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Athanasio BS, Oliveira ACDS, Pedrosa AL, Borges RS, Neto AOM, Oliveira RA, de Resende EDPF, de Moraes RF, Caramelli P, de Souza LC. The role of brain perfusion SPECT in the diagnosis of frontotemporal dementia: A systematic review. J Neuroimaging 2024; 34:308-319. [PMID: 38192155 DOI: 10.1111/jon.13189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND AND PURPOSE Frontotemporal dementia (FTD) is the second most common cause of presenile dementia. The clinical distinction between FTD, Alzheimer's disease (AD), and other dementias is a clinical challenge. Brain perfusion SPECT may contribute to the diagnosis of FTD, but its value is unclear. METHODS We performed a systematic review to investigate the diagnostic accuracy of the brain SPECT in (1) distinguishing FTD from AD and other dementias and (2) differentiating FTD variants. RESULTS Overall, 391 studies were retrieved on the initial search and 35 studies composed the final selection, comprising a total number of 3142 participants of which 1029 had FTD. The sensitivity and the specificity for the differential diagnosis of FTD versus AD ranged from 56% to 88% and from 51% to 93%, respectively. SPECT is not superior to the clinical method of diagnosis, but the combination of SPECT with clinical data seems to improve the diagnostic accuracy. CONCLUSION Brain perfusion SPECT has a limited value in the diagnostic framework of FTD. SPECT can be performed when FDG-PET is not available. SPECT is recommended only for selected cases when the diagnosis is challenging using conventional methods.
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Affiliation(s)
- Bruno S Athanasio
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Ana Luísa Pedrosa
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Rafael S Borges
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Avelar O M Neto
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Rafael A Oliveira
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Elisa de Paula França de Resende
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Grupo de Neurologia Cognitiva e do Comportamento, Faculdade de Medicina da UFMG, Belo Horizonte, Brazil
| | - Renata Freire de Moraes
- Instituto Hermes Pardini, Belo Horizonte, Brazil
- Programa de Pós-Graduação em Neurociências, UFMG, Belo Horizonte, Brazil
| | - Paulo Caramelli
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Grupo de Neurologia Cognitiva e do Comportamento, Faculdade de Medicina da UFMG, Belo Horizonte, Brazil
- Programa de Pós-Graduação em Neurociências, UFMG, Belo Horizonte, Brazil
| | - Leonardo Cruz de Souza
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Grupo de Neurologia Cognitiva e do Comportamento, Faculdade de Medicina da UFMG, Belo Horizonte, Brazil
- Programa de Pós-Graduação em Neurociências, UFMG, Belo Horizonte, Brazil
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Souza LCD, Hosogi ML, Machado TH, Carthery-Goulart MT, Yassuda MS, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Bahia VS, Takada LT. Diagnóstico da demência frontotemporal: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Dement Neuropsychol 2022; 16:40-52. [DOI: 10.1590/1980-5764-dn-2022-s103pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/08/2021] [Accepted: 04/27/2022] [Indexed: 11/30/2022] Open
Abstract
RESUMO A “demência frontotemporal” (DFT) é uma síndrome clínica, cujo denominador comum é o acometimento focal dos lobos frontais e/ou temporais. A DFT tem três fenótipos clínicos distintos: a variante comportamental e dois subtipos linguísticos, a saber, a afasia progressiva primária não-fluente/agramática (APP-NF/A) e a afasia progressiva primária semântica (APP-S). A DFT é a segunda causa mais comum de demência em indivíduos com idade inferior a 65 anos, após a doença de Alzheimer. O presente artigo apresenta recomendações para diagnóstico da DFT no cenário brasileiro, considerando os três níveis de complexidade do sistema de saúde: atenção primária à saúde e níveis secundários. São propostos protocolos de investigação diagnóstica abrangendo testagem cognitiva, avaliação comportamental, avaliação fonoaudiológica, exames laboratoriais e de neuroimagem.
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Affiliation(s)
- Leonardo Cruz de Souza
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
| | | | - Thais Helena Machado
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
| | | | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
| | | | | | | | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
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3
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Souza LCD, Hosogi ML, Machado TH, Carthery-Goulart MT, Yassuda MS, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Vale FAC, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Bahia VS, Takada LT. Diagnosis of frontotemporal dementia: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Dement Neuropsychol 2022. [DOI: 10.1590/1980-5764-dn-2022-s103en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
ABSTRACT “Frontotemporal dementia” (FTD) is a clinical syndrome characterized by the focal involvement of the frontal and/or temporal lobes. FTD has three clinical phenotypes: the behavioral variant and two linguistic subtypes, namely, non-fluent/agrammatic primary progressive aphasia (PPA-NF/A) and semantic PPA (PPA-S). FTD is the second most common cause of dementia in individuals under the age of 65 years. This article presents recommendations for the diagnosis of FTD in the Brazilian scenario, considering the three levels of complexity of the health system: primary health care, secondary and tertiary levels. Diagnostic guidelines are proposed, including cognitive testing, behavioral and language assessments, laboratory tests, and neuroimaging.
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Affiliation(s)
- Leonardo Cruz de Souza
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
| | | | - Thais Helena Machado
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
| | | | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
| | | | | | | | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
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4
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Ribeiro VT, Cordeiro TME, Filha RDS, Perez LG, Caramelli P, Teixeira AL, de Souza LC, Simões E Silva AC. Circulating Angiotensin-(1-7) Is Reduced in Alzheimer's Disease Patients and Correlates With White Matter Abnormalities: Results From a Pilot Study. Front Neurosci 2021; 15:636754. [PMID: 33897352 PMCID: PMC8063113 DOI: 10.3389/fnins.2021.636754] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/12/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Alzheimer’s disease (AD) is the leading cause of dementia worldwide. Despite the extensive research, its pathophysiology remains largely unelucidated. Currently, more attention is being given to the disease’s vascular and inflammatory aspects. In this context, the renin-angiotensin system (RAS) emerges as a credible player in AD pathogenesis. The RAS has multiple physiological functions, conducted by its two opposing axes: the classical, led by Angiotensin II (Ang II), and the alternative, driven by Angiotensin-(1–7) [Ang-(1–7)]. These peptides were shown to interact with AD pathology in animal studies, but evidence from humans is scarce. Only 20 studies dosed RAS molecules in AD patients’ bloodstream, none of which assessed both axes simultaneously. Therefore, we conducted a cross-sectional, case-control exploratory study to compare plasma levels of Ang II and Ang-(1–7) in AD patients vs. age-matched controls. Within each group, we searched for correlations between RAS biomarkers and measures from magnetic resonance imaging (MRI). Methods We evaluated patients with AD (n = 14) and aged-matched controls (n = 14). Plasma Ang II and Ang-(1–7) were dosed using ELISA. Brain MRI was performed in a 3 Tesla scan, and a three-dimensional T1-weighted volumetric sequence was obtained. Images were then processed by FreeSurfer to calculate: (1) white matter hypointensities (WMH) volume; (2) volumes of hippocampus, medial temporal cortex, and precuneus. Statistical analyses used non-parametrical tests (Mann-Whitney and Spearman). Results Ang-(1–7) levels in plasma were significantly lower in the AD patients than in controls [median (25th–75th percentiles)]: AD [101.5 (62.43–126.4)] vs. controls [209.3 (72–419.1)], p = 0.014. There was no significant difference in circulating Ang II. In the AD patients, but not in controls, there was a positive and significant correlation between Ang-(1–7) values and WMH volumes (Spearman’s rho = 0.56, p = 0.038). Ang-(1–7) did not correlate with cortical volumes in AD or in controls. Ang II did not correlate with any MRI variable in none of the groups. Conclusion If confirmed, our results strengthen the hypothesis that RAS alternative axis is downregulated in AD, and points to a possible interaction between Ang-(1–7) and cerebrovascular lesions in AD.
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Affiliation(s)
- Victor Teatini Ribeiro
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Thiago Macedo E Cordeiro
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Roberta da Silva Filha
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Lucas Giandoni Perez
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Paulo Caramelli
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Antônio Lúcio Teixeira
- Neuropsychiatry Program and Immuno-Psychiatry Lab, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Leonardo Cruz de Souza
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.,Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ana Cristina Simões E Silva
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Miletich RS. Positron Emission Tomography and Single-Photon Emission Computed Tomography in Neurology. Continuum (Minneap Minn) 2018; 22:1636-1654. [PMID: 27740992 DOI: 10.1212/con.0000000000000389] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) are now available for routine clinical applications in neurology. This article discusses their diagnostic use in dementia, brain tumors, epilepsy, parkinsonism, cerebrovascular disease, and traumatic brain injury. RECENT FINDINGS Neuromolecular imaging, also known as nuclear neurology, involves clinical imaging of both basal regional physiology (perfusion, metabolism, and transport mechanisms) and specific neurochemical physiology (currently, only the dopamine transporter). This article serves as an introduction to neuromolecular imaging, reviewing the literature supplemented by the author's experience. SUMMARY Neurologic PET and SPECT are no longer restricted to the research realm. These modalities have high diagnostic accuracy.
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6
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Kaneta T, Katsuse O, Hirano T, Ogawa M, Shihikura-Hino A, Yoshida K, Odawara T, Hirayasu Y, Inoue T. Voxel-wise correlations between cognition and cerebral blood flow using arterial spin-labeled perfusion MRI in patients with Alzheimer's disease: a cross-sectional study. BMC Neurol 2017; 17:91. [PMID: 28506213 PMCID: PMC5433075 DOI: 10.1186/s12883-017-0870-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 05/04/2017] [Indexed: 11/18/2022] Open
Abstract
Background To analyze voxel-wise correlation between cerebral blood flow (CBF) measured using ASL-MRI and cognition in patients with Alzheimer’s disease (AD). Methods Forty-one patients diagnosed with AD or mild cognitive impairment due to AD were recruited for this study. CBF images were obtained using ASL-MRI (n = 41) with a post-labeling delay (PLD) of 1.5 and 2.5 s (PLD1.5 and PLD2.5, respectively) using a 3 T scanner, in addition to brain perfusion SPECT with N-isopropyl-4-[I-123]iodoamphetamine (n = 28). Voxel-based analyses were performed for ASL-MRI and SPECT using Mini-Mental State Examination (MMSE) scores as covariates. Differences in CBF between PLD1.5 and PLD2.5 were assessed using a paired t-test with SPM12. Results Significant positive correlations were observed between MMSE scores and CBF at PLD1.5 in the right posterior cingulate cortex (PCC), and both temporo-parietal association cortexes. At PLD2.5, significant positive correlations were determined for MMSE scores and CBF in the superior parietal lobule and the right temporo-parietal association cortex. SPECT showed significant positive correlations in the PCC and both temporo-parietal association cortexes (right-side dominant). PLD1.5 showed significantly higher CBF than PLD2.5 in the proximal areas of vascular territories of the anterior, middle, and posterior cerebral arteries. Conclusions Significant positive correlations in CBF, measured with both ASL-MRI and SPECT, with cognition were found in the PCC and temporo-parietal association cortexes. PLD1.5 and PLD2.5 showed similar correlations with cognition, although the CBF images had significant differences.
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Affiliation(s)
- Tomohiro Kaneta
- Department of Radiology, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
| | - Omi Katsuse
- Department of Psychiatry, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Takamasa Hirano
- Department of Radiology, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Matsuyoshi Ogawa
- Department of Radiology, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Ayako Shihikura-Hino
- Department of Radiology, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Keisuke Yoshida
- Department of Radiology, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Toshinari Odawara
- Department of Psychiatry, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Yoshio Hirayasu
- Department of Psychiatry, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Tomio Inoue
- Department of Radiology, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
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Nguyen JP, Suarez A, Kemoun G, Meignier M, Le Saout E, Damier P, Nizard J, Lefaucheur JP. Repetitive transcranial magnetic stimulation combined with cognitive training for the treatment of Alzheimer's disease. Neurophysiol Clin 2017; 47:47-53. [DOI: 10.1016/j.neucli.2017.01.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 01/03/2017] [Indexed: 12/23/2022] Open
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Magin P, Juratowitch L, Dunbabin J, McElduff P, Goode S, Tapley A, Pond D. Attitudes to Alzheimer's disease testing of Australian general practice patients: a cross-sectional questionnaire-based study. Int J Geriatr Psychiatry 2016; 31:361-6. [PMID: 26258761 DOI: 10.1002/gps.4335] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 06/28/2015] [Accepted: 07/07/2015] [Indexed: 12/19/2022]
Abstract
OBJECTIVE In view of proposed screening for presymptomatic Alzheimer's disease (AD) with advanced imaging, and blood and cerebral spinal fluid analysis, we aimed to establish levels, and associations, of acceptance of AD testing modalities by general practice patients. METHODS A cross-sectional questionnaire-based study of consecutive patients (aged 50 years and over) of general practices of an Australian practice-based research network was used. The questionnaire elicited demographic data and attitudes to screening for other diseases and included the screening acceptance domain of the Perceptions Regarding Investigational Screening for Memory in Primary Care (PRISM-PC) instrument. This assesses receptivity to modalities of testing for AD: short questionnaire, blood test, cerebral imaging, and annual physician examination. Reflecting speculation of possible future AD diagnostic methods, an item regarding testing cerebral spinal fluid was also included. Associations of PRISM-PC scores were analyzed with multiple linear regression. RESULTS Of 489 participants (response rate 87%), 66.2% would like to know if they had AD. Participants were more accepting of testing modalities that were noninvasive or familiar (questionnaire, physician's examination, and blood test) as opposed to cerebral imaging or lumbar puncture. Attitudes to AD testing are influenced by a positive attitude to disease screening in general. Patients with a self-perceived higher risk of AD were less accepting of testing, as were participants with an educational level of junior high school (10 school years) or less. CONCLUSIONS This study demonstrates that a majority of patients would like to know if they have AD. Acceptability of testing modalities, however, varies. Noninvasive, familiar methods are more acceptable.
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Affiliation(s)
- Parker Magin
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.,General Practice Training Valley to Coast, New South Wales, Australia
| | - Laura Juratowitch
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
| | - Janet Dunbabin
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
| | - Patrick McElduff
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
| | - Susan Goode
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
| | - Amanda Tapley
- General Practice Training Valley to Coast, New South Wales, Australia
| | - Dimity Pond
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
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Prado LDGR, Bicalho ICS, Magalhães D, Caramelli P, Teixeira AL, de Souza LC. C9ORF72 and the FTD-ALS spectrum: A systematic review of neuroimaging studies. Dement Neuropsychol 2015; 9:413-421. [PMID: 29213991 PMCID: PMC5619324 DOI: 10.1590/1980-57642015dn94000413] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective To perform a systematic review of the literature on the neuroimaging
investigation of frontotemporal dementia (FTD) and amyotrophic lateral
sclerosis (ALS) associated with C9ORF72 mutation. Methods The search was performed on PubMed and LILACS with the following terms:
C9ORF72, MRI, SPECT, PET, ALS, FTD. No filters were
added. Results Twenty articles were selected. Most studies found consistent involvement of
frontotemporal regions in C9ORF72 carriers, including
prefrontal cortex, and also cingulate, subcortical regions, especially the
thalami, and posterior regions such as the parietal and occipital lobes.
Functional connectivity was also explored and impaired sensorimotor
connectivity in striatum and thalami was found in behavioral variant FTD
C9ORF72 carriers. Some papers have reported an absence
of significant abnormalities on brain imaging. Conclusion The inclusion of patients at different stages of the disease, differences in
neuroimaging methods across studies, and distinct clinical phenotypes
associated with C9ORF72 may account for the heterogeneity
of results.
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Affiliation(s)
- Laura de Godoy Rousseff Prado
- Postgraduate Program of Neuroscience, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Neuromuscular Diseases Center, Department of Neurology, University Hospital, UFMG
| | - Isabella Carolina Santos Bicalho
- Postgraduate Program of Neuroscience, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Neuromuscular Diseases Center, Department of Neurology, University Hospital, UFMG
| | - Daiane Magalhães
- Universidade José do Rosário Vellano - UNIFENAS, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Postgraduate Program of Neuroscience, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Internal Medicine Department, Medical School, UFMG.,Department of Neurology - University Hospital, UFMG
| | - Antônio Lúcio Teixeira
- Postgraduate Program of Neuroscience, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Neuromuscular Diseases Center, Department of Neurology, University Hospital, UFMG.,Internal Medicine Department, Medical School, UFMG.,Department of Neurology - University Hospital, UFMG
| | - Leonardo Cruz de Souza
- Postgraduate Program of Neuroscience, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Neuromuscular Diseases Center, Department of Neurology, University Hospital, UFMG.,Internal Medicine Department, Medical School, UFMG.,Department of Neurology - University Hospital, UFMG
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10
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Garriga M, Milà M, Mir M, Al-Baradie R, Huertas S, Castejon C, Casas L, Badenes D, Giménez N, Font MA, Gonzalez JM, Ysamat M, Aguilar M, Slevin M, Krupinski J. (123)I-FP-CIT SPECT imaging in early diagnosis of dementia in patients with and without a vascular component. Front Syst Neurosci 2015; 9:99. [PMID: 26190980 PMCID: PMC4486766 DOI: 10.3389/fnsys.2015.00099] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 06/15/2015] [Indexed: 01/18/2023] Open
Abstract
Alzheimer’s disease (AD) and vascular dementia (VaD) are the most common cause of dementia. Cerebral ischemia is a major risk factor for development of dementia. 123I-FP-CIT SPECT (DaTScan) is a complementary tool in the differential diagnoses of patients with incomplete or uncertain Parkinsonism. Additional application of DaTScan enables the categorization of Parkinsonian disease with dementia (PDD), and its differentiation from pure AD, and may further contribute to change the therapeutic decision. The aim of this study was to analyze the vascular contribution towards dementia and mild cognitive impairment (MCI). We evaluated the utility of DaTScan for the early diagnosis of dementia in patients with and without a clinical vascular component, and the association between neuropsychological function, vascular component and dopaminergic function on DaTScan. One-hundred and five patients with MCI or the initial phases of dementia were studied prospectively. We developed an initial assessment using neurologic examination, blood tests, cognitive function tests, structural neuroimaging and DaTScan. The vascular component was later quantified in two ways: clinically, according to the Framingham Risk Score (FRS) and by structural neuroimaging using Wahlund Scale Total Score (WSTS). Early diagnosis of dementia was associated with an abnormal DaTScan. A significant association was found between a high WSTS and an abnormal DaTScan (p < 0.01). Mixed AD was the group with the highest vascular component, followed by the VaD group, while MCI and pure AD showed similar WSTS. No significant associations were found between neuropsychological impairment and DaTScan independently of associated vascular component. DaTScan seems to be a good tool to discriminate, in a first clinical assessment, patients with MCI from those with established dementia. There was bigger general vascular affectation observable in MRI or CT in patients with abnormal dopaminergic uptake seen on DaTScan.
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Affiliation(s)
- Marina Garriga
- Neurology Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain ; Psychiatric Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain
| | - Marta Milà
- Neurology Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain
| | - Manzoor Mir
- College of Applied Medical Sciences, Majmaah University Almajmaah Al Majmaah, Saudi Arabia
| | - Raid Al-Baradie
- College of Applied Medical Sciences, Majmaah University Almajmaah Al Majmaah, Saudi Arabia
| | - Sonia Huertas
- Neurology Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain
| | - Cesar Castejon
- Neurology Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain
| | - Laura Casas
- Neurology Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain
| | - Dolors Badenes
- Neurology Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain
| | - Nuria Giménez
- Research Unit, Research Foundation Mútua Terrassa, Universitat de Barcelona Barcelona, Spain
| | - M Angels Font
- Research Unit, Research Foundation Mútua Terrassa, Universitat de Barcelona Barcelona, Spain
| | - Jose M Gonzalez
- Cetir-Grup Medic, CTD, Hospital Universitari Mútua de Terrassa Terrassa, Spain
| | - Maria Ysamat
- Cetir-Grup Medic, CTD, Hospital Universitari Mútua de Terrassa Terrassa, Spain
| | - Miguel Aguilar
- Neurology Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain
| | - Mark Slevin
- School of Healthcare Science, Manchester Metropolitan University Manchester, UK
| | - Jerzy Krupinski
- Neurology Unit, Hospital Universitari Mútua Terrassa Terrassa, Spain ; School of Healthcare Science, Manchester Metropolitan University Manchester, UK
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Li JL, Zhuang K, Wu GY, Ho WZ. Magnetic resonance imaging study of a simian/human immunodeficiency virus-infected Chinese rhesus macaque with HIV-associated dementia. AIDS Res Hum Retroviruses 2015; 31:272-3. [PMID: 25723352 DOI: 10.1089/aid.2014.0355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Jie-Liang Li
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, State Key Laboratory of Virology, Wuhan University School of Medicine, Wuhan, China
- Department of Pathology and Laboratory Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Ke Zhuang
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, State Key Laboratory of Virology, Wuhan University School of Medicine, Wuhan, China
| | - Guang-Yao Wu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wen-Zhe Ho
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, State Key Laboratory of Virology, Wuhan University School of Medicine, Wuhan, China
- Department of Pathology and Laboratory Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania
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12
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Abstract
Over the past 35 years or so, PET brain imaging has allowed powerful and unique insights into brain function under normal conditions and in disease states. Initially, as PET instrumentation continued to develop, studies were focused on brain perfusion and glucose metabolism. This permitted refinement of brain imaging for important, non-oncologic clinical indications. The ability of PET to not only provide spatial localization of metabolic changes but also to accurately and consistently quantify their distribution proved valuable for applications in the clinical setting. Specifically, glucose metabolism brain imaging using (F-18) fluorodeoxyglucose continues to be invaluable for evaluating patients with intractable seizures for identifying seizure foci and operative planning. Cerebral glucose metabolism also contributes to diagnosis of neurodegenerative diseases that cause dementia. Alzheimer disease, dementia with Lewy bodies, and the several variants of frontotemporal lobar degeneration have differing typical patterns of hypometabolism. In Alzheimer disease, hypometabolism has furthermore been associated with poorer cognitive performance and ensuing cognitive and functional decline. As the field of radiochemistry evolved, novel radioligands including radiolabeled flumazenil, dopamine transporter ligands, nicotine receptor ligands, and others have allowed for further understanding of molecular changes in the brain associated with various diseases. Recently, PET brain imaging reached another milestone with the approval of (F-18) florbetapir imaging by the United States Federal Drug Administration for detection of amyloid plaque accumulation in brain, the major histopathologic hallmark of Alzheimer disease, and efforts have been made to define the clinical role of this imaging agent in the setting of the currently limited treatment options. Hopefully, this represents the first of many new radiopharmaceuticals that would allow improved diagnostic and prognostic information in these and other clinical applications, including Parkinson disease and traumatic brain injury.
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Affiliation(s)
- Ilya Nasrallah
- Division of Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA
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13
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Abstract
PURPOSE OF REVIEW To critically discuss the neuropsychiatric symptoms in the prodromal stages of dementia in order to improve the early clinical diagnosis of cognitive and functional deterioration. RECENT FINDINGS Current criteria for cognitive syndrome, including Alzheimer's disease, comprise the neuropsychiatric symptoms in addition to cognitive and functional decline. Although there is growing evidence that neuropsychiatric symptoms may precede the prodromal stages of dementia, these manifestations have received less attention than traditional clinical hallmarks such as cognitive and functional deterioration. Depression, anxiety, apathy, irritability, agitation, sleep disorders, among other symptoms, have been hypothesized to represent a prodromal stage of dementia or, at least, they increase the risk for conversion from minor neurocognitive disorder to major neurocognitive disorder. Longitudinal investigations have provided increased evidence of progression to dementia in individuals with minor neurocognitive disorder when neuropsychiatric symptoms also were present. SUMMARY Although neuropsychiatric symptoms are strongly associated with a higher risk of cognitive and functional deterioration, frequently the clinician does not acknowledge these conditions as increasing the risk of dementia. When the clinician accurately diagnoses neuropsychiatric symptoms in the prodromal stage of dementia, he could early establish appropriate treatment and, may be, delay the beginning of clinical and functional deterioration.
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14
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Abstract
The ability to speak two languages often marvels monolinguals, although bilinguals report no difficulties in achieving this feat. Here, we examine how learning and using two languages affect language acquisition and processing as well as various aspects of cognition. We do so by addressing three main questions. First, how do infants who are exposed to two languages acquire them without apparent difficulty? Second, how does language processing differ between monolingual and bilingual adults? Last, what are the collateral effects of bilingualism on the executive control system across the lifespan? Research in all three areas has not only provided some fascinating insights into bilingualism but also revealed new issues related to brain plasticity and language learning.
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Affiliation(s)
- Albert Costa
- 1] Center for Brain and Cognition, Department of Technology, Pompeu Fabra University, 08018 Barcelona, Spain. [2] ICREA (Institució Catalana de Recerca I Estudis Avançats), Passeig Lluís Companys, 23; 08010 Barcelona, Spain
| | - Núria Sebastián-Gallés
- Center for Brain and Cognition, Department of Technology, Pompeu Fabra University, 08018 Barcelona, Spain
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15
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Sundermann B, Herr D, Schwindt W, Pfleiderer B. Multivariate classification of blood oxygen level-dependent FMRI data with diagnostic intention: a clinical perspective. AJNR Am J Neuroradiol 2013; 35:848-55. [PMID: 24029388 DOI: 10.3174/ajnr.a3713] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
SUMMARY There has been a recent upsurge of reports about applications of pattern-recognition techniques from the field of machine learning to functional MR imaging data as a diagnostic tool for systemic brain disease or psychiatric disorders. Entities studied include depression, schizophrenia, attention deficit hyperactivity disorder, and neurodegenerative disorders like Alzheimer dementia. We review these recent studies which-despite the optimism from some articles-predominantly constitute explorative efforts at the proof-of-concept level. There is some evidence that, in particular, support vector machines seem to be promising. However, the field is still far from real clinical application, and much work has to be done regarding data preprocessing, model optimization, and validation. Reporting standards are proposed to facilitate future meta-analyses or systematic reviews.
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Affiliation(s)
- B Sundermann
- From the Department of Clinical Radiology (B.S., W.S., B.P.), University Hospital Münster, Münster, Germany
| | - D Herr
- Department of Psychiatry and Psychotherapy (D.H.), University of Cologne, Cologne, Germany
| | - W Schwindt
- From the Department of Clinical Radiology (B.S., W.S., B.P.), University Hospital Münster, Münster, Germany
| | - B Pfleiderer
- From the Department of Clinical Radiology (B.S., W.S., B.P.), University Hospital Münster, Münster, Germany
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16
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Abstract
Neurodegenerative disorders leading to dementia are common diseases that affect many older and some young adults. Neuroimaging methods are important tools for assessing and monitoring pathological brain changes associated with progressive neurodegenerative conditions. In this review, the authors describe key findings from neuroimaging studies (magnetic resonance imaging and radionucleotide imaging) in neurodegenerative disorders, including Alzheimer's disease (AD) and prodromal stages, familial and atypical AD syndromes, frontotemporal dementia, amyotrophic lateral sclerosis with and without dementia, Parkinson's disease with and without dementia, dementia with Lewy bodies, Huntington's disease, multiple sclerosis, HIV-associated neurocognitive disorder, and prion protein associated diseases (i.e., Creutzfeldt-Jakob disease). The authors focus on neuroimaging findings of in vivo pathology in these disorders, as well as the potential for neuroimaging to provide useful information for differential diagnosis of neurodegenerative disorders.
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Affiliation(s)
- Shannon L. Risacher
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, and Indiana Alzheimer Disease Center Indiana University School of Medicine, Indianapolis, Indiana
| | - Andrew J. Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, and Indiana Alzheimer Disease Center Indiana University School of Medicine, Indianapolis, Indiana
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17
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McClure RA, Chumbley CW, Reyzer ML, Wilson K, Caprioli RM, Gore JC, Pham W. Identification of promethazine as an amyloid-binding molecule using a fluorescence high-throughput assay and MALDI imaging mass spectrometry. Neuroimage Clin 2013; 2:620-9. [PMID: 24179813 PMCID: PMC3778261 DOI: 10.1016/j.nicl.2013.04.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 04/19/2013] [Accepted: 04/22/2013] [Indexed: 01/22/2023]
Abstract
The identification of amyloid-binding compounds is a crucial step in the development of imaging probes and therapeutics for the detection and cure of Alzheimer's disease. Unfortunately, the process typically lags during the translation from in vitro to in vivo studies due to the impenetrable nature of the blood brain barrier (BBB). Here, we integrate fluorescence assay with MALDI imaging mass spectrometry to screen known compounds and repurpose their properties to enable the second function of binding to amyloid plaques. Through this approach, we identified an antihistamine compound, promethazine, that can bind to amyloid plaques. Finally, we demonstrate that promethazine is retained in the amyloid-burdened brain compared to a normal brain and that its distribution within the brain corroborates with that of amyloid plaques.
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Affiliation(s)
- Richard A. McClure
- Institute of Imaging Science, Vanderbilt University, 1161, 21st Avenue South, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt School of Medicine, USA
- Vanderbilt Brain Institute, USA
| | - Chad W. Chumbley
- Department of Chemistry, Vanderbilt University, USA
- Mass Spectrometry Research Center, Vanderbilt University, USA
| | - Michelle L. Reyzer
- Mass Spectrometry Research Center, Vanderbilt University, USA
- Department of Biochemistry, Vanderbilt University, USA
| | - Kevin Wilson
- Institute of Imaging Science, Vanderbilt University, 1161, 21st Avenue South, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt School of Medicine, USA
| | - Richard M. Caprioli
- Department of Chemistry, Vanderbilt University, USA
- Mass Spectrometry Research Center, Vanderbilt University, USA
- Department of Biochemistry, Vanderbilt University, USA
- Vanderbilt Ingram Cancer Center, Vanderbilt University, USA
| | - John C. Gore
- Institute of Imaging Science, Vanderbilt University, 1161, 21st Avenue South, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt School of Medicine, USA
- Vanderbilt Ingram Cancer Center, Vanderbilt University, USA
- Molecular Physiology and Biophysics, Vanderbilt University, USA
| | - Wellington Pham
- Institute of Imaging Science, Vanderbilt University, 1161, 21st Avenue South, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt School of Medicine, USA
- Vanderbilt Ingram Cancer Center, Vanderbilt University, USA
- Vanderbilt Institute of Chemical Biology, USA
- Vanderbilt Brain Institute, USA
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18
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de Souza LC, Bertoux M, Funkiewiez A, Samri D, Azuar C, Habert MO, Kas A, Lamari F, Sarazin M, Dubois B. Frontal presentation of Alzheimer's disease: a series of patients with biological evidence by CSF biomarkers. Dement Neuropsychol 2013; 7:66-74. [PMID: 29213822 PMCID: PMC5619547 DOI: 10.1590/s1980-57642013dn70100011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Besides its typical amnesic presentation, focal atypical presentations of Alzheimer's disease (AD) have been described in neuropathological studies. These phenotypical variants of AD (so-called "atypical AD") do not follow the typical amnestic pattern and include non-amnestic focal cortical syndromes, such as posterior cortical atrophy and frontal variant AD. These variants exhibit characteristic histological lesions of Alzheimer pathology at post-mortem exam. By using physiopathological markers, such as cerebrospinal fluid markers, it is now possible to establish in vivo a biological diagnosis of AD in these focal cortical syndromes. We report a series of eight patients who were diagnosed with behavioural variant frontotemporal dementia based on their clinical, neuropsychological and neuroimaging findings, while CSF biomarkers showed an AD biological profile, thus supporting a diagnosis of frontal variant of AD.
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Affiliation(s)
- Leonardo Cruz de Souza
- Université Pierre et Marie Curie Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière, UMR-S975, 47-83 bd de l'Hôpital, 75013 Paris, France. Inserm, U975, 47-83 bd de l'Hôpital, 75013 Paris, France. CNRS, UMR 7225, 47-83 bd de l'Hôpital, 75013 Paris, France 4 Institut du Cerveau et de la Moelle Epinière, ICM, 47-83 bd de l'Hôpital, 75013 Paris, France. Alzheimer Institute; Research and Resource Memory Centre; Centre de Référence des Démences Rares, Centre de Référence Maladie d'Alzheimer jeune, AP-HP, Pitié-Salpêtrière Hospital, 47-83 boulevard de l'Hôpital, 75013 Paris, France
| | - Maxime Bertoux
- Université Pierre et Marie Curie Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière, UMR-S975, 47-83 bd de l'Hôpital, 75013 Paris, France. Inserm, U975, 47-83 bd de l'Hôpital, 75013 Paris, France. CNRS, UMR 7225, 47-83 bd de l'Hôpital, 75013 Paris, France 4 Institut du Cerveau et de la Moelle Epinière, ICM, 47-83 bd de l'Hôpital, 75013 Paris, France. Alzheimer Institute; Research and Resource Memory Centre; Centre de Référence des Démences Rares, Centre de Référence Maladie d'Alzheimer jeune, AP-HP, Pitié-Salpêtrière Hospital, 47-83 boulevard de l'Hôpital, 75013 Paris, France
| | - Aurélie Funkiewiez
- Université Pierre et Marie Curie Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière, UMR-S975, 47-83 bd de l'Hôpital, 75013 Paris, France. Alzheimer Institute; Research and Resource Memory Centre; Centre de Référence des Démences Rares, Centre de Référence Maladie d'Alzheimer jeune, AP-HP, Pitié-Salpêtrière Hospital, 47-83 boulevard de l'Hôpital, 75013 Paris, France
| | - Dalila Samri
- Université Pierre et Marie Curie Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière, UMR-S975, 47-83 bd de l'Hôpital, 75013 Paris, France. Alzheimer Institute; Research and Resource Memory Centre; Centre de Référence des Démences Rares, Centre de Référence Maladie d'Alzheimer jeune, AP-HP, Pitié-Salpêtrière Hospital, 47-83 boulevard de l'Hôpital, 75013 Paris, France
| | - Carole Azuar
- Université Pierre et Marie Curie Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière, UMR-S975, 47-83 bd de l'Hôpital, 75013 Paris, France. Inserm, U975, 47-83 bd de l'Hôpital, 75013 Paris, France. CNRS, UMR 7225, 47-83 bd de l'Hôpital, 75013 Paris, France 4 Institut du Cerveau et de la Moelle Epinière, ICM, 47-83 bd de l'Hôpital, 75013 Paris, France. Alzheimer Institute; Research and Resource Memory Centre; Centre de Référence des Démences Rares, Centre de Référence Maladie d'Alzheimer jeune, AP-HP, Pitié-Salpêtrière Hospital, 47-83 boulevard de l'Hôpital, 75013 Paris, France
| | - Marie-Odile Habert
- Service de Médecine Nucléaire, AP-HP, Groupe hospitalier Pitié-Salpêtrière, F-75013, Paris, France
| | - Aurélie Kas
- Service de Médecine Nucléaire, AP-HP, Groupe hospitalier Pitié-Salpêtrière, F-75013, Paris, France
| | - Foudil Lamari
- Department of Metabolic Biochemistry, Pitié-Salpêtrière Hospital, Paris, France
| | - Marie Sarazin
- Université Pierre et Marie Curie Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière, UMR-S975, 47-83 bd de l'Hôpital, 75013 Paris, France. Inserm, U975, 47-83 bd de l'Hôpital, 75013 Paris, France. CNRS, UMR 7225, 47-83 bd de l'Hôpital, 75013 Paris, France 4 Institut du Cerveau et de la Moelle Epinière, ICM, 47-83 bd de l'Hôpital, 75013 Paris, France. Alzheimer Institute; Research and Resource Memory Centre; Centre de Référence des Démences Rares, Centre de Référence Maladie d'Alzheimer jeune, AP-HP, Pitié-Salpêtrière Hospital, 47-83 boulevard de l'Hôpital, 75013 Paris, France
| | - Bruno Dubois
- Université Pierre et Marie Curie Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière, UMR-S975, 47-83 bd de l'Hôpital, 75013 Paris, France. Inserm, U975, 47-83 bd de l'Hôpital, 75013 Paris, France. CNRS, UMR 7225, 47-83 bd de l'Hôpital, 75013 Paris, France 4 Institut du Cerveau et de la Moelle Epinière, ICM, 47-83 bd de l'Hôpital, 75013 Paris, France. Alzheimer Institute; Research and Resource Memory Centre; Centre de Référence des Démences Rares, Centre de Référence Maladie d'Alzheimer jeune, AP-HP, Pitié-Salpêtrière Hospital, 47-83 boulevard de l'Hôpital, 75013 Paris, France
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