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Thompson AG, Taschler B, Smith SM, Turner MR. Premorbid brain structure influences risk of amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2024; 95:360-365. [PMID: 38050140 PMCID: PMC10958375 DOI: 10.1136/jnnp-2023-332322] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/25/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a disease of the motor network associated with brain structure and functional connectivity alterations that are implicated in disease progression. Whether such changes have a causal role in ALS, fitting with a postulated influence of premorbid cerebral architecture on the phenotypes associated with neurodegenerative disorders is not known. METHODS This study considered causal effects and shared genetic risk of 2240 structural and functional MRI brain scan imaging-derived phenotypes (IDPs) on ALS using two sample Mendelian randomisation, with putative associations further examined with extensive sensitivity analysis. Shared genetic predisposition between IDPs and ALS was explored using genetic correlation analysis. RESULTS Increased white matter volume in the cerebral hemispheres was causally associated with ALS. Weaker causal associations were observed for brain stem grey matter volume, parieto-occipital white matter surface and volume of the left thalamic ventral anterior nucleus. Genetic correlation was observed between ALS and intracellular volume fraction and isotropic free water volume fraction within the posterior limb of the internal capsule. CONCLUSIONS This study provides evidence that premorbid brain structure, in particular white matter volume, contributes to the risk of ALS.
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Affiliation(s)
| | - Bernd Taschler
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Stephen M Smith
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Martin R Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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2
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Novel PET Biomarkers to Disentangle Molecular Pathways across Age-Related Neurodegenerative Diseases. Cells 2020; 9:cells9122581. [PMID: 33276490 PMCID: PMC7761606 DOI: 10.3390/cells9122581] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/25/2020] [Accepted: 11/28/2020] [Indexed: 12/11/2022] Open
Abstract
There is a need to disentangle the etiological puzzle of age-related neurodegenerative diseases, whose clinical phenotypes arise from known, and as yet unknown, pathways that can act distinctly or in concert. Enhanced sub-phenotyping and the identification of in vivo biomarker-driven signature profiles could improve the stratification of patients into clinical trials and, potentially, help to drive the treatment landscape towards the precision medicine paradigm. The rapidly growing field of neuroimaging offers valuable tools to investigate disease pathophysiology and molecular pathways in humans, with the potential to capture the whole disease course starting from preclinical stages. Positron emission tomography (PET) combines the advantages of a versatile imaging technique with the ability to quantify, to nanomolar sensitivity, molecular targets in vivo. This review will discuss current research and available imaging biomarkers evaluating dysregulation of the main molecular pathways across age-related neurodegenerative diseases. The molecular pathways focused on in this review involve mitochondrial dysfunction and energy dysregulation; neuroinflammation; protein misfolding; aggregation and the concepts of pathobiology, synaptic dysfunction, neurotransmitter dysregulation and dysfunction of the glymphatic system. The use of PET imaging to dissect these molecular pathways and the potential to aid sub-phenotyping will be discussed, with a focus on novel PET biomarkers.
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3
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Ripp I, Stadhouders T, Savio A, Goldhardt O, Cabello J, Calhoun V, Riedl V, Hedderich D, Diehl-Schmid J, Grimmer T, Yakushev I. Integrity of Neurocognitive Networks in Dementing Disorders as Measured with Simultaneous PET/Functional MRI. J Nucl Med 2020; 61:1341-1347. [PMID: 32358091 DOI: 10.2967/jnumed.119.234930] [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: 08/15/2019] [Accepted: 01/03/2020] [Indexed: 12/11/2022] Open
Abstract
Functional MRI (fMRI) studies have reported altered integrity of large-scale neurocognitive networks (NCNs) in dementing disorders. However, findings on the specificity of these alterations in patients with Alzheimer disease (AD) and behavioral-variant frontotemporal dementia (bvFTD) are still limited. Recently, NCNs have been successfully captured using PET with 18F-FDG. Methods: Network integrity was measured in 72 individuals (38 male) with mild AD or bvFTD, and in healthy controls, using a simultaneous resting-state fMRI and 18F-FDG PET. Indices of network integrity were calculated for each subject, network, and imaging modality. Results: In either modality, independent-component analysis revealed 4 major NCNs: anterior default-mode network (DMN), posterior DMN, salience network, and right central executive network (CEN). In fMRI data, the integrity of the posterior DMN was found to be significantly reduced in both patient groups relative to controls. In the AD group the anterior DMN and CEN appeared to be additionally affected. In PET data, only the integrity of the posterior DMN in patients with AD was reduced, whereas 3 remaining networks appeared to be affected only in patients with bvFTD. In a logistic regression analysis, the integrity of the anterior DMN as measured with PET alone accurately differentiated between the patient groups. A correlation between indices of 2 imaging modalities was low overall. Conclusion: FMRI and 18F-FDG PET capture partly different aspects of network integrity. A higher disease specificity for NCNs as derived from PET data supports metabolic connectivity imaging as a promising diagnostic tool.
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Affiliation(s)
- Isabelle Ripp
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Stadhouders
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Alexandre Savio
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Oliver Goldhardt
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jorge Cabello
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Vince Calhoun
- Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, New Mexico.,Mind Research Network and LBERI, Albuquerque, New Mexico
| | - Valentin Riedl
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; and.,Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Dennis Hedderich
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; and
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany .,Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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4
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Swash M, Burke D, Turner MR, Grosskreutz J, Leigh PN, deCarvalho M, Kiernan MC. Occasional essay: Upper motor neuron syndrome in amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2020; 91:227-234. [PMID: 32054724 DOI: 10.1136/jnnp-2019-321938] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/17/2019] [Accepted: 10/24/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Michael Swash
- Barts and the London School of Medicine, QMUL, Instituto de Medicina Molecular, Faculdade de Medicina, Univeridade de Lisboa, London, UK
| | - David Burke
- University of Sydney and Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Martin R Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Julian Grosskreutz
- Universitätsklinikum Jena, Friedrich-Schiller-University Jena, Jena, Germany
| | - P Nigel Leigh
- Trafford Centre for Biomedical Research, Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Mamede deCarvalho
- Instituto de Fisiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Univeridade de Lisboa, and Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Matthew C Kiernan
- University of Sydney and Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
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5
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Henderson RD, Garton FC, Kiernan MC, Turner MR, Eisen A. Human cerebral evolution and the clinical syndrome of amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2019; 90:570-575. [PMID: 29666205 PMCID: PMC6581076 DOI: 10.1136/jnnp-2017-317245] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 03/23/2018] [Accepted: 03/29/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Robert D Henderson
- Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Fleur C Garton
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Matthew C Kiernan
- Brain & Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Martin R Turner
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK
| | - Andrew Eisen
- Division of Neurology Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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6
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Moving beyond neurons: the role of cell type-specific gene regulation in Parkinson's disease heritability. NPJ PARKINSONS DISEASE 2019; 5:6. [PMID: 31016231 PMCID: PMC6470136 DOI: 10.1038/s41531-019-0076-6] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 02/28/2019] [Indexed: 01/04/2023]
Abstract
Parkinson’s disease (PD), with its characteristic loss of nigrostriatal dopaminergic neurons and deposition of α-synuclein in neurons, is often considered a neuronal disorder. However, in recent years substantial evidence has emerged to implicate glial cell types, such as astrocytes and microglia. In this study, we used stratified LD score regression and expression-weighted cell-type enrichment together with several brain-related and cell-type-specific genomic annotations to connect human genomic PD findings to specific brain cell types. We found that PD heritability attributable to common variation does not enrich in global and regional brain annotations or brain-related cell-type-specific annotations. Likewise, we found no enrichment of PD susceptibility genes in brain-related cell types. In contrast, we demonstrated a significant enrichment of PD heritability in a curated lysosomal gene set highly expressed in astrocytic, microglial, and oligodendrocyte subtypes, and in LoF-intolerant genes, which were found highly expressed in almost all tested cellular subtypes. Our results suggest that PD risk loci do not lie in specific cell types or individual brain regions, but rather in global cellular processes detectable across several cell types.
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7
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Visser AE, Rooney JPK, D'Ovidio F, Westeneng HJ, Vermeulen RCH, Beghi E, Chiò A, Logroscino G, Hardiman O, Veldink JH, van den Berg LH. Multicentre, cross-cultural, population-based, case-control study of physical activity as risk factor for amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2018; 89:797-803. [PMID: 29685899 DOI: 10.1136/jnnp-2017-317724] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 01/16/2018] [Accepted: 02/04/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To investigate the association between physical activity (PA) and amyotrophic lateral sclerosis (ALS) in population-based case-control studies in three European countries using a validated and harmonised questionnaire. METHODS Patients with incident ALS and controls were recruited from five population-based registers in The Netherlands, Ireland and Italy. Demographic and data regarding educational level, smoking, alcohol habits and lifetime PA levels in both leisure and work time were gathered by questionnaire, and quantified using metabolic equivalent of task scores. Logistic regression models adjusting for PA-related factors were used to determine the association between PA and ALS risk, and forest plots were used to visualise heterogeneity between regions. RESULTS 1557 patients and 2922 controls were included. We found a linear association between ALS and PA in leisure time (OR 1.07, P=0.01) and occupational activities (OR 1.06, P<0.001), and all activities combined (OR 1.06, P<0.001), with some heterogeneity between regions: the most evident association was seen in the Irish and Italian cohorts. After adjustment for other occupational exposures or exclusion of patients with a C9orf72 mutation, the ORs remained similar. CONCLUSION We provide new class I evidence for a positive association between PA and risk of ALS in a large multicentre study using harmonised methodology to objectively quantify PA levels, with some suggestions for population differences.
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Affiliation(s)
- Anne E Visser
- Department of Neurology, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - James P K Rooney
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
| | - Fabrizio D'Ovidio
- "Rita Levi Montalcini" Department of Neuroscience, University of Torino, Turin, Italy
| | - Henk-Jan Westeneng
- Department of Neurology, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Roel C H Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Ettore Beghi
- Department of Neuroscience, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Adriano Chiò
- "Rita Levi Montalcini" Department of Neuroscience, University of Torino, Turin, Italy
| | - Giancarlo Logroscino
- Unit of Neurodegenerative Diseases, Department of Clinical Research in Neurology, University of Bari "Aldo Moro", Pia Fondazione Cardinale G. Panico, Lecce, Italy.,Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
| | - Jan H Veldink
- Department of Neurology, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Leonard H van den Berg
- Department of Neurology, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
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8
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Chen Z, Lin K, Macklis JD, Al-Chalabi A. Proposed association between the hexanucleotide repeat of C9orf72 and opposability index of the thumb. Amyotroph Lateral Scler Frontotemporal Degener 2017; 18:175-181. [PMID: 28010125 PMCID: PMC5425628 DOI: 10.1080/21678421.2016.1257024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 10/22/2016] [Accepted: 10/31/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Amyotrophic lateral sclerosis (ALS) is a fatal disease caused by motor neuron and sub-cerebral projection neuron degeneration. We sought to explore the particular susceptibility of humans to neurodegeneration and whether any characteristic human features might predispose to selective vulnerability of the critical motor circuitry in ALS. The pathophysiology of the C9orf72 repeat is not yet understood, despite its role as a common cause of ALS and frontotemporal dementia. METHODS We examined the development of the monosynaptic cortico-motoneuronal system, key to skilled hand movements, measured by the thumb opposability index, and its relationship to the C9orf72 hexanucleotide repeat expansion, a strong predisposing factor for neurodegeneration, using the genomic tool BLAST. RESULTS We found a statistically significant linear relationship between the C9orf72 hexanucleotide bit score, a measure of genomic conservation of the aligned region across different species, and the thumb opposability index (Pearson's correlation coefficient of 0.78, p value 0.023). The C9orf72 hexanucleotide repeat was only found in humans, chimpanzees and gorillas, species with higher opposability indices. CONCLUSIONS This may support a role of the hexanucleotide repeat in the same developmental pathways in species with higher prehensility, which may be associated with the selective vulnerability of cortico-motoneuronal cells in humans, manifested most obviously as the 'split hand' syndrome in ALS.
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Affiliation(s)
- Zhongbo Chen
- Department of Basic and Clinical Neurosciences, Maurice Wohl Clinical Neuroscience Institute, King’s College LondonLondonUK
| | - Kuang Lin
- Department of Basic and Clinical Neurosciences, Maurice Wohl Clinical Neuroscience Institute, King’s College LondonLondonUK
| | - Jeffrey D. Macklis
- Department of Stem Cell and Regenerative Biology, Center for Brain Science and Harvard Stem Cell Institute, Harvard UniversityCambridgeMAUSA
| | - Ammar Al-Chalabi
- Department of Basic and Clinical Neurosciences, Maurice Wohl Clinical Neuroscience Institute, King’s College LondonLondonUK
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9
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Mouse models of frontotemporal dementia: A comparison of phenotypes with clinical symptomatology. Neurosci Biobehav Rev 2017; 74:126-138. [DOI: 10.1016/j.neubiorev.2017.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 01/04/2017] [Accepted: 01/06/2017] [Indexed: 12/12/2022]
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10
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Cortical synaptic and dendritic spine abnormalities in a presymptomatic TDP-43 model of amyotrophic lateral sclerosis. Sci Rep 2016; 6:37968. [PMID: 27897242 PMCID: PMC5126629 DOI: 10.1038/srep37968] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 10/31/2016] [Indexed: 12/11/2022] Open
Abstract
Layer V pyramidal neurons (LVPNs) within the motor cortex integrate sensory cues and co-ordinate voluntary control of motor output. In amyotrophic lateral sclerosis (ALS) LVPNs and spinal motor neurons degenerate. The pathogenesis of neural degeneration is unknown in ALS; 10% of cases have a genetic cause, whereas 90% are sporadic, with most of the latter showing TDP-43 inclusions. Clinical and experimental evidence implicate excitotoxicity as a prime aetiological candidate. Using patch clamp and dye-filling techniques in brain slices, combined with high-resolution confocal microscopy, we report increased excitatory synaptic inputs and dendritic spine densities in early presymptomatic mice carrying a TDP-43Q331K mutation. These findings demonstrate substantive alterations in the motor cortex neural network, long before an overt degenerative phenotype has been reported. We conclude that increased excitatory neurotransmission is a common pathophysiology amongst differing genetic cases of ALS and may be of relevance to the 95% of sporadic ALS cases that exhibit TDP-43 inclusions.
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11
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Ahmed RM, Devenney EM, Irish M, Ittner A, Naismith S, Ittner LM, Rohrer JD, Halliday GM, Eisen A, Hodges JR, Kiernan MC. Neuronal network disintegration: common pathways linking neurodegenerative diseases. J Neurol Neurosurg Psychiatry 2016; 87:1234-1241. [PMID: 27172939 PMCID: PMC5099318 DOI: 10.1136/jnnp-2014-308350] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 04/18/2016] [Indexed: 12/16/2022]
Abstract
Neurodegeneration refers to a heterogeneous group of brain disorders that progressively evolve. It has been increasingly appreciated that many neurodegenerative conditions overlap at multiple levels and therefore traditional clinicopathological correlation approaches to better classify a disease have met with limited success. Neuronal network disintegration is fundamental to neurodegeneration, and concepts based around such a concept may better explain the overlap between their clinical and pathological phenotypes. In this Review, promoters of overlap in neurodegeneration incorporating behavioural, cognitive, metabolic, motor, and extrapyramidal presentations will be critically appraised. In addition, evidence that may support the existence of large-scale networks that might be contributing to phenotypic differentiation will be considered across a neurodegenerative spectrum. Disintegration of neuronal networks through different pathological processes, such as prion-like spread, may provide a better paradigm of disease and thereby facilitate the identification of novel therapies for neurodegeneration.
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Affiliation(s)
- Rebekah M Ahmed
- Sydney Medical School Brain & Mind Centre, University of Sydney, Sydney, New South Wales, Australia Neuroscience Research Australia, University of NSW, Sydney, New South Wales, Australia
| | - Emma M Devenney
- Sydney Medical School Brain & Mind Centre, University of Sydney, Sydney, New South Wales, Australia Neuroscience Research Australia, University of NSW, Sydney, New South Wales, Australia
| | - Muireann Irish
- Neuroscience Research Australia, University of NSW, Sydney, New South Wales, Australia School of Psychology, the University of New South Wales, Sydney, Australia
| | - Arne Ittner
- Faculty of Medicine, Dementia Research Unit, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Sharon Naismith
- School of Psychology, Brain & Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Lars M Ittner
- Faculty of Medicine, Dementia Research Unit, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Jonathan D Rohrer
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Glenda M Halliday
- Neuroscience Research Australia, University of NSW, Sydney, New South Wales, Australia
| | - Andrew Eisen
- University of British Columbia, Vancouver, British Columbia, Canada
| | - John R Hodges
- Neuroscience Research Australia, University of NSW, Sydney, New South Wales, Australia
| | - Matthew C Kiernan
- Sydney Medical School Brain & Mind Centre, University of Sydney, Sydney, New South Wales, Australia
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12
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Mattsson N, Schott JM, Hardy J, Turner MR, Zetterberg H. Selective vulnerability in neurodegeneration: insights from clinical variants of Alzheimer's disease. J Neurol Neurosurg Psychiatry 2016; 87:1000-4. [PMID: 26746185 DOI: 10.1136/jnnp-2015-311321] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 12/05/2015] [Indexed: 11/04/2022]
Abstract
Selective vulnerability in the nervous system refers to the fact that subpopulations of neurons in different brain systems may be more or less prone to abnormal function or death in response to specific types of pathological states or injury. The concept has been used extensively as a potential way of explaining differences in degeneration patterns and the clinical presentation of different neurodegenerative diseases. Yet the increasing complexity of molecular histopathology at the cellular level in neurodegenerative disorders frequently appears at odds with phenotyping based on clinically-directed, macroscopic regional brain involvement. While cross-disease comparisons can provide insights into the differential vulnerability of networks and neuronal populations, we focus here on what is known about selective vulnerability-related factors that might explain the differential phenotypic expressions of the same disease-in this case, typical and atypical forms of Alzheimer's disease. Whereas considerable progress has been made in this area, much is yet to be elucidated; further studies comparing different phenotypic variants aimed at identifying both vulnerability and resilience factors may provide valuable insights into disease pathogenesis, and suggest novel targets for therapy.
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Affiliation(s)
- Niklas Mattsson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | | | - John Hardy
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Martin R Turner
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK
| | - Henrik Zetterberg
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
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13
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Turner MR, Swash M. The expanding syndrome of amyotrophic lateral sclerosis: a clinical and molecular odyssey. J Neurol Neurosurg Psychiatry 2015; 86:667-73. [PMID: 25644224 PMCID: PMC4453495 DOI: 10.1136/jnnp-2014-308946] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 10/24/2014] [Indexed: 12/12/2022]
Abstract
Recent advances in understanding amyotrophic lateral sclerosis (ALS) have delivered new questions. Disappointingly, the initial enthusiasm for transgenic mouse models of the disease has not been followed by rapid advances in therapy or prevention. Monogenic models may have inadvertently masked the true complexity of the human disease. ALS has evolved into a multisystem disorder, involving a final common pathway accessible via multiple upstream aetiological tributaries. Nonetheless, there is a common clinical core to ALS, as clear today as it was to Charcot and others. We stress the continuing relevance of clinical observations amid the increasing molecular complexity of ALS.
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Affiliation(s)
- Martin R Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Michael Swash
- Queen Mary University of London, London, UK University of Lisbon, Lisbon, Portugal
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14
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Eisen A, Kiernan M, Mitsumoto H, Swash M. Amyotrophic lateral sclerosis: a long preclinical period? J Neurol Neurosurg Psychiatry 2014; 85:1232-8. [PMID: 24648037 DOI: 10.1136/jnnp-2013-307135] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The onset of amyotrophic lateral sclerosis (ALS) is conventionally considered as commencing with the recognition of clinical symptoms. We propose that, in common with other neurodegenerations, the pathogenic mechanisms culminating in ALS phenotypes begin much earlier in life. Animal models of genetically determined ALS exhibit pathological abnormalities long predating clinical deficits. The overt clinical ALS phenotype may develop when safety margins are exceeded subsequent to years of mitochondrial dysfunction, neuroinflammation or an imbalanced environment of excitation and inhibition in the neuropil. Somatic mutations, the epigenome and external environmental influences may interact to trigger a metabolic cascade that in the adult eventually exceeds functional threshold. A long preclinical and subsequent presymptomatic period pose a challenge for recognition, since it offers an opportunity for protective and perhaps even preventive therapeutic intervention to rescue dysfunctional neurons. We suggest, by analogy with other neurodegenerations and from SOD1 ALS mouse studies, that vulnerability might be induced in the perinatal period.
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Affiliation(s)
- Andrew Eisen
- Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Hiroshi Mitsumoto
- Wesley J. Howe Professor of Neurology at CUMC, Eleanor and Lou Gehrig MDA/ALS Research Center, The Neurological Institute of New York, Columbia University Medical Center, New York, USA
| | - Michael Swash
- Queen Mary University of London, UK Institute of Neuroscience, University of Lisbon, Portugal
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15
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Metabolomics of Human Brain Aging and Age-Related Neurodegenerative Diseases. J Neuropathol Exp Neurol 2014; 73:640-57. [DOI: 10.1097/nen.0000000000000091] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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16
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Ambrosi G, Ghezzi C, Sepe S, Milanese C, Payan-Gomez C, Bombardieri CR, Armentero MT, Zangaglia R, Pacchetti C, Mastroberardino PG, Blandini F. Bioenergetic and proteolytic defects in fibroblasts from patients with sporadic Parkinson's disease. Biochim Biophys Acta Mol Basis Dis 2014; 1842:1385-94. [PMID: 24854107 DOI: 10.1016/j.bbadis.2014.05.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 05/05/2014] [Accepted: 05/07/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Parkinson's disease (PD) is a complex disease and the current interest and focus of scientific research is both investigating the variety of causes that underlie PD pathogenesis, and identifying reliable biomarkers to diagnose and monitor the progression of pathology. Investigation on pathogenic mechanisms in peripheral cells, such as fibroblasts derived from patients with sporadic PD and age/gender matched controls, might generate deeper understanding of the deficits affecting dopaminergic neurons and, possibly, new tools applicable to clinical practice. METHODS Primary fibroblast cultures were established from skin biopsies. Increased susceptibility to the PD-related toxin rotenone was determined with apoptosis- and necrosis-specific cell death assays. Protein quality control was evaluated assessing the efficiency of the Ubiquitin Proteasome System (UPS) and protein levels of autophagic markers. Changes in cellular bioenergetics were monitored by measuring oxygen consumption and glycolysis-dependent medium acidification. The oxido-reductive status was determined by detecting mitochondrial superoxide production and oxidation levels in proteins and lipids. RESULTS PD fibroblasts showed higher vulnerability to necrotic cell death induced by complex I inhibitor rotenone, reduced UPS function and decreased maximal and rotenone-sensitive mitochondrial respiration. No changes in autophagy and redox markers were detected. CONCLUSIONS Our study shows that increased susceptibility to rotenone and the presence of proteolytic and bioenergetic deficits that typically sustain the neurodegenerative process of PD can be detected in fibroblasts from idiopathic PD patients. Fibroblasts might therefore represent a powerful and minimally invasive tool to investigate PD pathogenic mechanisms, which might translate into considerable advances in clinical management of the disease.
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Affiliation(s)
- Giulia Ambrosi
- Laboratory of Functional Neurochemistry, Center for Research in Neurodegenerative Diseases, National Neurological Institute C. Mondino, Via Mondino 2, 27100 Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, University of Pavia, Via Ferrata 9, 27100 Pavia, Italy
| | - Cristina Ghezzi
- Laboratory of Functional Neurochemistry, Center for Research in Neurodegenerative Diseases, National Neurological Institute C. Mondino, Via Mondino 2, 27100 Pavia, Italy
| | - Sara Sepe
- Department of Genetics, Erasmus Medical Centre, Dr. Molewaterplein 50, 3015GE Rotterdam, The Netherlands
| | - Chiara Milanese
- Department of Genetics, Erasmus Medical Centre, Dr. Molewaterplein 50, 3015GE Rotterdam, The Netherlands; RiMED Foundation, Palermo, Italy
| | - Cesar Payan-Gomez
- Department of Genetics, Erasmus Medical Centre, Dr. Molewaterplein 50, 3015GE Rotterdam, The Netherlands; Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Cintia R Bombardieri
- Department of Genetics, Erasmus Medical Centre, Dr. Molewaterplein 50, 3015GE Rotterdam, The Netherlands
| | - Marie-Therese Armentero
- Laboratory of Functional Neurochemistry, Center for Research in Neurodegenerative Diseases, National Neurological Institute C. Mondino, Via Mondino 2, 27100 Pavia, Italy
| | - Roberta Zangaglia
- Laboratory of Functional Neurochemistry, Center for Research in Neurodegenerative Diseases, National Neurological Institute C. Mondino, Via Mondino 2, 27100 Pavia, Italy
| | - Claudio Pacchetti
- Laboratory of Functional Neurochemistry, Center for Research in Neurodegenerative Diseases, National Neurological Institute C. Mondino, Via Mondino 2, 27100 Pavia, Italy
| | | | - Fabio Blandini
- Laboratory of Functional Neurochemistry, Center for Research in Neurodegenerative Diseases, National Neurological Institute C. Mondino, Via Mondino 2, 27100 Pavia, Italy.
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Affiliation(s)
- Malcolm Proudfoot
- Nuffield Department of Clinical Neurosciences, University of Oxford, UK Oxford Centre for Human Brain Activity, University of Oxford, UK
| | - Mark W Woolrich
- Oxford Centre for Human Brain Activity, University of Oxford, UK
| | - Anna C Nobre
- Oxford Centre for Human Brain Activity, University of Oxford, UK
| | - Martin R Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, UK
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Abstract
Motor neurone disease (MND), the commonest clinical presentation of which is amyotrophic lateral sclerosis (ALS), is regarded as the most devastating of adult-onset neurodegenerative disorders. The last decade has seen major improvements in patient care, but also rapid scientific advances, so that rational therapies based on key pathogenic mechanisms now seem plausible. ALS is strikingly heterogeneous in both its presentation, with an average one-year delay from first symptoms to diagnosis, and subsequent rate of clinical progression. Although half of patients succumb within 3-4 years of symptom onset, typically through respiratory failure, a significant minority survives into a second decade. Although an apparently sporadic disorder for most patients, without clear environmental triggers, recent genetic studies have identified disease-causing mutations in genes in several seemingly disparate functional pathways, so that motor neuron degeneration may need to be understood as a common final pathway with a number of upstream causes. This apparent aetiological and clinical heterogeneity suggests that therapeutic studies should include detailed biomarker profiling, and consider genetic as well as clinical stratification. The most common mutation, accounting for 10% of all Western hemisphere ALS, is a hexanucleotide repeat expansion in C9orf72. This and several other genes implicate altered RNA processing and protein degradation pathways in the core of ALS pathogenesis. A major gap remains in understanding how such fundamental processes appear to function without obvious deficit in the decades prior to symptom emergence, and the study of pre-symptomatic gene carriers is an important new initiative.
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Affiliation(s)
- Dirk Bäumer
- Nuffield Department of Clinical Neurosciences, Oxford University, John Radcliffe Hospital, Oxford OX3 9DU, UK
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19
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Fekete T, Zach N, Mujica-Parodi LR, Turner MR. Multiple kernel learning captures a systems-level functional connectivity biomarker signature in amyotrophic lateral sclerosis. PLoS One 2013; 8:e85190. [PMID: 24391997 PMCID: PMC3877396 DOI: 10.1371/journal.pone.0085190] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 12/02/2013] [Indexed: 01/09/2023] Open
Abstract
There is significant clinical and prognostic heterogeneity in the neurodegenerative disorder amyotrophic lateral sclerosis (ALS), despite a common immunohistological signature. Consistent extra-motor as well as motor cerebral, spinal anterior horn and distal neuromuscular junction pathology supports the notion of ALS a system failure. Establishing a disease biomarker is a priority but a simplistic, coordinate-based approach to brain dysfunction using MRI is not tenable. Resting-state functional MRI reflects the organization of brain networks at the systems-level, and so changes in of motor functional connectivity were explored to determine their potential as the substrate for a biomarker signature. Intra- as well as inter-motor functional networks in the 0.03-0.06 Hz frequency band were derived from 40 patients and 30 healthy controls of similar age, and used as features for pattern detection, employing multiple kernel learning. This approach enabled an accurate classification of a group of patients that included a range of clinical sub-types. An average of 13 regions-of-interest were needed to reach peak discrimination. Subsequent analysis revealed that the alterations in motor functional connectivity were widespread, including regions not obviously clinically affected such as the cerebellum and basal ganglia. Complex network analysis showed that functional networks in ALS differ markedly in their topology, reflecting the underlying altered functional connectivity pattern seen in patients: 1) reduced connectivity of both the cortical and sub-cortical motor areas with non motor areas 2)reduced subcortical-cortical motor connectivity and 3) increased connectivity observed within sub-cortical motor networks. This type of analysis has potential to non-invasively define a biomarker signature at the systems-level. As the understanding of neurodegenerative disorders moves towards studying pre-symptomatic changes, there is potential for this type of approach to generate biomarkers for the testing of neuroprotective strategies.
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Affiliation(s)
- Tomer Fekete
- Department of Biomedical Engineering, Stony Brook University, New York, New York, United States of America
| | - Neta Zach
- Biological Basis of Behavior Program, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Lilianne R. Mujica-Parodi
- Department of Biomedical Engineering, Stony Brook University, New York, New York, United States of America
| | - Martin R. Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
- * E-mail:
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20
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Eisen A, Turner MR, Lemon R. Tools and talk: An evolutionary perspective on the functional deficits associated with amyotrophic lateral sclerosis. Muscle Nerve 2013; 49:469-77. [DOI: 10.1002/mus.24132] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 10/28/2013] [Accepted: 11/21/2013] [Indexed: 12/11/2022]
Affiliation(s)
- Andrew Eisen
- Division of Neurology; University of British Columbia; 2826 Highbury Street Vancouver BC V6R 3T6 Canada
| | - Martin R. Turner
- Medical Research Council and Motor Neurone Disease Association Lady Edith Wolfson Senior Clinical Fellow; Oxford University Nuffield Department of Clinical Neurosciences; Oxford United Kingdom
| | - Roger Lemon
- Sobell Department of Motor Neuroscience and Movement Disorders; Institute of Neurology; Queen Square London United Kingdom
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