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Estevez-Fraga C, Elmalem MS, Papoutsi M, Durr A, Rees EM, Hobbs NZ, Roos RAC, Landwehrmeyer B, Leavitt BR, Langbehn DR, Scahill RI, Rees G, Tabrizi SJ, Gregory S. Progressive alterations in white matter microstructure across the timecourse of Huntington's disease. Brain Behav 2023; 13:e2940. [PMID: 36917716 PMCID: PMC10097137 DOI: 10.1002/brb3.2940] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/01/2023] [Accepted: 02/14/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Whole-brain longitudinal diffusion studies are crucial to examine changes in structural connectivity in neurodegeneration. Here, we investigated the longitudinal alterations in white matter (WM) microstructure across the timecourse of Huntington's disease (HD). METHODS We examined changes in WM microstructure from premanifest to early manifest disease, using data from two cohorts with different disease burden. The TrackOn-HD study included 67 controls, 67 premanifest, and 10 early manifest HD (baseline and 24-month data); the PADDINGTON study included 33 controls and 49 early manifest HD (baseline and 15-month data). Longitudinal changes in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity, and radial diffusivity from baseline to last study visit were investigated for each cohort using tract-based spatial statistics. An optimized pipeline was employed to generate participant-specific templates to which diffusion tensor imaging maps were registered and change maps were calculated. We examined longitudinal differences between HD expansion-carriers and controls, and correlations with clinical scores, including the composite UHDRS (cUHDRS). RESULTS HD expansion-carriers from TrackOn-HD, with lower disease burden, showed a significant longitudinal decline in FA in the left superior longitudinal fasciculus and an increase in MD across subcortical WM tracts compared to controls, while in manifest HD participants from PADDINGTON, there were significant widespread longitudinal increases in diffusivity compared to controls. Baseline scores in clinical scales including the cUHDRS predicted WM microstructural change in HD expansion-carriers. CONCLUSION The present study showed significant longitudinal changes in WM microstructure across the HD timecourse. Changes were evident in larger WM areas and across more metrics as the disease advanced, suggesting a progressive alteration of WM microstructure with disease evolution.
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Affiliation(s)
- Carlos Estevez-Fraga
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Michael S Elmalem
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Marina Papoutsi
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Alexandra Durr
- Sorbonne Université, Paris Brain Institute (ICM), AP-HP, Inserm, CNRS, Pitié-Salpêtrière University Hospital, Paris, France
| | | | - Nicola Z Hobbs
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Raymund A C Roos
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Blair R Leavitt
- Centre for Huntington's Disease at UBC Hospital, Department of Medical Genetics and Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Rachael I Scahill
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Geraint Rees
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah J Tabrizi
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah Gregory
- Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
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Gregory S, Cole JH, Farmer RE, Rees EM, Roos RA, Sprengelmeyer R, Durr A, Landwehrmeyer B, Zhang H, Scahill RI, Tabrizi SJ, Frost C, Hobbs NZ. Longitudinal Diffusion Tensor Imaging Shows Progressive Changes in White Matter in Huntington’s Disease. J Huntingtons Dis 2015; 4:333-46. [DOI: 10.3233/jhd-150173] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [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)
- Sarah Gregory
- Wellcome Trust Centre for Neuroimaging, UCL, London, WC1N 3BG, UK
| | - James H. Cole
- UCL Institute of Neurology, University College London, UK
- Computational, Cognitive & Clinical Neuroimaging Laboratory, Department of Medicine, Imperial College London, UK
| | - Ruth E. Farmer
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine London, UK
| | - Elin M. Rees
- UCL Institute of Neurology, University College London, UK
| | - Raymund A.C. Roos
- Department of Neurology, Leiden University Medical Centre, 2300RC Leiden, The Netherlands
| | | | - Alexandra Durr
- Department of Genetics and Cytogenetics, INSERM UMR S679, APHP Hôpital de la Salpêtrière, Paris, France
| | | | - Hui Zhang
- Centre for Medical Image Computing, University College London, UK
| | | | | | - Chris Frost
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine London, UK
| | - Nicola Z. Hobbs
- UCL Institute of Neurology, University College London, UK
- IXICO Plc., London, UK
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Johnson EB, Rees EM, Labuschagne I, Durr A, Leavitt BR, Roos RAC, Reilmann R, Johnson H, Hobbs NZ, Langbehn DR, Stout JC, Tabrizi SJ, Scahill RI. The impact of occipital lobe cortical thickness on cognitive task performance: An investigation in Huntington's Disease. Neuropsychologia 2015; 79:138-46. [PMID: 26519555 DOI: 10.1016/j.neuropsychologia.2015.10.033] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [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: 06/05/2015] [Revised: 10/07/2015] [Accepted: 10/26/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND The occipital lobe is an important visual processing region of the brain. Following consistent findings of early neural changes in the occipital lobe in Huntington's Disease (HD), we examined cortical thickness across four occipital regions in premanifest (preHD) and early HD groups compared with controls. Associations between cortical thickness in gene positive individuals and performance on six cognitive tasks, each with a visual component, were examined. In addition, the association between cortical thickness in gene positive participants and one non-visual motor task was also examined for comparison. METHODS Cortical thickness was determined using FreeSurfer on T1-weighted 3T MR datasets from controls (N=97), preHD (N=109) and HD (N=69) from the TRACK-HD study. Regression models were fitted to assess between-group differences in cortical thickness, and relationships between performance on the cognitive tasks, the motor task and occipital thickness were examined in a subset of gene-positive participants (N=141). RESULTS Thickness of the occipital cortex in preHD and early HD participants was reduced compared with controls. Regionally-specific associations between reduced cortical thickness and poorer performance were found for five of the six cognitive tasks, with the strongest associations in lateral occipital and lingual regions. No associations were found with the cuneus. The non-visual motor task was not associated with thickness of any region. CONCLUSIONS The heterogeneous pattern of associations found in the present study suggests that occipital thickness negatively impacts cognition, but only in regions that are linked to relatively advanced visual processing (e.g., lateral occipital, lingual regions), rather than in basic visual processing regions such as the cuneus. Our results show, for the first time, the functional implications of occipital atrophy highlighted in recent studies in HD.
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Affiliation(s)
| | - Elin M Rees
- UCL Institute of Neurology, University College London, UK
| | - Izelle Labuschagne
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia
| | - Alexandra Durr
- Department of Genetics and Cytogenetics, and INSERMUMR S679, APHP, ICM Institute, Hôpital de la Salpêtrière, Paris, France
| | - Blair R Leavitt
- Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Raymund A C Roos
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Hans Johnson
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Nicola Z Hobbs
- UCL Institute of Neurology, University College London, UK
| | | | - Julie C Stout
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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Hobbs NZ, Farmer RE, Rees EM, Cole JH, Haider S, Malone IB, Sprengelmeyer R, Johnson H, Mueller HP, Sussmuth SD, Roos RAC, Durr A, Frost C, Scahill RI, Landwehrmeyer B, Tabrizi SJ. Short-interval observational data to inform clinical trial design in Huntington's disease. J Neurol Neurosurg Psychiatry 2015; 86:1291-8. [PMID: 25669748 DOI: 10.1136/jnnp-2014-309768] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 01/07/2015] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate candidate outcomes for disease-modifying trials in Huntington's disease (HD) over 6-month, 9-month and 15-month intervals, across multiple domains. To present guidelines on rapid efficacy readouts for disease-modifying trials. METHODS 40 controls and 61 patients with HD, recruited from four EU sites, underwent 3 T MRI and standard clinical and cognitive assessments at baseline, 6 and 15 months. Neuroimaging analysis included global and regional change in macrostructure (atrophy and cortical thinning), and microstructure (diffusion metrics). The main outcome was longitudinal effect size (ES) for each outcome. Such ESs can be used to calculate sample-size requirements for clinical trials for hypothesised treatment efficacies. RESULTS Longitudinal changes in macrostructural neuroimaging measures such as caudate atrophy and ventricular expansion were significantly larger in HD than controls, giving rise to consistently large ES over the 6-month, 9-month and 15-month intervals. Analogous ESs for cortical metrics were smaller with wide CIs. Microstructural (diffusion) neuroimaging metrics ESs were also typically smaller over the shorter intervals, although caudate diffusivity metrics performed strongly over 9 and 15 months. Clinical and cognitive outcomes exhibited small longitudinal ESs, particularly over 6-month and 9-month intervals, with wide CIs, indicating a lack of precision. CONCLUSIONS To exploit the potential power of specific neuroimaging measures such as caudate atrophy in disease-modifying trials, we propose their use as (1) initial short-term readouts in early phase/proof-of-concept studies over 6 or 9 months, and (2) secondary end points in efficacy studies over longer periods such as 15 months.
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Affiliation(s)
- Nicola Z Hobbs
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Ruth E Farmer
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Elin M Rees
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - James H Cole
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Salman Haider
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Ian B Malone
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | | | - Hans Johnson
- Department of Psychiatry, University of Iowa, Iowa City, Iowa, USA
| | | | | | - Raymund A C Roos
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Alexandra Durr
- APHP-Department of Genetics and INSERM UMR S679, ICM (Brain and Spine Institute), Salpêtrière University Hospital, Paris, France
| | - Chris Frost
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Rachael I Scahill
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | | | - Sarah J Tabrizi
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
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Rees EM, Farmer R, Cole JH, Henley SM, Sprengelmeyer R, Frost C, Scahill RI, Hobbs NZ, Tabrizi SJ. Inconsistent emotion recognition deficits across stimulus modalities in Huntington׳s disease. Neuropsychologia 2014; 64:99-104. [DOI: 10.1016/j.neuropsychologia.2014.09.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 08/28/2014] [Accepted: 09/13/2014] [Indexed: 10/24/2022]
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Rees EM, Farmer R, Cole JH, Haider S, Durr A, Landwehrmeyer B, Scahill RI, Tabrizi SJ, Hobbs NZ. Cerebellar abnormalities in Huntington's disease: a role in motor and psychiatric impairment? Mov Disord 2014; 29:1648-54. [PMID: 25123926 DOI: 10.1002/mds.25984] [Citation(s) in RCA: 39] [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] [Received: 01/30/2014] [Revised: 06/20/2014] [Accepted: 07/13/2014] [Indexed: 03/07/2024] Open
Abstract
The cerebellum has received limited attention in Huntington's disease (HD), despite signs of possible cerebellar dysfunction, including motor incoordination and impaired gait, which are currently attributed to basal ganglia atrophy and disrupted fronto-striatal circuits. This study is the first to investigate a potential contribution of macro- and microstructural cerebellar damage to clinical manifestations of HD. T1- and diffusion-weighted 3T magnetic resonance imaging (MRI) scans were obtained from 12 controls and 22 early-stage HD participants. Manual delineation and voxel-based morphometry were used to assess between-group differences in cerebellar volume, and diffusion metrics were compared between groups within the cerebellar gray and white matter. Associations between these imaging measures and clinical scores were examined within the HD group. Reduced paravermal volume was detected in HD compared with controls using voxel-based morphometry (P < 0.05), but no significant volumetric differences were found using manual delineation. Diffusion abnormalities were detected in both cerebellar gray matter and white matter. Smaller cerebellar volumes, although not significantly reduced, were significantly associated with impaired gait and psychiatric morbidity and of borderline significance with pronate/supinate-hand task performance. Abnormal cerebellar diffusion was associated with increased total motor score, impaired saccade initiation, tandem walking, and timed finger tapping. In conclusion, atrophy of the paravermis, possibly encompassing the cerebellar nuclei, and microstructural abnormalities within the cerebellum may contribute to HD neuropathology. Aberrant cerebellar diffusion and reduced cerebellar volume together associate with impaired motor function and increased psychiatric symptoms in stage I HD, potentially implicating the cerebellum more centrally in HD presentation than previously recognized.
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Affiliation(s)
- Elin M Rees
- University College London, Institute of Neurology, Queen Square, London, UK
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Abstract
Identifying markers able to characterise the progression of Huntington's Disease (HD) is of great importance to the HD research community, as such markers may provide valuable outcome measures in future clinical trials. Neuroimaging measures are obvious candidates because of their clear relevance to the neuropathology of the disease. Many also show improved precision and sensitivity compared with standard functional scales. This review summarizes findings from the wealth of longitudinal imaging studies in the literature, focusing on the most widely available imaging modalities: structural MRI (volumetric and diffusion imaging), functional MRI and PET. We discuss the longitudinal sensitivity, reproducibility and feasibility of each imaging modality for use in clinical trials.
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Affiliation(s)
- Elin M Rees
- UCL Institute of Neurology, University College London, Queen Square, London, UK
| | - Rachael I Scahill
- UCL Institute of Neurology, University College London, Queen Square, London, UK
| | - Nicola Z Hobbs
- UCL Institute of Neurology, University College London, Queen Square, London, UK
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Sprengelmeyer R, Orth M, Müller HP, Wolf RC, Grön G, Depping MS, Kassubek J, Justo D, Rees EM, Haider S, Cole JH, Hobbs NZ, Roos RAC, Dürr A, Tabrizi SJ, Süssmuth SD, Landwehrmeyer GB. The neuroanatomy of subthreshold depressive symptoms in Huntington's disease: a combined diffusion tensor imaging (DTI) and voxel-based morphometry (VBM) study. Psychol Med 2014; 44:1867-1878. [PMID: 24093462 DOI: 10.1017/s003329171300247x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depressive symptoms are prominent psychopathological features of Huntington's disease (HD), making a negative impact on social functioning and well-being. METHOD We compared the frequencies of a history of depression, previous suicide attempts and current subthreshold depression between 61 early-stage HD participants and 40 matched controls. The HD group was then split based on the overall HD group's median Hospital Anxiety and Depression Scale-depression score into a group of 30 non-depressed participants (mean 0.8, s.d. = 0.7) and a group of 31 participants with subthreshold depressive symptoms (mean 7.3, s.d. = 3.5) to explore the neuroanatomy underlying subthreshold depressive symptoms in HD using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI). RESULTS Frequencies of history of depression, previous suicide attempts or current subthreshold depressive symptoms were higher in HD than in controls. The severity of current depressive symptoms was also higher in HD, but not associated with the severity of HD motor signs or disease burden. Compared with the non-depressed HD group DTI revealed lower fractional anisotropy (FA) values in the frontal cortex, anterior cingulate cortex, insula and cerebellum of the HD group with subthreshold depressive symptoms. In contrast, VBM measures were similar in both HD groups. A history of depression, the severity of HD motor signs or disease burden did not correlate with FA values of these regions. CONCLUSIONS Current subthreshold depressive symptoms in early HD are associated with microstructural changes - without concomitant brain volume loss - in brain regions known to be involved in major depressive disorder, but not those typically associated with HD pathology.
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Affiliation(s)
| | - M Orth
- Department of Neurology,University of Ulm,Ulm,Germany
| | - H-P Müller
- Department of Neurology,University of Ulm,Ulm,Germany
| | - R C Wolf
- Centre for Psychosocial Medicine, Department of General Psychiatry,University of Heidelberg,Heidelberg,Germany
| | - G Grön
- Department of Psychiatry,University of Ulm,Ulm,Germany
| | - M S Depping
- Centre for Psychosocial Medicine, Department of General Psychiatry,University of Heidelberg,Heidelberg,Germany
| | - J Kassubek
- Department of Neurology,University of Ulm,Ulm,Germany
| | - D Justo
- Institut du Cerveau et de la Moelle épinière, Pitié-Salpêtrière Hospital,Pierre and Marie Curie University (UPMC),Paris,France
| | - E M Rees
- Department of Neurodegenerative Disease, Institute of Neurology,University College London,London,UK
| | - S Haider
- Department of Neurodegenerative Disease, Institute of Neurology,University College London,London,UK
| | - J H Cole
- Department of Neurodegenerative Disease, Institute of Neurology,University College London,London,UK
| | - N Z Hobbs
- Department of Neurodegenerative Disease, Institute of Neurology,University College London,London,UK
| | - R A C Roos
- Department of Neurology,Leiden University Medical Centre,Leiden,The Netherlands
| | - A Dürr
- Institut du Cerveau et de la Moelle épinière, Pitié-Salpêtrière Hospital,Pierre and Marie Curie University (UPMC),Paris,France
| | - S J Tabrizi
- Department of Neurodegenerative Disease, Institute of Neurology,University College London,London,UK
| | - S D Süssmuth
- Department of Neurology,University of Ulm,Ulm,Germany
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Abstract
Diffusion tensor imaging (DTI) has shown microstructural abnormalities in patients with Huntington's Disease (HD) and work is underway to characterise how these abnormalities change with disease progression. Using methods that will be applied in longitudinal research, we sought to establish the reliability of DTI in early HD patients and controls. Test-retest reliability, quantified using the intraclass correlation coefficient (ICC), was assessed using region-of-interest (ROI)-based white matter atlas and voxelwise approaches on repeat scan data from 22 participants (10 early HD, 12 controls). T1 data was used to generate further ROIs for analysis in a reduced sample of 18 participants. The results suggest that fractional anisotropy (FA) and other diffusivity metrics are generally highly reliable, with ICCs indicating considerably lower within-subject compared to between-subject variability in both HD patients and controls. Where ICC was low, particularly for the diffusivity measures in the caudate and putamen, this was partly influenced by outliers. The analysis suggests that the specific DTI methods used here are appropriate for cross-sectional research in HD, and give confidence that they can also be applied longitudinally, although this requires further investigation. An important caveat for DTI studies is that test-retest reliability may not be evenly distributed throughout the brain whereby highly anisotropic white matter regions tended to show lower relative within-subject variability than other white or grey matter regions.
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Affiliation(s)
- James H Cole
- Huntington's Disease Research Group, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK; Computational, Cognitive & Clinical Neuroimaging Laboratory, Department of Medicine, Imperial College London, UK
| | - Ruth E Farmer
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Elin M Rees
- Huntington's Disease Research Group, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Hans J Johnson
- Department of Psychiatry, University of Iowa, Iowa City, Iowa, USA
| | - Chris Frost
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Rachael I Scahill
- Huntington's Disease Research Group, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Nicola Z Hobbs
- Huntington's Disease Research Group, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
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Hobbs NZ, Cole JH, Farmer RE, Rees EM, Crawford HE, Malone IB, Roos RAC, Sprengelmeyer R, Durr A, Landwehrmeyer B, Scahill RI, Tabrizi SJ, Frost C. Evaluation of multi-modal, multi-site neuroimaging measures in Huntington's disease: Baseline results from the PADDINGTON study. Neuroimage Clin 2012; 2:204-11. [PMID: 24179770 PMCID: PMC3777685 DOI: 10.1016/j.nicl.2012.12.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [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: 10/18/2012] [Revised: 11/30/2012] [Accepted: 12/01/2012] [Indexed: 12/02/2022]
Abstract
Background Macro- and micro-structural neuroimaging measures provide valuable information on the pathophysiology of Huntington's disease (HD) and are proposed as biomarkers. Despite theoretical advantages of microstructural measures in terms of sensitivity to pathology, there is little evidence directly comparing the two. Methods 40 controls and 61 early HD subjects underwent 3 T MRI (T1- and diffusion-weighted), as part of the PADDINGTON study. Macrostructural volumetrics were obtained for the whole brain, caudate, putamen, corpus callosum (CC) and ventricles. Microstructural diffusion metrics of fractional anisotropy (FA), mean-, radial- and axial-diffusivity (MD, RD, AD) were computed for white matter (WM), CC, caudate and putamen. Group differences were examined adjusting for age, gender and site. A formal comparison of effect sizes determined which modality and metrics provided a statistically significant advantage over others. Results Macrostructural measures showed decreased regional and global volume in HD (p < 0.001); except the ventricles which were enlarged (p < 0.01). In HD, FA was increased in the deep grey-matter structures (p < 0.001), and decreased in the WM (CC, p = 0.035; WM, p = 0.053); diffusivity metrics (MD, RD, AD) were increased for all brain regions (p < 0.001). The largest effect sizes were for putamen volume, caudate volume and putamen diffusivity (AD, RD and MD); each was significantly larger than those for all other metrics (p < 0.05). Conclusion The highest performing macro- and micro-structural metrics had similar sensitivity to HD pathology quantified via effect sizes. Region-of-interest may be more important than imaging modality, with deep grey-matter regions outperforming the CC and global measures, for both volume and diffusivity. FA appears to be relatively insensitive to disease effects.
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Affiliation(s)
- Nicola Z Hobbs
- UCL Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK
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Crawford HE, Hobbs NZ, Cole J, Rees EM, Owen G, Langbehn DR, Frost C, Landwehrmeyer B, Reilmann R, Craufurd D, Stout JC, Durr A, Leavitt B, Roos RA, Tabrizi SJ, Scahill RI. G03 Corpus callosal atrophy in Huntington's disease. J Neurol Psychiatry 2012. [DOI: 10.1136/jnnp-2012-303524.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rees EM, Hobbs NZ, Farmer RE, Henley SMD, Haider S, Scahill RI, Tabrizi SJ. J09 Cognitive functions of the putamen in Huntington's disease. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2012-303524.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hobbs NZ, Cole J, Farmer RE, Rees EM, Scahill RI, Crawford HE, Roos RAC, Sprengelmeyer R, Durr A, Landwehrmeyer B, Tabrizi SJ, Frost C. G01 Evaluation of multi-modal, multi-site imaging measures in Huntington's disease: baseline results from the PADDINGTON study. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2012-303524.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cole J, Rees EM, Farmer RE, Crawford HE, Mueller HP, Sprengelmeyer R, Frost C, Durr A, Landwehrmeyer B, Tabrizi SJ, Scahill RI, Hobbs NZ. G07 Reliability of diffusion tensor imaging measures. J Neurol Psychiatry 2012. [DOI: 10.1136/jnnp-2012-303524.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dhaliwal GS, Murray RD, Rees EM, Howard CV, Beech DJ. Quantitative unbiased estimates of endometrial gland surface area and volume in cycling cows and heifers. Res Vet Sci 2002; 73:259-65. [PMID: 12443683 DOI: 10.1016/s0034-5288(02)00098-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Entire reproductive tracts were removed from seven normal healthy heifers and qualitative unbiased estimates made of endometrial gland volume density and glandular surface density. After examining approximately 55 microscopic fields of endometrium from each tract, a mean glandular surface density value of 10.2 mm(2)/mm(3) (CE 3.1%) was obtained. The stereological method was then employed in optimising the design of the main study. The endometrial height was measured for 17 healthy cycling heifers and 19 similar cows. Subsequently, unbiased estimates were made of intercaruncular endometrial gland volume per unit surface for all cattle were investigated; differences between heifers and cows generally, and the possible effect of the follicular and luteal phases of the oestrous cycle were compared. The mean surface area of glands per unit area of endometrium at the intercaruncular site in heifers and cows was approximately 18 mm(2)/mm(2) in the follicular phase and 26 mm(2)/mm(2) in the luteal phase, figures similar to the gland area found in women. The intercaruncular gland volume increased significantly, by about 30% during the luteal phase of the bovine oestrous cycle in heifers, from 0.01 to 0.13 per mm(3). The differences in endometrial anatomy between site of sampling and either follicular or luteal phases of the oestrous cycle were always more significant in heifers than cows. The endometrial thickness in cows was always greater than for heifers, irrespective of the site of sampling. It was concluded that the intercaruncular endometrium of cattle was far more active physiologically than recognised previously.
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Affiliation(s)
- G S Dhaliwal
- Department of Veterinary Clinical Science and Animal Husbandry, Veterinary Teaching Hospital, Leahurst, Neston, UK
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16
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Rees EM, Lloyd D, Williams AG. The effects of co-cultivation with the acetogen Acetitomaculum ruminis on the fermentative metabolism of the rumen fungi Neocallimastix patriciarum and Neocallimastix sp. strain L2. FEMS Microbiol Lett 1995; 133:175-80. [PMID: 8566705 DOI: 10.1111/j.1574-6968.1995.tb07880.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The effects of co-cultivation with the hydrogen-utilizing acetogenic bacterium Acetitomaculum ruminis on the fermentative activities of the rumen fungi Neocallimastix patriciarum or Neocallimastix sp. L2 were investigated. In both co-cultures acetate production increased, making it the predominant fermentation product, as the accumulation of lactate, formate, ethanol, H2 and (in the case of Neocallimastix sp. L2) succinate all decreased. The effects of co-cultivation with Methanobrevibacter smithii were more pronounced. Decreased activities of lactate dehydrogenase, alcohol dehydrogenase and (in the case of Neocallimastix sp. L2) fumarate reductase accompanied the shift in fermentation product formation. The rate of glucose utilization and the fungal biomass yield were also increased in the co-culture.
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Affiliation(s)
- E M Rees
- ICBD, Heriot-Watt University, Riccarton, Edinburgh, UK
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17
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Rees EM. The Children Act 1989. The challenge for the courts. J R Soc Health 1991; 111:72-4. [PMID: 2038021 DOI: 10.1177/146642409111100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- E M Rees
- Bexley Magistrates' Court, Bexleyheath, Kent
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Batty K, Cook PD, Kreutzer L, Peckous B, Post B, Rees EM. NGR (Nursing Grand Rounds): a project. Nurs Manag (Harrow) 1983; 14:56-9. [PMID: 6558491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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