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Biesbroek JM, Coenen M, DeCarli C, Fletcher EM, Maillard PM, Barkhof F, Barnes J, Benke T, Chen CPLH, Dal‐Bianco P, Dewenter A, Duering M, Enzinger C, Ewers M, Exalto LG, Franzmeier N, Hilal S, Hofer E, Koek HL, Maier AB, McCreary CR, Papma JM, Paterson RW, Pijnenburg YAL, Rubinski A, Schmidt R, Schott JM, Slattery CF, Smith EE, Sudre CH, Steketee RME, Teunissen CE, van den Berg E, van der Flier WM, Venketasubramanian N, Venkatraghavan V, Vernooij MW, Wolters FJ, Xin X, Kuijf HJ, Biessels GJ. Amyloid pathology and vascular risk are associated with distinct patterns of cerebral white matter hyperintensities: A multicenter study in 3132 memory clinic patients. Alzheimers Dement 2024; 20:2980-2989. [PMID: 38477469 PMCID: PMC11032573 DOI: 10.1002/alz.13765] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/30/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION White matter hyperintensities (WMH) are associated with key dementia etiologies, in particular arteriolosclerosis and amyloid pathology. We aimed to identify WMH locations associated with vascular risk or cerebral amyloid-β1-42 (Aβ42)-positive status. METHODS Individual patient data (n = 3,132; mean age 71.5 ± 9 years; 49.3% female) from 11 memory clinic cohorts were harmonized. WMH volumes in 28 regions were related to a vascular risk compound score (VRCS) and Aß42 status (based on cerebrospinal fluid or amyloid positron emission tomography), correcting for age, sex, study site, and total WMH volume. RESULTS VRCS was associated with WMH in anterior/superior corona radiata (B = 0.034/0.038, p < 0.001), external capsule (B = 0.052, p < 0.001), and middle cerebellar peduncle (B = 0.067, p < 0.001), and Aß42-positive status with WMH in posterior thalamic radiation (B = 0.097, p < 0.001) and splenium (B = 0.103, p < 0.001). DISCUSSION Vascular risk factors and Aß42 pathology have distinct signature WMH patterns. This regional vulnerability may incite future studies into how arteriolosclerosis and Aß42 pathology affect the brain's white matter. HIGHLIGHTS Key dementia etiologies may be associated with specific patterns of white matter hyperintensities (WMH). We related WMH locations to vascular risk and cerebral Aβ42 status in 11 memory clinic cohorts. Aβ42 positive status was associated with posterior WMH in splenium and posterior thalamic radiation. Vascular risk was associated with anterior and infratentorial WMH. Amyloid pathology and vascular risk have distinct signature WMH patterns.
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Coenen M, Biessels GJ, DeCarli C, Fletcher EF, Maillard PM, Barkhof F, Barnes J, Benke T, Boomsma JMF, P L H Chen C, Dal-Bianco P, Dewenter A, Duering M, Enzinger C, Ewers M, Exalto LG, Franzmeier N, Groeneveld O, Hilal S, Hofer E, Koek HL, Maier AB, McCreary CR, Papma JM, Paterson RW, Pijnenburg YAL, Rubinski A, Schmidt R, Schott JM, Slattery CF, Smith EE, Sudre CH, Steketee RME, van den Berg E, van der Flier WM, Venketasubramanian N, Vernooij MW, Wolters FJ, Xin X, Biesbroek JM, Kuijf HJ. Spatial distributions of white matter hyperintensities on brain MRI: A pooled analysis of individual participant data from 11 memory clinic cohorts. Neuroimage Clin 2023; 40:103547. [PMID: 38035457 PMCID: PMC10698002 DOI: 10.1016/j.nicl.2023.103547] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/27/2023] [Revised: 11/03/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION The spatial distribution of white matter hyperintensities (WMH) on MRI is often considered in the diagnostic evaluation of patients with cognitive problems. In some patients, clinicians may classify WMH patterns as "unusual", but this is largely based on expert opinion, because detailed quantitative information about WMH distribution frequencies in a memory clinic setting is lacking. Here we report voxel wise 3D WMH distribution frequencies in a large multicenter dataset and also aimed to identify individuals with unusual WMH patterns. METHODS Individual participant data (N = 3525, including 777 participants with subjective cognitive decline, 1389 participants with mild cognitive impairment and 1359 patients with dementia) from eleven memory clinic cohorts, recruited through the Meta VCI Map Consortium, were used. WMH segmentations were provided by participating centers or performed in Utrecht and registered to the Montreal Neurological Institute (MNI)-152 brain template for spatial normalization. To determine WMH distribution frequencies, we calculated WMH probability maps at voxel level. To identify individuals with unusual WMH patterns, region-of-interest (ROI) based WMH probability maps, rule-based scores, and a machine learning method (Local Outlier Factor (LOF)), were implemented. RESULTS WMH occurred in 82% of voxels from the white matter template with large variation between subjects. Only a small proportion of the white matter (1.7%), mainly in the periventricular areas, was affected by WMH in at least 20% of participants. A large portion of the total white matter was affected infrequently. Nevertheless, 93.8% of individual participants had lesions in voxels that were affected in less than 2% of the population, mainly located in subcortical areas. Only the machine learning method effectively identified individuals with unusual patterns, in particular subjects with asymmetric WMH distribution or with WMH at relatively rarely affected locations despite common locations not being affected. DISCUSSION Aggregating data from several memory clinic cohorts, we provide a detailed 3D map of WMH lesion distribution frequencies, that informs on common as well as rare localizations. The use of data-driven analysis with LOF can be used to identify unusual patterns, which might serve as an alert that rare causes of WMH should be considered.
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Affiliation(s)
- Mirthe Coenen
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands.
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, USA
| | - Evan F Fletcher
- Department of Neurology, University of California at Davis, USA
| | | | - Frederik Barkhof
- Radiology & Nuclear Medicine, Amsterdam UMC, Location Vrije Universiteit, the Netherlands; UCL Institute of Neurology, London, UK
| | - Josephine Barnes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Thomas Benke
- Clinic of Neurology, Medical University Innsbruck, Austria
| | - Jooske M F Boomsma
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Christopher P L H Chen
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | | | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany; Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Christian Enzinger
- Division of General Neurology, Department of Neurology, Medical University Graz, Austria; Division of Neuroradiology, Interventional and Vascular Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Lieza G Exalto
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Onno Groeneveld
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands; Department of Neurology, Isala, Meppel, the Netherlands
| | - Saima Hilal
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Edith Hofer
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Austria; Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Austria
| | - Huiberdina L Koek
- Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Andrea B Maier
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore; Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Cheryl R McCreary
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Janne M Papma
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Ross W Paterson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Reinhold Schmidt
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Austria
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Eric E Smith
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Carole H Sudre
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK; Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Rebecca M E Steketee
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Esther van den Berg
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Narayanaswamy Venketasubramanian
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Raffles Neuroscience Center, Raffles Hospital, Singapore, Singapore
| | - Meike W Vernooij
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Frank J Wolters
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Xu Xin
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands; Department of Neurology, Diakonessenhuis Hospital, Utrecht, the Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
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Hällqvist J, Pinto RC, Heywood WE, Cordey J, Foulkes AJM, Slattery CF, Leckey CA, Murphy EC, Zetterberg H, Schott JM, Mills K, Paterson RW. A Multiplexed Urinary Biomarker Panel Has Potential for Alzheimer's Disease Diagnosis Using Targeted Proteomics and Machine Learning. Int J Mol Sci 2023; 24:13758. [PMID: 37762058 PMCID: PMC10531486 DOI: 10.3390/ijms241813758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
As disease-modifying therapies are now available for Alzheimer's disease (AD), accessible, accurate and affordable biomarkers to support diagnosis are urgently needed. We sought to develop a mass spectrometry-based urine test as a high-throughput screening tool for diagnosing AD. We collected urine from a discovery cohort (n = 11) of well-characterised individuals with AD (n = 6) and their asymptomatic, CSF biomarker-negative study partners (n = 5) and used untargeted proteomics for biomarker discovery. Protein biomarkers identified were taken forward to develop a high-throughput, multiplexed and targeted proteomic assay which was tested on an independent cohort (n = 21). The panel of proteins identified are known to be involved in AD pathogenesis. In comparing AD and controls, a panel of proteins including MIEN1, TNFB, VCAM1, REG1B and ABCA7 had a classification accuracy of 86%. These proteins have been previously implicated in AD pathogenesis. This suggests that urine-targeted mass spectrometry has potential utility as a diagnostic screening tool in AD.
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Affiliation(s)
- Jenny Hällqvist
- Translational Mass Spectrometry Research Group, Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK; (J.H.); (K.M.)
| | - Rui C. Pinto
- Faculty of Medicine, School of Public Health, Imperial College London, London SW7 2BX, UK
| | - Wendy E. Heywood
- Translational Mass Spectrometry Research Group, Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK; (J.H.); (K.M.)
| | - Jonjo Cordey
- Translational Mass Spectrometry Research Group, Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK; (J.H.); (K.M.)
| | | | | | - Claire A. Leckey
- Translational Mass Spectrometry Research Group, Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK; (J.H.); (K.M.)
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Eimear C. Murphy
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, S-431 80 Mölndal, Sweden
- UK Dementia Research Institute, UCL, London WC1E 6BT, UK
| | - Jonathan M. Schott
- National Hospital for Neurology and Neurosurgery, Queen Square London, London WC1N 3BG, UK
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Kevin Mills
- Translational Mass Spectrometry Research Group, Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK; (J.H.); (K.M.)
| | - Ross W. Paterson
- National Hospital for Neurology and Neurosurgery, Queen Square London, London WC1N 3BG, UK
- Darent Valley Hospital, Dartford DA2 8DA, UK
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, S-431 80 Mölndal, Sweden
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Coenen M, Kuijf HJ, Huenges Wajer IMC, Duering M, Wolters FJ, Fletcher EF, Maillard PM, Barkhof F, Barnes J, Benke T, Boomsma JMF, Chen CPLH, Dal-Bianco P, Dewenter A, Enzinger C, Ewers M, Exalto LG, Franzmeier N, Groeneveld O, Hilal S, Hofer E, Koek DL, Maier AB, McCreary CR, Padilla CS, Papma JM, Paterson RW, Pijnenburg YAL, Rubinski A, Schmidt R, Schott JM, Slattery CF, Smith EE, Steketee RME, Sudre CH, van den Berg E, van der Flier WM, Venketasubramanian N, Vernooij MW, Xin X, DeCarli C, Biessels GJ, Biesbroek JM. Strategic white matter hyperintensity locations for cognitive impairment: A multicenter lesion-symptom mapping study in 3525 memory clinic patients. Alzheimers Dement 2023; 19:2420-2432. [PMID: 36504357 DOI: 10.1002/alz.12827] [Citation(s) in RCA: 7] [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: 04/19/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Impact of white matter hyperintensities (WMH) on cognition likely depends on lesion location, but a comprehensive map of strategic locations is lacking. We aimed to identify these locations in a large multicenter study. METHODS Individual patient data (n = 3525) from 11 memory clinic cohorts were harmonized. We determined the association of WMH location with attention and executive functioning, information processing speed, language, and verbal memory performance using voxel-based and region of interest tract-based analyses. RESULTS WMH in the left and right anterior thalamic radiation, forceps major, and left inferior fronto-occipital fasciculus were significantly related to domain-specific impairment, independent of total WMH volume and atrophy. A strategic WMH score based on these tracts inversely correlated with performance in all domains. DISCUSSION The data show that the impact of WMH on cognition is location-dependent, primarily involving four strategic white matter tracts. Evaluation of WMH location may support diagnosing vascular cognitive impairment. HIGHLIGHTS We analyzed white matter hyperintensities (WMH) in 3525 memory clinic patients from 11 cohorts The impact of WMH on cognition depends on location We identified four strategic white matter tracts A single strategic WMH score was derived from these four strategic tracts The strategic WMH score was an independent determinant of four cognitive domains.
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Affiliation(s)
- Mirthe Coenen
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Irene M C Huenges Wajer
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Frank J Wolters
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Evan F Fletcher
- Department of Neurology, University of California at Davis, Davis, California, USA
| | - Pauline M Maillard
- Department of Neurology, University of California at Davis, Davis, California, USA
| | - Frederik Barkhof
- Radiology & Nuclear Medicine, Amsterdam UMC, location Vrije Universiteit, Amsterdam, The Netherlands
- UCL Institute of Neurology, London, UK
| | - Josephine Barnes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Thomas Benke
- Clinic of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Jooske M F Boomsma
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Christopher P L H Chen
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - Peter Dal-Bianco
- Department of Neurology, Medical University Vienna, Vienna, Austria
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Christian Enzinger
- Division of General Neurology, Department of Neurology, Medical University Graz, Graz, Austria
- Division of Neuroradiology, Interventional and Vascular Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Lieza G Exalto
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Onno Groeneveld
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
- Department of Neurology, Isala MS Centre, Isala Hospital, Meppel, The Netherlands
| | - Saima Hilal
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Edith Hofer
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Dineke L Koek
- Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Andrea B Maier
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
- Department of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheryl R McCreary
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Catarina S Padilla
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
| | - Janne M Papma
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Ross W Paterson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Reinhold Schmidt
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Eric E Smith
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Rebecca M E Steketee
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Carole H Sudre
- MRC Unit for Lifelong Health and Ageing, the Centre for Medical Image Computing, UCL, London, UK
| | - Esther van den Berg
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Narayanaswamy Venketasubramanian
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
- Raffles Neuroscience Center, Raffles Hospital, Singapore, Singapore
| | - Meike W Vernooij
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Xu Xin
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, Davis, California, USA
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
- Department of Neurology, Diakonessenhuis Hospital, Utrecht, The Netherlands
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Veale T, Parker CS, Bocchetta M, Malone IB, Slattery CF, Schott JM, Fox NC, Zhang H, Cash DM. Atrophy and partial volume related bias in cortical region of interest NODDI metrics. Alzheimers Dement 2021. [DOI: 10.1002/alz.055418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Thomas Veale
- Dementia Research Centre, UCL Queen Square Institute of Neurology London United Kingdom
- UK Dementia Research Institute, UCL London United Kingdom
| | | | - Martina Bocchetta
- Dementia Research Centre, UCL Queen Square Institute of Neurology London United Kingdom
| | - Ian B Malone
- Dementia Research Centre, UCL Queen Square Institute of Neurology London United Kingdom
| | - Catherine F Slattery
- Dementia Research Centre, UCL Queen Square Institute of Neurology London United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology London United Kingdom
| | - Nick C Fox
- UK Dementia Research Institute, UCL London United Kingdom
- Dementia Research Centre London United Kingdom
| | - Hui Zhang
- Centre for Medical Image Computing, UCL London United Kingdom
| | - David M Cash
- Dementia Research Centre, UCL Queen Square Institute of Neurology London United Kingdom
- UK Dementia Research Institute, UCL London United Kingdom
- Centre for Medical Image Computing, UCL London United Kingdom
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Parker CS, Foulkes AJ, Slattery CF, Veale T, Cash DM, Fox NC, Schott JM, Zhang H. Disentangling axonal loss and demyelination using multi‐modal imaging: Application to young onset Alzheimer’s disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.050278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Catherine F. Slattery
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Thomas Veale
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - David M. Cash
- Centre for Medical Image Computing UCL London United Kingdom
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Nick C. Fox
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Jonathan M. Schott
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Hui Zhang
- Centre for Medical Image Computing UCL London United Kingdom
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Veale T, Malone IB, Poole T, Parker TD, Slattery CF, Paterson RW, Foulkes AJM, Thomas DL, Schott JM, Zhang H, Fox NC, Cash DM. Loss and dispersion of superficial white matter in Alzheimer's disease: a diffusion MRI study. Brain Commun 2021; 3:fcab272. [PMID: 34859218 PMCID: PMC8633427 DOI: 10.1093/braincomms/fcab272] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/24/2021] [Accepted: 10/18/2021] [Indexed: 11/22/2022] Open
Abstract
Pathological cerebral white matter changes in Alzheimer's disease have been shown using diffusion tensor imaging. Superficial white matter changes are relatively understudied despite their importance in cortico-cortical connections. Measuring superficial white matter degeneration using diffusion tensor imaging is challenging due to its complex organizational structure and proximity to the cortex. To overcome this, we investigated diffusion MRI changes in young-onset Alzheimer's disease using standard diffusion tensor imaging and Neurite Orientation Dispersion and Density Imaging to distinguish between disease-related changes that are degenerative (e.g. loss of myelinated fibres) and organizational (e.g. increased fibre dispersion). Twenty-nine young-onset Alzheimer's disease patients and 22 healthy controls had both single-shell and multi-shell diffusion MRI. We calculated fractional anisotropy, mean diffusivity, neurite density index, orientation dispersion index and tissue fraction (1-free water fraction). Diffusion metrics were sampled in 15 a priori regions of interest at four points along the cortical profile: cortical grey matter, grey/white boundary, superficial white matter (1 mm below grey/white boundary) and superficial/deeper white matter (2 mm below grey/white boundary). To estimate cross-sectional group differences, we used average marginal effects from linear mixed effect models of participants' diffusion metrics along the cortical profile. The superficial white matter of young-onset Alzheimer's disease individuals had lower neurite density index compared to controls in five regions (superior and inferior parietal, precuneus, entorhinal and parahippocampus) (all P < 0.05), and higher orientation dispersion index in three regions (fusiform, entorhinal and parahippocampus) (all P < 0.05). Young-onset Alzheimer's disease individuals had lower fractional anisotropy in the entorhinal and parahippocampus regions (both P < 0.05) and higher fractional anisotropy within the postcentral region (P < 0.05). Mean diffusivity was higher in the young-onset Alzheimer's disease group in the parahippocampal region (P < 0.05) and lower in the postcentral, precentral and superior temporal regions (all P < 0.05). In the overlying grey matter, disease-related changes were largely consistent with superficial white matter findings when using neurite density index and fractional anisotropy, but appeared at odds with orientation dispersion and mean diffusivity. Tissue fraction was significantly lower across all grey matter regions in young-onset Alzheimer's disease individuals (all P < 0.001) but group differences reduced in magnitude and coverage when moving towards the superficial white matter. These results show that microstructural changes occur within superficial white matter and along the cortical profile in individuals with young-onset Alzheimer's disease. Lower neurite density and higher orientation dispersion suggests underlying fibres undergo neurodegeneration and organizational changes, two effects previously indiscernible using standard diffusion tensor metrics in superficial white matter.
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Affiliation(s)
- Thomas Veale
- The Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, University College London, London, UK
| | - Ian B Malone
- The Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Teresa Poole
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Thomas D Parker
- The Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Catherine F Slattery
- The Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Ross W Paterson
- The Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, University College London, London, UK
| | - Alexander J M Foulkes
- The Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - David L Thomas
- The Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - Jonathan M Schott
- The Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Hui Zhang
- Department of Computer Science and Centre for Medical Image Computing, UCL, London, UK
| | - Nick C Fox
- The Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, University College London, London, UK
| | - David M Cash
- The Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, University College London, London, UK
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8
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Veale T, Malone IB, Poole T, Parker TD, Slattery CF, Schott JM, Zhang H, Fox NC, Cash DM. Uncovering superficial white matter changes in young‐onset Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.039746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Thomas Veale
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Ian B Malone
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Teresa Poole
- London School of Hygiene and Tropical Medicine London United Kingdom
| | - Thomas D Parker
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Catherine F Slattery
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Hui Zhang
- Centre for Medical Image Computing UCL London United Kingdom
| | - Nick C Fox
- UCL Queen Square Institute of Neurology London United Kingdom
| | - David M Cash
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
- Centre for Medical Image Computing UCL London United Kingdom
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Sani TP, Bond RL, Marshall CR, Hardy CJ, Russell LL, Moore KM, Slattery CF, Paterson RW, Woollacott IO, Wendi IP, Crutch SJ, Schott JM, Rohrer JD, Eriksson SH, Dijk DJ, Warren JD. Sleep symptoms in syndromes of frontotemporal dementia and Alzheimer's disease: A proof-of-principle behavioural study. eNeurologicalSci 2019; 17:100212. [PMID: 31828228 PMCID: PMC6889070 DOI: 10.1016/j.ensci.2019.100212] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 10/04/2019] [Accepted: 10/28/2019] [Indexed: 11/17/2022] Open
Abstract
Sleep is a key concern in dementias but their sleep phenotypes are not well defined. We addressed this issue in major FTD and AD syndromes versus healthy older controls. We surveyed sleep duration, quality and disruptive events, and daytime somnolence. Sleep symptoms were frequent in FTD and AD and distinguished these diseases. Sleep disturbance is an important clinical issue across major FTD and AD syndromes.
Sleep disruption is a key clinical issue in the dementias but the sleep phenotypes of these diseases remain poorly characterised. Here we addressed this issue in a proof-of-principle study of 67 patients representing major syndromes of frontotemporal dementia (FTD) and Alzheimer’s disease (AD), in relation to 25 healthy older individuals. We collected reports on clinically-relevant sleep characteristics - time spent overnight in bed, sleep quality, excessive daytime somnolence and disruptive sleep events. Difficulty falling or staying asleep at night and excessive daytime somnolence were significantly more frequently reported for patients with both FTD and AD than healthy controls. On average, patients with FTD and AD retired earlier and patients with AD spent significantly longer in bed overnight than did healthy controls. Excessive daytime somnolence was significantly more frequent in the FTD group than the AD group; AD syndromic subgroups showed similar sleep symptom profiles while FTD subgroups showed more variable profiles. Sleep disturbance is a significant clinical issue in major FTD and AD variant syndromes and may be even more salient in FTD than AD. These preliminary findings warrant further systematic investigation with electrophysiological and neuroanatomical correlation in major proteinopathies.
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Affiliation(s)
- Tara P. Sani
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
- Neurology Department, Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Rebecca L. Bond
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Charles R. Marshall
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Chris J.D. Hardy
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Lucy L. Russell
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Katrina M. Moore
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Catherine F. Slattery
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Ross W. Paterson
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Ione O.C. Woollacott
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Indra Putra Wendi
- Department of Chemistry and Biochemistry, Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Sebastian J. Crutch
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jonathan M. Schott
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jonathan D. Rohrer
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Sofia H. Eriksson
- Department of Clinical and Experiential Epilepsy, UCL Institute of Neurology, University College London, London, UK
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, University of Surrey, UK
- Dementia Research Institute, UK
| | - Jason D. Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
- Corresponding author at: Dementia Research Centre, UCL Institute of Neurology, University College London, London WC1N 3BG, UK.
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Canas LS, Sudre CH, De Vita E, Nihat A, Mok TH, Slattery CF, Paterson RW, Foulkes AJM, Hyare H, Cardoso MJ, Thornton J, Schott JM, Barkhof F, Collinge J, Ourselin S, Mead S, Modat M. Prion disease diagnosis using subject-specific imaging biomarkers within a multi-kernel Gaussian process. Neuroimage Clin 2019; 24:102051. [PMID: 31734530 PMCID: PMC6978211 DOI: 10.1016/j.nicl.2019.102051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 09/25/2019] [Accepted: 10/21/2019] [Indexed: 02/01/2023]
Abstract
Prion diseases are a group of rare neurodegenerative conditions characterised by a high rate of progression and highly heterogeneous phenotypes. Whilst the most common form of prion disease occurs sporadically (sporadic Creutzfeldt-Jakob disease, sCJD), other forms are caused by prion protein gene mutations, or exposure to prions in the diet or by medical procedures, such us surgeries. To date, there are no accurate quantitative imaging biomarkers that can be used to predict the future clinical diagnosis of a healthy subject, or to quantify the progression of symptoms over time. Besides, CJD is commonly mistaken for other forms of dementia. Due to the heterogeneity of phenotypes and the lack of a consistent geometrical pattern of disease progression, the approaches used to study other types of neurodegenerative diseases are not satisfactory to capture the progression of human form of prion disease. In this paper, using a tailored framework, we aim to classify and stratify patients with prion disease, according to the severity of their illness. The framework is initialised with the extraction of subject-specific imaging biomarkers. The extracted biomakers are then combined with genetic and demographic information within a Gaussian Process classifier, used to calculate the probability of a subject to be diagnosed with prion disease in the next year. We evaluate the effectiveness of the proposed method in a cohort of patients with inherited and sporadic forms of prion disease. The model has shown to be effective in the prediction of both inherited CJD (92% of accuracy) and sporadic CJD (95% of accuracy). However the model has shown to be less effective when used to stratify the different stages of the disease, in which the average accuracy is 85%, whilst the recall is 59%. Finally, our framework was extended as a differential diagnosis tool to identify both forms of CJD among another neurodegenerative disease. In summary we have developed a novel method for prion disease diagnosis and prediction of clinical onset using multiple sources of features, which may have use in other disorders with heterogeneous imaging features.
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Affiliation(s)
- Liane S Canas
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, London, SE1 7EH, United Kingdom.
| | - Carole H Sudre
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, London, SE1 7EH, United Kingdom; Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Enrico De Vita
- Institute of Neurology, University College London, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, London, SE1 7EH, United Kingdom
| | - Akin Nihat
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, London, United Kingdom; NHS National Prion Clinic, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Tze How Mok
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, London, United Kingdom; NHS National Prion Clinic, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Catherine F Slattery
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Alexander J M Foulkes
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Harpreet Hyare
- NHS National Prion Clinic, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - M Jorge Cardoso
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, London, SE1 7EH, United Kingdom
| | - John Thornton
- Institute of Neurology, University College London, United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Frederik Barkhof
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom; Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - John Collinge
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, London, United Kingdom; NHS National Prion Clinic, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Sébastien Ourselin
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, London, SE1 7EH, United Kingdom
| | - Simon Mead
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, London, United Kingdom; NHS National Prion Clinic, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Marc Modat
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, London, SE1 7EH, United Kingdom
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11
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den Haan J, Csinscik L, Parker T, Paterson RW, Slattery CF, Foulkes A, Bouwman FH, Verbraak FD, Scheltens P, Peto T, Lengyel I, Schott JM, Crutch SJ, Shakespeare TJ, Yong KXX. Retinal thickness as potential biomarker in posterior cortical atrophy and typical Alzheimer's disease. Alzheimers Res Ther 2019; 11:62. [PMID: 31319885 PMCID: PMC6639972 DOI: 10.1186/s13195-019-0516-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 07/08/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Retinal thickness can be measured non-invasively with optical coherence tomography (OCT) and may offer compelling potential as a biomarker for Alzheimer's disease (AD). Retinal thinning is hypothesized to be a result of retrograde atrophy and/or parallel neurodegenerative processes. Changes in the visual pathway are of particular interest in posterior cortical atrophy (PCA), the most common atypical AD phenotype predominantly affecting the parietal-occipital cortices. We therefore evaluated retinal thickness as non-invasive biomarker of neurodegeneration in well-characterized participants with posterior cortical atrophy (PCA) and typical Alzheimer's disease (tAD). METHODS Retinal thickness measures were acquired from 48 patient participants (N = 25 PCA; N = 23 tAD) fulfilling consensus diagnostic criteria and 70 age-matched controls. Participants were recruited between 2014 and 2016. All participants underwent optical coherence tomography (OCT) imaging, including measurement of peripapillary retinal nerve fiber layer (pRNFL) thickness and total macular thickness (mRT). Participants did not show evidence of any significant ophthalmological conditions. Subgroup analyses were performed in participants with available MRI and CSF measures, providing evidence of neurodegeneration and underlying AD pathology respectively. RESULTS There was no evidence of overall between-group differences in pRNFL thickness (mean PCA 98.7 ± 12.2; tAD 99.9 ± 8.7; controls 99.6 ± 10.0 μm, one-way analysis of variance (ANOVA) p = 0.92) or total mRT (mean PCA 266.9 ± 16.3; tAD 267.8 ± 13.6; controls 269.3 ± 13.6 μm, one-way ANOVA p = 0.75). Similarly, subgroup analysis with MRI biomarkers (PCA = 18, tAD = 17, controls = 31) showing neurodegeneration, and CSF biomarkers (PCA = 18, tAD = 14, controls = 13) supporting underlying AD pathology did not provide evidence of overall between-group differences in pRNFL or mRT measures (all p > 0.3). CONCLUSIONS Retinal thickness did not discriminate tAD and PCA from controls or from one another despite unequivocal differences on standard clinical, neuro-imaging and CSF measures. Findings from this well-characterized sample, including cases with PCA, do not support the hypothesis that retinal neurodegeneration, measured using conventional OCT, is a useful biomarker for AD or PCA.
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Affiliation(s)
- Jurre den Haan
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Mailbox 7057, 1007 MB Amsterdam, The Netherlands
| | - Lajos Csinscik
- Centre for Experimental Medicine, Queen’s University, Belfast, UK
- Institute of Ophthalmology UCL, London, UK
| | - Tom Parker
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Ross W. Paterson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | | | - Alexander Foulkes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Femke H. Bouwman
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Mailbox 7057, 1007 MB Amsterdam, The Netherlands
| | - Frank D. Verbraak
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Mailbox 7057, 1007 MB Amsterdam, The Netherlands
| | - Tunde Peto
- Centre for Experimental Medicine, Queen’s University, Belfast, UK
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL, London, UK
| | - Imre Lengyel
- Centre for Experimental Medicine, Queen’s University, Belfast, UK
- Institute of Ophthalmology UCL, London, UK
| | - Jonathan M. Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | | | - Keir X. X. Yong
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
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12
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Firth NC, Primativo S, Marinescu RV, Shakespeare TJ, Suarez-Gonzalez A, Lehmann M, Carton A, Ocal D, Pavisic I, Paterson RW, Slattery CF, Foulkes AJM, Ridha BH, Gil-Néciga E, Oxtoby NP, Young AL, Modat M, Cardoso MJ, Ourselin S, Ryan NS, Miller BL, Rabinovici GD, Warrington EK, Rossor MN, Fox NC, Warren JD, Alexander DC, Schott JM, Yong KXX, Crutch SJ. Longitudinal neuroanatomical and cognitive progression of posterior cortical atrophy. Brain 2019; 142:2082-2095. [PMID: 31219516 PMCID: PMC6598737 DOI: 10.1093/brain/awz136] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/28/2019] [Accepted: 03/24/2019] [Indexed: 01/27/2023] Open
Abstract
Posterior cortical atrophy is a clinico-radiological syndrome characterized by progressive decline in visual processing and atrophy of posterior brain regions. With the majority of cases attributable to Alzheimer's disease and recent evidence for genetic risk factors specifically related to posterior cortical atrophy, the syndrome can provide important insights into selective vulnerability and phenotypic diversity. The present study describes the first major longitudinal investigation of posterior cortical atrophy disease progression. Three hundred and sixty-one individuals (117 posterior cortical atrophy, 106 typical Alzheimer's disease, 138 controls) fulfilling consensus criteria for posterior cortical atrophy-pure and typical Alzheimer's disease were recruited from three centres in the UK, Spain and USA. Participants underwent up to six annual assessments involving MRI scans and neuropsychological testing. We constructed longitudinal trajectories of regional brain volumes within posterior cortical atrophy and typical Alzheimer's disease using differential equation models. We compared and contrasted the order in which regional brain volumes become abnormal within posterior cortical atrophy and typical Alzheimer's disease using event-based models. We also examined trajectories of cognitive decline and the order in which different cognitive tests show abnormality using the same models. Temporally aligned trajectories for eight regions of interest revealed distinct (P < 0.002) patterns of progression in posterior cortical atrophy and typical Alzheimer's disease. Patients with posterior cortical atrophy showed early occipital and parietal atrophy, with subsequent higher rates of temporal atrophy and ventricular expansion leading to tissue loss of comparable extent later. Hippocampal, entorhinal and frontal regions underwent a lower rate of change and never approached the extent of posterior cortical involvement. Patients with typical Alzheimer's disease showed early hippocampal atrophy, with subsequent higher rates of temporal atrophy and ventricular expansion. Cognitive models showed tests sensitive to visuospatial dysfunction declined earlier in posterior cortical atrophy than typical Alzheimer's disease whilst tests sensitive to working memory impairment declined earlier in typical Alzheimer's disease than posterior cortical atrophy. These findings indicate that posterior cortical atrophy and typical Alzheimer's disease have distinct sites of onset and different profiles of spatial and temporal progression. The ordering of disease events both motivates investigation of biological factors underpinning phenotypic heterogeneity, and informs the selection of measures for clinical trials in posterior cortical atrophy.
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Affiliation(s)
- Nicholas C Firth
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, Gower Street, London, UK
| | - Silvia Primativo
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
- Department of Human Science, LUMSA University, Via della Traspontina, 21, Rome, Italy
| | - Razvan-Valentin Marinescu
- Centre for Medical Image Computing, Department of Computer Science, University College London, Gower Street, London, UK
| | - Timothy J Shakespeare
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Aida Suarez-Gonzalez
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
- Department of Neurology, University Hospital Virgen del Rocio, Seville, Spain
| | - Manja Lehmann
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Amelia Carton
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Dilek Ocal
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Ivanna Pavisic
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Ross W Paterson
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Alexander J M Foulkes
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Basil H Ridha
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Eulogio Gil-Néciga
- Department of Neurology, University Hospital Virgen del Rocio, Seville, Spain
| | - Neil P Oxtoby
- Centre for Medical Image Computing, Department of Computer Science, University College London, Gower Street, London, UK
| | - Alexandra L Young
- Centre for Medical Image Computing, Department of Computer Science, University College London, Gower Street, London, UK
| | - Marc Modat
- School of Biomedical Engineering and Imaging Sciences, King's College London, UK
| | - M Jorge Cardoso
- School of Biomedical Engineering and Imaging Sciences, King's College London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King's College London, UK
| | - Natalie S Ryan
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Bruce L Miller
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Gil D Rabinovici
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Elizabeth K Warrington
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Martin N Rossor
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Nick C Fox
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Jason D Warren
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Daniel C Alexander
- Centre for Medical Image Computing, Department of Computer Science, University College London, Gower Street, London, UK
| | - Jonathan M Schott
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Keir X X Yong
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, Institute of Neurology, University College London, 8–11 Queen Square, London, UK
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13
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Slattery CF, Agustus JL, Paterson RW, McCallion O, Foulkes AJM, Macpherson K, Carton AM, Harding E, Golden HL, Jaisin K, Mummery CJ, Schott JM, Warren JD. The functional neuroanatomy of musical memory in Alzheimer's disease. Cortex 2019; 115:357-370. [PMID: 30846199 PMCID: PMC6525150 DOI: 10.1016/j.cortex.2019.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 12/06/2018] [Accepted: 02/01/2019] [Indexed: 12/20/2022]
Abstract
Background Memory for music has attracted much recent interest in Alzheimer's disease but the underlying brain mechanisms have not been defined in patients directly. Here we addressed this issue in an Alzheimer's disease cohort using activation fMRI of two core musical memory systems. Methods We studied 34 patients with younger onset Alzheimer's disease led either by episodic memory decline (typical Alzheimer's disease) or by visuospatial impairment (posterior cortical atrophy) in relation to 19 age-matched healthy individuals. We designed a novel fMRI paradigm based on passive listening to melodies that were either previously familiar or unfamiliar (musical semantic memory) and either presented singly or repeated (incidental musical episodic memory). Results Both syndromic groups showed significant functional neuroanatomical alterations relative to the healthy control group. For musical semantic memory, disease-associated activation group differences were localised to right inferior frontal cortex (reduced activation in the group with memory-led Alzheimer's disease); while for incidental musical episodic memory, disease-associated activation group differences were localised to precuneus and posterior cingulate cortex (abnormally enhanced activation in the syndromic groups). In post-scan behavioural testing, both patient groups had a deficit of musical episodic memory relative to healthy controls whereas musical semantic memory was unimpaired. Conclusions Our findings define functional neuroanatomical substrates for the differential involvement of musical semantic and incidental episodic memory in major phenotypes of Alzheimer's disease. The complex dynamic profile of brain activation group differences observed suggests that musical memory may be an informative probe of neural network function in Alzheimer's disease. These findings may guide the development of future musical interventions in dementia.
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Affiliation(s)
- Catherine F Slattery
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Jennifer L Agustus
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Ross W Paterson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Oliver McCallion
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Alexander J M Foulkes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Kirsty Macpherson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Amelia M Carton
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Emma Harding
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Hannah L Golden
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Kankamol Jaisin
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Catherine J Mummery
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Jason D Warren
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
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14
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Parker TD, Slattery CF, Yong KXX, Nicholas JM, Paterson RW, Foulkes AJM, Malone IB, Thomas DL, Cash DM, Crutch SJ, Fox NC, Schott JM. Differences in hippocampal subfield volume are seen in phenotypic variants of early onset Alzheimer's disease. Neuroimage Clin 2018; 21:101632. [PMID: 30558867 PMCID: PMC6411912 DOI: 10.1016/j.nicl.2018.101632] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 12/05/2018] [Accepted: 12/08/2018] [Indexed: 11/02/2022]
Abstract
The most common presentation of early onset Alzheimer's disease (EOAD - defined as symptom onset <65 years) is with progressive episodic memory impairment - amnestic or typical Alzheimer's disease (tAD). However, EOAD is notable for its phenotypic heterogeneity, with posterior cortical atrophy (PCA) - characterised by prominent higher-order visual processing deficits and relative sparing of episodic memory - the second most common canonical phenotype. The hippocampus, which comprises a number of interconnected anatomically and functionally distinct subfields, is centrally involved in Alzheimer's disease and is a crucial mediator of episodic memory. The extent to which volumes of individual hippocampal subfields differ between different phenotypes in EOAD is unclear. The aim of this analysis was to investigate the hypothesis that patients with a PCA phenotype will exhibit differences in specific hippocampal subfield volumes compared to tAD. We studied 63 participants with volumetric T1-weighted MRI performed on the same 3T scanner: 39 EOAD patients [27 with tAD and 12 with PCA] and 24 age-matched controls. Volumetric estimates of the following hippocampal subfields for each participant were obtained using Freesurfer version 6.0: CA1, CA2/3, CA4, presubiculum, subiculum, hippocampal tail, parasubiculum, the molecular and granule cell layers of the dentate gryus (GCMLDG), the molecular layer, and the hippocampal amygdala transition area (HATA). Linear regression analyses comparing mean hippocampal subfield volumes between groups, adjusting for age, sex and head size, were performed. Using a Bonferonni-corrected p-value of p < 0.0025, compared to controls, tAD was associated with atrophy in all hippocampal regions, except the parasubiculum. In PCA patients compared to controls, the strongest evidence for volume loss was in the left presubiclum, right subiculum, right GCMLDG, right molecular layer and the right HATA. Compared to PCA, patients with tAD had strong evidence for smaller volumes in left CA1 and left hippocampal tail. In conclusion, these data provide evidence that hippocampal subfield volumes differ in different phenotypes of EOAD.
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Affiliation(s)
- Thomas D Parker
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, UCL, London, UK.
| | - Catherine F Slattery
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, UCL, London, UK
| | - Keir X X Yong
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, UCL, London, UK
| | - Jennifer M Nicholas
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, UCL, London, UK; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Ross W Paterson
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, UCL, London, UK
| | - Alexander J M Foulkes
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, UCL, London, UK
| | - Ian B Malone
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, UCL, London, UK
| | - David L Thomas
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre, UCL Institute of Neurology, London, UK
| | - David M Cash
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, UCL, London, UK
| | - Sebastian J Crutch
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, UCL, London, UK
| | - Nick C Fox
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, UCL, London, UK
| | - Jonathan M Schott
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, UCL, London, UK
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15
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Drews A, De S, Flagmeier P, Wirthensohn DC, Chen WH, Whiten DR, Rodrigues M, Vincke C, Muyldermans S, Paterson RW, Slattery CF, Fox NC, Schott JM, Zetterberg H, Dobson CM, Gandhi S, Klenerman D. Inhibiting the Ca 2+ Influx Induced by Human CSF. Cell Rep 2018; 21:3310-3316. [PMID: 29241555 PMCID: PMC5745229 DOI: 10.1016/j.celrep.2017.11.057] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/28/2017] [Accepted: 11/15/2017] [Indexed: 11/25/2022] Open
Abstract
One potential therapeutic strategy for Alzheimer’s disease (AD) is to use antibodies that bind to small soluble protein aggregates to reduce their toxic effects. However, these therapies are rarely tested in human CSF before clinical trials because of the lack of sensitive methods that enable the measurement of aggregate-induced toxicity at low concentrations. We have developed highly sensitive single vesicle and single-cell-based assays that detect the Ca2+ influx caused by the CSF of individuals affected with AD and healthy controls, and we have found comparable effects for both types of samples. We also show that an extracellular chaperone clusterin; a nanobody specific to the amyloid-β peptide (Aβ); and bapineuzumab, a humanized monoclonal antibody raised against Aβ, could all reduce the Ca2+ influx caused by synthetic Aβ oligomers but are less effective in CSF. These assays could be used to characterize potential therapeutic agents in CSF before clinical trials. Human cerebrospinal fluid (CSF) can permeabilize membranes and induce Ca2+ influx CSF of control individuals and those with Alzheimer’s disease show similar Ca2+ influx An extracellular chaperone clusterin and a nanobody Nb3 can inhibit Ca2+ influx Bapineuzumab reduces Aβ-aggregate-induced Ca2+ influx but is less effective in CSF
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Affiliation(s)
- Anna Drews
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - Suman De
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - Patrick Flagmeier
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - David C Wirthensohn
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - Wei-Hsin Chen
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - Daniel R Whiten
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - Margarida Rodrigues
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - Cécile Vincke
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Serge Muyldermans
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Jonathan M Schott
- Dementia Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden; Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Christopher M Dobson
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - Sonia Gandhi
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - David Klenerman
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK; UK Dementia Research Institute, University of Cambridge, Cambridge CB2 0XY, UK.
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16
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Keuss SE, Slattery CF, Parker TD, Nicholas JM, Paterson RW, Foulkes AJ, Malone IB, Thomas DL, Modat M, Cash DM, Crutch SJ, Yong K, Ourselin S, Fox NC, Schott JM. P3‐437: LONGITUDINAL CORTICAL THICKNESS IN SPORADIC YOUNG ONSET ALZHEIMER'S DISEASE. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.1800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Sarah E. Keuss
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | | | - Thomas D. Parker
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | | | - Ross W. Paterson
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | | | - Ian B. Malone
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | - David L. Thomas
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | - Marc Modat
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | - David M. Cash
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | | | - Keir Yong
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | | | - Nick C. Fox
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
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17
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Parker TD, Slattery CF, Zhang J, Nicholas JM, Paterson RW, Foulkes AJM, Keuss SE, Malone IB, Thomas DL, Modat M, Cash DM, Crutch SJ, Yong K, Alexander DC, Ourselin S, Fox NC, Zhang H, Schott JM. P1‐474: SURFACE‐BASED ANALYSIS OF CORTICAL GREY MATTER MICROSTRUCTURE IN YOUNG‐ONSET ALZHEIMER'S DISEASE USING NEURITE ORIENTATION DISPERSION AND DENSITY IMAGING (NODDI). Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Thomas D. Parker
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | | | - Jiaying Zhang
- Department of Computer Science and Centre for Medical Image ComputingUCLLondonUnited Kingdom
| | - Jennifer M. Nicholas
- Department of Medical StatisticsLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
| | - Ross W. Paterson
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | | | - Sarah E. Keuss
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | - Ian B. Malone
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | - David L. Thomas
- Brain Repair & RehabilitationUCL Institute of NeurologyLondonUnited Kingdom
| | - Marc Modat
- Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUCLLondonUnited Kingdom
| | - David M. Cash
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | | | - Keir Yong
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | - Daniel C. Alexander
- Centre for Medical Image Computing, Department of Computer ScienceUniversity College LondonLondonUnited Kingdom
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUCLLondonUnited Kingdom
| | - Nick C. Fox
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | - Hui Zhang
- Department of Computer Science and Centre for Medical Image ComputingUCLLondonUnited Kingdom
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18
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Parker TD, Slattery CF, Nicholas JM, Paterson RW, Foulkes AJM, Malone IB, Thomas DL, Modat M, Cash DM, Crutch SJ, Yong K, Ourselin S, Fox NC, Schott JM. P2‐390: DIFFERENTIAL HIPPOCAMPAL SUBFIELD LOSS IN DIFFERENT PHENOTYPES OF YOUNG ONSET ALZHEIMER'S DISEASE. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.1081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Thomas D. Parker
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | | | | | - Ross W. Paterson
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | | | - Ian B. Malone
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | - David L. Thomas
- Brain Repair & RehabilitationUCL Institute of NeurologyLondonUnited Kingdom
| | - Marc Modat
- Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUnited Kingdom
| | - David M. Cash
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | | | - Keir Yong
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUnited Kingdom
| | - Nick C. Fox
- Dementia Research CentreUCL Institute of NeurologyLondonUnited Kingdom
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19
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Yong KXX, McCarthy ID, Poole T, Suzuki T, Yang B, Carton AM, Holloway C, Papadosifos N, Boampong D, Langham J, Slattery CF, Paterson RW, Foulkes AJM, Schott JM, Frost C, Tyler N, Crutch SJ. Navigational cue effects in Alzheimer's disease and posterior cortical atrophy. Ann Clin Transl Neurol 2018; 5:697-709. [PMID: 29928653 PMCID: PMC5989777 DOI: 10.1002/acn3.566] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/01/2018] [Accepted: 03/19/2018] [Indexed: 12/18/2022] Open
Abstract
Objective Deficits in spatial navigation are characteristic and disabling features of typical Alzheimer's disease (tAD) and posterior cortical atrophy (PCA). Visual cues have been proposed to mitigate such deficits; however, there is currently little empirical evidence for their use. Methods The effect of visual cues on visually guided navigation was assessed within a simplified real-world setting in individuals with tAD (n = 10), PCA (n = 8), and healthy controls (n = 12). In a repeated-measures design comprising 36 trials, participants walked to a visible target destination (an open door within a built environment), with or without the presence of an obstacle. Contrast and motion-based cues were evaluated; both aimed to facilitate performance by applying perceptual changes to target destinations without carrying explicit information. The primary outcome was completion time; secondary outcomes were measures of fixation position and walking path directness during consecutive task phases, determined using mobile eyetracking and motion capture methods. Results Results illustrate marked deficits in patients' navigational ability, with patient groups taking an estimated two to three times longer to reach target destinations than controls and exhibiting tortuous walking paths. There were no significant differences between tAD and PCA task performance. Overall, patients took less time to reach target destinations under cue conditions (contrast-cue: 11.8%; 95% CI: [2.5, 20.3]) and were more likely initially to fixate on targets. Interpretation The study evaluated navigation to destinations within a real-world environment. There is evidence that introducing perceptual changes to the environment may improve patients' navigational ability.
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Affiliation(s)
- Keir X X Yong
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom
| | - Ian D McCarthy
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom
| | - Teresa Poole
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom.,Department of Medical Statistics Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London United Kingdom
| | - Tatsuto Suzuki
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom
| | - Biao Yang
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom.,School of Architecture and Urban Planning Harbin Institute of Technology Shenzhen Graduate School Shenzhen China
| | - Amelia M Carton
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom.,Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Catherine Holloway
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom.,Department of Computer Science Faculty of Engineering Science University College London London United Kingdom
| | - Nikolaos Papadosifos
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom
| | - Derrick Boampong
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom
| | - Julia Langham
- Department of Medical Statistics Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London United Kingdom
| | - Catherine F Slattery
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom
| | - Ross W Paterson
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom
| | - Alexander J M Foulkes
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom
| | - Chris Frost
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom.,Department of Medical Statistics Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London United Kingdom
| | - Nick Tyler
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom
| | - Sebastian J Crutch
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom
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20
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Parker TD, Slattery CF, Zhang J, Nicholas JM, Paterson RW, Foulkes AJM, Malone IB, Thomas DL, Modat M, Cash DM, Crutch SJ, Alexander DC, Ourselin S, Fox NC, Zhang H, Schott JM. Cortical microstructure in young onset Alzheimer's disease using neurite orientation dispersion and density imaging. Hum Brain Mapp 2018; 39:3005-3017. [PMID: 29575324 PMCID: PMC6055830 DOI: 10.1002/hbm.24056] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/20/2018] [Accepted: 03/13/2018] [Indexed: 11/06/2022] Open
Abstract
Alzheimer's disease (AD) is associated with extensive alterations in grey matter microstructure, but our ability to quantify this in vivo is limited. Neurite orientation dispersion and density imaging (NODDI) is a multi-shell diffusion MRI technique that estimates neuritic microstructure in the form of orientation dispersion and neurite density indices (ODI/NDI). Mean values for cortical thickness, ODI, and NDI were extracted from predefined regions of interest in the cortical grey matter of 38 patients with young onset AD and 22 healthy controls. Five cortical regions associated with early atrophy in AD (entorhinal cortex, inferior temporal gyrus, middle temporal gyrus, fusiform gyrus, and precuneus) and one region relatively spared from atrophy in AD (precentral gyrus) were investigated. ODI, NDI, and cortical thickness values were compared between controls and patients for each region, and their associations with MMSE score were assessed. NDI values of all regions were significantly lower in patients. Cortical thickness measurements were significantly lower in patients in regions associated with early atrophy in AD, but not in the precentral gyrus. Decreased ODI was evident in patients in the inferior and middle temporal gyri, fusiform gyrus, and precuneus. The majority of AD-related decreases in cortical ODI and NDI persisted following adjustment for cortical thickness, as well as each other. There was evidence in the patient group that cortical NDI was associated with MMSE performance. These data suggest distinct differences in cortical NDI and ODI occur in AD and these metrics provide pathologically relevant information beyond that of cortical thinning.
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Affiliation(s)
- Thomas D Parker
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, United Kingdom
| | - Catherine F Slattery
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, United Kingdom
| | - Jiaying Zhang
- Department of Computer Science and Centre for Medical Image Computing, UCL, London, United Kingdom
| | - Jennifer M Nicholas
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, United Kingdom.,Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ross W Paterson
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, United Kingdom
| | - Alexander J M Foulkes
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, United Kingdom
| | - Ian B Malone
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, United Kingdom
| | - David L Thomas
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, United Kingdom.,Leonard Wolfson Experimental Neurology Centre, UCL Institute of Neurology, London, United Kingdom
| | - Marc Modat
- Translational Imaging Group, Centre for Medical Image Computing, UCL, London, United Kingdom
| | - David M Cash
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, United Kingdom.,Translational Imaging Group, Centre for Medical Image Computing, UCL, London, United Kingdom
| | - Sebastian J Crutch
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, United Kingdom
| | - Daniel C Alexander
- Department of Computer Science and Centre for Medical Image Computing, UCL, London, United Kingdom
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing, UCL, London, United Kingdom
| | - Nick C Fox
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, United Kingdom
| | - Hui Zhang
- Department of Computer Science and Centre for Medical Image Computing, UCL, London, United Kingdom
| | - Jonathan M Schott
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, United Kingdom
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21
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Paterson RW, Slattery CF, Poole T, Nicholas JM, Magdalinou NK, Toombs J, Chapman MD, Lunn MP, Heslegrave AJ, Foiani MS, Weston PSJ, Keshavan A, Rohrer JD, Rossor MN, Warren JD, Mummery CJ, Blennow K, Fox NC, Zetterberg H, Schott JM. Cerebrospinal fluid in the differential diagnosis of Alzheimer's disease: clinical utility of an extended panel of biomarkers in a specialist cognitive clinic. Alzheimers Res Ther 2018; 10:32. [PMID: 29558979 PMCID: PMC5861624 DOI: 10.1186/s13195-018-0361-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 02/22/2018] [Indexed: 01/08/2023]
Abstract
Background Cerebrospinal fluid (CSF) biomarkers are increasingly being used to support a diagnosis of Alzheimer’s disease (AD). Their clinical utility for differentiating AD from non-AD neurodegenerative dementias, such as dementia with Lewy bodies (DLB) or frontotemporal dementia (FTD), is less well established. We aimed to determine the diagnostic utility of an extended panel of CSF biomarkers to differentiate AD from a range of other neurodegenerative dementias. Methods We used immunoassays to measure conventional CSF markers of amyloid and tau pathology (amyloid beta (Aβ)1–42, total tau (T-tau), and phosphorylated tau (P-tau)) as well as amyloid processing (AβX-38, AβX-40, AβX-42, soluble amyloid precursor protein (sAPP)α, and sAPPβ), large fibre axonal degeneration (neurofilament light chain (NFL)), and neuroinflammation (YKL-40) in 245 patients with a variety of dementias and 30 controls. Patients fulfilled consensus criteria for AD (n = 156), DLB (n = 20), behavioural variant frontotemporal dementia (bvFTD; n = 45), progressive non-fluent aphasia (PNFA; n = 17), and semantic dementia (SD; n = 7); approximately 10% were pathology/genetically confirmed (n = 26). Global tests based on generalised least squares regression were used to determine differences between groups. Non-parametric receiver operating characteristic (ROC) curves and area under the curve (AUC) analyses were used to quantify how well each biomarker discriminated AD from each of the other diagnostic groups (or combinations of groups). CSF cut-points for the major biomarkers found to have diagnostic utility were validated using an independent cohort which included causes of AD (n = 104), DLB (n = 5), bvFTD (n = 12), PNFA (n = 3), SD (n = 9), and controls (n = 10). Results There were significant global differences in Aβ1–42, T-tau, T-tau/Aβ1–42 ratio, P-tau-181, NFL, AβX-42, AβX-42/X-40 ratio, APPα, and APPβ between groups. At a fixed sensitivity of 85%, AβX-42/X-40 could differentiate AD from controls, bvFTD, and SD with specificities of 93%, 85%, and 100%, respectively; for T-tau/Aβ1–42 these specificities were 83%, 70%, and 86%. AβX-42/X-40 had similar or higher specificity than Aβ1–42. No biomarker or ratio could differentiate AD from DLB or PNFA with specificity > 50%. Similar sensitivities and specificities were found in the independent validation cohort for differentiating AD and other dementias and in a pathology/genetically confirmed sub-cohort. Conclusions CSF AβX-42/X-40 and T-tau/Aβ1–42 ratios have utility in distinguishing AD from controls, bvFTD, and SD. None of the biomarkers tested had good specificity at distinguishing AD from DLB or PNFA. Electronic supplementary material The online version of this article (10.1186/s13195-018-0361-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Teresa Poole
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.,Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.,Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Jamie Toombs
- Department of Molecular Neuroscience, Institute of Neurology, UCL, London, UK
| | - Miles D Chapman
- Department of Neuroimmunology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Michael P Lunn
- Department of Neuroimmunology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Amanda J Heslegrave
- Department of Molecular Neuroscience, Institute of Neurology, UCL, London, UK
| | - Martha S Foiani
- Department of Molecular Neuroscience, Institute of Neurology, UCL, London, UK
| | - Philip S J Weston
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Ashvini Keshavan
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Martin N Rossor
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Catherine J Mummery
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Henrik Zetterberg
- Department of Molecular Neuroscience, Institute of Neurology, UCL, London, UK.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jonathan M Schott
- Dementia Research Centre, UCL Institute of Neurology, 8-11 Queen Square, London, WC1N 3BG, UK.
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22
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Clark CN, Golden HL, McCallion O, Nicholas JM, Cohen MH, Slattery CF, Paterson RW, Fletcher PD, Mummery CJ, Rohrer JD, Crutch SJ, Warren JD. Music models aberrant rule decoding and reward valuation in dementia. Soc Cogn Affect Neurosci 2018; 13:192-202. [PMID: 29186630 PMCID: PMC5827340 DOI: 10.1093/scan/nsx140] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 11/06/2017] [Accepted: 11/19/2017] [Indexed: 01/03/2023] Open
Abstract
Aberrant rule- and reward-based processes underpin abnormalities of socio-emotional behaviour in major dementias. However, these processes remain poorly characterized. Here we used music to probe rule decoding and reward valuation in patients with frontotemporal dementia (FTD) syndromes and Alzheimer's disease (AD) relative to healthy age-matched individuals. We created short melodies that were either harmonically resolved ('finished') or unresolved ('unfinished'); the task was to classify each melody as finished or unfinished (rule processing) and rate its subjective pleasantness (reward valuation). Results were adjusted for elementary pitch and executive processing; neuroanatomical correlates were assessed using voxel-based morphometry. Relative to healthy older controls, patients with behavioural variant FTD showed impairments of both musical rule decoding and reward valuation, while patients with semantic dementia showed impaired reward valuation but intact rule decoding, patients with AD showed impaired rule decoding but intact reward valuation and patients with progressive non-fluent aphasia performed comparably to healthy controls. Grey matter associations with task performance were identified in anterior temporal, medial and lateral orbitofrontal cortices, previously implicated in computing diverse biological and non-biological rules and rewards. The processing of musical rules and reward distils cognitive and neuroanatomical mechanisms relevant to complex socio-emotional dysfunction in major dementias.
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Affiliation(s)
- Camilla N Clark
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Hannah L Golden
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Oliver McCallion
- Oxford University Clinical Academic Graduate School, University of Oxford, Oxford, UK
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
- London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Miriam H Cohen
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Phillip D Fletcher
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Catherine J Mummery
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
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23
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Wellington H, Paterson RW, Suárez‐González A, Poole T, Frost C, Sjöbom U, Slattery CF, Magdalinou NK, Lehmann M, Portelius E, Fox NC, Blennow K, Zetterberg H, Schott JM. CSF neurogranin or tau distinguish typical and atypical Alzheimer disease. Ann Clin Transl Neurol 2018; 5:162-171. [PMID: 29468177 PMCID: PMC5817822 DOI: 10.1002/acn3.518] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/15/2017] [Accepted: 11/24/2017] [Indexed: 12/13/2022] Open
Abstract
Objective To assess whether high levels of cerebrospinal fluid neurogranin are found in atypical as well as typical Alzheimer's disease. Methods Immunoassays were used to measure cerebrospinal fluid neurogranin in 114 participants including healthy controls (n = 27), biomarker-proven amnestic Alzheimer's disease (n = 68), and the atypical visual variant of Alzheimer's (n = 19) according to international criteria. CSF total-tau, Aβ42, and neurofilament light concentrations were investigated using commercially available assays. All affected individuals had T1-weighted volumetric MR images available for analysis of whole and regional brain volumes. Associations between neurogranin, brain volumes, total-tau, Aβ42, and neurofilament light were assessed. Results Median cerebrospinal fluid neurogranin concentrations were higher in typical and atypical Alzheimer's compared to controls (P < 0.001 and P = 0.005). Both neurogranin and total-tau concentrations, but not neurofilament light and Aβ42, were higher in typical Alzheimer's compared to atypical patients (P = 0.004 and P = 0.03). There were significant differences in the left hippocampus and right and left superior parietal lobules in atypical patients, which were larger (P = 0.03) and smaller (P = 0.001 and P < 0.001), respectively, compared to typical patients. We found no evidence of associations between neurogranin and brain volumes but a strong association with total-tau (P < 0.001) and a weaker association with neurofilament light (P = 0.005). Interpretation These results show significant differences in neurogranin and total-tau between typical and atypical patients, which may relate to factors other than disease topography. The differential relationships between neurogranin, total-tau and neurofilament light in the Alzheimer's variants, provide evidence for mechanistically distinct and coupled markers of neurodegeneration.
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Affiliation(s)
| | - Ross W. Paterson
- Dementia Research CentreInstitute of Neurology, Queen Square, UCLLondonUK
| | | | - Teresa Poole
- Dementia Research CentreInstitute of Neurology, Queen Square, UCLLondonUK
- Faculty of Epidemiology and Population HealthDepartment of Medical StatisticsLondon School of Hygiene and Tropical MedicineLondonUK
| | - Chris Frost
- Dementia Research CentreInstitute of Neurology, Queen Square, UCLLondonUK
- Faculty of Epidemiology and Population HealthDepartment of Medical StatisticsLondon School of Hygiene and Tropical MedicineLondonUK
| | - Ulrika Sjöbom
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | | | | | - Manja Lehmann
- Dementia Research CentreInstitute of Neurology, Queen Square, UCLLondonUK
| | - Eric Portelius
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
| | - Nick C. Fox
- Dementia Research CentreInstitute of Neurology, Queen Square, UCLLondonUK
- UK Dementia Research Institute at UCLLondonUK
| | - Kaj Blennow
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
| | - Henrik Zetterberg
- Department of Molecular NeuroscienceInstitute of Neurology, UCLLondonUK
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- UK Dementia Research Institute at UCLLondonUK
| | - Jonathan M. Schott
- Dementia Research CentreInstitute of Neurology, Queen Square, UCLLondonUK
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24
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Pavisic IM, Firth NC, Parsons S, Rego DM, Shakespeare TJ, Yong KXX, Slattery CF, Paterson RW, Foulkes AJM, Macpherson K, Carton AM, Alexander DC, Shawe-Taylor J, Fox NC, Schott JM, Crutch SJ, Primativo S. Eyetracking Metrics in Young Onset Alzheimer's Disease: A Window into Cognitive Visual Functions. Front Neurol 2017; 8:377. [PMID: 28824534 PMCID: PMC5545969 DOI: 10.3389/fneur.2017.00377] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/17/2017] [Indexed: 12/19/2022] Open
Abstract
Young onset Alzheimer's disease (YOAD) is defined as symptom onset before the age of 65 years and is particularly associated with phenotypic heterogeneity. Atypical presentations, such as the clinic-radiological visual syndrome posterior cortical atrophy (PCA), often lead to delays in accurate diagnosis. Eyetracking has been used to demonstrate basic oculomotor impairments in individuals with dementia. In the present study, we aim to explore the relationship between eyetracking metrics and standard tests of visual cognition in individuals with YOAD. Fifty-seven participants were included: 36 individuals with YOAD (n = 26 typical AD; n = 10 PCA) and 21 age-matched healthy controls. Participants completed three eyetracking experiments: fixation, pro-saccade, and smooth pursuit tasks. Summary metrics were used as outcome measures and their predictive value explored looking at correlations with visuoperceptual and visuospatial metrics. Significant correlations between eyetracking metrics and standard visual cognitive estimates are reported. A machine-learning approach using a classification method based on the smooth pursuit raw eyetracking data discriminates with approximately 95% accuracy patients and controls in cross-validation tests. Results suggest that the eyetracking paradigms of a relatively simple and specific nature provide measures not only reflecting basic oculomotor characteristics but also predicting higher order visuospatial and visuoperceptual impairments. Eyetracking measures can represent extremely useful markers during the diagnostic phase and may be exploited as potential outcome measures for clinical trials.
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Affiliation(s)
- Ivanna M. Pavisic
- Dementia Research Centre, Department of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
| | - Nicholas C. Firth
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - Samuel Parsons
- Centre for Computational Statistics and Machine Learning, Faculty of Engineering Science, Department of Computer Science, University College London, London, United Kingdom
| | - David Martinez Rego
- Centre for Computational Statistics and Machine Learning, Faculty of Engineering Science, Department of Computer Science, University College London, London, United Kingdom
| | - Timothy J. Shakespeare
- Dementia Research Centre, Department of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
| | - Keir X. X. Yong
- Dementia Research Centre, Department of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
| | - Catherine F. Slattery
- Dementia Research Centre, Department of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
| | - Ross W. Paterson
- Dementia Research Centre, Department of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
| | - Alexander J. M. Foulkes
- Dementia Research Centre, Department of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
| | - Kirsty Macpherson
- Dementia Research Centre, Department of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
| | - Amelia M. Carton
- Dementia Research Centre, Department of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
| | - Daniel C. Alexander
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - John Shawe-Taylor
- Centre for Computational Statistics and Machine Learning, Faculty of Engineering Science, Department of Computer Science, University College London, London, United Kingdom
| | - Nick C. Fox
- Dementia Research Centre, Department of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
| | - Jonathan M. Schott
- Dementia Research Centre, Department of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
| | - Sebastian J. Crutch
- Dementia Research Centre, Department of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
| | - Silvia Primativo
- Dementia Research Centre, Department of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
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25
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Pavisic IM, Primativo S, Firth NC, Shakespeare TJ, Yong K, Slattery CF, Paterson RW, Foulkes AJ, Macpherson K, Carton AM, Alexander DC, Parsons S, Rego DM, Schott JM, Crutch SJ, Fox NC. [P4–289]: CAN EYETRACKING METRICS RELATE TO PERFORMANCE ON VISUAL COGNITIVE TESTS OF INDIVIDUALS WITH YOUNG‐ONSET ALZHEIMER's DISEASE? Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ivanna M. Pavisic
- University College London, Institute of NeurologyLondonUnited Kingdom
| | - Silvia Primativo
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Nicholas C. Firth
- University College London, Institute of NeurologyLondonUnited Kingdom
| | - Timothy J. Shakespeare
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Keir Yong
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Catherine F. Slattery
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Ross W. Paterson
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Alexander J.M. Foulkes
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Kirsty Macpherson
- University College London, Institute of NeurologyLondonUnited Kingdom
| | - Amelia M. Carton
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Daniel C. Alexander
- Department of Computer Science and Centre for Medical Image ComputingUCLLondonUnited Kingdom
| | - Samuel Parsons
- University College London, Computer ScienceLondonUnited Kingdom
| | | | - Jon M. Schott
- University College London, Institute of NeurologyLondonUnited Kingdom
| | - Sebastian J. Crutch
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Nick C. Fox
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
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26
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Slattery CF, Zhang J, Paterson RW, Foulkes AJM, Mancini L, Thomas DL, Modat M, Toussaint N, Cash DM, Thornton JS, Alexander DC, Ourselin S, Fox NC, Zhang H, Schott JM. [IC‐P‐168]: LONGITUDINAL NEURITE ORIENTATION DISPERSION AND DENSITY IMAGING IN YOUNG‐ONSET ALZHEIMER'S DISEASE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Catherine F. Slattery
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Jiaying Zhang
- Department of Computer Science and Centre for Medical Image ComputingUCLLondonUnited Kingdom
| | - Ross W. Paterson
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Alexander JM. Foulkes
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Laura Mancini
- Neuroradiological Academic Unit, Department of Brain Repair and RehabilitationUCL Institute of NeurologyLondonUnited Kingdom
| | - David L. Thomas
- Neuroradiological Academic Unit, Department of Brain Repair and RehabilitationUCL Institute of NeurologyLondonUnited Kingdom
| | - Marc Modat
- Translational Imaging Group, Centre for Medical Image ComputingDepartment of Medical Physics and Biomedical EngineeringUCLLondonUnited Kingdom
| | - Nicolas Toussaint
- Translational Imaging Group, Centre for Medical Image ComputingDepartment of Medical Physics and Biomedical EngineeringUCLLondonUnited Kingdom
| | - David M. Cash
- Translational Imaging Group, Centre for Medical Image ComputingDepartment of Medical Physics and Biomedical EngineeringUCLLondonUnited Kingdom
| | - John S. Thornton
- Neuroradiological Academic Unit, Department of Brain Repair and RehabilitationUCL Institute of NeurologyLondonUnited Kingdom
| | - Daniel C. Alexander
- Department of Computer Science and Centre for Medical Image ComputingUCLLondonUnited Kingdom
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image ComputingDepartment of Medical Physics and Biomedical EngineeringUCLLondonUnited Kingdom
| | - Nick C. Fox
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Hui Zhang
- Department of Computer Science and Centre for Medical Image ComputingUCLLondonUnited Kingdom
| | - Jonathan M. Schott
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
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27
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Hardy CJ, Marshall CR, Bocchetta M, Harding S, Russell LL, Agustus JL, Bond RL, Brotherhood EV, Carton AM, Clark CN, Cohen MH, Dick KM, Foulkes AJM, Koriath C, Gordon E, Paterson RW, Slattery CF, Woollacott IOC, Mead S, Mummery CJ, Rossor MN, Schott JM, Fox NC, Crutch SJ, Rohrer JD, Warren JD. [P1–335]: THEMES AND VARIATIONS IN PPA: A CLINICAL AND NEUROBIOLOGICAL ANALYSIS OF THE UCL COHORT. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Chris J.D. Hardy
- Institute of Neurology, University College LondonLondonUnited Kingdom
| | - Charles R. Marshall
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Martina Bocchetta
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Sophie Harding
- Institute of Neurology, University College LondonLondonUnited Kingdom
| | - Lucy L. Russell
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | | | - Rebecca L. Bond
- Institute of Neurology, University College LondonLondonUnited Kingdom
| | | | - Amelia M. Carton
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Camilla N. Clark
- Institute of Neurology, University College LondonLondonUnited Kingdom
| | - Miriam H. Cohen
- Institute of Neurology, University College LondonLondonUnited Kingdom
| | - Katrina M. Dick
- Institute of Neurology, University College LondonLondonUnited Kingdom
| | - Alexander JM. Foulkes
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Carolin Koriath
- Institute of Neurology, University College LondonLondonUnited Kingdom
| | - Elizabeth Gordon
- Institute of Neurology, University College LondonLondonUnited Kingdom
| | - Ross W. Paterson
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Catherine F. Slattery
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Ione OC. Woollacott
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Simon Mead
- Institute of Neurology, University College LondonLondonUnited Kingdom
| | | | - Martin N. Rossor
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Jonathan M. Schott
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Nick C. Fox
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Sebastian J. Crutch
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Jonathan D. Rohrer
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Jason D. Warren
- Institute of Neurology, University College LondonLondonUnited Kingdom
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28
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Primativo S, Marinescu RV, Firth NC, Yong K, Shakespeare TJ, Gonzalez AS, Carton AM, Lehmann M, Slattery CF, Paterson RW, Foulkes AJ, Ryan NS, Warrington EK, Fox NC, Alexander DC, Schott JM, Crutch SJ. [P4–261]: LONGITUDINAL EVALUATION OF NEUROPSYCHOLOGICAL AND NEUROIMAGING PROGRESSION IN POSTERIOR CORTICAL ATROPHY. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Silvia Primativo
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | | | - Nicholas C. Firth
- Department of Computer Science and Centre for Medical Image ComputingUCLLondonUnited Kingdom
| | - Keir Yong
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Timothy J. Shakespeare
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Aida Suarez Gonzalez
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Amelia M. Carton
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Manja Lehmann
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Catherine F. Slattery
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Ross W. Paterson
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Alexander J.M. Foulkes
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Natalie S. Ryan
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Elizabeth K. Warrington
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Nick C. Fox
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Daniel C. Alexander
- Department of Computer Science and Centre for Medical Image ComputingUCLLondonUnited Kingdom
| | - Jonathan M. Schott
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Sebastian J. Crutch
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
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Slattery CF, Zhang J, Paterson RW, Foulkes AJM, Carton A, Macpherson K, Mancini L, Thomas DL, Modat M, Toussaint N, Cash DM, Thornton JS, Henley SMD, Crutch SJ, Alexander DC, Ourselin S, Fox NC, Zhang H, Schott JM. ApoE influences regional white-matter axonal density loss in Alzheimer's disease. Neurobiol Aging 2017; 57:8-17. [PMID: 28578156 PMCID: PMC5538347 DOI: 10.1016/j.neurobiolaging.2017.04.021] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 04/14/2017] [Accepted: 04/22/2017] [Indexed: 01/10/2023]
Abstract
Mechanisms underlying phenotypic heterogeneity in young onset Alzheimer disease (YOAD) are poorly understood. We used diffusion tensor imaging and neurite orientation dispersion and density imaging (NODDI) with tract-based spatial statistics to investigate apolipoprotein (APOE) ε4 modulation of white-matter damage in 37 patients with YOAD (22, 59% APOE ε4 positive) and 23 age-matched controls. Correlation between neurite density index (NDI) and neuropsychological performance was assessed in 4 white-matter regions of interest. White-matter disruption was more widespread in ε4+ individuals but more focal (posterior predominant) in the absence of an ε4 allele. NODDI metrics indicate fractional anisotropy changes are underpinned by combinations of axonal loss and morphological change. Regional NDI in parieto-occipital white matter correlated with visual object and spatial perception battery performance (right and left, both p = 0.02), and performance (nonverbal) intelligence (WASI matrices, right, p = 0.04). NODDI provides tissue-specific microstructural metrics of white-matter tract damage in YOAD, including NDI which correlates with focal cognitive deficits, and APOEε4 status is associated with different patterns of white-matter neurodegeneration.
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Affiliation(s)
- Catherine F Slattery
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, UK.
| | - Jiaying Zhang
- Department of Computer Science and Centre for Medical Image Computing, UCL, London, UK
| | - Ross W Paterson
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, UK
| | | | - Amelia Carton
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, UK
| | - Kirsty Macpherson
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, UK
| | - Laura Mancini
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, UK
| | - David L Thomas
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK; Leonard Wolfson Experimental Neurology Centre, UCL Institute of Neurology, London, UK
| | - Marc Modat
- Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, UCL, London, UK
| | - Nicolas Toussaint
- Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, UCL, London, UK
| | - David M Cash
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, UK; Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, UCL, London, UK
| | - John S Thornton
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, UK
| | - Susie M D Henley
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, UK
| | - Sebastian J Crutch
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, UK
| | - Daniel C Alexander
- Department of Computer Science and Centre for Medical Image Computing, UCL, London, UK
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, UCL, London, UK
| | - Nick C Fox
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, UK
| | - Hui Zhang
- Department of Computer Science and Centre for Medical Image Computing, UCL, London, UK
| | - Jonathan M Schott
- Department of Neurodegenerative Disease, Institute of Neurology, UCL, London, UK
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30
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Golden HL, Clark CN, Nicholas JM, Cohen MH, Slattery CF, Paterson RW, Foulkes AJM, Schott JM, Mummery CJ, Crutch SJ, Warren JD. Music Perception in Dementia. J Alzheimers Dis 2017; 55:933-949. [PMID: 27802226 PMCID: PMC5260961 DOI: 10.3233/jad-160359] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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] [Indexed: 01/04/2023]
Abstract
Despite much recent interest in music and dementia, music perception has not been widely studied across dementia syndromes using an information processing approach. Here we addressed this issue in a cohort of 30 patients representing major dementia syndromes of typical Alzheimer's disease (AD, n = 16), logopenic aphasia (LPA, an Alzheimer variant syndrome; n = 5), and progressive nonfluent aphasia (PNFA; n = 9) in relation to 19 healthy age-matched individuals. We designed a novel neuropsychological battery to assess perception of musical patterns in the dimensions of pitch and temporal information (requiring detection of notes that deviated from the established pattern based on local or global sequence features) and musical scene analysis (requiring detection of a familiar tune within polyphonic harmony). Performance on these tests was referenced to generic auditory (timbral) deviance detection and recognition of familiar tunes and adjusted for general auditory working memory performance. Relative to healthy controls, patients with AD and LPA had group-level deficits of global pitch (melody contour) processing while patients with PNFA as a group had deficits of local (interval) as well as global pitch processing. There was substantial individual variation within syndromic groups. Taking working memory performance into account, no specific deficits of musical temporal processing, timbre processing, musical scene analysis, or tune recognition were identified. The findings suggest that particular aspects of music perception such as pitch pattern analysis may open a window on the processing of information streams in major dementia syndromes. The potential selectivity of musical deficits for particular dementia syndromes and particular dimensions of processing warrants further systematic investigation.
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Affiliation(s)
- Hannah L Golden
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Camilla N Clark
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Miriam H Cohen
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Catherine F Slattery
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Alexander J M Foulkes
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Catherine J Mummery
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Sebastian J Crutch
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
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31
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Paterson RW, Heywood WE, Heslegrave AJ, Magdalinou NK, Andreasson U, Sirka E, Bliss E, Slattery CF, Toombs J, Svensson J, Johansson P, Fox NC, Zetterberg H, Mills K, Schott JM. A targeted proteomic multiplex CSF assay identifies increased malate dehydrogenase and other neurodegenerative biomarkers in individuals with Alzheimer's disease pathology. Transl Psychiatry 2016; 6:e952. [PMID: 27845782 PMCID: PMC5314115 DOI: 10.1038/tp.2016.194] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/31/2016] [Indexed: 12/12/2022] Open
Abstract
Alzheimer's disease (AD) is the most common cause of dementia. Biomarkers are required to identify individuals in the preclinical phase, explain phenotypic diversity, measure progression and estimate prognosis. The development of assays to validate candidate biomarkers is costly and time-consuming. Targeted proteomics is an attractive means of quantifying novel proteins in cerebrospinal and other fluids, and has potential to help overcome this bottleneck in biomarker development. We used a previously validated multiplexed 10-min, targeted proteomic assay to assess 54 candidate cerebrospinal fluid (CSF) biomarkers in two independent cohorts comprising individuals with neurodegenerative dementias and healthy controls. Individuals were classified as 'AD' or 'non-AD' on the basis of their CSF T-tau and amyloid Aβ1-42 profile measured using enzyme-linked immunosorbent assay; biomarkers of interest were compared using univariate and multivariate analyses. In all, 35/31 individuals in Cohort 1 and 46/36 in Cohort 2 fulfilled criteria for AD/non-AD profile CSF, respectively. After adjustment for multiple comparisons, five proteins were elevated significantly in AD CSF compared with non-AD CSF in both cohorts: malate dehydrogenase; total APOE; chitinase-3-like protein 1 (YKL-40); osteopontin and cystatin C. In an independent multivariate orthogonal projection to latent structures discriminant analysis (OPLS-DA), these proteins were also identified as major contributors to the separation between AD and non-AD in both cohorts. Independent of CSF Aβ1-42 and tau, a combination of these biomarkers differentiated AD and non-AD with an area under curve (AUC)=0.88. This targeted proteomic multiple reaction monitoring (MRM)-based assay can simultaneously and rapidly measure multiple candidate CSF biomarkers. Applying this technique to AD we demonstrate differences in proteins involved in glucose metabolism and neuroinflammation that collectively have potential clinical diagnostic utility.
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Affiliation(s)
- R W Paterson
- Dementia Research Centre, Institute of Neurology, University College London, London, UK,Department of Neurodegeneration, University College London, Dementia Research Centre, Queen Square, London WC1N3BG, UK. E-mail:
| | - W E Heywood
- Centre for Translational Omics, Genetics and Genomic Medicine Programme, Institute of Child Health, University College London, London, UK
| | - A J Heslegrave
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - N K Magdalinou
- Lila Weston Institute, University College London Institute of Neurology, London, UK
| | - U Andreasson
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - E Sirka
- Centre for Translational Omics, Genetics and Genomic Medicine Programme, Institute of Child Health, University College London, London, UK
| | - E Bliss
- Centre for Translational Omics, Genetics and Genomic Medicine Programme, Institute of Child Health, University College London, London, UK
| | - C F Slattery
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - J Toombs
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - J Svensson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Endocrinology, Skaraborg Central Hospital, Skövde, Sweden
| | - P Johansson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Neuropsychiatry, Skaraborg Central Hospital, Falköping, Sweden
| | - N C Fox
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - H Zetterberg
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK,Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - K Mills
- Dementia Research Centre, Institute of Neurology, University College London, London, UK,Centre for Translational Omics, Genetics and Genomic Medicine Programme, Institute of Child Health, University College London, London, UK
| | - J M Schott
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
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32
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Clark CN, Nicholas JM, Gordon E, Golden HL, Cohen MH, Woodward FJ, Macpherson K, Slattery CF, Mummery CJ, Schott JM, Rohrer JD, Warren JD. Altered sense of humor in dementia. J Alzheimers Dis 2016; 49:111-9. [PMID: 26444779 PMCID: PMC4820649 DOI: 10.3233/jad-150413] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sense of humor is potentially relevant to social functioning in dementias, but has been little studied in these diseases. We designed a semi-structured informant questionnaire to assess humor behavior and preferences in patients with behavioral variant frontotemporal dementia (bvFTD; n = 15), semantic dementia (SD; n = 7), progressive nonfluent aphasia (PNFA; n = 10), and Alzheimer’s disease (AD; n = 16) versus healthy age-matched individuals (n = 21). Altered (including frankly inappropriate) humor responses were significantly more frequent in bvFTD and SD (all patients) than PNFA or AD (around 40% of patients). All patient groups liked satirical and absurdist comedy significantly less than did healthy controls. This pattern was reported premorbidly for satirical comedy in bvFTD, PNFA, and AD. Liking for slapstick comedy did not differ between groups. Altered sense of humor is particularly salient in bvFTD and SD, but also frequent in AD and PNFA. Humor may be a sensitive probe of social cognitive impairment in dementia, with diagnostic, biomarker and social implications.
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Affiliation(s)
- Camilla N Clark
- Dementia Research Centre, UCL Institute of Neurology, University College London, UK
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Institute of Neurology, University College London, UK.,London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Elizabeth Gordon
- Dementia Research Centre, UCL Institute of Neurology, University College London, UK
| | - Hannah L Golden
- Dementia Research Centre, UCL Institute of Neurology, University College London, UK
| | - Miriam H Cohen
- Dementia Research Centre, UCL Institute of Neurology, University College London, UK
| | - Felix J Woodward
- Dementia Research Centre, UCL Institute of Neurology, University College London, UK
| | - Kirsty Macpherson
- Dementia Research Centre, UCL Institute of Neurology, University College London, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Institute of Neurology, University College London, UK
| | - Catherine J Mummery
- Dementia Research Centre, UCL Institute of Neurology, University College London, UK
| | - Jonathan M Schott
- Dementia Research Centre, UCL Institute of Neurology, University College London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Institute of Neurology, University College London, UK
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London, UK
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33
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Bocchetta M, Gordon E, Marshall CR, Slattery CF, Cardoso MJ, Cash DM, Espak M, Modat M, Ourselin S, Frisoni GB, Schott JM, Warren JD, Rohrer JD. The habenula: an under-recognised area of importance in frontotemporal dementia? J Neurol Neurosurg Psychiatry 2016; 87:910-2. [PMID: 26567261 PMCID: PMC4975822 DOI: 10.1136/jnnp-2015-312067] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 09/30/2015] [Accepted: 10/23/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Martina Bocchetta
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio—Fatebenefratelli, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Elizabeth Gordon
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Charles R Marshall
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Catherine F Slattery
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - M Jorge Cardoso
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, London, UK
| | - David M Cash
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, London, UK
| | - Miklos Espak
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, London, UK
| | - Marc Modat
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, London, UK
| | - Sebastien Ourselin
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, London, UK
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio—Fatebenefratelli, Brescia, Italy
- Memory Clinic and Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Jonathan M Schott
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Jason D Warren
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Jonathan D Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
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34
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Foulkes AJ, Slattery CF, Paterson RW, Modat M, Callaghan MF, Weiskopf N, Schott JM, Fox NC. IC‐P‐161: Phenotypic Differences in Quantitative MRI Parameters in Typical Amnestic Alzheimer’s Disease and PCA in a Young‐Onset Alzheimer’s Cohort. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | - Marc Modat
- University College LondonLondonUnited Kingdom
| | | | - Nikolaus Weiskopf
- University College LondonLondonUnited Kingdom
- Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
| | | | - Nick C. Fox
- UCL Institute of NeurologyLondonUnited Kingdom
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35
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Suárez-González A, Lehmann M, Shakespeare TJ, Yong KXX, Paterson RW, Slattery CF, Foulkes AJM, Rabinovici GD, Gil-Néciga E, Roldán-Lora F, Schott JM, Fox NC, Crutch SJ. Effect of age at onset on cortical thickness and cognition in posterior cortical atrophy. Neurobiol Aging 2016; 44:108-113. [PMID: 27318138 PMCID: PMC4926954 DOI: 10.1016/j.neurobiolaging.2016.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 03/30/2016] [Accepted: 04/16/2016] [Indexed: 11/16/2022]
Abstract
Age at onset (AAO) has been shown to influence the phenotype of Alzheimer's disease (AD), but how it affects atypical presentations of AD remains unknown. Posterior cortical atrophy (PCA) is the most common form of atypical AD. In this study, we aimed to investigate the effect of AAO on cortical thickness and cognitive function in 98 PCA patients. We used Freesurfer (v5.3.0) to compare cortical thickness with AAO both as a continuous variable, and by dichotomizing the groups based on median age (58 years). In both the continuous and dichotomized analyses, we found a pattern suggestive of thinner cortex in precuneus and parietal areas in earlier-onset PCA, and lower cortical thickness in anterior cingulate and prefrontal cortex in later-onset PCA. These cortical thickness differences between PCA subgroups were consistent with earlier-onset PCA patients performing worse on cognitive tests involving parietal functions. Our results provide a suggestion that AAO may not only affect the clinico-anatomical characteristics in AD but may also affect atrophy patterns and cognition within atypical AD phenotypes.
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Affiliation(s)
- Aida Suárez-González
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK; Department of Neurology, University Hospital Virgen del Rocio, Seville, Spain.
| | - Manja Lehmann
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK; Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Timothy J Shakespeare
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Keir X X Yong
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Ross W Paterson
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Alexander J M Foulkes
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Gil D Rabinovici
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Eulogio Gil-Néciga
- Department of Neurology, University Hospital Virgen del Rocio, Seville, Spain
| | | | - Jonathan M Schott
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
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36
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Bond RL, Downey LE, Weston PSJ, Slattery CF, Clark CN, Macpherson K, Mummery CJ, Warren JD. Processing of Self versus Non-Self in Alzheimer's Disease. Front Hum Neurosci 2016; 10:97. [PMID: 27014028 PMCID: PMC4781858 DOI: 10.3389/fnhum.2016.00097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 02/22/2016] [Indexed: 11/29/2022] Open
Abstract
Despite considerable evidence for abnormalities of self-awareness in Alzheimer’s disease (AD), the cognitive mechanisms of altered self-processing in AD have not been fully defined. Here we addressed this issue in a detailed analysis of self/non-self-processing in three patients with AD. We designed a novel neuropsychological battery comprising tests of tactile body schema coding, attribution of tactile events to self versus external agents, and memory for self- versus non-self-generated vocal information, administered in conjunction with a daily life measure of self/non-self-processing (the Interpersonal Reactivity Index). Three male AD patients (aged 54–68 years; one with a pathogenic mutation in the Presenilin 1 gene, one with a pathogenic mutation in the Amyloid Precursor Protein gene, and one with a CSF protein profile supporting underlying AD pathology) were studied in relation to a group of eight healthy older male individuals (aged 58–74 years). Compared to healthy controls, all patients had relatively intact tactile body schema processing. In contrast, all patients showed impaired memory for words previously presented using the patient’s own voice whereas memory for words presented in other voices was less consistently affected. Two patients showed increased levels of emotional contagion and reduced perspective taking on the Interpersonal Reactivity Index. Our findings suggest that AD may be associated with deficient self/non-self differentiation over time despite a relatively intact body image: this profile of altered self-processing contrasts with the deficit of tactile body schema previously described in frontotemporal dementia associated with C9orf72 mutations. We present these findings as a preliminary rationale to direct future systematic study in larger patient cohorts.
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Affiliation(s)
- Rebecca L Bond
- Dementia Research Centre, UCL Institute of Neurology, University College London London, UK
| | - Laura E Downey
- Dementia Research Centre, UCL Institute of Neurology, University College London London, UK
| | - Philip S J Weston
- Dementia Research Centre, UCL Institute of Neurology, University College London London, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Institute of Neurology, University College London London, UK
| | - Camilla N Clark
- Dementia Research Centre, UCL Institute of Neurology, University College London London, UK
| | - Kirsty Macpherson
- Dementia Research Centre, UCL Institute of Neurology, University College London London, UK
| | - Catherine J Mummery
- Dementia Research Centre, UCL Institute of Neurology, University College London London, UK
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London London, UK
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37
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Affiliation(s)
| | | | | | | | - Nick C Fox
- From UCL Institute of Neurology, London, UK
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38
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Slattery CF, Schott JM. Picturing the torment of cluster headache. Neurology 2015; 85:1430-1. [PMID: 26481929 DOI: 10.1212/wnl.0000000000002042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Catherine F Slattery
- From the Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.
| | - Jonathan M Schott
- From the Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
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39
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Fletcher PD, Downey LE, Golden HL, Clark CN, Slattery CF, Paterson RW, Rohrer JD, Schott JM, Rossor MN, Warren JD. Pain and temperature processing in dementia: a clinical and neuroanatomical analysis. Brain 2015; 138:3360-72. [PMID: 26463677 PMCID: PMC4620514 DOI: 10.1093/brain/awv276] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 07/28/2015] [Indexed: 12/12/2022] Open
Abstract
Symptoms suggesting altered pain and temperature processing have been described in dementia diseases. Using a semi-structured caregiver questionnaire and MRI voxel-based morphometry in patients with frontotemporal degeneration or Alzheimer’s disease, Fletcher et al. show that these symptoms are underpinned by atrophy in a distributed thalamo-temporo-insular network implicated in somatosensory processing. Symptoms suggesting altered processing of pain and temperature have been described in dementia diseases and may contribute importantly to clinical phenotypes, particularly in the frontotemporal lobar degeneration spectrum, but the basis for these symptoms has not been characterized in detail. Here we analysed pain and temperature symptoms using a semi-structured caregiver questionnaire recording altered behavioural responsiveness to pain or temperature for a cohort of patients with frontotemporal lobar degeneration (n = 58, 25 female, aged 52–84 years, representing the major clinical syndromes and representative pathogenic mutations in the C9orf72 and MAPT genes) and a comparison cohort of patients with amnestic Alzheimer’s disease (n = 20, eight female, aged 53–74 years). Neuroanatomical associations were assessed using blinded visual rating and voxel-based morphometry of patients’ brain magnetic resonance images. Certain syndromic signatures were identified: pain and temperature symptoms were particularly prevalent in behavioural variant frontotemporal dementia (71% of cases) and semantic dementia (65% of cases) and in association with C9orf72 mutations (6/6 cases), but also developed in Alzheimer’s disease (45% of cases) and progressive non-fluent aphasia (25% of cases). While altered temperature responsiveness was more common than altered pain responsiveness across syndromes, blunted responsiveness to pain and temperature was particularly associated with behavioural variant frontotemporal dementia (40% of symptomatic cases) and heightened responsiveness with semantic dementia (73% of symptomatic cases) and Alzheimer’s disease (78% of symptomatic cases). In the voxel-based morphometry analysis of the frontotemporal lobar degeneration cohort, pain and temperature symptoms were associated with grey matter loss in a right-lateralized network including insula (P < 0.05 corrected for multiple voxel-wise comparisons within the prespecified anatomical region of interest) and anterior temporal cortex (P < 0.001 uncorrected over whole brain) previously implicated in processing homeostatic signals. Pain and temperature symptoms accompanying C9orf72 mutations were specifically associated with posterior thalamic atrophy (P < 0.05 corrected for multiple voxel-wise comparisons within the prespecified anatomical region of interest). Together the findings suggest candidate cognitive and neuroanatomical bases for these salient but under-appreciated phenotypic features of the dementias, with wider implications for the homeostatic pathophysiology and clinical management of neurodegenerative diseases.
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Affiliation(s)
- Phillip D Fletcher
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Laura E Downey
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Hannah L Golden
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Camilla N Clark
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jonathan M Schott
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Martin N Rossor
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
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Paterson RW, Toombs J, Slattery CF, Nicholas JM, Andreasson U, Magdalinou NK, Blennow K, Warren JD, Mummery CJ, Rossor MN, Lunn MP, Crutch SJ, Fox NC, Zetterberg H, Schott JM. Dissecting IWG-2 typical and atypical Alzheimer's disease: insights from cerebrospinal fluid analysis. J Neurol 2015; 262:2722-30. [PMID: 26410752 DOI: 10.1007/s00415-015-7904-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/10/2015] [Accepted: 09/11/2015] [Indexed: 10/23/2022]
Abstract
Pathobiological factors underlying phenotypic diversity in Alzheimer's disease (AD) are incompletely understood. We used an extended cerebrospinal fluid (CSF) panel to explore differences between "typical" with "atypical" AD and between amnestic, posterior cortical atrophy, logopenic aphasia and frontal variants. We included 97 subjects fulfilling International Working Group-2 research criteria for AD of whom 61 had "typical" AD and 36 "atypical" syndromes, and 30 controls. CSF biomarkers included total tau (T-tau), phosphorylated tau (P-tau), amyloid β1-42, amyloid βX-38/40/42, YKL-40, neurofilament light (NFL), and amyloid precursor proteins α and β. The typical and atypical groups were matched for age, sex, severity and rate of cognitive decline and had similar biomarker profiles, with the exception of NFL which was higher in the atypical group (p = 0.03). Sub-classifying the atypical group into its constituent clinical syndromes, posterior cortical atrophy was associated with the lowest T-tau [604.4 (436.8-675.8) pg/mL], P-tau (79.8 ± 21.8 pg/L), T-tau/Aβ1-42 ratio [2.3 (1.4-2.6)], AβX-40/X-42 ratio (22.1 ± 5.8) and rate of cognitive decline [1.9 (0.75-4.25) MMSE points/year]. Conversely, the frontal variant group had the highest levels of T-tau [1185.4 (591.7-1329.3) pg/mL], P-tau (116.4 ± 45.4 pg/L), T-tau/Aβ1-42 ratio [5.2 (3.3-6.9)] and AβX-40/X-42 ratio (27.9 ± 7.5), and rate of cognitive decline. Whilst on a group level IWG-2 "typical" and "atypical" AD share similar CSF profiles, which are very different from controls, atypical AD is a heterogeneous entity with evidence for subtle differences in amyloid processing and neurodegeneration between different clinical syndromes. These findings also have practical implications for the interpretation of clinical CSF biomarker results.
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Affiliation(s)
- Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, London, UK.
| | - Jamie Toombs
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | | | - Jennifer M Nicholas
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Ulf Andreasson
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | | | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Cath J Mummery
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Martin N Rossor
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Michael P Lunn
- Department of Clinical Neuroimmunology, National Hospital for Neurology and Neurosurgery, London, UK
| | | | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Henrik Zetterberg
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jonathan M Schott
- Dementia Research Centre, UCL Institute of Neurology, London, UK. .,Box 16 National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK.
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Paterson RW, Toombs J, Chapman MD, Nicholas JM, Heslegrave AJ, Slattery CF, Foulkes AJM, Clark CN, Lane CAS, Weston PSJ, Lunn MP, Fox NC, Zetterberg H, Schott JM. Do cerebrospinal fluid transfer methods affect measured amyloid β42, total tau, and phosphorylated tau in clinical practice? Alzheimers Dement (Amst) 2015; 1:380-4. [PMID: 27239518 PMCID: PMC4877931 DOI: 10.1016/j.dadm.2015.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction Cerebrospinal fluid (CSF) neurodegenerative markers are measured clinically to support a diagnosis of Alzheimer's disease. Several preanalytical factors may alter the CSF concentrations of amyloid β 1–42 (Aβ1–42) in particular with the potential to influence diagnosis. We aimed to determine whether routine handling of samples alters measured biomarker concentration compared with that of prompt delivery to the laboratory. Methods Forty individuals with suspected neurodegenerative diseases underwent diagnostic lumbar punctures using a standardized technique. A sample of each patient's CSF was sent to the laboratory by four different delivery methods: (1) by courier at room temperature; (2) by courier, on ice; (3) using standard hospital portering; and (4) after quarantining for >24 hours. Aβ1–42, total tau (t-tau), and phosphorylated tau (p-tau) levels measured using standard enzyme-linked immunosorbent assay techniques were compared between transfer methods. Results There were no significant differences in Aβ1–42, t-tau, or p-tau concentrations measured in samples transported via the different delivery methods despite significant differences in time taken to deliver samples. Discussion When CSF is collected in appropriate tubes, transferred at room temperature, and processed within 24 hours, neurodegenerative markers can be reliably determined.
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Affiliation(s)
- Ross W Paterson
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Jamie Toombs
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Miles D Chapman
- Department of Clinical Neuroimmunology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Jennifer M Nicholas
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Amanda J Heslegrave
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Alexander J M Foulkes
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Camilla N Clark
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Christopher A S Lane
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Philip S J Weston
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Michael P Lunn
- Department of Clinical Neuroimmunology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Nick C Fox
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Henrik Zetterberg
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK; Department of Neurochemistry and Psychiatry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Jonathan M Schott
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
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Paterson RW, Toombs J, Slattery CF, Nicholas J, Blennow K, Andreasson U, Magdalinou NK, Warren JD, Mummery CJ, Rossor MN, Lunn M, Crutch SJ, Fox NC, Zetterberg H, Schott JM. O3‐14‐01: Dissecting IWG‐2 typical and atypical Alzheimer's disease: Insights from cerebrospinal fluid analysis. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.07.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | | | | | - Ulf Andreasson
- The Sahlgrenska Academy, Institute of Neuroscience and PhysiologyUniversity of GothenburgGothenburgSweden
| | | | | | | | | | | | | | - Nick C. Fox
- UCL Institute of NeurologyLondonUnited Kingdom
| | - Henrik Zetterberg
- University of GothenburgGothenburgSweden
- UCL Institute of NeurologyLondonUnited Kingdom
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Slattery CF, Zhang J, Paterson RW, Foulkes AJ, Mancini L, Thomas DL, Modat M, Toussaint N, Cash DM, Thornton JS, Alexander DC, Ourselin S, Fox NC, Zhang H, Schott JM. IC‐P‐134: Neurite orientation dispersion and density imaging (NODDI) in young‐onset Alzheimer's disease and its syndromic variants. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | | | | | | | | | | | - Marc Modat
- University College LondonLondonUnited Kingdom
| | | | | | | | | | - Sebastien Ourselin
- Centre for Medical Image ComputingUniversity College LondonLondonUnited Kingdom
| | - Nick C. Fox
- UCL Institute of NeurologyLondonUnited Kingdom
| | - Hui Zhang
- University College LondonLondonUnited Kingdom
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44
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Slattery CF, Zhang J, Paterson RW, Foulkes AJ, Mancini L, Thomas DL, Modat M, Toussaint N, Cash DM, Thornton JS, Alexander DC, Ourselin S, Fox NC, Zhang H, Schott JM. O1‐02‐06: Neurite orientation dispersion and density imaging (NODDI) in young onset Alzheimer's disease and its syndromic variants. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | | | | | | | | | | | - Marc Modat
- University College LondonLondonUnited Kingdom
| | | | | | | | | | - Sebastien Ourselin
- Centre for Medical Image ComputingUniversity College LondonLondonUnited Kingdom
| | - Nick C. Fox
- UCL Institute of NeurologyLondonUnited Kingdom
| | - Hui Zhang
- University College LondonLondonUnited Kingdom
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45
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Slattery CF, Agustus JL, Paterson RW, White MJ, Foulkes AJ, Mancini L, Fox NC, Schott JM, Warren JD. IC‐P‐133: Music as a probe of default mode network function in young‐onset Alzheimer's disease. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | | | | | | | | | | | - Nick C. Fox
- UCL Institute of NeurologyLondonUnited Kingdom
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Shakespeare TJ, Kaski D, Yong KXX, Paterson RW, Slattery CF, Ryan NS, Schott JM, Crutch SJ. Abnormalities of fixation, saccade and pursuit in posterior cortical atrophy. Brain 2015; 138:1976-91. [PMID: 25895507 PMCID: PMC4572483 DOI: 10.1093/brain/awv103] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 02/17/2015] [Indexed: 12/13/2022] Open
Abstract
The clinico-neuroradiological syndrome posterior cortical atrophy is the cardinal 'visual dementia' and most common atypical Alzheimer's disease phenotype, offering insights into mechanisms underlying clinical heterogeneity, pathological propagation and basic visual phenomena (e.g. visual crowding). Given the extensive attention paid to patients' (higher order) perceptual function, it is surprising that there have been no systematic analyses of basic oculomotor function in this population. Here 20 patients with posterior cortical atrophy, 17 patients with typical Alzheimer's disease and 22 healthy controls completed tests of fixation, saccade (including fixation/target gap and overlap conditions) and smooth pursuit eye movements using an infrared pupil-tracking system. Participants underwent detailed neuropsychological and neurological examinations, with a proportion also undertaking brain imaging and analysis of molecular pathology. In contrast to informal clinical evaluations of oculomotor dysfunction frequency (previous studies: 38%, current clinical examination: 33%), detailed eyetracking investigations revealed eye movement abnormalities in 80% of patients with posterior cortical atrophy (compared to 17% typical Alzheimer's disease, 5% controls). The greatest differences between posterior cortical atrophy and typical Alzheimer's disease were seen in saccadic performance. Patients with posterior cortical atrophy made significantly shorter saccades especially for distant targets. They also exhibited a significant exacerbation of the normal gap/overlap effect, consistent with 'sticky fixation'. Time to reach saccadic targets was significantly associated with parietal and occipital cortical thickness measures. On fixation stability tasks, patients with typical Alzheimer's disease showed more square wave jerks whose frequency was associated with lower cerebellar grey matter volume, while patients with posterior cortical atrophy showed large saccadic intrusions whose frequency correlated significantly with generalized reductions in cortical thickness. Patients with both posterior cortical atrophy and typical Alzheimer's disease showed lower gain in smooth pursuit compared to controls. The current study establishes that eye movement abnormalities are near-ubiquitous in posterior cortical atrophy, and highlights multiple aspects of saccadic performance which distinguish posterior cortical atrophy from typical Alzheimer's disease. We suggest the posterior cortical atrophy oculomotor profile (e.g. exacerbation of the saccadic gap/overlap effect, preserved saccadic velocity) reflects weak input from degraded occipito-parietal spatial representations of stimulus location into a superior collicular spatial map for eye movement regulation. This may indicate greater impairment of identification of oculomotor targets rather than generation of oculomotor movements. The results highlight the critical role of spatial attention and object identification but also precise stimulus localization in explaining the complex real world perception deficits observed in posterior cortical atrophy and many other patients with dementia-related visual impairment.
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Affiliation(s)
- Timothy J Shakespeare
- 1 Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, London, UK
| | - Diego Kaski
- 2 Division of Brain Sciences, Imperial College London, Charing Cross Hospital, London UK
| | - Keir X X Yong
- 1 Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, London, UK
| | - Ross W Paterson
- 1 Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, London, UK
| | - Catherine F Slattery
- 1 Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, London, UK
| | - Natalie S Ryan
- 1 Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, London, UK
| | - Jonathan M Schott
- 1 Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, London, UK
| | - Sebastian J Crutch
- 1 Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, London, UK
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Fletcher PD, Downey LE, Golden HL, Clark CN, Slattery CF, Paterson RW, Schott JM, Rohrer JD, Rossor MN, Warren JD. Auditory hedonic phenotypes in dementia: A behavioural and neuroanatomical analysis. Cortex 2015; 67:95-105. [PMID: 25929717 PMCID: PMC4465962 DOI: 10.1016/j.cortex.2015.03.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 03/08/2015] [Accepted: 03/27/2015] [Indexed: 02/03/2023]
Abstract
Patients with dementia may exhibit abnormally altered liking for environmental sounds and music but such altered auditory hedonic responses have not been studied systematically. Here we addressed this issue in a cohort of 73 patients representing major canonical dementia syndromes (behavioural variant frontotemporal dementia (bvFTD), semantic dementia (SD), progressive nonfluent aphasia (PNFA) amnestic Alzheimer's disease (AD)) using a semi-structured caregiver behavioural questionnaire and voxel-based morphometry (VBM) of patients' brain MR images. Behavioural responses signalling abnormal aversion to environmental sounds, aversion to music or heightened pleasure in music (‘musicophilia’) occurred in around half of the cohort but showed clear syndromic and genetic segregation, occurring in most patients with bvFTD but infrequently in PNFA and more commonly in association with MAPT than C9orf72 mutations. Aversion to sounds was the exclusive auditory phenotype in AD whereas more complex phenotypes including musicophilia were common in bvFTD and SD. Auditory hedonic alterations correlated with grey matter loss in a common, distributed, right-lateralised network including antero-mesial temporal lobe, insula, anterior cingulate and nucleus accumbens. Our findings suggest that abnormalities of auditory hedonic processing are a significant issue in common dementias. Sounds may constitute a novel probe of brain mechanisms for emotional salience coding that are targeted by neurodegenerative disease.
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Affiliation(s)
- Phillip D Fletcher
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Laura E Downey
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Hannah L Golden
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Camilla N Clark
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Catherine F Slattery
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Martin N Rossor
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London, United Kingdom.
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Abstract
The preclinical phase of Alzheimer's disease (AD) occurs years, possibly decades, before the onset of clinical symptoms. Being able to detect the very earliest stages of AD is critical to improving understanding of AD biology, and identifying individuals at greatest risk of developing clinical symptoms with a view to treating AD pathophysiology before irreversible neurodegeneration occurs. Studies of dominantly inherited AD families and longitudinal studies of sporadic AD have contributed to knowledge of the earliest AD biomarkers. Here we appraise this evidence before reviewing novel, particularly fluid, biomarkers that may provide insights into AD pathogenesis and relate these to existing hypothetical disease models.
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Affiliation(s)
- Ross W Paterson
- Dementia Research Centre, Department of Neurodegeneration, UCL Institute of Neurology, London, UK,
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49
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Affiliation(s)
- C F Slattery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - S J Crutch
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - J M Schott
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
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50
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Slattery CF, Beck JA, Harper L, Adamson G, Abdi Z, Uphill J, Campbell T, Druyeh R, Mahoney CJ, Rohrer JD, Kenny J, Lowe J, Leung KK, Barnes J, Clegg SL, Blair M, Nicholas JM, Guerreiro RJ, Rowe JB, Ponto C, Zerr I, Kretzschmar H, Gambetti P, Crutch SJ, Warren JD, Rossor MN, Fox NC, Collinge J, Schott JM, Mead S. R47H TREM2 variant increases risk of typical early-onset Alzheimer's disease but not of prion or frontotemporal dementia. Alzheimers Dement 2014; 10:602-608.e4. [PMID: 25160042 DOI: 10.1016/j.jalz.2014.05.1751] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 03/19/2014] [Accepted: 05/26/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Rare TREM2 variants are significant risk factors for Alzheimer's disease (AD). METHODS We used next generation sequencing of the whole gene (n = 700), exon 2 Sanger sequencing (n = 2634), p.R47H genotyping (n = 3518), and genome wide association study imputation (n = 13,048) to determine whether TREM2 variants are risk factors or phenotypic modifiers in patients with AD (n = 1002), frontotemporal dementia (n = 358), sporadic (n = 2500), and variant (n = 115) Creutzfeldt-Jakob disease (CJD). RESULTS We confirm only p.R47H as a risk factor for AD (odds ratio or OR = 2.19; 95% confidence interval or CI = 1.04-4.51; P = .03). p.R47H does not significantly alter risk for frontotemporal dementia (OR = 0.81), variant or sporadic CJD (OR = 1.06 95%CI = 0.66-1.69) in our cohorts. Individuals with p.R47H associated AD (n = 12) had significantly earlier symptom onset than individuals with no TREM2 variants (n = 551) (55.2 years vs. 61.7 years, P = .02). We note that heterozygous p.R47H AD is memory led and otherwise indistinguishable from "typical" sporadic AD. CONCLUSION We find p.R47H is a risk factor for AD, but not frontotemporal dementia or prion disease.
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Affiliation(s)
- Catherine F Slattery
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Jonathan A Beck
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Lorna Harper
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Gary Adamson
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Zeinab Abdi
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - James Uphill
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Tracy Campbell
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Ron Druyeh
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Colin J Mahoney
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Jonathan D Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Janna Kenny
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Jessica Lowe
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Kelvin K Leung
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Josephine Barnes
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Shona L Clegg
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Melanie Blair
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Jennifer M Nicholas
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Rita J Guerreiro
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - James B Rowe
- Department of Clinical Neurosciences, Cambridge University, UK
| | - Claudia Ponto
- Department of Neurology, Clinical Dementia Center, Georg-August University Göttingen, Göttingen, Germany
| | - Inga Zerr
- Department of Neurology, Clinical Dementia Center, Georg-August University Göttingen, Göttingen, Germany
| | - Hans Kretzschmar
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Pierluigi Gambetti
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Sebastian J Crutch
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Jason D Warren
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Martin N Rossor
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Nick C Fox
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - John Collinge
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Jonathan M Schott
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Simon Mead
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK.
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