-quantitative analysis, blinded to each other. Quantitative group analyses were also performed. RESULTS CBS FDG-AD group demonstrated worse cognitive performances, mostly concerning attention, memory, visuospatial domains, and displayed more myoclonus and hallucinations. The non-AD metabolic group presented more often limb dystonia, ocular motor dysfunction, motor perseveration, and dysarthria. All patients classified as CBS FDG-AD tested positive at PIB-PET compared to 3 of 20 in the non-AD group. The individual FDG-PET classification demonstrated 76.92% of sensitivity, 100% of specificity and positive predictive value and 88.5% of balanced accuracy to detect positive PIB-PET scans. Individuals with positive and negative PIB-PET showed hypometabolism in posterior temporoparietal areas and in thalamus and brainstem, respectively, mainly contralateral to most affected side, disclosing possible metabolic signatures of CBS variants. CONCLUSION FDG-PET was useful to predict AD and non-AD CBS variants depicting their specific degeneration patterns, different clinical features, and brain amyloid deposition. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Jacy Bezerra Parmera
- Department of Neurology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Artur Martins Coutinho
- Laboratory of Nuclear Medicine (LIM 43), Center of Nuclear Medicine, Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Mateus Rozalem Aranha
- Laboratory of Nuclear Medicine (LIM 43), Center of Nuclear Medicine, Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Magnetic Resonance in Neuroradiology (LIM 44), Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Adalberto Studart-Neto
- Department of Neurology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Camila de Godoi Carneiro
- Laboratory of Nuclear Medicine (LIM 43), Center of Nuclear Medicine, Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Isabel Junqueira de Almeida
- Department of Physical Therapy, Speech, and Occupational Therapy, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Davi J Fontoura Solla
- Department of Neurology, Division of Neurosurgery, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Carla Rachel Ono
- Laboratory of Nuclear Medicine (LIM 43), Center of Nuclear Medicine, Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Egberto Reis Barbosa
- Department of Neurology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Ricardo Nitrini
- Department of Neurology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Carlos Alberto Buchpiguel
- Laboratory of Nuclear Medicine (LIM 43), Center of Nuclear Medicine, Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Sonia Maria Dozzi Brucki
- Department of Neurology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
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Saeed U, Lang AE, Masellis M. Neuroimaging Advances in Parkinson's Disease and Atypical Parkinsonian Syndromes. Front Neurol 2020; 11:572976. [PMID: 33178113 PMCID: PMC7593544 DOI: 10.3389/fneur.2020.572976] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/02/2020] [Indexed: 12/11/2022] Open
Abstract
Parkinson's disease (PD) and atypical Parkinsonian syndromes are progressive heterogeneous neurodegenerative diseases that share clinical characteristic of parkinsonism as a common feature, but are considered distinct clinicopathological disorders. Based on the predominant protein aggregates observed within the brain, these disorders are categorized as, (1) α-synucleinopathies, which include PD and other Lewy body spectrum disorders as well as multiple system atrophy, and (2) tauopathies, which comprise progressive supranuclear palsy and corticobasal degeneration. Although, great strides have been made in neurodegenerative disease research since the first medical description of PD in 1817 by James Parkinson, these disorders remain a major diagnostic and treatment challenge. A valid diagnosis at early disease stages is of paramount importance, as it can help accommodate differential prognostic and disease management approaches, enable the elucidation of reliable clinicopathological relationships ideally at prodromal stages, as well as facilitate the evaluation of novel therapeutics in clinical trials. However, the pursuit for early diagnosis in PD and atypical Parkinsonian syndromes is hindered by substantial clinical and pathological heterogeneity, which can influence disease presentation and progression. Therefore, reliable neuroimaging biomarkers are required in order to enhance diagnostic certainty and ensure more informed diagnostic decisions. In this article, an updated presentation of well-established and emerging neuroimaging biomarkers are reviewed from the following modalities: (1) structural magnetic resonance imaging (MRI), (2) diffusion-weighted and diffusion tensor MRI, (3) resting-state and task-based functional MRI, (4) proton magnetic resonance spectroscopy, (5) transcranial B-mode sonography for measuring substantia nigra and lentiform nucleus echogenicity, (6) single photon emission computed tomography for assessing the dopaminergic system and cerebral perfusion, and (7) positron emission tomography for quantifying nigrostriatal functions, glucose metabolism, amyloid, tau and α-synuclein molecular imaging, as well as neuroinflammation. Multiple biomarkers obtained from different neuroimaging modalities can provide distinct yet corroborative information on the underlying neurodegenerative processes. This integrative "multimodal approach" may prove superior to single modality-based methods. Indeed, owing to the international, multi-centered, collaborative research initiatives as well as refinements in neuroimaging technology that are currently underway, the upcoming decades will mark a pivotal and exciting era of further advancements in this field of neuroscience.
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Affiliation(s)
- Usman Saeed
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Anthony E Lang
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Edmond J Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Mario Masellis
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Center, Toronto, ON, Canada.,Cognitive and Movement Disorders Clinic, Sunnybrook Health Sciences Center, Toronto, ON, Canada
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van Eimeren T, Claßen J, Drzezga A, Eggers C, Hilker-Roggendorf R, Klucken J, Koschel J, Meyer PT, Redecker C, Theis H, Buhmann C. [Recommendation for the differentiated use of nuclear medical diagnostic for parkinsonian syndromes]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2020; 88:609-619. [PMID: 32957144 DOI: 10.1055/a-1207-0515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The present work provides an overview of the various nuclear medicine methods in the diagnosis of neurodegenerative parkinsonian syndromes and their respective evidence and is intended to enable practical decision-making aids in the application and interpretation of the methods and findings. The value of the procedures differs considerably in relation to the two relevant diagnostic questions. On the one hand, it is the question of whether there is a neurodegenerative parkinsonian syndrome at all, and on the other hand the question of which one. While the DAT-SPECT is undisputedly the method of choice for answering the first question (taking certain parameters into account), this method is not suitable for answering the second question. To categorise parkinsonian syndromes into idiopathic (i. e. Parkinson´s disease) or atypical, various procedures are used in everyday clinical practice including MIBG scintigraphy, and FDG-PET. We explain why FDG-PET currently is not only the most suitable of these methods to differentiate an idiopathic parkinsonian syndrome, from an atypical Parkinson's syndrome, but also enables sufficiently valid to distinguish the various atypical neurodegenerative Parkinson's syndromes (i. e. MSA, PSP and CBD) from each other and therefore should be reimbursed by health insurances.
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Affiliation(s)
- Thilo van Eimeren
- Uniklinik Köln, Klinik und Poliklinik für Nuklearmedizin; Klinik und Poliklinik für Neurologie; Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)
| | - Joseph Claßen
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Leipzig
| | - Alexander Drzezga
- Uniklinik Köln, Klinik und Poliklinik für Nuklearmedizin; Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE); Institut für Neurowissenschaften und Medizin (INM-2), Forschungszentrum Jülich
| | - Carsten Eggers
- Klinik für Neurologie, Universitätsklinikum Gießen und Marburg, Standort Marburg; Center for Mind, Brain & Behavior, Marburg
| | | | | | | | | | | | - Hendrik Theis
- Uniklinik Köln, Klinik und Poliklinik für Neurologie
| | - Carsten Buhmann
- Ambulanzzentrum und Neurologische Klinik, Universitätsklinikum Hamburg-Eppendorf
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Peng S, Spetsieris PG, Eidelberg D, Ma Y. Radiomics and supervised machine learning in the diagnosis of parkinsonism with FDG PET: promises and challenges. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:808. [PMID: 32793653 PMCID: PMC7396243 DOI: 10.21037/atm.2020.04.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Shichun Peng
- Center for Neurosciences, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Phoebe G Spetsieris
- Center for Neurosciences, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - David Eidelberg
- Center for Neurosciences, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Yilong Ma
- Center for Neurosciences, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
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Buchert R, Buhmann C, Apostolova I, Meyer PT, Gallinat J. Nuclear Imaging in the Diagnosis of Clinically Uncertain Parkinsonian Syndromes. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 116:747-754. [PMID: 31774054 DOI: 10.3238/arztebl.2019.0747] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/01/2019] [Accepted: 08/08/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Parkinsonian syndromes are classified by etiology mainly on clinical grounds, that is, on the basis of the clinical manifestations and with the aid of conventional ancillary studies. In most cases, the clinical diagnosis is clear. In up to 30% of cases, however, the etiological classification remains uncertain after completion of the basic clinical diagnostic evaluation, and additional investigation with nuclear imaging may be indicated. In particular, cerebral single-photon emission computed tomography (SPECT) with dopamine transporter (DAT) ligands may be helpful. DAT-SPECT can be used to demonstrate or rule out nigrostriatal degeneration and thereby differentiate neurodegenerative parkinsonian syndromes from symptomatic parkinsonian syndromes and other differential diagnoses. Positron emission tomography (PET) with the glucose analogue [18F]fluorodeoxyglucose (FDG) can be used to identify disease-specific patterns of neuronal dysfunction/degeneration in order to differentiate the various neurodegenerative parkinsonian syndromes from one another. METHODS In this review, we summarize the current state of the evidence on DAT-SPECT and FDG-PET for the indications mentioned above on the basis of a selective review of the literature. RESULTS DAT-SPECT has been adequately validated as an in vivo marker for nigrostriatal degeneration. Studies using the clinical diagnosis of a movement disorders specialist over the course of the disease as a reference have shown that DAT- SPECT is 78-100% sensitive (median, 93%) and 70-100% specific (median, 89%) for the differentiation of neurodegenerative parkinsonian syndromes from symptomatic parkinsonism and other differential diagnoses in clinically unclear cases. DAT- SPECT scanning led to a change of diagnosis in 27-56% of patients (median, 43%) and to a change of treatment in 33-72% (median, 43%). FDG-PET enables the differentiation of atypical neurodegenerative parkinsonian syndromes from the idiopathic parkinsonian syndrome (i.e., Parkinson's disease proper) with high sensitivity and specificity (both approximately 90%), when the clinical diagnosis by a movement disorders specialist over the course of the disease is used as a reference. CONCLUSION DAT-SPECT has been well documented to be highly diagnostically accurate and to have a relevant influence on the diagnosis and treatment of patients with clinically uncertain parkinsonian or tremor syndrome. It has not yet been shown to improve patient-relevant endpoints such as mortality, morbidity, and health-related quality of life; proof of this will probably have to await the introduction of neuroprotective treatments. The current evidence for the high differential diagnostic accuracy of FDG-PET in neurodegenerative parkinsonian syndromes needs to be reinforced by prospective studies with neuropathological verification of the diagnosis.
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Affiliation(s)
- Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf; Department of Neurology, University Medical Center Hamburg-Eppendorf; Department of Nuclear Medicine, Medical Center-University of Freiburg; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf
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Parkinsonian Syndrome with Frontal Lobe Involvement and Anti-Glycine Receptor Antibodies. Brain Sci 2020; 10:brainsci10060399. [PMID: 32585946 PMCID: PMC7349831 DOI: 10.3390/brainsci10060399] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 01/15/2023] Open
Abstract
Background: Atypical Parkinsonian syndromes with prominent frontal lobe involvement can occur in the 4R-taupathies progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). Secondary forms of movement disorders may occur in the context of autoimmune encephalitis with antineuronal antibodies, such as anti-glycine receptor (anti-GlyR) antibodies, which are typically associated with Stiff-Person spectrum syndrome, or progressive encephalomyelitis with rigidity and myoclonus. Overlaps between neurodegenerative and immunological mechanisms have been recently suggested in anti-IgLON5 disease. In this case study, the authors describe a patient with a Parkinsonian syndrome with frontal lobe involvement and anti-GlyR antibodies. Case presentation: The patient presented was a 63-year-old female. Her symptoms had begun with insomnia at the age of 60, after which, since the age of 61, increasing personality changes developed, leading to a diagnosis of depression with delusional symptoms. Severe cognitive deficits emerged, along with a left-side accentuated Parkinsonian syndrome with postural instability. The personality changes involved frontal systems. Magnetic resonance imaging (MRI) showed low-grade mesencephalon atrophy. [18F]fluorodeoxyglucose positron emission tomography (FDG PET) depicted a moderate hypometabolism bilateral frontal and of the midbrain, while [123I]FPCIT single-photon emission computed tomography (SPECT) revealed severely reduced dopamine transporter availability in both striata, indicating pronounced nigrostriatal degeneration. In addition, anti-GlyR antibodies were repeatedly found in the serum of the patient (max. titer of 1:640, reference: <1:20). Therefore, an anti-inflammatory treatment with steroids and azathioprine was administered; this resulted in a decrease of antibody titers (to 1:80) but no detectable clinical improvement. The cerebrospinal fluid (CSF) and electroencephalography diagnostics showed inconspicuous findings, and negative CSF anti-GlyR antibody results. Conclusion: The patient presented here was suffering from a complex Parkinsonian syndrome with frontal lobe involvement. Because of the high anti-GlyR antibody titers, the presence of an autoimmune cause of the disorder was discussed. However, since no typical signs of autoimmune anti-GlyR antibody syndrome (e.g., hyperexcitability, anti-GlyR antibodies in CSF, or other inflammatory CSF changes) were detected, the possibility that the anti-GlyR antibodies might have been an unrelated bystander should be considered. Alternatively, the anti-GlyR antibodies might have developed secondarily to neurodegeneration (most likely a 4-repeat tauopathy, PSP or CBD) without exerting overt clinical effects, as in cases of anti-IgLON5 encephalopathy. In this case, such antibodies might also potentially modify the clinical course of classical movement disorders. Further research on the role of antineuronal antibodies in Parkinsonian syndromes is needed.
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Rus T, Tomše P, Jensterle L, Grmek M, Pirtošek Z, Eidelberg D, Tang C, Trošt M. Differential diagnosis of parkinsonian syndromes: a comparison of clinical and automated - metabolic brain patterns' based approach. Eur J Nucl Med Mol Imaging 2020; 47:2901-2910. [PMID: 32337633 DOI: 10.1007/s00259-020-04785-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 03/20/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE Differentiation among parkinsonian syndromes may be clinically challenging, especially at early disease stages. In this study, we used 18F-FDG-PET brain imaging combined with an automated image classification algorithm to classify parkinsonian patients as Parkinson's disease (PD) or as an atypical parkinsonian syndrome (APS) at the time when the clinical diagnosis was still uncertain. In addition to validating the algorithm, we assessed its utility in a "real-life" clinical setting. METHODS One hundred thirty-seven parkinsonian patients with uncertain clinical diagnosis underwent 18F-FDG-PET and were classified using an automated image-based algorithm. For 66 patients in cohort A, the algorithm-based diagnoses were compared with their final clinical diagnoses, which were the gold standard for cohort A and were made 2.2 ± 1.1 years (mean ± SD) later by a movement disorder specialist. Seventy-one patients in cohort B were diagnosed by general neurologists, not strictly following diagnostic criteria, 2.5 ± 1.6 years after imaging. The clinical diagnoses were compared with the algorithm-based ones, which were considered the gold standard for cohort B. RESULTS Image-based automated classification of cohort A resulted in 86.0% sensitivity, 92.3% specificity, 97.4% positive predictive value (PPV), and 66.7% negative predictive value (NPV) for PD, and 84.6% sensitivity, 97.7% specificity, 91.7% PPV, and 95.5% NPV for APS. In cohort B, general neurologists achieved 94.7% sensitivity, 83.3% specificity, 81.8% PPV, and 95.2% NPV for PD, while 88.2%, 76.9%, 71.4%, and 90.9% for APS. CONCLUSION The image-based algorithm had a high specificity and the predictive values in classifying patients before a final clinical diagnosis was reached by a specialist. Our data suggest that it may improve the diagnostic accuracy by 10-15% in PD and 20% in APS when a movement disorder specialist is not easily available.
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Affiliation(s)
- Tomaž Rus
- Department of Neurology, UMC Ljubljana, Zaloška cesta 2, 1000, Ljubljana, Slovenia. .,Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia.
| | - Petra Tomše
- Department of Nuclear Medicine, UMC Ljubljana, Zaloška cesta 7, 1000, Ljubljana, Slovenia
| | - Luka Jensterle
- Department of Nuclear Medicine, UMC Ljubljana, Zaloška cesta 7, 1000, Ljubljana, Slovenia
| | - Marko Grmek
- Department of Nuclear Medicine, UMC Ljubljana, Zaloška cesta 7, 1000, Ljubljana, Slovenia
| | - Zvezdan Pirtošek
- Department of Neurology, UMC Ljubljana, Zaloška cesta 2, 1000, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA
| | - Chris Tang
- Center for Neurosciences, The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA
| | - Maja Trošt
- Department of Neurology, UMC Ljubljana, Zaloška cesta 2, 1000, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia.,Department of Nuclear Medicine, UMC Ljubljana, Zaloška cesta 7, 1000, Ljubljana, Slovenia
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Abstract
PURPOSE OF REVIEW Corticobasal degeneration (CBD) is a rapidly progressive neurodegenerative tauopathy diagnosed postmortem by pathological examination. The clinical presentation of corticobasal syndrome (CBS) is an apraxic, dystonic, and rigid limb with asymmetrical cortical signs and myoclonus. However, less than half of the patients with CBS receive a CBD diagnosis. As tau-lowering therapies have entered clinical trials, improved antemortem diagnosis of CBD is needed. Here, clinicopathological, neuroimaging, and biofluid data in CBS and/or CBD patients are briefly summarized and some knowledge gaps identified. RECENT FINDINGS Developments of MRI-based and nuclear medicine imaging modalities have increased pathophysiological insights of CBS and may improve diagnostic accuracy. In particular, several tau-PET ligands have been evaluated in CBS patients. Cerebrospinal fluid and plasma levels of neurofilament light chain can distinguish CBS from Parkinson's disease but not from other atypical forms of Parkinsonism. SUMMARY Structural and functional imaging approaches provide some aid in the diagnosis of CBD but have low-content validity. None of the currently available tau-PET ligands is suitable for detecting straight filament 4repeat tau disease in clinical routine. Biofluid markers reflecting the distinct tau and/or astrocyte disease of CBD are needed. Examining biosamples along with clinical parameters from longitudinally followed patients with autopsy-confirmed CBD diagnosis shall hopefully delineate improved biomarkers.
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Role of [18F]-FDG PET in patients with atypical parkinsonism associated with dementia. Clin Transl Imaging 2020. [DOI: 10.1007/s40336-020-00360-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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39
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18F-FDG in the differential diagnosis of neurodegenerative dementias. Clin Transl Imaging 2019. [DOI: 10.1007/s40336-019-00352-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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40
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Saranza GM, Whitwell JL, Kovacs GG, Lang AE. Corticobasal degeneration. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 149:87-136. [PMID: 31779825 DOI: 10.1016/bs.irn.2019.10.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Corticobasal degeneration (CBD) is a rare neurodegenerative disease characterized by the predominance of pathological 4 repeat tau deposition in various cell types and anatomical regions. Corticobasal syndrome (CBS) is one of the clinical phenotypes associated with CBD pathology, manifesting as a progressive asymmetric akinetic-rigid, poorly levodopa-responsive parkinsonism, with cerebral cortical dysfunction. CBD can manifest as several clinical phenotypes, and similarly, CBS can also have a pathologic diagnosis other than CBD. This chapter discusses the clinical manifestations of pathologically confirmed CBD cases, the current diagnostic criteria, as well as the pathologic and neuroimaging findings of CBD/CBS. At present, therapeutic options for CBD remain symptomatic. Further research is needed to improve the clinical diagnosis of CBD, as well as studies on disease-modifying therapies for this relentlessly progressive neurodegenerative disorder.
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Affiliation(s)
- Gerard M Saranza
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | | | - Gabor G Kovacs
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada; Tanz Centre for Research in Neurodegenerative Disease and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada; Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada; Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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41
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Ko JH, Spetsieris PG, Eidelberg D. Network Structure and Function in Parkinson's Disease. Cereb Cortex 2019; 28:4121-4135. [PMID: 29088324 DOI: 10.1093/cercor/bhx267] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Little is known of the structural and functional properties of abnormal brain networks associated with neurological disorders. We used a social network approach to characterize the properties of the Parkinson's disease (PD) metabolic topography in 4 independent patient samples and in an experimental non-human primate model. The PD network exhibited distinct features. Dense, mutually facilitating functional connections linked the putamen, globus pallidus, and thalamus to form a metabolically active core. The periphery was formed by weaker connections linking less active cortical regions. Notably, the network contained a separate module defined by interconnected, metabolically active nodes in the cerebellum, pons, frontal cortex, and limbic regions. Exaggeration of the small-world property was a consistent feature of disease networks in parkinsonian humans and in the non-human primate model; this abnormality was only partly corrected by dopaminergic treatment. The findings point to disease-related alterations in network structure and function as the basis for faulty information processing in this disorder.
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Affiliation(s)
- Ji Hyun Ko
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Phoebe G Spetsieris
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA.,Department of Neurology, Northwell Health, Manhasset, NY, USA
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42
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Forrest SL, Kril JJ, Halliday GM. Cellular and regional vulnerability in frontotemporal tauopathies. Acta Neuropathol 2019; 138:705-727. [PMID: 31203391 DOI: 10.1007/s00401-019-02035-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/04/2019] [Accepted: 06/12/2019] [Indexed: 12/11/2022]
Abstract
The frontotemporal tauopathies all deposit abnormal tau protein aggregates, but often of only certain isoforms and in distinguishing pathologies of five main types (neuronal Pick bodies, neurofibrillary tangles, astrocytic plaques, tufted astrocytes, globular glial inclusions and argyrophilic grains). In those with isoform specific tau aggregates glial pathologies are substantial, even though there is limited evidence that these cells normally produce tau protein. This review will assess the differentiating features and clinicopathological correlations of the frontotemporal tauopathies, the genetic predisposition for these different pathologies, their neuroanatomical selectivity, current observations on how they spread through the brain, and any potential contributing cellular and molecular changes. The findings show that diverse clinical phenotypes relate most to the brain region degenerating rather than the type of pathology involved, that different regions on the MAPT gene and novel risk genes are associated with specific tau pathologies, that the 4-repeat glial tauopathies do not follow individual patterns of spreading as identified for neuronal pathologies, and that genetic and pathological data indicate that neuroinflammatory mechanisms are involved. Each pathological frontotemporal tauopathy subtype with their distinct pathological features differ substantially in the cell type affected, morphology, biochemical and anatomical distribution of inclusions, a fundamental concept central to future success in understanding the disease mechanisms required for developing therapeutic interventions. Tau directed therapies targeting genetic mechanisms, tau aggregation and pathological spread are being trialled, although biomarkers that differentiate these diseases are required. Suggested areas of future research to address the regional and cellular vulnerabilities in frontotemporal tauopathies are discussed.
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43
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Rösler TW, Tayaranian Marvian A, Brendel M, Nykänen NP, Höllerhage M, Schwarz SC, Hopfner F, Koeglsperger T, Respondek G, Schweyer K, Levin J, Villemagne VL, Barthel H, Sabri O, Müller U, Meissner WG, Kovacs GG, Höglinger GU. Four-repeat tauopathies. Prog Neurobiol 2019; 180:101644. [PMID: 31238088 DOI: 10.1016/j.pneurobio.2019.101644] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/21/2019] [Accepted: 06/12/2019] [Indexed: 02/08/2023]
Abstract
Tau is a microtubule-associated protein with versatile functions in the dynamic assembly of the neuronal cytoskeleton. Four-repeat (4R-) tauopathies are a group of neurodegenerative diseases defined by cytoplasmic inclusions predominantly composed of tau protein isoforms with four microtubule-binding domains. Progressive supranuclear palsy, corticobasal degeneration, argyrophilic grain disease or glial globular tauopathy belong to the group of 4R-tauopathies. The present review provides an introduction in the current concept of 4R-tauopathies, including an overview of the neuropathological and clinical spectrum of these diseases. It describes the genetic and environmental etiological factors, as well as the contemporary knowledge about the pathophysiological mechanisms, including post-translational modifications, aggregation and fragmentation of tau, as well as the role of protein degradation mechanisms. Furthermore, current theories about disease propagation are discussed, involving different extracellular tau species and their cellular release and uptake mechanisms. Finally, molecular diagnostic tools for 4R-tauopathies, including tau-PET and fluid biomarkers, and investigational therapeutic strategies are presented. In summary, we report on 4R-tauopathies as overarching disease concept based on a shared pathophysiological concept, and highlight the challenges and opportunities on the way towards a causal therapy.
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Affiliation(s)
- Thomas W Rösler
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany; Dept. of Neurology, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Amir Tayaranian Marvian
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany; Dept. of Neurology, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Matthias Brendel
- Dept. of Nuclear Medicine, University of Munich, 81377 Munich, Germany
| | - Niko-Petteri Nykänen
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany
| | - Matthias Höllerhage
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany; Dept. of Neurology, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Sigrid C Schwarz
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany
| | | | - Thomas Koeglsperger
- Dept. of Neurology, University of Munich, 81377 Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany
| | - Gesine Respondek
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany; Dept. of Neurology, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Kerstin Schweyer
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany; Dept. of Neurology, Technical University of Munich, School of Medicine, 81675 Munich, Germany
| | - Johannes Levin
- Dept. of Neurology, University of Munich, 81377 Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany
| | - Victor L Villemagne
- Dept. of Molecular Imaging and Therapy, Austin Health, Heidelberg, VIC, 3084, Australia; The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia; Dept. of Medicine, Austin Health, University of Melbourne, Melbourne, VIC, Australia
| | - Henryk Barthel
- Dept. of Nuclear Medicine, University of Leipzig, 04103 Leipzig, Germany
| | - Osama Sabri
- Dept. of Nuclear Medicine, University of Leipzig, 04103 Leipzig, Germany
| | - Ulrich Müller
- Institute for Human Genetics, University of Giessen, 35392 Giessen, Germany
| | - Wassilios G Meissner
- Service de Neurologie, CHU Bordeaux, 33000 Bordeaux, France; Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; Dept. of Medicine, University of Otago, Christchurch, New Zealand; New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Gabor G Kovacs
- Institute of Neurology, Medical University of Vienna, 1090 Vienna, Austria; Dept. of Laboratory Medicine and Pathobiology, University of Toronto, Laboratory Medicine Program, University Health Network, Toronto, Canada; Tanz Centre for Research in Neurodegenerative Disease, Krembil Brain Institute, Toronto, Canada
| | - Günter U Höglinger
- Dept. of Translational Neurodegeneration, German Center for Neurodegenerative Diseases (DZNE), 81377 Munich, Germany; Dept. of Neurology, Technical University of Munich, School of Medicine, 81675 Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany; Dept. of Neurology, Hannover Medical School, 30625 Hannover, Germany.
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44
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Sala A, Perani D. Brain Molecular Connectivity in Neurodegenerative Diseases: Recent Advances and New Perspectives Using Positron Emission Tomography. Front Neurosci 2019; 13:617. [PMID: 31258466 PMCID: PMC6587303 DOI: 10.3389/fnins.2019.00617] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/29/2019] [Indexed: 12/12/2022] Open
Abstract
Positron emission tomography (PET) represents a unique molecular tool to get in vivo access to a wide spectrum of biological and neuropathological processes, of crucial relevance for neurodegenerative conditions. Although most PET findings are based on massive univariate approaches, in the last decade the increasing interest in multivariate methods has paved the way to the assessment of unexplored cerebral features, spanning from resting state brain networks to whole-brain connectome properties. Currently, the combination of molecular neuroimaging techniques with multivariate connectivity methods represents one of the most powerful, yet still emerging, approach to achieve novel insights into the pathophysiology of neurodegenerative diseases. In this review, we will summarize the available evidence in the field of PET molecular connectivity, with the aim to provide an overview of how these studies may increase the understanding of the pathogenesis of neurodegenerative diseases, over and above "traditional" structural/functional connectivity studies. Considering the available evidence, a major focus will be represented by molecular connectivity studies using [18F]FDG-PET, today applied in the major neuropathological spectra, from amyloidopathies and tauopathies to synucleinopathies and beyond. Pioneering studies using PET tracers targeting brain neuropathology and neurotransmission systems for connectivity studies will be discussed, their strengths and limitations highlighted with reference to both applied methodology and results interpretation. The most common methods for molecular connectivity assessment will be reviewed, with particular emphasis on the available strategies to investigate molecular connectivity at the single-subject level, of potential relevance for not only research but also diagnostic purposes. Finally, we will highlight possible future perspectives in the field, with reference in particular to newly available PET tracers, which will expand the application of molecular connectivity to new, exciting, unforeseen possibilities.
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Affiliation(s)
- Arianna Sala
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Division of Neuroscience, Faculty of Psychology, San Raffaele Scientific Institute (IRCCS), Milan, Italy
| | - Daniela Perani
- Division of Neuroscience, Faculty of Psychology, San Raffaele Scientific Institute (IRCCS), Milan, Italy.,Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy.,Nuclear Medicine Unit, Faculty of Psychology, San Raffaele Hospital (IRCCS), Milan, Italy
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45
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Network imaging biomarkers: insights and clinical applications in Parkinson's disease. Lancet Neurol 2019; 17:629-640. [PMID: 29914708 DOI: 10.1016/s1474-4422(18)30169-8] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 04/13/2018] [Accepted: 04/25/2018] [Indexed: 12/14/2022]
Abstract
Parkinson's disease presents several practical challenges: it can be difficult to distinguish from atypical parkinsonian syndromes, clinical ratings can be insensitive as markers of disease progression, and its non-motor manifestations are not readily assessed in animal models. These challenges, along with others, are beginning to be addressed by innovative imaging methods to characterise Parkinson's disease-specific functional networks across the whole brain and measure their expression in each patient. These signatures can help improve differential diagnosis, guide selection of patients for clinical trials, and quantify treatment responses and placebo effects in individual patients. The primary Parkinson's disease-related metabolic pattern has been replicated in multiple patient populations and used as an outcome measure in clinical trials. It can also be used as a predictor of near-term phenoconversion in prodromal syndromes, such as rapid eye movement sleep behaviour disorder. Functional network imaging holds great promise for future clinical use in the management of neurodegenerative disorders.
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46
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Conrad J, Kremmyda O, Högen T, Brendel M, Rominger A, Levin J, Danek A. [Posterior cortical atrophy-a heterogeneous syndrome : A case series]. DER NERVENARZT 2019; 90:1045-1050. [PMID: 30903200 DOI: 10.1007/s00115-019-0697-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Julian Conrad
- Klinik und Poliklinik für Neurologie, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, München, Deutschland.
- Deutsches Schwindel- und Gleichgewichtszentrum (DSGZ), Ludwig-Maximilians-Universität München, München, Deutschland.
| | - Olympia Kremmyda
- Klinik und Poliklinik für Neurologie, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, München, Deutschland
- Deutsches Schwindel- und Gleichgewichtszentrum (DSGZ), Ludwig-Maximilians-Universität München, München, Deutschland
| | - Tobias Högen
- Klinik und Poliklinik für Neurologie, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, München, Deutschland
| | - Matthias Brendel
- Klinik und Poliklinik für Nuklearmedizin, Ludwig-Maximilians-Universität München, München, Deutschland
| | - Axel Rominger
- Universitätsklinik für Nuklearmedizin, Inselspital, Universitätsspital Bern, Bern, Schweiz
| | - Johannes Levin
- Klinik und Poliklinik für Neurologie, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, München, Deutschland
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Feodor-Lynen-Straße 17, 81377, München, Deutschland
- Munich Cluster for Systems Neurology (SyNergy), München, Deutschland
| | - Adrian Danek
- Klinik und Poliklinik für Neurologie, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, München, Deutschland
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47
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Di Stasio F, Suppa A, Marsili L, Upadhyay N, Asci F, Bologna M, Colosimo C, Fabbrini G, Pantano P, Berardelli A. Corticobasal syndrome: neuroimaging and neurophysiological advances. Eur J Neurol 2019; 26:701-e52. [PMID: 30720235 DOI: 10.1111/ene.13928] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 01/30/2019] [Indexed: 01/14/2023]
Abstract
Corticobasal degeneration (CBD) is a neurodegenerative condition characterized by 4R tau protein deposition in several brain regions that clinically manifests itself as a heterogeneous atypical parkinsonism typically expressed in adulthood. The prototypical clinical phenotype of CBD is corticobasal syndrome (CBS). Important insights into the pathophysiological mechanisms underlying motor and higher cortical symptoms in CBS have been gained by using advanced neuroimaging and neurophysiological techniques. Structural and functional neuroimaging studies often show asymmetric cortical and subcortical abnormalities, mainly involving perirolandic and parietal regions and basal ganglia structures. Neurophysiological investigations including electroencephalography and somatosensory evoked potentials provide useful information on the origin of myoclonus and on cortical sensory loss. Transcranial magnetic stimulation demonstrates heterogeneous and asymmetric changes in the excitability and plasticity of primary motor cortex and abnormal hemispheric connectivity. Neuroimaging and neurophysiological abnormalities in multiple brain areas reflect asymmetric neurodegeneration, leading to asymmetric motor and higher cortical symptoms in CBS.
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Affiliation(s)
- F Di Stasio
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy
| | - A Suppa
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - L Marsili
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - N Upadhyay
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - F Asci
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - M Bologna
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - C Colosimo
- Department of Neurology, Santa Maria University Hospital, Terni, Italy
| | - G Fabbrini
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - P Pantano
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - A Berardelli
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
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48
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Alster P, Madetko NK, Koziorowski DM, Królicki L, Budrewicz S, Friedman A. Accumulation of Tau Protein, Metabolism and Perfusion-Application and Efficacy of Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) Imaging in the Examination of Progressive Supranuclear Palsy (PSP) and Corticobasal Syndrome (CBS). Front Neurol 2019; 10:101. [PMID: 30837933 PMCID: PMC6383629 DOI: 10.3389/fneur.2019.00101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 01/25/2019] [Indexed: 11/13/2022] Open
Abstract
Neuroimaging in the context of examining atypical parkinsonian tauopathies is an evolving matter. Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) bring tools, which may be reasonable in supplementary examination, however cannot be interpreted as a gold standard for correct diagnosis. The review presents advantages and limitations of tau radiotracers in PET, metabolic PET and perfusion SPECT. The aim of this paper is to highlight the possibilities and boundaries in the supplementary examination of tauopathic parkinsonian syndromes.
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Affiliation(s)
- Piotr Alster
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Leszek Królicki
- Department of Nuclear Medicine, Medical University of Warsaw, Warsaw, Poland
| | | | - Andrzej Friedman
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
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49
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Pardini M, Huey ED, Spina S, Kreisl WC, Morbelli S, Wassermann EM, Nobili F, Ghetti B, Grafman J. FDG-PET patterns associated with underlying pathology in corticobasal syndrome. Neurology 2019; 92:e1121-e1135. [PMID: 30700592 DOI: 10.1212/wnl.0000000000007038] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 10/26/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To evaluate brain 18Fluorodeoxyglucose PET (FDG-PET) differences among patients with a clinical diagnosis of corticobasal syndrome (CBS) and distinct underling primary pathologies. METHODS We studied 29 patients with a diagnosis of CBS who underwent FDG-PET scan and postmortem neuropathologic examination. Patients were divided into subgroups on the basis of primary pathologic diagnosis: CBS-corticobasal degeneration (CBS-CBD) (14 patients), CBS-Alzheimer disease (CBS-AD) (10 patients), and CBS-progressive supranuclear palsy (CBS-PSP) (5 patients). Thirteen age-matched healthy patients who underwent FDG-PET were the control group (HC). FDG-PET scans were compared between the subgroups and the HC using SPM-12, with a threshold of p FWE < 0.05. RESULTS There were no differences in Mattis Dementia Rating Scale or finger tapping scores between CBS groups. Compared to HC, the patients with CBS presented significant hypometabolism in frontoparietal regions, including the perirolandic area, basal ganglia, and thalamus of the clinically more affected hemisphere. Patients with CBS-CBD showed a similar pattern with a more marked, bilateral involvement of the basal ganglia. Patients with CBS-AD presented with posterior, asymmetric hypometabolism, including the lateral parietal and temporal lobes and the posterior cingulate. Finally, patients with CBS-PSP disclosed a more anterior hypometabolic pattern, including the medial frontal regions and the anterior cingulate. A conjunction analysis revealed that the primary motor cortex was the only common area of hypometabolism in all groups, irrespective of pathologic diagnosis. DISCUSSION AND CONCLUSIONS In patients with CBS, different underling pathologies are associated with different patterns of hypometabolism. Our data suggest that FDG-PET scans could help in the etiologic diagnosis of CBS.
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Affiliation(s)
- Matteo Pardini
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL.
| | - Edward D Huey
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - Salvatore Spina
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - William C Kreisl
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - Silvia Morbelli
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - Eric M Wassermann
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - Flavio Nobili
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - Bernardino Ghetti
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - Jordan Grafman
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
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Niethammer M, Eidelberg D. Network Imaging in Parkinsonian and Other Movement Disorders: Network Dysfunction and Clinical Correlates. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 144:143-184. [DOI: 10.1016/bs.irn.2018.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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