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Chelban V, Nikram E, Perez-Soriano A, Wilke C, Foubert-Samier A, Vijiaratnam N, Guo T, Jabbari E, Olufodun S, Gonzalez M, Senkevich K, Laurens B, Péran P, Rascol O, Le Traon AP, Todd EG, Costantini AA, Alikhwan S, Tariq A, Ng BL, Muñoz E, Painous C, Compta Y, Junque C, Segura B, Zhelcheska K, Wellington H, Schöls L, Jaunmuktane Z, Kobylecki C, Church A, Hu MTM, Rowe JB, Leigh PN, Massey L, Burn DJ, Pavese N, Foltynie T, Pchelina S, Wood N, Heslegrave AJ, Zetterberg H, Bocchetta M, Rohrer JD, Marti MJ, Synofzik M, Morris HR, Meissner WG, Houlden H. Neurofilament light levels predict clinical progression and death in multiple system atrophy. Brain 2022; 145:4398-4408. [PMID: 35903017 PMCID: PMC9762941 DOI: 10.1093/brain/awac253] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/06/2022] [Accepted: 06/17/2022] [Indexed: 11/12/2022] Open
Abstract
Disease-modifying treatments are currently being trialled in multiple system atrophy. Approaches based solely on clinical measures are challenged by heterogeneity of phenotype and pathogenic complexity. Neurofilament light chain protein has been explored as a reliable biomarker in several neurodegenerative disorders but data on multiple system atrophy have been limited. Therefore, neurofilament light chain is not yet routinely used as an outcome measure in multiple system atrophy. We aimed to comprehensively investigate the role and dynamics of neurofilament light chain in multiple system atrophy combined with cross-sectional and longitudinal clinical and imaging scales and for subject trial selection. In this cohort study, we recruited cross-sectional and longitudinal cases in a multicentre European set-up. Plasma and CSF neurofilament light chain concentrations were measured at baseline from 212 multiple system atrophy cases, annually for a mean period of 2 years in 44 multiple system atrophy patients in conjunction with clinical, neuropsychological and MRI brain assessments. Baseline neurofilament light chain characteristics were compared between groups. Cox regression was used to assess survival; receiver operating characteristic analysis to assess the ability of neurofilament light chain to distinguish between multiple system atrophy patients and healthy controls. Multivariate linear mixed-effects models were used to analyse longitudinal neurofilament light chain changes and correlated with clinical and imaging parameters. Polynomial models were used to determine the differential trajectories of neurofilament light chain in multiple system atrophy. We estimated sample sizes for trials aiming to decrease neurofilament light chain levels. We show that in multiple system atrophy, baseline plasma neurofilament light chain levels were better predictors of clinical progression, survival and degree of brain atrophy than the neurofilament light chain rate of change. Comparative analysis of multiple system atrophy progression over the course of disease, using plasma neurofilament light chain and clinical rating scales, indicated that neurofilament light chain levels rise as the motor symptoms progress, followed by deceleration in advanced stages. Sample size prediction suggested that significantly lower trial participant numbers would be needed to demonstrate treatment effects when incorporating plasma neurofilament light chain values into multiple system atrophy clinical trials in comparison to clinical measures alone. In conclusion, neurofilament light chain correlates with clinical disease severity, progression and prognosis in multiple system atrophy. Combined with clinical and imaging analysis, neurofilament light chain can inform patient stratification and serve as a reliable biomarker of treatment response in future multiple system atrophy trials of putative disease-modifying agents.
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Affiliation(s)
- Viorica Chelban
- Correspondence to: Dr Viorica Chelban Department of Neuromuscular Diseases UCL Queen Square Institute of Neurology London WC1N 3BG, UK E-mail:
| | - Elham Nikram
- Peninsula Technology Assessment Group (PenTAG), University of Exeter, Exeter EX 2LU, UK
| | - Alexandra Perez-Soriano
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona 08036, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid 28029, Spain
| | - Carlo Wilke
- Division Translational Genomics of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, 72074 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72074 Tübingen, Germany
| | - Alexandra Foubert-Samier
- CRMR AMS, Service de Neurologie – Maladies Neurodégénératives, CHU de Bordeaux, F-33000 Bordeaux, France
- Université de Bordeaux, CNRS, IMN, UMR 5293, F-33000 Bordeaux, France
- Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
- Inserm, CIC 1401 Bordeaux, Clinical Epidemiology Unit, F-33000 Bordeaux, France
| | - Nirosen Vijiaratnam
- Department Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Tong Guo
- Department Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Edwin Jabbari
- Department Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Simisola Olufodun
- Department of Neuromuscular Diseases, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Mariel Gonzalez
- Department of Neuromuscular Diseases, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Konstantin Senkevich
- Neurogenomics and Precision Medicine (NAP-Med) Laboratory, The Neuro (Montreal Neurological Institute-Hospital), Montreal, QC H3A 2B4, Canada
- Department of Neurology & Neurosurgery, McGill University, Montreal, QC H3A 2B4, Canada
- Laboratory of Human Genetics, Petersburg Nuclear Physics Institute named by B.P. Konstantinov of National Research Centre 'Kurchatov Institute', Gatchina 188300, Russia
- Laboratory of Medical Genetics, Pavlov First Saint-Petersburg State Medical University, St. Petersburg 197022, Russia
| | - Brice Laurens
- CRMR AMS, Service de Neurologie – Maladies Neurodégénératives, CHU de Bordeaux, F-33000 Bordeaux, France
- Université de Bordeaux, CNRS, IMN, UMR 5293, F-33000 Bordeaux, France
| | - Patrice Péran
- ToNIC, Toulouse NeuroImaging Center, UMR 1214, Université de Toulouse, 31024 Toulouse, France
| | - Olivier Rascol
- CRMR AMS, CHU de Toulouse, 31300 Toulouse, France
- Clinical Investigation Center CIC 1436, NS-Park/F-CRIN Network and NeuroToul COEN Center; Inserm, University of Toulouse 3 and CHU of Toulouse, F-31000 Toulouse, France
- Departments of Neurosciences and Clinical Pharmacology, CHU Toulouse and University of Toulouse 3, F-31000 Toulouse, France
| | - Anne Pavy Le Traon
- CRMR AMS, CHU de Toulouse, 31300 Toulouse, France
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm U 1297, Toulouse University, F-31000 Toulouse, France
| | - Emily G Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG London, UK
| | - Alyssa A Costantini
- Department Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Sondos Alikhwan
- Department of Neuromuscular Diseases, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Ambreen Tariq
- Department of Neuromuscular Diseases, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Bai Lin Ng
- Department of Economics, University College London, London WC1N 3BG, UK
| | - Esteban Muñoz
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona 08036, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid 28029, Spain
| | - Celia Painous
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona 08036, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid 28029, Spain
| | - Yaroslau Compta
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona 08036, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid 28029, Spain
| | - Carme Junque
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid 28029, Spain
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, 08035 Barcelona, Spain
| | - Barbara Segura
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid 28029, Spain
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, 08035 Barcelona, Spain
| | - Kristina Zhelcheska
- Department of Neuromuscular Diseases, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Henny Wellington
- Biomarkers Factory Laboratory, UK Dementia Research Institute, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Ludger Schöls
- Division Translational Genomics of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, 72074 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72074 Tübingen, Germany
| | - Zane Jaunmuktane
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, WC1N 3BG London, UK
| | - Christopher Kobylecki
- Department of Neurology, Manchester Academic Health Science Centre, Northern Care Alliance NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, Oxford Road, Manchester M13 9PT, UK
| | - Alistair Church
- Department of Neurology, Royal Gwent Hospital, Newport NP20 2UB, UK
| | - Michele T M Hu
- Division of Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK
| | - James B Rowe
- Department of Clinical Neurosciences, Cambridge University, Cambridge CB3 0SZ, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, CB3 0SZ Cambridge, UK
- Neurology Department, Cambridge University Hospitals NHS Trust, Cambridge CB2 0QQ, UK
| | - P Nigel Leigh
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
| | - Luke Massey
- Neurology Department, University Hospitals Dorset, Poole BH15 2JB, UK
| | - David J Burn
- Faculty of Medical Sciences, Clinical Ageing Research Unit, Newcastle University, NE4 5PL Newcastle, UK
| | - Nicola Pavese
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, WC1N 3BG London, UK
| | - Tom Foltynie
- Department Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Sofya Pchelina
- Laboratory of Human Genetics, Petersburg Nuclear Physics Institute named by B.P. Konstantinov of National Research Centre 'Kurchatov Institute', Gatchina 188300, Russia
- Laboratory of Medical Genetics, Pavlov First Saint-Petersburg State Medical University, St. Petersburg 197022, Russia
| | - Nicholas Wood
- Department Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Amanda J Heslegrave
- Biomarkers Factory Laboratory, UK Dementia Research Institute, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Henrik Zetterberg
- Biomarkers Factory Laboratory, UK Dementia Research Institute, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, WC1N 3BG London, UK
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, 405 30 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 405 30 Mölndal, Sweden
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong 1512-1518, China
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, WC1N 3BG London, UK
| | - Maria J Marti
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona 08036, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Department, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid 28029, Spain
| | - Matthis Synofzik
- Division Translational Genomics of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, 72074 Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72074 Tübingen, Germany
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Jabbari E, Holland N, Chelban V, Jones PS, Lamb R, Rawlinson C, Guo T, Costantini AA, Tan MMX, Heslegrave AJ, Roncaroli F, Klein JC, Ansorge O, Allinson KSJ, Jaunmuktane Z, Holton JL, Revesz T, Warner TT, Lees AJ, Zetterberg H, Russell LL, Bocchetta M, Rohrer JD, Williams NM, Grosset DG, Burn DJ, Pavese N, Gerhard A, Kobylecki C, Leigh PN, Church A, Hu MTM, Woodside J, Houlden H, Rowe JB, Morris HR. Diagnosis Across the Spectrum of Progressive Supranuclear Palsy and Corticobasal Syndrome. JAMA Neurol 2020; 77:377-387. [PMID: 31860007 PMCID: PMC6990759 DOI: 10.1001/jamaneurol.2019.4347] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/27/2019] [Indexed: 12/29/2022]
Abstract
Importance Atypical parkinsonian syndromes (APS), including progressive supranuclear palsy (PSP), corticobasal syndrome (CBS), and multiple system atrophy (MSA), may be difficult to distinguish in early stages and are often misdiagnosed as Parkinson disease (PD). The diagnostic criteria for PSP have been updated to encompass a range of clinical subtypes but have not been prospectively studied. Objective To define the distinguishing features of PSP and CBS subtypes and to assess their usefulness in facilitating early diagnosis and separation from PD. Design, Setting, Participants This cohort study recruited patients with APS and PD from movement disorder clinics across the United Kingdom from September 1, 2015, through December 1, 2018. Patients with APS were stratified into the following groups: those with Richardson syndrome (PSP-RS), PSP-subcortical (including PSP-parkinsonism and progressive gait freezing subtypes), PSP-cortical (including PSP-frontal and PSP-CBS overlap subtypes), MSA-parkinsonism, MSA-cerebellar, CBS-Alzheimer disease (CBS-AD), and CBS-non-AD. Data were analyzed from February 1, through May 1, 2019. Main Outcomes and Measures Baseline group comparisons used (1) clinical trajectory; (2) cognitive screening scales; (3) serum neurofilament light chain (NF-L) levels; (4) TRIM11, ApoE, and MAPT genotypes; and (5) volumetric magnetic resonance imaging measures. Results A total of 222 patients with APS (101 with PSP, 55 with MSA, 40 with CBS, and 26 indeterminate) were recruited (129 [58.1%] male; mean [SD] age at recruitment, 68.3 [8.7] years). Age-matched control participants (n = 76) and patients with PD (n = 1967) were included for comparison. Concordance between the antemortem clinical and pathologic diagnoses was achieved in 12 of 13 patients with PSP and CBS (92.3%) undergoing postmortem evaluation. Applying the Movement Disorder Society PSP diagnostic criteria almost doubled the number of patients diagnosed with PSP from 58 to 101. Forty-nine of 101 patients with reclassified PSP (48.5%) did not have the classic PSP-RS subtype. Patients in the PSP-subcortical group had a longer diagnostic latency and a more benign clinical trajectory than those in PSP-RS and PSP-cortical groups. The PSP-subcortical group was distinguished from PSP-cortical and PSP-RS groups by cortical volumetric magnetic resonance imaging measures (area under the curve [AUC], 0.84-0.89), cognitive profile (AUC, 0.80-0.83), serum NF-L level (AUC, 0.75-0.83), and TRIM11 rs564309 genotype. Midbrain atrophy was a common feature of all PSP groups. Eight of 17 patients with CBS (47.1%) undergoing cerebrospinal fluid analysis were identified as having the CBS-AD subtype. Patients in the CBS-AD group had a longer diagnostic latency, relatively benign clinical trajectory, greater cognitive impairment, and higher APOE-ε4 allele frequency than those in the CBS-non-AD group (AUC, 0.80-0.87; P < .05). Serum NF-L levels distinguished PD from all PSP and CBS cases combined (AUC, 0.80; P < .05). Conclusions and Relevance These findings suggest that studies focusing on the PSP-RS subtype are likely to miss a large number of patients with underlying PSP tau pathology. Analysis of cerebrospinal fluid defined a distinct CBS-AD subtype. The PSP and CBS subtypes have distinct characteristics that may enhance their early diagnosis.
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Affiliation(s)
- Edwin Jabbari
- Department of Clinical and Movement Neurosciences, UCL (University College London) Queen Square Institute of Neurology, London, United Kingdom
- Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Negin Holland
- Department of Clinical Neurosciences and MRC (Medical Research Council) Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Viorica Chelban
- Department of Clinical and Movement Neurosciences, UCL (University College London) Queen Square Institute of Neurology, London, United Kingdom
- Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - P. Simon Jones
- Department of Clinical Neurosciences and MRC (Medical Research Council) Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Ruth Lamb
- Department of Clinical and Movement Neurosciences, UCL (University College London) Queen Square Institute of Neurology, London, United Kingdom
- Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Charlotte Rawlinson
- Department of Clinical and Movement Neurosciences, UCL (University College London) Queen Square Institute of Neurology, London, United Kingdom
- Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Tong Guo
- Department of Clinical and Movement Neurosciences, UCL (University College London) Queen Square Institute of Neurology, London, United Kingdom
- Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Alyssa A. Costantini
- Department of Clinical and Movement Neurosciences, UCL (University College London) Queen Square Institute of Neurology, London, United Kingdom
- Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Manuela M. X. Tan
- Department of Clinical and Movement Neurosciences, UCL (University College London) Queen Square Institute of Neurology, London, United Kingdom
- Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Amanda J. Heslegrave
- UK Dementia Research Institute, UCL Queen Square Institute of Neurology, London, United Kingdom
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Federico Roncaroli
- Department of Neurology, Manchester Academic Health Science Centre, Salford Royal NHS (National Health Service) Foundation Trust, University of Manchester, Manchester, United Kingdom
| | - Johannes C. Klein
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Olaf Ansorge
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Kieren S. J. Allinson
- Department of Clinical Neurosciences and MRC (Medical Research Council) Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Zane Jaunmuktane
- Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, London, United Kingdom
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Janice L. Holton
- Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, London, United Kingdom
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Tamas Revesz
- Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, London, United Kingdom
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Thomas T. Warner
- Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, London, United Kingdom
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Andrew J. Lees
- Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, London, United Kingdom
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Henrik Zetterberg
- UK Dementia Research Institute, UCL Queen Square Institute of Neurology, London, United Kingdom
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Lucy L. Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Jonathan D. Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Nigel M. Williams
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Donald G. Grosset
- Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - David J. Burn
- Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Nicola Pavese
- Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Alexander Gerhard
- Departments of Geriatrics and Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Christopher Kobylecki
- Department of Neurology, Manchester Academic Health Science Centre, Salford Royal NHS (National Health Service) Foundation Trust, University of Manchester, Manchester, United Kingdom
| | - P. Nigel Leigh
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Alistair Church
- Department of Neurology, Royal Gwent Hospital, Newport, United Kingdom
| | - Michele T. M. Hu
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - John Woodside
- Department of Clinical and Movement Neurosciences, UCL (University College London) Queen Square Institute of Neurology, London, United Kingdom
- Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Henry Houlden
- Department of Clinical and Movement Neurosciences, UCL (University College London) Queen Square Institute of Neurology, London, United Kingdom
- Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - James B. Rowe
- Department of Clinical Neurosciences and MRC (Medical Research Council) Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Huw R. Morris
- Department of Clinical and Movement Neurosciences, UCL (University College London) Queen Square Institute of Neurology, London, United Kingdom
- Movement Disorders Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
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