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Heywood A, Stocks J, Schneider JA, Arfanakis K, Bennett DA, Beg MF, Wang L. In vivo effect of LATE-NC on integrity of white matter connections to the hippocampus. Alzheimers Dement 2024; 20:4401-4410. [PMID: 38877688 PMCID: PMC11247713 DOI: 10.1002/alz.13808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION TAR DNA-binding protein 43 (TDP-43) is a highly prevalent proteinopathy that is involved in neurodegenerative processes, including axonal damage. To date, no ante mortem biomarkers exist for TDP-43, and few studies have directly assessed its impact on neuroimaging measures utilizing pathologic quantification. METHODS Ante mortem diffusion-weighted images were obtained from community-dwelling older adults. Regression models calculated the relationship between post mortem TDP-43 burden and ante mortem fractional anisotropy (FA) within each voxel in connection with the hippocampus, controlling for coexisting Alzheimer's disease and demographics. RESULTS Results revealed a significant negative relationship (false discovery rate [FDR] corrected p < .05) between post mortem TDP-43 and ante mortem FA in one cluster within the left medial temporal lobe connecting to the parahippocampal cortex, entorhinal cortex, and cingulate, aligning with the ventral subdivision of the cingulum. FA within this cluster was associated with cognition. DISCUSSION Greater TDP-43 burden is associated with lower FA within the limbic system, which may contribute to impairment in learning and memory. HIGHLIGHTS Post mortem TDP-43 pathological burden is associated with reduced ante mortem fractional anisotropy. Reduced FA located in the parahippocampal portion of the cingulum. FA in this area was associated with reduced episodic and semantic memory. FA in this area was associated with increased inward hippocampal surface deformation.
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Affiliation(s)
- Ashley Heywood
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jane Stocks
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
- Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Suite, Chicago, Illinois, USA
- Department of Diagnostic Radiology, Rush University Medical Center, Chicago, Illinois, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Mirza Faisal Beg
- Simon Fraser University, School of Engineering Science, 8888 University Drive, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus, Ohio, USA
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2
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Imokawa T, Yokoyama K, Takahashi K, Oyama J, Tsuchiya J, Sanjo N, Tateishi U. Brain perfusion SPECT in dementia: what radiologists should know. Jpn J Radiol 2024:10.1007/s11604-024-01612-5. [PMID: 38888851 DOI: 10.1007/s11604-024-01612-5] [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: 03/25/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024]
Abstract
The findings of brain perfusion single-photon emission computed tomography (SPECT), which detects abnormalities often before changes manifest in morphological imaging, mainly reflect neurodegeneration and contribute to dementia evaluation. A major shift is about to occur in dementia practice to the approach of diagnosing based on biomarkers and treating with disease-modifying drugs. Accordingly, brain perfusion SPECT will be required to serve as a biomarker of neurodegeneration. Hypoperfusion in Alzheimer's disease (AD) is typically seen in the posterior cingulate cortex and precuneus early in the disease, followed by the temporoparietal cortices. On the other hand, atypical presentations of AD such as the posterior variant, logopenic variant, frontal variant, and corticobasal syndrome exhibit hypoperfusion in areas related to symptoms. Additionally, hypoperfusion especially in the precuneus and parietal association cortex can serve as a predictor of progression from mild cognitive impairment to AD. In dementia with Lewy bodies (DLB), the differentiating feature is the presence of hypoperfusion in the occipital lobes in addition to that observed in AD. Hypoperfusion of the occipital lobe is not a remarkable finding, as it is assumed to reflect functional loss due to impairment of the cholinergic and dopaminergic systems rather than degeneration per se. Moreover, the cingulate island sign reflects the degree of AD pathology comorbid in DLB. Frontotemporal dementia is characterized by regional hypoperfusion according to the three clinical types, and the background pathology is diverse. Idiopathic normal pressure hydrocephalus shows apparent hypoperfusion around the Sylvian fissure and corpus callosum and apparent hyperperfusion in high-convexity areas. The cortex or striatum with diffusion restriction on magnetic resonance imaging in prion diseases reflects spongiform degeneration and brain perfusion SPECT reveals hypoperfusion in the same areas. Brain perfusion SPECT findings in dementia should be carefully interpreted considering background pathology.
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Affiliation(s)
- Tomoki Imokawa
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
- Department of Radiology, Japanese Red Cross Omori Hospital, Ota-Ku, Tokyo, Japan
| | - Kota Yokoyama
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan.
| | - Kanae Takahashi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Jun Oyama
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Junichi Tsuchiya
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Nobuo Sanjo
- Department of Neurology and Neurological Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
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Gonzalez-Gomez R, Ibañez A, Moguilner S. Multiclass characterization of frontotemporal dementia variants via multimodal brain network computational inference. Netw Neurosci 2023; 7:322-350. [PMID: 37333999 PMCID: PMC10270711 DOI: 10.1162/netn_a_00285] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/03/2022] [Indexed: 04/03/2024] Open
Abstract
Characterizing a particular neurodegenerative condition against others possible diseases remains a challenge along clinical, biomarker, and neuroscientific levels. This is the particular case of frontotemporal dementia (FTD) variants, where their specific characterization requires high levels of expertise and multidisciplinary teams to subtly distinguish among similar physiopathological processes. Here, we used a computational approach of multimodal brain networks to address simultaneous multiclass classification of 298 subjects (one group against all others), including five FTD variants: behavioral variant FTD, corticobasal syndrome, nonfluent variant primary progressive aphasia, progressive supranuclear palsy, and semantic variant primary progressive aphasia, with healthy controls. Fourteen machine learning classifiers were trained with functional and structural connectivity metrics calculated through different methods. Due to the large number of variables, dimensionality was reduced, employing statistical comparisons and progressive elimination to assess feature stability under nested cross-validation. The machine learning performance was measured through the area under the receiver operating characteristic curves, reaching 0.81 on average, with a standard deviation of 0.09. Furthermore, the contributions of demographic and cognitive data were also assessed via multifeatured classifiers. An accurate simultaneous multiclass classification of each FTD variant against other variants and controls was obtained based on the selection of an optimum set of features. The classifiers incorporating the brain's network and cognitive assessment increased performance metrics. Multimodal classifiers evidenced specific variants' compromise, across modalities and methods through feature importance analysis. If replicated and validated, this approach may help to support clinical decision tools aimed to detect specific affectations in the context of overlapping diseases.
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Affiliation(s)
- Raul Gonzalez-Gomez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Agustín Ibañez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Cognitive Neuroscience Center, Universidad de San Andres, Buenos Aires, Argentina
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
- Trinity College Dublin, Dublin, Ireland
| | - Sebastian Moguilner
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Cognitive Neuroscience Center, Universidad de San Andres, Buenos Aires, Argentina
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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4
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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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5
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Scarian E, Fiamingo G, Diamanti L, Palmieri I, Gagliardi S, Pansarasa O. The Role of VCP Mutations in the Spectrum of Amyotrophic Lateral Sclerosis-Frontotemporal Dementia. Front Neurol 2022; 13:841394. [PMID: 35273561 PMCID: PMC8902152 DOI: 10.3389/fneur.2022.841394] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/28/2022] [Indexed: 01/02/2023] Open
Abstract
Amyotrophic Lateral Sclerosis (ALS) and Frontotemporal Dementia (FTD) are two neurological diseases which, respectively, and primarily affect motor neurons and frontotemporal lobes. Although they can lead to different signs and symptoms, it is now evident that these two pathologies form a continuum and that hallmarks of both diseases can be present within the same person in the so-called ALS-FTD spectrum. Many studies have focused on the genetic overlap of these pathologies and it is now clear that different genes, such as C9orf72, TARDBP, SQSTM1, FUS, and p97/VCP can be mutated in both the diseases. VCP was one of the first genes associated with both FTD and ALS representing an early example of gene overlapping. VCP belongs to the type II AAA (ATPases Associated with diverse cellular activities) family and is involved in ubiquitinated proteins degradation, autophagy, lysosomal clearance and mitochondrial quality control. Since its numerous roles, mutations in this gene lead to different pathological features, first and foremost TDP-43 mislocalization. This review aims to outline recent findings on VCP roles and on how its mutations are linked to the neuropathology of ALS and FTD.
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Affiliation(s)
- Eveljn Scarian
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Cellular Models and Neuroepigenetics Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Giuseppe Fiamingo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Luca Diamanti
- Neuroncology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Ilaria Palmieri
- Department of Molecular Medicine, University of Pavia, Pavia, Italy.,Neurogenetics Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Stella Gagliardi
- Molecular Biology and Transcriptomics Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Orietta Pansarasa
- Cellular Models and Neuroepigenetics Unit, IRCCS Mondino Foundation, Pavia, Italy
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McKenna MC, Murad A, Huynh W, Lope J, Bede P. The changing landscape of neuroimaging in frontotemporal lobar degeneration: from group-level observations to single-subject data interpretation. Expert Rev Neurother 2022; 22:179-207. [PMID: 35227146 DOI: 10.1080/14737175.2022.2048648] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION While the imaging signatures of frontotemporal lobar degeneration (FTLD) phenotypes and genotypes are well-characterised based on group-level descriptive analyses, the meaningful interpretation of single MRI scans remains challenging. Single-subject MRI classification frameworks rely on complex computational models and large training datasets to categorise individual patients into diagnostic subgroups based on distinguishing imaging features. Reliable individual subject data interpretation is hugely important in the clinical setting to expedite the diagnosis and classify individuals into relevant prognostic categories. AREAS COVERED This article reviews (1) the neuroimaging studies that propose single-subject MRI classification strategies in symptomatic and pre-symptomatic FTLD, (2) potential practical implications and (3) the limitations of current single-subject data interpretation models. EXPERT OPINION Classification studies in FTLD have demonstrated the feasibility of categorising individual subjects into diagnostic groups based on multiparametric imaging data. Preliminary data indicate that pre-symptomatic FTLD mutation carriers may also be reliably distinguished from controls. Despite momentous advances in the field, significant further improvements are needed before these models can be developed into viable clinical applications.
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Affiliation(s)
| | - Aizuri Murad
- Computational Neuroimaging Group, Trinity College Dublin, Ireland
| | - William Huynh
- Brain and Mind Centre, University of Sydney, Australia
| | - Jasmin Lope
- Computational Neuroimaging Group, Trinity College Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Trinity College Dublin, Ireland.,Pitié-Salpêtrière University Hospital, Sorbonne University, France
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7
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Duan J, Wang JC, Li HX, Guo L, Ma LK. 1.5T magnetic resonance imaging in evaluating fetal head and abdomen malformations: a preliminary study. Am J Transl Res 2021; 13:9063-9069. [PMID: 34540019 PMCID: PMC8430194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Magnetic resonance imaging (MRI) is increasingly used in the diagnosis of fetal malformations. The purpose of this study was to determine the diagnostic value of 1.5T MRI in fetal head and abdominal malformations. METHODS A total of 132 pregnant women admitted to Shijiazhuang NO.4 Hospital were included and divided into a control group (CG; n=63) and a research group (RG; n=69) according to different prenatal examination methods. Patients in CG were given ultrasound, while those in RG underwent 1.5T MRI examination. The image quality of 1.5T MRI in different amniotic fluid, different gestational weeks with normal amniotic fluid and different fetal positions with normal amniotic fluid were compared. The detection rate and diagnostic value of the two methods were also compared, with the histological and pathological results as the gold standard. RESULTS The image quality of 1.5T MRI was not affected by different gestational age with normal amniotic fluid, different fetal positions with normal amniotic fluid, or different amniotic fluid, indicating the feasibility of 1.5T MRI in fetal malformation examination. Histopathological diagnosis revealed 39 cases of head and abdominal deformities in CG and 50 cases in RG. Based on the results of ultrasound examination, there were 32 cases of deformities and 31 of non-deformities in CG. In RG, 1.5T MRI revealed 48 malformations and 21 non-malformations. The sensitivity, specificity, accuracy, missed diagnosis and misdiagnosis rates were 82.05%, 75.00%, 79.37%, 17.95% and 25.00% respectively in CG where ultrasonography was performed, and were 96.00%, 94.74%, 95.65%, 4.00% and 5.26% respectively in RG where 1.5T MRI was performed. The data identified significant differences in sensitivity, accuracy and missed diagnosis between RG and CG. CONCLUSION 1.5T MRI is effective in diagnosing fetal head and abdominal malformations.
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Affiliation(s)
- Jun Duan
- Radiology Department, Shijiazhuang NO. 4 Hospital (The Obstetrics and Gynecology Hospital Affiliated to Hebei Medical University)Shijiazhuang 050000, Hebei, China
| | - Jin-Cai Wang
- Radiology Department, Shijiazhuang NO. 4 Hospital (The Obstetrics and Gynecology Hospital Affiliated to Hebei Medical University)Shijiazhuang 050000, Hebei, China
| | - Hui-Xian Li
- Thoracic Surgery, Shijiazhuang People’s HospitalShijiazhuang 050000, Hebei, China
| | - Ling Guo
- Radiology Department, Shijiazhuang NO. 4 Hospital (The Obstetrics and Gynecology Hospital Affiliated to Hebei Medical University)Shijiazhuang 050000, Hebei, China
| | - Li-Ke Ma
- Internal Medicine-Cardiovascular Department, Shijiazhuang No. 3 HospitalShijiazhuang 050000, Hebei, China
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8
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Lu J, Huang L, Lv Y, Peng S, Xu Q, Li L, Ge J, Zhang H, Guan Y, Zhao Q, Guo Q, Chen K, Wu P, Ma Y, Zuo C. A disease-specific metabolic imaging marker for diagnosis and progression evaluation of semantic variant primary progressive aphasia. Eur J Neurol 2021; 28:2927-2939. [PMID: 34110063 DOI: 10.1111/ene.14919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE The diagnosis and monitoring of semantic variant primary progressive aphasia (sv-PPA) are clinically challenging. We aimed to establish a distinctive metabolic pattern in sv-PPA for diagnosis and severity evaluation. METHODS Fifteen sv-PPA patients and 15 controls were enrolled to identify sv-PPA-related pattern (sv-PPARP) by principal component analysis of 18 F-fluorodeoxyglucose positron emission tomography. Eighteen Alzheimer disease dementia (AD) and 14 behavioral variant frontotemporal dementia (bv-FTD) patients were enrolled to test the discriminatory power. Correspondingly, regional metabolic activities extracted from the voxelwise analysis were evaluated for the discriminatory power. RESULTS The sv-PPARP was characterized as decreased metabolic activity mainly in the bilateral temporal lobe (left predominance), middle orbitofrontal gyrus, left hippocampus/parahippocampus gyrus, fusiform gyrus, insula, inferior orbitofrontal gyrus, and striatum, with increased activity in the bilateral lingual gyrus, cuneus, calcarine gyrus, and right precentral and postcentral gyrus. The pattern expression had significant discriminatory power (area under the curve [AUC] = 0.98, sensitivity = 100%, specificity = 94.4%) in distinguishing sv-PPA from AD, and the asymmetry index offered complementary discriminatory power (AUC = 0.91, sensitivity = 86.7%, specificity = 92.9%) in distinguishing sv-PPA from bv-FTD. In sv-PPA patients, the pattern expression correlated with Boston Naming Test scores at baseline and showed significant increase in the subset of patients with follow-up. The voxelwise analysis showed similar topography, and the regional metabolic activities had equivalent or better discriminatory power and clinical correlations with Boston Naming Test scores. The ability to reflect disease progression in longitudinal follow-up seemed to be inferior to the pattern expression. CONCLUSIONS The sv-PPARP might serve as an objective biomarker for diagnosis and progression evaluation.
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Affiliation(s)
- Jiaying Lu
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Lin Huang
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yingru Lv
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shichun Peng
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Qian Xu
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ling Li
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jingjie Ge
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Huiwei Zhang
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yihui Guan
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qihao Guo
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Keliang Chen
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ping Wu
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Yilong Ma
- Center for Neurosciences, Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Chuantao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,Human Phenome Institute, Fudan University, Shanghai, China.,Institute of Functional and Molecular Medicine Imaging, Fudan University, Shanghai, China
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9
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Massalimova A, Ni R, Nitsch RM, Reisert M, von Elverfeldt D, Klohs J. Diffusion Tensor Imaging Reveals Whole-Brain Microstructural Changes in the P301L Mouse Model of Tauopathy. NEURODEGENER DIS 2021; 20:173-184. [PMID: 33975312 DOI: 10.1159/000515754] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/05/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Increased expression of hyperphosphorylated tau and the formation of neurofibrillary tangles are associated with neuronal loss and white matter damage. Using high-resolution ex vivo diffusion tensor imaging (DTI), we investigated microstructural changes in the white and grey matter in the P301L mouse model of human tauopathy at 8.5 months of age. For unbiased computational analysis, we implemented a pipeline for voxel-based analysis (VBA) and atlas-based analysis (ABA) of DTI mouse brain data. METHODS Hemizygous and homozygous transgenic P301L mice and non-transgenic littermates were used. DTI data were acquired for generation of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) maps. VBA on the entire brain was performed using SPM8 and the SPM Mouse toolbox. Initially, all DTI maps were coregistered with the Allen mouse brain atlas to bring them to one common coordinate space. In VBA, coregistered DTI maps were normalized and smoothed in order to perform two-sample and unpaired t tests with false discovery rate correction to compare hemizygotes with non-transgenic littermates, homozygotes with non-transgenic littermates, and hemizygotes with homozygotes on each DTI parameter map. In ABA, the average values for selected regions of interests were computed with coregistered DTI maps and labels in Allen mouse brain atlas. Afterwards, a Kruskal-Wallis one-way ANOVA on ranks with a Tukey post hoc test was executed on the estimated average values. RESULTS With VBA, we found pronounced and brain-wide spread changes when comparing homozygous, P301L mice with non-transgenic littermates, which were not seen when comparing hemizygous P301L with non-transgenic animals. Statistical comparison of DTI metrics in selected brain regions by ABA corroborated findings from VBA. FA was found to be decreased in most brain regions, while MD, RD, and AD were increased in homozygotes compared to hemizygotes and non-transgenic littermates. DISCUSSION/CONCLUSION High-resolution ex vivo DTI demonstrated brain-wide microstructural and gene-dose-dependent changes in the P301L mouse model of human tauopathy. The DTI analysis pipeline may serve for the phenotyping of models of tauopathy and other brain diseases.
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Affiliation(s)
- Aidana Massalimova
- Institute for Biomedical Engineering, ETH & University of Zurich, Zurich, Switzerland
| | - Ruiqing Ni
- Institute for Biomedical Engineering, ETH & University of Zurich, Zurich, Switzerland
| | - Roger M Nitsch
- Zurich Neuroscience Center (ZNZ), Zurich, Switzerland.,Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
| | - Marco Reisert
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominik von Elverfeldt
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jan Klohs
- Institute for Biomedical Engineering, ETH & University of Zurich, Zurich, Switzerland.,Zurich Neuroscience Center (ZNZ), Zurich, Switzerland
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10
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Dev SI, Dickerson BC, Touroutoglou A. Neuroimaging in Frontotemporal Lobar Degeneration: Research and Clinical Utility. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1281:93-112. [PMID: 33433871 PMCID: PMC8787866 DOI: 10.1007/978-3-030-51140-1_7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Frontotemporal lobar dementia (FTLD) is a clinically and pathologically complex disease. Advances in neuroimaging techniques have provided a specialized set of tools to investigate underlying pathophysiology and identify clinical biomarkers that aid in diagnosis, prognostication, monitoring, and identification of appropriate endpoints in clinical trials. In this chapter, we review data discussing the utility of neuroimaging biomarkers in sporadic FTLD, with an emphasis on current and future clinical applications. Among those modalities readily utilized in clinical settings, T1-weighted structural magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) are best supported in differential diagnosis and as targets for clinical trial endpoints. However, a number of nonclinical neuroimaging modalities, including diffusion tensor imaging and resting-state functional connectivity MRI, show promise as biomarkers to predict progression and as clinical trial endpoints. Other neuroimaging modalities, including amyloid PET, Tau PET, and arterial spin labeling MRI, are also discussed, though more work is required to establish their utility in FTLD in clinical settings.
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Affiliation(s)
- Sheena I Dev
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA.
| | - Alexandra Touroutoglou
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
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11
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Singleton EH, Pijnenburg YAL, Sudre CH, Groot C, Kochova E, Barkhof F, La Joie R, Rosen HJ, Seeley WW, Miller B, Cardoso MJ, Papma J, Scheltens P, Rabinovici GD, Ossenkoppele R. Investigating the clinico-anatomical dissociation in the behavioral variant of Alzheimer disease. Alzheimers Res Ther 2020; 12:148. [PMID: 33189136 PMCID: PMC7666520 DOI: 10.1186/s13195-020-00717-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/26/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND We previously found temporoparietal-predominant atrophy patterns in the behavioral variant of Alzheimer's disease (bvAD), with relative sparing of frontal regions. Here, we aimed to understand the clinico-anatomical dissociation in bvAD based on alternative neuroimaging markers. METHODS We retrospectively included 150 participants, including 29 bvAD, 28 "typical" amnestic-predominant AD (tAD), 28 behavioral variant of frontotemporal dementia (bvFTD), and 65 cognitively normal participants. Patients with bvAD were compared with other diagnostic groups on glucose metabolism and metabolic connectivity measured by [18F]FDG-PET, and on subcortical gray matter and white matter hyperintensity (WMH) volumes measured by MRI. A receiver-operating-characteristic-analysis was performed to determine the neuroimaging measures with highest diagnostic accuracy. RESULTS bvAD and tAD showed predominant temporoparietal hypometabolism compared to controls, and did not differ in direct contrasts. However, overlaying statistical maps from contrasts between patients and controls revealed broader frontoinsular hypometabolism in bvAD than tAD, partially overlapping with bvFTD. bvAD showed greater anterior default mode network (DMN) involvement than tAD, mimicking bvFTD, and reduced connectivity of the posterior cingulate cortex with prefrontal regions. Analyses of WMH and subcortical volume showed closer resemblance of bvAD to tAD than to bvFTD, and larger amygdalar volumes in bvAD than tAD respectively. The top-3 discriminators for bvAD vs. bvFTD were FDG posterior-DMN-ratios (bvAD bvFTD, area under the curve [AUC] range 0.85-0.91, all p < 0.001). The top-3 for bvAD vs. tAD were amygdalar volume (bvAD>tAD), MRI anterior-DMN-ratios (bvADCONCLUSIONS Subtle frontoinsular hypometabolism and anterior DMN involvement may underlie the prominent behavioral phenotype in bvAD.
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Affiliation(s)
- Ellen H. Singleton
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Yolande A. L. Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Carole H. Sudre
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Colin Groot
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Elena Kochova
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
- Center for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Renaud La Joie
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, USA
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, USA
| | - William W. Seeley
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, USA
| | - Bruce Miller
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, USA
| | - M. Jorge Cardoso
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Translational Imaging Group, CMIC, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Janne Papma
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Gil D. Rabinovici
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, USA
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
- Molecular Biophysics and Integrated Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, CA USA
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, USA
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
- Clinical Memory Research Unit, Lund University, Lund, Sweden
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12
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Deravet N, Orban de Xivry JJ, Ivanoiu A, Bier JC, Segers K, Yüksel D, Lefèvre P. Frontotemporal dementia patients exhibit deficits in predictive saccades. J Comput Neurosci 2020; 49:357-369. [PMID: 32944827 DOI: 10.1007/s10827-020-00765-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 09/02/2020] [Accepted: 09/10/2020] [Indexed: 12/14/2022]
Abstract
Prediction and time estimation are all but required for motor function in everyday life. In the context of eye movements, for instance, they allow predictive saccades and eye re-acceleration in anticipation of a target re-appearance. While the neural pathways involved are not fully understood, it is known that the frontal lobe plays an important role. As such, neurological disorders that affect it, such as frontotemporal (FTD) dementia, are likely to induce deficits in such movements. In this work, we study the performances of frontotemporal dementia patients in an oculomotor task designed to elicit predictive saccades at different rates, and compare them to young and older adults. Clear deficits in the production of predictive saccades were found in patients, in particular when the time between saccades was short (~500 ms). Furthermore, one asymptomatic C9ORF72 mutation bearer showed patterns of oculomotor behavior similar to FTD patients. He exhibited FTD symptoms within 3 years post-measure, suggesting that an impairment of oculomotor function could be an early clinical sign. Taken together, these results argue in favor of a role of the frontal lobe in predictive movements timing over short timescales, and suggest that predictive saccades in FTD patients warrant further investigation to fully assess their potential as a diagnostic aid.
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Affiliation(s)
- Nicolas Deravet
- Institute of Information and Communication Technologies, Electronics, and Applied Mathematics, Université catholique de Louvain, Louvain-La-Neuve, Belgium.,Institute of Neuroscience, Université catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Jean-Jacques Orban de Xivry
- Department of Movement Sciences, Movement Control and Neuroplasticity Research Group, Katholieke Universiteit Leuven, Leuven, Belgium.,Leuven Brain Institute, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Adrian Ivanoiu
- Institute of Neuroscience, Université catholique de Louvain, Louvain-La-Neuve, Belgium.,Neurology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Jean-Christophe Bier
- Neurology Department, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Kurt Segers
- Neurology Department, Brugmann University Hospital, Brussels, Belgium
| | - Demet Yüksel
- Institute of Neuroscience, Université catholique de Louvain, Louvain-La-Neuve, Belgium.,Ophthalmology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Philippe Lefèvre
- Institute of Information and Communication Technologies, Electronics, and Applied Mathematics, Université catholique de Louvain, Louvain-La-Neuve, Belgium. .,Institute of Neuroscience, Université catholique de Louvain, Louvain-La-Neuve, Belgium.
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13
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Häkkinen S, Chu SA, Lee SE. Neuroimaging in genetic frontotemporal dementia and amyotrophic lateral sclerosis. Neurobiol Dis 2020; 145:105063. [PMID: 32890771 DOI: 10.1016/j.nbd.2020.105063] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/30/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023] Open
Abstract
Frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) have a strong clinical, genetic and pathological overlap. This review focuses on the current understanding of structural, functional and molecular neuroimaging signatures of genetic FTD and ALS. We overview quantitative neuroimaging studies on the most common genes associated with FTD (MAPT, GRN), ALS (SOD1), and both (C9orf72), and summarize visual observations of images reported in the rarer genes (CHMP2B, TARDBP, FUS, OPTN, VCP, UBQLN2, SQSTM1, TREM2, CHCHD10, TBK1).
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Affiliation(s)
- Suvi Häkkinen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Stephanie A Chu
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Suzee E Lee
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
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14
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Chagué P, Marro B, Fadili S, Houot M, Morin A, Samper-González J, Beunon P, Arrivé L, Dormont D, Dubois B, Teichmann M, Epelbaum S, Colliot O. Radiological classification of dementia from anatomical MRI assisted by machine learning-derived maps. J Neuroradiol 2020; 48:412-418. [PMID: 32407907 DOI: 10.1016/j.neurad.2020.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/25/2020] [Accepted: 04/26/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND PURPOSE Many artificial intelligence tools are currently being developed to assist diagnosis of dementia from magnetic resonance imaging (MRI). However, these tools have so far been difficult to integrate in the clinical routine workflow. In this work, we propose a new simple way to use them and assess their utility for improving diagnostic accuracy. MATERIALS AND METHODS We studied 34 patients with early-onset Alzheimer's disease (EOAD), 49 with late-onset AD (LOAD), 39 with frontotemporal dementia (FTD) and 24 with depression from the pre-existing cohort CLIN-AD. Support vector machine (SVM) automatic classifiers using 3D T1 MRI were trained to distinguish: LOAD vs. Depression, FTD vs. LOAD, EOAD vs. Depression, EOAD vs. FTD. We extracted SVM weight maps, which are tridimensional representations of discriminant atrophy patterns used by the classifier to take its decisions and we printed posters of these maps. Four radiologists (2 senior neuroradiologists and 2 unspecialized junior radiologists) performed a visual classification of the 4 diagnostic pairs using 3D T1 MRI. Classifications were performed twice: first with standard radiological reading and then using SVM weight maps as a guide. RESULTS Diagnostic performance was significantly improved by the use of the weight maps for the two junior radiologists in the case of FTD vs. EOAD. Improvement was over 10 points of diagnostic accuracy. CONCLUSION This tool can improve the diagnostic accuracy of junior radiologists and could be integrated in the clinical routine workflow.
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Affiliation(s)
- Pierre Chagué
- Department of radiology, AP-HP, Hôpital Saint-Antoine, Paris, France; Institut du Cerveau et de la Moelle épinière, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Université, 75013 Paris, France; Inria, Aramis-project team, Paris, France
| | - Béatrice Marro
- Department of radiology, AP-HP, Hôpital Saint-Antoine, Paris, France
| | - Sarah Fadili
- Department of radiology, AP-HP, Hôpital Saint-Antoine, Paris, France
| | - Marion Houot
- Institut du Cerveau et de la Moelle épinière, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Université, 75013 Paris, France
| | - Alexandre Morin
- Institut du Cerveau et de la Moelle épinière, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Université, 75013 Paris, France; Department of Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), 75013 Paris, France
| | - Jorge Samper-González
- Institut du Cerveau et de la Moelle épinière, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Université, 75013 Paris, France; Inria, Aramis-project team, Paris, France
| | - Paul Beunon
- Department of radiology, AP-HP, Hôpital Saint-Antoine, Paris, France
| | - Lionel Arrivé
- Department of radiology, AP-HP, Hôpital Saint-Antoine, Paris, France
| | - Didier Dormont
- Institut du Cerveau et de la Moelle épinière, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Université, 75013 Paris, France; Inria, Aramis-project team, Paris, France; Department of Neuroradiology, AP-HP, Hôpital de la Pitié-Salpêtrière, 75013 Paris, France
| | - Bruno Dubois
- Institut du Cerveau et de la Moelle épinière, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Université, 75013 Paris, France; Department of Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), 75013 Paris, France
| | - Marc Teichmann
- Institut du Cerveau et de la Moelle épinière, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Université, 75013 Paris, France; Department of Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), 75013 Paris, France
| | - Stéphane Epelbaum
- Institut du Cerveau et de la Moelle épinière, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Université, 75013 Paris, France; Inria, Aramis-project team, Paris, France; Department of Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), 75013 Paris, France
| | - Olivier Colliot
- Institut du Cerveau et de la Moelle épinière, ICM, Inserm, U 1127, CNRS, UMR 7225, Sorbonne Université, 75013 Paris, France; Inria, Aramis-project team, Paris, France; Department of Neuroradiology, AP-HP, Hôpital de la Pitié-Salpêtrière, 75013 Paris, France; Department of Neurology, AP-HP, Hôpital de la Pitié-Salpêtrière, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), 75013 Paris, France.
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15
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Moonis G, Subramaniam RM, Trofimova A, Burns J, Bykowski J, Chakraborty S, Holloway K, Ledbetter LN, Lee RK, Pannell JS, Pollock JM, Powers WJ, Roca RP, Rosenow JM, Shih RY, Utukuri PS, Corey AS. ACR Appropriateness Criteria® Dementia. J Am Coll Radiol 2020; 17:S100-S112. [PMID: 32370954 DOI: 10.1016/j.jacr.2020.01.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 12/24/2022]
Abstract
Degenerative disease of the central nervous system is a growing public health concern. The primary role of neuroimaging in the workup of patients with probable or possible Alzheimer disease has typically been to exclude other significant intracranial abnormalities. In general, the imaging findings in structural studies, such as MRI, are nonspecific and have limited potential in differentiating different types of dementia. Advanced imaging methods are not routinely used in community or general practices for the diagnosis or differentiation of forms of dementia. Nonetheless, in patients who have been evaluated by a dementia expert, FDG-PET helps to distinguish Alzheimer disease from frontotemporal dementia. In patients with suspected dementia with Lewy bodies, functional imaging of the dopamine transporter (ioflupane) using SPECT may be helpful. In patients with suspected normal-pressure hydrocephalus, DTPA cisternography and HMPAO SPECT/CT brain may provide assessment. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Gul Moonis
- Columbia University Medical Center, New York, New York.
| | | | | | - Judah Burns
- Panel Chair, Montefiore Medical Center, Bronx, New York
| | | | - Santanu Chakraborty
- Ottawa Hospital Research Institute and the Department of Radiology, The University of Ottawa, Ottawa, Ontario, Canada; Canadian Association of Radiologists
| | - Kathryn Holloway
- MCVH-Virginia Commonwealth University, Richmond, Virginia; Neurosurgery Expert
| | | | - Ryan K Lee
- Einstein Healthcare Network, Philadelphia, Pennsylvania
| | - Jeffrey S Pannell
- University of California San Diego Medical Center, San Diego, California
| | | | - William J Powers
- University of North Carolina School of Medicine, Chapel Hill, North Carolina; American Academy of Neurology
| | - Robert P Roca
- Sheppard Pratt Health System, Towson, Maryland; American Psychiatric Association
| | - Joshua M Rosenow
- Northwestern University Feinberg School of Medicine, Chicago, Illinois; Neurosurgery Expert
| | - Robert Y Shih
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | | | - Amanda S Corey
- Specialty Chair, Atlanta VA Health Care System and Emory University, Atlanta, Georgia
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16
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Suppa A, Fabbrini A, Guerra A, Petsas N, Asci F, Di Stasio F, Trebbastoni A, Vasselli F, De Lena C, Pantano P, Berardelli A. Altered speech-related cortical network in frontotemporal dementia. Brain Stimul 2020; 13:765-773. [PMID: 32289706 DOI: 10.1016/j.brs.2020.02.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/08/2020] [Accepted: 02/24/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND In healthy subjects (HS), transcranial magnetic stimulation (TMS) demonstrated an increase in motor-evoked potential (MEP) amplitudes during specific linguistic tasks. This finding indicates functional connections between speech-related cortical areas and the dominant primary motor cortex (M1). OBJECTIVE To investigate M1 function with TMS and the speech-related cortical network with neuroimaging measures in frontotemporal dementia (FTD), including the non-fluent variant of primary progressive aphasia (nfv-PPA) and the behavioral variant of FTD (bv-FTD). METHODS M1 excitability changes during specific linguistc tasks were examined using TMS in 24 patients (15 with nfv-PPA and 9 with bv-FTD) and in 18 age-matched HS. In the same patients neuroimaging was used to assess changes in specific white matter (WM) bundles and grey matter (GM) regions involved in language processing, with diffusion tensor imaging (DTI) and voxel-based morphometry (VBM). RESULTS During the linguistic task, M1 excitability increased in HS, whereas in FTD patients it did not. M1 excitability changes were comparable in nfv-PPA and bv-FTD. DTI revealed decreased fractional anisotropy in the superior and inferior longitudinal and uncinate fasciculi. Moreover, VBM disclosed GM volume loss in the left frontal operculum though not in the parietal operculum or precentral gyrus. Furthermore, WM and GM changes were comparable in nfv-PPA and bv-FTD. There was no correlation between neurophysiological and neuroimaging changes in FTD. Atrophy in the left frontal operculum correlated with linguistic dysfunction, assessed by semantic and phonemic fluency tests. CONCLUSION We provide converging neurophysiological and neuroimaging evidence of abnormal speech-related cortical network activation in FTD.
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Affiliation(s)
- Antonio Suppa
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Università 30, 00185, Rome, Italy; IRCCS Neuromed, Via Atinense 18, 86077, Pozzilli, IS, Italy
| | | | - Andrea Guerra
- IRCCS Neuromed, Via Atinense 18, 86077, Pozzilli, IS, Italy
| | | | - Francesco Asci
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Università 30, 00185, Rome, Italy
| | - Flavio Di Stasio
- Department of Neurology, St John the Baptist Hospital, ACISMOM, 00148, Rome, Italy
| | - Alessandro Trebbastoni
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Università 30, 00185, Rome, Italy
| | - Federica Vasselli
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Università 30, 00185, Rome, Italy
| | - Carlo De Lena
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Università 30, 00185, Rome, Italy
| | - Patrizia Pantano
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Università 30, 00185, Rome, Italy; IRCCS Neuromed, Via Atinense 18, 86077, Pozzilli, IS, Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Università 30, 00185, Rome, Italy; IRCCS Neuromed, Via Atinense 18, 86077, Pozzilli, IS, Italy.
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17
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18
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Abstract
Frontotemporal dementia is a clinically and pathologically heterogeneous group of neurodegenerative disorders, with progressive impairment of behavior and language. They can be closely related to amyotrophic lateral sclerosis, clinically and through shared genetics and similar pathology. Approximately 40% of people with frontotemporal dementia report a family history of dementia, motor neuron disease or parkinsonism, and half of these familial cases are attributed to mutations in three genes (C9orf72, MAPT and PGRN). Akinetic-rigidity is a common feature in several types of frontotemporal dementia, particularly the behavioral variant and the non-fluent agrammatic variant of primary progressive aphasia, and the familial dementias. The majority of patients develop a degree of parkinsonism during the course of the illness, and signs may be present at the time of initial diagnosis. However, the parkinsonism of frontotemporal dementia is very different from that observed in idiopathic Parkinson's disease: it may be symmetric, axial, and poorly responsive to levodopa. Tremor is uncommon, and may be postural, action or occasionally rest tremor. The emergence of parkinsonism is often part of an evolving phenotype, in which frontotemporal dementia comes to resemble corticobasal syndrome or progressive supranuclear palsy. This chapter describes the prevalence and phenomenology of parkinsonism in each of the major syndromes, and according to the common genetic forms of frontotemporal dementia. We discuss the changing nosology and terminology surrounding the diagnoses, and the significance of parkinsonism as a core feature of frontotemporal dementia, relevant to clinical management and the design of future clinical trials.
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Affiliation(s)
- James B Rowe
- Cambridge University Centre for Frontotemporal Dementia and Cambridge University Centre for Parkinson-plus, Cambridge University, Cambridge, United Kingdom
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19
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Feis RA, Bouts MJRJ, de Vos F, Schouten TM, Panman JL, Jiskoot LC, Dopper EGP, van der Grond J, van Swieten JC, Rombouts SARB. A multimodal MRI-based classification signature emerges just prior to symptom onset in frontotemporal dementia mutation carriers. J Neurol Neurosurg Psychiatry 2019; 90:1207-1214. [PMID: 31203211 DOI: 10.1136/jnnp-2019-320774] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/26/2019] [Accepted: 05/12/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Multimodal MRI-based classification may aid early frontotemporal dementia (FTD) diagnosis. Recently, presymptomatic FTD mutation carriers, who have a high risk of developing FTD, were separated beyond chance level from controls using MRI-based classification. However, it is currently unknown how these scores from classification models progress as mutation carriers approach symptom onset. In this longitudinal study, we investigated multimodal MRI-based classification scores between presymptomatic FTD mutation carriers and controls. Furthermore, we contrasted carriers that converted during follow-up ('converters') and non-converting carriers ('non-converters'). METHODS We acquired anatomical MRI, diffusion tensor imaging and resting-state functional MRI in 55 presymptomatic FTD mutation carriers and 48 healthy controls at baseline, and at 2, 4, and 6 years of follow-up as available. At each time point, FTD classification scores were calculated using a behavioural variant FTD classification model. Classification scores were tested in a mixed-effects model for mean differences and differences over time. RESULTS Presymptomatic mutation carriers did not have higher classification score increase over time than controls (p=0.15), although carriers had higher FTD classification scores than controls on average (p=0.032). However, converters (n=6) showed a stronger classification score increase over time than non-converters (p<0.001). CONCLUSIONS Our findings imply that presymptomatic FTD mutation carriers may remain similar to controls in terms of MRI-based classification scores until they are close to symptom onset. This proof-of-concept study shows the promise of longitudinal MRI data acquisition in combination with machine learning to contribute to early FTD diagnosis.
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Affiliation(s)
- Rogier A Feis
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands .,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Mark J R J Bouts
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Frank de Vos
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Tijn M Schouten
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Jessica L Panman
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Lize C Jiskoot
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Elise G P Dopper
- Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Clinical Genetics, VU University Medical Centre, Amsterdam, The Netherlands
| | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.,Institute of Psychology, Leiden University, Leiden, The Netherlands
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20
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Wang L, Heywood A, Stocks J, Bae J, Ma D, Popuri K, Toga AW, Kantarci K, Younes L, Mackenzie IR, Zhang F, Beg MF, Rosen H. Grant Report on PREDICT-ADFTD: Multimodal Imaging Prediction of AD/FTD and Differential Diagnosis. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2019; 4:e190017. [PMID: 31754634 PMCID: PMC6868780 DOI: 10.20900/jpbs.20190017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We report on the ongoing project "PREDICT-ADFTD: Multimodal Imaging Prediction of AD/FTD and Differential Diagnosis" describing completed and future work supported by this grant. This project is a multi-site, multi-study collaboration effort with research spanning seven sites across the US and Canada. The overall goal of the project is to study neurodegeneration within Alzheimer's Disease, Frontotemporal Dementia, and related neurodegenerative disorders, using a variety of brain imaging and computational techniques to develop methods for the early and accurate prediction of disease and its course. The overarching goal of the project is to develop the earliest and most accurate biomarker that can differentiate clinical diagnoses to inform clinical trials and patient care. In its third year, this project has already completed several projects to achieve this goal, focusing on (1) structural MRI (2) machine learning and (3) FDG-PET and multimodal imaging. Studies utilizing structural MRI have identified key features of underlying pathology by studying hippocampal deformation that is unique to clinical diagnosis and also post-mortem confirmed neuropathology. Several machine learning experiments have shown high classification accuracy in the prediction of disease based on Convolutional Neural Networks utilizing MRI images as input. In addition, we have also achieved high accuracy in predicting conversion to DAT up to five years in the future. Further, we evaluated multimodal models that combine structural and FDG-PET imaging, in order to compare the predictive power of multimodal to unimodal models. Studies utilizing FDG-PET have shown significant predictive ability in the prediction and progression of disease.
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Affiliation(s)
- Lei Wang
- Northwestern University Feinberg School of Medicine, Chicago, 60611 IL, USA
| | - Ashley Heywood
- Northwestern University Feinberg School of Medicine, Chicago, 60611 IL, USA
| | - Jane Stocks
- Northwestern University Feinberg School of Medicine, Chicago, 60611 IL, USA
| | - Jinhyeong Bae
- Northwestern University Feinberg School of Medicine, Chicago, 60611 IL, USA
| | - Da Ma
- School of Engineering Science, Simon Fraser University, Burnaby, V6A1S6 BC, Canada
| | - Karteek Popuri
- School of Engineering Science, Simon Fraser University, Burnaby, V6A1S6 BC, Canada
| | - Arthur W. Toga
- Keck School of Medicine of University of Southern California, Los Angeles, 90033 CA, USA
| | - Kejal Kantarci
- Departments of Neurology and Radiology, Mayo Clinic, Rochester, 55905 MN, USA
| | - Laurent Younes
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, 21218 MD, USA
| | - Ian R. Mackenzie
- Department of Pathology and Lab Medicine, University of British Columbia, Vancouver, B6T1Z4 BC, Canada
| | - Fengqing Zhang
- Department of Psychology, Drexel University, Philadelphia, 19104 PA, USA
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby, V6A1S6 BC, Canada
| | - Howard Rosen
- Department of Neurology, University of California, San Francisco, 94143 CA, USA
| | - Alzheimer’s Disease Neuroimaging Initiative
- Data used in preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (http://adni.loni.usc.edu/). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNIAcknowledgement_List.pdf
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21
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Staffaroni AM, Ljubenkov PA, Kornak J, Cobigo Y, Datta S, Marx G, Walters SM, Chiang K, Olney N, Elahi FM, Knopman DS, Dickerson BC, Boeve BF, Gorno-Tempini ML, Spina S, Grinberg LT, Seeley WW, Miller BL, Kramer JH, Boxer AL, Rosen HJ. Longitudinal multimodal imaging and clinical endpoints for frontotemporal dementia clinical trials. Brain 2019; 142:443-459. [PMID: 30698757 DOI: 10.1093/brain/awy319] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 11/02/2018] [Indexed: 12/22/2022] Open
Abstract
Frontotemporal dementia refers to a group of progressive neurodegenerative syndromes usually caused by the accumulation of pathological tau or TDP-43 proteins. The effects of these proteins in the brain are complex, and each can present with several different clinical syndromes. Clinical efficacy trials of drugs targeting these proteins must use endpoints that are meaningful to all participants despite the variability in symptoms across patients. There are many candidate clinical measures, including neuropsychological scores and functional measures. Brain imaging is another potentially attractive outcome that can be precisely quantified and provides evidence of disease modification. Most imaging studies in frontotemporal dementia have been cross-sectional, and few have compared longitudinal changes in cortical volume with changes in other measures such as perfusion and white matter integrity. The current study characterized longitudinal changes in 161 patients with three frontotemporal dementia syndromes: behavioural variant frontotemporal dementia (n = 77) and the semantic (n = 45) and non-fluent (n = 39) variants of primary progressive aphasia. Visits included comprehensive neuropsychological and functional assessment, structural MRI (3 T), diffusion tensor imaging, and arterial spin labelled perfusion imaging. The goal was to identify measures that are appropriate as clinical trial outcomes for each group, as well as those that might be appropriate for trials that would include more than one of these groups. Linear mixed effects models were used to estimate changes in each measure, and to examine the correlation between imaging and clinical changes. Sample sizes were estimated based on the observed effects for theoretical clinical trials using bootstrapping techniques to provide 95% confidence intervals for these estimates. Declines in functional and neuropsychological measures, as well as frontal and temporal cortical volumes and white matter microstructure were detected in all groups. Imaging changes were statistically significantly correlated with, and explained a substantial portion of variance in, the change in most clinical measures. Perfusion and diffusion tensor imaging accounted for variation in clinical decline beyond volume alone. Sample size estimates for atrophy and diffusion imaging were comparable to clinical measures. Corpus callosal fractional anisotropy led to the lowest sample size estimates for all three syndromes. These findings provide further guidance on selection of trial endpoints for studies in frontotemporal dementia and support the use of neuroimaging, particularly structural and diffusion weighted imaging, as biomarkers. Diffusion and perfusion imaging appear to offer additional utility for explaining clinical change beyond the variance explained by volume alone, arguing for considering multimodal imaging in treatment trials.
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Affiliation(s)
- Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Peter A Ljubenkov
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Samir Datta
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Gabe Marx
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Samantha M Walters
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Kevin Chiang
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Nick Olney
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Fanny M Elahi
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - David S Knopman
- Department of Neurology, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, Minnesota USA
| | - Bradford C Dickerson
- Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charleston, MA, USA
| | - Bradley F Boeve
- Department of Neurology, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, Minnesota USA
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Salvatore Spina
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Lea T Grinberg
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA.,Department of Pathology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA.,Department of Pathology - LIM 22, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - William W Seeley
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA.,Department of Pathology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Joel H Kramer
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
| | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, University of California at San Francisco (UCSF), San Francisco, CA, USA
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22
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Krämer J, Lueg G, Schiffler P, Vrachimis A, Weckesser M, Wenning C, Pawlowski M, Johnen A, Teuber A, Wersching H, Meuth SG, Duning T. Diagnostic Value of Diffusion Tensor Imaging and Positron Emission Tomography in Early Stages of Frontotemporal Dementia. J Alzheimers Dis 2019; 63:239-253. [PMID: 29614640 DOI: 10.3233/jad-170224] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Due to suboptimal sensitivity and specificity of structural and molecular neuroimaging tools, the diagnosis of behavioral variant frontotemporal dementia (bvFTD) remains challenging. OBJECTIVE Investigation of the sensitivity of diffusion tensor imaging (DTI) and fluorodeoxyglucose positron emission tomography (FDG-PET) to detect cerebral alterations in early stages of bvFTD despite inconspicuous conventional MRI. METHODS Thirty patients with early stages of bvFTD underwent a detailed neuropsychological examination, cerebral 3T MRI with DTI analysis, and FDG-PET. After 12 months of follow-up, all patients finally fulfilled the diagnosis of bvFTD. Individual FDG-PET data analyses showed that 20 patients exhibited a "typical" pattern for bvFTD with bifrontal and/or temporal hypometabolism (bvFTD/PET+), and that 10 patients showed a "non-typical"/normal pattern (bvFTD/PET-). DTI data were compared with 42 healthy controls in an individual and voxel-based group analysis. To examine the clinical relevance of the findings, associations between pathologically altered voxels of DTI or FDG-PET results and behavioral symptoms were estimated by linear regression analyses. RESULTS DTI voxel-based group analyses revealed microstructural degeneration in bifrontal and bitemporal areas in bvFTD/PET+ and bvFTD/PET- groups. However, when comparing the sensitivity of individual DTI data analysis with FDG-PET, DTI appeared to be less sensitive. Neuropsychological symptoms were considerably related to neurodegeneration within frontotemporal areas identified by DTI and FDG-PET. CONCLUSION DTI seems to be an interesting tool for detection of functionally relevant neurodegenerative alterations in early stages of bvFTD, even in bvFTD/PET- patients. However, at a single subject level, it seems to be less sensitive than FDG-PET. Thus, improvement of individual DTI analysis is necessary.
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Affiliation(s)
- Julia Krämer
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - Gero Lueg
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - Patrick Schiffler
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - Alexis Vrachimis
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.,Department of Nuclear Medicine, German Oncology Center, Limassol, Cyprus
| | - Matthias Weckesser
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Christian Wenning
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | | | - Andreas Johnen
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - Anja Teuber
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Heike Wersching
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Sven G Meuth
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - Thomas Duning
- Department of Neurology, University Hospital Münster, Münster, Germany
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23
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Whitwell JL. FTD spectrum: Neuroimaging across the FTD spectrum. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019; 165:187-223. [PMID: 31481163 DOI: 10.1016/bs.pmbts.2019.05.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Frontotemporal dementia is a complex and heterogeneous neurodegenerative disease that encompasses many clinical syndromes, pathological diseases, and genetic mutations. Neuroimaging has played a critical role in our understanding of the underlying pathophysiology of frontotemporal dementia and provided biomarkers to aid diagnosis. Early studies defined patterns of neurodegeneration and hypometabolism associated with the clinical, pathological and genetic aspects of frontotemporal dementia, with more recent studies highlighting how the breakdown of structural and functional brain networks define frontotemporal dementia. Molecular positron emission tomography ligands allowing the in vivo imaging of tau proteins have also provided important insights, although more work is needed to understand the biology of the currently available ligands.
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24
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Yu J, Lee TM. The longitudinal decline of white matter microstructural integrity in behavioral variant frontotemporal dementia and its association with executive function. Neurobiol Aging 2019; 76:62-70. [DOI: 10.1016/j.neurobiolaging.2018.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/23/2018] [Accepted: 12/15/2018] [Indexed: 12/13/2022]
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25
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Jiskoot LC, Panman JL, Meeter LH, Dopper EGP, Donker Kaat L, Franzen S, van der Ende EL, van Minkelen R, Rombouts SARB, Papma JM, van Swieten JC. Longitudinal multimodal MRI as prognostic and diagnostic biomarker in presymptomatic familial frontotemporal dementia. Brain 2019; 142:193-208. [PMID: 30508042 PMCID: PMC6308313 DOI: 10.1093/brain/awy288] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 09/26/2018] [Accepted: 10/02/2018] [Indexed: 12/12/2022] Open
Abstract
Developing and validating sensitive biomarkers for the presymptomatic stage of familial frontotemporal dementia is an important step in early diagnosis and for the design of future therapeutic trials. In the longitudinal Frontotemporal Dementia Risk Cohort, presymptomatic mutation carriers and non-carriers from families with familial frontotemporal dementia due to microtubule-associated protein tau (MAPT) and progranulin (GRN) mutations underwent a clinical assessment and multimodal MRI at baseline, 2-, and 4-year follow-up. Of the cohort of 73 participants, eight mutation carriers (three GRN, five MAPT) developed clinical features of frontotemporal dementia ('converters'). Longitudinal whole-brain measures of white matter integrity (fractional anisotropy) and grey matter volume in these converters (n = 8) were compared with healthy mutation carriers ('non-converters'; n = 35) and non-carriers (n = 30) from the same families. We also assessed the prognostic performance of decline within white matter and grey matter regions of interest by means of receiver operating characteristic analyses followed by stepwise logistic regression. Longitudinal whole-brain analyses demonstrated lower fractional anisotropy values in extensive white matter regions (genu corpus callosum, forceps minor, uncinate fasciculus, and superior longitudinal fasciculus) and smaller grey matter volumes (prefrontal, temporal, cingulate, and insular cortex) over time in converters, present from 2 years before symptom onset. White matter integrity loss of the right uncinate fasciculus and genu corpus callosum provided significant classifiers between converters, non-converters, and non-carriers. Converters' within-individual disease trajectories showed a relatively gradual onset of clinical features in MAPT, whereas GRN mutations had more rapid changes around symptom onset. MAPT converters showed more decline in the uncinate fasciculus than GRN converters, and more decline in the genu corpus callosum in GRN than MAPT converters. Our study confirms the presence of spreading predominant frontotemporal pathology towards symptom onset and highlights the value of multimodal MRI as a prognostic biomarker in familial frontotemporal dementia.
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Affiliation(s)
- Lize C Jiskoot
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jessica L Panman
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lieke H Meeter
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Elise G P Dopper
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, VU Medical Center, Amsterdam, The Netherlands
| | - Laura Donker Kaat
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Sanne Franzen
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Rick van Minkelen
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Janne M Papma
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
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26
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Talai AS, Sedlacik J, Boelmans K, Forkert ND. Widespread diffusion changes differentiate Parkinson's disease and progressive supranuclear palsy. NEUROIMAGE-CLINICAL 2018; 20:1037-1043. [PMID: 30342392 PMCID: PMC6197764 DOI: 10.1016/j.nicl.2018.09.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/17/2018] [Accepted: 09/25/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Parkinson's disease (PD) and progressive supranuclear palsy - Richardson's syndrome (PSP-RS) are often represented by similar clinical symptoms, which may challenge diagnostic accuracy. The objective of this study was to investigate and compare regional cerebral diffusion properties in PD and PSP-RS subjects and evaluate the use of these metrics for an automatic classification framework. MATERIAL AND METHODS Diffusion-tensor MRI datasets from 52 PD and 21 PSP-RS subjects were employed for this study. Using an atlas-based approach, regional median values of mean diffusivity (MD), fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were measured and employed for feature selection using RELIEFF and subsequent classification using a support vector machine. RESULTS According to RELIEFF, the top 17 diffusion values consisting of deep gray matter structures, the brainstem, and frontal cortex were found to be especially informative for an automatic classification. A MANCOVA analysis performed on these diffusion values as dependent variables revealed that PSP-RS and PD subjects differ significantly (p < .001). Generally, PSP-RS subjects exhibit reduced FA, and increased MD, RD, and AD values in nearly all brain structures analyzed compared to PD subjects. The leave-one-out cross-validation of the support vector machine classifier revealed that the classifier can differentiate PD and PSP-RS subjects with an accuracy of 87.7%. More precisely, six PD subjects were wrongly classified as PSP-RS and three PSP-RS subjects were wrongly classified as PD. CONCLUSION The results of this study demonstrate that PSP-RS subjects exhibit widespread and more severe diffusion alterations compared to PD patients, which appears valuable for an automatic computer-aided diagnosis approach.
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Affiliation(s)
- Aron S Talai
- Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Canada
| | - Jan Sedlacik
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Germany
| | - Kai Boelmans
- Department of Neurology, University Hospital Würzburg, Germany
| | - Nils D Forkert
- Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Canada.
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27
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Jiskoot LC, Bocchetta M, Nicholas JM, Cash DM, Thomas D, Modat M, Ourselin S, Rombouts SA, Dopper EG, Meeter LH, Panman JL, van Minkelen R, van der Ende EL, Donker Kaat L, Pijnenburg YA, Borroni B, Galimberti D, Masellis M, Tartaglia MC, Rowe J, Graff C, Tagliavini F, Frisoni GB, Laforce R, Finger E, de Mendonça A, Sorbi S, Papma JM, van Swieten JC, Rohrer JD. Presymptomatic white matter integrity loss in familial frontotemporal dementia in the GENFI cohort: A cross-sectional diffusion tensor imaging study. Ann Clin Transl Neurol 2018; 5:1025-1036. [PMID: 30250860 PMCID: PMC6144447 DOI: 10.1002/acn3.601] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/08/2018] [Indexed: 12/12/2022] Open
Abstract
Objective We aimed to investigate mutation-specific white matter (WM) integrity changes in presymptomatic and symptomatic mutation carriers of the C9orf72,MAPT, and GRN mutations by use of diffusion-weighted imaging within the Genetic Frontotemporal dementia Initiative (GENFI) study. Methods One hundred and forty mutation carriers (54 C9orf72, 30 MAPT, 56 GRN), 104 presymptomatic and 36 symptomatic, and 115 noncarriers underwent 3T diffusion tensor imaging. Linear mixed effects models were used to examine the association between diffusion parameters and years from estimated symptom onset in C9orf72,MAPT, and GRN mutation carriers versus noncarriers. Post hoc analyses were performed on presymptomatic mutation carriers only, as well as left-right asymmetry analyses on GRN mutation carriers versus noncarriers. Results Diffusion changes in C9orf72 mutation carriers are present significantly earlier than both MAPT and GRN mutation carriers - characteristically in the posterior thalamic radiation and more posteriorly located tracts (e.g., splenium of the corpus callosum, posterior corona radiata), as early as 30 years before estimated symptom onset. MAPT mutation carriers showed early involvement of the uncinate fasciculus and cingulum, sparing the internal capsule, whereas involvement of the anterior and posterior internal capsule was found in GRN. Restricting analyses to presymptomatic mutation carriers only, similar - albeit less extensive - patterns were found: posteriorly located WM tracts (e.g., posterior thalamic radiation, splenium of the corpus callosum, posterior corona radiata) in presymptomatic C9orf72, the uncinate fasciculus in presymptomatic MAPT, and the internal capsule (anterior and posterior limbs) in presymptomatic GRN mutation carriers. In GRN, most tracts showed significant left-right differences in one or more diffusion parameter, with the most consistent results being found in the UF, EC, RPIC, and ALIC. Interpretation This study demonstrates the presence of early and widespread WM integrity loss in presymptomatic FTD, and suggests a clear genotypic "fingerprint." Our findings corroborate the notion of FTD as a network-based disease, where changes in connectivity are some of the earliest detectable features, and identify diffusion tensor imaging as a potential neuroimaging biomarker for disease-tracking and -staging in presymptomatic to early-stage familial FTD.
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28
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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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29
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Meijboom R, Steketee RME, Ham LS, van der Lugt A, van Swieten JC, Smits M. Differential Hemispheric Predilection of Microstructural White Matter and Functional Connectivity Abnormalities between Respectively Semantic and Behavioral Variant Frontotemporal Dementia. J Alzheimers Dis 2018; 56:789-804. [PMID: 28059782 DOI: 10.3233/jad-160564] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Semantic dementia (SD) and behavioral variant frontotemporal dementia (bvFTD), subtypes of frontotemporal dementia, are characterized by distinct clinical symptoms and neuroimaging features, with predominant left temporal grey matter (GM) atrophy in SD and bilateral or right frontal GM atrophy in bvFTD. Such differential hemispheric predilection may also be reflected by other neuroimaging features, such as brain connectivity. This study investigated white matter (WM) microstructure and functional connectivity differences between SD and bvFTD, focusing on the hemispheric predilection of these differences. Eight SD and 12 bvFTD patients, and 17 controls underwent diffusion tensor imaging and resting state functional MRI at 3T. Whole-brain WM microstructure was assessed to determine distinct WM tracts affected in SD and bvFTD. For these tracts, diffusivity measures and lateralization indices were calculated. Functional connectivity was established for GM regions affected in early stage SD or bvFTD. Results of a direct comparison between SD and bvFTD are reported. Whole-brain WM microstructure abnormalities were more pronounced in the left hemisphere in SD and bilaterally- with a slight predilection for the right- in bvFTD. Lateralization of tract-specific abnormalities was seen in SD only, toward the left hemisphere. Functional connectivity of disease-specific regions was mainly decreased bilaterally in SD and in the right hemisphere in bvFTD. SD and bvFTD show WM microstructure and functional connectivity abnormalities in different regions, that are respectively more pronounced in the left hemisphere in SD and in the right hemisphere in bvFTD. This indicates differential hemispheric predilection of brain connectivity abnormalities between SD and bvFTD.
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Affiliation(s)
- Rozanna Meijboom
- Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Centre Rotterdam, The Netherlands
| | - Rebecca M E Steketee
- Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Centre Rotterdam, The Netherlands
| | - Leontine S Ham
- Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Centre Rotterdam, The Netherlands
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Centre Rotterdam, The Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus MC - University Medical Centre Rotterdam, The Netherlands
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Centre Rotterdam, The Netherlands
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Lansdall CJ, Coyle-Gilchrist ITS, Jones PS, Vázquez Rodríguez P, Wilcox A, Wehmann E, Dick KM, Robbins TW, Rowe JB. White matter change with apathy and impulsivity in frontotemporal lobar degeneration syndromes. Neurology 2018; 90:e1066-e1076. [PMID: 29453244 PMCID: PMC5874447 DOI: 10.1212/wnl.0000000000005175] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/21/2017] [Indexed: 12/11/2022] Open
Abstract
Objective To identify the white matter correlates of apathy and impulsivity in the major syndromes associated with frontotemporal lobar degeneration, using diffusion-weighted imaging and data from the PiPPIN (Pick's Disease and Progressive Supranuclear Palsy: Prevalence and Incidence) study. We included behavioral and language variants of frontotemporal dementia, corticobasal syndrome, and progressive supranuclear palsy. Methods Seventy patients and 30 controls underwent diffusion tensor imaging at 3-tesla after detailed assessment of apathy and impulsivity. We used tract-based spatial statistics of fractional anisotropy and mean diffusivity, correlating with 8 orthogonal dimensions of apathy and impulsivity derived from a principal component analysis of neuropsychological, behavioral, and questionnaire measures. Results Three components were associated with significant white matter tract abnormalities. Carer-rated change in everyday skills, self-care, and motivation correlated with widespread changes in dorsal frontoparietal and corticospinal tracts, while carer observations of impulsive–apathetic and challenging behaviors revealed disruption in ventral frontotemporal tracts. Objective neuropsychological tests of cognitive control, reflection impulsivity, and reward responsiveness were associated with focal changes in the right frontal lobe and presupplementary motor area. These changes were observed across clinical diagnostic groups, and were not restricted to the disorders for which diagnostic criteria include apathy and impulsivity. Conclusion The current study provides evidence of distinct structural network changes in white matter associated with different neurobehavioral components of apathy and impulsivity across the diverse spectrum of syndromes and pathologies associated with frontotemporal lobar degeneration.
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Affiliation(s)
- Claire J Lansdall
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK.
| | - Ian T S Coyle-Gilchrist
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - P Simon Jones
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Patricia Vázquez Rodríguez
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Alicia Wilcox
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Eileen Wehmann
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Katrina M Dick
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - Trevor W Robbins
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
| | - James B Rowe
- From the Departments of Clinical Neurosciences (C.J.L., I.T.S.C.-G., P.S.J., P.V.R., A.W., E.W., J.B.R.) and Psychology (T.W.R.), and Behavioral and Clinical Neuroscience Institute (T.W.R., J.B.R.), University of Cambridge, UK; University Medical Centre Hamburg-Eppendorf (E.W.), University of Hamburg, Germany; The Dementia Research Centre (K.M.D.), Institute of Neurology, University College London; and MRC Cognition and Brain Sciences Unit (J.B.R.), Cambridge, UK
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Luis E, Ortiz A, Eudave L, Ortega-Cubero S, Borroni B, van der Zee J, Gazzina S, Caroppo P, Rubino E, D'Agata F, Le Ber I, Santana I, Cunha G, Almeida MR, Boutoleau-Bretonnière C, Hannequin D, Wallon D, Rainero I, Galimberti D, Van Broeckhoven C, Pastor MA, Pastor P. Neuroimaging Correlates of Frontotemporal Dementia Associated with SQSTM1 Mutations. J Alzheimers Dis 2018; 53:303-13. [PMID: 27163810 DOI: 10.3233/jad-160006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Frontotemporal lobar degeneration (FTLD) is a progressive dementia characterized by focal atrophy of frontal and/or temporal lobes caused by mutations in the gene coding for sequestosome 1 (SQSTM1), among other genes. Rare SQSTM1 gene mutations have been associated with Paget's disease of bone, amyotrophic lateral sclerosis, and, more recently, frontotemporal lobar degeneration (FTLD). OBJECTIVE The aim of the study was to determine whether a characteristic pattern of grey and white matter loss is associated with SQSTM1 dysfunction. METHODS We performed a voxel-based morphometry (VBM) study in FTD subjects carrying SQSTM1 pathogenic variants (FTD/SQSTM1 mutation carriers; n = 10), compared with FTD subjects not carrying SQSTM1 mutations (Sporadic FTD; n = 20) and healthy controls with no SQSTM1 mutations (HC/SQSTM1 noncarriers; n = 20). The groups were matched according to current age, disease duration, and gender. RESULTS After comparing FTD/SQSTM1 carriers with Sporadic FTD, a predominantly right cortical atrophy pattern was localized in the inferior frontal, medial orbitofrontal, precentral gyri, and the anterior insula. White matter atrophy was found in both medial and inferior frontal gyri, pallidum, and putamen. FTD/SQSTM1 carriers compared with HC/SQSTM1 noncarriers showed atrophy at frontal, temporal, and parietal lobes of both hemispheres whereas the MRI pattern found in Sporadic FTD compared with controls was frontal and left temporal lobe atrophy, extending toward parietal and occipital lobes of both hemispheres. CONCLUSIONS These results suggest that fronto-orbito-insular regions including corticospinal projections as described in ALS are probably more susceptible to the damaging effect of SQSTM1 mutations delineatinga specific gene-linked atrophy pattern.
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Affiliation(s)
- Elkin Luis
- Neuroimaging Laboratory, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain.,School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Alexandra Ortiz
- Neuroimaging Laboratory, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain
| | - Luis Eudave
- Neuroimaging Laboratory, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain
| | - Sara Ortega-Cubero
- Neurogenetics Laboratory, Division of Neurosciences, Center for Applied Medical Research, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Spain
| | - Barbara Borroni
- Centre for Aging Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy
| | - Julie van der Zee
- Neurodegenerative Brain Diseases Group, Department of Molecular Genetics, VIB, Antwerp, Belgium.,Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Stefano Gazzina
- Centre for Aging Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy
| | - Paola Caroppo
- Besta Neurological Institut, Milan, Italy.,Institut du Cerveau et de la Moelle épinière (ICM), Sorbonne Universités, Université Pierre et Marie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Elisa Rubino
- Università degli Studi di Torino, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Federico D'Agata
- Università degli Studi di Torino, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Isabelle Le Ber
- Institut du Cerveau et de la Moelle épinière (ICM), Sorbonne Universités, Université Pierre et Marie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitério de Coimbra, Coimbra, Portugal and Faculty of Medicine, Coimbra University, Coimbra, Portugal
| | - Gil Cunha
- Neurorradiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Maria R Almeida
- Neurogenetics Laboratory, Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | | | - Didier Hannequin
- Department of Genetics, Rouen University Hospital, Rouen, France.,Inserm U1079, Rouen University, IRIB, Normandy University, Rouen, France.,CNR-MAJ, Rouen University Hospital, Rouen, France.,Department of Neurology, Rouen University Hospital, Rouen, France
| | - David Wallon
- Inserm U1079, Rouen University, IRIB, Normandy University, Rouen, France.,CNR-MAJ, Rouen University Hospital, Rouen, France
| | - Innocenzo Rainero
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Turin, Italy
| | - Daniela Galimberti
- Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Christine Van Broeckhoven
- Neurodegenerative Brain Diseases Group, Department of Molecular Genetics, VIB, Antwerp, Belgium.,Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Maria A Pastor
- Neuroimaging Laboratory, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain.,School of Education and Psychology, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Spain.,Department of Neurology, Clínica Universidad de Navarra, University of Navarra School of Medicine, Pamplona, Spain
| | - Pau Pastor
- Neurogenetics Laboratory, Division of Neurosciences, Center for Applied Medical Research, University of Navarra, Pamplona, Spain.,CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Spain.,Memory and Movement Disorders Units, Department of Neurology, University Hospital Mutua de Terrassa, Terrassa, Barcelona, Spain
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Biomarkers for Alzheimer’s Disease and Frontotemporal Lobar Degeneration: Imaging. NEURODEGENER DIS 2018. [DOI: 10.1007/978-3-319-72938-1_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Faria AV, Liang Z, Miller MI, Mori S. Brain MRI Pattern Recognition Translated to Clinical Scenarios. Front Neurosci 2017; 11:578. [PMID: 29104527 PMCID: PMC5655969 DOI: 10.3389/fnins.2017.00578] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/02/2017] [Indexed: 12/27/2022] Open
Abstract
We explored the performance of structure-based computational analysis in four neurodegenerative conditions [Ataxia (AT, n = 16), Huntington's Disease (HD, n = 52), Alzheimer's Disease (AD, n = 66), and Primary Progressive Aphasia (PPA, n = 50)], all characterized by brain atrophy. The independent variables were the volumes of 283 anatomical areas, derived from automated segmentation of T1-high resolution brain MRIs. The segmentation based volumetric quantification reduces image dimensionality from the voxel level [on the order of O(106)] to anatomical structures [O(102)] for subsequent statistical analysis. We evaluated the effectiveness of this approach on extracting anatomical features, already described by human experience and a priori biological knowledge, in specific scenarios: (1) when pathologies were relatively homogeneous, with evident image alterations (e.g., AT); (2) when the time course was highly correlated with the anatomical changes (e.g., HD), an analogy for prediction; (3) when the pathology embraced heterogeneous phenotypes (e.g., AD) so the classification was less efficient but, in compensation, anatomical and clinical information were less redundant; and (4) when the entity was composed of multiple subgroups that had some degree of anatomical representation (e.g., PPA), showing the potential of this method for the clustering of more homogeneous phenotypes that can be of clinical importance. Using the structure-based quantification and simple linear classifiers (partial least square), we achieve 87.5 and 73% of accuracy on differentiating AT and pre-symptomatic HD patents from controls, respectively. More importantly, the anatomical features automatically revealed by the classifiers agreed with the patterns previously described on these pathologies. The accuracy was lower (68%) on differentiating AD from controls, as AD does not display a clear anatomical phenotype. On the other hand, the method identified PPA clinical phenotypes and their respective anatomical signatures. Although most of the data are presented here as proof of concept in simulated clinical scenarios, structure-based analysis was potentially effective in characterizing phenotypes, retrieving relevant anatomical features, predicting prognosis, and aiding diagnosis, with the advantage of being easily translatable to clinics and understandable biologically.
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Affiliation(s)
- Andreia V Faria
- Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
| | - Zifei Liang
- Department of Radiology, New York University, New York, NY, United States
| | - Michael I Miller
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Susumu Mori
- Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
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Abstract
Sleep disorders appear to be frequent comorbidities in patients with frontotemporal dementia (FTD). Insomnia and excessive daytime sleepiness commonly occur in patients with FTD and significantly contribute to caregiver burden and burnout. Sleep is severely fragmented in FTD patients, likely secondary to behavioral disturbances, other primary sleep disorders such as sleep disordered breathing and restless leg syndrome, and neurodegeneration of nuclei involved in sleep and wakefulness. Treatment of primary sleep disorders may improve excessive daytime sleepiness and sleep quality and may improve daytime cognitive functioning. Rapid eye movement (REM) sleep behavior disorder is rare in FTD and may be confused with excessive nocturnal activity due to disturbed circadian rhythm. The relationship between FTD, sleep quality, and sleep disorders requires further study to better understand the contribution of disturbed sleep to daytime neurocognitive functioning and quality of life in FTD. Further, future studies should focus on comparing sleep disturbances between different FTD syndromes, especially behavioral variant FTD and primary progressive aphasia. Comorbid sleep disorders should be promptly sought and treated in patients with FTD to improve patient and caregiver quality of life.
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Affiliation(s)
- Stuart J McCarter
- Mayo Center for Sleep Medicine, Mayo Clinic and Foundation, 200 First Street Southwest, Rochester, MN, 55905, USA.
| | - Erik K St Louis
- Mayo Center for Sleep Medicine, Mayo Clinic and Foundation, 200 First Street Southwest, Rochester, MN, 55905, USA
- Department of Medicine, Mayo Clinic and Foundation, Rochester, MN, USA
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Bradley F Boeve
- Mayo Center for Sleep Medicine, Mayo Clinic and Foundation, 200 First Street Southwest, Rochester, MN, 55905, USA
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA
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Meeter LH, Kaat LD, Rohrer JD, van Swieten JC. Imaging and fluid biomarkers in frontotemporal dementia. Nat Rev Neurol 2017. [PMID: 28621768 DOI: 10.1038/nrneurol.2017.75] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Frontotemporal dementia (FTD), the second most common type of presenile dementia, is a heterogeneous neurodegenerative disease characterized by progressive behavioural and/or language problems, and includes a range of clinical, genetic and pathological subtypes. The diagnostic process is hampered by this heterogeneity, and correct diagnosis is becoming increasingly important to enable future clinical trials of disease-modifying treatments. Reliable biomarkers will enable us to better discriminate between FTD and other forms of dementia and to predict disease progression in the clinical setting. Given that different underlying pathologies probably require specific pharmacological interventions, robust biomarkers are essential for the selection of patients with specific FTD subtypes. This Review emphasizes the increasing availability and potential applications of structural and functional imaging biomarkers, and cerebrospinal fluid and blood fluid biomarkers in sporadic and genetic FTD. The relevance of new MRI modalities - such as voxel-based morphometry, diffusion tensor imaging and arterial spin labelling - in the early stages of FTD is discussed, together with the ability of these modalities to classify FTD subtypes. We highlight promising new fluid biomarkers for staging and monitoring of FTD, and underline the importance of large, multicentre studies of individuals with presymptomatic FTD. Harmonization in the collection and analysis of data across different centres is crucial for the implementation of new biomarkers in clinical practice, and will become a great challenge in the next few years.
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Affiliation(s)
- Lieke H Meeter
- Department of Neurology, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, Netherlands
| | - Laura Donker Kaat
- Department of Neurology, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, Netherlands.,Department of Clinical Genetics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, Netherlands
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative diseases, Institute of Neurology, Queen Square, University College London, London WC1N 3BG, UK
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, Netherlands.,Department of Clinical Genetics, VU University Medical Center, De Boelelaan 1118, 1081 HZ Amsterdam, Netherlands
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Marcotte K, Graham NL, Fraser KC, Meltzer JA, Tang-Wai DF, Chow TW, Freedman M, Leonard C, Black SE, Rochon E. White Matter Disruption and Connected Speech in Non-Fluent and Semantic Variants of Primary Progressive Aphasia. Dement Geriatr Cogn Dis Extra 2017; 7:52-73. [PMID: 28611820 PMCID: PMC5465709 DOI: 10.1159/000456710] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/06/2017] [Indexed: 02/04/2023] Open
Abstract
Differential patterns of white matter disruption have recently been reported in the non-fluent (nfvPPA) and semantic (svPPA) variants of primary progressive aphasia (PPA). No single measure is sufficient to distinguish between the PPA variants, but connected speech allows for the quantification of multiple measures. The aim of the present study was to further investigate the white matter correlates associated with connected speech features in PPA. We examined the relationship between white matter metrics and connected speech deficits using an automated analysis of transcriptions of connected speech and diffusion tensor imaging in language-related tracts. Syntactic, lexical, and semantic features were automatically extracted from transcriptions of topic-directed interviews conducted with groups of individuals with nfvPPA or svPPA as well as with a group of healthy controls. A principal component analysis was performed in order to reduce the number of language measures and yielded a five-factor solution. The results indicated that nfvPPA patients differed from healthy controls on a syntactic factor, and svPPA patients differed from controls on two semantic factors. However, the patient groups did not differ on any factor. Moreover, a correlational analysis revealed that the lexical richness factor was significantly correlated with radial diffusivity in the left inferior longitudinal fasciculus, which suggests that semantic deficits in connected speech reflect a disruption of this ventral pathway, and which is largely consistent with the results of previous studies. Using an automated approach for the analysis of connected speech combined with probabilistic tractography, the present findings demonstrate that nfvPPA patients are impaired relative to healthy controls on syntactic measures and have increased radial diffusivity in the left superior longitudinal fasciculus, whereas the svPPA group was impaired on lexico-semantic measures relative to controls and showed increased radial diffusivity in the uncinate and inferior longitudinal fasciculus bilaterally.
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Affiliation(s)
- Karine Marcotte
- aToronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,bÉcole d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada.,cCentre de recherche de l'Hôpital du Sacré-Cœur de Montréal, Montreal, Québec, Canada
| | - Naida L Graham
- aToronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,dDepartment of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kathleen C Fraser
- eDepartment of Computer Science, University of Toronto, Toronto, Ontario, Canada
| | - Jed A Meltzer
- dDepartment of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,fRotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,gDepartment of Psychology, University of Toronto, Toronto, Ontario, Canada.,hHeart and Stroke Foundation, Center for Stroke Recovery, Ottawa, Ontario, Canada
| | - David F Tang-Wai
- iDepartment of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,jUniversity Health Network Memory Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Tiffany W Chow
- fRotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,iDepartment of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,kDepartment of Clinical Neurology, University of Southern California, Los Angeles, California, USA
| | - Morris Freedman
- fRotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,lDepartment of Medicine, Division of Neurology, Baycrest Health Sciences, University of Toronto, and Mt. Sinai Hospital, Toronto, Ontario, Canada.,mSam and Ida Ross Memory Clinic, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Carol Leonard
- dDepartment of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,hHeart and Stroke Foundation, Center for Stroke Recovery, Ottawa, Ontario, Canada.,nSchool of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Sandra E Black
- aToronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,fRotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,hHeart and Stroke Foundation, Center for Stroke Recovery, Ottawa, Ontario, Canada.,iDepartment of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,oInstitute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,pL.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,qBrain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Elizabeth Rochon
- aToronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,dDepartment of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,hHeart and Stroke Foundation, Center for Stroke Recovery, Ottawa, Ontario, Canada.,rRehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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Bisenius S, Mueller K, Diehl-Schmid J, Fassbender K, Grimmer T, Jessen F, Kassubek J, Kornhuber J, Landwehrmeyer B, Ludolph A, Schneider A, Anderl-Straub S, Stuke K, Danek A, Otto M, Schroeter ML. Predicting primary progressive aphasias with support vector machine approaches in structural MRI data. NEUROIMAGE-CLINICAL 2017; 14:334-343. [PMID: 28229040 PMCID: PMC5310935 DOI: 10.1016/j.nicl.2017.02.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 01/27/2017] [Accepted: 02/03/2017] [Indexed: 12/16/2022]
Abstract
Primary progressive aphasia (PPA) encompasses the three subtypes nonfluent/agrammatic variant PPA, semantic variant PPA, and the logopenic variant PPA, which are characterized by distinct patterns of language difficulties and regional brain atrophy. To validate the potential of structural magnetic resonance imaging data for early individual diagnosis, we used support vector machine classification on grey matter density maps obtained by voxel-based morphometry analysis to discriminate PPA subtypes (44 patients: 16 nonfluent/agrammatic variant PPA, 17 semantic variant PPA, 11 logopenic variant PPA) from 20 healthy controls (matched for sample size, age, and gender) in the cohort of the multi-center study of the German consortium for frontotemporal lobar degeneration. Here, we compared a whole-brain with a meta-analysis-based disease-specific regions-of-interest approach for support vector machine classification. We also used support vector machine classification to discriminate the three PPA subtypes from each other. Whole brain support vector machine classification enabled a very high accuracy between 91 and 97% for identifying specific PPA subtypes vs. healthy controls, and 78/95% for the discrimination between semantic variant vs. nonfluent/agrammatic or logopenic PPA variants. Only for the discrimination between nonfluent/agrammatic and logopenic PPA variants accuracy was low with 55%. Interestingly, the regions that contributed the most to the support vector machine classification of patients corresponded largely to the regions that were atrophic in these patients as revealed by group comparisons. Although the whole brain approach took also into account regions that were not covered in the regions-of-interest approach, both approaches showed similar accuracies due to the disease-specificity of the selected networks. Conclusion, support vector machine classification of multi-center structural magnetic resonance imaging data enables prediction of PPA subtypes with a very high accuracy paving the road for its application in clinical settings. Aim was to evaluate the potential of multi-center MRI data for individual PPA diagnosis. We used support vector machine classification in PPA variants and healthy controls. We compared a whole brain approach with a ROI (taken from meta-analyses) approach. Accuracies were overall quite high, for both, the whole brain and the ROI approach.
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Affiliation(s)
- Sandrine Bisenius
- Max Planck Institute for Human Cognitive and Brain Sciences & Clinic for Cognitive Neurology, University Hospital Leipzig, Germany
| | - Karsten Mueller
- Max Planck Institute for Human Cognitive and Brain Sciences & Clinic for Cognitive Neurology, University Hospital Leipzig, Germany
| | - Janine Diehl-Schmid
- Clinic and Polyclinic for Psychiatry & Psychotherapy, Technical University Munich, Germany
| | - Klaus Fassbender
- Clinic and Polyclinic for Neurology, Saarland University Homburg, Germany
| | - Timo Grimmer
- Clinic and Polyclinic for Psychiatry & Psychotherapy, Technical University Munich, Germany
| | - Frank Jessen
- Clinic and Polyclinic for Psychiatry and Psychotherapy, University of Bonn, Germany
| | - Jan Kassubek
- Department of Neurology, University of Ulm, Germany
| | - Johannes Kornhuber
- Clinic for Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, Germany
| | | | | | - Anja Schneider
- Clinic for Psychiatry and Psychotherapy, University of Goettingen, Germany
| | | | - Katharina Stuke
- Max Planck Institute for Human Cognitive and Brain Sciences & Clinic for Cognitive Neurology, University Hospital Leipzig, Germany
| | - Adrian Danek
- Clinic of Neurology, Ludwig Maximilian University of Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Germany
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences & Clinic for Cognitive Neurology, University Hospital Leipzig, Germany
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Steketee RME, Meijboom R, de Groot M, Bron EE, Niessen WJ, van der Lugt A, van Swieten JC, Smits M. Concurrent white and gray matter degeneration of disease-specific networks in early-stage Alzheimer's disease and behavioral variant frontotemporal dementia. Neurobiol Aging 2016; 43:119-28. [PMID: 27255821 DOI: 10.1016/j.neurobiolaging.2016.03.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/22/2016] [Accepted: 03/30/2016] [Indexed: 01/08/2023]
Abstract
This study investigates regional coherence between white matter (WM) microstructure and gray matter (GM) volume and perfusion measures in Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) using a correlational approach. WM-GM coherence, compared with controls, was stronger between cingulum WM and frontotemporal GM in AD, and temporoparietal GM in bvFTD. In addition, in AD compared with controls, coherence was stronger between inferior fronto-occipital fasciculus WM microstructure and occipital GM perfusion. In this first study assessing regional WM-GM coherence in AD and bvFTD, we show that WM microstructure and GM volume and perfusion measures are coherent, particularly in regions implicated in AD and bvFTD pathology. This indicates concurrent degeneration in disease-specific networks. Our methodology allows for the detection of incipient abnormalities that go undetected in conventional between-group analyses.
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Affiliation(s)
- Rebecca M E Steketee
- Department of Radiology, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Rozanna Meijboom
- Department of Radiology, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Marius de Groot
- Department of Epidemiology, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands; Biomedical Imaging Group Rotterdam, Department of Medical Informatics, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands; Biomedical Imaging Group Rotterdam, Department of Radiology, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Esther E Bron
- Biomedical Imaging Group Rotterdam, Department of Medical Informatics, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands; Biomedical Imaging Group Rotterdam, Department of Radiology, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Wiro J Niessen
- Biomedical Imaging Group Rotterdam, Department of Medical Informatics, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands; Biomedical Imaging Group Rotterdam, Department of Radiology, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands; Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands
| | - Aad van der Lugt
- Department of Radiology, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Marion Smits
- Department of Radiology, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands.
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Pathophysiology of the behavioral variant of frontotemporal lobar degeneration: A study combining MRI and FDG-PET. Brain Imaging Behav 2016; 11:240-252. [DOI: 10.1007/s11682-016-9521-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Masdeu JC, Pascual B. Genetic and degenerative disorders primarily causing dementia. HANDBOOK OF CLINICAL NEUROLOGY 2016; 135:525-564. [PMID: 27432682 DOI: 10.1016/b978-0-444-53485-9.00026-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Neuroimaging comprises a powerful set of instruments to diagnose the different causes of dementia, clarify their neurobiology, and monitor their treatment. Magnetic resonance imaging (MRI) depicts volume changes with neurodegeneration and inflammation, as well as abnormalities in functional and structural connectivity. MRI arterial spin labeling allows for the quantification of regional cerebral blood flow, characteristically altered in Alzheimer's disease, diffuse Lewy-body disease, and the frontotemporal dementias. Positron emission tomography allows for the determination of regional metabolism, with similar abnormalities as flow, and for the measurement of β-amyloid and abnormal tau deposition in the brain, as well as regional inflammation. These instruments allow for the quantification in vivo of most of the pathologic features observed in disorders causing dementia. Importantly, they allow for the longitudinal study of these abnormalities, having revealed, for instance, that the deposition of β-amyloid in the brain can antecede by decades the onset of dementia. Thus, a therapeutic window has been opened and the efficacy of immunotherapies directed at removing β-amyloid from the brain of asymptomatic individuals is currently being tested. Tau and inflammation imaging, still in their infancy, combined with genomics, should provide powerful insights into these disorders and facilitate their treatment.
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Affiliation(s)
- Joseph C Masdeu
- Department of Neurology, Houston Methodist Hospital, Houston, TX, USA.
| | - Belen Pascual
- Department of Neurology, Houston Methodist Hospital, Houston, TX, USA
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Larvie M, Fischl B. Volumetric and fiber-tracing MRI methods for gray and white matter. HANDBOOK OF CLINICAL NEUROLOGY 2016; 135:39-60. [PMID: 27432659 DOI: 10.1016/b978-0-444-53485-9.00003-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Magnetic resonance imaging (MRI) is capable of generating high-resolution brain images with fine anatomic detail and unique tissue contrasts that reveal structures that are not visible to the eye. Sharply defined gray- and white-matter interfaces allow for quantitative anatomic analysis that can be accurately performed with largely automated segmentation methods. In an analogous fashion, diffusion MRI in the brain provides structural information based on contrasts derived from the diffusivity of water in brain tissue, which can highlight the orientation of neuronal axons. Also using largely automated methods, diffusion MRI can be used to generate models of white-matter tracts throughout the brain, a method known as tractography, as well as characterize the microstructural integrity of neuronal axons. Tractographic analysis has helped to define connectivity in the brain that powerfully informs understanding of brain function, and, together with other diffusion metrics, is useful in evaluation of the normal and diseased brain. The quantitative methods of brain segmentation, tractography, and diffusion MRI extend MRI into a realm beyond visual inspection and provide otherwise unachievable sensitivity and specificity in the analysis of brain structure and function.
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Affiliation(s)
- Mykol Larvie
- Divisions of Neuroradiology and Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, MA, USA.
| | - Bruce Fischl
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
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Tahmasian M, Shao J, Meng C, Grimmer T, Diehl-Schmid J, Yousefi BH, Förster S, Riedl V, Drzezga A, Sorg C. Based on the Network Degeneration Hypothesis: Separating Individual Patients with Different Neurodegenerative Syndromes in a Preliminary Hybrid PET/MR Study. J Nucl Med 2015; 57:410-5. [DOI: 10.2967/jnumed.115.165464] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 10/29/2015] [Indexed: 12/19/2022] Open
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Yang Q, Guo QH, Bi YC. The brain connectivity basis of semantic dementia: a selective review. CNS Neurosci Ther 2015; 21:784-92. [PMID: 26336932 DOI: 10.1111/cns.12449] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 08/07/2015] [Accepted: 08/07/2015] [Indexed: 01/19/2023] Open
Abstract
Semantic dementia (SD) is a neurodegenerative disorder characterized by the progressive loss of semantic memory and conceptual knowledge, coupled with asymmetric local brain atrophy concentrated in the anterior temporal lobe. Recent developments in neuroimaging techniques, especially the emergence of the "human connectomics," have made possible the study of the brain's functional and structural connections and the topological properties of the brain networks. Recent studies applying these techniques have shown that SD manifests extensive structural and functional connectivity alterations, providing important insights into the pathogenesis of SD and the neural basis of semantic memory in general. In this review, we present and discuss the existing findings about the brain connectivity changes in SD and how they might be related to the various behavioral deficits associated with this disorder and propose important unanswered questions that warrant further investigation.
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Affiliation(s)
- Qing Yang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qi-Hao Guo
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan-Chao Bi
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
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Mascalchi M, Toschi N, Giannelli M, Ginestroni A, Della Nave R, Nicolai E, Bianchi A, Tessa C, Salvatore E, Aiello M, Soricelli A, Diciotti S. Progression of microstructural damage in spinocerebellar ataxia type 2: a longitudinal DTI study. AJNR Am J Neuroradiol 2015; 36:1096-101. [PMID: 25882284 DOI: 10.3174/ajnr.a4343] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 11/21/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE The ability of DTI to track the progression of microstructural damage in patients with inherited ataxias has not been explored so far. We performed a longitudinal DTI study in patients with spinocerebellar ataxia type 2. MATERIALS AND METHODS Ten patients with spinocerebellar ataxia type 2 and 16 healthy age-matched controls were examined twice with DTI (mean time between scans, 3.6 years [patients] and 3.3 years [controls]) on the same 1.5T MR scanner. Using tract-based spatial statistics, we analyzed changes in DTI-derived indices: mean diffusivity, axial diffusivity, radial diffusivity, fractional anisotropy, and mode of anisotropy. RESULTS At baseline, the patients with spinocerebellar ataxia type 2, as compared with controls, showed numerous WM tracts with significantly increased mean diffusivity, axial diffusivity, and radial diffusivity and decreased fractional anisotropy and mode of anisotropy in the brain stem, cerebellar peduncles, cerebellum, cerebral hemisphere WM, corpus callosum, and thalami. Longitudinal analysis revealed changes in axial diffusivity and mode of anisotropy in patients with spinocerebellar ataxia type 2 that were significantly different than those in the controls. In patients with spinocerebellar ataxia type 2, axial diffusivity was increased in WM tracts of the right cerebral hemisphere and the corpus callosum, and the mode of anisotropy was extensively decreased in hemispheric cerebral WM, corpus callosum, internal capsules, cerebral peduncles, pons and left cerebellar peduncles, and WM of the left paramedian vermis. There was no correlation between the progression of changes in DTI-derived indices and clinical deterioration. CONCLUSIONS DTI can reveal the progression of microstructural damage of WM fibers in the brains of patients with spinocerebellar ataxia type 2, and mode of anisotropy seems particularly sensitive to such changes. These results support the potential of DTI-derived indices as biomarkers of disease progression.
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Affiliation(s)
- M Mascalchi
- From the Quantitative and Functional Neuroradiology Research Unit (M.M.), Meyer Children and Careggi Hospitals of Florence, Florence, Italy "Mario Serio" Department of Experimental and Clinical Biomedical Sciences (M.M., A.B.), University of Florence, Florence, Italy
| | - N Toschi
- Medical Physics Section (N.T.), Department of Biomedicine and Prevention, University of Rome "Tor Vergata," Rome, Italy Department of Radiology (N.T.), Athinoula A. Martinos Center for Biomedical Imaging, Boston, Massachusetts Harvard Medical School (N.T.), Boston, Massachusetts
| | - M Giannelli
- Unit of Medical Physics (M.G.), Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana," Pisa, Italy
| | - A Ginestroni
- Neuroradiology Unit (A.G.), Careggi General Hospital, Florence, Italy
| | | | - E Nicolai
- IRCSS SDN Foundation (E.N., M.A., A.S.), Naples, Italy
| | - A Bianchi
- From the Quantitative and Functional Neuroradiology Research Unit (M.M.), Meyer Children and Careggi Hospitals of Florence, Florence, Italy
| | - C Tessa
- Unit of Radiology (C.T.), Versilia Hospital, Lido di Camaiore, Italy
| | - E Salvatore
- Department of Neurological Sciences (E.S.), University of Naples Federico II, Naples, Italy
| | - M Aiello
- IRCSS SDN Foundation (E.N., M.A., A.S.), Naples, Italy
| | - A Soricelli
- IRCSS SDN Foundation (E.N., M.A., A.S.), Naples, Italy University of Naples Parthenope (A.S.), Naples, Italy
| | - S Diciotti
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" (S.D.), University of Bologna, Cesena, Italy
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Suri S, Topiwala A, Mackay CE, Ebmeier KP, Filippini N. Using structural and diffusion magnetic resonance imaging to differentiate the dementias. Curr Neurol Neurosci Rep 2015; 14:475. [PMID: 25030502 DOI: 10.1007/s11910-014-0475-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Dementia is one of the major causes of personal, societal and financial dependence in older people and in today's ageing society there is a pressing need for early and accurate markers of cognitive decline. There are several subtypes of dementia but the four most common are Alzheimer's disease, Lewy body dementia, vascular dementia and frontotemporal dementia. These disorders can only be diagnosed at autopsy, and ante-mortem assessments of "probable dementia (e.g. of Alzheimer type)" are traditionally driven by clinical symptoms of cognitive or behavioural deficits. However, owing to the overlapping nature of symptoms and age of onset, a significant proportion of dementia cases remain incorrectly diagnosed. Misdiagnosis can have an extensive impact, both at the level of the individual, who may not be offered the appropriate treatment, and on a wider scale, by influencing the entry of patients into relevant clinical trials. Magnetic resonance imaging (MRI) may help to improve diagnosis by providing non-invasive and detailed disease-specific markers of cognitive decline. MRI-derived measurements of grey and white matter structural integrity are potential surrogate markers of disease progression, and may also provide valuable diagnostic information. This review summarises the latest evidence on the use of structural and diffusion MRI in differentiating between the four major dementia subtypes.
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Affiliation(s)
- Sana Suri
- Department of Psychiatry, Warneford Hospital, Warneford Lane, University of Oxford, Oxford, OX3 7JX, UK
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Christensen A, Alpert K, Rogalski E, Cobia D, Rao J, Beg MF, Weintraub S, Mesulam MM, Wang L. Hippocampal subfield surface deformity in non-semantic primary progressive aphasia. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2015; 1:14-23. [PMID: 25893207 PMCID: PMC4398964 DOI: 10.1016/j.dadm.2014.11.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Alzheimer neuropathology is found in almost half of patients with nonsemantic primary progressive aphasia (PPA). This study examined hippocampal abnormalities in PPA to determine similarities to those described in amnestic Alzheimer disease. Methods In 37 PPA patients and 32 healthy controls, we generated hippocampal subfield surface maps from structural magnetic resonance images and administered a face memory test. We analyzed group and hemisphere differences for surface shape measures and their relationship with test scores and APOE genotype. Results The hippocampus in PPA showed inward deformity (CA1 and subiculum subfields) and outward deformity (CA2–4 + dentate gyrus subfield) and smaller left than right volumes. Memory performance was related to hippocampal shape abnormalities in PPA patients, but not controls, even in the absence of memory impairments. Conclusions Hippocampal deformity in PPA is related to memory test scores. This may reflect a combination of intrinsic degenerative phenomena with transsynaptic or Wallerian effects of neocortical neuronal loss.
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Affiliation(s)
- Adam Christensen
- Department of Psychiatry and Behavioral Sciences, Division of Clinical Psychology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611
| | - Kathryn Alpert
- Department of Psychiatry and Behavioral Sciences, Division of Clinical Psychology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611
| | - Emily Rogalski
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611
| | - Derin Cobia
- Department of Psychiatry and Behavioral Sciences, Division of Clinical Psychology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611
| | - Julia Rao
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611
| | | | - Sandra Weintraub
- Department of Psychiatry and Behavioral Sciences, Division of Clinical Psychology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611 ; Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611 ; Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611
| | - M-Marsel Mesulam
- Department of Psychiatry and Behavioral Sciences, Division of Clinical Psychology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611 ; Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611 ; Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611
| | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Division of Clinical Psychology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611 ; Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611
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Henley SMD, Downey LE, Nicholas JM, Kinnunen KM, Golden HL, Buckley A, Mahoney CJ, Crutch SJ. Degradation of cognitive timing mechanisms in behavioural variant frontotemporal dementia. Neuropsychologia 2014; 65:88-101. [PMID: 25447066 PMCID: PMC4410788 DOI: 10.1016/j.neuropsychologia.2014.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 10/07/2014] [Indexed: 12/01/2022]
Abstract
The current study examined motor timing in frontotemporal dementia (FTD), which manifests as progressive deterioration in social, behavioural and cognitive functions. Twenty-patients fulfilling consensus clinical criteria for behavioural variant FTD (bvFTD), 11 patients fulfilling consensus clinical criteria for semantic-variant primary progressive aphasia (svPPA), four patients fulfilling criteria for nonfluent/agrammatic primary progressive aphasia (naPPA), eight patients fulfilling criteria for Alzheimer׳s disease (AD), and 31 controls were assessed on both an externally- and self-paced finger-tapping task requiring maintenance of a regular, 1500 ms beat over 50 taps. Grey and white matter correlates of deficits in motor timing were examined using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI). bvFTD patients exhibited significant deficits in aspects of both externally- and self-paced tapping. Increased mean inter-response interval (faster than target tap time) in the self-paced task was associated with reduced grey matter volume in the cerebellum bilaterally, right middle temporal gyrus, and with increased axial diffusivity in the right superior longitudinal fasciculus, regions and tracts which have been suggested to be involved in a subcortical–cortical network of structures underlying timing abilities. This suggests that such structures can be affected in bvFTD, and that impaired motor timing may underlie some characteristics of the bvFTD phenotype. We examine motor timing in behavioural variant FTD. Patients with behavioural variant FTD showed impaired motor timing. Patients tended to tap faster than target and speed up during the task. Faster tapping was associated with reduced grey matter in the cerebellum. Impaired timing might underlie some other behavioural features of FTD.
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Affiliation(s)
- Susie M D Henley
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London WC1N 3BG, United Kingdom; National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, Queens Square, London WC1N 3BG, United Kingdom.
| | - Laura E Downey
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London WC1N 3BG, United Kingdom.
| | - Jennifer M Nicholas
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
| | - Kirsi M Kinnunen
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London WC1N 3BG, United Kingdom.
| | - Hannah L Golden
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London WC1N 3BG, United Kingdom.
| | - Aisling Buckley
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London WC1N 3BG, United Kingdom.
| | - Colin J Mahoney
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London WC1N 3BG, United Kingdom.
| | - Sebastian J Crutch
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London WC1N 3BG, United Kingdom.
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Diehl-Schmid J, Onur OA, Kuhn J, Gruppe T, Drzezga A. Imaging Frontotemporal Lobar Degeneration. Curr Neurol Neurosci Rep 2014; 14:489. [DOI: 10.1007/s11910-014-0489-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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50
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Mahoney CJ, Ridgway GR, Malone IB, Downey LE, Beck J, Kinnunen KM, Schmitz N, Golden HL, Rohrer JD, Schott JM, Rossor MN, Ourselin S, Mead S, Fox NC, Warren JD. Profiles of white matter tract pathology in frontotemporal dementia. Hum Brain Mapp 2014; 35:4163-79. [PMID: 24510641 PMCID: PMC4312919 DOI: 10.1002/hbm.22468] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 12/13/2013] [Accepted: 01/07/2014] [Indexed: 12/11/2022] Open
Abstract
Despite considerable interest in improving clinical and neurobiological characterisation of frontotemporal dementia and in defining the role of brain network disintegration in its pathogenesis, information about white matter pathway alterations in frontotemporal dementia remains limited. Here we investigated white matter tract damage using an unbiased, template-based diffusion tensor imaging (DTI) protocol in a cohort of 27 patients with the behavioral variant of frontotemporal dementia (bvFTD) representing both major genetic and sporadic forms, in relation both to healthy individuals and to patients with Alzheimer's disease. Widespread white matter tract pathology was identified in the bvFTD group compared with both healthy controls and Alzheimer's disease group, with prominent involvement of uncinate fasciculus, cingulum bundle and corpus callosum. Relatively discrete and distinctive white matter profiles were associated with genetic subgroups of bvFTD associated with MAPT and C9ORF72 mutations. Comparing diffusivity metrics, optimal overall separation of the bvFTD group from the healthy control group was signalled using radial diffusivity, whereas optimal overall separation of the bvFTD group from the Alzheimer's disease group was signalled using fractional anisotropy. Comparing white matter changes with regional grey matter atrophy (delineated using voxel based morphometry) in the bvFTD cohort revealed co-localisation between modalities particularly in the anterior temporal lobe, however white matter changes extended widely beyond the zones of grey matter atrophy. Our findings demonstrate a distributed signature of white matter alterations that is likely to be core to the pathophysiology of bvFTD and further suggest that this signature is modulated by underlying molecular pathologies.
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Affiliation(s)
- Colin J Mahoney
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
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