1
|
Ding J, Yang Q, Drossinos N, Guo Q. Advances in semantic dementia: Neuropsychology, pathology & neuroimaging. Ageing Res Rev 2024; 99:102375. [PMID: 38866186 DOI: 10.1016/j.arr.2024.102375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/14/2024]
Abstract
Semantic dementia is a kind of neurodegenerative disorder, characterized by prominent semantic impairments and anterior temporal lobe atrophy. Since 2010, more studies have devoted to this rare disorder, revealing that it is more complex than we think. Clinical advances include more specific findings of semantic impairments and other higher order cognitive deficits. Neuroimaging techniques can help revealing the different brain networks affected (both structurally and functionally) in this condition. Pathological and genetic studies have also found more complex situations of semantic dementia, which might explain the huge variance existing in semantic dementia. Moreover, the current diagnosis criteria mainly focus on semantic dementia's classical prototype. We further delineated the features of three subtypes of semantic dementia based on atrophy lateralization with three severity stages. In a broader background, as a part of the continuum of neurodegenerative disorders, semantic dementia is commonly compared with other resembling conditions. Therefore, we summarized the differential diagnosis between semantic dementia and them. Finally, we introduced the challenges and achievements of its diagnosis, treatment, care and cross cultural comparison. By providing a comprehensive picture of semantic dementia on different aspects of advances, we hope to deepen the understanding of semantic dementia and promote more inspirations on both clinical and theoretical studies about it.
Collapse
Affiliation(s)
- Junhua Ding
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Qing Yang
- Department of Rehabilitation, Hushan Hospital, Fudan University, Shanghai, China
| | - Niki Drossinos
- Division of Psychology, Communication and Human Neuroscience, University of Manchester, Manchester, UK
| | - Qihao Guo
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
2
|
Landin-Romero R, Kumfor F, Ys Lee A, Leyton C, Piguet O. Clinical and cortical trajectories in non-fluent primary progressive aphasia and Alzheimer's disease: A role for emotion processing. Brain Res 2024; 1829:148777. [PMID: 38286395 DOI: 10.1016/j.brainres.2024.148777] [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] [Received: 11/21/2023] [Revised: 01/12/2024] [Accepted: 01/18/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVES To examine the clinical trajectories and neural correlates of cognitive and emotion processing changes in the non-fluent/agrammatic (nfvPPA) and the logopenic (lvPPA) variants of primary progressive aphasia (PPA). DESIGN Observational case-control longitudinal cohort study. SETTING Research clinic of frontotemporal dementia. PARTICIPANTS This study recruited 29 non-semantic PPA patients (15 nfvPPA and 14 lvPPA) and compared them with 15 Alzheimer's disease (AD) patients and 14 healthy controls. MEASUREMENTS Participants completed an annual assessment (median = 2 years; range = 1-5 years) of general cognition, emotion processing and structural MRI. Linear mixed effects models investigated clinical and imaging trajectories between groups. RESULTS Over time, lvPPA showed the greatest cognitive deterioration. In contrast, nfvPPA showed significant decline in emotion recognition, whereas AD showed preserved emotion recognition, even with disease progression. Importantly, lvPPA also developed emotion processing impairments, with disease progression. Both nfvPPA and lvPPA showed continuing cortical atrophy in hallmark language-processing regions associated with these syndromes, together with progressive involvement of the right hemisphere regions, mirroring left hemisphere atrophy patterns at presentation. Decline in emotion processing was associated with bilateral frontal atrophy in nfvPPA and right temporal atrophy in lvPPA. CONCLUSIONS Our results show divergent clinical courses in nfvPPA and lvPPA, with rapid cognitive and neural deterioration in lvPPA and emotion processing decline in both groups and support the concurrent assessment of cognition and emotion processing in the clinic to inform diagnosis and monitoring in the non-semantic variants of PPA.
Collapse
Affiliation(s)
- Ramon Landin-Romero
- Sydney School of Health Sciences & Brain and Mind Centre, The University of Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Australia.
| | - Fiona Kumfor
- School of Psychology & Brain and Mind Centre, The University of Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Australia
| | - Austin Ys Lee
- ARC Centre of Excellence in Cognition and its Disorders, Australia
| | - Cristian Leyton
- School of Psychology & Brain and Mind Centre, The University of Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Australia
| | - Olivier Piguet
- School of Psychology & Brain and Mind Centre, The University of Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Australia
| |
Collapse
|
3
|
Mendez MF, Nasir I. Distinguishing Semantic Variant Primary Progressive Aphasia from Alzheimer’s Disease. J Alzheimers Dis Rep 2023; 7:227-234. [PMID: 37090957 PMCID: PMC10116168 DOI: 10.3233/adr-230010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/01/2023] [Indexed: 03/30/2023] Open
Abstract
The differentiation of semantic variant primary progressive aphasia from dementia and Alzheimer’s disease can be difficult, particularly when the semantic anomia is pronounced. This report describes a patient who presented with complaints of memory loss and proved to have prominent semantic loss of all types of nouns, common and proper, concrete and abstract, yet continued to live independently and maintain his activities of daily living. The evaluation was consistent for semantic variant primary progressive aphasia with degradation of semantic knowledge and focal anterior temporal atrophy and hypometabolism. This report summarizes the literature and discusses the differential diagnosis of this disorder from Alzheimer’s disease and related dementias.
Collapse
Affiliation(s)
- Mario F. Mendez
- Department of Neurology, Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Neurology Service, Neurobehavior Unit, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Correspondence to: Mario F. Mendez, MD, PhD, Neurobehavior Unit, V.A. Greater Los Angeles Healthcare Center, 11301 Wilshire Blvd., Los Angeles, CA 90073, USA. Tel.: +1 310 478 3711/Ext. 42696; Fax: +1 310 268 4181; E-mail:
| | - Imaad Nasir
- Department of Neurology, Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Neurology Service, Neurobehavior Unit, V.A. Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| |
Collapse
|
4
|
Shekari E, Nozari N. A narrative review of the anatomy and function of the white matter tracts in language production and comprehension. Front Hum Neurosci 2023; 17:1139292. [PMID: 37051488 PMCID: PMC10083342 DOI: 10.3389/fnhum.2023.1139292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/24/2023] [Indexed: 03/28/2023] Open
Abstract
Much is known about the role of cortical areas in language processing. The shift towards network approaches in recent years has highlighted the importance of uncovering the role of white matter in connecting these areas. However, despite a large body of research, many of these tracts’ functions are not well-understood. We present a comprehensive review of the empirical evidence on the role of eight major tracts that are hypothesized to be involved in language processing (inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, extreme capsule, middle longitudinal fasciculus, superior longitudinal fasciculus, arcuate fasciculus, and frontal aslant tract). For each tract, we hypothesize its role based on the function of the cortical regions it connects. We then evaluate these hypotheses with data from three sources: studies in neurotypical individuals, neuropsychological data, and intraoperative stimulation studies. Finally, we summarize the conclusions supported by the data and highlight the areas needing further investigation.
Collapse
Affiliation(s)
- Ehsan Shekari
- Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran
| | - Nazbanou Nozari
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition (CNBC), Pittsburgh, PA, United States
- *Correspondence: Nazbanou Nozari
| |
Collapse
|
5
|
Quartarone C, Navarrete E, Budisavljević S, Peressotti F. Exploring the ventral white matter language network in bimodal and unimodal bilinguals. BRAIN AND LANGUAGE 2022; 235:105187. [PMID: 36244164 DOI: 10.1016/j.bandl.2022.105187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 09/25/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
We used diffusion magnetic resonance imaging tractography to investigate the effect of language modality on the anatomy of the ventral white matter language network by comparing unimodal (Italian/English) and bimodal bilinguals (Italian/Italian Sign Language). We extracted the diffusion tractography measures of the Inferior Longitudinal fasciculus (ILF), Uncinate fasciculus (UF) and Inferior Fronto-Occipital fasciculus (IFOF) and we correlated them with the degree of bilingualism and the individual performance in fluency tasks. For both groups of bilinguals, the microstructural properties of the right ILF were correlated with individual level of proficiency in L2, confirming the involvement of this tract in bilingualism. In addition, we found that the degree of left lateralization of the ILF predicted the performance in semantic fluency in L1. The microstructural properties of the right UF correlated with performance in phonological fluency in L1, only for bimodal bilinguals. Overall, the pattern shows both similarities and differences between the two groups of bilinguals.
Collapse
Affiliation(s)
- Cinzia Quartarone
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione - University of Padua, Via Venezia, 8, 35137 Padova, Italy
| | - Eduardo Navarrete
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione - University of Padua, Via Venezia, 8, 35137 Padova, Italy
| | - Sanja Budisavljević
- School of Medicine, St. Andrews University, College Gate, St Andrews KY16, 9AJ, UK
| | - Francesca Peressotti
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione - University of Padua, Via Venezia, 8, 35137 Padova, Italy.
| |
Collapse
|
6
|
Waszczuk K, Tyburski E, Rek-Owodziń K, Plichta P, Rudkowski K, Podwalski P, Bielecki M, Mak M, Bober A, Misiak B, Sagan L, Michalczyk A, Kucharska-Mazur J, Samochowiec J. Relationship between White Matter Alterations and Pathophysiological Symptoms in Patients with Ultra-High Risk of Psychosis, First-Episode, and Chronic Schizophrenia. Brain Sci 2022; 12:brainsci12030354. [PMID: 35326310 PMCID: PMC8946295 DOI: 10.3390/brainsci12030354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/20/2022] [Accepted: 03/03/2022] [Indexed: 12/03/2022] Open
Abstract
Some symptoms of schizophrenia might be present before full-blown psychosis, so white matter changes must be studied both in individuals with emerging psychosis and chronic schizophrenia. A total of 86 patients—12 ultra-high risk of psychosis (UHR), 20 first episode psychosis (FEP), 54 chronic schizophrenia (CS), and 33 healthy controls (HC)—underwent psychiatric examination and diffusion tensor imaging (DTI) in a 3-Tesla MRI scanner. We assessed fractional anisotropy (FA) and mean diffusivity (MD) of the superior longitudinal fasciculus (SLF) and inferior longitudinal fasciculus (ILS). We found that CS patients had lower FA than FEP patients (p = 0.025) and HC (p = 0.088), and higher MD than HC (p = 0.037) in the right SLF. In the CS group, we found positive correlations of MD in both right ILF (rho = 0.39, p < 0.05) and SLF (rho = 0.43, p < 0.01) with disorganization symptoms, as well as negative correlation of FA in the right ILF with disorganization symptoms (rho = −0.43, p < 0.05). Among UHR individuals, we found significant negative correlations between MD in the left ILF and negative (r = −0.74, p < 0.05) and general symptoms (r = −0.77, p < 0.05). However promising, these findings should be treated as preliminary, and further research must verify whether they can be treated as potential biomarkers of psychosis.
Collapse
Affiliation(s)
- Katarzyna Waszczuk
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Ernest Tyburski
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Katarzyna Rek-Owodziń
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Piotr Plichta
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Krzysztof Rudkowski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Piotr Podwalski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Maksymilian Bielecki
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Monika Mak
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Adrianna Bober
- Institute of Psychology, University of Szczecin, Krakowska 69 Street, 71-017 Szczecin, Poland
| | - Błażej Misiak
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Leszek Sagan
- Department of Neurosurgery, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1 Street, 71-252 Szczecin, Poland
| | - Anna Michalczyk
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Jolanta Kucharska-Mazur
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| |
Collapse
|
7
|
Migliaccio R, Cacciamani F. The temporal lobe in typical and atypical Alzheimer disease. HANDBOOK OF CLINICAL NEUROLOGY 2022; 187:449-466. [PMID: 35964987 DOI: 10.1016/b978-0-12-823493-8.00004-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Alzheimer disease (AD) is defined neuropathologically by abnormal extra-cellular β-amyloid plaques combined with intraneuronal tau aggregation. Patients sharing the same neuropathological features but presenting different clinical manifestations and evolutions have led to the notion of AD spectrum. This spectrum encompasses typical and atypical forms of AD. For all of them, specific parts of the temporal lobes, as well as their structural and functional connections with other brain regions, are affected. In typical amnestic late-onset Alzheimer's disease (>65 years old; LOAD), tau pathology gradually spreads to the brain from the medial temporal lobe (MTL). MTL is an inhomogeneous structure consisting of several subregions densely connected to each other and to other cortical and subcortical brain regions. These regions play a crucial role in the storage of information in episodic memory. In less common early-onset AD (<65 years old; EOAD), a large proportion of patients presents atypical clinical manifestations, in which memory impairment is not inaugural and predominant. Instead, these patients have predominant and/or isolated deficits in language, visuospatial, motor, or executive/behavioral functions. In atypical variants, brain damage is mainly centered on the posterior regions, with relative sparing of the MTL. However, the temporal lobe also appears to be variably and specifically damaged in some subtypes of EOAD. For example, the left superior temporal gyrus is the core of brain damage in the language variant, as well as the ventral regions of the temporal lobe play an important role in the clinic of the visual variant.
Collapse
Affiliation(s)
- Raffaella Migliaccio
- Paris Brain Institute, INSERM U1127, Hôpital de la Pitié-Salpêtrière, Paris, France; Department of Neurology, Institut de la mémoire et de la maladie d'Alzheimer, Hôpital de la Pitié-Salpêtrière, Paris, France.
| | | |
Collapse
|
8
|
Borghesani V, DeLeon J, Gorno-Tempini ML. Frontotemporal dementia: A unique window on the functional role of the temporal lobes. HANDBOOK OF CLINICAL NEUROLOGY 2022; 187:429-448. [PMID: 35964986 PMCID: PMC9793689 DOI: 10.1016/b978-0-12-823493-8.00011-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Frontotemporal dementia (FTD) is an umbrella term covering a plethora of progressive changes in executive functions, motor abilities, behavior, and/or language. Different clinical syndromes have been described in relation to localized atrophy, informing on the functional networks that underlie these specific cognitive, emotional, and behavioral processes. These functional declines are linked with the underlying neurodegeneration of frontal and/or temporal lobes due to diverse molecular pathologies. Initially, the accumulation of misfolded proteins targets specifically susceptible cell assemblies, leading to relatively focal neurodegeneration that later spreads throughout large-scale cortical networks. Here, we discuss the most recent clinical, neuropathological, imaging, and genetics findings in FTD-spectrum syndromes affecting the temporal lobe. We focus on the semantic variant of primary progressive aphasia and its mirror image, the right temporal variant of FTD. Incipient focal atrophy of the left anterior temporal lobe (ATL) manifests with predominant naming, word comprehension, reading, and object semantic deficits, while cases of predominantly right ATL atrophy present with impairments of socioemotional, nonverbal semantic, and person-specific knowledge. Overall, the observations in FTD allow for crucial clinical-anatomic inferences, shedding light on the role of the temporal lobes in both cognition and complex behaviors. The concerted activity of both ATLs is critical to ensure that percepts are translated into concepts, yet important hemispheric differences should be acknowledged. On one hand, the left ATL attributes meaning to linguistic, external stimuli, thus supporting goal-oriented, action-related behaviors (e.g., integrating sounds and letters into words). On the other hand, the right ATL assigns meaning to emotional, visceral stimuli, thus guiding socially relevant behaviors (e.g., integrating body sensations into feelings of familiarity).
Collapse
Affiliation(s)
- Valentina Borghesani
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada; Department of Psychology, Université de Montréal, Montréal, QC, Canada.
| | - Jessica DeLeon
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, United States; Department of Neurology, Dyslexia Center, University of California, San Francisco, CA, United States
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, United States; Department of Neurology, Dyslexia Center, University of California, San Francisco, CA, United States
| |
Collapse
|
9
|
Tippett DC, Keser Z. Clinical and neuroimaging characteristics of primary progressive aphasia. HANDBOOK OF CLINICAL NEUROLOGY 2022; 185:81-97. [PMID: 35078612 PMCID: PMC9951770 DOI: 10.1016/b978-0-12-823384-9.00016-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The chapter covers the clinical syndrome of a primary progressive aphasia (PPA), the demographics of this rare neurodegenerative disease, defining clinical and neuroanatomic characteristics of each PPA variant, disease progression, and behavioral features. The chapter begins with a brief introduction that includes references to seminal papers that defined this clinical syndrome and its three variants. The classic PPA subtypes discussed in the chapter are semantic variant PPA (svPPA), nonfluent/agrammatic PPA (nfaPPA), and logopenic variant PPA (lvPPA). The key language and cognitive characteristics, and language tasks that can elicit these language impairments, are detailed. Overlap in the clinical profiles of the PPA variants, which make differential diagnosis challenging, are explained. Disease progression is described, revealing that the PPA variants become more similar over time. Although PPA is language-predominant dementia, there are behavioral manifestations, particularly in svPPA. Changes in behavior in this variant are addressed as well as behavioral changes in nfaPPA and lvPPA that are less well recognized. The patterns of atrophy in the left temporal, parietal, and/or frontal cortices unique to each PPA variant are described. The underlying neuropathologies of the PPA variants are discussed, specifically tauopathies and non-tauopathies associated with svPPA and nfaPPA and Alzheimer's disease pathology in lvPPA.
Collapse
Affiliation(s)
- Donna C. Tippett
- Departments of Neurology, Otolaryngology—Head and Neck Surgery, and Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Zafer Keser
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| |
Collapse
|
10
|
Ulugut H, Stek S, Wagemans LEE, Jutten RJ, Keulen MA, Bouwman FH, Prins ND, Lemstra AW, Krudop W, Teunissen CE, van Berckel BNM, Ossenkoppele R, Barkhof F, van der Flier WM, Scheltens P, Pijnenburg YAL. The natural history of primary progressive aphasia: beyond aphasia. J Neurol 2021; 269:1375-1385. [PMID: 34216263 PMCID: PMC8857134 DOI: 10.1007/s00415-021-10689-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/15/2021] [Accepted: 06/24/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Primary progressive aphasia (PPA) is divided into three prototypical subtypes that are all characterized by their single core symptom of aphasia. Although later in their course, other cognitive, behavioral, and motor domains may become involved, little is known about the progression profile of each subtype relative to the other subtypes. METHODS In this longitudinal retrospective cohort study, based on the recent biomarker-supported diagnostic criteria, 24 subjects diagnosed with semantic variant (svPPA), 22 with non-fluent variant (nfvPPA), and 18 with logopenic variant (lvPPA) were collected and followed up for 1-6 years. Symptom distribution, cognitive test and neuropsychiatric inventory scores, and progression into another syndrome were assessed. RESULTS Over time, lvPPA progressed with broader language problems (PPA-extended) and nfvPPA progressed to mutism, whereas semantic impairment remained the major problem in svPPA. Apart from linguistic problems, svPPA developed pronounced behavioral disturbances, whereas lvPPA exhibited a greater cognitive decline. By contrast, in nfvPPA motor deficits were more common. Furthermore, within 5 years (IQR = 2.5) after clinical onset, 65.6% of the patients additionally fulfilled the clinical criteria for another neurodegenerative syndrome (PPA-plus). Fourteen out of 24 (58%) svPPA patients additionally met the diagnostic criteria of behavioral variant frontotemporal dementia (5.1 years, IQR = 1.1), whereas the clinical features of 15/18 (83%) lvPPA patients were consistent with Alzheimer disease dementia (4.5 years IQR = 3.4). Furthermore, 12/22 (54%) of the subjects with the nfvPPA progressed to meet the diagnostic criteria of corticobasal syndrome, progressive supranuclear palsy, or motor neuron disease (5.1 years IQR = 3.4). DISCUSSION Despite aphasia being the initial and unique hallmark of the syndrome, our longitudinal results showed that PPA is not a language limited disorder and progression differs widely for each subtype, both with respect to the nature of symptoms and disease duration.
Collapse
Affiliation(s)
- Hulya Ulugut
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands.
| | - Simone Stek
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Lianne E E Wagemans
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Roos J Jutten
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Maria Antoinette Keulen
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Femke H Bouwman
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Niels D Prins
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Afina W Lemstra
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Welmoed Krudop
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Charlotte E Teunissen
- Neurological Laboratory Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Rik Ossenkoppele
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- UCL Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Wiesje M van der Flier
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| |
Collapse
|
11
|
Zemmoura I, Burkhardt E, Herbet G. The inferior longitudinal fasciculus: anatomy, function and surgical considerations. J Neurosurg Sci 2021; 65:590-604. [PMID: 33940783 DOI: 10.23736/s0390-5616.21.05391-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The inferior longitudinal fasciculus (ILF) is a large association white matter tract that interconnects, in a bidirectional manner, the occipital cortex to anterior temporal structures. In view of both its pattern of cortical projections and its recently evidenced multilayered anatomical organization, the ILF has been supposed to be vital for maintaining a wide range of cognitive and affective processes operating on the visual modality. As tumors commonly damage the temporal cortex, an updated knowledge of the functional anatomy of this ventral tract is needed to better map and monitor online its potential functions and thus to improve surgical outcomes. In this review, we first describe the gross anatomy of the ILF, its array of cortical terminations and its different layers. We then provide a comprehensive review of the functions that have been assigned to the tract. We successively address its role in object and face recognition, visual emotion recognition, language and semantic, including reading, and memory. It is especially shown that the ILF is critically involved in visually-guided behaviors, as its breakdown, both in sudden neurosurgical and progressive neurodegenerative diseases, is commonly associated with visual-specific neuropsychological syndromes (e.g. prosopagnosia and pure alexia, and so on). In the last section, we discuss the extent to which the ILF can reorganize in response to glioma infiltration and to surgery, and provide some reflections on how its intra-operative mapping may be refined.
Collapse
Affiliation(s)
- Ilyess Zemmoura
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France - .,CHRU de Tours, Neurosurgery Department, Tours, France -
| | - Eléonor Burkhardt
- Praxiling, CNRS UMR 5267, Paul Valéry Montpellier 3 University, Montpellier, France
| | - Guillaume Herbet
- Institute of Functional Genomics, University of Montpellier, CNRS UMR5203, INSERM U1191, Montpellier, France.,Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| |
Collapse
|
12
|
Dev SI, Dickerson BC, Touroutoglou A. Neuroimaging in Frontotemporal Lobar Degeneration: Research and Clinical Utility. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1281:93-112. [PMID: 33433871 DOI: 10.1007/978-3-030-51140-1_7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Frontotemporal lobar dementia (FTLD) is a clinically and pathologically complex disease. Advances in neuroimaging techniques have provided a specialized set of tools to investigate underlying pathophysiology and identify clinical biomarkers that aid in diagnosis, prognostication, monitoring, and identification of appropriate endpoints in clinical trials. In this chapter, we review data discussing the utility of neuroimaging biomarkers in sporadic FTLD, with an emphasis on current and future clinical applications. Among those modalities readily utilized in clinical settings, T1-weighted structural magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) are best supported in differential diagnosis and as targets for clinical trial endpoints. However, a number of nonclinical neuroimaging modalities, including diffusion tensor imaging and resting-state functional connectivity MRI, show promise as biomarkers to predict progression and as clinical trial endpoints. Other neuroimaging modalities, including amyloid PET, Tau PET, and arterial spin labeling MRI, are also discussed, though more work is required to establish their utility in FTLD in clinical settings.
Collapse
Affiliation(s)
- Sheena I Dev
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA.
| | - Alexandra Touroutoglou
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| |
Collapse
|
13
|
Feis RA, van der Grond J, Bouts MJRJ, Panman JL, Poos JM, Schouten TM, de Vos F, Jiskoot LC, Dopper EGP, van Buchem MA, van Swieten JC, Rombouts SARB. Classification using fractional anisotropy predicts conversion in genetic frontotemporal dementia, a proof of concept. Brain Commun 2021; 2:fcaa079. [PMID: 33543126 PMCID: PMC7846185 DOI: 10.1093/braincomms/fcaa079] [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] [Received: 11/04/2019] [Revised: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 11/14/2022] Open
Abstract
Frontotemporal dementia is a highly heritable and devastating neurodegenerative disease. About 10–20% of all frontotemporal dementia is caused by known pathogenic mutations, but a reliable tool to predict clinical conversion in mutation carriers is lacking. In this retrospective proof-of-concept case-control study, we investigate whether MRI-based and cognition-based classifiers can predict which mutation carriers from genetic frontotemporal dementia families will develop symptoms (‘convert’) within 4 years. From genetic frontotemporal dementia families, we included 42 presymptomatic frontotemporal dementia mutation carriers. We acquired anatomical, diffusion-weighted imaging, and resting-state functional MRI, as well as neuropsychological data. After 4 years, seven mutation carriers had converted to frontotemporal dementia (‘converters’), while 35 had not (‘non-converters’). We trained regularized logistic regression models on baseline MRI and cognitive data to predict conversion to frontotemporal dementia within 4 years, and quantified prediction performance using area under the receiver operating characteristic curves. The prediction model based on fractional anisotropy, with highest contribution of the forceps minor, predicted conversion to frontotemporal dementia beyond chance level (0.81 area under the curve, family-wise error corrected P = 0.025 versus chance level). Other MRI-based and cognitive features did not outperform chance level. Even in a small sample, fractional anisotropy predicted conversion in presymptomatic frontotemporal dementia mutation carriers beyond chance level. After validation in larger data sets, conversion prediction in genetic frontotemporal dementia may facilitate early recruitment into clinical trials.
Collapse
Affiliation(s)
- Rogier A Feis
- Department of Radiology, Leiden University Medical Centre, 2333 ZA, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, 2333 ZA, Leiden, the Netherlands.,Institute of Psychology, Leiden University, 2333 AK, Leiden, the Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Centre, 2333 ZA, Leiden, the Netherlands
| | - Mark J R J Bouts
- Department of Radiology, Leiden University Medical Centre, 2333 ZA, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, 2333 ZA, Leiden, the Netherlands.,Institute of Psychology, Leiden University, 2333 AK, Leiden, the Netherlands
| | - Jessica L Panman
- Department of Radiology, Leiden University Medical Centre, 2333 ZA, Leiden, the Netherlands.,Department of Neurology, Erasmus Medical Centre, 3015 GD, Rotterdam, the Netherlands
| | - Jackie M Poos
- Department of Radiology, Leiden University Medical Centre, 2333 ZA, Leiden, the Netherlands.,Department of Neurology, Erasmus Medical Centre, 3015 GD, Rotterdam, the Netherlands
| | - Tijn M Schouten
- Department of Radiology, Leiden University Medical Centre, 2333 ZA, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, 2333 ZA, Leiden, the Netherlands.,Institute of Psychology, Leiden University, 2333 AK, Leiden, the Netherlands
| | - Frank de Vos
- Department of Radiology, Leiden University Medical Centre, 2333 ZA, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, 2333 ZA, Leiden, the Netherlands.,Institute of Psychology, Leiden University, 2333 AK, Leiden, the Netherlands
| | - Lize C Jiskoot
- Department of Radiology, Leiden University Medical Centre, 2333 ZA, Leiden, the Netherlands.,Department of Neurology, Erasmus Medical Centre, 3015 GD, Rotterdam, the Netherlands.,Dementia Research Centre, University College London, London, WC1N 3AR, UK
| | - Elise G P Dopper
- Department of Radiology, Leiden University Medical Centre, 2333 ZA, Leiden, the Netherlands.,Department of Neurology, Erasmus Medical Centre, 3015 GD, Rotterdam, the Netherlands
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Centre, 2333 ZA, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, 2333 ZA, Leiden, the Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Centre, 3015 GD, Rotterdam, the Netherlands
| | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Centre, 2333 ZA, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, 2333 ZA, Leiden, the Netherlands.,Institute of Psychology, Leiden University, 2333 AK, Leiden, the Netherlands
| |
Collapse
|
14
|
Zhao Y, Ficek B, Webster K, Frangakis C, Caffo B, Hillis AE, Faria A, Tsapkini K. White Matter Integrity Predicts Electrical Stimulation (tDCS) and Language Therapy Effects in Primary Progressive Aphasia. Neurorehabil Neural Repair 2021; 35:44-57. [PMID: 33317422 PMCID: PMC7748290 DOI: 10.1177/1545968320971741] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS), in conjunction with language therapy, improves language therapy outcomes in primary progressive aphasia (PPA). However, no studies show whether white matter integrity predicts language therapy or tDCS effects in PPA. OBJECTIVE We aimed to determine whether white matter integrity, measured by diffusion tensor imaging (DTI), predicts written naming/spelling language therapy effects (letter accuracy on trained and untrained words) with and without tDCS over the left inferior frontal gyrus (IFG) in PPA. METHODS Thirty-nine participants with PPA were randomly assigned to tDCS or sham condition, coupled with language therapy for 15 daily sessions. White matter integrity was measured by mean diffusivity (MD) and fractional anisotropy (FA) in DTI scans before therapy. Written naming outcomes were evaluated before, immediately after, 2 weeks, and 2 months posttherapy. To assess tDCS treatment effect, we used a mixed-effects model with treatment evaluation and time interaction. We considered a forward model selection approach to identify brain regions/fasciculi of which white matter integrity can predict improvement in performance of word naming. RESULTS Both sham and tDCS groups significantly improved in trained items immediately after and at 2 months posttherapy. Improvement in the tDCS group was greater and generalized to untrained words. White matter integrity of ventral language pathways predicted tDCS effects in trained items whereas white matter integrity of dorsal language pathways predicted tDCS effects in untrained items. CONCLUSIONS White matter integrity influences both language therapy and tDCS effects. Thus, it holds promise as a biomarker for deciding which patients will benefit from language therapy and tDCS.
Collapse
Affiliation(s)
- Yi Zhao
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health
| | - Bronte Ficek
- Department of Neurology, Johns Hopkins School of Medicine
| | - Kimberly Webster
- Department of Neurology, Johns Hopkins School of Medicine
- Department of Otolaryngology-Head and Neck Surgery
| | - Constantine Frangakis
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health
- Department of Radiology, Johns Hopkins School of Medicine
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
| | - Brian Caffo
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins School of Medicine
- Department of Cognitive Science, Johns Hopkins University
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine
| | - Andreia Faria
- Department of Radiology, Johns Hopkins School of Medicine
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins School of Medicine
- Department of Cognitive Science, Johns Hopkins University
| |
Collapse
|
15
|
Ramanan S, Roquet D, Goldberg ZL, Hodges JR, Piguet O, Irish M, Lambon Ralph MA. Establishing two principal dimensions of cognitive variation in logopenic progressive aphasia. Brain Commun 2020; 2:fcaa125. [PMID: 33376980 PMCID: PMC7750924 DOI: 10.1093/braincomms/fcaa125] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/25/2020] [Accepted: 07/13/2020] [Indexed: 12/28/2022] Open
Abstract
Logopenic progressive aphasia is a neurodegenerative syndrome characterized by sentence repetition and naming difficulties arising from left-lateralized temporoparietal atrophy. Clinical descriptions of logopenic progressive aphasia largely concentrate on profiling language deficits, however, accumulating evidence points to the presence of cognitive deficits even on tasks with minimal language demands. Although non-linguistic cognitive deficits in logopenic progressive aphasia are thought to scale with disease severity, patients at discrete stages of language dysfunction display overlapping cognitive profiles, suggesting individual-level variation in cognitive performance, independent of primary language dysfunction. To address this issue, we used principal component analysis to decompose the individual-level variation in cognitive performance in 43 well-characterized logopenic progressive aphasia patients who underwent multi-domain neuropsychological assessments and structural neuroimaging. The principal component analysis solution revealed the presence of two, statistically independent factors, providing stable and clinically intuitive explanations for the majority of variance in cognitive performance in the syndrome. Factor 1 reflected 'speech production and verbal memory' deficits which typify logopenic progressive aphasia. Systematic variations were also confirmed on a second, orthogonal factor mainly comprising visuospatial and executive processes. Adopting a case-comparison approach, we further demonstrate that pairs of patients with comparable Factor 1 scores, regardless of their severity, diverge considerably on visuo-executive test performance, underscoring the inter-individual variability in cognitive profiles in comparably 'logopenic' patients. Whole-brain voxel-based morphometry analyses revealed that speech production and verbal memory factor scores correlated with left middle frontal gyrus, while visuospatial and executive factor scores were associated with grey matter intensity of right-lateralized temporoparietal, middle frontal regions and their underlying white matter connectivity. Importantly, logopenic progressive aphasia patients with poorer visuospatial and executive factor scores demonstrated greater right-lateralized temporoparietal and frontal atrophy. Our findings demonstrate the inherent variation in cognitive performance at an individual- and group-level in logopenic progressive aphasia, suggesting the presence of a genuine co-occurring cognitive impairment that is statistically independent of language function and disease severity.
Collapse
Affiliation(s)
- Siddharth Ramanan
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
- The University of Sydney, School of Psychology, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Daniel Roquet
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
- The University of Sydney, School of Psychology, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Zoë-Lee Goldberg
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
| | - John R Hodges
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
- The University of Sydney, School of Medical Sciences, Sydney, NSW, Australia
| | - Olivier Piguet
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
- The University of Sydney, School of Psychology, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - Muireann Irish
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, Australia
- The University of Sydney, School of Psychology, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | | |
Collapse
|
16
|
Abstract
BACKGROUND Semantic dementia (SD) is characterized by progressive semantic anomia extending to a multimodal loss of semantic knowledge. Although often considered an early-onset dementia, SD also occurs in later life, when it may be misdiagnosed as Alzheimer disease (AD). OBJECTIVE To evaluate late-onset SD in comparison to early-onset SD and to AD. METHODS We identified 74 individuals with SD and then compared those with late-onset SD (≥65 years of age) to those with early-onset SD (<65) on demographic and clinical features. We also compared a subgroup of 23 of the late-onset SD individuals with an equal number of individuals with clinically probable AD. RESULTS Twenty-six (35.1%) of the SD individuals were late onset, and 48 (64.9%) were early onset. There were no differences between the two groups on clinical measures, although greater asymmetry of temporal involvement trended to significance in the late-onset SD group. Compared to the 23 AD individuals, the subgroup of 23 late-onset SD individuals had worse performance on confrontational naming, irregular word reading, and face recognition; however, this subgroup displayed better verbal delayed recall and constructions. The late-onset SD individuals also experienced early personality changes at a time when most individuals with AD had not yet developed behavioral changes. CONCLUSIONS Approximately one-third of SD individuals may be late onset, and the differentiation of late-onset SD from AD can lead to better disease management, education, and prognosis. SD may be distinguished by screening for disproportionate changes in reading, face recognition, and personality.
Collapse
|
17
|
How the speed of word finding depends on ventral tract integrity in primary progressive aphasia. NEUROIMAGE-CLINICAL 2020; 28:102450. [PMID: 33395954 PMCID: PMC7586239 DOI: 10.1016/j.nicl.2020.102450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 11/26/2022]
Abstract
Noise words influence naming time, but not accuracy, more in PPA than in controls. Noise effect difference between PPA and controls reflects ventral tract integrity. The noise effect is smaller when ventral tract integrity is lower in the individuals with PPA. Simulations reveal that propagation of noise is reduced when tract integrity is low.
Primary progressive aphasia (PPA) is a clinical neurodegenerative syndrome with word finding problems as a core clinical symptom. Many aspects of word finding have been clarified in psycholinguistics using picture naming and a picture-word interference (PWI) paradigm, which emulates naming under contextual noise. However, little is known about how word finding depends on white-matter tract integrity, in particular, the atrophy of tracts located ventrally to the Sylvian fissure. To elucidate this question, we examined word finding in individuals with PPA and healthy controls employing PWI, tractography, and computer simulations using the WEAVER++ model of word finding. Twenty-three individuals with PPA and twenty healthy controls named pictures in two noise conditions. Mixed-effects modelling was performed on naming accuracy and reaction time (RT) and fixel-based tractography analyses were conducted to assess the relation between ventral white-matter integrity and naming performance. Naming RTs were longer for individuals with PPA compared to controls and, critically, individuals with PPA showed a larger noise effect compared to controls. Moreover, this difference in noise effect was differentially related to tract integrity. Whereas the noise effect did not depend much on tract integrity in controls, a lower tract integrity was related to a smaller noise effect in individuals with PPA. Computer simulations supported an explanation of this paradoxical finding in terms of reduced propagation of noise when tract integrity is low. By using multimodal analyses, our study indicates the significance of the ventral pathway for naming and the importance of RT measurement in the clinical assessment of PPA.
Collapse
|
18
|
Häkkinen S, Chu SA, Lee SE. Neuroimaging in genetic frontotemporal dementia and amyotrophic lateral sclerosis. Neurobiol Dis 2020; 145:105063. [PMID: 32890771 DOI: 10.1016/j.nbd.2020.105063] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/30/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023] Open
Abstract
Frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) have a strong clinical, genetic and pathological overlap. This review focuses on the current understanding of structural, functional and molecular neuroimaging signatures of genetic FTD and ALS. We overview quantitative neuroimaging studies on the most common genes associated with FTD (MAPT, GRN), ALS (SOD1), and both (C9orf72), and summarize visual observations of images reported in the rarer genes (CHMP2B, TARDBP, FUS, OPTN, VCP, UBQLN2, SQSTM1, TREM2, CHCHD10, TBK1).
Collapse
Affiliation(s)
- Suvi Häkkinen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Stephanie A Chu
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Suzee E Lee
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
| |
Collapse
|
19
|
Nicolas R, Hiba B, Dilharreguy B, Barse E, Baillet M, Edde M, Pelletier A, Periot O, Helmer C, Allard M, Dartigues JF, Amieva H, Pérès K, Fernandez P, Catheline G. Changes Over Time of Diffusion MRI in the White Matter of Aging Brain, a Good Predictor of Verbal Recall. Front Aging Neurosci 2020; 12:218. [PMID: 32922282 PMCID: PMC7456903 DOI: 10.3389/fnagi.2020.00218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/19/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: Extensive research using water-diffusion MRI reported age-related modifications of cerebral White Matter (WM). Moreover, water-diffusion parameter modifications have been frequently associated with cognitive performances in the elderly sample, reinforcing the idea of aging inducing microstructural disconnection of the brain which in turn impacts cognition. However, only few studies really assessed over-time modifications of these parameters and their relationship with episodic memory outcome of elderly. Materials and Methods: One-hundred and thirty elderly subjects without dementia (74.1 ± 4.1 years; 47% female) were included in this study. Diffusion tensor imaging (DTI) was performed at two-time points (3.49 ± 0.68 years apart), allowing the assessment of changes in water-diffusion parameters over time using a specific longitudinal pipeline. White matter hyperintensity (WMH) burden and gray matter (GM) atrophy were also measured on FLAIR and T1-weighted sequences collected during these two MRI sessions. Free and cued verbal recall scores assessed at the last follow-up of the cohort were used as episodic memory outcome. Changes in water-diffusion parameters over time were included in serial linear regression models to predict retrieval or storage ability of elderly. Results: GM atrophy and an increase in mean diffusivity (MD) and WMH load between the two-time points were observed. The increase in MD was significantly correlated with WMH load and the different memory scores. In models accounting for the baseline cognitive score, GM atrophy, or WMH load, MD changes still significantly predict free verbal recall, and not total verbal recall, suggesting the specific association with the retrieval deficit in healthy aging. Conclusion: In elderly, microstructural WM changes are good predictors of lower free verbal recall performances. Moreover, this contribution is not only driven by WMH load increase. This last observation is in line with studies reporting early water-diffusion modification in WM tissue during aging, resulting lately in the appearance of WMH on conventional MRI.
Collapse
Affiliation(s)
- Renaud Nicolas
- Université de Bordeaux, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,CNRS, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France
| | - Bassem Hiba
- Université de Bordeaux, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,CNRS, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France
| | - Bixente Dilharreguy
- Université de Bordeaux, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,CNRS, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France
| | - Elodie Barse
- Université de Bordeaux, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,CNRS, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,Laboratoire Neuroimagerie et vie quotidienne, EPHE-PSL University, Bordeaux, France
| | - Marion Baillet
- Université de Bordeaux, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,CNRS, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,Laboratoire Neuroimagerie et vie quotidienne, EPHE-PSL University, Bordeaux, France
| | - Manon Edde
- Université de Bordeaux, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,CNRS, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,Laboratoire Neuroimagerie et vie quotidienne, EPHE-PSL University, Bordeaux, France
| | - Amandine Pelletier
- Université de Bordeaux, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,CNRS, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,Laboratoire Neuroimagerie et vie quotidienne, EPHE-PSL University, Bordeaux, France
| | - Olivier Periot
- Université de Bordeaux, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,CNRS, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France
| | - Catherine Helmer
- Université de Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health Research Center, Bordeaux, France.,INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Heath Research Center, Bordeaux, France
| | - Michele Allard
- Université de Bordeaux, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,CNRS, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,Service de Médecine Nucléaire, CHU de Bordeaux, Bordeaux, France
| | - Jean-François Dartigues
- Université de Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health Research Center, Bordeaux, France.,INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Heath Research Center, Bordeaux, France.,CMRR, CHU de Bordeaux, Bordeaux, France
| | - Hélène Amieva
- Université de Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health Research Center, Bordeaux, France.,INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Heath Research Center, Bordeaux, France
| | - Karine Pérès
- Université de Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health Research Center, Bordeaux, France.,INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Heath Research Center, Bordeaux, France
| | - Philippe Fernandez
- Université de Bordeaux, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,CNRS, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,Service de Médecine Nucléaire, CHU de Bordeaux, Bordeaux, France
| | - Gwénaëlle Catheline
- Université de Bordeaux, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,CNRS, INCIA, UMR 5287-équipe NeuroImagerie et Cognition Humaine, Bordeaux, France.,Laboratoire Neuroimagerie et vie quotidienne, EPHE-PSL University, Bordeaux, France
| |
Collapse
|
20
|
Utianski RL, Botha H, Whitwell JL, Martin PR, Schwarz CG, Duffy JR, Clark HM, Spychalla AJ, Senjem ML, Petersen RC, Knopman DS, Jack CR, Lowe VJ, Josephs KA. Longitudinal flortaucipir ([ 18F]AV-1451) PET uptake in semantic dementia. Neurobiol Aging 2020; 92:135-140. [PMID: 32417749 PMCID: PMC7365267 DOI: 10.1016/j.neurobiolaging.2020.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 04/07/2020] [Accepted: 04/09/2020] [Indexed: 11/23/2022]
Abstract
To assess volume loss and flortaucipir uptake in patients with semantic dementia (SD) over time. Eight SD patients (3 female) underwent clinical evaluations, flortaucipir positron emission tomography, and brain magnetic resonance imaging at 2 visits. Voxel-level comparisons of magnetic resonance imaging gray and white matter volume loss and flortaucipir positron emission tomography uptake were performed in SPM12, comparing SD patients to controls at each visit. T-tests on difference images and paired t-tests of flortaucipir uptake were also performed. At the voxel level, SD patients showed asymmetric, bilateral gray volume loss in the temporal lobes, which, via visual inspection, extended posteriorly at follow-up. White matter loss and flortaucipir uptake were noted in SD patients in the left temporal lobe only, which appeared to extend posteriorly, without involvement of the right hemisphere at follow-up. Longitudinal analyses did not support significant changes in flortaucipir uptake between visits. The biological mechanisms of flortaucipir signal in suspected underlying TAR-DNA binding protein 43 pathology are unknown. A 1-year interval is not sufficient time to demonstrate significant longitudinal flortaucipir uptake changes in SD.
Collapse
Affiliation(s)
| | - Hugo Botha
- Departments of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Peter R Martin
- Departments of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Joseph R Duffy
- Departments of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Matthew L Senjem
- Departments of Radiology, Mayo Clinic, Rochester, MN, USA; Departments of Information Technology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Val J Lowe
- Departments of Radiology, Mayo Clinic, Rochester, MN, USA
| | | |
Collapse
|
21
|
Ramanan S, Marstaller L, Hodges JR, Piguet O, Irish M. Understanding the neural basis of episodic amnesia in logopenic progressive aphasia: A multimodal neuroimaging study. Cortex 2020; 125:272-287. [DOI: 10.1016/j.cortex.2019.12.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/19/2019] [Accepted: 12/21/2019] [Indexed: 12/13/2022]
|
22
|
Herbet G, Duffau H. Revisiting the Functional Anatomy of the Human Brain: Toward a Meta-Networking Theory of Cerebral Functions. Physiol Rev 2020; 100:1181-1228. [PMID: 32078778 DOI: 10.1152/physrev.00033.2019] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
For more than one century, brain processing was mainly thought in a localizationist framework, in which one given function was underpinned by a discrete, isolated cortical area, and with a similar cerebral organization across individuals. However, advances in brain mapping techniques in humans have provided new insights into the organizational principles of anatomo-functional architecture. Here, we review recent findings gained from neuroimaging, electrophysiological, as well as lesion studies. Based on these recent data on brain connectome, we challenge the traditional, outdated localizationist view and propose an alternative meta-networking theory. This model holds that complex cognitions and behaviors arise from the spatiotemporal integration of distributed but relatively specialized networks underlying conation and cognition (e.g., language, spatial cognition). Dynamic interactions between such circuits result in a perpetual succession of new equilibrium states, opening the door to considerable interindividual behavioral variability and to neuroplastic phenomena. Indeed, a meta-networking organization underlies the uniquely human propensity to learn complex abilities, and also explains how postlesional reshaping can lead to some degrees of functional compensation in brain-damaged patients. We discuss the major implications of this approach in fundamental neurosciences as well as for clinical developments, especially in neurology, psychiatry, neurorehabilitation, and restorative neurosurgery.
Collapse
Affiliation(s)
- Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors," INSERM U1191, Institute of Functional Genomics, Montpellier, France; and University of Montpellier, Montpellier, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors," INSERM U1191, Institute of Functional Genomics, Montpellier, France; and University of Montpellier, Montpellier, France
| |
Collapse
|
23
|
Del Tufo SN, Earle FS, Cutting LE. The impact of expressive language development and the left inferior longitudinal fasciculus on listening and reading comprehension. J Neurodev Disord 2019; 11:37. [PMID: 31838999 PMCID: PMC6912995 DOI: 10.1186/s11689-019-9296-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 11/11/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND During the first 3-years of life, as the brain undergoes dramatic growth, children begin to develop speech and language. Hallmarks of this progression are seen when children reach developmental milestones, forming the foundation of language. Expressive language milestones, such as the production of a child's first word, are delayed in 5-8% of children. While for some children delays in reaching these milestones are harbingers of developmental disorders, for others expressive language delays appear to resolve. Regardless of whether or not early language skills appear resolved, difficulty with later comprehension is a likely outcome. Whether this heightened risk for poor comprehension differs based on text features, individual characteristics, or receipt of intervention remains unknown. Moreover, this relationship between expressive language development and comprehension is not yet linked to neurobiology, though the inferior longitudinal fasciculus (ILF) is a potential neurobiological correlate. Therefore, we investigated the impact of, and interactions between, expressive language development, early intervention, and the ILF on comprehension. METHODS Longitudinal recurrent survival analyses predicted the risk of answering a comprehension question incorrectly. Predictors of comprehension included expressive language development, passage features, participant characteristics, fractional anisotropy, receipt of early intervention, and later diagnosis of speech or language disorders. RESULTS Children with later expressive language milestones had poorer comprehension. When comprehension text features were examined, children with later milestones had poorer listening and reading comprehension, and poorer narrative and expository comprehension. The left ILF acted as a neurodevelopmental correlate, one that moderated the relationship between expressive language milestones and comprehension. Specifically, the left ILF exacerbated the relationship for those who did not receive early intervention and buffered the relationship for those who received intervention services. Early intervention decreased the risk of poor comprehension by 39% for children later diagnosed with a speech or language disorder. CONCLUSIONS Early intervention should be provided for children with delayed expressive language milestones, particularly those who are at risk for speech or language disorders. The ILF plays a critical role in the relationship between expressive language development and comprehension, which may be that of a protective factor for children with the most severe early issues with speech and language.
Collapse
Affiliation(s)
- Stephanie N Del Tufo
- Peabody College of Education and Human Development, Vanderbilt University, 416C One Magnolia Circle, Box 228, Nashville, TN, 37203, USA.,Vanderbilt Brain Institute, Vanderbilt University School of Medicine, 6133 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, USA.,Vanderbilt Kennedy Center, Vanderbilt University, 110 Magnolia Circle, Nashville, TN, 37203, USA.,College of Education and Human Development, University of Delaware, 106 Alison Hall West, Newark, DE, 19716, USA
| | - F Sayako Earle
- Communication Sciences and Disorders, University of Delaware, 100 Discovery Boulevard, Newark, DE, 19713, USA
| | - Laurie E Cutting
- Peabody College of Education and Human Development, Vanderbilt University, 416C One Magnolia Circle, Box 228, Nashville, TN, 37203, USA. .,Vanderbilt Brain Institute, Vanderbilt University School of Medicine, 6133 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, USA. .,Vanderbilt Kennedy Center, Vanderbilt University, 110 Magnolia Circle, Nashville, TN, 37203, USA.
| |
Collapse
|
24
|
Cocquyt EM, Lanckmans E, van Mierlo P, Duyck W, Szmalec A, Santens P, De Letter M. The white matter architecture underlying semantic processing: A systematic review. Neuropsychologia 2019; 136:107182. [PMID: 31568774 DOI: 10.1016/j.neuropsychologia.2019.107182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 09/02/2019] [Accepted: 09/03/2019] [Indexed: 12/23/2022]
Abstract
From a holistic point of view, semantic processes are subserved by large-scale subcortico-cortical networks. The dynamic routing of information between grey matter structures depends on the integrity of subcortical white matter pathways. Nonetheless, controversy remains on which of these pathways support semantic processing. Therefore, a systematic review of the literature was performed with a focus on anatomo-functional correlations obtained from direct electrostimulation during awake tumor surgery, and conducted between diffusion tensor imaging metrics and behavioral semantic performance in healthy and aphasic individuals. The 43 included studies suggest that the left inferior fronto-occipital fasciculus contributes to the essential connectivity that allows semantic processing. However, it remains uncertain whether its contributive role is limited to the organization of semantic knowledge or extends to the level of semantic control. Moreover, the functionality of the left uncinate fasciculus, inferior longitudinal fasciculus and the posterior segment of the indirect arcuate fasciculus in semantic processing has to be confirmed by future research.
Collapse
Affiliation(s)
- E-M Cocquyt
- Department of Rehabilitation Sciences, Ghent University, Belgium; Research Group BrainComm, Ghent University, Belgium.
| | - E Lanckmans
- Department of Rehabilitation Sciences, Ghent University, Belgium; Research Group BrainComm, Ghent University, Belgium
| | - P van Mierlo
- Research Group BrainComm, Ghent University, Belgium; Department of Electronics and Information Systems, Medical Image and Signal Processing Group, Ghent University, Belgium
| | - W Duyck
- Faculty of Psychology and Educational Sciences, Department of Experimental Psychology, Ghent University, Belgium
| | - A Szmalec
- Faculty of Psychology and Educational Sciences, Department of Experimental Psychology, Ghent University, Belgium; Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - P Santens
- Research Group BrainComm, Ghent University, Belgium; Department of Neurology, Ghent University Hospital, Belgium
| | - M De Letter
- Department of Rehabilitation Sciences, Ghent University, Belgium; Research Group BrainComm, Ghent University, Belgium
| |
Collapse
|
25
|
Staffaroni AM, Ljubenkov PA, Kornak J, Cobigo Y, Datta S, Marx G, Walters SM, Chiang K, Olney N, Elahi FM, Knopman DS, Dickerson BC, Boeve BF, Gorno-Tempini ML, Spina S, Grinberg LT, Seeley WW, Miller BL, Kramer JH, Boxer AL, Rosen HJ. Longitudinal multimodal imaging and clinical endpoints for frontotemporal dementia clinical trials. Brain 2019; 142:443-459. [PMID: 30698757 DOI: 10.1093/brain/awy319] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 11/02/2018] [Indexed: 12/22/2022] Open
Abstract
Frontotemporal dementia refers to a group of progressive neurodegenerative syndromes usually caused by the accumulation of pathological tau or TDP-43 proteins. The effects of these proteins in the brain are complex, and each can present with several different clinical syndromes. Clinical efficacy trials of drugs targeting these proteins must use endpoints that are meaningful to all participants despite the variability in symptoms across patients. There are many candidate clinical measures, including neuropsychological scores and functional measures. Brain imaging is another potentially attractive outcome that can be precisely quantified and provides evidence of disease modification. Most imaging studies in frontotemporal dementia have been cross-sectional, and few have compared longitudinal changes in cortical volume with changes in other measures such as perfusion and white matter integrity. The current study characterized longitudinal changes in 161 patients with three frontotemporal dementia syndromes: behavioural variant frontotemporal dementia (n = 77) and the semantic (n = 45) and non-fluent (n = 39) variants of primary progressive aphasia. Visits included comprehensive neuropsychological and functional assessment, structural MRI (3 T), diffusion tensor imaging, and arterial spin labelled perfusion imaging. The goal was to identify measures that are appropriate as clinical trial outcomes for each group, as well as those that might be appropriate for trials that would include more than one of these groups. Linear mixed effects models were used to estimate changes in each measure, and to examine the correlation between imaging and clinical changes. Sample sizes were estimated based on the observed effects for theoretical clinical trials using bootstrapping techniques to provide 95% confidence intervals for these estimates. Declines in functional and neuropsychological measures, as well as frontal and temporal cortical volumes and white matter microstructure were detected in all groups. Imaging changes were statistically significantly correlated with, and explained a substantial portion of variance in, the change in most clinical measures. Perfusion and diffusion tensor imaging accounted for variation in clinical decline beyond volume alone. Sample size estimates for atrophy and diffusion imaging were comparable to clinical measures. Corpus callosal fractional anisotropy led to the lowest sample size estimates for all three syndromes. These findings provide further guidance on selection of trial endpoints for studies in frontotemporal dementia and support the use of neuroimaging, particularly structural and diffusion weighted imaging, as biomarkers. Diffusion and perfusion imaging appear to offer additional utility for explaining clinical change beyond the variance explained by volume alone, arguing for considering multimodal imaging in treatment trials.
Collapse
Affiliation(s)
- Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Peter A Ljubenkov
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Samir Datta
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Gabe Marx
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Samantha M Walters
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Kevin Chiang
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Nick Olney
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Fanny M Elahi
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - David S Knopman
- Department of Neurology, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, Minnesota USA
| | - Bradford C Dickerson
- Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charleston, MA, USA
| | - Bradley F Boeve
- Department of Neurology, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, Minnesota USA
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Salvatore Spina
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Lea T Grinberg
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA.,Department of Pathology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA.,Department of Pathology - LIM 22, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - William W Seeley
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA.,Department of Pathology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Joel H Kramer
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| |
Collapse
|
26
|
Ash S, Nevler N, Phillips J, Irwin DJ, McMillan CT, Rascovsky K, Grossman M. A longitudinal study of speech production in primary progressive aphasia and behavioral variant frontotemporal dementia. BRAIN AND LANGUAGE 2019; 194:46-57. [PMID: 31075725 PMCID: PMC6656376 DOI: 10.1016/j.bandl.2019.04.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 02/10/2019] [Accepted: 04/22/2019] [Indexed: 05/03/2023]
Abstract
We examined longitudinal change in language expression during a semi-structured speech sample in 48 patients with primary progressive aphasia (PPA) or behavioral variant frontotemporal dementia (bvFTD) and related this to longitudinal neuroimaging of cortical thickness available in 25 of these patients. All patient groups declined significantly on measures of both speech fluency and grammar, although patients with nonfluent/agrammatic PPA (naPPA) declined to a greater extent than patients with the semantic variant, the logopenic variant, and bvFTD. These patient groups also declined on several neuropsychological measures, but there was no correlation between decline in speech expression and decline in neuropsychological performance. Longitudinal decline in grammaticality, assessed by the number of well-formed sentences produced, was associated with longitudinal progression of gray matter atrophy in left frontal operculum/insula and bilateral temporal cortex.
Collapse
Affiliation(s)
- Sharon Ash
- Penn Frontotemporal Degeneration Center and Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, United States.
| | - Naomi Nevler
- Penn Frontotemporal Degeneration Center and Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, United States
| | - Jeffrey Phillips
- Penn Frontotemporal Degeneration Center and Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, United States
| | - David J Irwin
- Penn Frontotemporal Degeneration Center and Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, United States
| | - Corey T McMillan
- Penn Frontotemporal Degeneration Center and Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, United States
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center and Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, United States
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center and Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, United States
| |
Collapse
|
27
|
Leyton CE, Landin-Romero R, Liang CT, Burrell JR, Kumfor F, Hodges JR, Piguet O. Correlates of anomia in non-semantic variants of primary progressive aphasia converge over time. Cortex 2019; 120:201-211. [PMID: 31325799 DOI: 10.1016/j.cortex.2019.06.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/08/2019] [Accepted: 06/18/2019] [Indexed: 12/12/2022]
Abstract
To track neural correlates of naming performance with disease progression, we estimated key areas affected in nonfluent/agrammatic (nfvPPA) and logopenic (lvPPA) primary progressive aphasia variants over time and changes in naming correlates over time. Twenty-nine non-semantic PPA participants (17 nfvPPA and 12 lvPPA) were selected based upon current diagnostic criteria and PiB-PET status and conducted a confrontation-naming task and a structural MRI. Linear mixed-effect models implemented in FreeSurfer were used for tracking cortical thickness and epicenters of atrophy over time. Using averaged cortical thickness of epicenters and naming performance as variables of interest, two sets of multivariate analyses were conducted to compare atrophy progression and naming correlates across groups. While all PPA participants demonstrated naming deterioration and progressive cortical thinning in the left temporal lobe and the left inferior frontal gyrus, the lvPPA cohort showed greater naming deterioration and thinning in the left posterior inferior parietal cortex over time than it did the nfvPPA cohort. The multivariate analyses confirmed a widespread cortical thinning in lvPPA over time, but a more rapid thinning in the right superior frontal gyrus of nfvPPA participants. Impaired naming correlated with common cortical regions in both groups. These regions included the left anterior superior temporal gyrus and the posterior middle temporal gyrus, which was primarily affected in lvPPA. Non-semantic PPA variants initially present with separate epicenters of atrophy and different spatial-temporal patterns of neurodegeneration over time, but the common involvement in key cortical regions of the left temporal lobe accounts for naming deterioration in both groups.
Collapse
Affiliation(s)
- Cristian E Leyton
- The University of Sydney, Brain and Mind Centre, Faculty of Health Sciences, Sydney, NSW, Australia; Frontotemporal Disorders Unit, Department of Neurology Massachusetts, General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Ramon Landin-Romero
- The University of Sydney, Brain and Mind Centre, School of Psychology, Sydney, NSW, Australia.
| | - Cheng Tao Liang
- The University of Sydney, Brain and Mind Centre, School of Psychology, Sydney, NSW, Australia.
| | - James R Burrell
- Concord Repatriation General Hospital, Sydney, NSW, Australia.
| | - Fiona Kumfor
- The University of Sydney, Brain and Mind Centre, School of Psychology, Sydney, NSW, Australia.
| | - John R Hodges
- The University of Sydney, Brain and Mind Centre, School of Psychology, Sydney, NSW, Australia.
| | - Olivier Piguet
- The University of Sydney, Brain and Mind Centre, School of Psychology, Sydney, NSW, Australia.
| |
Collapse
|
28
|
Pineault J, Jolicœur P, Grimault S, Lacombe J, Brambati SM, Bier N, Chayer C, Joubert S. A MEG study of the neural substrates of semantic processing in semantic variant primary progressive aphasia. Neurocase 2019; 25:118-129. [PMID: 31256711 DOI: 10.1080/13554794.2019.1631853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Despite a well-documented pattern of semantic impairment, the patterns of brain activation during semantic processing in semantic variant primary progressive aphasia (svPPA) still remain poorly understood. In the current study, one svPPA patient (EC) and six elderly controls carried out a general-level semantic categorization task while their brain activity was recorded using magnetoencephalography (MEG). Despite similar behavioral performance, EC showed hyperactivation of the left inferior temporal gyrus (ITG) and right anterior temporal lobe (ATL) relative to controls. This suggests that periatrophic regions within the ATL region may support preserved semantic abilities in svPPA.
Collapse
Affiliation(s)
- Jessica Pineault
- a Département de psychologie , Université de Montréal , Montréal , Canada.,b Centre de Recherche, Institut Universitaire de Gériatrie de Montréal , Université de Montréal , Montréal , Canada
| | - Pierre Jolicœur
- a Département de psychologie , Université de Montréal , Montréal , Canada.,c Centre de Recherche en Neuropsychologie et Cognition , Université de Montréal , Montréal , Canada
| | - Stephan Grimault
- a Département de psychologie , Université de Montréal , Montréal , Canada.,c Centre de Recherche en Neuropsychologie et Cognition , Université de Montréal , Montréal , Canada
| | - Jacinthe Lacombe
- a Département de psychologie , Université de Montréal , Montréal , Canada.,b Centre de Recherche, Institut Universitaire de Gériatrie de Montréal , Université de Montréal , Montréal , Canada
| | - Simona Maria Brambati
- a Département de psychologie , Université de Montréal , Montréal , Canada.,b Centre de Recherche, Institut Universitaire de Gériatrie de Montréal , Université de Montréal , Montréal , Canada
| | - Nathalie Bier
- b Centre de Recherche, Institut Universitaire de Gériatrie de Montréal , Université de Montréal , Montréal , Canada.,d Faculté de médecine , Université de Montréal , Montréal , Canada
| | - Céline Chayer
- d Faculté de médecine , Université de Montréal , Montréal , Canada.,e Service de neurologie , Hôpital Maisonneuve-Rosemont , Montréal , Canada
| | - Sven Joubert
- a Département de psychologie , Université de Montréal , Montréal , Canada.,b Centre de Recherche, Institut Universitaire de Gériatrie de Montréal , Université de Montréal , Montréal , Canada
| |
Collapse
|
29
|
Lagarde J, Hahn V, Sarazin M. Afasia primaria progressiva. Neurologia 2019. [DOI: 10.1016/s1634-7072(19)42020-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
30
|
Abstract
Frontotemporal dementia (FTD) is a common young-onset dementia presenting with heterogeneous and distinct syndromes. It is characterized by progressive deficits in behavior, language, and executive function. The disease may exhibit similar characteristics to many psychiatric disorders owing to its prominent behavioral features. The concept of precision medicine has recently emerged, and it involves neurodegenerative disease treatment that is personalized to match an individual's specific pattern of neuroimaging, neuropathology, and genetic variability. In this paper, the pathophysiology underlying FTD, which is characterized by the selective degeneration of the frontal and temporal cortices, is reviewed. We also discuss recent advancements in FTD research from the perspectives of clinical, imaging, molecular characterizations, and treatment. This review focuses on the approach of precision medicine to manage the clinical and biological complexities of FTD.
Collapse
Affiliation(s)
- Mu-N Liu
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, Memory and Aging Centre, University of California, San Francisco, San Francisco, CA, United States
| | - Chi-Ieong Lau
- Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, United Kingdom.,College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
| | - Ching-Po Lin
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan.,Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
| |
Collapse
|
31
|
Steinacker P, Barschke P, Otto M. Biomarkers for diseases with TDP-43 pathology. Mol Cell Neurosci 2018; 97:43-59. [PMID: 30399416 DOI: 10.1016/j.mcn.2018.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 10/26/2018] [Accepted: 10/29/2018] [Indexed: 01/01/2023] Open
Abstract
The discovery that aggregated transactive response DNA-binding protein 43 kDa (TDP-43) is the major component of pathological ubiquitinated inclusions in amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD) caused seminal progress in the unveiling of the genetic bases and molecular characteristics of these now so-called TDP-43 proteinopathies. Substantial increase in the knowledge of clinic-pathological coherencies, especially for FTLD variants, could be made in the last decade, but also revealed a considerable complexity of TDP-43 pathology and often a poor correlation of clinical and molecular disease characteristics. To date, an underlying TDP-43 pathology can be predicted only for patients with mutations in the genes C9orf72 and GRN, but is dependent on neuropathological verification in patients without family history, which represent the majority of cases. As etiology-specific therapies for neurodegenerative proteinopathies are emerging, methods to forecast TDP-43 pathology at patients' lifetime are highly required. Here, we review the current status of research pursued to identify specific indicators to predict or exclude TDP-43 pathology in the ALS-FTLD spectrum disorders and findings on candidates for prognosis and monitoring of disease progression in TDP-43 proteinopathies with a focus on TDP-43 with its pathological forms, neurochemical and imaging biomarkers.
Collapse
Affiliation(s)
| | - Peggy Barschke
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany.
| |
Collapse
|
32
|
Herbet G, Zemmoura I, Duffau H. Functional Anatomy of the Inferior Longitudinal Fasciculus: From Historical Reports to Current Hypotheses. Front Neuroanat 2018; 12:77. [PMID: 30283306 PMCID: PMC6156142 DOI: 10.3389/fnana.2018.00077] [Citation(s) in RCA: 184] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/30/2018] [Indexed: 12/13/2022] Open
Abstract
The inferior longitudinal fasciculus (ILF) is a long-range, associative white matter pathway that connects the occipital and temporal-occipital areas of the brain to the anterior temporal areas. In view of the ILF's anatomic connections, it has been suggested that this pathway has a major role in a relatively large array of brain functions. Until recently, however, the literature data on these potential functions were scarce. Here, we review the key findings of recent anatomic, neuromodulation, and neuropsychological studies. We also summarize reports on how this tract is disrupted in a wide range of brain disorders, including psychopathologic, neurodevelopmental, and neurologic diseases. Our review reveals that the ILF is a multilayered, bidirectional tract involved in processing and modulating visual cues and thus in visually guided decisions and behaviors. Accordingly, sudden disruption of the ILF by neurologic insult is mainly associated with neuropsychological impairments of visual cognition (e.g., visual agnosia, prosopagnosia, and alexia). Furthermore, disruption of the ILF may constitute the pathophysiologic basis for visual hallucinations and socio-emotional impairments in schizophrenia, as well as emotional difficulties in autism spectrum disorder. Degeneration of the ILF in neurodegenerative diseases affecting the temporal lobe may explain (at least in part) the gradual onset of semantic and lexical access difficulties. Although some of the functions mediated by the ILF appear to be relatively lateralized, observations from neurosurgery suggest that disruption of the tract's anterior portion can be dynamically compensated for by the contralateral portion. This might explain why bilateral disruption of the ILF in either acute or progressive disease is highly detrimental in neuropsychological terms.
Collapse
Affiliation(s)
- Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- INSERM-1051, Team 4, Saint-Eloi Hospital, Institute for Neurosciences of Montpellier, Montpellier, France
- University of Montpellier, Montpellier, France
| | - Ilyess Zemmoura
- Department of Neurosurgery, Tours University Medical Center, Tours, France
- UMR 1253, iBrain, INSERM, University of Tours, Tours, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- INSERM-1051, Team 4, Saint-Eloi Hospital, Institute for Neurosciences of Montpellier, Montpellier, France
- University of Montpellier, Montpellier, France
| |
Collapse
|
33
|
Montembeault M, Brambati SM, Gorno-Tempini ML, Migliaccio R. Clinical, Anatomical, and Pathological Features in the Three Variants of Primary Progressive Aphasia: A Review. Front Neurol 2018; 9:692. [PMID: 30186225 PMCID: PMC6110931 DOI: 10.3389/fneur.2018.00692] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/31/2018] [Indexed: 11/22/2022] Open
Abstract
Primary progressive aphasias (PPA) are neurodegenerative diseases clinically characterized by an early and relatively isolated language impairment. Three main clinical variants, namely the nonfluent/agrammatic variant (nfvPPA), the semantic variant (svPPA), and the logopenic variant (lvPPA) have been described, each with specific linguistic/cognitive deficits, corresponding anatomical and most probable pathological features. Since the discovery and the development of diagnostic criteria for the PPA variants by the experts in the field, significant progress has been made in the understanding of these diseases. This review aims to provide an overview of the literature on each of the PPA variant in terms of their clinical, anatomical and pathological features, with a specific focus on recent findings. In terms of clinical advancements, recent studies have allowed a better characterization and differentiation of PPA patients based on both their linguistic and non-linguistic profiles. In terms of neuroimaging, techniques such as diffusion imaging and resting-state fMRI have allowed a deeper understanding of the impact of PPA on structural and functional connectivity alterations beyond the well-defined pattern of regional gray matter atrophy. Finally, in terms of pathology, despite significant advances, clinico-pathological correspondence in PPA remains far from absolute. Nonetheless, the improved characterization of PPA has the potential to have a positive impact on the management of patients. Improved reliability of diagnoses and the development of reliable in vivo biomarkers for underlying neuropathology will also be increasingly important in the future as trials for etiology-specific treatments become available.
Collapse
Affiliation(s)
- Maxime Montembeault
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle Épinière (ICM), FrontLab, Paris, France.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.,Département de Psychologie, Université de Montréal, Montréal, QC, Canada
| | - Simona M Brambati
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.,Département de Psychologie, Université de Montréal, Montréal, QC, Canada
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, University of California at San Francisco, San Francisco, CA, United States
| | - Raffaella Migliaccio
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, and Université Pierre et Marie Curie-Paris 6, UMR S 1127, Institut du Cerveau et de la Moelle Épinière (ICM), FrontLab, Paris, France.,Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Paris, France
| |
Collapse
|
34
|
Herbet G, Moritz-Gasser S, Lemaitre AL, Almairac F, Duffau H. Functional compensation of the left inferior longitudinal fasciculus for picture naming. Cogn Neuropsychol 2018; 36:140-157. [DOI: 10.1080/02643294.2018.1477749] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- Institute for Neuroscience of Montpellier, INSERM U1051 (Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors research group), Montpellier, France
- Department of Medicine, University of Montpellier, Montpellier, France
| | - Sylvie Moritz-Gasser
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- Institute for Neuroscience of Montpellier, INSERM U1051 (Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors research group), Montpellier, France
- Department of Medicine, University of Montpellier, Montpellier, France
| | - Anne-Laure Lemaitre
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- Department of Psychology, University of Lille, Lille, France
| | - Fabien Almairac
- Department of Neurosurgery, Nice University Medical Center, Nice, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- Institute for Neuroscience of Montpellier, INSERM U1051 (Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors research group), Montpellier, France
- Department of Medicine, University of Montpellier, Montpellier, France
| |
Collapse
|
35
|
Herbet G, Moritz-Gasser S, Boiseau M, Duvaux S, Cochereau J, Duffau H. Converging evidence for a cortico-subcortical network mediating lexical retrieval. Brain 2018; 139:3007-3021. [PMID: 27604309 DOI: 10.1093/brain/aww220] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 07/13/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France.,Institute for Neuroscience of Montpellier (INM), INSERM-1051, Team 4, Saint-Eloi Hospital, Montpellier University Medical Center, F-34091, Montpellier, France
| | - Sylvie Moritz-Gasser
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France.,Institute for Neuroscience of Montpellier (INM), INSERM-1051, Team 4, Saint-Eloi Hospital, Montpellier University Medical Center, F-34091, Montpellier, France.,Department of Neurology, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France
| | - Morgane Boiseau
- Department of Neurology, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France
| | - Sophie Duvaux
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France
| | - Jérôme Cochereau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France.,Institute for Neuroscience of Montpellier (INM), INSERM-1051, Team 4, Saint-Eloi Hospital, Montpellier University Medical Center, F-34091, Montpellier, France
| |
Collapse
|
36
|
Rae CL, Davies G, Garfinkel SN, Gabel MC, Dowell NG, Cercignani M, Seth AK, Greenwood KE, Medford N, Critchley HD. Deficits in Neurite Density Underlie White Matter Structure Abnormalities in First-Episode Psychosis. Biol Psychiatry 2017; 82:716-725. [PMID: 28359565 DOI: 10.1016/j.biopsych.2017.02.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 01/30/2017] [Accepted: 02/08/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Structural abnormalities across multiple white matter tracts are recognized in people with early psychosis, consistent with dysconnectivity as a neuropathological account of symptom expression. We applied advanced neuroimaging techniques to characterize microstructural white matter abnormalities for a deeper understanding of the developmental etiology of psychosis. METHODS Thirty-five first-episode psychosis patients, and 19 healthy controls, participated in a quantitative neuroimaging study using neurite orientation dispersion and density imaging, a multishell diffusion-weighted magnetic resonance imaging technique that distinguishes white matter fiber arrangement and geometry from changes in neurite density. Fractional anisotropy (FA) and mean diffusivity images were also derived. Tract-based spatial statistics compared white matter structure between patients and control subjects and tested associations with age, symptom severity, and medication. RESULTS Patients with first-episode psychosis had lower regional FA in multiple commissural, corticospinal, and association tracts. These abnormalities predominantly colocalized with regions of reduced neurite density, rather than aberrant fiber bundle arrangement (orientation dispersion index). There was no direct relationship with active symptoms. FA decreased and orientation dispersion index increased with age in patients, but not control subjects, suggesting accelerated effects of white matter geometry change. CONCLUSIONS Deficits in neurite density appear fundamental to abnormalities in white matter integrity in early psychosis. In the first application of neurite orientation dispersion and density imaging in psychosis, we found that processes compromising axonal fiber number, density, and myelination, rather than processes leading to spatial disruption of fiber organization, are implicated in the etiology of psychosis. This accords with a neurodevelopmental origin of aberrant brain-wide structural connectivity predisposing individuals to psychosis.
Collapse
Affiliation(s)
- Charlotte L Rae
- Sackler Centre for Consciousness Science, University of Sussex, Falmer, Brighton; Division of Neuroscience, University of Sussex, Falmer, Brighton.
| | - Geoff Davies
- Brighton & Sussex Medical School, School of Psychology, University of Sussex, Falmer, Brighton; Sussex Partnership National Health Service Foundation Trust, United Kingdom
| | - Sarah N Garfinkel
- Sackler Centre for Consciousness Science, University of Sussex, Falmer, Brighton; Division of Neuroscience, University of Sussex, Falmer, Brighton
| | - Matt C Gabel
- Division of Neuroscience, University of Sussex, Falmer, Brighton
| | | | - Mara Cercignani
- Division of Neuroscience, University of Sussex, Falmer, Brighton
| | - Anil K Seth
- Sackler Centre for Consciousness Science, University of Sussex, Falmer, Brighton; School of Engineering & Informatics, University of Sussex, Falmer, Brighton
| | - Kathryn E Greenwood
- Brighton & Sussex Medical School, School of Psychology, University of Sussex, Falmer, Brighton; Sussex Partnership National Health Service Foundation Trust, United Kingdom
| | - Nick Medford
- Sackler Centre for Consciousness Science, University of Sussex, Falmer, Brighton; Division of Neuroscience, University of Sussex, Falmer, Brighton; Sussex Partnership National Health Service Foundation Trust, United Kingdom
| | - Hugo D Critchley
- Sackler Centre for Consciousness Science, University of Sussex, Falmer, Brighton; Division of Neuroscience, University of Sussex, Falmer, Brighton; Sussex Partnership National Health Service Foundation Trust, United Kingdom
| |
Collapse
|
37
|
Staffaroni AM, Elahi FM, McDermott D, Marton K, Karageorgiou E, Sacco S, Paoletti M, Caverzasi E, Hess CP, Rosen HJ, Geschwind MD. Neuroimaging in Dementia. Semin Neurol 2017; 37:510-537. [PMID: 29207412 PMCID: PMC5823524 DOI: 10.1055/s-0037-1608808] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Although the diagnosis of dementia still is primarily based on clinical criteria, neuroimaging is playing an increasingly important role. This is in large part due to advances in techniques that can assist with discriminating between different syndromes. Magnetic resonance imaging remains at the core of differential diagnosis, with specific patterns of cortical and subcortical changes having diagnostic significance. Recent developments in molecular PET imaging techniques have opened the door for not only antemortem but early, even preclinical, diagnosis of underlying pathology. This is vital, as treatment trials are underway for pharmacological agents with specific molecular targets, and numerous failed trials suggest that earlier treatment is needed. This article provides an overview of classic neuroimaging findings as well as new and cutting-edge research techniques that assist with clinical diagnosis of a range of dementia syndromes, with an emphasis on studies using pathologically proven cases.
Collapse
Affiliation(s)
- Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Fanny M. Elahi
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Dana McDermott
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Kacey Marton
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Elissaios Karageorgiou
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
- Neurological Institute of Athens, Athens, Greece
| | - Simone Sacco
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
- Institute of Radiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Matteo Paoletti
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
- Institute of Radiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Eduardo Caverzasi
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Christopher P. Hess
- Division of Neuroradiology, Department of Radiology, University of California, San Francisco (UCSF), California
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Michael D. Geschwind
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| |
Collapse
|
38
|
Elahi FM, Marx G, Cobigo Y, Staffaroni AM, Kornak J, Tosun D, Boxer AL, Kramer JH, Miller BL, Rosen HJ. Longitudinal white matter change in frontotemporal dementia subtypes and sporadic late onset Alzheimer's disease. NEUROIMAGE-CLINICAL 2017; 16:595-603. [PMID: 28975068 PMCID: PMC5614750 DOI: 10.1016/j.nicl.2017.09.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 08/17/2017] [Accepted: 09/06/2017] [Indexed: 12/14/2022]
Abstract
Background Degradation of white matter microstructure has been demonstrated in frontotemporal lobar degeneration (FTLD) and Alzheimer's disease (AD). In preparation for clinical trials, ongoing studies are investigating the utility of longitudinal brain imaging for quantification of disease progression. To date only one study has examined sample size calculations based on longitudinal changes in white matter integrity in FTLD. Objective To quantify longitudinal changes in white matter microstructural integrity in the three canonical subtypes of frontotemporal dementia (FTD) and AD using diffusion tensor imaging (DTI). Methods 60 patients with clinical diagnoses of FTD, including 27 with behavioral variant frontotemporal dementia (bvFTD), 14 with non-fluent variant primary progressive aphasia (nfvPPA), and 19 with semantic variant PPA (svPPA), as well as 19 patients with AD and 69 healthy controls were studied. We used a voxel-wise approach to calculate annual rate of change in fractional anisotropy (FA) and mean diffusivity (MD) in each group using two time points approximately one year apart. Mean rates of change in FA and MD in 48 atlas-based regions-of-interest, as well as global measures of cognitive function were used to calculate sample sizes for clinical trials (80% power, alpha of 5%). Results All FTD groups showed statistically significant baseline and longitudinal white matter degeneration, with predominant involvement of frontal tracts in the bvFTD group, frontal and temporal tracts in the PPA groups and posterior tracts in the AD group. Longitudinal change in MD yielded a larger number of regions with sample sizes below 100 participants per therapeutic arm in comparison with FA. SvPPA had the smallest sample size based on change in MD in the fornix (n = 41 participants per study arm to detect a 40% effect of drug), and nfvPPA and AD had their smallest sample sizes based on rate of change in MD within the left superior longitudinal fasciculus (n = 49 for nfvPPA, and n = 23 for AD). BvFTD generally showed the largest sample size estimates (minimum n = 140 based on MD in the corpus callosum). The corpus callosum appeared to be the best region for a potential study that would include all FTD subtypes. Change in global measure of functional status (CDR box score) yielded the smallest sample size for bvFTD (n = 71), but clinical measures were inferior to white matter change for the other groups. Conclusions All three of the canonical subtypes of FTD are associated with significant change in white matter integrity over one year. These changes are consistent enough that drug effects in future clinical trials could be detected with relatively small numbers of participants. While there are some differences in regions of change across groups, the genu of the corpus callosum is a region that could be used to track progression in studies that include all subtypes. We show longitudinal change in white matter in frontotemporal lobar degeneration (FTLD) and Alzheimer’s disease (AD). We use diffusion tensor imaging (DTI) to quantify rate of white matter degeneration in FTLD and AD. In preparation for clinical trials, utility of longitudinal DTI as surrogate marker of therapeutic efficacy is investigated. We produce sample sizes based on rate of change in DTI metrics in the three canonical subtypes of FTLD and AD.
Collapse
Affiliation(s)
- Fanny M Elahi
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, United States
| | - Gabe Marx
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, United States
| | - Yann Cobigo
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, United States
| | - Adam M Staffaroni
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, United States
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
| | - Duygu Tosun
- Department of Veteran Affairs Medical Center, San Francisco, CA, United States.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, United States
| | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, United States
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, United States
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, United States
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, United States
| |
Collapse
|
39
|
Meeter LH, Kaat LD, Rohrer JD, van Swieten JC. Imaging and fluid biomarkers in frontotemporal dementia. Nat Rev Neurol 2017. [PMID: 28621768 DOI: 10.1038/nrneurol.2017.75] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Frontotemporal dementia (FTD), the second most common type of presenile dementia, is a heterogeneous neurodegenerative disease characterized by progressive behavioural and/or language problems, and includes a range of clinical, genetic and pathological subtypes. The diagnostic process is hampered by this heterogeneity, and correct diagnosis is becoming increasingly important to enable future clinical trials of disease-modifying treatments. Reliable biomarkers will enable us to better discriminate between FTD and other forms of dementia and to predict disease progression in the clinical setting. Given that different underlying pathologies probably require specific pharmacological interventions, robust biomarkers are essential for the selection of patients with specific FTD subtypes. This Review emphasizes the increasing availability and potential applications of structural and functional imaging biomarkers, and cerebrospinal fluid and blood fluid biomarkers in sporadic and genetic FTD. The relevance of new MRI modalities - such as voxel-based morphometry, diffusion tensor imaging and arterial spin labelling - in the early stages of FTD is discussed, together with the ability of these modalities to classify FTD subtypes. We highlight promising new fluid biomarkers for staging and monitoring of FTD, and underline the importance of large, multicentre studies of individuals with presymptomatic FTD. Harmonization in the collection and analysis of data across different centres is crucial for the implementation of new biomarkers in clinical practice, and will become a great challenge in the next few years.
Collapse
Affiliation(s)
- Lieke H Meeter
- Department of Neurology, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, Netherlands
| | - Laura Donker Kaat
- Department of Neurology, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, Netherlands.,Department of Clinical Genetics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, Netherlands
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative diseases, Institute of Neurology, Queen Square, University College London, London WC1N 3BG, UK
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, Netherlands.,Department of Clinical Genetics, VU University Medical Center, De Boelelaan 1118, 1081 HZ Amsterdam, Netherlands
| |
Collapse
|
40
|
Gordon E, Rohrer JD, Fox NC. Advances in neuroimaging in frontotemporal dementia. J Neurochem 2017; 138 Suppl 1:193-210. [PMID: 27502125 DOI: 10.1111/jnc.13656] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/02/2016] [Accepted: 05/03/2016] [Indexed: 12/12/2022]
Abstract
Frontotemporal dementia (FTD) is a clinically and neuroanatomically heterogeneous neurodegenerative disorder with multiple underlying genetic and pathological causes. Whilst initial neuroimaging studies highlighted the presence of frontal and temporal lobe atrophy or hypometabolism as the unifying feature in patients with FTD, more detailed studies have revealed diverse patterns across individuals, with variable frontal or temporal predominance, differing degrees of asymmetry, and the involvement of other cortical areas including the insula and cingulate, as well as subcortical structures such as the basal ganglia and thalamus. Recent advances in novel imaging modalities including diffusion tensor imaging, resting-state functional magnetic resonance imaging and molecular positron emission tomography imaging allow the possibility of investigating alterations in structural and functional connectivity and the visualisation of pathological protein deposition. This review will cover the major imaging modalities currently used in research and clinical practice, focusing on the key insights they have provided into FTD, including the onset and evolution of pathological changes and also importantly their utility as biomarkers for disease detection and staging, differential diagnosis and measurement of disease progression. Validating neuroimaging biomarkers that are able to accomplish these tasks will be crucial for the ultimate goal of powering upcoming clinical trials by correctly stratifying patient enrolment and providing sensitive markers for evaluating the effects and efficacy of disease-modifying therapies. This review describes the key insights provided by research into the major neuroimaging modalities currently used in research and clinical practice, including what they tell us about the onset and evolution of FTD and how they may be used as biomarkers for disease detection and staging, differential diagnosis and measurement of disease progression. This article is part of the Frontotemporal Dementia special issue.
Collapse
Affiliation(s)
- Elizabeth Gordon
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| |
Collapse
|
41
|
Leyton CE, Hodges JR, Piguet O, Ballard KJ. Common and divergent neural correlates of anomia in amnestic and logopenic presentations of Alzheimer's disease. Cortex 2017; 86:45-54. [DOI: 10.1016/j.cortex.2016.10.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 10/12/2016] [Accepted: 10/24/2016] [Indexed: 11/16/2022]
|
42
|
Landin-Romero R, Tan R, Hodges JR, Kumfor F. An update on semantic dementia: genetics, imaging, and pathology. ALZHEIMERS RESEARCH & THERAPY 2016; 8:52. [PMID: 27915998 PMCID: PMC5137205 DOI: 10.1186/s13195-016-0219-5] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Progressive and relatively circumscribed loss of semantic knowledge, referred to as semantic dementia (SD) which falls under the broader umbrella of frontotemporal dementia, was officially identified as a clinical syndrome less than 50 years ago. Here, we review recent neuroimaging, pathological, and genetic research in SD. From a neuroimaging perspective, SD is characterised by hallmark asymmetrical atrophy of the anterior temporal pole and anterior fusiform gyrus, which is usually left lateralised. Functional magnetic resonance imaging (fMRI) studies have revealed widespread changes in connectivity, implicating the anterior temporal regions in semantic deficits in SD. Task-related fMRI have also demonstrated the relative preservation of frontal and parietal regions alongside preserved memory performance. In addition, recent longitudinal studies have demonstrated that, with disease progression, atrophy encroaches into the contralateral temporal pole and medial prefrontal cortices, which reflects emerging changes in behaviour and social cognition. Notably, unlike other frontotemporal dementia subtypes, recent research has demonstrated strong clinicopathological concordance in SD, with TDP43 type C as the most common pathological subtype. Moreover, an underlying genetic cause appears to be relatively rare in SD, with the majority of cases having a sporadic form of the disease. The relatively clear diagnosis, clinical course, and pathological homogeneity of SD make this syndrome a promising target for novel disease-modifying interventions. The development of neuroimaging markers of disease progression at the individual level is an important area of research for future studies to address, in order to assist with this endeavour.
Collapse
Affiliation(s)
- Ramon Landin-Romero
- Neuroscience Research Australia, PO Box 1165, Randwick, Sydney, NSW, 2031, Australia.,School of Medical Sciences, the University of New South Wales, Sydney, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Rachel Tan
- Neuroscience Research Australia, PO Box 1165, Randwick, Sydney, NSW, 2031, Australia.,School of Medical Sciences, the University of New South Wales, Sydney, Australia
| | - John R Hodges
- Neuroscience Research Australia, PO Box 1165, Randwick, Sydney, NSW, 2031, Australia.,School of Medical Sciences, the University of New South Wales, Sydney, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Fiona Kumfor
- Neuroscience Research Australia, PO Box 1165, Randwick, Sydney, NSW, 2031, Australia. .,School of Medical Sciences, the University of New South Wales, Sydney, Australia. .,ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia.
| |
Collapse
|