1
|
Keith CM, Haut MW, D'Haese PF, Mehta RI, Vieira Ligo Teixeira C, Coleman MM, Miller M, Ward M, Navia RO, Marano G, Wang X, McCuddy WT, Lindberg K, Wilhelmsen KC. More Similar than Different: Memory, Executive Functions, Cortical Thickness, and Glucose Metabolism in Biomarker-Positive Alzheimer's Disease and Behavioral Variant Frontotemporal Dementia. J Alzheimers Dis Rep 2024; 8:57-73. [PMID: 38312533 PMCID: PMC10836603 DOI: 10.3233/adr-230049] [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: 06/20/2023] [Accepted: 12/13/2023] [Indexed: 02/06/2024] Open
Abstract
Background Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are typically associated with very different clinical and neuroanatomical presentations; however, there is increasing recognition of similarities. Objective To examine memory and executive functions, as well as cortical thickness, and glucose metabolism in AD and bvFTD signature brain regions. Methods We compared differences in a group of biomarker-defined participants with Alzheimer's disease and a group of clinically diagnosed participants with bvFTD. These groups were also contrasted with healthy controls (HC). Results As expected, memory functions were generally more impaired in AD, followed by bvFTD, and both clinical groups performed more poorly than the HC group. Executive function measures were similar in AD compared to bvFTD for motor sequencing and go/no-go, but bvFTD had more difficulty with a set shifting task. Participants with AD showed thinner cortex and lower glucose metabolism in the angular gyrus compared to bvFTD. Participants with bvFTD had thinner cortex in the insula and temporal pole relative to AD and healthy controls, but otherwise the two clinical groups were similar for other frontal and temporal signature regions. Conclusions Overall, the results of this study highlight more similarities than differences between AD and bvFTD in terms of cognitive functions, cortical thickness, and glucose metabolism. Further research is needed to better understand the mechanisms mediating this overlap and how these relationships evolve longitudinally.
Collapse
Affiliation(s)
- Cierra M Keith
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - Marc W Haut
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, USA
- Department of Neurology, West Virginia University, Morgantown, WV, USA
- Department of Radiology, West Virginia University, Morgantown, WV, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - Pierre-François D'Haese
- Department of Neuroradiology, West Virginia University, Morgantown, WV, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - Rashi I Mehta
- Department of Neuroradiology, West Virginia University, Morgantown, WV, USA
- Department of Radiology, West Virginia University, Morgantown, WV, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | | | - Michelle M Coleman
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - Mark Miller
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - Melanie Ward
- Department of Neurology, West Virginia University, Morgantown, WV, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - R Osvaldo Navia
- Department of Medicine, West Virginia University, Morgantown, WV, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - Gary Marano
- Department of Neuroradiology, West Virginia University, Morgantown, WV, USA
- Department of Radiology, West Virginia University, Morgantown, WV, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - Xiaofei Wang
- Department of Radiology, West Virginia University, Morgantown, WV, USA
| | - William T McCuddy
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, USA
- Department of Medicine, West Virginia University, Morgantown, WV, USA
| | - Katharine Lindberg
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - Kirk C Wilhelmsen
- Department of Neurology, West Virginia University, Morgantown, WV, USA
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| |
Collapse
|
2
|
Dominke C, Fischer AM, Grimmer T, Diehl-Schmid J, Jahn T. CERAD-NAB and flexible battery based neuropsychological differentiation of Alzheimer's dementia and depression using machine learning approaches. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:221-248. [PMID: 36320158 DOI: 10.1080/13825585.2022.2138255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
Depression (DEP) and dementia of the Alzheimer's type (DAT) represent the most common neuropsychiatric disorders in elderly patients. Accurate differential diagnosis is indispensable to ensure appropriate treatment. However, DEP can yet mimic cognitive symptoms of DAT and patients with DAT often also present with depressive symptoms, impeding correct diagnosis. Machine learning (ML) approaches could eventually improve this discrimination using neuropsychological test data, but evidence is still missing. We therefore employed Support Vector Machine (SVM), Naïve Bayes (NB), Random Forest (RF) and conventional Logistic Regression (LR) to retrospectively predict the diagnoses of 189 elderly patients (68 DEP and 121 DAT) based on either the well-established Consortium to Establish a Registry for Alzheimer's Disease neuropsychological assessment battery (CERAD-NAB) or a flexible battery approach (FLEXBAT). The best performing combination consisted of FLEXBAT and NB, correctly classifying 87.0% of patients as either DAT or DEP. However, all accuracies were similar across algorithms and test batteries (83.0% - 87.0%). Accordingly, our study is the first to show that common ML algorithms with their default parameters can accurately differentiate between patients clinically diagnosed with DAT or DEP using neuropsychological test data, but do not necessarily outperform conventional LR.
Collapse
Affiliation(s)
- Clara Dominke
- Division Clinical Neuropsychology, Department of Psychology, Ludwig-Maximilians-University, Munich, Germany
| | - Alina Maria Fischer
- School of Medicine, Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Timo Grimmer
- School of Medicine, Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Janine Diehl-Schmid
- School of Medicine, Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
- Centre for Geriatric Medicine, Kbo-Inn-Salzach-Klinikum, Wasserburg am Inn, Germany
| | - Thomas Jahn
- Division Clinical Neuropsychology, Department of Psychology, Ludwig-Maximilians-University, Munich, Germany
- School of Medicine, Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| |
Collapse
|
3
|
Macchitella L, Tosi G, Giaquinto F, Iaia M, Rizzi E, Chiarello Y, Bertoux M, Angelelli P, Romano DL. Genuine Memory Deficits as Assessed by the Free and Cued Selective Reminding Test (FCSRT) in the Behavioural Variant of Frontotemporal Dementia. A Systematic Review and Meta-analysis Study. Neuropsychol Rev 2023:10.1007/s11065-023-09613-3. [PMID: 37736861 DOI: 10.1007/s11065-023-09613-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/07/2023] [Indexed: 09/23/2023]
Abstract
The current diagnostic criteria for the behavioural variant of frontotemporal dementia (bvFTD) foresee a relative sparing of long-term memory. Although bvFTD patients were thought to report secondary memory deficits associated with prefrontal dysfunctions, some studies indicated the presence of a "genuine memory deficit" related to mesial temporal lobe dysfunctions. Among various neuropsychological tests, the Free and Cue Selective Reminding Test (FCSRT) has been recommended to distinguish genuine from apparent amnesia. We conducted a systematic review and a random effect Bayesian meta-analysis to evaluate the nature and severity of memory deficit in bvFTD. Our objective was to determine whether the existing literature offers evidence of genuine or apparent amnesia in patients with bvFTD, as assessed via the FCSRT. On 06/19/2021, we conducted a search across four databases (PMC, Scopus, Web of Science, and PubMed). We included all studies that evaluated memory performance using the FCSRT in patients with bvFTD, as long as they also included either cognitively unimpaired participants or AD groups. We tested publication bias through the Funnel plot and Egger's test. To assess the quality of studies, we used the Newcastle-Ottawa quality assessment scale adapted for cross-sectional studies. We included 16 studies in the meta-analysis. The results showed that bvFTD patients perform better than AD patients (pooled effects between 0.95 and 1.14), as their memory performance stands between AD and control groups (pooled effects between - 2.19 and - 1.25). Moreover, patients with bvFTD present both genuine and secondary memory disorders. As a major limitation of this study, due to our adoption of a rigorous methodology and stringent inclusion criteria, we ended up with just 16 studies. Nonetheless, our robust findings can contribute to the ongoing discussion on international consensus criteria for bvFTD and the selection of appropriate neuropsychological tools to facilitate the differential diagnosis between AD and bvFTD.
Collapse
Affiliation(s)
- Luigi Macchitella
- Department of Human and Social Sciences, University of Salento, Piazza Tancredi 7, 73100, Lecce, Italy
- Scientific Institute I.R.C.C.S. "E. Medea", Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Piazza Di Summa, 72100, Brindisi, Italy
| | - Giorgia Tosi
- Department of Human and Social Sciences, University of Salento, Piazza Tancredi 7, 73100, Lecce, Italy.
- Department of Psychology, University of Milano-Bicocca, Piazza Ateneo Nuovo 1, 20126, Milan, Italy.
| | - Francesco Giaquinto
- Department of Human and Social Sciences, University of Salento, Piazza Tancredi 7, 73100, Lecce, Italy
| | - Marika Iaia
- Department of Human and Social Sciences, University of Salento, Piazza Tancredi 7, 73100, Lecce, Italy
| | - Ezia Rizzi
- Department of Human and Social Sciences, University of Salento, Piazza Tancredi 7, 73100, Lecce, Italy
| | - Ylenia Chiarello
- Department of Human and Social Sciences, University of Salento, Piazza Tancredi 7, 73100, Lecce, Italy
| | - Maxime Bertoux
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, LiCEND, DISTALZ, 42 rue Paul Duez, 59000, Lille, France
| | - Paola Angelelli
- Department of Human and Social Sciences, University of Salento, Piazza Tancredi 7, 73100, Lecce, Italy
| | - Daniele Luigi Romano
- Department of Human and Social Sciences, University of Salento, Piazza Tancredi 7, 73100, Lecce, Italy
- Department of Psychology, University of Milano-Bicocca, Piazza Ateneo Nuovo 1, 20126, Milan, Italy
| |
Collapse
|
4
|
Bueno APA, de Souza LC, Pinaya WHL, Teixeira AL, de Prado LGR, Caramelli P, Hornberger M, Sato JR. Papez Circuit Gray Matter and Episodic Memory in Amyotrophic Lateral Sclerosis and Behavioural Variant Frontotemporal Dementia. Brain Imaging Behav 2021; 15:996-1006. [PMID: 32734436 DOI: 10.1007/s11682-020-00307-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Amyotrophic lateral sclerosis and behavioural variant frontotemporal dementia are two different diseases recognized to overlap at clinical, pathological and genetic characteristics. Both conditions are traditionally known for relative sparing of episodic memory. However, recent studies have disputed that with the report of patients presenting with marked episodic memory impairment. Besides that, structural and functional changes in temporal lobe regions responsible for episodic memory processing are often detected in neuroimaging studies of both conditions. In this study, we investigated the gray matter features associated with the Papez circuit in amyotrophic lateral sclerosis, behavioural variant frontotemporal dementia and healthy controls to further explore similarities and differences between the two conditions. Our non-demented amyotrophic lateral sclerosis patients showed no episodic memory deficits measured by a short-term delayed recall test while no changes in gray matter of the Papez circuit were found. Compared with the amyotrophic lateral sclerosis group, the behavioural variant frontotemporal dementia group had lower performance on the short-term delayed recall test and marked atrophy in gray matter of the Papez circuit. Bilateral atrophy of entorhinal cortex and mammillary bodies distinguished behavioural variant frontotemporal dementia from amyotrophic lateral sclerosis patients as well as atrophy in left cingulate, left hippocampus and right parahippocampal gyrus. Taken together, our results suggest that sub-regions of the Papez circuit could be differently affected in amyotrophic lateral sclerosis and behavioural variant frontotemporal dementia.
Collapse
Affiliation(s)
- Ana Paula Arantes Bueno
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André, Brazil.
| | - Leonardo Cruz de Souza
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Walter Hugo Lopez Pinaya
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André, Brazil.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Lodon, UK
| | - Antônio Lúcio Teixeira
- Department of Psychiatry and Behavioural Sciences, University of Texas Health, Houston, TX, USA.,Santa Casa BH Ensino e Pesquisa, Belo Horizonte, Brazil
| | | | - Paulo Caramelli
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Michael Hornberger
- Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK.,Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - João Ricardo Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André, Brazil
| |
Collapse
|
5
|
Kim NG, Lee HW. Stereoscopic Depth Perception and Visuospatial Dysfunction in Alzheimer's Disease. Healthcare (Basel) 2021; 9:healthcare9020157. [PMID: 33546119 PMCID: PMC7913121 DOI: 10.3390/healthcare9020157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/21/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
With visuospatial dysfunction emerging as a potential marker that can detect Alzheimer's disease (AD) even in its earliest stages and with disturbance in stereopsis suspected to be the prime contributor to visuospatial deficits in AD, we assessed stereoscopic abilities of patients with AD and mild cognitive impairment (MCI). Whereas previous research assessing patients' stereoacuity has yielded mixed results, we assessed patients' capacity to process coarse disparities that can convey adequate depth information about objects in the environment. We produced two virtual cubes at two different distances from the observer by manipulating disparity type (absolute vs. relative), disparity direction (crossed vs. uncrossed) and disparity magnitude, then had participants judge the object that appeared closer to them. Two patient groups performed as well as, or even better than elderly controls, suggesting that AD patients' coarse disparity processing capacity is capable of supporting common tasks involving reaching, grasping, driving, and navigation. Results may help researchers narrow down the exact cause(s) of visuospatial deficits in AD and develop and validate measures to assess visuospatial dysfunction in clinical trials and disease diagnosis.
Collapse
Affiliation(s)
- Nam-Gyoon Kim
- Department of Psychology, Keimyung University, Daegu 42601, Korea
- Correspondence: ; Tel.: +82-53-580-5415
| | - Ho-Won Lee
- Department of Neurology, School of Medicine & Brain Science and Engineering Institute, Kyungpook National University, Daegu 41566, Korea;
| |
Collapse
|
6
|
Staffaroni AM, Bajorek L, Casaletto KB, Cobigo Y, Goh SYM, Wolf A, Heuer HW, Elahi FM, Ljubenkov PA, Dever R, Kornak J, Appleby B, Bove J, Bordelon Y, Brannelly P, Brushaber D, Caso C, Coppola G, Dheel C, Dickerson BC, Dickinson S, Dominguez S, Domoto-Reilly K, Faber K, Ferrall J, Fields JA, Fishman A, Fong J, Foroud T, Forsberg LK, Gavrilova R, Gearhart D, Ghazanfari B, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford N, Grant I, Grossman M, Haley D, Hsiung GY, Huey ED, Irwin DJ, Jones DT, Jones L, Kantarci K, Karydas A, Kaufer DI, Kerwin DR, Knopman DS, Kraft R, Kremers WK, Kukull WA, Litvan I, Lucente D, Lungu C, Mackenzie IR, Maldonado M, Manoochehri M, McGinnis SM, McKinley E, Mendez MF, Miller BL, Multani N, Onyike C, Padmanabhan J, Pantelyat A, Pearlman R, Petrucelli L, Potter M, Rademakers R, Ramos EM, Rankin KP, Rascovsky K, Roberson ED, Rogalski E, Sengdy P, Shaw LM, Syrjanen J, Tartaglia MC, Tatton N, Taylor J, Toga A, Trojanowski JQ, Weintraub S, Wang P, Wong B, Wszolek Z, Boxer AL, Boeve BF, Kramer JH, Rosen HJ. Assessment of executive function declines in presymptomatic and mildly symptomatic familial frontotemporal dementia: NIH-EXAMINER as a potential clinical trial endpoint. Alzheimers Dement 2020; 16:11-21. [PMID: 31914230 PMCID: PMC6842665 DOI: 10.1016/j.jalz.2019.01.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Identifying clinical measures that track disease in the earliest stages of frontotemporal lobar degeneration (FTLD) is important for clinical trials. Familial FTLD provides a unique paradigm to study early FTLD. Executive dysfunction is a clinically relevant hallmark of FTLD and may be a marker of disease progression. METHODS Ninety-three mutation carriers with no symptoms or minimal/questionable symptoms (MAPT, n = 31; GRN, n = 28; C9orf72, n = 34; Clinical Dementia Rating scale plus NACC FTLD Module < 1) and 78 noncarriers enrolled through Advancing Research and Treatment in Frontotemporal Lobar Degeneration/Longitudinal Evaluation of Familial Frontotemporal Dementia Subjects studies completed the Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (NIH-EXAMINER) and the UDS neuropsychological battery. Linear mixed-effects models were used to identify group differences in cognition at baseline and longitudinally. We examined associations between cognition, clinical functioning, and magnetic resonance imaging volumes. RESULTS NIH-EXAMINER scores detected baseline and differences in slopes between carriers and noncarriers, even in carriers with a baseline Clinical Dementia Rating scale plus NACC FTLD Module = 0. NIH-EXAMINER declines were associated with worsening clinical symptoms and brain volume loss. DISCUSSION The NIH-EXAMINER is sensitive to cognitive changes in presymptomatic familial FTLD and is a promising surrogate endpoint.
Collapse
Affiliation(s)
- Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Lynn Bajorek
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Kaitlin B. Casaletto
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Sheng-Yang M. Goh
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Amy Wolf
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Hilary W. Heuer
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Fanny M. Elahi
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Peter A. Ljubenkov
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Reilly Dever
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of
California, San Francisco, San Francisco, CA, USA
| | - Brian Appleby
- Department of Neurology, Case Western Reserve University,
Cleveland, OH, USA
| | - Jessica Bove
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - Yvette Bordelon
- Department of Neurology, University of California, Los
Angeles, Los Angeles, CA, USA
| | - Patrick Brannelly
- Tau Consortium, Rainwater Charitable Foundation, Fort
Worth, TX, USA
| | | | - Christina Caso
- Department of Neurology, University of Washington, Seattle,
WA, USA
| | - Giovanni Coppola
- Department of Neurology, University of California, Los
Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Bradford C. Dickerson
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan Dickinson
- Association for Frontotemporal Degeneration, Radnor, PA,
USA
| | - Sophia Dominguez
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kelly Faber
- National Cell Repository for Alzheimer’s Disease
(NCRAD), Indiana University, Indianapolis, IN, USA
| | - Jessica Ferrall
- Department of Neurology, University of North Carolina,
Chapel Hill, NC, USA
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic,
Rochester, MN, USA
| | - Ann Fishman
- School of Medicine, Department of Psychiatry, Johns
Hopkins University, Baltimore, MD, USA
| | - Jamie Fong
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Tatiana Foroud
- National Cell Repository for Alzheimer’s Disease
(NCRAD), Indiana University, Indianapolis, IN, USA
| | | | | | - Debra Gearhart
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Behnaz Ghazanfari
- Tanz Centre for Research in Neurodegenerative Diseases,
University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University
of Toronto, Toronto, Ontario, Canada
| | - Nupur Ghoshal
- Departments of Neurology and Psychiatry, Washington
University School of Medicine, Washington University, St. Louis, MO, USA
| | - Jill Goldman
- Department of Neurology, Columbia University, New York,
NY, USA
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Columbia University, New York, NY, USA
| | | | | | - Ian Grant
- Feinberg School of Medicine, Department of Neurology,
Northwestern University, Chicago, IL, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - Dana Haley
- Department of Neurology, Mayo Clinic, Jacksonville, FL,
USA
| | - Ging-Yuek Hsiung
- Division of Neurology, Deptartment of Medicine, University
of British Columbia, Vancouver, British Columbia, Canada
| | - Edward D. Huey
- Department of Neurology, Columbia University, New York,
NY, USA
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Columbia University, New York, NY, USA
| | - David J. Irwin
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - David T. Jones
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Lynne Jones
- Department of Radiology, Washington University School of
Medicine, Washington University, St. Louis, MO, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN,
USA
| | - Anna Karydas
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Daniel I. Kaufer
- Department of Neurology, University of North Carolina,
Chapel Hill, NC, USA
| | - Diana R. Kerwin
- Department of Neurology and Neurotherapeutics, Center for
Alzheimer’s and Neurodegenerative Diseases, The University of Texas,
Southwestern Medical Center at Dallas, Dallas, TX, USA
- Department of Internal Medicine, The University of Texas,
Southwestern Medical Center at Dallas, Dallas, TX, USA
| | | | - Ruth Kraft
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Walter K. Kremers
- Department of Health Sciences Research, Mayo Clinic,
Rochester, MN, USA
| | - Walter A. Kukull
- National Alzheimer Coordinating Center (NACC), University
of Washington, Seattle, WA, USA
| | - Irene Litvan
- Department of Neurosciences, Parkinson and Other Movement
Disorders Center, University of California, San Diego, San Diego, CA, USA
| | - Diane Lucente
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Codrin Lungu
- National Institute of Neurological Disorders and Stroke
(NINDS), Bethesda, MD, USA
| | - Ian R. Mackenzie
- Department of Pathology and Laboratory Medicine,
University of British Columbia, Vancouver, British Columbia, Canada
| | - Miranda Maldonado
- Department of Neurology, University of California, Los
Angeles, Los Angeles, CA, USA
| | | | - Scott M. McGinnis
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily McKinley
- Department of Neurology, Alzheimer’s Disease
Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mario F. Mendez
- Department of Neurology, University of California, Los
Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, Los Angeles, CA, USA
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Namita Multani
- Tanz Centre for Research in Neurodegenerative Diseases,
University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University
of Toronto, Toronto, Ontario, Canada
| | - Chiadi Onyike
- Department of Geriatric Psychiatry and Neuropsychiatry,
Johns Hopkins University, Baltimore, MD, USA
| | - Jaya Padmanabhan
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alex Pantelyat
- School of Medicine, Department of Neurology, Johns
Hopkins University, Baltimore, MD, USA
| | | | - Len Petrucelli
- Department of Neurosciences, Mayo Clinic, Jacksonville,
FL, USA
| | - Madeline Potter
- National Cell Repository for Alzheimer’s Disease
(NCRAD), Indiana University, Indianapolis, IN, USA
| | - Rosa Rademakers
- Department of Neurosciences, Mayo Clinic, Jacksonville,
FL, USA
| | - Eliana Marisa Ramos
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, Los Angeles, CA, USA
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Katya Rascovsky
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - Erik D. Roberson
- Department of Neurology, Alzheimer’s Disease
Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emily Rogalski
- Feinberg School of Medicine, Department of Psychiatry and
Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Pheth Sengdy
- Division of Neurology, Deptartment of Medicine, University
of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie M. Shaw
- Perelman School of Medicine, Department of Pathology and
Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jeremy Syrjanen
- Department of Health Sciences Research, Mayo Clinic,
Rochester, MN, USA
| | - M. Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases,
University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University
of Toronto, Toronto, Ontario, Canada
| | - Nadine Tatton
- Association for Frontotemporal Degeneration, Radnor, PA,
USA
| | - Joanne Taylor
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Arthur Toga
- Departments of Ophthalmology, Neurology, Psychiatry and
the Behavioral Sciences, Radiology and Engineering, Laboratory of Neuroimaging
(LONI), USC, Los Angeles, CA, USA
| | - John Q. Trojanowski
- Perelman School of Medicine, Department of Pathology and
Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sandra Weintraub
- Feinberg School of Medicine, Department of Neurology,
Northwestern University, Chicago, IL, USA
| | - Ping Wang
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Bonnie Wong
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Adam L. Boxer
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Brad F. Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| |
Collapse
|
7
|
Bertoux M, Flanagan EC, Hobbs M, Ruiz-Tagle A, Delgado C, Miranda M, Ibáñez A, Slachevsky A, Hornberger M. Structural Anatomical Investigation of Long-Term Memory Deficit in Behavioral Frontotemporal Dementia. J Alzheimers Dis 2019; 62:1887-1900. [PMID: 29614645 DOI: 10.3233/jad-170771] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although a growing body of work has shown that behavioral variant frontotemporal dementia (bvFTD) could present with severe amnesia in approximately half of cases, memory assessment is currently the clinical standard to distinguish bvFTD from Alzheimer's disease (AD). Thus, the concept of "relatively preserved episodic memory" in bvFTD remains the basis of its clinical distinction from AD and a criterion for bvFTD's diagnosis. This view is supported by the idea that bvFTD is not characterized by genuine amnesia and hippocampal degeneration, by contrast to AD. In this multicenter study, we aimed to investigate the neural correlates of memory performance in bvFTD as assessed by the Free and Cued Selective Reminding Test (FCSRT). Imaging explorations followed a two-step procedure, first relying on a visual rating of atrophy of 35 bvFTD and 34 AD patients' MRI, contrasted with 29 controls; and then using voxel-based morphometry (VBM) in a subset of bvFTD patients. Results showed that 43% of bvFTD patients presented with a genuine amnesia. Data-driven analysis on visual rating data showed that, in bvFTD, memory recall & storage performances were significantly predicted by atrophy in rostral prefrontal and hippocampal/perihippocampal regions, similar to mild AD. VBM results in bvFTD (pFWE<0.05) showed similar prefrontal and hippocampal regions in addition to striatal and lateral temporal involvement. Our findings showed the involvement of prefrontal as well as medial/lateral temporal atrophy in memory deficits of bvFTD patients. This contradicts the common view that only frontal deficits explain memory impairment in this disease and plead for an updated view on memory dysfunctions in bvFTD.
Collapse
Affiliation(s)
- Maxime Bertoux
- Norwich Medical School, University of East Anglia, Norwich, UK.,Centre de Référence Démence Rares, Pitié-Salpêtrière, INSERM UMRS 975, Paris, France
| | - Emma C Flanagan
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Matthew Hobbs
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Amparo Ruiz-Tagle
- Laboratorio de Neurosciencas, Centro de Investigación Avanzada en Educación, Universidad de Chile, Santiago, Chile
| | - Carolina Delgado
- Department of Neurology, Clinic Hospital, University of Chile, Santiago, Chile
| | - Marcelo Miranda
- Department of Neurology, Clinica Las Condes, Santiago, Chile
| | - Agustín Ibáñez
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile.,Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Universidad Autónoma del Caribe, Barranquilla, Colombia.,Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), Sydney University, NSW, Australia
| | - Andrea Slachevsky
- Physiopathology Department, Neuroscience Department, Faculty of Medicine, University of Chile, Santiago, Chile.,Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
| | | |
Collapse
|
8
|
Witter S, Witter R, Vilu R, Samoson A. Medical Plants and Nutraceuticals for Amyloid-β Fibrillation Inhibition. J Alzheimers Dis Rep 2018; 2:239-252. [PMID: 30599045 PMCID: PMC6311354 DOI: 10.3233/adr-180066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2018] [Indexed: 11/30/2022] Open
Abstract
Plaque formation due to amyloid-β oligomerization and fibrillation is a key issue for its deposition in the brains of dementia and Alzheimer's disease patients. Related drugs preventing this peptide fibril accumulation bear the potential of considerable medical and social value. In this study, we performed in vitro fibrillation inhibition tests with eight different medical plant extracts and nutraceuticals using fluorescence spectroscopy. Successful inhibition of the following plant extracts and nutraceuticals were obtained: Withania somnifera, Centella asiatica, Bacopa monnieri, and Convolvulus pluricaulis, providing new drug candidates for the prevention and treatment of Alzheimer's disease.
Collapse
Affiliation(s)
- Steffi Witter
- Department of Health Technologies, School of Information Technologies, Tallinn University of Technology, Tallinn, Estonia
| | - Raiker Witter
- Department of Health Technologies, School of Information Technologies, Tallinn University of Technology, Tallinn, Estonia
- Karlsruhe Institute of Technology (KIT), Institute of Nanotechnology, Eggenstein-Leopoldshafen, Germany
| | - Raivo Vilu
- Competence Center of Food and Fermentation Technology (TFTAK), Tallinn, Estonia
| | - Ago Samoson
- Department of Health Technologies, School of Information Technologies, Tallinn University of Technology, Tallinn, Estonia
| |
Collapse
|
9
|
McCarthy J, Collins DL, Ducharme S. Morphometric MRI as a diagnostic biomarker of frontotemporal dementia: A systematic review to determine clinical applicability. Neuroimage Clin 2018; 20:685-696. [PMID: 30218900 PMCID: PMC6140291 DOI: 10.1016/j.nicl.2018.08.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/31/2018] [Accepted: 08/28/2018] [Indexed: 01/21/2023]
Abstract
Frontotemporal dementia (FTD) is difficult to diagnose, due to its heterogeneous nature and overlap in symptoms with primary psychiatric disorders. Brain MRI for atrophy is a key biomarker but lacks sensitivity in the early stage. Morphometric MRI-based measures and machine learning techniques are a promising tool to improve diagnostic accuracy. Our aim was to review the current state of the literature using morphometric MRI to classify FTD and assess its applicability for clinical practice. A search was completed using Pubmed and PsychInfo of studies which conducted a classification of subjects with FTD from non-FTD (controls or another disorder) using morphometric MRI metrics on an individual level, using single or combined approaches. 28 relevant articles were included and systematically reviewed following PRISMA guidelines. The studies were categorized based on the type of FTD subjects included and the group(s) against which they were classified. Studies varied considerably in subject selection, MRI methodology, and classification approach, and results are highly heterogeneous. Overall many studies indicate good diagnostic accuracy, with higher performance when differentiating FTD from controls (highest result was accuracy of 100%) than other dementias (highest result was AUC of 0.874). Very few machine learning algorithms have been tested in prospective replication. In conclusion, morphometric MRI with machine learning shows potential as an early diagnostic biomarker of FTD, however studies which use rigorous methodology and validate findings in an independent real-life cohort are necessary before this method can be recommended for use clinically.
Collapse
Affiliation(s)
- Jillian McCarthy
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - D Louis Collins
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Simon Ducharme
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada.
| |
Collapse
|
10
|
Bertoux M, Ramanan S, Slachevsky A, Wong S, Henriquez F, Musa G, Delgado C, Flanagan E, Bottlaender M, Sarazin M, Hornberger M, Dubois B. So Close Yet So Far: Executive Contribution to Memory Processing in Behavioral Variant Frontotemporal Dementia. J Alzheimers Dis 2018; 54:1005-1014. [PMID: 27567869 DOI: 10.3233/jad-160522] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Memory impairment in behavioral variant frontotemporal dementia (bvFTD) is traditionally considered to be mild and attributed to prefrontal cortex dysfunction. Recent studies, however, indicated that some patients can present with a memory impairment of the hippocampal type, showing storage and consolidation deficits in addition to the more executive/prefrontal related encoding and strategic difficulties. OBJECTIVE This study aimed to study the relationship between executive functions (EF) and memory processes in bvFTD via a data-driven approach. METHOD Participants consisted of 71 bvFTD (among which 60.6% had a lumbar puncture showing non-Alzheimer biomarker profile) and 60 controls (among which 45% had amyloid imaging showing a normal profile). EF were assessed by the Frontal Assessment Battery, semantic/lexical verbal fluency tests, and forward/backward digit spans. Patients were split into amnestic (n = 33) and non-amnestic (n = 38) subgroups based on normative data (total recall score) from the Free and Cued Selective Reminding Test (FCSRT). Relationships between FCSRT subscores and EF measures were explored through hierarchical clustering analysis, partial correlation analysis with an EF component, and automated linear modeling. RESULTS Convergent findings across the statistical approaches show that, overall, memory performance was independent from EF in bvFTD whereas the relationship was stronger in controls. Indeed, in bvFTD, memory performance did not cluster with EF, was not correlated with the EF component, and was only partially (4% - 12.7%) predicted by EF. DISCUSSION These findings show that executive dysfunctions cannot solely explain the memory deficits occurring in bvFTD. Indeed, some patients present with a genuine amnesia affecting storage and consolidation abilities, which are independent from executive dysfunctions. On the clinical level, this study highlights the importance of revising the neuropsychological diagnosis criteria for bvFTD.
Collapse
Affiliation(s)
- Maxime Bertoux
- Norwich Medical School, University of East Anglia, UK.,Centre de Référence Démence Rares, Pitié-Salpêtrière, Paris, France.,Sorbonne Universités, Paris VI, France
| | | | - Andrea Slachevsky
- Department of Physiopathology and Neuroscience, Faculty of Medicine, University of Chile, Santiago, Chile.,Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
| | | | - Fernando Henriquez
- Cognitive Neurology and Dementia, Neurology Department, Hospital del Salvador, Santiago, Chile
| | - Gada Musa
- Cognitive Neurology and Dementia, Neurology Department, Hospital del Salvador, Santiago, Chile
| | - Carolina Delgado
- Cognitive Neurology and Dementia, Neurology Department, Hospital del Salvador, Santiago, Chile
| | - Emma Flanagan
- Norwich Medical School, University of East Anglia, UK
| | | | - Marie Sarazin
- Centre Psychiatrie & Neurosciences, Sainte-Anne, Paris, France
| | | | - Bruno Dubois
- Centre de Référence Démence Rares, Pitié-Salpêtrière, Paris, France.,Sorbonne Universités, Paris VI, France
| |
Collapse
|
11
|
Palmer BW, Harmell AL, Dunn LB, Kim SY, Pinto LL, Golshan S, Jeste DV. Multimedia Aided Consent for Alzheimer's Disease Research. Clin Gerontol 2018; 41:20-32. [PMID: 29182458 PMCID: PMC6085078 DOI: 10.1080/07317115.2017.1373177] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Optimizing the research consent process simultaneously fosters respect for autonomy and protection of those with diminished capacity for autonomy. This study evaluated the effectiveness of an enhanced research consent procedure, employing multimedia disclosure and corrective feedback, in improving decisional capacity among 114 people with mild-to-moderate Alzheimer's disease (AD) and 134 non-psychiatric comparison (NC) subjects. METHODS Participants were randomized to consent type (routine versus enhanced) and protocol type (lower versus higher risk). Outcomes included a 5-item questionnaire assessing immediate comprehension, MacArthur Competence Assessment Tool for Clinical Research assessing four components of decision-making capacity, and categorical decisional capacity (based on a cut-score established in reference to expert judgments for a subset of participants). RESULTS There was no significant effect of the enhanced consent procedure, relative to routine consent, on immediate comprehension or decisional capacity. CONCLUSIONS Multimedia tools do not appear to be the solution to better consent for AD research. CLINICAL IMPLICATIONS Given the ethical primacy of informed consent and issues of justice for impaired populations who might be harmed by an absence of research-based treatment advances, continued search for ways to more meaningfully engage people with AD in the consent or assent process is warranted.
Collapse
Affiliation(s)
- Barton W Palmer
- a Veterans Affairs San Diego Healthcare System , San Diego , California , USA.,b Veterans Medical Research Foundation , San Diego , California , USA.,c Department of Psychiatry , University of California, San Diego , La Jolla , California , USA.,d Center for Healthy Aging/Stein Institute for Research on Aging , University of California, San Diego , La Jolla , California , USA
| | - Alexandrea L Harmell
- c Department of Psychiatry , University of California, San Diego , La Jolla , California , USA.,d Center for Healthy Aging/Stein Institute for Research on Aging , University of California, San Diego , La Jolla , California , USA.,e San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology , San Diego , California , USA.,f Mental Health Service , San Francisco VA Healthcare System , San Francisco , California , USA
| | - Laura B Dunn
- g Department of Psychiatry and Behavioral Sciences , Stanford University , Stanford , California , USA
| | - Scott Y Kim
- h Department of Bioethics , National Institute of Health , Bethesda , Maryland , USA
| | - Luz L Pinto
- b Veterans Medical Research Foundation , San Diego , California , USA.,c Department of Psychiatry , University of California, San Diego , La Jolla , California , USA.,d Center for Healthy Aging/Stein Institute for Research on Aging , University of California, San Diego , La Jolla , California , USA
| | - Shahrokh Golshan
- b Veterans Medical Research Foundation , San Diego , California , USA.,c Department of Psychiatry , University of California, San Diego , La Jolla , California , USA
| | - Dilip V Jeste
- c Department of Psychiatry , University of California, San Diego , La Jolla , California , USA.,d Center for Healthy Aging/Stein Institute for Research on Aging , University of California, San Diego , La Jolla , California , USA
| |
Collapse
|
12
|
Gurevich P, Stuke H, Kastrup A, Stuke H, Hildebrandt H. Neuropsychological Testing and Machine Learning Distinguish Alzheimer's Disease from Other Causes for Cognitive Impairment. Front Aging Neurosci 2017; 9:114. [PMID: 28487650 PMCID: PMC5403832 DOI: 10.3389/fnagi.2017.00114] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 04/07/2017] [Indexed: 12/28/2022] Open
Abstract
With promising results in recent treatment trials for Alzheimer’s disease (AD), it becomes increasingly important to distinguish AD at early stages from other causes for cognitive impairment. However, existing diagnostic methods are either invasive (lumbar punctures, PET) or inaccurate Magnetic Resonance Imaging (MRI). This study investigates the potential of neuropsychological testing (NPT) to specifically identify those patients with possible AD among a sample of 158 patients with Mild Cognitive Impairment (MCI) or dementia for various causes. Patients were divided into an early stage and a late stage group according to their Mini Mental State Examination (MMSE) score and labeled as AD or non-AD patients based on a post-mortem validated threshold of the ratio between total tau and beta amyloid in the cerebrospinal fluid (CSF; Total tau/Aβ(1–42) ratio, TB ratio). All patients completed the established Consortium to Establish a Registry for Alzheimer’s Disease—Neuropsychological Assessment Battery (CERAD-NAB) test battery and two additional newly-developed neuropsychological tests (recollection and verbal comprehension) that aimed at carving out specific Alzheimer-typical deficits. Based on these test results, an underlying AD (pathologically increased TB ratio) was predicted with a machine learning algorithm. To this end, the algorithm was trained in each case on all patients except the one to predict (leave-one-out validation). In the total group, 82% of the patients could be correctly identified as AD or non-AD. In the early group with small general cognitive impairment, classification accuracy was increased to 89%. NPT thus seems to be capable of discriminating between AD patients and patients with cognitive impairment due to other neurodegenerative or vascular causes with a high accuracy, and may be used for screening in clinical routine and drug studies, especially in the early course of this disease.
Collapse
Affiliation(s)
- Pavel Gurevich
- Department of Mathematics, Free University of BerlinBerlin, Germany.,Faculty of Science, Peoples' Friendship University of RussiaMoscow, Russia
| | - Hannes Stuke
- Department of Mathematics, Free University of BerlinBerlin, Germany
| | - Andreas Kastrup
- Department of Neurology, Municipal Hospital of Bremen-OstBremen, Germany
| | - Heiner Stuke
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin BerlinBerlin, Germany
| | - Helmut Hildebrandt
- Department of Neurology, Municipal Hospital of Bremen-OstBremen, Germany.,Department of Psychology, University of OldenburgOldenburg, Germany
| |
Collapse
|
13
|
Nilakantan AS, Voss JL, Weintraub S, Mesulam MM, Rogalski EJ. Selective verbal recognition memory impairments are associated with atrophy of the language network in non-semantic variants of primary progressive aphasia. Neuropsychologia 2017; 100:10-17. [PMID: 28391035 DOI: 10.1016/j.neuropsychologia.2017.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 03/20/2017] [Accepted: 04/03/2017] [Indexed: 11/30/2022]
Abstract
Primary progressive aphasia (PPA) is clinically defined by an initial loss of language function and preservation of other cognitive abilities, including episodic memory. While PPA primarily affects the left-lateralized perisylvian language network, some clinical neuropsychological tests suggest concurrent initial memory loss. The goal of this study was to test recognition memory of objects and words in the visual and auditory modality to separate language-processing impairments from retentive memory in PPA. Individuals with non-semantic PPA had longer reaction times and higher false alarms for auditory word stimuli compared to visual object stimuli. Moreover, false alarms for auditory word recognition memory were related to cortical thickness within the left inferior frontal gyrus and left temporal pole, while false alarms for visual object recognition memory was related to cortical thickness within the right-temporal pole. This pattern of results suggests that specific vulnerability in processing verbal stimuli can hinder episodic memory in PPA, and provides evidence for differential contributions of the left and right temporal poles in word and object recognition memory.
Collapse
Affiliation(s)
- Aneesha S Nilakantan
- Interdepartmental Neuroscience Program, Northwestern University, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL 60611, USA; Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, Chicago, IL 60611, USA.
| | - Joel L Voss
- Interdepartmental Neuroscience Program, Northwestern University, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL 60611, USA; Department of Psychiatry, Northwestern University, Chicago, IL 60611, USA; Department of Neurology, Northwestern Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Sandra Weintraub
- Interdepartmental Neuroscience Program, Northwestern University, Chicago, IL 60611, USA; Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, Chicago, IL 60611, USA; Department of Psychiatry, Northwestern University, Chicago, IL 60611, USA
| | - M-Marsel Mesulam
- Interdepartmental Neuroscience Program, Northwestern University, Chicago, IL 60611, USA; Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, Chicago, IL 60611, USA; Department of Neurology, Northwestern Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Emily J Rogalski
- Interdepartmental Neuroscience Program, Northwestern University, Chicago, IL 60611, USA; Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, Chicago, IL 60611, USA
| |
Collapse
|
14
|
Longitudinal Executive Function and Episodic Memory Profiles in Behavioral-Variant Frontotemporal Dementia and Alzheimer's Disease. J Int Neuropsychol Soc 2017; 23:34-43. [PMID: 27751195 DOI: 10.1017/s1355617716000837] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES With comparable baseline performance on executive functions (EF) and memory between Alzheimer's disease (AD) and behavioral-variant frontotemporal dementia (bvFTD), it is currently unclear if both diseases can be distinguished longitudinally on these measures reliably. METHODS A total of 111 participants (33 AD, 31 bvFTD, and 47 controls) were followed-up annually over a 4-year period and tested on measures of EF, memory, and orientation. Linear mixed-effect models were constructed using disease severity as a nuisance variable to examine profiles of neuropsychological performance decline. RESULTS At baseline, overlap in terms of cognitive impairment between bvFTD and AD on multiple EF, memory, and orientation measures was present. Longitudinally, only disinhibition (Hayling total errors) appeared sensitive to discriminating AD from bvFTD; however, only after the first annual follow-up. Subgroup analyses on smaller samples revealed comparable profiles on EF tasks at baseline and over time between bvFTD and AD who presented with impaired EF at presentation, and on memory and orientation tasks between AD and bvFTD who presented with severe amnesia. CONCLUSIONS Our results replicate previous findings showing only moderate discriminability between AD and bvFTD at clinical presentation on EF and memory measures. More importantly, we also show that longitudinal trajectories strongly overlap for both dementias on these measures. Disinhibition emerged as the sole measure that in the long run was significantly more impaired in bvFTD. Future studies should use tests designed to target cortical regions that are specifically impaired in bvFTD, such as the ventromedial prefrontal cortex, to improve the accurate discrimination of these diseases. (JINS, 2017, 23, 34-43).
Collapse
|
15
|
Krudop WA, Kerssens CJ, Dols A, Prins ND, Möller C, Schouws S, van der Flier WM, Scheltens P, Sikkes S, Stek ML, Pijnenburg YAL. Identifying bvFTD Within the Wide Spectrum of Late Onset Frontal Lobe Syndrome: A Clinical Approach. Am J Geriatr Psychiatry 2015; 23:1056-66. [PMID: 25921226 DOI: 10.1016/j.jagp.2015.04.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 04/02/2015] [Accepted: 04/02/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The behavioral variant of frontotemporal dementia (bvFTD) can be difficult to diagnose because of the extensive differential diagnosis, including many other diseases presenting with a frontal lobe syndrome. We aimed to identify the diagnostic spectrum causing a late onset frontal lobe syndrome and examine the quality of commonly used instruments to distinguish between bvFTD and non-bvFTD patients, within this syndrome. METHODS A total of 137 patients fulfilling the criteria of late onset frontal lobe syndrome, aged 45 to 75 years, were included in a prospective observational study. Diagnoses were made after clinical and neuropsychological examination, and neuroimaging and cerebral spinal fluid results were taken into account. Baseline characteristics and the scores on the Mini-Mental State Exam (MMSE), frontal assessment battery (FAB), Frontal Behavioral Inventory (FBI), and Stereotypy Rating Inventory (SRI) were compared between the bvFTD and the non-bvFTD group. RESULTS Fifty-five (40%) of the patients received a bvFTD diagnosis (33% probable and 7% possible bvFTD). Fifty-one patients (37%) had a psychiatric disorder, including 20 with major depressive disorder. Thirty-one patients received an alternative neurological, including neurodegenerative, diagnosis. MMSE and FAB scores were unspecific for a particular diagnosis. A score above 12 on the positive FBI subscale or a score above 5 on the SRI were indicative of a bvFTD diagnosis. CONCLUSION A broad spectrum of both neurological and psychiatric disorders underlies late onset frontal lobe syndrome, of which bvFTD was the most prevalent diagnosis in our cohort. The commonly used MMSE and the FAB could not successfully distinguish between bvFTD and non-bvFTD, but this could be achieved with the more specific FBI and SRI.
Collapse
Affiliation(s)
- Welmoed A Krudop
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands.
| | - Cora J Kerssens
- Department of Old Age Psychiatry, GGZInGeest, Amsterdam, the Netherlands
| | - Annemiek Dols
- Department of Old Age Psychiatry, GGZInGeest, Amsterdam, the Netherlands
| | - Niels D Prins
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
| | - Christiane Möller
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
| | - Sigfried Schouws
- Department of Old Age Psychiatry, GGZInGeest, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
| | - Sietske Sikkes
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Max L Stek
- Department of Old Age Psychiatry, GGZInGeest, Amsterdam, the Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
| |
Collapse
|