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Yong K, Petzold A, Foster P, Young A, Bell S, Bai Y, Leff AP, Crutch S, Greenwood JA. The Graded Incomplete Letters Test (GILT): a rapid test to detect cortical visual loss, with UK Biobank implementation. Behav Res Methods 2024; 56:7748-7760. [PMID: 38890263 PMCID: PMC11362218 DOI: 10.3758/s13428-024-02448-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2024] [Indexed: 06/20/2024]
Abstract
Impairments of object recognition are core features of neurodegenerative syndromes, in particular posterior cortical atrophy (PCA; the 'visual-variant Alzheimer's disease'). These impairments arise from damage to higher-level cortical visual regions and are often missed or misattributed to common ophthalmological conditions. Consequently, diagnosis can be delayed for years with considerable implications for patients. We report a new test for the rapid measurement of cortical visual loss - the Graded Incomplete Letters Test (GILT). The GILT is an optimised psychophysical variation of a test used to diagnose cortical visual impairment, which measures thresholds for recognising letters under levels of increasing visual degradation (decreasing "completeness") in a similar fashion to ophthalmic tests. The GILT was administered to UK Biobank participants (total n=2,359) and participants with neurodegenerative conditions characterised by initial cortical visual (PCA, n=18) or memory loss (typical Alzheimer's disease, n=9). UK Biobank participants, including both typical adults and those with ophthalmological conditions, were able to recognise letters under low levels of completeness. In contrast, participants with PCA consistently made errors with only modest decreases in completeness. GILT sensitivity to PCA was 83.3% for participants reaching the 80% accuracy cut-off, increasing to 88.9% using alternative cut-offs (60% or 100% accuracy). Specificity values were consistently over 94% when compared to UK Biobank participants without or with documented visual conditions, regardless of accuracy cut-off. These first-release UK Biobank and clinical verification data suggest the GILT has utility in both rapidly detecting visual perceptual losses following posterior cortical damage and differentiating perceptual losses from common eye-related conditions.
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Affiliation(s)
- Kxx Yong
- Queen Square Institute of Neurology, University College London, London, UK.
| | - A Petzold
- Queen Square Institute of Neurology, University College London, London, UK
- Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
- Neuro-ophthalmology Expertise Centre, Amsterdam UMC, Amsterdam, NL, The Netherlands
| | - P Foster
- Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - A Young
- Big Data Institute, Nuffield, Department of Population Health, University of Oxford, Oxford, UK
| | - S Bell
- UK Biobank, Stockport, UK
| | - Y Bai
- Queen Square Institute of Neurology, University College London, London, UK
| | - A P Leff
- Queen Square Institute of Neurology, University College London, London, UK
| | - S Crutch
- Queen Square Institute of Neurology, University College London, London, UK
| | - J A Greenwood
- Experimental Psychology, University College London, London, UK.
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Singh NA, Alnobani A, Graff‐Radford J, Machulda MM, Mielke MM, Schwarz CG, Senjem ML, Jack CR, Lowe VJ, Kanekiyo T, Josephs KA, Whitwell JL. Relationships between PET and blood plasma biomarkers in corticobasal syndrome. Alzheimers Dement 2024; 20:4765-4774. [PMID: 38885334 PMCID: PMC11247700 DOI: 10.1002/alz.13914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/26/2024] [Accepted: 04/28/2024] [Indexed: 06/20/2024]
Abstract
INTRODUCTION Corticobasal syndrome (CBS) can result from underlying Alzheimer's disease (AD) pathologies. Little is known about the utility of blood plasma metrics to predict positron emission tomography (PET) biomarker-confirmed AD in CBS. METHODS A cohort of eighteen CBS patients (8 amyloid beta [Aβ]+; 10 Aβ-) and 8 cognitively unimpaired (CU) individuals underwent PET imaging and plasma analysis. Plasma concentrations were compared using a Kruskal-Wallis test. Spearman correlations assessed relationships between plasma concentrations and PET uptake. RESULTS CBS Aβ+ group showed a reduced Aβ42/40 ratio, with elevated phosphorylated tau (p-tau)181, glial fibrillary acidic protein (GFAP), and neurofilament light (NfL) concentrations, while CBS Aβ- group only showed elevated NfL concentration compared to CU. Both p-tau181 and GFAP were able to differentiate CBS Aβ- from CBS Aβ+ and showed positive associations with Aβ and tau PET uptake. DISCUSSION This study supports use of plasma p-tau181 and GFAP to detect AD in CBS. NfL shows potential as a non-specific disease biomarker of CBS regardless of underlying pathology. HIGHLIGHTS Plasma phosphorylated tau (p-tau)181 and glial fibrillary acidic protein (GFAP) concentrations differentiate corticobasal syndrome (CBS) amyloid beta (Aβ)- from CBS Aβ+. Plasma neurofilament light concentrations are elevated in CBS Aβ- and Aβ+ compared to controls. Plasma p-tau181 and GFAP concentrations were associated with Aβ and tau positron emission tomography (PET) uptake. Aβ42/40 ratio showed a negative correlation with Aβ PET uptake.
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Affiliation(s)
| | - Alla Alnobani
- Department of Neuroscience, Mayo ClinicJacksonvilleFloridaUSA
| | | | - Mary M. Machulda
- Department of Psychiatry & Psychology, Mayo ClinicRochesterMinnesotaUSA
| | - Michelle M. Mielke
- Department of Epidemiology and PreventionWake Forest UniversityWinston‐SalemNorth CarolinaUSA
| | | | | | | | - Val J. Lowe
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
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Oh SY, Nguyen TT, Kang JJ, Kirsch V, Boegle R, Kim JS, Dieterich M. Visuospatial cognition in acute unilateral peripheral vestibulopathy. Front Neurol 2023; 14:1230495. [PMID: 37789890 PMCID: PMC10542894 DOI: 10.3389/fneur.2023.1230495] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/28/2023] [Indexed: 10/05/2023] Open
Abstract
Background This study aims to investigate the presence of spatial cognitive impairments in patients with acute unilateral peripheral vestibulopathy (vestibular neuritis, AUPV) during both the acute phase and the recovery phase. Methods A total of 72 AUPV patients (37 with right-sided AUPV and 35 with left-sided AUPV; aged 34-80 years, median 60.5; 39 males, 54.2%) and 35 healthy controls (HCs; aged 43-75 years, median 59; 20 males, 57.1%) participated in the study. Patients underwent comprehensive neurotological assessments, including video-oculography, video head impulse and caloric tests, ocular and cervical vestibular-evoked myogenic potentials, and pure-tone audiometry. Additionally, the Visual Object and Space Perception (VOSP) battery was used to evaluate visuospatial perception, while the Block design test and Corsi block-tapping test assessed visuospatial memory within the first 2 days (acute phase) and 4 weeks after symptom onset (recovery phase). Results Although AUPV patients were able to successfully perform visuospatial perception tasks within normal parameters, they demonstrated statistically worse performance on the visuospatial memory tests compared to HCs during the acute phase. When comparing right versus left AUPV groups, significant decreased scores in visuospatial perception and memory were observed in the right AUPV group relative to the left AUPV group. In the recovery phase, patients showed substantial improvements even in these previously diminished visuospatial cognitive performances. Conclusion AUPV patients showed different spatial cognition responses, like spatial memory, depending on the affected ear, improving with vestibular compensation over time. We advocate both objective and subjective visuospatial assessments and the development of tests to detect potential cognitive deficits after unilateral vestibular impairments.
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Affiliation(s)
- Sun-Young Oh
- Jeonbuk National University College of Medicine, Jeonju, Republic of Korea
- Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Thanh Tin Nguyen
- Jeonbuk National University College of Medicine, Jeonju, Republic of Korea
- Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, Republic of Korea
- Department of Pharmacology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Jin-Ju Kang
- Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, Republic of Korea
| | - Valerie Kirsch
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
| | - Rainer Boegle
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
| | - Ji-Soo Kim
- Department of Neurology, Seoul National University Bundang Hospital & School of Medicine, Seoul, Republic of Korea
| | - Marianne Dieterich
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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Lima M, Tábuas-Pereira M, Durães J, Vieira D, Faustino P, Baldeiras I, Santana I. Neuropsychological Assessment in the Distinction Between Biomarker Defined Frontal-Variant of Alzheimer's Disease and Behavioral-Variant of Frontotemporal Dementia. J Alzheimers Dis 2023; 91:1303-1312. [PMID: 36617783 DOI: 10.3233/jad-220897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Frontal-variant of Alzheimer's disease (fvAD) was purposed for patients with AD pathology that, despite the typical amnestic presentation, show early and progressive deterioration of behavior and executive functions, closely resembling the behavioral-variant of frontotemporal dementia (bvFTD). This leads to a challenging differential diagnosis where neuropsychological evaluation and in vivo pathological evidence are essential. OBJECTIVE To evaluate the contribution of a comprehensive neuropsychological assessment (NP) battery in distinguishing between fvAD-dementia and bvFTD supported by cerebrospinal fluid (CSF) biomarkers. METHODS We included 40 patients with a baseline NP profile with prominent early executive and/or behavioral dysfunction, who meet both diagnosis of bvFTD and fvAD-dementia, according to international criteria. All patients underwent comprehensive NP assessment and CSF-AD biomarker evaluation. Neuropsychological domains as well as clinical and sociodemographic features, and APOE genotype were compared between groups. RESULTS 21 patients (52.5%) met the biological criteria for AD (decreased Aβ42 together with increased T-tau or P-tau in CSF) and were therefore classified as fvAD (mean age was 64.57, with 47.6% female). There were no differences between groups regarding age/age-at-onset, gender, or educational level. Regarding neuropsychological profile, performances in language and memory functions were equivalent in both groups. Significant differences were found in visuo-constructional abilities (p = 0.004), Trail Making Test A (p < 0.001), and Raven's Colored Progressive Matrices (p = 0.019), with fvAD patients showing worst performances. CONCLUSION In patients with an early prominent frontal profile, a higher impairment in attention and visuo-spatial functions, signaling additional right hemisphere fronto-parietal dysfunction, point towards a diagnosis of fvAD-dementia and may be useful in clinical practice.
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Affiliation(s)
- Marisa Lima
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
| | - Miguel Tábuas-Pereira
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Durães
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Daniela Vieira
- Neurology Department, Centro Hospitalar do Médio Ave, Porto, Portugal
| | - Pedro Faustino
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Inês Baldeiras
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Olfati N, Shoeibi A, Litvan I. Clinical Spectrum of Tauopathies. Front Neurol 2022; 13:944806. [PMID: 35911892 PMCID: PMC9329580 DOI: 10.3389/fneur.2022.944806] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 06/20/2022] [Indexed: 11/20/2022] Open
Abstract
Tauopathies are both clinical and pathological heterogeneous disorders characterized by neuronal and/or glial accumulation of misfolded tau protein. It is now well understood that every pathologic tauopathy may present with various clinical phenotypes based on the primary site of involvement and the spread and distribution of the pathology in the nervous system making clinicopathological correlation more and more challenging. The clinical spectrum of tauopathies includes syndromes with a strong association with an underlying primary tauopathy, including Richardson syndrome (RS), corticobasal syndrome (CBS), non-fluent agrammatic primary progressive aphasia (nfaPPA)/apraxia of speech, pure akinesia with gait freezing (PAGF), and behavioral variant frontotemporal dementia (bvFTD), or weak association with an underlying primary tauopathy, including Parkinsonian syndrome, late-onset cerebellar ataxia, primary lateral sclerosis, semantic variant PPA (svPPA), and amnestic syndrome. Here, we discuss clinical syndromes associated with various primary tauopathies and their distinguishing clinical features and new biomarkers becoming available to improve in vivo diagnosis. Although the typical phenotypic clinical presentations lead us to suspect specific underlying pathologies, it is still challenging to differentiate pathology accurately based on clinical findings due to large phenotypic overlaps. Larger pathology-confirmed studies to validate the use of different biomarkers and prospective longitudinal cohorts evaluating detailed clinical, biofluid, and imaging protocols in subjects presenting with heterogenous phenotypes reflecting a variety of suspected underlying pathologies are fundamental for a better understanding of the clinicopathological correlations.
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Affiliation(s)
- Nahid Olfati
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- UC San Diego Department of Neurosciences, Parkinson and Other Movement Disorder Center, San Diego, CA, United States
| | - Ali Shoeibi
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Irene Litvan
- UC San Diego Department of Neurosciences, Parkinson and Other Movement Disorder Center, San Diego, CA, United States
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North C, Desai R, Saunders R, Suárez-González A, Bamiou D, Costafreda SG, de Haan G, Halls G, Heutink J, O'Nions E, Utoomprurkporn N, John A, Stott J. Neuropsychological deficits in Posterior Cortical Atrophy and typical Alzheimer's disease: A meta-analytic review. Cortex 2021; 143:223-236. [PMID: 34464853 DOI: 10.1016/j.cortex.2021.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/13/2021] [Accepted: 07/30/2021] [Indexed: 11/27/2022]
Abstract
AIMS To identify cognitive tests that best differentiate between Posterior Cortical Atrophy (PCA) and typical Alzheimer's Disease (tAD), as well as PCA and healthy control (HC) participants. METHOD Medline, PsycInfo and Web of Science were systematically searched using terms related to PCA, tAD, and cognitive testing. Seventeen studies were identified, including 441 PCA, 391 tAD, and 284 HC participants. Standardised effect sizes of mean scores were calculated to measure performance differences on cognitive tests for PCA versus tAD and PCA versus HC groups. Meta-analyses used a random effects model. RESULTS The most discriminating cognitive tests for PCA and tAD presentations were measures of visuospatial function and verbal memory. Large, significant effect sizes were produced for all measures of visuospatial function, most notably for Rey-Osterrieth Copy (Hedges' g = -2.79), VOSP Fragmented letters (Hedges' g = -1.73), VOSP Dot Counting (Hedges' g = -1.74), and VOSP Cube Analysis (Hedges' g = -1.98). For measures of verbal memory, the RAVLT delay and Digit Span Backwards produced significant medium effects (Hedges' g = .62 and -.56, respectively). CONCLUSION Establishing a common framework for testing individuals with PCA has important implications for diagnosis and treatment, and forms a practical objective for future research. Findings from this meta-analysis suggest that measures of visuospatial function and verbal memory would form an important part of this framework.
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Affiliation(s)
- Courtney North
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Roopal Desai
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Rob Saunders
- Centre for Outcomes Research and Effectiveness, University College London, UK
| | | | - Doris Bamiou
- UCL Ear Institute, University College London, UK
| | - Sergi G Costafreda
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Gera de Haan
- University of Groningen, Groningen, the Netherlands; Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, the Netherlands
| | - Georgia Halls
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Joost Heutink
- University of Groningen, Groningen, the Netherlands; Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, the Netherlands
| | - Elizabeth O'Nions
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Nattawan Utoomprurkporn
- UCL Ear Institute, University College London, UK; Faculty of Medicine, Chulalongkorn University, Thailand
| | - Amber John
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Joshua Stott
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Su Y, Fu J, Zhang Y, Xu J, Dong Q, Cheng X. Visuospatial dysfunction is associated with posterior distribution of white matter damage in non-demented cerebral amyloid angiopathy. Eur J Neurol 2021; 28:3113-3120. [PMID: 34157199 DOI: 10.1111/ene.14993] [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] [Received: 05/31/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Cerebral amyloid angiopathy (CAA) is a well-recognized contributor to cognitive decline in the elderly. The posterior cortical predilection of CAA pathology would cause visuospatial dysfunction, which is still underexplored. We aimed to investigate whether the visuospatial dysfunction in CAA is associated with the posterior distribution of small vessel disease (SVD) imaging markers. METHODS We recruited 60 non-demented CAA cases from a Chinese prospective cohort and 30 cases with non-CAA SVD as controls. We used the Visual Object and Space Perception (VOSP) battery to evaluate visuospatial abilities, and multivariable regression models to assess their associations with SVD imaging markers. RESULTS There was visuospatial dysfunction, especially visual object perception impairment, in CAA compared to controls (Z-score of VOSP: -0.11 ± 0.66 vs. 0.22 ± 0.54, p = 0.023). The VOSP score in CAA was independently related to the fronto-occipital gradient of white matter hyperintensity volumes (coefficient = 0.03, 95% confidence interval [CI] = 0.003-0.05, p = 0.030) and mean fractional anisotropy values on diffusion tensor imaging (coefficient = 4.72, 95% CI = 0.97-8.48, p = 0.015), but not the severity of global SVD imaging markers or the gradient of lobar cerebral microbleeds with adjustments for age and global cognition score. CONCLUSIONS This finding suggests that the damage of posterior white matter rather than global disease severity may be a major contributor to visuospatial dysfunction in CAA.
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Affiliation(s)
- Ya Su
- Department of Neurology, National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiayu Fu
- Department of Neurology, National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yanrong Zhang
- Department of Nursing, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiajie Xu
- Department of Neurology, National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qiang Dong
- Department of Neurology, National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xin Cheng
- Department of Neurology, National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Shea YF, Pan Y, Mak HKF, Bao Y, Lee SC, Chiu PKC, Chan HWF. A systematic review of atypical Alzheimer's disease including behavioural and psychological symptoms. Psychogeriatrics 2021; 21:396-406. [PMID: 33594793 DOI: 10.1111/psyg.12665] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/06/2021] [Accepted: 01/25/2021] [Indexed: 12/20/2022]
Abstract
Alzheimer's disease (AD) is the commonest cause of dementia, characterized by the clinical presentation of progressive anterograde episodic memory impairment. However, atypical presentation of patients is increasingly recognized. These atypical AD include logopenic aphasia, behavioural variant AD, posterior cortical atrophy, and corticobasal syndrome. These atypical AD are more common in patients with young onset AD before the age of 65 years old. Since medical needs (including the behavioural and psychological symptoms of dementia) of atypical AD patients could be different from typical AD patients, it is important for clinicians to be aware of these atypical forms of AD. In addition, disease modifying treatment may be available in the future. This review aims at providing an update on various important subtypes of atypical AD including behavioural and psychological symptoms.
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Affiliation(s)
- Yat-Fung Shea
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Yining Pan
- School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Henry Ka-Fung Mak
- Department of Diagnostic Radiology, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Yiwen Bao
- Department of Diagnostic Radiology, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Shui-Ching Lee
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Patrick Ka-Chun Chiu
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Hon-Wai Felix Chan
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
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Parmera JB, Coutinho AM, Aranha MR, Studart-Neto A, de Godoi Carneiro C, de Almeida IJ, Fontoura Solla DJ, Ono CR, Barbosa ER, Nitrini R, Buchpiguel CA, Brucki SMD. FDG-PET Patterns Predict Amyloid Deposition and Clinical Profile in Corticobasal Syndrome. Mov Disord 2020; 36:651-661. [PMID: 33206389 DOI: 10.1002/mds.28373] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/13/2020] [Accepted: 10/19/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Corticobasal syndrome (CBS) is an atypical parkinsonian syndrome related to multiple underlying pathologies. OBJECTIVE To investigate if individual brain [18 F]fluorodeoxyglucose-positron emission tomography (FDG-PET) patterns could distinguish CBS due to Alzheimer's disease (AD) from other pathologies based on [11 C]Pittsburgh Compound-B (PIB)-PET. METHODS Forty-five patients with probable CBS were prospectively evaluated regarding cognitive and movement disorders profile. They underwent FDG-PET and were distributed into groups: likely related to AD (CBS FDG-AD) or likely non-AD (CBS FDG-nonAD) pathology. Thirty patients underwent PIB-PET on a hybrid PET-magnetic resonance imaging equipment to assess their amyloid status. FDG and PIB-PET images were classified individually based on visual and semi-quantitative analysis, blinded to each other. Quantitative group analyses were also performed. RESULTS CBS FDG-AD group demonstrated worse cognitive performances, mostly concerning attention, memory, visuospatial domains, and displayed more myoclonus and hallucinations. The non-AD metabolic group presented more often limb dystonia, ocular motor dysfunction, motor perseveration, and dysarthria. All patients classified as CBS FDG-AD tested positive at PIB-PET compared to 3 of 20 in the non-AD group. The individual FDG-PET classification demonstrated 76.92% of sensitivity, 100% of specificity and positive predictive value and 88.5% of balanced accuracy to detect positive PIB-PET scans. Individuals with positive and negative PIB-PET showed hypometabolism in posterior temporoparietal areas and in thalamus and brainstem, respectively, mainly contralateral to most affected side, disclosing possible metabolic signatures of CBS variants. CONCLUSION FDG-PET was useful to predict AD and non-AD CBS variants depicting their specific degeneration patterns, different clinical features, and brain amyloid deposition. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Jacy Bezerra Parmera
- Department of Neurology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Artur Martins Coutinho
- Laboratory of Nuclear Medicine (LIM 43), Center of Nuclear Medicine, Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Mateus Rozalem Aranha
- Laboratory of Nuclear Medicine (LIM 43), Center of Nuclear Medicine, Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil.,Laboratory of Magnetic Resonance in Neuroradiology (LIM 44), Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Adalberto Studart-Neto
- Department of Neurology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Camila de Godoi Carneiro
- Laboratory of Nuclear Medicine (LIM 43), Center of Nuclear Medicine, Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Isabel Junqueira de Almeida
- Department of Physical Therapy, Speech, and Occupational Therapy, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Davi J Fontoura Solla
- Department of Neurology, Division of Neurosurgery, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Carla Rachel Ono
- Laboratory of Nuclear Medicine (LIM 43), Center of Nuclear Medicine, Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Egberto Reis Barbosa
- Department of Neurology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Ricardo Nitrini
- Department of Neurology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Carlos Alberto Buchpiguel
- Laboratory of Nuclear Medicine (LIM 43), Center of Nuclear Medicine, Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Sonia Maria Dozzi Brucki
- Department of Neurology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
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Franco-Macías E, Rodrigo-Herrero S, Luque-Tirado A, Méndez-Barrio C, Medina-Rodriguez M, Graciani-Cantisán E, Sánchez-Arjona MB, Maillet D. Reliability and Feasibility of the Memory Associative Test TMA-93. J Alzheimers Dis Rep 2020; 4:431-440. [PMID: 33283164 PMCID: PMC7683101 DOI: 10.3233/adr-200215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Memory tests focused on binding may be more sensitive to diagnose Alzheimer's disease (AD) at an early phase. TMA-93 examines relational binding by images. OBJECTIVE Evaluate the reliability (internal consistency and inter-rater and test-retest reliability) and feasibility of the TMA-93 in a clinic setting with low-educated individuals and limited face-to-face time per patient. METHODS The study was undertaken in a neurology outpatient clinic of a hospital in Southern Spain. The internal consistency of the TMA-93 was estimated in 35 patients with amnestic mild cognitive impairment (aMCI) and 40 healthy controls (HCs). The inter-rater reliability (by two raters) and feasibility (by recording the percentage of participants who completed the test, and by timing the administration time) were evaluated in HCs (n = 16), aMCI patients (n = 18), and mild dementia patients (n = 15). The test-retest reliability for the TMA-93 total score was studied in 51 HCs tested by the same examiner 2-4 months apart. The internal consistency was estimated by Cronbach's alpha. The inter-rater and test-retest reliability was quantified by the intraclass correlation coefficient (ICC). The administration time was compared by diagnosis. RESULTS The internal consistency was "optimal" (Cronbach's alpha = 0.936). The test-retest reliability was "good" [ICC = 0.802 (CI 95% = 0.653-0.887)]. The inter-rater reliability was "optimal" [ICC = 0.999, (CI 95% = 0.999-1)]. All participants completed the test. The administration time ranged from less than 3 min in HCs to 6 min in aMCI patients, and 7 min in mild dementia patients. CONCLUSION Good feasibility and reliability support using the TMA-93 for examining visual relational binding, particularly in the context of low-educational attainment and limited time per patient.
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Affiliation(s)
- Emilio Franco-Macías
- Unidad de Memoria, Servicio de Neurología, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Silvia Rodrigo-Herrero
- Unidad de Memoria. Servicio de Neurología, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
| | - Andrea Luque-Tirado
- Unidad de Memoria, Servicio de Neurología, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Carlota Méndez-Barrio
- Unidad de Memoria. Servicio de Neurología, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
| | - Manuel Medina-Rodriguez
- Unidad de Memoria, Servicio de Neurología, Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | | | - Didier Maillet
- Service de Neurologie, Hôpital Saint-Louis (AP-HP), Paris, France
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11
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Groot C, Yeo BTT, Vogel JW, Zhang X, Sun N, Mormino EC, Pijnenburg YAL, Miller BL, Rosen HJ, La Joie R, Barkhof F, Scheltens P, van der Flier WM, Rabinovici GD, Ossenkoppele R. Latent atrophy factors related to phenotypical variants of posterior cortical atrophy. Neurology 2020; 95:e1672-e1685. [PMID: 32675078 PMCID: PMC7713727 DOI: 10.1212/wnl.0000000000010362] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 04/06/2020] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To determine whether atrophy relates to phenotypical variants of posterior cortical atrophy (PCA) recently proposed in clinical criteria (i.e., dorsal, ventral, dominant-parietal, and caudal) we assessed associations between latent atrophy factors and cognition. METHODS We employed a data-driven Bayesian modeling framework based on latent Dirichlet allocation to identify latent atrophy factors in a multicenter cohort of 119 individuals with PCA (age 64 ± 7 years, 38% male, Mini-Mental State Examination 21 ± 5, 71% β-amyloid positive, 29% β-amyloid status unknown). The model uses standardized gray matter density images as input (adjusted for age, sex, intracranial volume, MRI scanner field strength, and whole-brain gray matter volume) and provides voxelwise probabilistic maps for a predetermined number of atrophy factors, allowing every individual to express each factor to a degree without a priori classification. Individual factor expressions were correlated to 4 PCA-specific cognitive domains (object perception, space perception, nonvisual/parietal functions, and primary visual processing) using general linear models. RESULTS The model revealed 4 distinct yet partially overlapping atrophy factors: right-dorsal, right-ventral, left-ventral, and limbic. We found that object perception and primary visual processing were associated with atrophy that predominantly reflects the right-ventral factor. Furthermore, space perception was associated with atrophy that predominantly represents the right-dorsal and right-ventral factors. However, individual participant profiles revealed that the large majority expressed multiple atrophy factors and had mixed clinical profiles with impairments across multiple domains, rather than displaying a discrete clinical-radiologic phenotype. CONCLUSION Our results indicate that specific brain behavior networks are vulnerable in PCA, but most individuals display a constellation of affected brain regions and symptoms, indicating that classification into 4 mutually exclusive variants is unlikely to be clinically useful.
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Affiliation(s)
- Colin Groot
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden.
| | - B T Thomas Yeo
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Jacob W Vogel
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Xiuming Zhang
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Nanbo Sun
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Elizabeth C Mormino
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Yolande A L Pijnenburg
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Bruce L Miller
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Howard J Rosen
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Renaud La Joie
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Frederik Barkhof
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Philip Scheltens
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Wiesje M van der Flier
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Gil D Rabinovici
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Rik Ossenkoppele
- From the Department of Neurology and Alzheimer Center (C.G., Y.A.L.P., P.S., W.M.v.d.F., R.O.), and Departments of Radiology and Nuclear Medicine (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Department of Electrical and Computer Engineering (B.T.T.Y., X.Z., N.S.), Clinical Imaging Research Centre, N1 Institute for Health and Memory Networks Program, National University of Singapore; Montreal Neurological Institute (J.W.V.), McGill University, Montreal, Canada; Computer Science and Artificial Intelligence Laboratory (X.Z.), Massachusetts Institute of Technology, Cambridge; Department of Neurology and Neurological Sciences (E.C.M.), Stanford University, CA; Departments of Neurology, Radiology and Biomedical Imaging (B.L.M., H.J.R., R.L.J., G.D.R.), University of California, San Francisco; Institutes of Neurology & Healthcare Engineering (F.B.), University College London, UK; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
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12
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Sakae N, Josephs KA, Litvan I, Murray ME, Duara R, Uitti RJ, Wszolek ZK, van Gerpen J, Graff-Radford NR, Dickson DW. Clinicopathologic subtype of Alzheimer's disease presenting as corticobasal syndrome. Alzheimers Dement 2019; 15:1218-1228. [PMID: 31399334 DOI: 10.1016/j.jalz.2019.04.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/26/2019] [Accepted: 04/03/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The corticobasal syndrome (CBS) is associated with several neuropathologic disorders, including corticobasal degeneration and Alzheimer's disease (AD). METHOD In this report, we studied 43 AD patients with CBS (AD-CBS) and compared them with 42 AD patients with typical amnestic syndrome (AD-AS), as well as 15 cases of corticobasal degeneration and CBS pathology. RESULTS Unlike AD-AS, AD-CBS had prominent motor problems, including limb apraxia (90%), myoclonus (81%), and gait disorders (70%). Alien limb phenomenon was reported in 26% and cortical sensory loss in 14%. Language problems were also more frequent in AD-CBS, and memory impairment was less frequent. AD-CBS had more tau pathology in perirolandic cortices but less in superior temporal cortex than AD-AS. In addition, AD-CBS had greater neuronal loss in the substantia nigra. DISCUSSION AD-CBS is a clinicopathological subtype of AD with an atypical distribution of Alzheimer-type tau pathology. Greater neuronal loss in the substantia nigra may contribute to Parkinsonism which is not a feature of typical AD.
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Affiliation(s)
- Nobutaka Sakae
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | - Irene Litvan
- Department of Neurology, University of California San Diego, La Jolla, CA, USA
| | | | - Ranjan Duara
- Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Ryan J Uitti
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Jay van Gerpen
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
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Pardini M, Huey ED, Spina S, Kreisl WC, Morbelli S, Wassermann EM, Nobili F, Ghetti B, Grafman J. FDG-PET patterns associated with underlying pathology in corticobasal syndrome. Neurology 2019; 92:e1121-e1135. [PMID: 30700592 DOI: 10.1212/wnl.0000000000007038] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 10/26/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To evaluate brain 18Fluorodeoxyglucose PET (FDG-PET) differences among patients with a clinical diagnosis of corticobasal syndrome (CBS) and distinct underling primary pathologies. METHODS We studied 29 patients with a diagnosis of CBS who underwent FDG-PET scan and postmortem neuropathologic examination. Patients were divided into subgroups on the basis of primary pathologic diagnosis: CBS-corticobasal degeneration (CBS-CBD) (14 patients), CBS-Alzheimer disease (CBS-AD) (10 patients), and CBS-progressive supranuclear palsy (CBS-PSP) (5 patients). Thirteen age-matched healthy patients who underwent FDG-PET were the control group (HC). FDG-PET scans were compared between the subgroups and the HC using SPM-12, with a threshold of p FWE < 0.05. RESULTS There were no differences in Mattis Dementia Rating Scale or finger tapping scores between CBS groups. Compared to HC, the patients with CBS presented significant hypometabolism in frontoparietal regions, including the perirolandic area, basal ganglia, and thalamus of the clinically more affected hemisphere. Patients with CBS-CBD showed a similar pattern with a more marked, bilateral involvement of the basal ganglia. Patients with CBS-AD presented with posterior, asymmetric hypometabolism, including the lateral parietal and temporal lobes and the posterior cingulate. Finally, patients with CBS-PSP disclosed a more anterior hypometabolic pattern, including the medial frontal regions and the anterior cingulate. A conjunction analysis revealed that the primary motor cortex was the only common area of hypometabolism in all groups, irrespective of pathologic diagnosis. DISCUSSION AND CONCLUSIONS In patients with CBS, different underling pathologies are associated with different patterns of hypometabolism. Our data suggest that FDG-PET scans could help in the etiologic diagnosis of CBS.
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Affiliation(s)
- Matteo Pardini
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL.
| | - Edward D Huey
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - Salvatore Spina
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - William C Kreisl
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - Silvia Morbelli
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - Eric M Wassermann
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - Flavio Nobili
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - Bernardino Ghetti
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
| | - Jordan Grafman
- From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (M.P., F.N.) and Health Sciences (S.M.), University of Genoa; IRCCS Ospedale Policlinico San Martino (M.P., S.M., F.N.), Genoa, Italy; Cognitive Neuroscience Division, Department of Neurology (E.D.H.), Gertrude H. Sergievsky Center, New York; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (E.D.H., W.C.K.), Columbia University Medical Center, New York, NY; Department of Neurology (S.S.), UCSF Memory and Aging Center, UCSF, San Francisco, CA; Department of Pathology and Laboratory Medicine (S.S., B.G.), Indiana University School of Medicine, Indianapolis; Nuclear Medicine Unit (S.M.), IRCCS AOU San Martino, IST, Genoa, Italy; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Psychiatry and Behavioral Sciences & Cognitive Neurology/Alzheimer's Disease Research Center (J.G.), Feinberg School of Medicine and Department of Psychology, Northwestern University; and Brain Injury Research, Cognitive Neuroscience Lab, Think and Speak Lab (J.G.), Shirley Ryan AbilityLab, Chicago, IL
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14
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Crutch SJ, Schott JM, Rabinovici GD, Murray M, Snowden JS, van der Flier WM, Dickerson BC, Vandenberghe R, Ahmed S, Bak TH, Boeve BF, Butler C, Cappa SF, Ceccaldi M, de Souza LC, Dubois B, Felician O, Galasko D, Graff-Radford J, Graff-Radford NR, Hof PR, Krolak-Salmon P, Lehmann M, Magnin E, Mendez MF, Nestor PJ, Onyike CU, Pelak VS, Pijnenburg Y, Primativo S, Rossor MN, Ryan NS, Scheltens P, Shakespeare TJ, Suárez González A, Tang-Wai DF, Yong KXX, Carrillo M, Fox NC. Consensus classification of posterior cortical atrophy. Alzheimers Dement 2017; 13:870-884. [PMID: 28259709 PMCID: PMC5788455 DOI: 10.1016/j.jalz.2017.01.014] [Citation(s) in RCA: 377] [Impact Index Per Article: 53.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 01/06/2017] [Indexed: 11/23/2022]
Abstract
INTRODUCTION A classification framework for posterior cortical atrophy (PCA) is proposed to improve the uniformity of definition of the syndrome in a variety of research settings. METHODS Consensus statements about PCA were developed through a detailed literature review, the formation of an international multidisciplinary working party which convened on four occasions, and a Web-based quantitative survey regarding symptom frequency and the conceptualization of PCA. RESULTS A three-level classification framework for PCA is described comprising both syndrome- and disease-level descriptions. Classification level 1 (PCA) defines the core clinical, cognitive, and neuroimaging features and exclusion criteria of the clinico-radiological syndrome. Classification level 2 (PCA-pure, PCA-plus) establishes whether, in addition to the core PCA syndrome, the core features of any other neurodegenerative syndromes are present. Classification level 3 (PCA attributable to AD [PCA-AD], Lewy body disease [PCA-LBD], corticobasal degeneration [PCA-CBD], prion disease [PCA-prion]) provides a more formal determination of the underlying cause of the PCA syndrome, based on available pathophysiological biomarker evidence. The issue of additional syndrome-level descriptors is discussed in relation to the challenges of defining stages of syndrome severity and characterizing phenotypic heterogeneity within the PCA spectrum. DISCUSSION There was strong agreement regarding the definition of the core clinico-radiological syndrome, meaning that the current consensus statement should be regarded as a refinement, development, and extension of previous single-center PCA criteria rather than any wholesale alteration or redescription of the syndrome. The framework and terminology may facilitate the interpretation of research data across studies, be applicable across a broad range of research scenarios (e.g., behavioral interventions, pharmacological trials), and provide a foundation for future collaborative work.
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Affiliation(s)
| | | | - Gil D Rabinovici
- Department of Neurology, Memory & Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Melissa Murray
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Julie S Snowden
- Cerebral Function Unit, Greater Manchester Neuroscience Centre, Salford Royal NHS Foundation Trust, Salford, UK; Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Wiesje M van der Flier
- Department of Neurology, VU University Medical Centre, Amsterdam Neuroscience, Amsterdam, The Netherlands; Alzheimer Center, VU University Medical Centre, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Samrah Ahmed
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Thomas H Bak
- Human Cognitive Neuroscience, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Christopher Butler
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Stefano F Cappa
- Center for Cognitive Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Mathieu Ceccaldi
- INSERM U 1106, Institut des Neurosciences des Systèmes, Aix Marseille Université, Marseilles, France
| | - Leonardo Cruz de Souza
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Bruno Dubois
- Institute for Memory and Alzheimer's Disease, UMR-S975, Salpêtrière Hospital, Pierre & Marie Curie University, Paris, France
| | - Olivier Felician
- Aix-Marseille Université, INSERM, Institut de Neurosciences des Systèmes, Marseille, France; AP-HM Hôpitaux de la Timone, Service de Neurologie et Neuropsychologie, Marseille, France
| | - Douglas Galasko
- Department of Neurosciences, University of California, San Diego, San Diego, USA
| | | | | | - Patrick R Hof
- Fishberg Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Pierre Krolak-Salmon
- Clinical and Research Memory Center of Lyon, Hospices Civils de Lyon, INSERM U1028, CNRS UMR5292, University of Lyon, Lyon, France
| | - Manja Lehmann
- Dementia Research Centre, UCL Institute of Neurology, London, UK; Department of Neurology, Memory & Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Eloi Magnin
- Department of Neurology, Regional Memory Centre (CMRR), CHU Besançon, Besançon, France
| | - Mario F Mendez
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Peter J Nestor
- Cognitive Neurology and Neurodegeneration Group, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Chiadi U Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Victoria S Pelak
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Yolande Pijnenburg
- Department of Neurology, VU University Medical Centre, Amsterdam Neuroscience, Amsterdam, The Netherlands; Alzheimer Center, VU University Medical Centre, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Silvia Primativo
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Martin N Rossor
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Natalie S Ryan
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Philip Scheltens
- Department of Neurology, VU University Medical Centre, Amsterdam Neuroscience, Amsterdam, The Netherlands; Alzheimer Center, VU University Medical Centre, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | | | - Aida Suárez González
- Dementia Research Centre, UCL Institute of Neurology, London, UK; Memory Disorders Unit, Neurology Department, University Hospital Virgen del Rocio, Seville, Spain
| | - David F Tang-Wai
- Division of Neurology, University Health Network Memory Clinic, University of Toronto, Toronto, Ontario, Canada
| | - Keir X X Yong
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Maria Carrillo
- Medical and Scientific Relations, Alzheimer's Association, Chicago, IL, USA
| | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, London, UK
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15
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Baker JM, Salinas J, Berkowitz AL. Clinical Reasoning: A 56-year-old man with cognitive impairment and difficulty tying his necktie. Neurology 2015; 85:e116-22. [PMID: 26459946 DOI: 10.1212/wnl.0000000000002021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Jessica M Baker
- From the Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
| | - Joel Salinas
- From the Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Aaron L Berkowitz
- From the Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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16
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Abstract
Although Alzheimer's disease is the most common cause of dementia in the elderly, there are several conditions (ie, frontotemporal dementia or Huntington's disease) associated with a relatively earlier onset. This article provides arguments in favor of a comprehensive neuropsychological assessment in the differential diagnosis of young-onset dementia, as episodic memory impairment is not observed early in the course of most types of young-onset dementia that predominantly affect the domains of behavior, executive, language, and/or motor function.
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