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Moguilner S, Herzog R, Perl YS, Medel V, Cruzat J, Coronel C, Kringelbach M, Deco G, Ibáñez A, Tagliazucchi E. Biophysical models applied to dementia patients reveal links between geographical origin, gender, disease duration, and loss of neural inhibition. Alzheimers Res Ther 2024; 16:79. [PMID: 38605416 PMCID: PMC11008050 DOI: 10.1186/s13195-024-01449-0] [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: 11/06/2023] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND The hypothesis of decreased neural inhibition in dementia has been sparsely studied in functional magnetic resonance imaging (fMRI) data across patients with different dementia subtypes, and the role of social and demographic heterogeneities on this hypothesis remains to be addressed. METHODS We inferred regional inhibition by fitting a biophysical whole-brain model (dynamic mean field model with realistic inter-areal connectivity) to fMRI data from 414 participants, including patients with Alzheimer's disease, behavioral variant frontotemporal dementia, and controls. We then investigated the effect of disease condition, and demographic and clinical variables on the local inhibitory feedback, a variable related to the maintenance of balanced neural excitation/inhibition. RESULTS Decreased local inhibitory feedback was inferred from the biophysical modeling results in dementia patients, specific to brain areas presenting neurodegeneration. This loss of local inhibition correlated positively with years with disease, and showed differences regarding the gender and geographical origin of the patients. The model correctly reproduced known disease-related changes in functional connectivity. CONCLUSIONS Results suggest a critical link between abnormal neural and circuit-level excitability levels, the loss of grey matter observed in dementia, and the reorganization of functional connectivity, while highlighting the sensitivity of the underlying biophysical mechanism to demographic and clinical heterogeneities in the patient population.
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Affiliation(s)
- Sebastian Moguilner
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Av. Diag. Las Torres 2640, Santiago Región Metropolitana, Peñalolén, 7941169, Chile
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), 1207 1651 4th St, 3rd Floor, San Francisco, CA, 94143, USA
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Vito Dumas 284, B1644BID, Buenos Aires, VIC, Argentina
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Trinity College Dublin, Lloyd Building Trinity College Dublin, Dublin, D02 PN40, Ireland
| | - Rubén Herzog
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Av. Diag. Las Torres 2640, Santiago Región Metropolitana, Peñalolén, 7941169, Chile
| | - Yonatan Sanz Perl
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Vito Dumas 284, B1644BID, Buenos Aires, VIC, Argentina
- National Scientific and Technical Research Council (CONICET), Godoy Cruz 2290, CABA, 1425, Argentina
- Institute of Applied and Interdisciplinary Physics and Department of Physics, University of Buenos Aires, Pabellón 1, Ciudad Universitaria, CABA, 1428, Argentina
- Center for Brain and Cognition, Computational Neuroscience Group, Universitat Pompeu Fabra, Plaça de La Mercè, 10-12, Barcelona, 08002, Spain
| | - Vicente Medel
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Av. Diag. Las Torres 2640, Santiago Región Metropolitana, Peñalolén, 7941169, Chile
- Centro Interdisciplinario de Neurociencia de Valparaíso (CINV), Universidad de Valparaíso, Harrington 287, Valparaíso, 2381850, Chile
| | - Josefina Cruzat
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Av. Diag. Las Torres 2640, Santiago Región Metropolitana, Peñalolén, 7941169, Chile
| | - Carlos Coronel
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Av. Diag. Las Torres 2640, Santiago Región Metropolitana, Peñalolén, 7941169, Chile
| | - Morten Kringelbach
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, St.Cross Rd, Oxford, OX1 3JA, UK
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Ln, Headington, Oxford, OX3 7JX, UK
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Blvd. 82, Aarhus, 8200, Denmark
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Universitat Pompeu Fabra, Plaça de La Mercè, 10-12, Barcelona, 08002, Spain
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1a, Leipzig, 04103, Germany
- Institució Catalana de Recerca I Estudis Avancats (ICREA), Passeig de Lluís Companys, 23, Barcelona, 08010, Spain
- Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Rd,, Clayton, VIC, 3168, Australia
| | - Agustín Ibáñez
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Av. Diag. Las Torres 2640, Santiago Región Metropolitana, Peñalolén, 7941169, Chile.
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), 1207 1651 4th St, 3rd Floor, San Francisco, CA, 94143, USA.
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Vito Dumas 284, B1644BID, Buenos Aires, VIC, Argentina.
- Trinity College Institute of Neuroscience, Trinity College Dublin, 152 - 160 Pearse St, Dublin, D02 R590, Ireland.
- Trinity College Dublin, Lloyd Building Trinity College Dublin, Dublin, D02 PN40, Ireland.
| | - Enzo Tagliazucchi
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Av. Diag. Las Torres 2640, Santiago Región Metropolitana, Peñalolén, 7941169, Chile.
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Vito Dumas 284, B1644BID, Buenos Aires, VIC, Argentina.
- National Scientific and Technical Research Council (CONICET), Godoy Cruz 2290, CABA, 1425, Argentina.
- Institute of Applied and Interdisciplinary Physics and Department of Physics, University of Buenos Aires, Pabellón 1, Ciudad Universitaria, CABA, 1428, Argentina.
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2
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Heikkinen AL, Paajanen TI, Hänninen T, Tikkanen V, Hublin C, Koivisto AM, Remes AM, Krüger J. Neuropsychological Profiles, Etiologies, and Medical Comorbidities in Early-Onset Dementia and Cognitive Impairment: A Memory Outpatient Clinic Cohort Study. J Alzheimers Dis 2024; 97:1765-1776. [PMID: 38306037 DOI: 10.3233/jad-230877] [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] [Indexed: 02/03/2024]
Abstract
Background Although early-onset dementia (EOD) is associated with diagnostic challenges that differ from those of related to late-onset dementia, only limited studies have addressed the neuropsychological and health characteristics or specified the diagnoses underlying early-onset cognitive impairment in a real-world clinical setting. Objective To investigate the neuropsychological profiles, etiologies, and comorbidities of an unselected cohort of memory clinic patients (≤65 years at symptom onset). Methods The patients' (n = 210) diagnoses were determined based on comprehensive diagnostic workup. Medical comorbidities and neuropsychological profiles were compared between clinically relevant patient groups, namely early-onset dementia (n = 55), mild cognitive impairment due to vascular or suspected neurodegenerative (MCI-n, n = 35) or non-neurodegenerative (MCI-o, n = 106) etiologies, and subjective cognitive decline (n = 14). Results The most prevalent diagnoses were Alzheimer's disease (AD, 14%) and depression (11%). Multiple prior medical conditions were common (67%); however, EOD patients had fewer other diagnoses (p = 0.008) than MCI-o patients. Compared to other groups, EOD patients had more severe deficits (p < 0.001) on immediate and delayed memory, processing speed, symptom awareness, and global cognition. AD patients had weaker memory retention ability but less behavioral symptoms than frontotemporal dementia (FTD) patients (p≤0.05). Depression was associated with better immediate memory, symptom awareness, and global cognition than AD and FTD (p < 0.05). Conclusions EOD is associated with more severe and widespread neuropsychological deficits but fewer prior medical diagnoses than nondegenerative etiologies of cognitive impairment. AD and depression are common etiologies and the neuropsychological profiles are partly overlapping; however, memory, symptom awareness and global cognitive impairment measures may help in the differential diagnosis.
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Affiliation(s)
- Anna-Leena Heikkinen
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Teemu I Paajanen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Tuomo Hänninen
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Veera Tikkanen
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
| | - Christer Hublin
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Anne M Koivisto
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
- Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland
- Clinical Neurosciences, University of Helsinki, Helsinki, Finland
| | - Anne M Remes
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- Clinical Neurosciences, University of Helsinki, Helsinki, Finland
| | - Johanna Krüger
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
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3
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Moguilner S, Whelan R, Adams H, Valcour V, Tagliazucchi E, Ibáñez A. Visual deep learning of unprocessed neuroimaging characterises dementia subtypes and generalises across non-stereotypic samples. EBioMedicine 2023; 90:104540. [PMID: 36972630 PMCID: PMC10066533 DOI: 10.1016/j.ebiom.2023.104540] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/02/2023] [Accepted: 03/10/2023] [Indexed: 03/28/2023] Open
Abstract
BACKGROUND Dementia's diagnostic protocols are mostly based on standardised neuroimaging data collected in the Global North from homogeneous samples. In other non-stereotypical samples (participants with diverse admixture, genetics, demographics, MRI signals, or cultural origins), classifications of disease are difficult due to demographic and region-specific sample heterogeneities, lower quality scanners, and non-harmonised pipelines. METHODS We implemented a fully automatic computer-vision classifier using deep learning neural networks. A DenseNet was applied on raw (unpreprocessed) data from 3000 participants (behavioural variant frontotemporal dementia-bvFTD, Alzheimer's disease-AD, and healthy controls; both male and female as self-reported by participants). We tested our results in demographically matched and unmatched samples to discard possible biases and performed multiple out-of-sample validations. FINDINGS Robust classification results across all groups were achieved from standardised 3T neuroimaging data from the Global North, which also generalised to standardised 3T neuroimaging data from Latin America. Moreover, DenseNet also generalised to non-standardised, routine 1.5T clinical images from Latin America. These generalisations were robust in samples with heterogenous MRI recordings and were not confounded by demographics (i.e., were robust in both matched and unmatched samples, and when incorporating demographic variables in a multifeatured model). Model interpretability analysis using occlusion sensitivity evidenced core pathophysiological regions for each disease (mainly the hippocampus in AD, and the insula in bvFTD) demonstrating biological specificity and plausibility. INTERPRETATION The generalisable approach outlined here could be used in the future to aid clinician decision-making in diverse samples. FUNDING The specific funding of this article is provided in the acknowledgements section.
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Affiliation(s)
- Sebastian Moguilner
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA, USA; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland; Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Robert Whelan
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA, USA; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland
| | - Hieab Adams
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Victor Valcour
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA, USA; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Enzo Tagliazucchi
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Department of Physics, University of Buenos Aires, Caba, Argentina
| | - Agustín Ibáñez
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA, USA; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland; Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland.
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4
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Geraudie A, Battista P, García AM, Allen IE, Miller ZA, Gorno-Tempini ML, Montembeault M. Speech and language impairments in behavioral variant frontotemporal dementia: A systematic review. Neurosci Biobehav Rev 2021; 131:1076-1095. [PMID: 34673112 DOI: 10.1016/j.neubiorev.2021.10.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 01/11/2023]
Abstract
Although behavioral variant frontotemporal dementia (bvFTD) is classically defined by behavioral and socio-emotional changes, impairments often extend to other cognitive functions. These include early speech and language deficits related to the disease's core neural disruptions. Yet, their scope and clinical relevance remains poorly understood. This systematic review characterizes such disturbances in bvFTD, considering clinically, neuroanatomically, genetically, and neuropathologically defined subgroups. We included 181 experimental studies, with at least 5 bvFTD patients diagnosed using accepted criteria, comparing speech and language outcomes between bvFTD patients and healthy controls or between bvFTD subgroups. Results reveal extensive and heterogeneous deficits across cohorts, with (a) consistent lexico-semantic, reading & writing, and prosodic impairments; (b) inconsistent deficits in motor speech and grammar; and (c) relative preservation of phonological skills. Also, preliminary findings suggest that the severity of speech and language deficits might be associated with global cognitive impairment, predominantly temporal or fronto-temporal atrophy and MAPT mutations (vs C9orf72). Although under-recognized, these impairments contribute to patient characterization and phenotyping, while potentially informing diagnosis and management.
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Affiliation(s)
- Amandine Geraudie
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Neurology Department, Toulouse University Hospital, Toulouse, France
| | - Petronilla Battista
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, USA; Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Via Generale Nicola Bellomo, Bari, Italy
| | - Adolfo M García
- Global Brain Health Institute, University of California, San Francisco, USA; Universidad De San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Isabel E Allen
- Global Brain Health Institute, University of California, San Francisco, USA; Department of Epidemiology & Biostatistics, University of California San Francisco, CA, USA
| | - Zachary A Miller
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, USA
| | - Maxime Montembeault
- Memory and Aging Center, Department of Neurology, University of California San Francisco, CA, USA.
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5
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Fieldhouse JLP, Gossink FT, Feenstra TC, de Boer SCM, Lemstra AW, Prins ND, Bouwman F, Koene T, Rhodius-Meester HFM, Gillissen F, Teunissen CE, van der Flier WM, Scheltens P, Dols A, Vijverberg EGB, Pijnenburg YAL. Clinical Phenotypes of Behavioral Variant Frontotemporal Dementia by Age at Onset. J Alzheimers Dis 2021; 82:381-390. [PMID: 34024833 PMCID: PMC8293634 DOI: 10.3233/jad-210179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Behavioral variant frontotemporal dementia (bvFTD) is generally considered a young-onset dementia, although age at onset is highly variable. While several studies indicate clinical differences regarding age at onset, no biomarker validated cohort studies with updated clinical criteria have been performed. Objective: We aimed to examine behavior, cognition, and mortality over the full age spectrum in a cohort of bvFTD patients with neuroimaging, genetic, or histopathological confirmation and exclusion of positive Alzheimer’s disease biomarkers or severe cerebrovascular damage. Methods: In total, 315 patients with a clinical diagnosis of probable or definite bvFTD were included from the Amsterdam Dementia Cohort and grouped into quartiles by age-at-diagnosis. Neuropsychiatric symptoms and cognitive functioning were assessed with the neuropsychiatric inventory, the geriatric depression scale and a neuropsychological test battery. Data on mortality was obtained from the Dutch municipal register. Associations between age-at-diagnosis and clinical features and mortality risk were examined. Results: Age-at-diagnosis ranged from 26 to 85 years and established quartiles with mean ages of 52±6, 61±2, 66±2, and 74±3 years. In the total sample, 44.4%exceeded an age of 65 years at time of diagnosis. Earlier age-at-diagnosis was associated with more severe behavioral symptoms, while later age-at-diagnosis was associated with more severe memory impairment. Unexpectedly, mortality risk was not associated with age-at-diagnosis. Conclusion: In bvFTD, symptom profile is associated with age-at-diagnosis. This should be taken into account with regard to diagnostics, patient management, and trial design. Additionally, based on our sample, the prevalence of late-onset bvFTD is higher than generally thought.
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Affiliation(s)
- Jay L P Fieldhouse
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Flora T Gossink
- GGZ inGeest, Department of Old Age Psychiatry, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Reinier van Arkel, Geriatric and Hospital Psychiatric Centre (COZ), Jeroen Bosch Hospital, Den Bosch, The Netherlands
| | | | - Sterre C M de Boer
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Afina W Lemstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Niels D Prins
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Brain Research Center, Amsterdam, The Netherlands
| | - Femke Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Ted Koene
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Hanneke F M Rhodius-Meester
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Internal medicine, Geriatric Medicine section, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Freek Gillissen
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Annemieke Dols
- GGZ inGeest, Department of Old Age Psychiatry, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Everard G B Vijverberg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Brain Research Center, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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Marelli C, Hourregue C, Gutierrez LA, Paquet C, Menjot de Champfleur N, De Verbizier D, Jacob M, Dubois J, Maleska AM, Hirtz C, Navucet S, Bennys K, Dumurgier J, Cognat E, Berr C, Magnin E, Lehmann S, Gabelle A. Cerebrospinal Fluid and Plasma Biomarkers do not Differ in the Presenile and Late-Onset Behavioral Variants of Frontotemporal Dementia. J Alzheimers Dis 2021; 74:903-911. [PMID: 32083577 DOI: 10.3233/jad-190378] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Memory troubles and hippocampal atrophy are considered more frequent and focal atrophy less severe in late-onset (>65 years) than in presenile behavioral variant of frontotemporal dementia (bvFTD). OBJECTIVE To compare cerebrospinal fluid (CSF) and plasma biomarkers in late-onset and presenile bvFTD. METHODS Multicentric retrospective study (2007-2017) on patients with clinical diagnosis of bvFTD. RESULTS This study included 44 patients (67%) with presenile and 22 (33%) with late-onset bvFTD (comparable mean disease duration; n = 11 with causal mutations). Hippocampal atrophy was more frequent (80% versus 25.8%) and severe in late-onset bvFTD (median Scheltens score: 3 [0-4] versus 1 [0-3]), without difference after adjustment for age. Lobar atrophy and focal hypometabolism/hypoperfusion were not different between groups. The median CSF Aβ1-42 and phosphorylated tau (P-tau) concentrations were in the normal range and comparable between groups. Axonal neurodegeneration biomarkers were within the normal range (CSF T-tau; plasma T-tau in late-onset bvFTD) or higher (plasma neurofilament light chain (NFL); plasma T-tau in presenile bvFTD) than the normal values, but globally not different between bvFTD groups. Plasma glial fibrillary acid protein (GFAP) was strongly increased in both bvFTD groups compared with the values in controls of the same age. CONCLUSION The CSF and plasma biomarker profiles did not suggest a more aggressive neurodegeneration in the presenile group (comparable T-tau, NFL, and GFAP levels) or the co-existence of Alzheimer's disease in the late-onset group (comparable and within normal range CSF Aβ1-42 and P-tau). The severity of the neurodegenerative process seems comparable in presenile and late-onset bvFTD.
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Affiliation(s)
- Cecilia Marelli
- Memory Research and Resources Alzheimer Center, Department of Neurology, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France.,Inserm U1198 MMDN, Montpellier, France; EPHE, Paris, France, Montpellier, France
| | - Claire Hourregue
- Memory Research and Resources Alzheimer Center, Department of Neurology, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France
| | - Laure-Anne Gutierrez
- Memory Research and Resources Alzheimer Center, Department of Neurology, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France.,INSERM U1061, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Claire Paquet
- Center of Cognitive Neurology, Lariboisière Fernand-Widal Hospital, APHP, University of Paris Diderot, Paris, France
| | - Nicolas Menjot de Champfleur
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France.,Department of Neuroradiology, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France.,Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors, " Institut National de la Santé et de la Recherche Médicale Unité 583, Institut of Neurosciences of Montpellier, Saint Eloi Hospital, Montpellier, France
| | - Delphine De Verbizier
- Department of Nuclear Medicine, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France
| | - Melissa Jacob
- Memory Research and Resources Alzheimer Center, Department of Neurology, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France
| | - Jonathan Dubois
- INSERM U1061, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Aleksandra Maceski Maleska
- Laboratoire de Biochimie Protéomique Clinique, INSERM-UM 1183, University Hospital Center, University of Montpellier, Montpellier, France
| | - Christophe Hirtz
- Laboratoire de Biochimie Protéomique Clinique, INSERM-UM 1183, University Hospital Center, University of Montpellier, Montpellier, France
| | - Sophie Navucet
- Memory Research and Resources Alzheimer Center, Department of Neurology, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France
| | - Karim Bennys
- Memory Research and Resources Alzheimer Center, Department of Neurology, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France
| | - Julien Dumurgier
- Center of Cognitive Neurology, Lariboisière Fernand-Widal Hospital, APHP, University of Paris Diderot, Paris, France
| | - Emmanuel Cognat
- Center of Cognitive Neurology, Lariboisière Fernand-Widal Hospital, APHP, University of Paris Diderot, Paris, France
| | - Claudine Berr
- Memory Research and Resources Alzheimer Center, Department of Neurology, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France.,INSERM U1061, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Eloi Magnin
- Department of Neurology, Centre Mémoire Ressources Recherche Besançon Franche-Comté, CHU de Besançon, Besançon, France
| | - Sylvain Lehmann
- Laboratoire de Biochimie Protéomique Clinique, INSERM-UM 1183, University Hospital Center, University of Montpellier, Montpellier, France
| | - Audrey Gabelle
- Memory Research and Resources Alzheimer Center, Department of Neurology, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France.,INSERM U1061, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
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7
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Bastin C, Bahri MA, Bernard C, Hustinx R, Salmon E. Frontal hypometabolism in neurocognitive disorder with behavioral disturbance. J Nucl Med 2021; 62:jnumed.120.260497. [PMID: 33789936 PMCID: PMC8612193 DOI: 10.2967/jnumed.120.260497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 11/16/2022] Open
Abstract
Criteria for the behavioral variant of frontotemporal dementia (bvFTD) include decreased frontal metabolism. FDG-PET was used to investigate whether patients with neurocognitive disorder and behavioral disturbance (bvNCD) who did not fulfill three bvFTD criteria had characteristic brain metabolic pattern. Methods: Patients were referred from memory clinic to nuclear medicine for differential diagnosis of NCD with dysexecutive syndrome and predominant mild frontal atrophy. Patients were classified into two groups before FDG-PET, probable bvFTD (n = 25) or bvNCD (n = 27) when only two bvFTD criteria were met. Results: Voxel-based and multivariate PLS analyses of FDG-PET did not show significant between-group difference at inclusion. After 4.8 years of follow-up, most patients with probable bvFTD received the same diagnosis, 3 remained very stable and one participant was given a psychiatric diagnosis. Five patients with bvNCD fulfilled criteria for probable bvFTD at 4.4 years mean follow up, while 2 participants remained very stable and 3 received alternative neurological or psychiatric diagnoses. When initial FDG-PET were compared between groups stratified at follow up (26 bvFTD versus 17 bvNCD), there was a trend (p<.001uncorrected) for lower prefrontal with relatively preserved premotor metabolism in bvFTD compared to bvNCD. Twelve bvNCD participants had neuropsychological testing before inclusion. They all presented executive dysfunction and normal visuospatial performance, and most (n = 9) had memory encoding impairment. Conclusion: Frontal hypometabolism was observed in a dysexecutive presentation of frontal neurodegenerative disorder (bvNCD) that did not fulfill all clinical criteria for bvFTD.
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Affiliation(s)
- Christine Bastin
- GIGA Cyclotron Research Centre, University of Liege, Liege, Belgium
| | | | - Claire Bernard
- Nuclear Medicine Department, CHU Liege, Liege, Belgium; and
| | - Roland Hustinx
- GIGA Cyclotron Research Centre, University of Liege, Liege, Belgium
- Nuclear Medicine Department, CHU Liege, Liege, Belgium; and
| | - Eric Salmon
- GIGA Cyclotron Research Centre, University of Liege, Liege, Belgium
- Memory Clinic, Department of Neurology, CHU Liege, Liege, Belgium
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8
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Bachli MB, Sedeño L, Ochab JK, Piguet O, Kumfor F, Reyes P, Torralva T, Roca M, Cardona JF, Campo CG, Herrera E, Slachevsky A, Matallana D, Manes F, García AM, Ibáñez A, Chialvo DR. Evaluating the reliability of neurocognitive biomarkers of neurodegenerative diseases across countries: A machine learning approach. Neuroimage 2019; 208:116456. [PMID: 31841681 PMCID: PMC7008715 DOI: 10.1016/j.neuroimage.2019.116456] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 10/29/2019] [Accepted: 12/09/2019] [Indexed: 12/12/2022] Open
Abstract
Accurate early diagnosis of neurodegenerative diseases represents a growing challenge for current clinical practice. Promisingly, current tools can be complemented by computational decision-support methods to objectively analyze multidimensional measures and increase diagnostic confidence. Yet, widespread application of these tools cannot be recommended unless they are proven to perform consistently and reproducibly across samples from different countries. We implemented machine-learning algorithms to evaluate the prediction power of neurocognitive biomarkers (behavioral and imaging measures) for classifying two neurodegenerative conditions –Alzheimer Disease (AD) and behavioral variant frontotemporal dementia (bvFTD)– across three different countries (>200 participants). We use machine-learning tools integrating multimodal measures such as cognitive scores (executive functions and cognitive screening) and brain atrophy volume (voxel based morphometry from fronto-temporo-insular regions in bvFTD, and temporo-parietal regions in AD) to identify the most relevant features in predicting the incidence of the diseases. In the Country-1 cohort, predictions of AD and bvFTD became maximally improved upon inclusion of cognitive screenings outcomes combined with atrophy levels. Multimodal training data from this cohort allowed predicting both AD and bvFTD in the other two novel datasets from other countries with high accuracy (>90%), demonstrating the robustness of the approach as well as the differential specificity and reliability of behavioral and neural markers for each condition. In sum, this is the first study, across centers and countries, to validate the predictive power of cognitive signatures combined with atrophy levels for contrastive neurodegenerative conditions, validating a benchmark for future assessments of reliability and reproducibility.
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Affiliation(s)
- M Belen Bachli
- Center for Complex Systems & Brain Sciences (CEMSC(3)), Escuela de Ciencia y Tecnologia (ECyT), Universidad Nacional de San Martín, 25 de Mayo 1169, San Martín, (1650), Buenos Aires, Argentina
| | - Lucas Sedeño
- Institute of Cognitive and Translational Neuroscience (INCYyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Godoy Cruz 2290, Buenos Aires, Argentina.
| | - Jeremi K Ochab
- Marian Smoluchowski Institute of Physics, Mark Kac Complex Systems Research Center Jagiellonian University, Ul. Łojasiewicza 11, PL30-348, Kraków, Poland
| | - Olivier Piguet
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, Australia; The University of Sydney, Brain and Mind Centre and School of Psychology, Sydney, Australia
| | - Fiona Kumfor
- ARC Centre of Excellence in Cognition and Its Disorders, Sydney, Australia; The University of Sydney, Brain and Mind Centre and School of Psychology, Sydney, Australia
| | - Pablo Reyes
- Radiology, Hospital Universitario San Ignacio (HUSI), Bogotá, Colombia; Medical School, Physiology Sciences, Psychiatry and Mental Health Pontificia Universidad Javeriana (PUJ) - Centro de Memoria y Cognición Intellectus, Hospital Universitario San Ignacio (HUSI), Bogotá, Colombia
| | - Teresa Torralva
- Institute of Cognitive and Translational Neuroscience (INCYyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - María Roca
- Institute of Cognitive and Translational Neuroscience (INCYyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | | | - Cecilia Gonzalez Campo
- Institute of Cognitive and Translational Neuroscience (INCYyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Godoy Cruz 2290, Buenos Aires, Argentina
| | - Eduar Herrera
- Departamento de Estudios Psicológicos, Universidad Icesi, Cali, Colombia
| | - Andrea Slachevsky
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile; Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, ICBM, Neurosciences Department, East Neuroscience Department, Faculty of Medicine, University of Chile, Avenida Salvador 486, Providencia, Santiago, Chile; Memory and Neuropsychiatric Clinic (CMYN) Neurology Department- Hospital del Salvador & University of Chile, Av. Salvador 364, Providencia, Santiago, Chile; Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Chile
| | - Diana Matallana
- Medical School, Aging Institute, Psychiatry and Mental Health, Pontificia Universidad Javeriana (PUJ) - Centro de Memoria y Cognición Intellectus. Hospital Universitario San Ignacio (HUSI), Bogotá, Colombia
| | - Facundo Manes
- Institute of Cognitive and Translational Neuroscience (INCYyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Godoy Cruz 2290, Buenos Aires, Argentina; ARC Centre of Excellence in Cognition and Its Disorders, Sydney, Australia
| | - Adolfo M García
- Institute of Cognitive and Translational Neuroscience (INCYyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Godoy Cruz 2290, Buenos Aires, Argentina; Faculty of Education, National University of Cuyo (UNCuyo), Sobremonte 74, C5500, Mendoza, Argentina
| | - Agustín Ibáñez
- Institute of Cognitive and Translational Neuroscience (INCYyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Godoy Cruz 2290, Buenos Aires, Argentina; ARC Centre of Excellence in Cognition and Its Disorders, Sydney, Australia; Universidad Autónoma del Caribe, Calle 90, No 46-112, C2754, Barranquilla, Colombia; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Diagonal Las Torres, 2640, Santiago, Chile
| | - Dante R Chialvo
- Center for Complex Systems & Brain Sciences (CEMSC(3)), Escuela de Ciencia y Tecnologia (ECyT), Universidad Nacional de San Martín, 25 de Mayo 1169, San Martín, (1650), Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Godoy Cruz 2290, Buenos Aires, Argentina
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9
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Ortelli P, Ferrazzoli D, Cian V, Zarucchi M, Palamara G, Giobbia A, Frazzitta G, Maestri R, Canesi M. How Cognition and Motivation "Freeze" the Motor Behavior in Parkinson's Disease. Front Neurosci 2019; 13:1302. [PMID: 31866812 PMCID: PMC6909398 DOI: 10.3389/fnins.2019.01302] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/20/2019] [Indexed: 01/30/2023] Open
Abstract
Objective Freezing of gait (FoG) is a debilitating problem in patients with PD. The multifactorial pathogenesis of FoG remains poorly understood. We aimed to find which factors are most strongly associated with the occurrence of FoG. Methods Three hundred five PD patients were enrolled and subdivided according to the presence (FoG +, n = 128) or absence (FoG-, n = 177) of FoG. Several clinical, functional, and neuropsychological data were collected and compared between groups. The association between the probability of presence of FoG and possible explanatory variables was assessed by logistic regression analysis. Results FoG + patients were younger at the diagnosis (p = 0.04), and their mean daily dose of dopaminergic drugs (p < 0.0001) was higher in comparison with FoG- patients. FoG + patients get worse in Frontal Assessment Battery (p = 0.005), had higher scores in Apathy Evaluation Scale (p = 0.03), and were much more impaired on Wisconsin Card Sorting Test (WCST) (p = 0.018), Trail Making Test A (p = 0.0013), and Ray Auditory Verbal Learning Test (p = 0.012). Levodopa equivalent dose, age (direct), age at disease onset (inverse), and WCST were significant predictors of FoG (p = 0.01, p = 0.0025, p = 0.0016, and p = 0.029, respectively). Conclusion FoG + patients show more deficits in executive functions and in motivation. The main explanatory variables of FoG occurrence are levodopa equivalent dose, age, age at disease onset, and WCST. These data suggest that a specific involvement of frontal cortical circuits in PD is responsible for certain cognitive–behavioral alterations related to the occurrence of FoG.
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Affiliation(s)
- Paola Ortelli
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Como, Italy
| | - Davide Ferrazzoli
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Como, Italy
| | - Veronica Cian
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Como, Italy.,School of Specialization in Neuropsychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Marianna Zarucchi
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Como, Italy
| | - Grazia Palamara
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Como, Italy
| | - Alessandro Giobbia
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Como, Italy
| | | | - Roberto Maestri
- Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCCS SpA SB, Pavia, Italy
| | - Margherita Canesi
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital, Como, Italy
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10
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San Lee J, Yoo S, Park S, Kim HJ, Park KC, Seong JK, Suh MK, Lee J, Jang H, Kim KW, Kim Y, Cho SH, Kim SJ, Kim JP, Jung YH, Kim EJ, Suh YL, Lockhart SN, Seeley WW, Na DL, Seo SW. Differences in neuroimaging features of early- versus late-onset nonfluent/agrammatic primary progressive aphasia. Neurobiol Aging 2019; 86:92-101. [PMID: 31784276 DOI: 10.1016/j.neurobiolaging.2019.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 01/18/2023]
Abstract
This study investigated distinct neuroimaging features measured by cortical thickness and subcortical structural shape abnormality in early-onset (EO, onset age <65 years) and late-onset (LO, onset age ≥65 years) nonfluent/agrammatic variant of primary progressive aphasia (nfvPPA) patients. Cortical thickness and subcortical structural shape analyses were performed using a surface-based method from 38 patients with nfvPPA and 76 cognitively normal individuals. To minimize the effects of physiological aging, we used W-scores in comparisons between the groups. The EO-nfvPPA group exhibited more extensive cortical thickness reductions predominantly in the left perisylvian, lateral and medial prefrontal, temporal, posterior cingulate, and precuneus regions than the LO-nfvPPA group. The EO-nfvPPA group also exhibited significantly greater subcortical structural shape abnormality than the LO-nfvPPA group, mainly in the left striatum, hippocampus, and amygdala. Our findings suggested that there were differences in neuroimaging features between these groups by the age of symptom onset, which might be explained by underlying heterogeneous neuropathological differences or the age-related brain reserve hypothesis.
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Affiliation(s)
- Jin San Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea; Department of Neurology, Kyung Hee University Hospital, Seoul, Korea
| | - Sole Yoo
- Department of Cognitive Science, Yonsei University, Seoul, Korea
| | - Seongbeom Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Key-Chung Park
- Department of Neurology, Kyung Hee University Hospital, Seoul, Korea
| | - Joon-Kyung Seong
- Department of Bio-convergence Engineering, School of Biomedical Engineering, Korea University, Seoul, Korea
| | - Mee Kyung Suh
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Juyoun Lee
- Department of Neurology, Chungnam National University Hospital, Daejeon, Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Ko Woon Kim
- Department of Neurology, Chonbuk National University Medical School & Hospital, Jeonju, Korea
| | - Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Soo Hyun Cho
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Seung Joo Kim
- Department of Neurology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jun Pyo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Young Hee Jung
- Department of Neurology, Myungji Hospital, Goyang, Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
| | - Yeon-Lim Suh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Samuel N Lockhart
- Department of Internal Medicine, Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, USA
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Neuroscience Center, Samsung Medical Center, Seoul, Korea; Samsung Alzheimer Research Center, Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Korea; Department of Health Sciences and Technology, Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
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11
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Martins LT, Teixeira IA, Laks J, Marinho V. Recognizing Late Onset Frontotemporal Dementia with the DAPHNE scale: A case report. Dement Neuropsychol 2018; 12:75-79. [PMID: 29682237 PMCID: PMC5901253 DOI: 10.1590/1980-57642018dn12-010011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Frontotemporal dementias are classically described as early onset dementias with personality and behavioral changes, however, late onset forms can also be found. Considering the paucity of information about late onset behavioral variant frontotemporal dementia and its challenging diagnosis, we present a case report of an 85-year-old woman with behavioral changes and slow progression to dementia who was first diagnosed as having bipolar disorder and then Alzheimer's disease. The Daphne scale provided a structured means to improve clinical diagnosis, also supported by characteristic features on MRI and SPECT, while CSF biomarkers ruled out atypical Alzheimer's disease.
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Affiliation(s)
- Leonardo Tafarello Martins
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Ivan Abdalla Teixeira
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil.,MSc Student Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
| | - Jerson Laks
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil.,Associate Professor, Universidade do Estado do Rio de Janeiro, RJ, Brazil.,Invited Professor, Postgraduate Program in Translational Biomedicine, Universidade do Grande Rio (Biotrans - Unigranrio)
| | - Valeska Marinho
- Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil.,PhD. Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, RJ, Brazil
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12
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Seo SW, Thibodeau MP, Perry DC, Hua A, Sidhu M, Sible I, Vargas JNS, Gaus SE, Rabinovici GD, Rankin KD, Boxer AL, Kramer JH, Rosen HJ, Gorno-Tempini ML, Grinberg LT, Huang EJ, DeArmond SJ, Trojanowski JQ, Miller BL, Seeley WW. Early vs late age at onset frontotemporal dementia and frontotemporal lobar degeneration. Neurology 2018; 90:e1047-e1056. [PMID: 29453245 DOI: 10.1212/wnl.0000000000005163] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 01/02/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To examine clinicopathologic correlations in early vs late age at onset frontotemporal dementia (FTD) and frontotemporal lobar degeneration (FTLD). METHODS All patients were clinically evaluated and prospectively diagnosed at the UCSF Memory and Aging Center. Two consecutive series were included: (1) patients with a clinically diagnosed FTD syndrome who underwent autopsy (cohort 1) and (2) patients with a primary pathologic diagnosis of FTLD, regardless of the clinical syndrome (cohort 2). These series were divided by age at symptom onset (cutoff 65 years). RESULTS In cohort 1, 48 (25.3%) were 65 years or older at symptom onset. Pathologic causes of behavioral variant FTD (bvFTD) were similar in the early age at onset (EO) and late age at onset (LO) bvFTD groups. In corticobasal syndrome (CBS), however, the most common pathologic substrate differed according to age at onset: progressive supranuclear palsy (42.9%) in LO-CBS and Alzheimer disease (AD; 40.7%) in EO-CBS. In cohort 2, 57 (28.4%) were classified as LO-FTLD. Regarding FTLD major molecular classes, FTLD with transactive response DNA-binding protein of 43 kDa was most common in EO-FTLD (44.4%), whereas FTLD-tau (58.3%) was most common in LO-FTLD. Antemortem diagnosis of a non-FTD syndrome, usually AD-type dementia, was more frequent in LO-FTLD than EO-FTLD (19.3% vs 7.7%, p = 0.017). LO-FTLD was also associated with more prevalent comorbid pathologic changes. Of these, moderate to severe AD neuropathologic change and argyrophilic grain disease were overrepresented among patients who received an antemortem diagnosis of AD-type dementia. CONCLUSION Patients with FTD and FTLD often develop symptoms after age 65, and age at onset represents an important consideration when making antemortem neuropathologic predictions.
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Affiliation(s)
- Sang Won Seo
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Marie-Pierre Thibodeau
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - David C Perry
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Alice Hua
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Manu Sidhu
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Isabel Sible
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Jose Norberto S Vargas
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Stephanie E Gaus
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Gil D Rabinovici
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Katherine D Rankin
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Adam L Boxer
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Joel H Kramer
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Howard J Rosen
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Maria Luisa Gorno-Tempini
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Lea T Grinberg
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Eric J Huang
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Stephen J DeArmond
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - John Q Trojanowski
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - Bruce L Miller
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia
| | - William W Seeley
- From the Memory and Aging Center, Department of Neurology (S.W.S., D.C.P., A.H., M.S., I.S., J.N.S.V., S.E.G., G.R., K.D.R., A.L.B., J.H.K., H.J.R., M.L.G.-T., L.T.G., B.L.M., W.W.S.), and Department of Pathology (L.T.G., E.J.H., S.J.D., W.W.S.), University of California, San Francisco; Department of Neurology (S.W.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Geriatrics (M.-P.T.), Centre Hospitalier de l'Université de Montréal, University of Montreal, Canada; and Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research and Institute on Aging (J.Q.T.), University of Pennsylvania, Philadelphia.
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Elamin M, Holloway G, Bak TH, Pal S. The Utility of the Addenbrooke's Cognitive Examination Version Three in Early-Onset Dementia. Dement Geriatr Cogn Disord 2016; 41:9-15. [PMID: 26473749 DOI: 10.1159/000439248] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/06/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Early-onset dementia (EOD) is defined as functionally relevant cognitive decline with age of onset at less than 65 years. The aim of this study was to investigate the utility of the recently validated third version of the Addenbrooke's Cognitive Examination (ACE-III) in predicting dementia diagnoses in EOD. METHODS ACE-III scores of EOD patients were compared to those of healthy controls (HC) and individuals with subjective memory impairment (SMI). RESULTS The study included 71 EOD patients (Alzheimer's disease, n = 31; primary progressive aphasia, n = 11; behavioural-variant frontotemporal dementia, n = 18, and posterior cortical atrophy, n = 11); there were 28 HC and 15 individuals with SMI. At a cut-off score of 88/100, the ACE-III displayed high sensitivity and specificity in distinguishing EOD from HC (91.5 and 96.4%) and SMI (91.5 and 86.7%). CONCLUSIONS The ACE-III is a reliable cognitive screening tool in EOD.
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Affiliation(s)
- Marwa Elamin
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK
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14
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Mapping brain morphological and functional conversion patterns in predementia late-onset bvFTD. Eur J Nucl Med Mol Imaging 2016; 43:1337-47. [DOI: 10.1007/s00259-016-3335-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 02/08/2016] [Indexed: 02/01/2023]
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15
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Jang YK, Kwon H, Kim YJ, Jung NY, Lee JS, Lee J, Chin J, Im K, Jeon S, Lee JM, Seong JK, Kim JH, Kim S, Choe YS, Lee KH, Kim ST, Kim JS, Lee JH, Na DL, Seo SW, Kim HJ. Early- vs late-onset subcortical vascular cognitive impairment. Neurology 2016; 86:527-34. [PMID: 26764026 DOI: 10.1212/wnl.0000000000002357] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 10/14/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the differences between early-onset subcortical vascular cognitive impairment (EO-SVCI) and late-onset subcortical vascular cognitive impairment (LO-SVCI) with regard to pathologic burden, structural changes, and cognitive function. METHODS We prospectively recruited 142 patients from a single referral center. Patients were divided into EO-SVCI (n = 30, age at onset <65 years) and LO-SVCI (n = 112, age at onset ≥ 65 years) groups. All patients underwent neuropsychological tests, 3T brain MRI, and [(11)C] Pittsburgh compound B (PiB)-PET. We compared pathologic burden such as small vessel disease and amyloid burden; structural changes such as structural network, cortical thickness, and hippocampal volume; and cognitive function between EO-SVCI and LO-SVCI. RESULTS EO-SVCI patients had more lacunes, while LO-SVCI patients had higher PiB standardized uptake value ratios. EO-SVCI patients exhibited more severe structural network disruptions in the frontal area, while LO-SVCI patients exhibited more severe cortical and hippocampal atrophy. Although disease severity did not differ between the 2 groups, frontal-executive dysfunction was more severe in EO-SVCI patients. CONCLUSIONS EO-SVCI patients showed more vascular related factors, while LO-SVCI patients exhibited more Alzheimer disease-related characteristics. The greater number of lacunes in EO-SVCI might account for the more severe frontal network disruption and frontal-executive dysfunction, while the greater amyloid burden in LO-SVCI might account for the more severe cortical and hippocampal atrophy. Our findings suggest that the age at onset is a crucial factor that determines distinct features in SVCI patients, such as pathologic burden, structural changes, and cognitive function.
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Affiliation(s)
- Young Kyoung Jang
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hunki Kwon
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yeo Jin Kim
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Na Yeon Jung
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin San Lee
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Juyoun Lee
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Juhee Chin
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kiho Im
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seun Jeon
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Min Lee
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon-Kyoung Seong
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Hun Kim
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seonwoo Kim
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yearn Seong Choe
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Han Lee
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Tae Kim
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Seung Kim
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Hong Lee
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Duk L Na
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Won Seo
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Jin Kim
- From the Departments of Neurology (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Nuclear Medicine (Y.S.C., K.-H.L.), and Radiology (S.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine; Neuroscience Center (Y.K.J., Y.J.K., J.S.L., J.L., J.C., D.L.N., S.W.S., H.J.K.), Samsung Medical Center, Seoul, Korea; Department of Biomedical Engineering (H.K., J.M.L.), Hanyang University, Seoul, Korea; Department of Neurology (N.Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea; Division of Newborn Medicine (K.I.), Boston Children's Hospital, Harvard Medical School, Boston, MA; McGill Centre for Integrative Neuroscience (S.J.), Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Departments of Biomedical Engineering (J.-K.S.) and Computer and Radio Communications Engineering (J.H.K.), Korea University; Biostatistics Team (S.K.), Samsung Biomedical Research Institute; and Departments of Nuclear Medicine (J.S.K.) and Neurology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Hopkins SAA, Chan D. Key emerging issues in frontotemporal dementia. J Neurol 2015; 263:407-413. [PMID: 26338811 DOI: 10.1007/s00415-015-7880-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 08/11/2015] [Indexed: 12/12/2022]
Abstract
Frontotemporal dementia (FTD) encompasses the syndromes of behavioural variant FTD (bvFTD) and primary progressive aphasia (PPA) and refers to those neurodegenerative diseases characterised by predominant pathological involvement of the frontal and temporal lobes. Recent years have witnessed major advances in the clinical characterisation of FTD, reflected in the publication of updated diagnostic criteria for bvFTD and PPA, and the discovery of new pathogenic mutations has added to the understanding of genotype-phenotype interactions and of disease mechanisms. Emerging results from longitudinal studies of familial FTD show that imaging and cognitive changes occur years before symptom onset and such studies may yield biomarkers of early disease that in turn will facilitate earlier diagnosis. The hope and (guarded) expectation is that these advances may together herald the beginning of the end of the chapter in which FTD is considered an inexorably progressive and untreatable condition.
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Affiliation(s)
- Sarah A A Hopkins
- Department of Medicine for the Elderly, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| | - Dennis Chan
- Department of Clinical Neurosciences, Herchel Smith Building for Brain and Mind Sciences, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK.
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