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Khadhraoui E, Nickl-Jockschat T, Henkes H, Behme D, Müller SJ. Automated brain segmentation and volumetry in dementia diagnostics: a narrative review with emphasis on FreeSurfer. Front Aging Neurosci 2024; 16:1459652. [PMID: 39291276 PMCID: PMC11405240 DOI: 10.3389/fnagi.2024.1459652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 08/19/2024] [Indexed: 09/19/2024] Open
Abstract
BackgroundDementia can be caused by numerous different diseases that present variable clinical courses and reveal multiple patterns of brain atrophy, making its accurate early diagnosis by conventional examinative means challenging. Although highly accurate and powerful, magnetic resonance imaging (MRI) currently plays only a supportive role in dementia diagnosis, largely due to the enormous volume and diversity of data it generates. AI-based software solutions/algorithms that can perform automated segmentation and volumetry analyses of MRI data are being increasingly used to address this issue. Numerous commercial and non-commercial software solutions for automated brain segmentation and volumetry exist, with FreeSurfer being the most frequently used.ObjectivesThis Review is an account of the current situation regarding the application of automated brain segmentation and volumetry to dementia diagnosis.MethodsWe performed a PubMed search for “FreeSurfer AND Dementia” and obtained 493 results. Based on these search results, we conducted an in-depth source analysis to identify additional publications, software tools, and methods. Studies were analyzed for design, patient collective, and for statistical evaluation (mathematical methods, correlations).ResultsIn the studies identified, the main diseases and cohorts represented were Alzheimer’s disease (n = 276), mild cognitive impairment (n = 157), frontotemporal dementia (n = 34), Parkinson’s disease (n = 29), dementia with Lewy bodies (n = 20), and healthy controls (n = 356). The findings and methods of a selection of the studies identified were summarized and discussed.ConclusionOur evaluation showed that, while a large number of studies and software solutions are available, many diseases are underrepresented in terms of their incidence. There is therefore plenty of scope for targeted research.
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Affiliation(s)
- Eya Khadhraoui
- Clinic for Neuroradiology, University Hospital, Magdeburg, Germany
| | - Thomas Nickl-Jockschat
- Department of Psychiatry and Psychotherapy, University Hospital, Magdeburg, Germany
- German Center for Mental Health (DZPG), Partner Site Halle-Jena-Magdeburg, Magdeburg, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Magdeburg, Germany
| | - Hans Henkes
- Neuroradiologische Klinik, Katharinen-Hospital, Klinikum-Stuttgart, Stuttgart, Germany
| | - Daniel Behme
- Clinic for Neuroradiology, University Hospital, Magdeburg, Germany
- Stimulate Research Campus Magdeburg, Magdeburg, Germany
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Michels L, O'Gorman-Tuura R, Bachmann D, Müller S, Studer S, Saake A, Gruber E, Rauen K, Buchmann A, Zuber I, Hock C, Gietl A, Treyer V. The links among age, sex, and glutathione: A cross-sectional magnetic resonance spectroscopy study. Neurobiol Aging 2024; 144:19-29. [PMID: 39255570 DOI: 10.1016/j.neurobiolaging.2024.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 08/27/2024] [Accepted: 08/28/2024] [Indexed: 09/12/2024]
Abstract
Glutathione (GSH) is a brain marker for oxidative stress and has previously been associated with cerebral amyloid deposition and memory decline. However, to date, no study has examined the links among GSH, sex, age, amyloid, and Apolipoprotein E (APOE) genotype in a large non-clinical cohort of older adults. We performed APOE genotyping, magnetic resonance spectroscopy (MRS) as well as simultaneous positron emission tomography with the radiotracer Flutemetamol (Amyloid-PET), in a group of older adults. The final analysis set comprised 140 healthy older adults (mean age: 64.7 years) and 49 participants with mild cognitive impairment (mean age: 71.4 years). We recorded metabolites in the posterior cingulate cortex (PCC) by a GSH-edited MEGAPRESS sequence. Structural equation modeling revealed that higher GSH levels were associated with female sex, but neither APOE- epsilon 4 carrier status nor age showed significant associations with GSH. Conversely, older age and the presence of an APOE4 allele, but not sex, are linked to higher global amyloid load. Our results suggest that the PCC shows sex-specific GSH alterations in older adults.
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Affiliation(s)
- Lars Michels
- Department of Neuroradiology, Clinical Neuroscience Center (KNZ), University Hospital Zurich, Zurich, Switzerland.
| | | | - Dario Bachmann
- Institute for Regenerative Medicine, University of Zurich Campus Schlieren, Schlieren, Switzerland
| | - Susanne Müller
- Department of Neuroradiology, Clinical Neuroscience Center (KNZ), University Hospital Zurich, Zurich, Switzerland
| | - Sandro Studer
- Institute for Regenerative Medicine, University of Zurich Campus Schlieren, Schlieren, Switzerland
| | - Antje Saake
- Institute for Regenerative Medicine, University of Zurich Campus Schlieren, Schlieren, Switzerland
| | - Esmeralda Gruber
- Institute for Regenerative Medicine, University of Zurich Campus Schlieren, Schlieren, Switzerland
| | - Katrin Rauen
- Institute for Regenerative Medicine, University of Zurich Campus Schlieren, Schlieren, Switzerland; Department of Geriatric Psychiatry, Psychiatric Hospital Zurich, Zurich, Switzerland
| | - Andreas Buchmann
- Institute for Regenerative Medicine, University of Zurich Campus Schlieren, Schlieren, Switzerland
| | - Isabelle Zuber
- Institute for Regenerative Medicine, University of Zurich Campus Schlieren, Schlieren, Switzerland
| | - Christoph Hock
- Institute for Regenerative Medicine, University of Zurich Campus Schlieren, Schlieren, Switzerland; Neurimmune, Schlieren, Switzerland
| | - Anton Gietl
- Institute for Regenerative Medicine, University of Zurich Campus Schlieren, Schlieren, Switzerland; Department of Geriatric Psychiatry, Psychiatric Hospital Zurich, Zurich, Switzerland
| | - Valerie Treyer
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; Institute for Regenerative Medicine, University of Zurich Campus Schlieren, Schlieren, Switzerland
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Harrison JR, Foley SF, Baker E, Bracher-Smith M, Holmans P, Stergiakouli E, Linden DEJ, Caseras X, Jones DK, Escott-Price V. Pathway-specific polygenic scores for Alzheimer's disease are associated with changes in brain structure in younger and older adults. Brain Commun 2023; 5:fcad229. [PMID: 37744023 PMCID: PMC10517196 DOI: 10.1093/braincomms/fcad229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 05/17/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Genome-wide association studies have identified multiple Alzheimer's disease risk loci with small effect sizes. Polygenic risk scores, which aggregate these variants, are associated with grey matter structural changes. However, genome-wide scores do not allow mechanistic interpretations. The present study explored associations between disease pathway-specific scores and grey matter structure in younger and older adults. Data from two separate population cohorts were used as follows: the Avon Longitudinal Study of Parents and Children, mean age 19.8, and UK Biobank, mean age 64.4 (combined n = 18 689). Alzheimer's polygenic risk scores were computed using the largest genome-wide association study of clinically assessed Alzheimer's to date. Relationships between subcortical volumes and cortical thickness, pathway-specific scores and genome-wide scores were examined. Increased pathway-specific scores were associated with reduced cortical thickness in both the younger and older cohorts. For example, the reverse cholesterol transport pathway score showed evidence of association with lower left middle temporal cortex thickness in the younger Avon participants (P = 0.034; beta = -0.013, CI -0.025, -0.001) and in the older UK Biobank participants (P = 0.019; beta = -0.003, CI -0.005, -4.56 × 10-4). Pathway scores were associated with smaller subcortical volumes, such as smaller hippocampal volume, in UK Biobank older adults. There was also evidence of positive association between subcortical volumes in Avon younger adults. For example, the tau protein-binding pathway score was negatively associated with left hippocampal volume in UK Biobank (P = 8.35 × 10-05; beta = -11.392, CI -17.066, -5.718) and positively associated with hippocampal volume in the Avon study (P = 0.040; beta = 51.952, CI 2.445, 101.460). The immune response score had a distinct pattern of association, being only associated with reduced thickness in the right posterior cingulate in older and younger adults (P = 0.011; beta = -0.003, CI -0.005, -0.001 in UK Biobank; P = 0.034; beta = -0.016, CI -0.031, -0.001 in the Avon study). The immune response score was associated with smaller subcortical volumes in the older adults, but not younger adults. The disease pathway scores showed greater evidence of association with imaging phenotypes than the genome-wide score. This suggests that pathway-specific polygenic methods may allow progress towards a mechanistic understanding of structural changes linked to polygenic risk in pre-clinical Alzheimer's disease. Pathway-specific profiling could further define pathophysiology in individuals, moving towards precision medicine in Alzheimer's disease.
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Affiliation(s)
- Judith R Harrison
- Institute of Neuroscience, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, CF24 4HQ, UK
| | - Sonya F Foley
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, CF24 4HQ, UK
| | - Emily Baker
- Dementia Research Institute & MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Matthew Bracher-Smith
- MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Peter Holmans
- MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Evie Stergiakouli
- Bristol Population Health Science Institute, Bristol University, Oakfield House, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK
| | - David E J Linden
- School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Xavier Caseras
- MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Derek K Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, CF24 4HQ, UK
- Mary MacKillop Institute for Health Research, Australian Catholic University, 5/215 Spring St, Melbourne, VIC 3000, Australia
| | - Valentina Escott-Price
- Dementia Research Institute & MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, CF24 4HQ, UK
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Liu J, Zhang Y, Qiu J, Wei D. Linking negative affect, personality and social conditions to structural brain development during the transition from late adolescent to young adulthood. J Affect Disord 2023; 325:14-21. [PMID: 36623558 DOI: 10.1016/j.jad.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/30/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND The transition from late adolescence to early adulthood is a period that experiences a surge of life changes and brain reorganization caused by internal and external factors, including negative affect, personality, and social conditions. METHODS Non-imaging phenotype and structural brain variables were available on 497 healthy participants (279 females and 218 males) between 17 and 22 years old. We used sparse canonical correlation analysis (sCCA) on the high-dimensional and longitudinal data to extract modes with maximum covariation between structural brain changes and negative affect, personality, and social conditions. RESULTS Separate sCCAs for cortical volume, cortical thickness, cortical surface area and subcortical volume confirmed that each imaging phenotype was correlated with non-imaging features (sCCA |r| range: 0.21-0.38, all pFDR < 0.01). Bilateral superior frontal, left caudal anterior cingulate and bilateral caudate had the highest canonical cross-loadings (|ρ| = 0.15-0.32). In longitudinal data analysis, scan-interval, negative affect, and enthusiasm had the highest association with structural brain changes (|ρ| = 0.07-0.38); at baseline, intellect and politeness were associated with individual variability in the structural brain (|ρ| = 0.10-0.25). LIMITATIONS The present study used non-imaging variables only at baseline, making it impossible to explore the relationship between changing behavior and structural brain development. CONCLUSIONS Individual structural brain changes are associated with multiple factors. In addition to time-dependent variables, we find that negative affect, enthusiasm and social support play a numerically weak but significant role in structural brain development during the transition from late adolescence to young adulthood.
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Affiliation(s)
- Jiahui Liu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Yi Zhang
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China; Southwest University Branch, Collaborative Innovation Center of Assessment Toward Basic Education Quality at Beijing Normal University, China.
| | - Dongtao Wei
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China.
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Cuberas-Borrós G, Roca I, Castell-Conesa J, Núñez L, Boada M, López OL, Grifols C, Barceló M, Pareto D, Páez A. Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's disease: additional results from the AMBAR study. Eur J Nucl Med Mol Imaging 2022; 49:4589-4600. [PMID: 35867135 PMCID: PMC9606044 DOI: 10.1007/s00259-022-05915-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/14/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE This study was designed to detect structural and functional brain changes in Alzheimer's disease (AD) patients treated with therapeutic plasma exchange (PE) with albumin replacement, as part of the recent AMBAR phase 2b/3 clinical trial. METHODS Mild-to-moderate AD patients were randomized into four arms: three arms receiving PE with albumin (one with low-dose albumin, and two with low/high doses of albumin alternated with IVIG), and a placebo (sham PE) arm. All arms underwent 6 weeks of weekly conventional PE followed by 12 months of monthly low-volume PE. Magnetic resonance imaging (MRI) volumetric analyses and regional and statistical parametric mapping (SPM) analysis on 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET) were performed. RESULTS MRI analyses (n = 198 patients) of selected subcortical structures showed fewer volume changes from baseline to final visit in the high albumin + IVIG treatment group (p < 0.05 in 3 structures vs. 4 to 9 in other groups). The high albumin + IVIG group showed no statistically significant reduction of right hippocampus. SPM 18FDG-PET analyses (n = 213 patients) showed a worsening of metabolic activity in the specific areas affected in AD (posterior cingulate, precuneus, and parieto-temporal regions). The high-albumin + IVIG treatment group showed the greatest metabolic stability over the course of the study, i.e., the smallest percent decline in metabolism (MaskAD), and least progression of defect compared to placebo. CONCLUSIONS PE with albumin replacement was associated with fewer deleterious changes in subcortical structures and less metabolic decline compared to the typical of the progression of AD. This effect was more marked in the group treated with high albumin + IVIG. TRIAL REGISTRATION (AMBAR trial registration: EudraCT#: 2011-001,598-25; ClinicalTrials.gov ID: NCT01561053).
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Affiliation(s)
- Gemma Cuberas-Borrós
- Research & Innovation Unit, Althaia Xarxa Assistencial Universitària de Manresa, Carrer Dr. Joan Soler 1-3, 08242, Manresa, Spain.
- Department of Nuclear Medicine, Hospital Universitari Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Isabel Roca
- Department of Nuclear Medicine, Hospital Universitari Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Castell-Conesa
- Department of Nuclear Medicine, Hospital Universitari Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Núñez
- Alzheimer's Research Group, Grifols, Barcelona, Spain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Oscar L López
- Departments of Neurology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | | | - Deborah Pareto
- Radiology Department (IDI), Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Antonio Páez
- Alzheimer's Research Group, Grifols, Barcelona, Spain
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Nabizadeh F, Balabandian M, Rostami MR, Ward RT, Ahmadi N, Pourhamzeh M. Plasma p-tau181 associated with structural changes in mild cognitive impairment. Aging Clin Exp Res 2022; 34:2139-2147. [PMID: 35648357 DOI: 10.1007/s40520-022-02148-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/02/2022] [Indexed: 01/29/2023]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease associated with dementia and is a serious concern for the health of individuals and government health care systems worldwide. Gray matter atrophy and white matter damage are major contributors to cognitive deficits in AD patients, as demonstrated by magnetic resonance imaging (MRI). Many of these brain changes associated with AD begin to occur about 15 years before the onset of initial clinical symptoms. Therefore, it is critical to find biomarkers reflective of these brain changes associated with AD to identify this disease and monitor its prognosis and development. The increased plasma level of hyperphosphorylated tau 181 (p-tau181) has been recently considered a novel biomarker for the diagnosis of AD, preclinical AD, and mild cognitive impairment (MCI). In the current study, we examined the association of cerebrospinal fluid (CSF) and plasma levels of p-tau181 with structural brain changes in cortical thickness, cortical volume, surface area, and subcortical volume in MCI patients. In this cross-sectional study, we included the information of 461 MCI patients from the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. The results of voxel-wise partial correlation analyses showed a significant negative correlation between the increased levels of plasma p-tau181, CSF total tau, and CSF p-tau181 with structural changes in widespread brain regions. These results provide evidence for the use of plasma p-tau181 as a diagnostic marker for structural changes in the brain associated with the early stages of AD and neurodegeneration.
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Affiliation(s)
- Fardin Nabizadeh
- Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Balabandian
- Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mohammad Reza Rostami
- Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Richard T Ward
- Center for the Study of Emotion and Attention, University of Florida, Florida, USA
- Department of Psychology, University of Florida, Florida, USA
| | - Niloufar Ahmadi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mahsa Pourhamzeh
- Division of Neuroscience, Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Qin Y, Cui J, Ge X, Tian Y, Han H, Fan Z, Liu L, Luo Y, Yu H. Hierarchical multi-class Alzheimer’s disease diagnostic framework using imaging and clinical features. Front Aging Neurosci 2022; 14:935055. [PMID: 36034132 PMCID: PMC9399682 DOI: 10.3389/fnagi.2022.935055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Due to the clinical continuum of Alzheimer’s disease (AD), the accuracy of early diagnostic remains unsatisfactory and warrants further research. The objectives of this study were: (1) to develop an effective hierarchical multi-class framework for clinical populations, namely, normal cognition (NC), early mild cognitive impairment (EMCI), late mild cognitive impairment (LMCI), and AD, and (2) to explore the geometric properties of cognition-related anatomical structures in the cerebral cortex. A total of 1,670 participants were enrolled in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database, comprising 985 participants (314 NC, 208 EMCI, 258 LMCI, and 205 AD) in the model development set and 685 participants (417 NC, 110 EMCI, 83 LMCI, and 75 AD) after 2017 in the temporal validation set. Four cortical geometric properties for 148 anatomical structures were extracted, namely, cortical thickness (CTh), fractal dimension (FD), gyrification index (GI), and sulcus depth (SD). By integrating these imaging features with Mini-Mental State Examination (MMSE) scores at four-time points after the initial visit, we identified an optimal subset of 40 imaging features using the temporally constrained group sparse learning method. The combination of selected imaging features and clinical variables improved the multi-class performance using the AdaBoost algorithm, with overall accuracy rates of 0.877 in the temporal validation set. Clinical Dementia Rating (CDR) was the primary clinical variable associated with AD-related populations. The most discriminative imaging features included the bilateral CTh of the dorsal part of the posterior cingulate gyrus, parahippocampal gyrus (PHG), parahippocampal part of the medial occipito-temporal gyrus, and angular gyrus, the GI of the left inferior segment of the insula circular sulcus, and the CTh and SD of the left superior temporal sulcus (STS). Our hierarchical multi-class framework underscores the utility of combining cognitive variables with imaging features and the reliability of surface-based morphometry, facilitating more accurate early diagnosis of AD in clinical practice.
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Affiliation(s)
- Yao Qin
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jing Cui
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xiaoyan Ge
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yuling Tian
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Hongjuan Han
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Zhao Fan
- Center of Translational Medicine, School of Basic Medical Sciences, Shanxi Medical University, Taiyuan, China
| | - Long Liu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yanhong Luo
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Hongmei Yu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
- Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Taiyuan, China
- *Correspondence: Hongmei Yu,
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Perez SD, Phillips JS, Norise C, Kinney NG, Vaddi P, Halpin A, Rascovsky K, Irwin DJ, McMillan CT, Xie L, Wisse LE, Yushkevich PA, Kallogjeri D, Grossman M, Cousins KA. Neuropsychological and Neuroanatomical Features of Patients with Behavioral/Dysexecutive Variant Alzheimer’s disease (AD): A Comparison to Behavioral Variant Frontotemporal Dementia and Amnestic AD Groups. J Alzheimers Dis 2022; 89:641-658. [PMID: 35938245 PMCID: PMC10117623 DOI: 10.3233/jad-215728] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: An understudied variant of Alzheimer’s disease (AD), the behavioral/dysexecutive variant of AD (bvAD), is associated with progressive personality, behavior, and/or executive dysfunction and frontal atrophy. Objective: This study characterizes the neuropsychological and neuroanatomical features associated with bvAD by comparing it to behavioral variant frontotemporal dementia (bvFTD), amnestic AD (aAD), and subjects with normal cognition. Methods: Subjects included 16 bvAD, 67 bvFTD, and 18 aAD patients, and 26 healthy controls. Neuropsychological assessment and MRI data were compared between these groups. Results: Compared to bvFTD, bvAD showed more significant visuospatial impairments (Rey Figure copy and recall), more irritability (Neuropsychological Inventory), and equivalent verbal memory (Philadelphia Verbal Learning Test). Compared to aAD, bvAD indicated more executive dysfunction (F-letter fluency) and better visuospatial performance. Neuroimaging analysis found that bvAD showed cortical thinning relative to bvFTD posteriorly in left temporal-occipital regions; bvFTD had cortical thinning relative to bvAD in left inferior frontal cortex. bvAD had cortical thinning relative to aAD in prefrontal and anterior temporal regions. All patient groups had lower volumes than controls in both anterior and posterior hippocampus. However, bvAD patients had higher average volume than aAD patients in posterior hippocampus and higher volume than bvFTD patients in anterior hippocampus after adjustment for age and intracranial volume. Conclusion: Findings demonstrated that underlying pathology mediates disease presentation in bvAD and bvFTD.
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Affiliation(s)
- Sophia Dominguez Perez
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Jeffrey S. Phillips
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Catherine Norise
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nikolas G. Kinney
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Prerana Vaddi
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amy Halpin
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychology, University of Maine, Orono, ME, USA
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David J. Irwin
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Corey T. McMillan
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Long Xie
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Image Computing and Science Lab & Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura E.M. Wisse
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Image Computing and Science Lab & Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Diagnostic Radiology, Lund University, Lund, Sweden
| | - Paul A. Yushkevich
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Image Computing and Science Lab & Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dorina Kallogjeri
- Department of Otolaryngology, Washington University, St. Louis, MO, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Katheryn A.Q. Cousins
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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9
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Putcha D, Carvalho N, Dev S, McGinnis SM, Dickerson BC, Wong B. Verbal Encoding Deficits Impact Recognition Memory in Atypical “Non-Amnestic” Alzheimer’s Disease. Brain Sci 2022; 12:brainsci12070843. [PMID: 35884649 PMCID: PMC9313460 DOI: 10.3390/brainsci12070843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 02/01/2023] Open
Abstract
Memory encoding and retrieval deficits have been identified in atypical Alzheimer’s disease (AD), including posterior cortical atrophy (PCA) and logopenic variant primary progressive aphasia (lvPPA), despite these groups being referred to as “non-amnestic”. There is a critical need to better understand recognition memory in atypical AD. We investigated performance on the California Verbal Learning Test (CVLT-II-SF) in 23 amyloid-positive, tau-positive, and neurodegeneration-positive participants with atypical “non-amnestic” variants of AD (14 PCA, 9 lvPPA) and 14 amnestic AD participants. Recognition memory performance was poor across AD subgroups but trended toward worse in the amnestic group. Encoding was related to recognition memory in non-amnestic but not in amnestic AD. We also observed cortical atrophy in dissociable subregions of the distributed memory network related to encoding (left middle temporal and angular gyri, posterior cingulate and precuneus) compared to recognition memory (anterior medial temporal cortex). We conclude that recognition memory is not spared in all patients with atypical variants of AD traditionally thought to be “non-amnestic”. The non-amnestic AD patients with poor recognition memory were those who struggled to encode the material during the learning trials. In contrast, the amnestic AD group had poor recognition memory regardless of encoding ability.
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Affiliation(s)
- Deepti Putcha
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA; (N.C.); (S.D.); (S.M.M.); (B.C.D.); (B.W.)
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA
- Center for Brain Mind Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
- Correspondence:
| | - Nicole Carvalho
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA; (N.C.); (S.D.); (S.M.M.); (B.C.D.); (B.W.)
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Sheena Dev
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA; (N.C.); (S.D.); (S.M.M.); (B.C.D.); (B.W.)
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Scott M. McGinnis
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA; (N.C.); (S.D.); (S.M.M.); (B.C.D.); (B.W.)
- Center for Brain Mind Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Bradford C. Dickerson
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA; (N.C.); (S.D.); (S.M.M.); (B.C.D.); (B.W.)
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Bonnie Wong
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA; (N.C.); (S.D.); (S.M.M.); (B.C.D.); (B.W.)
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA
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10
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Termine A, Fabrizio C, Caltagirone C, Petrosini L. A Reproducible Deep-Learning-Based Computer-Aided Diagnosis Tool for Frontotemporal Dementia Using MONAI and Clinica Frameworks. Life (Basel) 2022; 12:947. [PMID: 35888037 PMCID: PMC9323676 DOI: 10.3390/life12070947] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 12/16/2022] Open
Abstract
Despite Artificial Intelligence (AI) being a leading technology in biomedical research, real-life implementation of AI-based Computer-Aided Diagnosis (CAD) tools into the clinical setting is still remote due to unstandardized practices during development. However, few or no attempts have been made to propose a reproducible CAD development workflow for 3D MRI data. In this paper, we present the development of an easily reproducible and reliable CAD tool using the Clinica and MONAI frameworks that were developed to introduce standardized practices in medical imaging. A Deep Learning (DL) algorithm was trained to detect frontotemporal dementia (FTD) on data from the NIFD database to ensure reproducibility. The DL model yielded 0.80 accuracy (95% confidence intervals: 0.64, 0.91), 1 sensitivity, 0.6 specificity, 0.83 F1-score, and 0.86 AUC, achieving a comparable performance with other FTD classification approaches. Explainable AI methods were applied to understand AI behavior and to identify regions of the images where the DL model misbehaves. Attention maps highlighted that its decision was driven by hallmarking brain areas for FTD and helped us to understand how to improve FTD detection. The proposed standardized methodology could be useful for benchmark comparison in FTD classification. AI-based CAD tools should be developed with the goal of standardizing pipelines, as varying pre-processing and training methods, along with the absence of model behavior explanations, negatively impact regulators' attitudes towards CAD. The adoption of common best practices for neuroimaging data analysis is a step toward fast evaluation of efficacy and safety of CAD and may accelerate the adoption of AI products in the healthcare system.
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Affiliation(s)
- Andrea Termine
- Data Science Unit, IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (A.T.); (C.F.)
| | - Carlo Fabrizio
- Data Science Unit, IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (A.T.); (C.F.)
| | - Carlo Caltagirone
- Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy;
| | - Laura Petrosini
- Experimental and Behavioral Neurophysiology, IRCCS Santa Lucia Foundation, 00143 Rome, Italy
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11
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Isella V, Crivellaro C, Formenti A, Musarra M, Pacella S, Morzenti S, Ferri F, Mapelli C, Gallivanone F, Guerra L, Appollonio I, Ferrarese C. Validity of cingulate–precuneus–temporo-parietal hypometabolism for single-subject diagnosis of biomarker-proven atypical variants of Alzheimer’s Disease. J Neurol 2022; 269:4440-4451. [PMID: 35347453 PMCID: PMC9293827 DOI: 10.1007/s00415-022-11086-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/14/2022]
Abstract
The aim of our study was to establish empirically to what extent reduced glucose uptake in the precuneus, posterior cingulate and/or temporo-parietal cortex (PCTP), which is thought to indicate brain amyloidosis in patients with dementia or MCI due to Alzheimer’s Disease (AD), permits to distinguish amyloid-positive from amyloid-negative patients with non-classical AD phenotypes at the single-case level. We enrolled 127 neurodegenerative patients with cognitive impairment and a positive (n. 63) or negative (n. 64) amyloid marker (cerebrospinal fluid or amy-PET). Three rating methods of FDG-PET scan were applied: purely qualitative visual interpretation of uptake images (VIUI), and visual reading assisted by a semi-automated and semi-quantitative tool: INLAB, provided by the Italian National Research Council, or Cortex ID Suite, marketed by GE Healthcare. Fourteen scans (11.0%) patients remained unclassified by VIUI or INLAB procedures, therefore, validity values were computed on the remaining 113 cases. The three rating approaches showed good total accuracy (77–78%), good to optimal sensitivity (81–93%), but poorer specificity (62–75%). VIUI showed the highest sensitivity and the lowest specificity, and also the highest proportion of unclassified cases. Cases with asymmetric temporo-parietal hypometabolism and a progressive aphasia or corticobasal clinical profile, in particular, tended to be rated as AD-like, even if biomarkers indicated non-amyloid pathology. Our findings provide formal support to the value of PCTP hypometabolism for single-level diagnosis of amyloid pathophysiology in atypical AD, but also highlight the risk of qualitative assessment to misclassify patients with non-AD PPA or CBS underpinned by asymmetric temporo-parietal hypometabolism.
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12
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Putcha D, Eckbo R, Katsumi Y, Dickerson BC, Touroutoglou A, Collins JA. Tau and the fractionated default mode network in atypical Alzheimer's disease. Brain Commun 2022; 4:fcac055. [PMID: 35356035 PMCID: PMC8963312 DOI: 10.1093/braincomms/fcac055] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/26/2022] [Accepted: 03/07/2022] [Indexed: 11/12/2022] Open
Abstract
Alzheimer's disease-related atrophy in the posterior cingulate cortex, a key node of the default mode network, is present in the early stages of disease progression across clinical phenotypic variants of the disease. In the typical amnestic variant, posterior cingulate cortex neuropathology has been linked with disrupted connectivity of the posterior default mode network, but it remains unclear if this relationship is observed across atypical variants of Alzheimer's disease. In the present study, we first sought to determine if tau pathology is consistently present in the posterior cingulate cortex and other posterior nodes of the default mode network across the atypical Alzheimer's disease syndromic spectrum. Second, we examined functional connectivity disruptions within the default mode network and sought to determine if tau pathology is related to functional disconnection within this network. We studied a sample of 25 amyloid-positive atypical Alzheimer's disease participants examined with high-resolution MRI, tau (18F-AV-1451) PET, and resting-state functional MRI. In these patients, high levels of tau pathology in the posteromedial cortex and hypoconnectivity between temporal and parietal nodes of the default mode network were observed relative to healthy older controls. Furthermore, higher tau signal and reduced grey matter density in the posterior cingulate cortex and angular gyrus were associated with reduced parietal functional connectivity across individual patients, related to poorer cognitive scores. Our findings converge with what has been reported in amnestic Alzheimer's disease, and together these observations offer a unifying mechanistic feature that relates posterior cingulate cortex tau deposition to aberrant default mode network connectivity across heterogeneous clinical phenotypes of Alzheimer's disease.
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Affiliation(s)
- Deepti Putcha
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ryan Eckbo
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Yuta Katsumi
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Bradford C. Dickerson
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Alzheimer’s Disease Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Alexandra Touroutoglou
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jessica A. Collins
- Frontotemporal Disorders Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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13
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Verbal and Nonverbal Memory in Neurodegenerative and Stroke Aphasia: Evidence From the Turkish Version of the Three Words Three Shapes Test. Cogn Behav Neurol 2022; 35:49-65. [PMID: 35239599 DOI: 10.1097/wnn.0000000000000294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although language impairment is the most salient feature of cognitive impairment in both primary progressive aphasia (PPA) and stroke aphasia (SA), memory can also be impaired in both patient populations. OBJECTIVE To identify distinctive features of verbal and nonverbal memory processing in individuals with PPA and those with SA. METHOD We gave individuals with PPA (n = 14), those with SA (n = 8), and healthy controls (HC; n = 13) a comprehensive neuropsychological test battery and the Turkish version of the Three Words Three Shapes Test (3W3S-Turkish). The 3W3S-Turkish Test includes five subtests: Copy, Incidental Recall, Acquisition, Delayed Recall, and Recognition. High-resolution brain scans were performed in a subset of individuals with PPA and those with SA. Lesion distribution was limited to the dorsal language areas in the SA group, whereas peak atrophy areas in the PPA group extended beyond the language network, including the medial temporal lobe, precuneus, and posterior/medial portions of the cingulate cortex. RESULTS Both the PPA and SA groups showed impairment in incidental recall, and the PPA group showed additional impairment in delayed recall. Greater impairment for verbal stimuli suggestive of material-specific memory impairment was evident in the PPA group's scores on the Incidental Recall and Delayed Recall subtests. Both aphasia groups retained the acquired information regardless of material type. CONCLUSION Although both aphasia groups shared similarities in the involvement of the dorsal prefrontal working memory/attention network, the PPA group showed greater impairment in delayed recall compared with the SA group.
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14
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Song R, Wu X, Liu H, Guo D, Tang L, Zhang W, Feng J, Li C. Prediction of Cognitive Progression in Individuals with Mild Cognitive Impairment Using Radiomics as an Improvement of the ATN System: A Five-Year Follow-Up Study. Korean J Radiol 2022; 23:89-100. [PMID: 34983097 PMCID: PMC8743156 DOI: 10.3348/kjr.2021.0323] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 11/15/2022] Open
Abstract
Objective To improve the N biomarker in the amyloid/tau/neurodegeneration system by radiomics and study its value for predicting cognitive progression in individuals with mild cognitive impairment (MCI). Materials and Methods A group of 147 healthy controls (HCs) (72 male; mean age ± standard deviation, 73.7 ± 6.3 years), 197 patients with MCI (114 male; 72.2 ± 7.1 years), and 128 patients with Alzheimer’s disease (AD) (74 male; 73.7 ± 8.4 years) were included. Optimal A, T, and N biomarkers for discriminating HC and AD were selected using receiver operating characteristic (ROC) curve analysis. A radiomics model containing comprehensive information of the whole cerebral cortex and deep nuclei was established to create a new N biomarker. Cerebrospinal fluid (CSF) biomarkers were evaluated to determine the optimal A or T biomarkers. All MCI patients were followed up until AD conversion or for at least 60 months. The predictive value of A, T, and the radiomics-based N biomarker for cognitive progression of MCI to AD were analyzed using Kaplan-Meier estimates and the log-rank test. Results The radiomics-based N biomarker showed an ROC curve area of 0.998 for discriminating between AD and HC. CSF Aβ42 and p-tau proteins were identified as the optimal A and T biomarkers, respectively. For MCI patients on the Alzheimer’s continuum, isolated A+ was an indicator of cognitive stability, while abnormalities of T and N, separately or simultaneously, indicated a high risk of progression. For MCI patients with suspected non-Alzheimer’s disease pathophysiology, isolated T+ indicated cognitive stability, while the appearance of the radiomics-based N+ indicated a high risk of progression to AD. Conclusion We proposed a new radiomics-based improved N biomarker that could help identify patients with MCI who are at a higher risk for cognitive progression. In addition, we clarified the value of a single A/T/N biomarker for predicting the cognitive progression of MCI.
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Affiliation(s)
- Rao Song
- Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaojia Wu
- Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | | | - Dajing Guo
- Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lin Tang
- Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Zhang
- Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Junbang Feng
- Department of Radiology, Chongqing Emergency Medical Center, Chongqing, China
| | - Chuanming Li
- Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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15
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Ossenkoppele R, Singleton EH, Groot C, Dijkstra AA, Eikelboom WS, Seeley WW, Miller B, Laforce RJ, Scheltens P, Papma JM, Rabinovici GD, Pijnenburg YAL. Research Criteria for the Behavioral Variant of Alzheimer Disease: A Systematic Review and Meta-analysis. JAMA Neurol 2021; 79:48-60. [PMID: 34870696 PMCID: PMC8649917 DOI: 10.1001/jamaneurol.2021.4417] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance The behavioral variant of Alzheimer disease (bvAD) is characterized by early and predominant behavioral deficits caused by AD pathology. This AD phenotype is insufficiently understood and lacks standardized clinical criteria, limiting reliability and reproducibility of diagnosis and scientific reporting. Objective To perform a systematic review and meta-analysis of the bvAD literature and use the outcomes to propose research criteria for this syndrome. Data Sources A systematic literature search in PubMed/MEDLINE and Web of Science databases (from inception through April 7, 2021) was performed in duplicate. Study Selection Studies reporting on behavioral, neuropsychological, or neuroimaging features in bvAD and, when available, providing comparisons with typical amnestic-predominant AD (tAD) or behavioral variant frontotemporal dementia (bvFTD). Data Extraction and Synthesis This analysis involved random-effects meta-analyses on group-level study results of clinical data and systematic review of the neuroimaging literature. The study was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Main Outcomes and Measures Behavioral symptoms (neuropsychiatric symptoms and bvFTD core clinical criteria), cognitive function (global cognition, episodic memory, and executive functioning), and neuroimaging features (structural magnetic resonance imaging, [18F]fluorodeoxyglucose-positron emission tomography, perfusion single-photon emission computed tomography, amyloid positron emission tomography, and tau positron emission tomography). Results The search led to the assessment of 83 studies, including 13 suitable for meta-analysis. Data were collected for 591 patients with bvAD. There was moderate to substantial heterogeneity and moderate risk of bias across studies. Cases with bvAD showed more severe behavioral symptoms than tAD (standardized mean difference [SMD], 1.16 [95% CI, 0.74-1.59]; P < .001) and a trend toward less severe behavioral symptoms compared with bvFTD (SMD, -0.22 [95% CI, -0.47 to 0.04]; P = .10). Meta-analyses of cognitive data indicated worse executive performance in bvAD vs tAD (SMD, -1.03 [95% CI, -1.74 to -0.32]; P = .008) but not compared with bvFTD (SMD, -0.61 [95% CI, -1.75 to 0.53]; P = .29). Cases with bvAD showed a nonsignificant difference of worse memory performance compared with bvFTD (SMD, -1.31 [95% CI, -2.75 to 0.14]; P = .08) but did not differ from tAD (SMD, 0.43 [95% CI, -0.46 to 1.33]; P = .34). The neuroimaging literature revealed 2 distinct bvAD neuroimaging phenotypes: an AD-like pattern with relative frontal sparing and a relatively more bvFTD-like pattern characterized by additional anterior involvement, with the AD-like pattern being more prevalent. Conclusions and Relevance These data indicate that bvAD is clinically most similar to bvFTD, while it shares most pathophysiological features with tAD. Based on these insights, we propose research criteria for bvAD aimed at improving the consistency and reliability of future research and aiding the clinical assessment of this AD phenotype.
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Affiliation(s)
- Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.,Lund University, Clinical Memory Research Unit, Lund, Sweden
| | - Ellen H Singleton
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Colin Groot
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Anke A Dijkstra
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Location VUMC, Amsterdam, the Netherlands
| | - Willem S Eikelboom
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Bruce Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Robert Jr Laforce
- Clinique Interdisciplinaire de Mémoire, Centre Hospitalier Universitaire de Québec, Québec, Canada
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Janne M Papma
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco.,Weill Institute for Neurosciences, University of California, San Francisco, San Francisco.,Associate Editor, JAMA Neurology
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
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de Godoy LL, Studart-Neto A, Wylezinska-Arridge M, Tsunemi MH, Moraes NC, Yassuda MS, Coutinho AM, Buchpiguel CA, Nitrini R, Bisdas S, da Costa Leite C. The Brain Metabolic Signature in Superagers Using In Vivo 1H-MRS: A Pilot Study. AJNR Am J Neuroradiol 2021; 42:1790-1797. [PMID: 34446458 DOI: 10.3174/ajnr.a7262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 05/28/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Youthful memory performance in older adults may reflect an underlying resilience to the conventional pathways of aging. Subjects having this unusual characteristic have been recently termed "superagers." This study aimed to explore the significance of imaging biomarkers acquired by 1H-MRS to characterize superagers and to differentiate them from their normal-aging peers. MATERIALS AND METHODS Fifty-five patients older than 80 years of age were screened using a detailed neuropsychological protocol, and 25 participants, comprising 12 superagers and 13 age-matched controls, were statistically analyzed. We used state-of-the-art 3T 1H-MR spectroscopy to quantify 18 neurochemicals in the posterior cingulate cortex of our subjects. All 1H-MR spectroscopy data were analyzed using LCModel. Results were further processed using 2 approaches to investigate the technique accuracy: 1) comparison of the average concentration of metabolites estimated with Cramer-Rao lower bounds <20%; and 2) calculation and comparison of the weighted means of metabolites' concentrations. RESULTS The main finding observed was a higher total N-acetyl aspartate concentration in superagers than in age-matched controls using both approaches (P = .02 and P = .03 for the weighted means), reflecting a positive association of total N-acetyl aspartate with higher cognitive performance. CONCLUSIONS 1H-MR spectroscopy emerges as a promising technique to unravel neurochemical mechanisms related to cognitive aging in vivo and providing a brain metabolic signature in superagers. This may contribute to monitoring future interventional therapies to avoid or postpone the pathologic processes of aging.
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Affiliation(s)
- L L de Godoy
- From the Department of Radiology and Oncology (L.L.d.G., C.d.C.L.), Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- The National Hospital of Neurology and Neurosurgery (M.W.-A., S.B.), University College London, London, UK
| | - A Studart-Neto
- Department of Neurology (A.S.-N., N.C.M., M.S.Y., R.N.), Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - M Wylezinska-Arridge
- The National Hospital of Neurology and Neurosurgery (M.W.-A., S.B.), University College London, London, UK
| | - M H Tsunemi
- Department of Biostatistics, Institute of Biosciences (M.H.T.), Universidade Estadual Paulista, Botucatu, Sao Paulo, SP, Brazil
| | - N C Moraes
- Department of Neurology (A.S.-N., N.C.M., M.S.Y., R.N.), Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - M S Yassuda
- Department of Neurology (A.S.-N., N.C.M., M.S.Y., R.N.), Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - A M Coutinho
- Division and Laboratory of Nuclear Medicine (A.M.C., C.A.B.), Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - C A Buchpiguel
- Division and Laboratory of Nuclear Medicine (A.M.C., C.A.B.), Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - R Nitrini
- Department of Neurology (A.S.-N., N.C.M., M.S.Y., R.N.), Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - S Bisdas
- The National Hospital of Neurology and Neurosurgery (M.W.-A., S.B.), University College London, London, UK
| | - C da Costa Leite
- From the Department of Radiology and Oncology (L.L.d.G., C.d.C.L.), Hospital das Clínicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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Cerebrospinal Fluid Amyloid Beta, Tau Levels, Apolipoprotein, and 1H-MRS Brain Metabolites in Alzheimer's Disease: A Systematic Review. Acad Radiol 2021; 28:1447-1463. [PMID: 32651050 DOI: 10.1016/j.acra.2020.06.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/09/2020] [Accepted: 06/03/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND There is compelling evidence that neurochemical changes measured by proton magnetic resonance spectroscopy (1H-MRS) occur at different phases of Alzheimer's disease (AD). However, the extent to which these neurochemical changes are associated with validated AD biomarkers and/or apolipoprotein (APOE) ε4 is yet to be established. OBJECTIVE This systematic review analyzed the available evidence on (1) neurochemical changes; and (2) the relations between brain metabolite and validated cerebrospinal fluid biomarkers, and/or APOE in AD. METHODS PubMed, Cochrane, Scopus, and gray literature were systematically screened for studies deemed fit for the purpose of the current systematic review. RESULTS Twenty four articles met the inclusion criteria. Decreased levels of N-acetyl aspartate (NAA), NAA/(creatine) Cr, and NAA/(myo-inositol) ml, and increased ml, ml/Cr, Cho (choline)/Cr, and ml/NAA were found in the posterior cingulate cortex/precuneus. Increased ml is associated with increased tau levels, reduced NAA/Cr is associated with increased tau. ml/Cr is negatively correlated with Aβ42, and ml/Cr is positively correlated with t-tau. NAA and glutathione levels are reduced in APOE ε4 carriers. APOE ε4 exerts no modulatory effect on NAA/Cr. There is interaction between APOE ε4, Aβ42, and ml/Cr. CONCLUSION NAA, ml, NAA/Cr, NAA/ml and ml/Cr may be potentially useful biomarkers that may highlight functional changes in the clinical stages of AD. The combinations of ml and tau, NAA/Cr and Aβ42, and NAA/Cr and tau may support the diagnostic process of differentiating MCI/AD from healthy individuals. Large, longitudinal studies are required to clarify the effect of APOE ε4 on brain metabolites.
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Piersson AD, Ibrahim B, Suppiah S, Mohamad M, Hassan HA, Omar NF, Ibrahim MI, Yusoff AN, Ibrahim N, Saripan MI, Razali RM. Multiparametric MRI for the improved diagnostic accuracy of Alzheimer's disease and mild cognitive impairment: Research protocol of a case-control study design. PLoS One 2021; 16:e0252883. [PMID: 34547018 PMCID: PMC8454976 DOI: 10.1371/journal.pone.0252883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 05/18/2021] [Indexed: 11/19/2022] Open
Abstract
Background Alzheimer’s disease (AD) is a major neurocognitive disorder identified by memory loss and a significant cognitive decline based on previous level of performance in one or more cognitive domains that interferes in the independence of everyday activities. The accuracy of imaging helps to identify the neuropathological features that differentiate AD from its common precursor, mild cognitive impairment (MCI). Identification of early signs will aid in risk stratification of disease and ensures proper management is instituted to reduce the morbidity and mortality associated with AD. Magnetic resonance imaging (MRI) using structural MRI (sMRI), functional MRI (fMRI), diffusion tensor imaging (DTI), and magnetic resonance spectroscopy (1H-MRS) performed alone is inadequate. Thus, the combination of multiparametric MRI is proposed to increase the accuracy of diagnosing MCI and AD when compared to elderly healthy controls. Methods This protocol describes a non-interventional case control study. The AD and MCI patients and the healthy elderly controls will undergo multi-parametric MRI. The protocol consists of sMRI, fMRI, DTI, and single-voxel proton MRS sequences. An eco-planar imaging (EPI) will be used to perform resting-state fMRI sequence. The structural images will be analysed using Computational Anatomy Toolbox-12, functional images will be analysed using Statistical Parametric Mapping-12, DPABI (Data Processing & Analysis for Brain Imaging), and Conn software, while DTI and 1H-MRS will be analysed using the FSL (FMRIB’s Software Library) and Tarquin respectively. Correlation of the MRI results and the data acquired from the APOE genotyping, neuropsychological evaluations (i.e. Montreal Cognitive Assessment [MoCA], and Mini–Mental State Examination [MMSE] scores) will be performed. The imaging results will also be correlated with the sociodemographic factors. The diagnosis of AD and MCI will be standardized and based on the DSM-5 criteria and the neuropsychological scores. Discussion The combination of sMRI, fMRI, DTI, and MRS sequences can provide information on the anatomical and functional changes in the brain such as regional grey matter volume atrophy, impaired functional connectivity among brain regions, and decreased metabolite levels specifically at the posterior cingulate cortex/precuneus. The combination of multiparametric MRI sequences can be used to stratify the management of MCI and AD patients. Accurate imaging can decide on the frequency of follow-up at memory clinics and select classifiers for machine learning that may aid in the disease identification and prognostication. Reliable and consistent quantification, using standardised protocols, are crucial to establish an optimal diagnostic capability in the early detection of Alzheimer’s disease.
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Affiliation(s)
- Albert Dayor Piersson
- Diagnostic Imaging and Radiotherapy Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Imaging Technology & Sonography, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Buhari Ibrahim
- Faculty of Medicine and Health Sciences, Department of Radiology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Faculty of Medicine and Health Sciences, Neuroscience Laboratory for Cognitive Function and Behavioural Imaging (NeuroCoB), Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Faculty of Basic Medical Sciences, Department of Physiology, Bauchi State University PMB 65, Gadau, Nigeria
| | - Subapriya Suppiah
- Faculty of Medicine and Health Sciences, Department of Radiology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Faculty of Medicine and Health Sciences, Neuroscience Laboratory for Cognitive Function and Behavioural Imaging (NeuroCoB), Universiti Putra Malaysia, Seri Kembangan, Malaysia
- * E-mail:
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hasyma Abu Hassan
- Faculty of Medicine and Health Sciences, Department of Radiology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Nur Farhayu Omar
- Faculty of Medicine and Health Sciences, Department of Radiology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Mohd Izuan Ibrahim
- Diagnostic Imaging and Radiotherapy Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ahmad Nazlim Yusoff
- Diagnostic Imaging and Radiotherapy Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normala Ibrahim
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - M. Iqbal Saripan
- Faculty of Engineering, Department of Computer & Communication Systems, University Putra Malaysia, Seri Kembangan, Malaysia
| | - Rizah Mazzuin Razali
- Gerontology Unit, Department of Medicine, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
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Piersson AD, Mohamad M, Suppiah S, Rajab NF. Topographical patterns of whole-brain structural alterations in association with genetic risk, cerebrospinal fluid, positron emission tomography biomarkers of Alzheimer’s disease, and neuropsychological measures. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00440-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Kim REY, Lee M, Kang DW, Wang SM, Kim NY, Lee MK, Lim HK, Kim D. Deep Learning-Based Segmentation to Establish East Asian Normative Volumes Using Multisite Structural MRI. Diagnostics (Basel) 2020; 11:diagnostics11010013. [PMID: 33374745 PMCID: PMC7824436 DOI: 10.3390/diagnostics11010013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 11/16/2022] Open
Abstract
Normative brain magnetic resonance imaging (MRI) is essential to interpret the state of an individual's brain health. However, a normative study is often expensive for small research groups. Although several attempts have been made to establish brain MRI norms, the focus has been limited to certain age ranges. This study aimed to establish East Asian normative brain data using multi-site MRI and determine the robustness of these data for clinical research. Normative MRI was gathered covering a wide range of cognitively normal East Asian populations (age: 18-96 years) from two open sources and three research sites. Eight sub-regional volumes were extracted in the left and right hemispheres using an in-house deep learning-based tool. Repeated measure consistency and multicenter reliability were determined using intraclass correlation coefficients and compared to a widely used tool, FreeSurfer. Our results showed highly consistent outcomes with high reliability across sites. Our method outperformed FreeSurfer in repeated measure consistency for most structures and multicenter reliability for all structures. The normative MRI we constructed was able to identify sub-regional differences in mild cognitive impairments and dementia after covariate adjustments. Our investigation suggests it is possible to provide a sound normative reference for neurodegenerative or aging research.
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Affiliation(s)
- Regina E. Y. Kim
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (R.E.Y.K.); (M.L.)
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul 15355, Korea
- Department of Psychiatry, University of Iowa, Iowa City, IA 52240, USA
| | - Minho Lee
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (R.E.Y.K.); (M.L.)
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (S.-M.W.); (N.-Y.K.)
| | - Nak-Young Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (S.-M.W.); (N.-Y.K.)
| | - Min Kyoung Lee
- Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (S.-M.W.); (N.-Y.K.)
- Correspondence: (H.K.L.); (D.K.); Tel.: +82-70-5223-4414 (D.K.)
| | - Donghyeon Kim
- Research Institute, NEUROPHET Inc., Seoul 06247, Korea; (R.E.Y.K.); (M.L.)
- Correspondence: (H.K.L.); (D.K.); Tel.: +82-70-5223-4414 (D.K.)
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21
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Katrinli S, Stevens J, Wani AH, Lori A, Kilaru V, van Rooij SJH, Hinrichs R, Powers A, Gillespie CF, Michopoulos V, Gautam A, Jett M, Hammamieh R, Yang R, Wildman D, Qu A, Koenen K, Aiello AE, Jovanovic T, Uddin M, Ressler KJ, Smith AK. Evaluating the impact of trauma and PTSD on epigenetic prediction of lifespan and neural integrity. Neuropsychopharmacology 2020; 45:1609-1616. [PMID: 32380512 PMCID: PMC7421899 DOI: 10.1038/s41386-020-0700-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/17/2020] [Accepted: 04/29/2020] [Indexed: 01/08/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating disorder that develops in some people following trauma exposure. Trauma and PTSD have been associated with accelerated cellular aging. This study evaluated the effect of trauma and PTSD on accelerated GrimAge, an epigenetic predictor of lifespan, in traumatized civilians. This study included 218 individuals with current PTSD, 427 trauma-exposed controls without any history of PTSD and 209 subjects with lifetime PTSD history who are not categorized as current PTSD cases. The Traumatic Events Inventory (TEI) and Clinician-Administered PTSD Scale (CAPS) were used to measure lifetime trauma burden and PTSD, respectively. DNA from whole blood was interrogated using the MethylationEPIC or HumanMethylation450 BeadChips. GrimAge estimates were calculated using the methylation age calculator. Cortical thickness of 69 female subjects was assessed by using T1-weighted structural MRI images. Associations between trauma exposure, PTSD, cortical thickness, and GrimAge acceleration were tested with multiple regression models. Lifetime trauma burden (p = 0.03), current PTSD (p = 0.02) and lifetime PTSD (p = 0.005) were associated with GrimAge acceleration, indicative of a shorter predicted lifespan. The association with lifetime PTSD was replicated in an independent cohort (p = 0.04). In the MRI sub sample, GrimAge acceleration also associated with cortical atrophy in the right lateral orbitofrontal cortex (padj = 0.03) and right posterior cingulate (padj = 0.04), brain areas associated with emotion-regulation and threat-regulation. Our findings suggest that lifetime trauma and PTSD may contribute to a higher epigenetic-based mortality risk. We also demonstrate a relationship between cortical atrophy in PTSD-relevant brain regions and shorter predicted lifespan.
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Affiliation(s)
- Seyma Katrinli
- Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA
| | - Jennifer Stevens
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Agaz H Wani
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Adriana Lori
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Varun Kilaru
- Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Rebecca Hinrichs
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Abigail Powers
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Charles F Gillespie
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Vasiliki Michopoulos
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Aarti Gautam
- Integrative Systems Biology, US Army Center for Environmental Health Research, Fort Detrick, MD, USA
| | - Marti Jett
- Integrative Systems Biology, US Army Center for Environmental Health Research, Fort Detrick, MD, USA
| | - Rasha Hammamieh
- Integrative Systems Biology, US Army Center for Environmental Health Research, Fort Detrick, MD, USA
| | - Ruoting Yang
- Integrative Systems Biology, US Army Center for Environmental Health Research, Fort Detrick, MD, USA
- The Geneva Foundation, Fort Detrick, MD, USA
| | - Derek Wildman
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Annie Qu
- Department of Statistics, University of Illinois, Champaign, IL, USA
| | - Karestan Koenen
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tanja Jovanovic
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Monica Uddin
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Kerry J Ressler
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
- Department of Psychiatry, McLean Hospital and Harvard Medical School and McLean Hospital, Belmont, MA, USA
| | - Alicia K Smith
- Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA.
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA.
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Beer AL, Plank T, Greenlee MW. Aging and central vision loss: Relationship between the cortical macro-structure and micro-structure. Neuroimage 2020; 212:116670. [PMID: 32088318 DOI: 10.1016/j.neuroimage.2020.116670] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 12/17/2022] Open
Abstract
Aging and central vision loss are associated with cortical atrophies, but little is known about the relationship between cortical thinning and the underlying cellular structure. We compared the macro- and micro-structure of the cortical gray and superficial white matter of 38 patients with juvenile (JMD) or age-related (AMD) macular degeneration and 38 healthy humans (19-84 years) by multimodal MRI including diffusion-tensor imaging (DTI). A factor analysis showed that cortical thickness, tissue-dependent measures, and DTI-based measures were sensitive to distinct components of brain structure. Age-related cortical thinning and increased diffusion were observed across most of the cortex, but increased T1-weighted intensities (frontal), reduced T2-weighted intensities (occipital), and reduced anisotropy (medial) were limited to confined cortical regions. Vision loss was associated with cortical thinning and enhanced diffusion in the gray matter (less in the white matter) of the occipital central visual field representation. Moreover, AMD (but not JMD) patients showed enhanced diffusion in lateral occipito-temporal cortex and cortical thinning in the posterior cingulum. These findings demonstrate that changes in brain structure are best quantified by multimodal imaging. They further suggest that age-related brain atrophies (cortical thinning) reflect diverse micro-structural etiologies. Moreover, juvenile and age-related macular degeneration are associated with distinct patterns of micro-structural alterations.
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Affiliation(s)
- Anton L Beer
- Institut für Psychologie, Universität Regensburg, Regensburg, Germany.
| | - Tina Plank
- Institut für Psychologie, Universität Regensburg, Regensburg, Germany
| | - Mark W Greenlee
- Institut für Psychologie, Universität Regensburg, Regensburg, Germany
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23
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Slattery CF, Agustus JL, Paterson RW, McCallion O, Foulkes AJM, Macpherson K, Carton AM, Harding E, Golden HL, Jaisin K, Mummery CJ, Schott JM, Warren JD. The functional neuroanatomy of musical memory in Alzheimer's disease. Cortex 2019; 115:357-370. [PMID: 30846199 PMCID: PMC6525150 DOI: 10.1016/j.cortex.2019.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 12/06/2018] [Accepted: 02/01/2019] [Indexed: 12/20/2022]
Abstract
Background Memory for music has attracted much recent interest in Alzheimer's disease but the underlying brain mechanisms have not been defined in patients directly. Here we addressed this issue in an Alzheimer's disease cohort using activation fMRI of two core musical memory systems. Methods We studied 34 patients with younger onset Alzheimer's disease led either by episodic memory decline (typical Alzheimer's disease) or by visuospatial impairment (posterior cortical atrophy) in relation to 19 age-matched healthy individuals. We designed a novel fMRI paradigm based on passive listening to melodies that were either previously familiar or unfamiliar (musical semantic memory) and either presented singly or repeated (incidental musical episodic memory). Results Both syndromic groups showed significant functional neuroanatomical alterations relative to the healthy control group. For musical semantic memory, disease-associated activation group differences were localised to right inferior frontal cortex (reduced activation in the group with memory-led Alzheimer's disease); while for incidental musical episodic memory, disease-associated activation group differences were localised to precuneus and posterior cingulate cortex (abnormally enhanced activation in the syndromic groups). In post-scan behavioural testing, both patient groups had a deficit of musical episodic memory relative to healthy controls whereas musical semantic memory was unimpaired. Conclusions Our findings define functional neuroanatomical substrates for the differential involvement of musical semantic and incidental episodic memory in major phenotypes of Alzheimer's disease. The complex dynamic profile of brain activation group differences observed suggests that musical memory may be an informative probe of neural network function in Alzheimer's disease. These findings may guide the development of future musical interventions in dementia.
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Affiliation(s)
- Catherine F Slattery
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Jennifer L Agustus
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Ross W Paterson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Oliver McCallion
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Alexander J M Foulkes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Kirsty Macpherson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Amelia M Carton
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Emma Harding
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Hannah L Golden
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Kankamol Jaisin
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Catherine J Mummery
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Jason D Warren
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
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Voevodskaya O, Poulakis K, Sundgren P, van Westen D, Palmqvist S, Wahlund LO, Stomrud E, Hansson O, Westman E. Brain myoinositol as a potential marker of amyloid-related pathology: A longitudinal study. Neurology 2019; 92:e395-e405. [PMID: 30610093 PMCID: PMC6369900 DOI: 10.1212/wnl.0000000000006852] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 09/18/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the association between longitudinal changes in proton magnetic resonance spectroscopy (MRS) metabolites and amyloid pathology in individuals without dementia, and to explore the relationship between MRS and cognitive decline. METHODS In this longitudinal multiple time point study (a subset of the Swedish BioFINDER), we included cognitively healthy participants, individuals with subjective cognitive decline, and individuals with mild cognitive impairment. MRS was acquired serially in 294 participants (670 individual spectra) from the posterior cingulate/precuneus. Using mixed-effects models, we assessed the association between MRS and baseline β-amyloid (Aβ), and between MRS and the longitudinal Mini-Mental State Examination, accounting for APOE, age, and sex. RESULTS While baseline MRS metabolites were similar in Aβ positive (Aβ+) and negative (Aβ-) individuals, in the Aβ+ group, the estimated rate of change was +1.9%/y for myo-inositol (mI)/creatine (Cr) and -2.0%/y for N-acetylaspartate (NAA)/mI. In the Aβ- group, mI/Cr and NAA/mI yearly change was -0.05% and +1.2%; however, this was not significant across time points. The mild cognitive impairment Aβ+ group showed the steepest MRS changes, with an estimated rate of +2.93%/y (p = 0.07) for mI/Cr and -3.55%/y (p < 0.01) for NAA/mI. Furthermore, in the entire cohort, we found that Aβ+ individuals with low baseline NAA/mI had a significantly higher rate of cognitive decline than Aβ+ individuals with high baseline NAA/mI. CONCLUSION We demonstrate that the longitudinal change in mI/Cr and NAA/mI is associated with underlying amyloid pathology. MRS may be a useful noninvasive marker of Aβ-related processes over time. In addition, we show that in Aβ+ individuals, baseline NAA/mI may predict the rate of future cognitive decline.
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Affiliation(s)
- Olga Voevodskaya
- From the Division of Clinical Geriatrics (O.V., K.P., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.S., D.v.W.), Lund University; Imaging and Function (D.v.W.), Skåne University Health Care, Lund; Clinical Memory Research Unit (S.P., E.S., O.H.), Department of Clinical Sciences, Malmö, Lund University; Memory Clinic (E.S., O.H.), Skåne University Hospital, Malmö, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Konstantinos Poulakis
- From the Division of Clinical Geriatrics (O.V., K.P., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.S., D.v.W.), Lund University; Imaging and Function (D.v.W.), Skåne University Health Care, Lund; Clinical Memory Research Unit (S.P., E.S., O.H.), Department of Clinical Sciences, Malmö, Lund University; Memory Clinic (E.S., O.H.), Skåne University Hospital, Malmö, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Pia Sundgren
- From the Division of Clinical Geriatrics (O.V., K.P., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.S., D.v.W.), Lund University; Imaging and Function (D.v.W.), Skåne University Health Care, Lund; Clinical Memory Research Unit (S.P., E.S., O.H.), Department of Clinical Sciences, Malmö, Lund University; Memory Clinic (E.S., O.H.), Skåne University Hospital, Malmö, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Danielle van Westen
- From the Division of Clinical Geriatrics (O.V., K.P., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.S., D.v.W.), Lund University; Imaging and Function (D.v.W.), Skåne University Health Care, Lund; Clinical Memory Research Unit (S.P., E.S., O.H.), Department of Clinical Sciences, Malmö, Lund University; Memory Clinic (E.S., O.H.), Skåne University Hospital, Malmö, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Sebastian Palmqvist
- From the Division of Clinical Geriatrics (O.V., K.P., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.S., D.v.W.), Lund University; Imaging and Function (D.v.W.), Skåne University Health Care, Lund; Clinical Memory Research Unit (S.P., E.S., O.H.), Department of Clinical Sciences, Malmö, Lund University; Memory Clinic (E.S., O.H.), Skåne University Hospital, Malmö, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Lars-Olof Wahlund
- From the Division of Clinical Geriatrics (O.V., K.P., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.S., D.v.W.), Lund University; Imaging and Function (D.v.W.), Skåne University Health Care, Lund; Clinical Memory Research Unit (S.P., E.S., O.H.), Department of Clinical Sciences, Malmö, Lund University; Memory Clinic (E.S., O.H.), Skåne University Hospital, Malmö, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Erik Stomrud
- From the Division of Clinical Geriatrics (O.V., K.P., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.S., D.v.W.), Lund University; Imaging and Function (D.v.W.), Skåne University Health Care, Lund; Clinical Memory Research Unit (S.P., E.S., O.H.), Department of Clinical Sciences, Malmö, Lund University; Memory Clinic (E.S., O.H.), Skåne University Hospital, Malmö, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Oskar Hansson
- From the Division of Clinical Geriatrics (O.V., K.P., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.S., D.v.W.), Lund University; Imaging and Function (D.v.W.), Skåne University Health Care, Lund; Clinical Memory Research Unit (S.P., E.S., O.H.), Department of Clinical Sciences, Malmö, Lund University; Memory Clinic (E.S., O.H.), Skåne University Hospital, Malmö, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Eric Westman
- From the Division of Clinical Geriatrics (O.V., K.P., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.S., D.v.W.), Lund University; Imaging and Function (D.v.W.), Skåne University Health Care, Lund; Clinical Memory Research Unit (S.P., E.S., O.H.), Department of Clinical Sciences, Malmö, Lund University; Memory Clinic (E.S., O.H.), Skåne University Hospital, Malmö, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Steinacker P, Barschke P, Otto M. Biomarkers for diseases with TDP-43 pathology. Mol Cell Neurosci 2018; 97:43-59. [PMID: 30399416 DOI: 10.1016/j.mcn.2018.10.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 10/26/2018] [Accepted: 10/29/2018] [Indexed: 01/01/2023] Open
Abstract
The discovery that aggregated transactive response DNA-binding protein 43 kDa (TDP-43) is the major component of pathological ubiquitinated inclusions in amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD) caused seminal progress in the unveiling of the genetic bases and molecular characteristics of these now so-called TDP-43 proteinopathies. Substantial increase in the knowledge of clinic-pathological coherencies, especially for FTLD variants, could be made in the last decade, but also revealed a considerable complexity of TDP-43 pathology and often a poor correlation of clinical and molecular disease characteristics. To date, an underlying TDP-43 pathology can be predicted only for patients with mutations in the genes C9orf72 and GRN, but is dependent on neuropathological verification in patients without family history, which represent the majority of cases. As etiology-specific therapies for neurodegenerative proteinopathies are emerging, methods to forecast TDP-43 pathology at patients' lifetime are highly required. Here, we review the current status of research pursued to identify specific indicators to predict or exclude TDP-43 pathology in the ALS-FTLD spectrum disorders and findings on candidates for prognosis and monitoring of disease progression in TDP-43 proteinopathies with a focus on TDP-43 with its pathological forms, neurochemical and imaging biomarkers.
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Affiliation(s)
| | - Peggy Barschke
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany.
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26
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McCarthy J, Collins DL, Ducharme S. Morphometric MRI as a diagnostic biomarker of frontotemporal dementia: A systematic review to determine clinical applicability. Neuroimage Clin 2018; 20:685-696. [PMID: 30218900 PMCID: PMC6140291 DOI: 10.1016/j.nicl.2018.08.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/31/2018] [Accepted: 08/28/2018] [Indexed: 01/21/2023]
Abstract
Frontotemporal dementia (FTD) is difficult to diagnose, due to its heterogeneous nature and overlap in symptoms with primary psychiatric disorders. Brain MRI for atrophy is a key biomarker but lacks sensitivity in the early stage. Morphometric MRI-based measures and machine learning techniques are a promising tool to improve diagnostic accuracy. Our aim was to review the current state of the literature using morphometric MRI to classify FTD and assess its applicability for clinical practice. A search was completed using Pubmed and PsychInfo of studies which conducted a classification of subjects with FTD from non-FTD (controls or another disorder) using morphometric MRI metrics on an individual level, using single or combined approaches. 28 relevant articles were included and systematically reviewed following PRISMA guidelines. The studies were categorized based on the type of FTD subjects included and the group(s) against which they were classified. Studies varied considerably in subject selection, MRI methodology, and classification approach, and results are highly heterogeneous. Overall many studies indicate good diagnostic accuracy, with higher performance when differentiating FTD from controls (highest result was accuracy of 100%) than other dementias (highest result was AUC of 0.874). Very few machine learning algorithms have been tested in prospective replication. In conclusion, morphometric MRI with machine learning shows potential as an early diagnostic biomarker of FTD, however studies which use rigorous methodology and validate findings in an independent real-life cohort are necessary before this method can be recommended for use clinically.
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Affiliation(s)
- Jillian McCarthy
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - D Louis Collins
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Simon Ducharme
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada.
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27
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28
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Whitwell JL, Graff-Radford J, Tosakulwong N, Weigand SD, Machulda MM, Senjem ML, Spychalla AJ, Vemuri P, Jones DT, Drubach DA, Knopman DS, Boeve BF, Ertekin-Taner N, Petersen RC, Lowe VJ, Jack CR, Josephs KA. Imaging correlations of tau, amyloid, metabolism, and atrophy in typical and atypical Alzheimer's disease. Alzheimers Dement 2018; 14:1005-1014. [PMID: 29605222 DOI: 10.1016/j.jalz.2018.02.020] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/18/2017] [Accepted: 02/07/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Neuroimaging modalities can measure different aspects of the disease process in Alzheimer's disease, although the relationship between these modalities is unclear. METHODS We assessed subject-level regional correlations between tau on [18F]AV-1451 positron emission tomography (PET), β amyloid on Pittsburgh compound B PET, hypometabolism on [18F] fluorodeoxyglucose PET, and cortical thickness on magnetic resonance imaging in 96 participants with typical and atypical Alzheimer's disease presentations. We also assessed how correlations between modalities varied according to age, presenting syndrome, tau-PET severity, and asymmetry. RESULTS [18F]AV-1451 uptake showed the strongest regional correlation with hypometabolism. Correlations between [18F]AV-1451 uptake and both hypometabolism and cortical thickness were stronger in participants with greater cortical tau severity. In addition, age, tau asymmetry, and clinical diagnosis influenced the strength of the correlation between [18F]AV-1451 uptake and cortical thickness. DISCUSSION These findings support a close relationship between tau and hypometabolism in Alzheimer's disease but show that correlations between neuroimaging modalities vary across participants.
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Affiliation(s)
| | | | | | - Stephen D Weigand
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Mary M Machulda
- Department of Psychology and Psychiatry, Mayo Clinic, Rochester, MN, USA
| | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN, USA; Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | | | | | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Nilüfer Ertekin-Taner
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA; Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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29
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Kinno R, Shiromaru A, Mori Y, Futamura A, Kuroda T, Yano S, Murakami H, Ono K. Differential Effects of the Factor Structure of the Wechsler Memory Scale-Revised on the Cortical Thickness and Complexity of Patients Aged Over 75 Years in a Memory Clinic Setting. Front Aging Neurosci 2017; 9:405. [PMID: 29270122 PMCID: PMC5725440 DOI: 10.3389/fnagi.2017.00405] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/24/2017] [Indexed: 11/26/2022] Open
Abstract
The Wechsler Memory Scale-Revised (WMS-R) is one of the internationally well-known batteries for memory assessment in a general memory clinic setting. Several factor structures of the WMS-R for patients aged under 74 have been proposed. However, little is known about the factor structure of the WMS-R for patients aged over 75 years and its neurological significance. Thus, we conducted exploratory factor analysis to determine the factor structure of the WMS-R for patients aged over 75 years in a memory clinic setting. Regional cerebral blood flow (rCBF) was calculated from single-photon emission computed tomography data. Cortical thickness and cortical fractal dimension, as the marker of cortical complexity, were calculated from high resolution magnetic resonance imaging data. We found that the four factors appeared to be the most appropriate solution to the model, including recognition memory, paired associate memory, visual-and-working memory, and attention as factors. Patients with mild cognitive impairments showed significantly higher factor scores for paired associate memory, visual-and-working memory, and attention than patients with Alzheimer's disease. Regarding the neuroimaging data, the factor scores for paired associate memory positively correlated with rCBF in the left pericallosal and hippocampal regions. Moreover, the factor score for paired associate memory showed most robust correlations with the cortical thickness in the limbic system, whereas the factor score for attention correlated with the cortical thickness in the bilateral precuneus. Furthermore, each factor score correlated with the cortical fractal dimension in the bilateral frontotemporal regions. Interestingly, the factor scores for the visual-and-working memory and attention selectively correlated with the cortical fractal dimension in the right posterior cingulate cortex and right precuneus cortex, respectively. These findings demonstrate that recognition memory, paired associate memory, visual-and-working memory, and attention can be crucial factors for interpreting the WMS-R results of elderly patients aged over 75 years in a memory clinic setting. Considering these findings, the results of WMS-R in elderly patients aged over 75 years in a memory clinic setting should be cautiously interpreted.
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Affiliation(s)
| | | | | | | | | | | | | | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
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30
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Perry DC, Brown JA, Possin KL, Datta S, Trujillo A, Radke A, Karydas A, Kornak J, Sias AC, Rabinovici GD, Gorno-Tempini ML, Boxer AL, De May M, Rankin KP, Sturm VE, Lee SE, Matthews BR, Kao AW, Vossel KA, Tartaglia MC, Miller ZA, Seo SW, Sidhu M, Gaus SE, Nana AL, Vargas JNS, Hwang JHL, Ossenkoppele R, Brown AB, Huang EJ, Coppola G, Rosen HJ, Geschwind D, Trojanowski JQ, Grinberg LT, Kramer JH, Miller BL, Seeley WW. Clinicopathological correlations in behavioural variant frontotemporal dementia. Brain 2017; 140:3329-3345. [PMID: 29053860 PMCID: PMC5841140 DOI: 10.1093/brain/awx254] [Citation(s) in RCA: 213] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/27/2017] [Accepted: 08/07/2017] [Indexed: 12/12/2022] Open
Abstract
Accurately predicting the underlying neuropathological diagnosis in patients with behavioural variant frontotemporal dementia (bvFTD) poses a daunting challenge for clinicians but will be critical for the success of disease-modifying therapies. We sought to improve pathological prediction by exploring clinicopathological correlations in a large bvFTD cohort. Among 438 patients in whom bvFTD was either the top or an alternative possible clinical diagnosis, 117 had available autopsy data, including 98 with a primary pathological diagnosis of frontotemporal lobar degeneration (FTLD), 15 with Alzheimer's disease, and four with amyotrophic lateral sclerosis who lacked neurodegenerative disease-related pathology outside of the motor system. Patients with FTLD were distributed between FTLD-tau (34 patients: 10 corticobasal degeneration, nine progressive supranuclear palsy, eight Pick's disease, three frontotemporal dementia with parkinsonism associated with chromosome 17, three unclassifiable tauopathy, and one argyrophilic grain disease); FTLD-TDP (55 patients: nine type A including one with motor neuron disease, 27 type B including 21 with motor neuron disease, eight type C with right temporal lobe presentations, and 11 unclassifiable including eight with motor neuron disease), FTLD-FUS (eight patients), and one patient with FTLD-ubiquitin proteasome system positive inclusions (FTLD-UPS) that stained negatively for tau, TDP-43, and FUS. Alzheimer's disease was uncommon (6%) among patients whose only top diagnosis during follow-up was bvFTD. Seventy-nine per cent of FTLD-tau, 86% of FTLD-TDP, and 88% of FTLD-FUS met at least 'possible' bvFTD diagnostic criteria at first presentation. The frequency of the six core bvFTD diagnostic features was similar in FTLD-tau and FTLD-TDP, suggesting that these features alone cannot be used to separate patients by major molecular class. Voxel-based morphometry revealed that nearly all pathological subgroups and even individual patients share atrophy in anterior cingulate, frontoinsula, striatum, and amygdala, indicating that degeneration of these regions is intimately linked to the behavioural syndrome produced by these diverse aetiologies. In addition to these unifying features, symptom profiles also differed among pathological subtypes, suggesting distinct anatomical vulnerabilities and informing a clinician's prediction of pathological diagnosis. Data-driven classification into one of the 10 most common pathological diagnoses was most accurate (up to 60.2%) when using a combination of known predictive factors (genetic mutations, motor features, or striking atrophy patterns) and the results of a discriminant function analysis that incorporated clinical, neuroimaging, and neuropsychological data.
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Affiliation(s)
- David C Perry
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jesse A Brown
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Katherine L Possin
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Samir Datta
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Andrew Trujillo
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Anneliese Radke
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- University of California Davis, Davis, CA, USA
| | - Anna Karydas
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Ana C Sias
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Gil D Rabinovici
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Adam L Boxer
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Mary De May
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Katherine P Rankin
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Virginia E Sturm
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Suzee E Lee
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Brandy R Matthews
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Aimee W Kao
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Keith A Vossel
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - Maria Carmela Tartaglia
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Canada
| | - Zachary A Miller
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sang Won Seo
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
| | - Manu Sidhu
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Stephanie E Gaus
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Alissa L Nana
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jose Norberto S Vargas
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Ji-Hye L Hwang
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Rik Ossenkoppele
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Alainna B Brown
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- University of Washington School of Medicine, Seattle, WA, USA
| | - Eric J Huang
- Department of Pathology and Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Giovanni Coppola
- Neurogenetics program, Department of Neurology, and Semel Institute for Neuroscience and Human Behaviour, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Howard J Rosen
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Geschwind
- Neurogenetics program, Department of Neurology, and Semel Institute for Neuroscience and Human Behaviour, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - John Q Trojanowski
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lea T Grinberg
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology and Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Joel H Kramer
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - William W Seeley
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology and Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
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Zink DN, Miller JB, Caldwell JZK, Bird C, Banks SJ. The relationship between neuropsychological tests of visuospatial function and lobar cortical thickness. J Clin Exp Neuropsychol 2017; 40:518-527. [PMID: 29113534 DOI: 10.1080/13803395.2017.1384799] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Tests of visuospatial function are often administered in comprehensive neuropsychological evaluations. These tests are generally considered assays of parietal lobe function; however, the neural correlates of these tests, using modern imaging techniques, are not well understood. In the current study we investigated the relationship between three commonly used tests of visuospatial function and lobar cortical thickness in each hemisphere. METHOD Data from 374 patients who underwent a neuropsychological evaluation and MRI scans in an outpatient dementia clinic were included in the analysis. We examined the relationships between cortical thickness, as assessed with Freesurfer, and performance on three tests: Judgment of Line Orientation (JoLO), Block Design (BD) from the Fourth edition of the Wechsler Adult Intelligence Scale, and Brief Visuospatial Memory Test-Revised Copy Trial (BVMT-R-C) in patients who showed overall average performance on these tasks. Using a series of multiple regression models, we assessed which lobe's overall cortical thickness best predicted test performance. RESULTS Among the individual lobes, JoLO performance was best predicted by cortical thickness in the right temporal lobe. BD performance was best predicted by cortical thickness in the right parietal lobe, and BVMT-R-C performance was best predicted by cortical thickness in the left parietal lobe. CONCLUSIONS Performance on constructional tests of visuospatial function appears to correspond best with underlying cortical thickness of the parietal lobes, while performance on visuospatial judgment tests appears to correspond best to temporal lobe thickness. Future research using voxel-wise and connectivity techniques and including more diverse samples will help further understanding of the regions and networks involved in visuospatial tests.
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Affiliation(s)
- Davor N Zink
- a Department of Psychology , University of Nevada Las Vegas , Las Vegas , NV , USA
| | - Justin B Miller
- b Department of Neuropsychology , Cleveland Clinic Lou Ruvo Center for Brain Health , Las Vegas , NV , USA
| | - Jessica Z K Caldwell
- b Department of Neuropsychology , Cleveland Clinic Lou Ruvo Center for Brain Health , Las Vegas , NV , USA
| | - Christopher Bird
- b Department of Neuropsychology , Cleveland Clinic Lou Ruvo Center for Brain Health , Las Vegas , NV , USA
| | - Sarah J Banks
- b Department of Neuropsychology , Cleveland Clinic Lou Ruvo Center for Brain Health , Las Vegas , NV , USA
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Zhou J, Liu S, Ng KK, Wang J. Applications of Resting-State Functional Connectivity to Neurodegenerative Disease. Neuroimaging Clin N Am 2017; 27:663-683. [DOI: 10.1016/j.nic.2017.06.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Ahmed S, Baker I, Husain M, Thompson S, Kipps C, Hornberger M, Hodges JR, Butler CR. Memory Impairment at Initial Clinical Presentation in Posterior Cortical Atrophy. J Alzheimers Dis 2017; 52:1245-50. [PMID: 27128371 DOI: 10.3233/jad-160018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Posterior cortical atrophy (PCA) is characterized by core visuospatial and visuoperceptual deficits, and predominant atrophy in the parieto-occipital cortex. The most common underlying pathology is Alzheimer's disease (AD). Existing diagnostic criteria suggest that episodic memory is relatively preserved. The aim of this study was to examine memory performance at initial clinical presentation in PCA, compared to early-onset AD patients (EOAD). 15 PCA patients and 32 EOAD patients, and 34 healthy controls were entered into the study. Patients were tested on the Addenbrooke's Cognitive Examination (ACE-R), consisting of subscales in memory and visuospatial skills. PCA and EOAD patients were significantly impaired compared to controls on the ACE total score (p < 0.001), visuospatial skills (p < 0.001), and memory (p < 0.001). Consistent with the salient diagnostic deficits, PCA patients were significantly more impaired on visuospatial skills compared to EOAD patients (p < 0.001). However, there was no significant difference between patient groups in memory. Further analysis of learning, recall, and recognition components of the memory subscale showed that EOAD and PCA patients were significantly impaired compared to controls on all three components (p < 0.001), however, there was no significant difference between EOAD and PCA patients. The results of this study show that memory is impaired in the majority of PCA patients at clinical presentation. The findings suggest that memory impairment must be considered in assessment and management of PCA. Further study into memory in PCA is warranted, since the ACE-R is a brief screening tool and is likely to underestimate the presence of memory impairment.
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Affiliation(s)
- Samrah Ahmed
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Ian Baker
- Russell Cairns Unit, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK.,Department of Experimental Psychology, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Sian Thompson
- Department of Clinical Neurology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Christopher Kipps
- Wessex Neurological Centre, University Hospitals Southampton NHS Foundation Trust and University of Southampton and Wessex Collaboration for Leadership in Applied Health Research and Care (CLAHRC), Southampton, UK
| | | | - John R Hodges
- Neuroscience Research Australia and University of New South Wales, Sydney, Australia
| | - Christopher R Butler
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
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Hayes JP, Logue MW, Sadeh N, Spielberg JM, Verfaellie M, Hayes SM, Reagan A, Salat DH, Wolf EJ, McGlinchey RE, Milberg WP, Stone A, Schichman SA, Miller MW. Mild traumatic brain injury is associated with reduced cortical thickness in those at risk for Alzheimer's disease. Brain 2017; 140:813-825. [PMID: 28077398 DOI: 10.1093/brain/aww344] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 11/09/2016] [Indexed: 12/14/2022] Open
Abstract
Moderate-to-severe traumatic brain injury is one of the strongest environmental risk factors for the development of neurodegenerative diseases such as late-onset Alzheimer's disease, although it is unclear whether mild traumatic brain injury, or concussion, also confers risk. This study examined mild traumatic brain injury and genetic risk as predictors of reduced cortical thickness in brain regions previously associated with early Alzheimer's disease, and their relationship with episodic memory. Participants were 160 Iraq and Afghanistan War veterans between the ages of 19 and 58, many of whom carried mild traumatic brain injury and post-traumatic stress disorder diagnoses. Whole-genome polygenic risk scores for the development of Alzheimer's disease were calculated using summary statistics from the largest Alzheimer's disease genome-wide association study to date. Results showed that mild traumatic brain injury moderated the relationship between genetic risk for Alzheimer's disease and cortical thickness, such that individuals with mild traumatic brain injury and high genetic risk showed reduced cortical thickness in Alzheimer's disease-vulnerable regions. Among males with mild traumatic brain injury, high genetic risk for Alzheimer's disease was associated with cortical thinning as a function of time since injury. A moderated mediation analysis showed that mild traumatic brain injury and high genetic risk indirectly influenced episodic memory performance through cortical thickness, suggesting that cortical thinning in Alzheimer's disease-vulnerable brain regions is a mechanism for reduced memory performance. Finally, analyses that examined the apolipoprotein E4 allele, post-traumatic stress disorder, and genetic risk for schizophrenia and depression confirmed the specificity of the Alzheimer's disease polygenic risk finding. These results provide evidence that mild traumatic brain injury is associated with greater neurodegeneration and reduced memory performance in individuals at genetic risk for Alzheimer's disease, with the caveat that the order of causal effects cannot be inferred from cross-sectional studies. These results underscore the importance of documenting head injuries even within the mild range as they may interact with genetic risk to produce negative long-term health consequences such as neurodegenerative disease.
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Affiliation(s)
- Jasmeet P Hayes
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.,Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA
| | - Mark W Logue
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.,Biomedical Genetics, Boston University School of Medicine, Boston, MA, USA.,Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Naomi Sadeh
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Jeffrey M Spielberg
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.,Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA
| | - Mieke Verfaellie
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.,Memory Disorders Research Center, VA Boston Healthcare System, Boston, MA, USA
| | - Scott M Hayes
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.,Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA.,Memory Disorders Research Center, VA Boston Healthcare System, Boston, MA, USA
| | - Andrew Reagan
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - David H Salat
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard University, Boston, MA, USA.,Harvard Medical School, Harvard University, Boston, MA, USA
| | - Erika J Wolf
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Regina E McGlinchey
- Geriatric Research, Educational and Clinical Center and Translational Research Center for TBI and Stress Disorders, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - William P Milberg
- Geriatric Research, Educational and Clinical Center and Translational Research Center for TBI and Stress Disorders, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Annjanette Stone
- Pharmacogenomics Analysis Laboratory, Research Service, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA
| | - Steven A Schichman
- Pharmacogenomics Analysis Laboratory, Research Service, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA
| | - Mark W Miller
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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Suri S, Emir U, Stagg CJ, Near J, Mekle R, Schubert F, Zsoldos E, Mahmood A, Singh-Manoux A, Kivimäki M, Ebmeier KP, Mackay CE, Filippini N. Effect of age and the APOE gene on metabolite concentrations in the posterior cingulate cortex. Neuroimage 2017; 152:509-516. [PMID: 28323160 PMCID: PMC5440729 DOI: 10.1016/j.neuroimage.2017.03.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 03/16/2017] [Indexed: 01/20/2023] Open
Abstract
Proton magnetic resonance spectroscopy (1H-MRS) has provided valuable information about the neurochemical profile of Alzheimer's disease (AD). However, its clinical utility has been limited in part by the lack of consistent information on how metabolite concentrations vary in the normal aging brain and in carriers of apolipoprotein E (APOE) ε4, an established risk gene for AD. We quantified metabolites within an 8cm3 voxel within the posterior cingulate cortex (PCC)/precuneus in 30 younger (20-40 years) and 151 cognitively healthy older individuals (60-85 years). All 1H-MRS scans were performed at 3T using the short-echo SPECIAL sequence and analyzed with LCModel. The effect of APOE was assessed in a sub-set of 130 volunteers. Older participants had significantly higher myo-inositol and creatine, and significantly lower glutathione and glutamate than younger participants. There was no significant effect of APOE or an interaction between APOE and age on the metabolite profile. Our data suggest that creatine, a commonly used reference metabolite in 1H-MRS studies, does not remain stable across adulthood within this region and therefore may not be a suitable reference in studies involving a broad age-range. Increases in creatine and myo-inositol may reflect age-related glial proliferation; decreases in glutamate and glutathione suggest a decline in synaptic and antioxidant efficiency. Our findings inform longitudinal clinical studies by characterizing age-related metabolite changes in a non-clinical sample.
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Affiliation(s)
- Sana Suri
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom.
| | - Uzay Emir
- Functional Magnetic Resonance Imaging of the Brain Centre, University of Oxford, Oxford OX3 9DU, United Kingdom
| | - Charlotte J Stagg
- Functional Magnetic Resonance Imaging of the Brain Centre, University of Oxford, Oxford OX3 9DU, United Kingdom
| | - Jamie Near
- Douglas Mental Health University Institute and Department of Psychiatry, McGill University, Montreal, Canada H4H 1R3
| | - Ralf Mekle
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Berlin, Germany; Center for Stroke Research, Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Schubert
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Berlin, Germany
| | - Enikő Zsoldos
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Abda Mahmood
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Archana Singh-Manoux
- Centre for Research in Epidemiology and Population Health, INSERM, U1018 Villejuif, France
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, United Kingdom
| | - Klaus P Ebmeier
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Clare E Mackay
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Nicola Filippini
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
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Foley SF, Tansey KE, Caseras X, Lancaster T, Bracht T, Parker G, Hall J, Williams J, Linden DEJ. Multimodal Brain Imaging Reveals Structural Differences in Alzheimer's Disease Polygenic Risk Carriers: A Study in Healthy Young Adults. Biol Psychiatry 2017; 81:154-161. [PMID: 27157680 PMCID: PMC5177726 DOI: 10.1016/j.biopsych.2016.02.033] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 02/08/2016] [Accepted: 02/29/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Recent genome-wide association studies have identified genetic loci that jointly make a considerable contribution to risk of developing Alzheimer's disease (AD). Because neuropathological features of AD can be present several decades before disease onset, we investigated whether effects of polygenic risk are detectable by neuroimaging in young adults. We hypothesized that higher polygenic risk scores (PRSs) for AD would be associated with reduced volume of the hippocampus and other limbic and paralimbic areas. We further hypothesized that AD PRSs would affect the microstructure of fiber tracts connecting the hippocampus with other brain areas. METHODS We analyzed the association between AD PRSs and brain imaging parameters using T1-weighted structural (n = 272) and diffusion-weighted scans (n = 197). RESULTS We found a significant association between AD PRSs and left hippocampal volume, with higher risk associated with lower left hippocampal volume (p = .001). This effect remained when the APOE gene was excluded (p = .031), suggesting that the relationship between hippocampal volume and AD is the result of multiple genetic factors and not exclusively variability in the APOE gene. The diffusion tensor imaging analysis revealed that fractional anisotropy of the right cingulum was inversely correlated with AD PRSs (p = .009). We thus show that polygenic effects of AD risk variants on brain structure can already be detected in young adults. CONCLUSIONS This finding paves the way for further investigation of the effects of AD risk variants and may become useful for efforts to combine genotypic and phenotypic data for risk prediction and to enrich future prevention trials of AD.
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Affiliation(s)
- Sonya F Foley
- Cardiff University Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Wales, United Kingdom; Cardiff University Brain Research Imaging Centre, School of Psychology, Wales, United Kingdom; Central Biotechnology Services, TIME Institute, Wales, United Kingdom.
| | - Katherine E Tansey
- Cardiff University Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Wales, United Kingdom; Medical Research Council Integrative Epidemiology Unit, School of Social and Community Medicine, Faculty of Medicine & Dentistry, University of Bristol, Bristol, United Kingdom
| | - Xavier Caseras
- Cardiff University Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Wales, United Kingdom; Cardiff University Brain Research Imaging Centre, School of Psychology, Wales, United Kingdom
| | - Thomas Lancaster
- Cardiff University Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Wales, United Kingdom; Cardiff University Brain Research Imaging Centre, School of Psychology, Wales, United Kingdom
| | - Tobias Bracht
- Cardiff University Brain Research Imaging Centre, School of Psychology, Wales, United Kingdom
| | - Greg Parker
- Cardiff University Brain Research Imaging Centre, School of Psychology, Wales, United Kingdom
| | - Jeremy Hall
- Cardiff University Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Wales, United Kingdom; Neuroscience and Mental Health Research Institute, Wales, United Kingdom
| | - Julie Williams
- Cardiff University Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Wales, United Kingdom
| | - David E J Linden
- Cardiff University Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Wales, United Kingdom; Cardiff University Brain Research Imaging Centre, School of Psychology, Wales, United Kingdom
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Kumfor F, Halliday GM, Piguet O. Clinical Aspects of Alzheimer's Disease. ADVANCES IN NEUROBIOLOGY 2017; 15:31-53. [PMID: 28674977 DOI: 10.1007/978-3-319-57193-5_2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Alzheimer's disease is the most common form of dementia accounting for 50-60% of all dementia cases. This chapter briefly reviews the history of Alzheimer's disease and provides an overview of the clinical syndromes associated with Alzheimer pathology and their associated neuroimaging findings. This chapter also reviews the neuropathology and genetics of Alzheimer's disease and concludes by discussing current work undertaken to identify suitable in vivo biomarkers for the disease.
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Affiliation(s)
- Fiona Kumfor
- School of Psychology, Central Medical School and Brain & Mind Centre, University of Sydney, Mallett St, Sydney, 2006, NSW, Australia.
| | - Glenda M Halliday
- School of Psychology, Central Medical School and Brain & Mind Centre, University of Sydney, Mallett St, Sydney, 2006, NSW, Australia
| | - Olivier Piguet
- School of Psychology, Central Medical School and Brain & Mind Centre, University of Sydney, Mallett St, Sydney, 2006, NSW, Australia
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Jhunjhunwala K, George L, Kotikalapudi R, Gupta PK, Lenka A, Stezin A, Naduthota RM, Yadav R, Gupta AK, Saini J, Pal PK. A preliminary study of the neuroanatomical correlates of primary writing tremor: role of cerebellum. Neuroradiology 2016; 58:827-36. [PMID: 27216204 DOI: 10.1007/s00234-016-1700-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 05/11/2016] [Indexed: 12/16/2022]
Abstract
INTRODUCTION To explore the neuroanatomical correlates of primary writing tremor (PWT) and the role of cerebellum, using advanced structural neuroimaging. Till date, there are no studies exploring the gray and white matter changes using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) in PWT. METHODS Ten male patients with PWT were evaluated clinically and with magnetic resonance imaging. VBM and DTI images of patients were compared with that of 10 healthy male subjects. Spatially unbiased infra-tentorial template (SUIT) analysis was done to investigate the alterations of cerebellar gray matter. Region-of-interest analysis was performed on regions observed to be significantly different on DTI analysis. RESULTS The mean duration of illness and mean age of the patients were 3.5 ± 1.9 and 51.7 ± 8.6 years, respectively. On VBM analysis, the cluster of gray matter atrophy was found in bilateral cerebellar areas of culmen and left declive, right superior and medial frontal gyrus, bilateral middle frontal gyrus, bilateral anterior cingulate gyrus, and bilateral parahippocampal gyrus. DTI showed significantly reduced fractional anisotrophy of the anterior thalamic radiation, cingulum, and inferior fronto-occipital fasciculus in PWT patients compared to controls. The axial diffusivity, mean diffusivity, and radial diffusivity maps did not reveal any significant differences. On SUIT analysis, significant atrophy was found in right uvula and semilunar lobule in patients with PWT compared to controls. CONCLUSIONS Our study found that patients with PWT had predominant gray matter atrophy in parts of cerebellum and frontal lobe along with white matter changes of the cingulum and frontal lobe connections.
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Affiliation(s)
- Ketan Jhunjhunwala
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India.,Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India
| | - Lija George
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India
| | - Raviteja Kotikalapudi
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India
| | - Pradeep Kumar Gupta
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India
| | - Abhishek Lenka
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India.,Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India
| | - Albert Stezin
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India.,Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India
| | - Rajini M Naduthota
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India
| | - Arun Kumar Gupta
- Departments of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India
| | - Jitender Saini
- Departments of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India.
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Voevodskaya O, Sundgren PC, Strandberg O, Zetterberg H, Minthon L, Blennow K, Wahlund LO, Westman E, Hansson O. Myo-inositol changes precede amyloid pathology and relate to APOE genotype in Alzheimer disease. Neurology 2016; 86:1754-61. [PMID: 27164711 PMCID: PMC4862247 DOI: 10.1212/wnl.0000000000002672] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 01/14/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We aimed to test whether in vivo levels of magnetic resonance spectroscopy (MRS) metabolites myo-inositol (mI), N-acetylaspartate (NAA), and choline are abnormal already during preclinical Alzheimer disease (AD), relating these changes to amyloid or tau pathology, and functional connectivity. METHODS In this cross-sectional multicenter study (a subset of the prospective Swedish BioFINDER study), we included 4 groups, representing the different stages of predementia AD: (1) cognitively healthy elderly with normal CSF β-amyloid 42 (Aβ42), (2) cognitively healthy elderly with abnormal CSF Aβ42, (3) patients with subjective cognitive decline and abnormal CSF Aβ42, (4) patients with mild cognitive decline and abnormal CSF Aβ42 (Ntotal = 352). Spectroscopic markers measured in the posterior cingulate/precuneus were considered alongside known disease biomarkers: CSF Aβ42, phosphorylated tau, total tau, [(18)F]-flutemetamol PET, f-MRI, and the genetic risk factor APOE. RESULTS Amyloid-positive cognitively healthy participants showed a significant increase in mI/creatine and mI/NAA levels compared to amyloid-negative healthy elderly (p < 0.05). In amyloid-positive healthy elderly, mI/creatine and mI/NAA correlated with cortical retention of [(18)F] flutemetamol tracer ([Formula: see text] = 0.44, p = 0.02 and [Formula: see text] = 0.51, p = 0.01, respectively). Healthy elderly APOE ε4 carriers with normal CSF Aβ42 levels had significantly higher mI/creatine levels (p < 0.001) than ε4 noncarriers. Finally, elevated mI/creatine was associated with decreased functional connectivity within the default mode network (rpearson = -0.16, p = 0.02), independently of amyloid pathology. CONCLUSIONS mI levels are elevated already at asymptomatic stages of AD. Moreover, mI/creatine concentrations were increased in healthy APOE ε4 carriers with normal CSF Aβ42 levels, suggesting that mI levels may reveal regional brain consequences of APOE ε4 before detectable amyloid pathology.
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Affiliation(s)
- Olga Voevodskaya
- From Clinical Geriatrics (O.V., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.C.S., O.S.), Lund University; Clinical Neurochemistry Laboratory (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; Memory Clinic (L.M., O.H.), Skåne University Hospital; and Clinical Memory Research Unit (L.M., O.H.), Department of Clinical Sciences, Malmö, Lund University, Sweden.
| | - Pia C Sundgren
- From Clinical Geriatrics (O.V., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.C.S., O.S.), Lund University; Clinical Neurochemistry Laboratory (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; Memory Clinic (L.M., O.H.), Skåne University Hospital; and Clinical Memory Research Unit (L.M., O.H.), Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Olof Strandberg
- From Clinical Geriatrics (O.V., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.C.S., O.S.), Lund University; Clinical Neurochemistry Laboratory (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; Memory Clinic (L.M., O.H.), Skåne University Hospital; and Clinical Memory Research Unit (L.M., O.H.), Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Henrik Zetterberg
- From Clinical Geriatrics (O.V., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.C.S., O.S.), Lund University; Clinical Neurochemistry Laboratory (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; Memory Clinic (L.M., O.H.), Skåne University Hospital; and Clinical Memory Research Unit (L.M., O.H.), Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Lennart Minthon
- From Clinical Geriatrics (O.V., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.C.S., O.S.), Lund University; Clinical Neurochemistry Laboratory (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; Memory Clinic (L.M., O.H.), Skåne University Hospital; and Clinical Memory Research Unit (L.M., O.H.), Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Kaj Blennow
- From Clinical Geriatrics (O.V., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.C.S., O.S.), Lund University; Clinical Neurochemistry Laboratory (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; Memory Clinic (L.M., O.H.), Skåne University Hospital; and Clinical Memory Research Unit (L.M., O.H.), Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Lars-Olof Wahlund
- From Clinical Geriatrics (O.V., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.C.S., O.S.), Lund University; Clinical Neurochemistry Laboratory (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; Memory Clinic (L.M., O.H.), Skåne University Hospital; and Clinical Memory Research Unit (L.M., O.H.), Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Eric Westman
- From Clinical Geriatrics (O.V., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.C.S., O.S.), Lund University; Clinical Neurochemistry Laboratory (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; Memory Clinic (L.M., O.H.), Skåne University Hospital; and Clinical Memory Research Unit (L.M., O.H.), Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Oskar Hansson
- From Clinical Geriatrics (O.V., L.-O.W., E.W.), Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm; Department of Diagnostic Radiology (P.C.S., O.S.), Lund University; Clinical Neurochemistry Laboratory (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; Memory Clinic (L.M., O.H.), Skåne University Hospital; and Clinical Memory Research Unit (L.M., O.H.), Department of Clinical Sciences, Malmö, Lund University, Sweden.
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Foley JM, Salat DH, Stricker NH, McGlinchey RE, Milberg WP, Grande LJ, Leritz EC. Glucose Dysregulation Interacts With APOE-∊4 to Potentiate Temporoparietal Cortical Thinning. Am J Alzheimers Dis Other Demen 2016; 31:76-86. [PMID: 26006791 PMCID: PMC4913470 DOI: 10.1177/1533317515587084] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We examined the interactive effects of apolipoprotein ∊4 (APOE-∊4), a risk factor for Alzheimer's disease (AD), and diabetes risk on cortical thickness among 107 healthy elderly participants; in particular, participants included 27 APOE-∊4+ and 80 APOE-∊4- controls using T1-weighted structural magnetic resonance imaging. Regions of interests included select frontal, temporal, and parietal cortical regions. Among APOE-∊4, glucose abnormalities independently predicted reduced cortical thickness among temporoparietal regions but failed to predict changes for noncarriers. However, among noncarriers, age independently predicted reduced cortical thickness among temporoparietal and frontal regions. Diabetes risk is particularly important for the integrity of cortical gray matter in APOE-∊4 and demonstrates a pattern of thinning that is expected in preclinical AD. However, in the absence of this genetic factor, age confers risk for reduced cortical thickness among regions of expected compromise. This study supports aggressive management of cerebrovascular factors and earlier preclinical detection of AD among individuals presenting with genetic and metabolic risks.
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Affiliation(s)
- Jessica M Foley
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - David H Salat
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Nikki H Stricker
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Regina E McGlinchey
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - William P Milberg
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Laura J Grande
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Elizabeth C Leritz
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Whitwell JL, Weigand SD, Duffy JR, Strand EA, Machulda MM, Senjem ML, Gunter JL, Lowe VJ, Jack CR, Josephs KA. Clinical and MRI models predicting amyloid deposition in progressive aphasia and apraxia of speech. NEUROIMAGE-CLINICAL 2016; 11:90-98. [PMID: 26937376 PMCID: PMC4752814 DOI: 10.1016/j.nicl.2016.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 01/11/2016] [Accepted: 01/18/2016] [Indexed: 12/14/2022]
Abstract
Beta-amyloid (Aβ) deposition can be observed in primary progressive aphasia (PPA) and progressive apraxia of speech (PAOS). While it is typically associated with logopenic PPA, there are exceptions that make predicting Aβ status challenging based on clinical diagnosis alone. We aimed to determine whether MRI regional volumes or clinical data could help predict Aβ deposition. One hundred and thirty-nine PPA (n = 97; 15 agrammatic, 53 logopenic, 13 semantic and 16 unclassified) and PAOS (n = 42) subjects were prospectively recruited into a cross-sectional study and underwent speech/language assessments, 3.0 T MRI and C11-Pittsburgh Compound B PET. The presence of Aβ was determined using a 1.5 SUVR cut-point. Atlas-based parcellation was used to calculate gray matter volumes of 42 regions-of-interest across the brain. Penalized binary logistic regression was utilized to determine what combination of MRI regions, and what combination of speech and language tests, best predicts Aβ (+) status. The optimal MRI model and optimal clinical model both performed comparably in their ability to accurately classify subjects according to Aβ status. MRI accurately classified 81% of subjects using 14 regions. Small left superior temporal and inferior parietal volumes and large left Broca's area volumes were particularly predictive of Aβ (+) status. Clinical scores accurately classified 83% of subjects using 12 tests. Phonological errors and repetition deficits, and absence of agrammatism and motor speech deficits were particularly predictive of Aβ (+) status. In comparison, clinical diagnosis was able to accurately classify 89% of subjects. However, the MRI model performed well in predicting Aβ deposition in unclassified PPA. Clinical diagnosis provides optimum prediction of Aβ status at the group level, although regional MRI measurements and speech and language testing also performed well and could have advantages in predicting Aβ status in unclassified PPA subjects. We examine whether MRI or clinical data can predict Aβ deposition in PPA and PAOS. MRI and clinical data accurately classified 81% and 83% of subjects, respectively. Small superior temporal gyri and phonological errors best predicted Aβ deposition. In comparison, clinical diagnosis accurately classified 89% of subjects. MRI and clinical data could predict discordant svPPA, lvPPA and unclassified cases.
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Affiliation(s)
| | - Stephen D Weigand
- Department of Health Sciences Research (Biostatistics), Mayo Clinic, Rochester, MN, USA
| | - Joseph R Duffy
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Mary M Machulda
- Department of Psychiatry and Psychology (Neuropsychology), Mayo Clinic, Rochester, MN, USA
| | - Matthew L Senjem
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Jeffrey L Gunter
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Functional neuroanatomy of spatial sound processing in Alzheimer's disease. Neurobiol Aging 2015; 39:154-64. [PMID: 26923412 PMCID: PMC4782736 DOI: 10.1016/j.neurobiolaging.2015.12.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 12/08/2015] [Accepted: 12/15/2015] [Indexed: 12/23/2022]
Abstract
Deficits of auditory scene analysis accompany Alzheimer's disease (AD). However, the functional neuroanatomy of spatial sound processing has not been defined in AD. We addressed this using a “sparse” fMRI virtual auditory spatial paradigm in 14 patients with typical AD in relation to 16 healthy age-matched individuals. Sound stimulus sequences discretely varied perceived spatial location and pitch of the sound source in a factorial design. AD was associated with loss of differentiated cortical profiles of auditory location and pitch processing at the prescribed threshold, and significant group differences were identified for processing auditory spatial variation in posterior cingulate cortex (controls > AD) and the interaction of pitch and spatial variation in posterior insula (AD > controls). These findings build on emerging evidence for altered brain mechanisms of auditory scene analysis and suggest complex dysfunction of network hubs governing the interface of internal milieu and external environment in AD. Auditory spatial processing may be a sensitive probe of this interface and contribute to characterization of brain network failure in AD and other neurodegenerative syndromes.
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43
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Möller C, Hafkemeijer A, Pijnenburg YAL, Rombouts SARB, van der Grond J, Dopper E, van Swieten J, Versteeg A, Steenwijk MD, Barkhof F, Scheltens P, Vrenken H, van der Flier WM. Different patterns of cortical gray matter loss over time in behavioral variant frontotemporal dementia and Alzheimer's disease. Neurobiol Aging 2015; 38:21-31. [PMID: 26827640 DOI: 10.1016/j.neurobiolaging.2015.10.020] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 10/16/2015] [Accepted: 10/24/2015] [Indexed: 10/22/2022]
Abstract
We examined patterns of cortical thickness loss and cognitive decline over time in 19 patients with Alzheimer's disease (AD), 10 with behavioral variant frontotemporal dementia (bvFTD), and 34 controls with a mean interval of 2.1 ± 0.4 years. We measured vertexwise and regional cortical thickness changes of 6 lobar regions of interest between groups with the longitudinal FreeSurfer pipeline. Compared with controls, AD and bvFTD had a steeper rate of cognitive decline and showed faster cortical thinning per year. Decrease of thickness over time was highest in AD and generalized throughout the whole brain, most pronounced posteriorly, whereas bvFTD patients had a more selective loss in frontal cortex and in anterior parts of the temporal lobes. In a direct comparison, AD patients showed faster cortical thinning in the insula, temporal, and parietal regions, whereas bvFTD patients only showed faster cortical thinning in the orbitofrontal gyrus. Decline of cognitive performances was in line with cortical thinning and deteriorated the most in AD patients.
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Affiliation(s)
- Christiane Möller
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Anne Hafkemeijer
- Institute of Psychology, Leiden University, Leiden, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Serge A R B Rombouts
- Institute of Psychology, Leiden University, Leiden, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Elise Dopper
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Clinical Genetics, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - John van Swieten
- Department of Clinical Genetics, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands; Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Adriaan Versteeg
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Martijn D Steenwijk
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Hugo Vrenken
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands; Department of Physics and Medical Technology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.
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44
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McCarthy CS, Ramprashad A, Thompson C, Botti JA, Coman IL, Kates WR. A comparison of FreeSurfer-generated data with and without manual intervention. Front Neurosci 2015; 9:379. [PMID: 26539075 PMCID: PMC4612506 DOI: 10.3389/fnins.2015.00379] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 09/29/2015] [Indexed: 01/18/2023] Open
Abstract
This paper examined whether FreeSurfer-generated data differed between a fully-automated, unedited pipeline and an edited pipeline that included the application of control points to correct errors in white matter segmentation. In a sample of 30 individuals, we compared the summary statistics of surface area, white matter volumes, and cortical thickness derived from edited and unedited datasets for the 34 regions of interest (ROIs) that FreeSurfer (FS) generates. To determine whether applying control points would alter the detection of significant differences between patient and typical groups, effect sizes between edited and unedited conditions in individuals with the genetic disorder, 22q11.2 deletion syndrome (22q11DS) were compared to neurotypical controls. Analyses were conducted with data that were generated from both a 1.5 tesla and a 3 tesla scanner. For 1.5 tesla data, mean area, volume, and thickness measures did not differ significantly between edited and unedited regions, with the exception of rostral anterior cingulate thickness, lateral orbitofrontal white matter, superior parietal white matter, and precentral gyral thickness. Results were similar for surface area and white matter volumes generated from the 3 tesla scanner. For cortical thickness measures however, seven edited ROI measures, primarily in frontal and temporal regions, differed significantly from their unedited counterparts, and three additional ROI measures approached significance. Mean effect sizes for edited ROIs did not differ from most unedited ROIs for either 1.5 or 3 tesla data. Taken together, these results suggest that although the application of control points may increase the validity of intensity normalization and, ultimately, segmentation, it may not affect the final, extracted metrics that FS generates. Potential exceptions to and limitations of these conclusions are discussed.
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Affiliation(s)
- Christopher S McCarthy
- Department of Psychiatry and Behavioral Sciences, Center for Psychiatric Neuroimaging, State University of New York at Upstate Medical University Syracuse, NY, USA
| | - Avinash Ramprashad
- Department of Psychiatry and Behavioral Sciences, Center for Psychiatric Neuroimaging, State University of New York at Upstate Medical University Syracuse, NY, USA
| | - Carlie Thompson
- Department of Psychiatry and Behavioral Sciences, Center for Psychiatric Neuroimaging, State University of New York at Upstate Medical University Syracuse, NY, USA
| | - Jo-Anna Botti
- Department of Psychiatry and Behavioral Sciences, Center for Psychiatric Neuroimaging, State University of New York at Upstate Medical University Syracuse, NY, USA
| | - Ioana L Coman
- Department of Psychiatry and Behavioral Sciences, Center for Psychiatric Neuroimaging, State University of New York at Upstate Medical University Syracuse, NY, USA
| | - Wendy R Kates
- Department of Psychiatry and Behavioral Sciences, Center for Psychiatric Neuroimaging, State University of New York at Upstate Medical University Syracuse, NY, USA
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45
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Scheff SW, Price DA, Ansari MA, Roberts KN, Schmitt FA, Ikonomovic MD, Mufson EJ. Synaptic change in the posterior cingulate gyrus in the progression of Alzheimer's disease. J Alzheimers Dis 2015; 43:1073-90. [PMID: 25147118 DOI: 10.3233/jad-141518] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Mild cognitive impairment (MCI) is considered to be an early stage in the progression of Alzheimer's disease (AD) providing an opportunity to investigate brain pathogenesis prior to the onset of dementia. Neuroimaging studies have identified the posterior cingulate gyrus (PostC) as a cortical region affected early in the onset of AD. This association cortex is involved in a variety of different cognitive tasks and is intimately connected with the hippocampal/entorhinal cortex region, a component of the medial temporal memory circuit that displays early AD pathology. We quantified the total number of synapses in lamina 3 of the PostC using unbiased stereology coupled with electron microscopy from short postmortem autopsy tissue harvested from cases at different stage of AD progression. Individuals in the early stages of AD showed a significant decline in synaptic numbers compared to individuals with no cognitive impairment (NCI). Subjects with MCI exhibited synaptic numbers that were between the AD and NCI cohorts. Adjacent tissue was evaluated for changes in both pre and postsynaptic proteins levels. Individuals with MCI demonstrated a significant loss in presynaptic markers synapsin-1 and synaptophysin and postsynaptic markers PSD-95 and SAP-97. Levels of [3H]PiB binding was significantly increased in MCI and AD and correlated strongly with levels of synaptic proteins. All synaptic markers showed a significant association with Mini-Mental Status Examination scores. These results support the idea that the PostC synaptic function is affected during the prodromal stage of the disease and may underlie some of the early clinical sequelae associated with AD.
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Affiliation(s)
- Stephen W Scheff
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Douglas A Price
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Mubeen A Ansari
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Kelly N Roberts
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | | | - Milos D Ikonomovic
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA Geriatric Research Educational and Clinical Center, V.A. Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Elliott J Mufson
- Rush University Medical Center, Department of Neurological Sciences, Chicago, IL, USA
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Whitwell JL, Duffy JR, Strand EA, Machulda MM, Senjem ML, Schwarz CG, Reid R, Baker MC, Perkerson RB, Lowe VJ, Rademakers R, Jack CR, Josephs KA. Clinical and neuroimaging biomarkers of amyloid-negative logopenic primary progressive aphasia. BRAIN AND LANGUAGE 2015; 142:45-53. [PMID: 25658633 PMCID: PMC4380294 DOI: 10.1016/j.bandl.2015.01.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 01/07/2015] [Accepted: 01/08/2015] [Indexed: 06/01/2023]
Abstract
Logopenic primary progressive aphasia (lvPPA) is a progressive language disorder characterized by anomia, difficulty repeating complex sentences, and phonological errors. The majority, although not all, lvPPA patients have underlying Alzheimer's disease. We aimed to determine whether clinical or neuroimaging features differ according to the deposition of Aβ on Pittsburgh-compound B PET in lvPPA. Clinical features, patterns of atrophy on MRI, hypometabolism on FDG-PET, and white matter tract degeneration were compared between six PiB-negative and 20 PiB-positive lvPPA patients. PiB-negative patients showed more asymmetric left-sided patterns of atrophy, hypometabolism and white matter tract degeneration, with greater left anteromedial temporal and medial prefrontal involvement, than PiB-positive patients. PiB-positive patients showed greater involvement of right temporoparietal and frontal lobes. There was very little evidence for clinical differences between the groups. Strikingly asymmetric neuroimaging findings with relatively preserved right hemisphere may provide clues that AD pathology is absent in lvPPA.
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Affiliation(s)
| | - Joseph R Duffy
- Department of Neurology (Division of Speech Pathology), Mayo Clinic, Rochester, MN, United States
| | - Edythe A Strand
- Department of Neurology (Division of Speech Pathology), Mayo Clinic, Rochester, MN, United States
| | - Mary M Machulda
- Department of Psychiatry and Psychology (Neuropsychology), Mayo Clinic, Rochester, MN, United States
| | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN, United States; Department of Information Technology, Mayo Clinic, Rochester, MN, United States
| | | | - Robert Reid
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Matthew C Baker
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, United States
| | - Ralph B Perkerson
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, United States
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, United States
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Keith A Josephs
- Department of Neurology (Division of Behavioral Neurology), Mayo Clinic, Rochester, MN, United states
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47
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Demencia frontotemporal variante conductual: biomarcadores, una aproximación a la enfermedad. Neurologia 2015; 30:50-61. [DOI: 10.1016/j.nrl.2013.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 03/16/2013] [Indexed: 11/22/2022] Open
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48
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Golden HL, Nicholas JM, Yong KXX, Downey LE, Schott JM, Mummery CJ, Crutch SJ, Warren JD. Auditory spatial processing in Alzheimer's disease. Brain 2015; 138:189-202. [PMID: 25468732 PMCID: PMC4285196 DOI: 10.1093/brain/awu337] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 10/01/2014] [Accepted: 10/10/2014] [Indexed: 11/13/2022] Open
Abstract
The location and motion of sounds in space are important cues for encoding the auditory world. Spatial processing is a core component of auditory scene analysis, a cognitively demanding function that is vulnerable in Alzheimer's disease. Here we designed a novel neuropsychological battery based on a virtual space paradigm to assess auditory spatial processing in patient cohorts with clinically typical Alzheimer's disease (n = 20) and its major variant syndrome, posterior cortical atrophy (n = 12) in relation to healthy older controls (n = 26). We assessed three dimensions of auditory spatial function: externalized versus non-externalized sound discrimination, moving versus stationary sound discrimination and stationary auditory spatial position discrimination, together with non-spatial auditory and visual spatial control tasks. Neuroanatomical correlates of auditory spatial processing were assessed using voxel-based morphometry. Relative to healthy older controls, both patient groups exhibited impairments in detection of auditory motion, and stationary sound position discrimination. The posterior cortical atrophy group showed greater impairment for auditory motion processing and the processing of a non-spatial control complex auditory property (timbre) than the typical Alzheimer's disease group. Voxel-based morphometry in the patient cohort revealed grey matter correlates of auditory motion detection and spatial position discrimination in right inferior parietal cortex and precuneus, respectively. These findings delineate auditory spatial processing deficits in typical and posterior Alzheimer's disease phenotypes that are related to posterior cortical regions involved in both syndromic variants and modulated by the syndromic profile of brain degeneration. Auditory spatial deficits contribute to impaired spatial awareness in Alzheimer's disease and may constitute a novel perceptual model for probing brain network disintegration across the Alzheimer's disease syndromic spectrum.
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Affiliation(s)
- Hannah L Golden
- 1 Dementia Research Centre, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Jennifer M Nicholas
- 1 Dementia Research Centre, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK 2 Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Keir X X Yong
- 1 Dementia Research Centre, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Laura E Downey
- 1 Dementia Research Centre, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Jonathan M Schott
- 1 Dementia Research Centre, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Catherine J Mummery
- 1 Dementia Research Centre, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Sebastian J Crutch
- 1 Dementia Research Centre, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Jason D Warren
- 1 Dementia Research Centre, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK
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49
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Biomarkers: a new approach to behavioural variant frontotemporal dementia. NEUROLOGÍA (ENGLISH EDITION) 2015. [DOI: 10.1016/j.nrleng.2013.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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50
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Gomar JJ, Gordon ML, Dickinson D, Kingsley PB, Uluğ AM, Keehlisen L, Huet S, Buthorn JJ, Koppel J, Christen E, Conejero-Goldberg C, Davies P, Goldberg TE. APOE genotype modulates proton magnetic resonance spectroscopy metabolites in the aging brain. Biol Psychiatry 2014; 75:686-92. [PMID: 23831342 PMCID: PMC3887136 DOI: 10.1016/j.biopsych.2013.05.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 05/08/2013] [Accepted: 05/11/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Proton magnetic resonance spectroscopy ((1)H-MRS) studies on healthy aging have reported inconsistent findings and have not systematically taken into account the possible modulatory effect of APOE genotype. We aimed to quantify brain metabolite changes in healthy subjects in relation to age and the presence of the APOE E4 genetic risk factor for Alzheimer's disease. Additionally, we examined these measures in relation to cognition. METHODS We studied a cohort of 112 normal adults between 50 and 86 years old who were genotyped for APOE genetic polymorphism. Measurements of (1)H-MRS metabolites were obtained in the posterior cingulate and precuneus region. Measures of general cognitive functioning, memory, executive function, semantic fluency, and speed of processing were also obtained. RESULTS General linear model analysis demonstrated that older APOE E4 carriers had significantly higher choline/creatine and myo-inositol/creatine ratios than APOE E3 homozygotes. Structural equation modeling resulted in a model with an excellent goodness of fit and in which the APOE × age interaction and APOE status each had a significant effect on (1)H-MRS metabolites (choline/creatine and myo-inositol/creatine). Furthermore, the APOE × age variable modulation of cognition was mediated by (1)H-MRS metabolites. CONCLUSIONS In a healthy aging normal population, choline/creatine and myo-inositol/creatine ratios were significantly increased in APOE E4 carriers, suggesting the presence of neuroinflammatory processes and greater membrane turnover in older carriers. Structural equation modeling analysis confirmed these possible neurodegenerative markers and also indicated the mediator role of these metabolites on cognitive performance among older APOE E4 carriers.
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Affiliation(s)
- Jesus J Gomar
- Litwin-Zucker Research Center, The Feinstein Institute for Medical Research, Manhasset, New York; FIDMAG Hermanas Hospitalarias, Sant Boi de Llobregat, Spain
| | - Marc L Gordon
- Litwin-Zucker Research Center, The Feinstein Institute for Medical Research, Manhasset, New York; Hofstra North Shore Long Island Jewish School of Medicine, Hempstead, New York
| | - Dwight Dickinson
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Peter B Kingsley
- Department of Radiology, North Shore University Hospital, Manhasset, New York
| | - Aziz M Uluğ
- Hofstra North Shore Long Island Jewish School of Medicine, Hempstead, New York; Susan and Leonard Feinstein Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York
| | - Lynda Keehlisen
- Litwin-Zucker Research Center, The Feinstein Institute for Medical Research, Manhasset, New York
| | - Sarah Huet
- Litwin-Zucker Research Center, The Feinstein Institute for Medical Research, Manhasset, New York
| | - Justin J Buthorn
- Litwin-Zucker Research Center, The Feinstein Institute for Medical Research, Manhasset, New York
| | - Jeremy Koppel
- Litwin-Zucker Research Center, The Feinstein Institute for Medical Research, Manhasset, New York; Hofstra North Shore Long Island Jewish School of Medicine, Hempstead, New York
| | - Erica Christen
- Litwin-Zucker Research Center, The Feinstein Institute for Medical Research, Manhasset, New York
| | | | - Peter Davies
- Litwin-Zucker Research Center, The Feinstein Institute for Medical Research, Manhasset, New York; Hofstra North Shore Long Island Jewish School of Medicine, Hempstead, New York
| | - Terry E Goldberg
- Litwin-Zucker Research Center, The Feinstein Institute for Medical Research, Manhasset, New York; Hofstra North Shore Long Island Jewish School of Medicine, Hempstead, New York.
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