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De Francesco S, Crema C, Archetti D, Muscio C, Reid RI, Nigri A, Bruzzone MG, Tagliavini F, Lodi R, D'Angelo E, Boeve B, Kantarci K, Firbank M, Taylor JP, Tiraboschi P, Redolfi A. Differential diagnosis of neurodegenerative dementias with the explainable MRI based machine learning algorithm MUQUBIA. Sci Rep 2023; 13:17355. [PMID: 37833302 PMCID: PMC10575864 DOI: 10.1038/s41598-023-43706-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Biomarker-based differential diagnosis of the most common forms of dementia is becoming increasingly important. Machine learning (ML) may be able to address this challenge. The aim of this study was to develop and interpret a ML algorithm capable of differentiating Alzheimer's dementia, frontotemporal dementia, dementia with Lewy bodies and cognitively normal control subjects based on sociodemographic, clinical, and magnetic resonance imaging (MRI) variables. 506 subjects from 5 databases were included. MRI images were processed with FreeSurfer, LPA, and TRACULA to obtain brain volumes and thicknesses, white matter lesions and diffusion metrics. MRI metrics were used in conjunction with clinical and demographic data to perform differential diagnosis based on a Support Vector Machine model called MUQUBIA (Multimodal Quantification of Brain whIte matter biomArkers). Age, gender, Clinical Dementia Rating (CDR) Dementia Staging Instrument, and 19 imaging features formed the best set of discriminative features. The predictive model performed with an overall Area Under the Curve of 98%, high overall precision (88%), recall (88%), and F1 scores (88%) in the test group, and good Label Ranking Average Precision score (0.95) in a subset of neuropathologically assessed patients. The results of MUQUBIA were explained by the SHapley Additive exPlanations (SHAP) method. The MUQUBIA algorithm successfully classified various dementias with good performance using cost-effective clinical and MRI information, and with independent validation, has the potential to assist physicians in their clinical diagnosis.
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Affiliation(s)
- Silvia De Francesco
- Laboratory of Neuroinformatics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Claudio Crema
- Laboratory of Neuroinformatics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Damiano Archetti
- Laboratory of Neuroinformatics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Cristina Muscio
- ASST Bergamo Ovest, Bergamo, Italy
- Division of Neurology V/Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Robert I Reid
- Department of Information Technology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
| | - Anna Nigri
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Maria Grazia Bruzzone
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Fabrizio Tagliavini
- Scientific Directorate, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Raffaele Lodi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Egidio D'Angelo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Brad Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael Firbank
- Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne, UK
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne, UK
| | - Pietro Tiraboschi
- Division of Neurology V/Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alberto Redolfi
- Laboratory of Neuroinformatics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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van Staalduinen EK, Zeineh MM. Medial Temporal Lobe Anatomy. Neuroimaging Clin N Am 2022; 32:475-489. [PMID: 35843657 DOI: 10.1016/j.nic.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The medial temporal lobe (MTL) is a complex anatomic region encompassing the hippocampal formation, parahippocampal region, and amygdaloid complex. To enable the reader to understand the well-studied regional anatomic relationships and cytoarchitecture that form the basis of functional connectivity, the authors have created a detailed yet approachable anatomic reference for clinicians and scientists, with special attention to MR imaging. They have focused primarily on the hippocampal formation, discussing its gross structural features, anatomic relationships, and subfield anatomy and further discuss hippocampal terminology and development, hippocampal connectivity, normal anatomic variants, clinically relevant disease processes, and automated hippocampal segmentation software.
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Affiliation(s)
| | - Michael M Zeineh
- Department of Radiology, Stanford University, 1201 Welch Road, Room P271, Stanford, CA 94305, USA.
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McKeever A, Paris AF, Cullen J, Hayes L, Ritchie CW, Ritchie K, Waldman AD, Wells K, Busza A, Carriere I, O'Brien JT, Su L. Hippocampal Subfield Volumes in Middle-Aged Adults at Risk of Dementia. J Alzheimers Dis 2021; 75:1211-1218. [PMID: 32417786 DOI: 10.3233/jad-200238] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) begins decades before the onset of dementia. There is a need to investigate biomarkers of early AD for use in clinical trials and to facilitate early intervention. OBJECTIVE We aimed to determine whether changes in hippocampal subfield volumes in healthy middle-aged adults were associated with risk of future dementia. METHODS We included 150 participants from the PREVENT-Dementia cohort, which recruited subjects aged 40-59 with or without a family history of dementia (FHD; included here were 81 with FHD and 69 without). Hippocampal subfield volumes were segmented from high resolution T2-weighted 3T MRI images taken at baseline and 2-year follow-up. RESULTS FHD and greater 20 year-risk of dementia due to cardiovascular risk factors were both associated with lower CA1 volume. FHD was also associated with a relative increase in combined CA3, CA4, and dentate gyrus volume between baseline and follow-up. CONCLUSION CA1 atrophy may commence as early as middle-age in those with a high risk of future dementia, while increases in CA3, CA4, and dentate gyrus volume may be a response to early AD in the form of inflammation or neurogenesis.
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Affiliation(s)
- Anna McKeever
- Department of Psychiatry, University of Cambridge, UK
| | - Alvar F Paris
- Department of Psychiatry, University of Cambridge, UK
| | - James Cullen
- Department of Psychiatry, University of Cambridge, UK
| | | | | | - Karen Ritchie
- Centre for Dementia Prevention, University of Edinburgh, UK.,Inserm, University Montpellier, France
| | - Adam D Waldman
- Centre for Dementia Prevention, University of Edinburgh, UK
| | - Katie Wells
- The Centre for Psychiatry, Imperial College London, UK
| | - Albert Busza
- Clinical Imaging Facility, Imperial College London, UK
| | | | | | - Li Su
- Department of Psychiatry, University of Cambridge, UK
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Mak E, Nicastro N, Malpetti M, Savulich G, Surendranathan A, Holland N, Passamonti L, Jones PS, Carter SF, Su L, Hong YT, Fryer TD, Williams GB, Aigbirhio F, Rowe JB, O'Brien JT. Imaging tau burden in dementia with Lewy bodies using [ 18F]-AV1451 positron emission tomography. Neurobiol Aging 2020; 101:172-180. [PMID: 33631469 PMCID: PMC8209140 DOI: 10.1016/j.neurobiolaging.2020.11.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/27/2020] [Accepted: 11/07/2020] [Indexed: 12/16/2022]
Abstract
Alzheimer's disease (AD) pathology is frequently observed as a comorbidity in people with dementia with Lewy bodies (DLB). Here, we evaluated the in vivo distribution of tau burden and its influence on the clinical phenotype of DLB. Tau deposition was quantified using [18F]-AV1451 positron emission tomography in people with DLB (n = 10), AD (n = 27), and healthy controls (n = 14). A subset of patients with Lewy body diseases (n = 4) also underwent [11C]-PK11195 positron emission tomography to estimate microglial activation. [18F]-AV1451 BPND was lower in DLB than AD across widespread regions. The medial temporal lobe [18F]-AV1451 BPND distinguished people with DLB from AD (AUC = 0.87), and negatively correlated with Addenbrooke's Cognitive Examination-Revised and Mini-Mental State Examination. There was a high degree of colocalization between [18F]-AV1451 and [11C]-PK11195 binding (p < 0.001). Our findings of minimal tau burden in DLB confirm previous studies. Nevertheless, the associations of [18F]-AV1451 binding with cognitive impairment suggest that tau may interact synergistically with other pathologic processes to aggravate disease severity in DLB. We evaluated [18F]-AV1451 uptake in dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). There is minimal tau deposition in DLB compared to healthy controls. Tau imaging may be useful for differential diagnosis of DLB and AD. Tau deposition was correlated with cognitive impairment in DLB.
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Affiliation(s)
- Elijah Mak
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Nicolas Nicastro
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK; Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Maura Malpetti
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - George Savulich
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Ajenthan Surendranathan
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Negin Holland
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Luca Passamonti
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - P Simon Jones
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Stephen F Carter
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Li Su
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Young T Hong
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK; Wolfson Brain Imaging Centre, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Tim D Fryer
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK; Wolfson Brain Imaging Centre, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Guy B Williams
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK; Wolfson Brain Imaging Centre, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Franklin Aigbirhio
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - John T O'Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
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Huang L, Chen K, Hu X, Guo Q. Differential Atrophy in the Hippocampal Subfield Volumes in Four Types of Mild Dementia. Front Neurosci 2020; 14:699. [PMID: 32742253 PMCID: PMC7364129 DOI: 10.3389/fnins.2020.00699] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/09/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To investigate the bilateral hippocampal subfield volumetric differences in four types of mild dementia, namely typical Alzheimer's disease (tAD), dementia with Lewy bodies (DLB), semantic dementia (SD), and posterior cortical atrophy (PCA), to assist differential diagnosis. METHODS One hundred three participants, including 22 tAD, 34 SD (17 left SD and 17 right SD), 15 DLB, 12 PCA patients, and 20 normal controls (NC), were recruited. All subjects received standard neuropsychological assessments and magnetic resonance imaging (MRI). The hippocampal subfields were automatically segmented via Freesurfer. The study compared the volumetric differences and used the receiver operating characteristic (ROC) curves to estimate the efficacy of each hippocampal subfield to distinguish between groups. Spearman correlation analysis was used to investigate the relationship between memory recall scores and hippocampal subfield volumes. RESULTS The hippocampal subfield atrophy varied in different groups: tAD, SD, and PCA patients had subregional atrophy in bilateral hippocampi compared to NC, and DLB patients showed preserved volumes; left SD patients suffered the most severe atrophy of the left hippocampus, and right SD patients were atrophied mostly in the right hippocampus. There was no significant difference in the volume of hippocampal subregions between tAD and PCA subjects, but the former tended to be atrophied more asymmetrically. ROC analysis showed that, for discrimination, the areas under the curve (AUC) of some subfields were larger than the total hippocampus, but none observed significant difference. In addition, immediate recall scores were correlated to left CA1, CA2/3, CA4/DG, subiculum, and presubiculum (p < 0.05), and delayed recall scores were strongly related to bilateral CA2/3, CA4/DG, subiculum, and presubiculum (r = 0.38-0.52, p < 0.05). CONCLUSION Differential atrophy patterns in the bilateral hippocampal subfield volumes could serve the differential diagnosis in patients with different causes of mild dementia: left CA1 for tAD; left presubiculum for LSD; right CA4/DG, right presubiculum, and right subiculum for RSD; CA4/DG and right CA2/3 for DLB; right CA2/3 and right CA4/DG for PCA. Additionally, several hippocampal subfield volumes were significantly associated with memory scores, further highlighting the essential role of the hippocampus in memory decline.
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Affiliation(s)
- Lin Huang
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Keliang Chen
- Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaochen Hu
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Qihao Guo
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
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van den Noort M, Vermeire K, Bosch P, Staudte H, Krajenbrink T, Jaswetz L, Struys E, Yeo S, Barisch P, Perriard B, Lee SH, Lim S. A Systematic Review on the Possible Relationship Between Bilingualism, Cognitive Decline, and the Onset of Dementia. Behav Sci (Basel) 2019; 9:E81. [PMID: 31340609 PMCID: PMC6680432 DOI: 10.3390/bs9070081] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 12/20/2022] Open
Abstract
A systematic review was conducted to investigate whether bilingualism has a protective effect against cognitive decline in aging and can protect against dementia. We searched the Medline, ScienceDirect, Scopus, and ERIC databases with a cut-off date of 31 March, 2019, thereby following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocol. Our search resulted in 34 eligible studies. Mixed results were found with respect to the protective effect of bilingualism against cognitive decline. Several studies showed a protective effect whereas other studies failed to find it. Moreover, evidence for a delay of the onset of dementia of between 4 and 5.5 years in bilingual individuals compared to monolinguals was found in several studies, but not in all. Methodological differences in the set-up of the studies seem to explain these mixed results. Lifelong bilingualism is a complex individual process, and many factors seem to influence this and need to be further investigated. This can be best achieved through large longitudinal studies with objective behavioral and neuroimaging measurements. In conclusion, although some evidence was found for a cognitive reserve-enhancing effect of lifelong bilingualism and protection against dementia, to date, no firm conclusions can be drawn.
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Affiliation(s)
- Maurits van den Noort
- Research Group of Pain and Neuroscience, Kyung Hee University, Seoul 130-701, Korea.
- Brussels Institute for Applied Linguistics, Vrije Universiteit Brussel, Brussels 1050, Belgium.
| | - Katrien Vermeire
- Department of Communication Sciences and Disorders, Long Island University (LIU) Brooklyn, Brooklyn, NY 11201, USA
| | - Peggy Bosch
- Psychiatric Research Group, LVR-Klinik Bedburg-Hau, 47511 Bedburg-Hau, Germany
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, 6525 Nijmegen, The Netherlands
| | - Heike Staudte
- Psychiatric Research Group, LVR-Klinik Bedburg-Hau, 47511 Bedburg-Hau, Germany
| | - Trudy Krajenbrink
- Department of Medicine, Neurology, University of Fribourg, 1700 Fribourg, Switzerland
| | - Lars Jaswetz
- Behavioural Science Institute, Radboud University, 6525 Nijmegen, The Netherlands
| | - Esli Struys
- Brussels Institute for Applied Linguistics, Vrije Universiteit Brussel, Brussels 1050, Belgium
| | - Sujung Yeo
- College of Oriental Medicine, Sang Ji University, Wonju 26339, Korea
| | - Pia Barisch
- Department of Psychology, Ruhr University Bochum, 44801 Bochum, Germany
| | - Benoît Perriard
- Department of Medicine, Neurology, University of Fribourg, 1700 Fribourg, Switzerland
| | - Sook-Hyun Lee
- Research Group of Pain and Neuroscience, Kyung Hee University, Seoul 130-701, Korea
| | - Sabina Lim
- Research Group of Pain and Neuroscience, Kyung Hee University, Seoul 130-701, Korea.
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Risacher SL, Saykin AJ. Neuroimaging in aging and neurologic diseases. HANDBOOK OF CLINICAL NEUROLOGY 2019; 167:191-227. [PMID: 31753134 DOI: 10.1016/b978-0-12-804766-8.00012-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neuroimaging biomarkers for neurologic diseases are important tools, both for understanding pathology associated with cognitive and clinical symptoms and for differential diagnosis. This chapter explores neuroimaging measures, including structural and functional measures from magnetic resonance imaging (MRI) and molecular measures primarily from positron emission tomography (PET), in healthy aging adults and in a number of neurologic diseases. The spectrum covers neuroimaging measures from normal aging to a variety of dementias: late-onset Alzheimer's disease [AD; including mild cognitive impairment (MCI)], familial and nonfamilial early-onset AD, atypical AD syndromes, posterior cortical atrophy (PCA), logopenic aphasia (lvPPA), cerebral amyloid angiopathy (CAA), vascular dementia (VaD), sporadic and familial behavioral-variant frontotemporal dementia (bvFTD), semantic dementia (SD), progressive nonfluent aphasia (PNFA), frontotemporal dementia with motor neuron disease (FTD-MND), frontotemporal dementia with amyotrophic lateral sclerosis (FTD-ALS), corticobasal degeneration (CBD), progressive supranuclear palsy (PSP), dementia with Lewy bodies (DLB), Parkinson's disease (PD) with and without dementia, and multiple systems atrophy (MSA). We also include a discussion of the appropriate use criteria (AUC) for amyloid imaging and conclude with a discussion of differential diagnosis of neurologic dementia disorders in the context of neuroimaging.
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Affiliation(s)
- Shannon L Risacher
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States.
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Zheng F, Cui D, Zhang L, Zhang S, Zhao Y, Liu X, Liu C, Li Z, Zhang D, Shi L, Liu Z, Hou K, Lu W, Yin T, Qiu J. The Volume of Hippocampal Subfields in Relation to Decline of Memory Recall Across the Adult Lifespan. Front Aging Neurosci 2018; 10:320. [PMID: 30364081 PMCID: PMC6191512 DOI: 10.3389/fnagi.2018.00320] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/24/2018] [Indexed: 12/27/2022] Open
Abstract
Background: The hippocampus is an important limbic structure closely related to memory function. However, few studies have focused on the association between hippocampal subfields and age-related memory decline. We investigated the volume alterations of hippocampal subfields at different ages and assessed the correlations with Immediate and Delayed recall abilities. Materials and Methods: A total of 275 participants aged 20-89 years were classified into 4 groups: Young, 20-35 years; Middle-early, 36-50 years; Middle-late, 51-65 years; Old, 66-89 years. All data were acquired from the Dallas Lifespan Brain Study (DLBS). The volumes of hippocampal subfields were obtained using Freesurfer software. Analysis of covariance (ANCOVA) was performed to analyze alterations of subfield volumes among the 4 groups, and multiple comparisons between groups were performed using the Bonferroni method. Spearman correlation with false discovery rate correction was used to investigate the relationship between memory recall scores and hippocampal subfield volumes. Results: Apart from no significant difference in the left parasubiculum (P = 0.269) and a slight difference in the right parasubiculum (P = 0.022), the volumes of other hippocampal subfields were significantly different across the adult lifespan (P < 0.001). The hippocampal fissure volume was increased in the Old group, while volumes for other subfields decreased. In addition, Immediate recall scores were associated with volumes of the bilateral molecular layer, granule cell layer of the dentate gyrus (GC-DG), cornus ammonis (CA) 1, CA2/3, CA4, left fimbria and hippocampal amygdala transition area (HATA), and right fissure (P < 0.05). Delayed recall scores were associated with the bilateral molecular layer, GC-DG, CA2/3 and CA4; left tail, presubiculum, CA1, subiculum, fimbria and HATA (P < 0.05). Conclusion: The parasubiculum volume was not significantly different across the adult lifespan, while atrophy in dementia patients in some studies. Based on these findings, we speculate that volume changes in this region might be considered as a biomarker for dementia disorders. Additionally, several hippocampal subfield volumes were significantly associated with memory scores, further highlighting the key role of the hippocampus in age-related memory decline. These regions could be used to assess the risk of memory decline across the adult lifespan.
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Affiliation(s)
- Fenglian Zheng
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Dong Cui
- College of Radiology, Taishan Medical University, Taian, China
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Li Zhang
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Shitong Zhang
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, China
| | - Yue Zhao
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
- College of Mechanical and Electronic Engineering, Shandong University of Science and Technology, Qingdao, China
| | - Xiaojing Liu
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Chunhua Liu
- School of Basic Medical Sciences, Taishan Medical University, Taian, China
| | - Zhengmei Li
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Dongsheng Zhang
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Liting Shi
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Zhipeng Liu
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Kun Hou
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Wen Lu
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
| | - Tao Yin
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Jianfeng Qiu
- Medical Engineering and Technology Research Center, Taishan Medical University, Taian, China
- Imaging-X Joint Laboratory, Taian, China
- College of Radiology, Taishan Medical University, Taian, China
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Blamire AM. MR approaches in neurodegenerative disorders. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2018; 108:1-16. [PMID: 30538047 DOI: 10.1016/j.pnmrs.2018.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/22/2018] [Accepted: 11/01/2018] [Indexed: 06/09/2023]
Abstract
Neurodegenerative disease is the umbrella term which refers to a range of clinical conditions causing degeneration of neurons within the central nervous system leading to loss of brain function and eventual death. The most prevalent of these is Alzheimer's disease (AD), which affects approximately 50 million people worldwide and is predicted to reach 75 million by 2030. Neurodegenerative diseases can only be fully diagnosed at post mortem by neuropathological assessment of the type and distribution of protein deposits which characterise each different condition, but there is a clear role for imaging technologies in aiding patient diagnoses in life. Magnetic resonance imaging (MRI) and spectroscopy (MRS) techniques have been applied to study these conditions for many years. In this review, we consider the range of MR-based measurements and describe the findings in AD, but also contrast these with the second most common dementia, dementia with Lewy bodies (DLB). The most definitive observation is the major structural brain changes seen in AD using conventional T1-weighted (T1w) MRI, where medial temporal lobe structures are notably atrophied in most symptomatic patients with AD, but often preserved in DLB. Indeed these findings are sufficiently robust to have been incorporated into clinical diagnostic criteria. Diffusion tensor imaging (DTI) reveals widespread changes in tissue microstructure, with increased mean diffusivity and decreased fractional anisotropy reflecting the degeneration of the white matter structures. There are suggestions that there are subtle differences between AD and DLB populations. At the metabolic level, atrophy-corrected MRS demonstrates reduced density of healthy neurons in brain areas with altered perfusion and in regions known to show higher deposits of pathogenic proteins. As studies have moved from patients with advanced disease and clear dysfunction to patients with earlier presentation such as with mild cognitive impairment (MCI), which in some represents the first signs of their ensuing dementia, the ability of MRI to detect differences has been weaker and further work is still required, ideally in much larger cohorts than previously studied. The vast majority of imaging research in dementia populations has been univariate with respect to the MR-derived parameters considered. To date, none of these measurements has uniquely replicated the patterns of tissue involvement seen by neuropathology, and the ability of MR techniques to deliver a non-invasive diagnosis eludes us. Future opportunities may lie in combining MR and nuclear medicine approaches (position emission tomography, PET) to provide a more complete view of structural and metabolic changes. Such developments will require multi-variate analyses, possibly combined with artificial intelligence or deep learning algorithms, to enhance our ability to combine the array of image-derived information, genetic, gender and lifestyle factors.
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Affiliation(s)
- Andrew M Blamire
- Institute of Cellular Medicine and Centre for In Vivo Imaging, Newcastle University, UK.
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Mak E, Donaghy PC, McKiernan E, Firbank MJ, Lloyd J, Petrides GS, Thomas AJ, O'Brien JT. Beta amyloid deposition maps onto hippocampal and subiculum atrophy in dementia with Lewy bodies. Neurobiol Aging 2018; 73:74-81. [PMID: 30339962 DOI: 10.1016/j.neurobiolaging.2018.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
Abstract
Although dementia with Lewy bodies (DLB) is a synucleinopathy, it is frequently accompanied by beta amyloid (Aβ) accumulation. Elucidating the relationships of Aβ with gray matter atrophy in DLB may yield insights regarding the contributions of comorbid Alzheimer's disease to its disease progression. Twenty healthy controls and 25 DLB subjects underwent clinical assessment, [18F]-Florbetapir, and 3T magnetic resonance imaging. FreeSurfer was used to estimate cortical thickness and subcortical volumes, and PetSurfer was used to quantify [18F]-Florbetapir standardized uptake value ratio. Principal component analysis was used to identify the dominant Aβ component for correlations with regional cortical thickness, hippocampal subfields, and subcortical structures. Relative to healthy controls, the DLB group demonstrated increased Aβ in widespread regions encompassing the frontal and temporoparietal cortices, whereas cortical thinning was restricted to the temporal lobe. Among DLB subjects, the Aβ component was significantly associated with more severe hippocampal and subiculum atrophy. These findings may reflect an early process of superimposed AD-like atrophy in DLB, thereby conferring support for the therapeutic potential of anti-Aβ interventions in people with DLB.
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Affiliation(s)
- Elijah Mak
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Paul C Donaghy
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | | | - Michael J Firbank
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Jim Lloyd
- Nuclear Medicine Department, Newcastle Upon Tyne Hospitals, NHS Foundation Trust, Newcastle upon Tyne, UK
| | - George S Petrides
- Nuclear Medicine Department, Newcastle Upon Tyne Hospitals, NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Alan J Thomas
- Institute for Ageing and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK.
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Pang CCC, Kiecker C, O'Brien JT, Noble W, Chang RCC. Ammon's Horn 2 (CA2) of the Hippocampus: A Long-Known Region with a New Potential Role in Neurodegeneration. Neuroscientist 2018; 25:167-180. [PMID: 29865938 DOI: 10.1177/1073858418778747] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The hippocampus has a critical role in cognition and human memory and is one of the most studied structures in the brain. Despite more than 400 years of research, little is known about the Ammon's horn region cornu ammonis 2 (CA2) subfield in comparison to other subfield regions (CA1, CA3, and CA4). Recent findings have shown that CA2 plays a bigger role than previously thought. Here, we review understanding of hippocampus and CA2 ontogenesis, together with basic and clinical findings about the potential role of this region in neurodegenerative disease. The CA2 has widespread anatomical connectivity, unique signaling molecules, and intrinsic electrophysiological properties. Experimental studies using in vivo models found that the CA2 region has a role in cognition, especially in social memory and object recognition. In models of epilepsy and hypoxia, the CA2 exhibits higher resilience to cell death and hypoxia in comparison with neighboring regions, and while hippocampal atrophy remains poorly understood in Parkinson's disease (PD) and dementia with Lewy bodies (DLB), findings from postmortem PD brain demonstrates clear accumulation of α-synuclein pathology in CA2, and the CA2-CA3 region shows relatively more atrophy compared with other hippocampal subfields. Taken together, there is a growing body of evidence suggesting that the CA2 can be an ideal hallmark with which to differentiate different neurodegenerative stages of PD. Here, we summarize these recent data and provide new perspectives/ideas for future investigations to unravel the contribution of the CA2 to neurodegenerative diseases.
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Affiliation(s)
- Cindy Chi-Ching Pang
- 1 Laboratory of Neurodegenerative Diseases, School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.,2 Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Clemens Kiecker
- 3 Department of Developmental Neurobiology, King's College London, London, UK
| | - John T O'Brien
- 4 Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Wendy Noble
- 2 Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Raymond Chuen-Chung Chang
- 1 Laboratory of Neurodegenerative Diseases, School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.,5 State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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12
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Su L, Hayes L, Soteriades S, Williams G, Brain SAE, Firbank MJ, Longoni G, Arnold RJ, Rowe JB, O'Brien JT. Hippocampal Stratum Radiatum, Lacunosum, and Moleculare Sparing in Mild Cognitive Impairment. J Alzheimers Dis 2018; 61:415-424. [PMID: 29171994 PMCID: PMC5819729 DOI: 10.3233/jad-170344] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is associated with atrophy in entorhinal cortex (ERC), the hippocampus, and its subfields Cornu Ammonis 1 (CA1) and subiculum, which predict conversion from mild cognitive impairment (MCI) to clinical AD. The stratum radiatum, lacunosum, and moleculare (SRLM) are also important gateways involving ERC and CA1, which are affected by early AD pathology. OBJECTIVE To assess whether the SRLM is affected in MCI and AD. METHODS In this proof-of-concept study, 27 controls, 13 subjects with AD, and 22 with MCI underwent 3T MRI. T1 maps were used for whole-hippocampal volumetry, T2 maps were segmented for hippocampal subfield areas, entorhinal cortex and subiculum thickness, and evaluated for SRLM integrity. RESULTS Significant CA1 atrophy and subiculum thinning were found in both AD and MCI compared to similarly aged controls. However, SRLM integrity was only significantly reduced in AD but not in MCI compared to controls. There were no significant differences in other hippocampal subfields (CA2, CA3/dentate gyrus) or ERC thickness between the groups. Finally, CA1 and CA3/DG areas and SRLM clarity were correlated with clinical and cognitive measurements of disease severity. CONCLUSION Although this study was cross sectional, it suggests a progression of specific subfield changes from MCI to established AD that is associated with the reduced integrity of SRLM, which may reflect more widespread hippocampal involvement as the disease progresses and the relative preservation of SRLM in MCI. These results provide new MRI biomarkers for disease staging and understanding of the neurobiology in AD.
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Affiliation(s)
- Li Su
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SP
- China-UK Centre for Cognition and Ageing Research, Faculty of Psychology, Southwest University, Chongqing, China
| | - Lawrence Hayes
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SP
| | - Soteris Soteriades
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SP
| | - Guy Williams
- Wolfson Brain Imaging Centre, University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge CB2 0QQ
| | - Susannah AE Brain
- Oxford University Hospitals NHS Trust, Windmill Road, Oxford OX3 7LD
| | - Michael J Firbank
- Institute of Neuroscience and Newcastle University Institute for Ageing, Newcastle University Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL
| | - Giulia Longoni
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SP
| | - Robert J Arnold
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SP
| | - James B Rowe
- Department of Clinical Neurosciences, Cambridge University, CB2 0SZ
- MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SP
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Hall B, Mak E, Cervenka S, Aigbirhio FI, Rowe JB, O’Brien JT. In vivo tau PET imaging in dementia: Pathophysiology, radiotracer quantification, and a systematic review of clinical findings. Ageing Res Rev 2017; 36:50-63. [PMID: 28315409 DOI: 10.1016/j.arr.2017.03.002] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/15/2017] [Accepted: 03/06/2017] [Indexed: 12/14/2022]
Abstract
In addition to the deposition of β-amyloid plaques, neurofibrillary tangles composed of aggregated hyperphosphorylated tau are one of the pathological hallmarks of Alzheimer's disease and other neurodegenerative disorders. Until now, our understanding about the natural history and topography of tau deposition has only been based on post-mortem and cerebrospinal fluid studies, and evidence continues to implicate tau as a central driver of downstream neurodegenerative processes and cognitive decline. Recently, it has become possible to assess the regional distribution and severity of tau burden in vivo with the development of novel radiotracers for positron emission tomography (PET) imaging. In this article, we provide a comprehensive discussion of tau pathophysiology, its quantification with novel PET radiotracers, as well as a systematic review of tau PET imaging in normal aging and various dementia conditions: mild cognitive impairment, Alzheimer's disease, frontotemporal dementia, progressive supranuclear palsy, and Lewy body dementia. We discuss the main findings in relation to group differences, clinical-cognitive correlations of tau PET, and multi-modal relationships among tau PET and other pathological markers. Collectively, the small but growing literature of tau PET has yielded consistent anatomical patterns of tau accumulation that recapitulate post-mortem distribution of neurofibrillary tangles which correlate with cognitive functions and other markers of pathology. In general, AD is characterised by increased tracer retention in the inferior temporal lobe, extending into the frontal and parietal regions in more severe cases. It is also noted that the spatial topography of tau accumulation is markedly distinct to that of amyloid burden in aging and AD. Tau PET imaging has also revealed characteristic spatial patterns among various non-AD tauopathies, supporting its potential role for differential diagnosis. Finally, we propose novel directions for future tau research, including (a) longitudinal imaging in preclinical dementia, (b) multi-modal mapping of tau pathology onto other pathological processes such as neuroinflammation, and (c) the need for more validation studies against post-mortem samples of the same subjects.
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14
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Hirjak D, Wolf RC, Remmele B, Seidl U, Thomann AK, Kubera KM, Schröder J, Maier-Hein KH, Thomann PA. Hippocampal formation alterations differently contribute to autobiographic memory deficits in mild cognitive impairment and Alzheimer's disease. Hippocampus 2017; 27:702-715. [PMID: 28281317 DOI: 10.1002/hipo.22726] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 02/27/2017] [Accepted: 03/01/2017] [Indexed: 12/17/2022]
Abstract
Autobiographical memory (AM) is part of declarative memory and includes both semantic and episodic aspects. AM deficits are among the major complaints of patients with Alzheimer's disease (AD) even in early or preclinical stages. Previous MRI studies in AD patients have showed that deficits in semantic and episodic AM are associated with hippocampal alterations. However, the question which specific hippocampal subfields and adjacent extrahippocampal structures contribute to deficits of AM in individuals with mild cognitive impairment (MCI) and AD patients has not been investigated so far. Hundred and seven participants (38 AD patients, 38 MCI individuals and 31 healthy controls [HC]) underwent MRI at 3 Tesla. AM was assessed with a semi-structured interview (E-AGI). FreeSurfer 5.3 was used for hippocampal parcellation. Semantic and episodic AM scores were related to the volume of 5 hippocampal subfields and cortical thickness in the parahippocampal and entorhinal cortex. Both semantic and episodic AM deficits were associated with bilateral hippocampal alterations. These associations referred mainly to CA1, CA2-3, presubiculum, and subiculum atrophy. Episodic, but not semantic AM loss was associated with cortical thickness reduction of the bilateral parahippocampal and enthorinal cortex. In MCI individuals, episodic, but not semantic AM deficits were associated with alterations of the CA1, presubiculum and subiculum. Our findings support the crucial role of CA1, presubiculum, and subiculum in episodic memory. The present results implicate that in MCI individuals, semantic and episodic AM deficits are subserved by distinct neuronal systems.
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Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Germany
| | - Robert C Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Germany
| | - Barbara Remmele
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Germany
| | - Ulrich Seidl
- Department of Psychiatry, Center for Mental Health, Stuttgart, Germany
| | - Anne K Thomann
- Department of Internal Medicine II, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Germany
| | | | - Klaus H Maier-Hein
- Medical Image Computing Group, Division Medical and Biological Informatics, German Cancer Research Center (DKFZ), Germany
| | - Philipp A Thomann
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Germany
- Center for Mental Health, Odenwald District Healthcare Center, Albert-Schweitzer-Straße 10-20, Erbach, 64711, Germany
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15
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Multi-modal MRI investigation of volumetric and microstructural changes in the hippocampus and its subfields in mild cognitive impairment, Alzheimer's disease, and dementia with Lewy bodies. Int Psychogeriatr 2017; 29:545-555. [PMID: 28088928 PMCID: PMC5819731 DOI: 10.1017/s1041610216002143] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Volumetric atrophy and microstructural alterations in diffusion tensor imaging (DTI) measures of the hippocampus have been reported in people with Alzheimer's disease (AD) and mild cognitive impairment (MCI). However, no study to date has jointly investigated concomitant microstructural and volumetric changes of the hippocampus in dementia with Lewy bodies (DLB). METHODS A total of 84 subjects (23 MCI, 17 DLB, 14 AD, and 30 healthy controls) were recruited for a multi-modal imaging (3T MRI and DTI) study that included neuropsychological evaluation. Freesurfer was used to segment the total hippocampus and delineate its subfields. The hippocampal segmentations were co-registered to the mean diffusivity (MD) and fractional anisotropy (FA) maps obtained from the DTI images. RESULTS Both AD and MCI groups showed significantly smaller hippocampal volumes compared to DLB and controls, predominantly in the CA1 and subiculum subfields. Compared to controls, hippocampal MD was elevated in AD, but not in MCI. DLB was characterized by both volumetric and microstructural preservation of the hippocampus. In MCI, higher hippocampal MD was associated with greater atrophy of the hippocampus and CA1 region. Hippocampal volume was a stronger predictor of memory scores compared to MD within the MCI group. CONCLUSIONS Through a multi-modal integration, we report novel evidence that the hippocampus in DLB is characterized by both macrostructural and microstructural preservation. Contrary to recent suggestions, our findings do not support the view that DTI measurements of the hippocampus are superior to volumetric changes in characterizing group differences, particularly between MCI and controls.
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16
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Agosta F, Galantucci S, Filippi M. Advanced magnetic resonance imaging of neurodegenerative diseases. Neurol Sci 2016; 38:41-51. [PMID: 27848119 DOI: 10.1007/s10072-016-2764-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/07/2016] [Indexed: 12/15/2022]
Abstract
Magnetic resonance imaging (MRI) is playing an increasingly important role in the study of neurodegenerative diseases, delineating the structural and functional alterations determined by these conditions. Advanced MRI techniques are of special interest for their potential to characterize the signature of each neurodegenerative condition and aid both the diagnostic process and the monitoring of disease progression. This aspect will become crucial when disease-modifying (personalized) therapies will be established. MRI techniques are very diverse and go from the visual inspection of MRI scans to more complex approaches, such as manual and automatic volume measurements, diffusion tensor MRI, and functional MRI. All these techniques allow us to investigate the different features of neurodegeneration. In this review, we summarize the most recent advances concerning the use of MRI in some of the most important neurodegenerative conditions, putting an emphasis on the advanced techniques.
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Affiliation(s)
- Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy
| | - Sebastiano Galantucci
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy. .,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.
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17
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Zhou M, Zhang F, Zhao L, Qian J, Dong C. Entorhinal cortex: a good biomarker of mild cognitive impairment and mild Alzheimer's disease. Rev Neurosci 2016; 27:185-95. [PMID: 26444348 DOI: 10.1515/revneuro-2015-0019] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/01/2015] [Indexed: 11/15/2022]
Abstract
Entorhinal cortex (EC), thought to be the location of the earliest lesions in Alzheimer's disease (AD), has been widely studied in recent years. With the irreversible pathological changes of AD, there is an urgent need to find biomarkers that can be used to predict the presence of the disease before it is clinically expressed. The aim of this review is to summarize and analyze recent findings that are relevant to the important role of EC in the diagnosis of mild cognitive impairment (MCI) and mild AD and to describe a range of neuroimaging techniques used to define the EC boundary. A comprehensive literature search for articles published up to May 2015 was performed. Our research highlights the finding that atrophy in EC reflects the early pathological changes of AD and can be a strong predictor of prodromal AD. The early changes in EC are a good imaging biomarker that can be used to discriminate individuals with MCI from normal control subjects. A larger degree of atrophy in EC predicts increased disease severity, and the right EC in patients with mild AD exhibited greater changes than the left side. In addition, the EC seems to have an obvious advantage over the hippocampus as a biomarker when predicting future conversion to AD in individuals with MCI, and it may be of help in following the course of disease progression. In this review, we also summarize the main differences observed between the hippocampus and the EC when differentiating diseases. These findings will hopefully provide an opportunity for the effective prevention and early treatment of AD.
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18
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Delli Pizzi S, Franciotti R, Bubbico G, Thomas A, Onofrj M, Bonanni L. Atrophy of hippocampal subfields and adjacent extrahippocampal structures in dementia with Lewy bodies and Alzheimer's disease. Neurobiol Aging 2016; 40:103-109. [DOI: 10.1016/j.neurobiolaging.2016.01.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 01/12/2016] [Accepted: 01/15/2016] [Indexed: 10/22/2022]
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19
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Mak E, Su L, Williams GB, Watson R, Firbank M, Blamire A, O'Brien J. Differential Atrophy of Hippocampal Subfields: A Comparative Study of Dementia with Lewy Bodies and Alzheimer Disease. Am J Geriatr Psychiatry 2016; 24:136-43. [PMID: 26324541 DOI: 10.1016/j.jagp.2015.06.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 06/16/2015] [Accepted: 06/18/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Dementia with Lewy bodies (DLB) is characterized by relative preservation of the medial temporal lobe compared with Alzheimer disease (AD). The differential involvement of the hippocampal subfields in both diseases has not been clearly established, however. We aim to investigate hippocampal subfield differences in vivo in a clinical cohort of DLB and AD subjects. METHODS 104 participants (35 DLBs, 36 ADs, and 35 healthy comparison [HC] subjects) underwent clinical assessment and 3T T1-weighted imaging. A Bayesian model implemented in Freesurfer was used to automatically segment the hippocampus and its subfields. We also examined associations between hippocampal subfields and tests of memory function. RESULTS Both the AD and DLB groups demonstrated significant atrophy of the total hippocampus relative to HC but the DLB group was characterized by preservation of the cornu ammonis 1 (CA1), fimbria, and fissure. In contrast, all the hippocampal subfields except the fissure were significantly atrophied in AD compared with both DLB and HC groups. Among DLB subjects, CA1 was correlated with the Recent Memory score of the CAMCOG and Delayed Recall subscores of the HVLT. CONCLUSIONS DLB is characterized by milder hippocampal atrophy that was accompanied by preservation of the CA1. The CA1 was also associated with memory function in DLB. Our findings highlight the promising role of hippocampal subfield volumetry, particularly that of the CA1, as a biomarker for the distinction between AD and DLB.
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Affiliation(s)
- Elijah Mak
- Department of Psychiatry, School of Clinical Medicine, Addenbrooke University of Cambridge, UK
| | - Li Su
- Department of Psychiatry, School of Clinical Medicine, Addenbrooke University of Cambridge, UK
| | - Guy B Williams
- Wolfson Brain Imaging Centre, University of Cambridge, UK
| | - Rosie Watson
- Department of Aged Care, The Royal Melbourne Hospital, Melbourne, Australia; Institute of Neuroscience, Newcastle University, Newcastle, UK; The Florey Institute of Neuroscience and the Department of Medicine, The University of Melbourne, Parkville, Australia
| | - Michael Firbank
- Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Andrew Blamire
- Institute of Cellular Medicine and Newcastle Magnetic Resonance Centre, Newcastle, UK
| | - John O'Brien
- Department of Psychiatry, School of Clinical Medicine, Addenbrooke University of Cambridge, UK.
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20
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Landy KM, Salmon DP, Filoteo JV, Heindel WC, Galasko D, Hamilton JM. Visual search in Dementia with Lewy Bodies and Alzheimer's disease. Cortex 2015; 73:228-39. [PMID: 26476402 DOI: 10.1016/j.cortex.2015.08.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 08/03/2015] [Accepted: 08/31/2015] [Indexed: 11/30/2022]
Abstract
Visual search is an aspect of visual cognition that may be more impaired in Dementia with Lewy Bodies (DLB) than Alzheimer's disease (AD). To assess this possibility, the present study compared patients with DLB (n = 17), AD (n = 30), or Parkinson's disease with dementia (PDD; n = 10) to non-demented patients with PD (n = 18) and normal control (NC) participants (n = 13) on single-feature and feature-conjunction visual search tasks. In the single-feature task participants had to determine if a target stimulus (i.e., a black dot) was present among 3, 6, or 12 distractor stimuli (i.e., white dots) that differed in one salient feature. In the feature-conjunction task participants had to determine if a target stimulus (i.e., a black circle) was present among 3, 6, or 12 distractor stimuli (i.e., white dots and black squares) that shared either of the target's salient features. Results showed that target detection time in the single-feature task was not influenced by the number of distractors (i.e., "pop-out" effect) for any of the groups. In contrast, target detection time increased as the number of distractors increased in the feature-conjunction task for all groups, but more so for patients with AD or DLB than for any of the other groups. These results suggest that the single-feature search "pop-out" effect is preserved in DLB and AD patients, whereas ability to perform the feature-conjunction search is impaired. This pattern of preserved single-feature search with impaired feature-conjunction search is consistent with a deficit in feature binding that may be mediated by abnormalities in networks involving the dorsal occipito-parietal cortex.
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Affiliation(s)
- Kelly M Landy
- Department of Neurosciences, University of California, San Diego, CA, United States
| | - David P Salmon
- Department of Neurosciences, University of California, San Diego, CA, United States.
| | - J Vincent Filoteo
- Department of Psychiatry, University of California, San Diego, CA, United States; Psychology Service, Veterans Affairs San Diego Healthcare System, CA, United States
| | - William C Heindel
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, United States
| | - Douglas Galasko
- Department of Neurosciences, University of California, San Diego, CA, United States; Neurology Service, Veterans Affairs San Diego Healthcare System, CA, United States
| | - Joanne M Hamilton
- Department of Neurosciences, University of California, San Diego, CA, United States
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21
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Blanc F, Colloby SJ, Philippi N, de Pétigny X, Jung B, Demuynck C, Phillipps C, Anthony P, Thomas A, Bing F, Lamy J, Martin-Hunyadi C, O'Brien JT, Cretin B, McKeith I, Armspach JP, Taylor JP. Cortical Thickness in Dementia with Lewy Bodies and Alzheimer's Disease: A Comparison of Prodromal and Dementia Stages. PLoS One 2015; 10:e0127396. [PMID: 26061655 PMCID: PMC4489516 DOI: 10.1371/journal.pone.0127396] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/15/2015] [Indexed: 11/18/2022] Open
Abstract
Objectives To assess and compare cortical thickness (CTh) of patients with prodromal Dementia with Lewy bodies (pro-DLB), prodromal Alzheimer's disease (pro-AD), DLB dementia (DLB-d), AD dementia (AD-d) and normal ageing. Methods Study participants(28 pro-DLB, 27 pro-AD, 31 DLB-d, 54 AD-d and 33 elderly controls) underwent 3Tesla T1 3D MRI and detailed clinical and cognitive assessments. We used FreeSurfer analysis package to measure CTh and investigate patterns of cortical thinning across groups. Results Comparison of CTh between pro-DLB and pro-AD (p<0.05, FDR corrected) showed more right anterior insula thinning in pro-DLB, and more bilateral parietal lobe and left parahippocampal gyri thinning in pro-AD. Comparison of prodromal patients to healthy elderly controls showed the involvement of the same regions. In DLB-d (p<0.05, FDR corrected) cortical thinning was found predominantly in the right temporo-parietal junction, and insula, cingulate, orbitofrontal and lateral occipital cortices. In AD-d(p<0.05, FDR corrected),the most significant areas affected included the entorhinal cortices, parahippocampal gyri and parietal lobes. The comparison of AD-d and DLB-d demonstrated more CTh in AD-d in the left entorhinal cortex (p<0.05, FDR corrected). Conclusion Cortical thickness is a sensitive measure for characterising patterns of grey matter atrophy in early stages of DLB distinct from AD. Right anterior insula involvement may be a key region at the prodromal stage of DLB and needs further investigation.
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Affiliation(s)
- Frederic Blanc
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
- * E-mail:
| | - Sean J. Colloby
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Nathalie Philippi
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Xavier de Pétigny
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - Barbara Jung
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - Catherine Demuynck
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - Clélie Phillipps
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - Pierre Anthony
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Alan Thomas
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Fabrice Bing
- University Hospital of Strasbourg, Neuroradiology Service, Strasbourg, France
| | - Julien Lamy
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
| | - Catherine Martin-Hunyadi
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
- University Hospital of Strasbourg, Hôpital de jour de gériatrie, Geriatry Service, Strasbourg, France
| | - John T. O'Brien
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Benjamin Cretin
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Ian McKeith
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jean-Paul Armspach
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de MédecineTranslationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France
| | - John-Paul Taylor
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
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Peraza LR, Taylor JP, Kaiser M. Divergent brain functional network alterations in dementia with Lewy bodies and Alzheimer's disease. Neurobiol Aging 2015; 36:2458-67. [PMID: 26115566 PMCID: PMC4706129 DOI: 10.1016/j.neurobiolaging.2015.05.015] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/05/2015] [Accepted: 05/23/2015] [Indexed: 01/29/2023]
Abstract
The clinical phenotype of dementia with Lewy bodies (DLB) is different from Alzheimer's disease (AD), suggesting a divergence between these diseases in terms of brain network organization. To fully understand this, we studied functional networks from resting-state functional magnetic resonance imaging in cognitively matched DLB and AD patients. The DLB group demonstrated a generalized lower synchronization compared with the AD and healthy controls, and this was more severe for edges connecting distant brain regions. Global network measures were significantly different between DLB and AD. For instance, AD showed lower small-worldness than healthy controls, while DLB showed higher small-worldness (AD < controls < DLB), and this was also the case for global efficiency (DLB > controls > AD) and clustering coefficient (DLB < controls < AD). Differences were also found for nodal measures at brain regions associated with each disease. Finally, we found significant associations between network performance measures and global cognitive impairment and severity of cognitive fluctuations in DLB. These results show network divergences between DLB and AD which appear to reflect their neuropathological differences.
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Affiliation(s)
- Luis R Peraza
- Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK.
| | - John-Paul Taylor
- Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Marcus Kaiser
- Interdisciplinary Computing and Complex BioSystems (ICOS) research group, School of Computing Science, Newcastle University, Newcastle upon Tyne, UK; Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
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23
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Narayanan L, Murray AD. What is the role of neuroimaging in dementia? A review. IMAGING 2014. [DOI: 10.1259/img.20120015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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24
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Kenny ER, O'Brien JT, Firbank MJ, Blamire AM. Subcortical connectivity in dementia with Lewy bodies and Alzheimer's disease. Br J Psychiatry 2013; 203:209-14. [PMID: 23846997 DOI: 10.1192/bjp.bp.112.108464] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Resting-state functional magnetic resonance imaging (fMRI) can be used to measure correlations in spontaneous low-frequency fluctuations in the blood oxygen level-dependent (BOLD) signal which represent functional connectivity between key brain areas. AIMS To investigate functional connectivity with regions hypothesised to be differentially affected in dementia with Lewy bodies (DLB) compared with Alzheimer's disease and controls. METHOD Fifteen participants with probable DLB, 16 with probable Alzheimer's disease and 16 controls were scanned in the resting-state using a 3T scanner. The BOLD signal time-series of fluctuations in seed regions were correlated with all other voxels to measure functional connectivity. RESULTS Participants with DLB and Alzheimer's disease showed greater caudate and thalamic connectivity compared with controls. Those with DLB showed greater putamen connectivity compared with those with Alzheimer's disease and the controls. No regions showed less connectivity in DLB or Alzheimer's disease v. controls, or in DLB v. Alzheimer's disease. CONCLUSIONS Altered connectivity in DLB and Alzheimer's disease provides new insights into the neurobiology of these disorders and may aid in earlier diagnosis.
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Affiliation(s)
- Eva R Kenny
- Newcastle Magnetic Resonance Centre and Institute for Ageing and Health, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
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25
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Hayashi H, Kawakatsu S, Suzuki A, Shibuya Y, Kobayashi R, Sato C, Otani K. Application of the VSRAD, a specific and sensitive voxel-based morphometry, to comparison of entorhinal cortex atrophy between dementia with Lewy bodies and Alzheimer's disease. Dement Geriatr Cogn Disord 2013. [PMID: 23208522 DOI: 10.1159/000345792] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Previous studies using magnetic resonance imaging (MRI) showed that dementia with Lewy bodies (DLB) had less atrophy in some medial temporal structures than Alzheimer's disease (AD). However, very few studies have focused on the entorhinal cortex, which is closely related to episodic memory. We compared the degree of entorhinal cortex atrophy between the two types of dementia using the voxel-based specific regional analysis system for AD (VSRAD) targeting this region. METHODS The subjects consisted of 60 patients with DLB and 210 patients with AD. The degree of entorhinal cortex atrophy was quantified by application of the VSRAD to MRI data, and a Z score >2 was defined as significant atrophy. RESULTS The DLB group had significantly lower Z scores than the AD group (mean ± SD: 2.25 ± 1.10 vs. 2.85 ± 1.33, p < 0.01). The analysis of covariance with possible confounding factors as covariates also showed that Z scores were significantly lower in the DLB group than in the AD group (p < 0.01). The proportion of patients with atrophy was significantly lower in the DLB group than in the AD group (53 vs. 72%, p < 0.01). CONCLUSIONS The present study using the VSRAD suggests that DLB shows less atrophy in the entorhinal cortex than AD.
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Affiliation(s)
- Hiroshi Hayashi
- Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan.
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26
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Watson R, O’Brien JT. Differentiating dementia with Lewy bodies and Alzheimer’s disease using MRI. Neurodegener Dis Manag 2012. [DOI: 10.2217/nmt.12.41] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
SUMMARY Despite the characteristic clinical differences between dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD), a large degree of overlap exists. In particular, the clinical diagnostic criteria for DLB lack sensitivity so that many cases of DLB will be missed during life. MRI techniques offer a noninvasive method to assess the brain structure and function in more detail. In particular, advanced MRI methods such as diffusion-tensor imaging, functional MRI, arterial spin labeling (perfusion) and magnetic resonance spectroscopy may offer more sensitive methods to detect early and, possibly, preclinical change in dementia and contribute to our understanding of the differences between AD and DLB. This paper provides an overview of MRI changes in DLB and AD, the relationship to other imaging modalities such as single-photon emission computed tomography and PET, highlighting the differences between the conditions currently applicable to the clinical setting, as well as recent developments in MRI methods yet to be translated into large-scale clinical studies.
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Affiliation(s)
- Rosie Watson
- Institute for Ageing & Health, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - John T O’Brien
- Institute for Ageing & Health, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
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27
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Graff-Radford J, Boeve BF, Pedraza O, Ferman TJ, Przybelski S, Lesnick TG, Vemuri P, Senjem ML, Smith GE, Knopman DS, Lowe V, Jack CR, Petersen RC, Kantarci K. Imaging and acetylcholinesterase inhibitor response in dementia with Lewy bodies. Brain 2012; 135:2470-7. [PMID: 22810436 DOI: 10.1093/brain/aws173] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Acetylcholinesterase inhibitors are commonly used to treat patients with dementia with Lewy bodies. Hippocampal atrophy on magnetic resonance imaging and amyloid-β load on positron emission tomography are associated with the Alzheimer's disease-related pathology in patients with dementia with Lewy bodies. To date, few studies have investigated imaging markers that predict treatment response in patients with dementia with Lewy bodies. Our objective was to determine whether imaging markers of Alzheimer's disease-related pathology such as hippocampal volume, brain amyloid-β load on (11)C Pittsburgh compound B positron emission tomography predict treatment response to acetylcholinesterase inhibitors in patients with dementia with Lewy bodies. We performed a retrospective analysis on consecutive treatment-naive patients with dementia with Lewy bodies (n = 54) from the Mayo Clinic Alzheimer's Disease Research Centre who subsequently received acetylcholinesterase inhibitors and underwent magnetic resonance imaging with hippocampal volumetry. Baseline and follow-up assessments were obtained with the Mattis Dementia Rating Scale. Subjects were divided into three groups (reliable improvement, stable or reliable decline) using Dementia Rating Scale reliable change indices determined previously. Associations between hippocampal volumes and treatment response were tested with analysis of covariance adjusting for baseline Dementia Rating Scale, age, gender, magnetic resonance field strength and Dementia Rating Scale interval. Seven subjects underwent (11)C Pittsburgh compound B imaging within 12 weeks of magnetic resonance imaging. Global cortical (11)C Pittsburgh compound B retention (scaled to cerebellar retention) was calculated in these patients. Using a conservative psychometric method of assessing treatment response, there were 12 patients with reliable decline, 29 stable cases and 13 patients with reliable improvement. The improvers had significantly larger hippocampi than those that declined (P = 0.02) and the stable (P = 0.04) group. An exploratory analysis demonstrated larger grey matter volumes in the temporal and parietal lobes in improvers compared with those who declined (P < 0.05). The two patients who had a positive (11)C Pittsburgh compound B positron emission tomography scan declined and those who had a negative (11)C Pittsburgh compound B positron emission tomography scan improved or were stable after treatment. Patients with dementia with Lewy bodies who do not have the imaging features of coexistent Alzheimer's disease-related pathology are more likely to cognitively improve with acetylcholinesterase inhibitor treatment.
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28
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Abstract
Dementia with Lewy bodies (DLB) is a relative newcomer to the field of late-life dementia. Although a diversity of imaging methodologies is now available for the study of dementia, these have been applied most often to Alzheimer's disease (AD). Studies on DLB, although fewer, have yielded fascinating and important insights into the underlying pathophysiology of this condition and allowed clinical differentiation of DLB from other dementias. Imaging research on DLB has had significant ramifications in terms of raising the profile of DLB and helping define it as a distinctive and separate disease entity from AD.
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Affiliation(s)
- John-Paul Taylor
- Institute for Ageing and Health, Wolfson Research Centre, Campus for Aging and Vitality, Newcastle University, Newcastle Upon Tyne, NE4 5PL, UK.
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29
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Chow N, Aarsland D, Honarpisheh H, Beyer MK, Somme JH, Elashoff D, Rongve A, Tysnes OB, Thompson PM, Apostolova LG. Comparing hippocampal atrophy in Alzheimer's dementia and dementia with lewy bodies. Dement Geriatr Cogn Disord 2012; 34:44-50. [PMID: 22922563 PMCID: PMC3470878 DOI: 10.1159/000339727] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2012] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/AIMS Dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) are the two most common neurodegenerative dementias. During the early stages, clinical distinction between them is often challenging. Our objective is to compare hippocampal atrophy patterns in mild AD and mild DLB. We hypothesized that DLB subjects have milder hippocampal atrophy relative to AD subjects. METHODS We analyzed the T1-weighted magnetic resonance imaging data from 113 subjects: 55 AD, 16 DLB and 42 cognitively normal elderly (normal controls, NC). Using the hippocampal radial distance technique and multiple linear regression, we analyzed the effect of clinical diagnosis on hippocampal radial distance, while adjusting for gender and age. Three-dimensional statistical maps were adjusted for multiple comparisons using permutation-based statistics with a threshold of p < 0.01. RESULTS Compared to NC, AD exhibited significantly greater atrophy in the cornu ammonis (CA)1, CA2-3 and subicular regions bilaterally while DLB showed left-predominant atrophy in the CA1 region and subiculum. Compared directly, AD and DLB did not reveal statistically significant differences. CONCLUSION Hippocampal atrophy, while present in mildly impaired DLB subjects, is less severe than atrophy seen in mildly impaired AD subjects, when compared to NC. Both groups show predominant atrophy of the CA1 subfield and subiculum.
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Affiliation(s)
- Nicole Chow
- Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA, Laboratory of Neuro Imaging, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Dag Aarsland
- Centre for Age-Related Diseases, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway, Karolinska Institute – Alzheimer Disease Research Center, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden, Institute of Clinical Medicine, University of Oslo, Norway
| | - Hedieh Honarpisheh
- Pathology and Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Mona K. Beyer
- Norwegian Center for Movement Disorders, Stavanger University Hospital, Stavanger, Norway
| | - Johanne H. Somme
- Department of Neurology, Cruces University Hospital, Baraclado, Spain
| | - David Elashoff
- Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA, USA
| | - Arvid Rongve
- Department of Psychiatry, Haugesund Hospital, Haugesund, Norway
| | - Ole B. Tysnes
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Paul M. Thompson
- Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA, Laboratory of Neuro Imaging, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Liana G. Apostolova
- Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA, Laboratory of Neuro Imaging, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
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30
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Kenny ER, Blamire AM, Firbank MJ, O'Brien JT. Functional connectivity in cortical regions in dementia with Lewy bodies and Alzheimer's disease. ACTA ACUST UNITED AC 2011; 135:569-81. [PMID: 22189566 PMCID: PMC3708629 DOI: 10.1093/brain/awr327] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Using resting-state functional magnetic resonance imaging, spontaneous low-frequency fluctuations in the blood oxygenation level-dependent signal were measured to investigate connectivity between key brain regions hypothesized to be differentially affected in dementia with Lewy bodies compared with Alzheimer's disease and healthy controls. These included connections of the hippocampus, because of its role in learning, and parietal and occipital areas involved in memory, attention and visual processing. Connectivity was investigated in 47 subjects aged 60 years and over: 15 subjects with dementia with Lewy bodies, 16 subjects with Alzheimer's disease and 16 control subjects. Subjects were scanned using a 3 Tesla magnetic resonance imaging system. The mean blood oxygenation level-dependent signal time series was extracted from seed regions in the hippocampus, posterior cingulate cortex, precuneus and primary visual cortex and correlated with all other brain voxels to determine functional connectivity. Both subjects with dementia with Lewy bodies and Alzheimer's disease showed greater connectivity than control subjects. Compared with controls, the dementia with Lewy bodies group had greater connectivity between the right posterior cingulate cortex and other brain areas. In dementia with Lewy bodies, there were no significant differences in hippocampal connectivity compared with controls, but in Alzheimer's disease left hippocampal connectivity was greater compared with controls. There were no significant differences between groups for precuneus or primary visual cortex connectivity. No seed regions showed significantly less connectivity in subjects with dementia with Lewy bodies or Alzheimer's disease compared with controls. We found greater connectivity with the posterior cingulate in dementia with Lewy bodies and with the hippocampus in Alzheimer's disease. Consistent with the known relative preservation of memory in dementia with Lewy bodies compared with Alzheimer's disease, hippocampal connectivity was not found to be greater in dementia with Lewy bodies. Importantly, while metabolic imaging shows functional change in primary visual cortex in dementia with Lewy bodies, which is hypothesized to account for visual hallucinations, we found connectivity with this region to be unaffected. This implicates areas beyond visual sensory input level in the visual symptoms and visual-perceptual dysfunction seen in dementia with Lewy bodies.
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Affiliation(s)
- Eva R Kenny
- Newcastle Magnetic Resonance Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
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31
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Firbank MJ, Blamire AM, Teodorczuk A, Teper E, Mitra D, O'Brien JT. Diffusion tensor imaging in Alzheimer's disease and dementia with Lewy bodies. Psychiatry Res 2011; 194:176-83. [PMID: 21955457 DOI: 10.1016/j.pscychresns.2011.08.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 07/29/2011] [Accepted: 08/04/2011] [Indexed: 11/19/2022]
Abstract
White matter changes have been investigated in Alzheimer's disease (AD) in a number of studies using diffusion imaging. Fewer studies have investigated dementia with Lewy bodies (DLB). We used diffusion-weighted magnetic resonance imaging (MRI) and high-resolution (0.3 mm in-plane) coronal 3T MRI of the medial temporal lobe in 16 subjects with AD, 16 with DLB and 16 similarly aged healthy subjects. We found increased mean diffusivity in the temporal lobe of AD, and reduced fractional anisotropy (FA) in a small cluster in the right postcentral gyrus region in the DLB group. Mean FA in this cluster correlated with UPDRS (Unified Parkinson's Disease Rating Scale) motor score. We had previously reported reduced visibility in the AD group of a dark appearing layer of the hippocampus in the high-resolution images. In an SPM analysis on all subjects, there were significant clusters of reduced FA in the corpus callosum, fornix and stria terminalis that correlated with the visual rating of the hippocampus. These results suggest that changes to the hippocampus are associated with structural changes to the white matter fibres of the hippocampus output, and that changes in motor function are associated with changes in white matter underlying somatosensory cortex.
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Affiliation(s)
- Michael J Firbank
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
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32
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Kantarci K, Lowe VJ, Boeve BF, Weigand SD, Senjem ML, Przybelski SA, Dickson DW, Parisi JE, Knopman DS, Smith GE, Ferman TJ, Petersen RC, Jack CR. Multimodality imaging characteristics of dementia with Lewy bodies. Neurobiol Aging 2011; 33:2091-105. [PMID: 22018896 DOI: 10.1016/j.neurobiolaging.2011.09.024] [Citation(s) in RCA: 136] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 09/06/2011] [Accepted: 09/16/2011] [Indexed: 12/14/2022]
Abstract
Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia after Alzheimer's disease (AD). Our objective was to determine whether the (11)C-Pittsburgh Compound-B (PiB) retention and regional hypometabolism on positron emission tomography (PET) and regional cortical atrophy on magnetic resonance imaging (MRI) are complementary in characterizing patients with DLB and differentiating them from AD. We studied age-, gender-, and education-matched patients with a clinical diagnosis of DLB (n = 21), AD (n = 21), and cognitively normal subjects (n = 42). Hippocampal atrophy, global cortical PiB retention and occipital lobe metabolism in combination distinguished DLB from AD better than any of the measurements alone (area under the receiver operating characteristic = 0.98). Five of the DLB and AD patients who underwent autopsy were distinguished through multimodality imaging. These data demonstrate that magnetic resonance imaging and PiB positron emission tomography contribute to characterizing the distinct pathological mechanisms in patients with AD compared with DLB. Occipital and posterior parietotemporal lobe hypometabolism is a distinguishing feature of DLB and this regional hypometabolic pattern is independent of the amyloid pathology.
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Affiliation(s)
- Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
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33
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Smart SD, Firbank MJ, O'Brien JT. Validation of automated white matter hyperintensity segmentation. J Aging Res 2011; 2011:391783. [PMID: 21904678 PMCID: PMC3167190 DOI: 10.4061/2011/391783] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 07/01/2011] [Accepted: 07/03/2011] [Indexed: 11/20/2022] Open
Abstract
Introduction. White matter hyperintensities (WMHs) are a common finding on MRI scans of older people and are associated with vascular disease. We compared 3 methods for automatically segmenting WMHs from MRI scans. Method. An operator manually segmented WMHs on MRI images from a 3T scanner. The scans were also segmented in a fully automated fashion by three different programmes. The voxel overlap between manual and automated segmentation was compared. Results. Between observer overlap ratio was 63%. Using our previously described in-house software, we had overlap of 62.2%. We investigated the use of a modified version of SPM segmentation; however, this was not successful, with only 14% overlap. Discussion. Using our previously reported software, we demonstrated good segmentation of WMHs in a fully automated fashion.
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Affiliation(s)
- Sean D Smart
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK
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34
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Ashford JW, Salehi A, Furst A, Bayley P, Frisoni GB, Jack CR, Sabri O, Adamson MM, Coburn KL, Olichney J, Schuff N, Spielman D, Edland SD, Black S, Rosen A, Kennedy D, Weiner M, Perry G. Imaging the Alzheimer brain. J Alzheimers Dis 2011; 26 Suppl 3:1-27. [PMID: 21971448 PMCID: PMC3760773 DOI: 10.3233/jad-2011-0073] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This supplement to the Journal of Alzheimer's Disease contains more than half of the chapters from The Handbook of Imaging the Alzheimer Brain, which was first presented at the International Conference on Alzheimer's Disease in Paris, in July, 2011. While the Handbook contains 27 chapters that are modified articles from 2009, 2010, and 2011 issues of the Journal of Alzheimer's Disease, this supplement contains the 31 new chapters of that book and an introductory article drawn from the introductions to each section of the book. The Handbook was designed to provide a multilevel overview of the full field of brain imaging related to Alzheimer's disease (AD). The Handbook, as well as this supplement, contains both reviews of the basic concepts of imaging, the latest developments in imaging, and various discussions and perspectives of the problems of the field and promising directions. The Handbook was designed to be useful for students and clinicians interested in AD as well as scientists studying the brain and pathology related to AD.
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