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Garcia-Cordero I, Anastassiadis C, Khoja A, Morales-Rivero A, Thapa S, Vasilevskaya A, Davenport C, Sumra V, Couto B, Multani N, Taghdiri F, Anor C, Misquitta K, Vandevrede L, Heuer H, Tang-Wai D, Dickerson B, Pantelyat A, Litvan I, Boeve B, Rojas JC, Ljubenkov P, Huey E, Fox S, Kovacs GG, Boxer A, Lang A, Tartaglia MC. Evaluating the Effect of Alzheimer's Disease-Related Biomarker Change in Corticobasal Syndrome and Progressive Supranuclear Palsy. Ann Neurol 2024. [PMID: 38578117 DOI: 10.1002/ana.26930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/26/2024] [Accepted: 03/11/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES To evaluate the effect of Alzheimer's disease (AD) -related biomarker change on clinical features, brain atrophy and functional connectivity of patients with corticobasal syndrome (CBS) and progressive supranuclear palsy (PSP). METHODS Data from patients with a clinical diagnosis of CBS, PSP, and AD and healthy controls were obtained from the 4-R-Tauopathy Neuroimaging Initiative 1 and 2, the Alzheimer's Disease Neuroimaging Initiative, and a local cohort from the Toronto Western Hospital. Patients with CBS and PSP were divided into AD-positive (CBS/PSP-AD) and AD-negative (CBS/PSP-noAD) groups based on fluid biomarkers and amyloid PET scans. Cognitive, motor, and depression scores; AD fluid biomarkers (cerebrospinal p-tau, t-tau, and amyloid-beta, and plasma ptau-217); and neuroimaging data (amyloid PET, MRI and fMRI) were collected. Clinical features, whole-brain gray matter volume and functional networks connectivity were compared across groups. RESULTS Data were analyzed from 87 CBS/PSP-noAD and 23 CBS/PSP-AD, 18 AD, and 30 healthy controls. CBS/PSP-noAD showed worse performance in comparison to CBS/PSP-AD in the PSPRS [mean(SD): 34.8(15.8) vs 23.3(11.6)] and the UPDRS scores [mean(SD): 34.2(17.0) vs 21.8(13.3)]. CBS/PSP-AD demonstrated atrophy in AD signature areas and brainstem, while CBS/PSP-noAD patients displayed atrophy in frontal and temporal areas, globus pallidus, and brainstem compared to healthy controls. The default mode network showed greatest disconnection in CBS/PSP-AD compared with CBS/PSP-no AD and controls. The thalamic network connectivity was most affected in CBS/PSP-noAD. INTERPRETATION AD biomarker positivity may modulate the clinical presentation of CBS/PSP, with evidence of distinctive structural and functional brain changes associated with the AD pathology/co-pathology. ANN NEUROL 2024.
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Affiliation(s)
- Indira Garcia-Cordero
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Chloe Anastassiadis
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Abeer Khoja
- University Health Network Memory Clinic, Toronto, ON, Canada
- Neurology Division, Medical Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alonso Morales-Rivero
- University Health Network Memory Clinic, Toronto, ON, Canada
- ABC Medical Center, Mexico City, Mexico
| | - Simrika Thapa
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Anna Vasilevskaya
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Carly Davenport
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Vishaal Sumra
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Blas Couto
- Rossy PSP Program, University Health Network and the University of Toronto, Toronto, ON, Canada
- The Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto, ON, Canada
- Institute of Cognitive and Translational Neuroscience (INCyT-INECO-CONICET), Favaloro University Hospital, Buenos Aires, Argentina
| | - Namita Multani
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Foad Taghdiri
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Cassandra Anor
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Karen Misquitta
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Lawren Vandevrede
- Memory and Aging Center, Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Hilary Heuer
- Memory and Aging Center, Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - David Tang-Wai
- Krembil Brain Institute, University Health Network, Toronto, ON, Canada
| | - Bradford Dickerson
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Irene Litvan
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | - Bradley Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Julio C Rojas
- Memory and Aging Center, Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Peter Ljubenkov
- Memory and Aging Center, Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Edward Huey
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Susan Fox
- Rossy PSP Program, University Health Network and the University of Toronto, Toronto, ON, Canada
- The Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto, ON, Canada
| | - Gabor G Kovacs
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
- Rossy PSP Program, University Health Network and the University of Toronto, Toronto, ON, Canada
- The Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto, ON, Canada
- Krembil Brain Institute, University Health Network, Toronto, ON, Canada
| | - Adam Boxer
- Memory and Aging Center, Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Anthony Lang
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
- Rossy PSP Program, University Health Network and the University of Toronto, Toronto, ON, Canada
- The Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto, ON, Canada
- Krembil Brain Institute, University Health Network, Toronto, ON, Canada
| | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
- University Health Network Memory Clinic, Toronto, ON, Canada
- Rossy PSP Program, University Health Network and the University of Toronto, Toronto, ON, Canada
- Krembil Brain Institute, University Health Network, Toronto, ON, Canada
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Vandebergh M, Ramos EM, Corriveau-Lecavalier N, Ramanan VK, Kornak J, Mester C, Kolander T, Brushaber D, Staffaroni AM, Geschwind D, Wolf A, Kantarci K, Gendron TF, Petrucelli L, Van den Broeck M, Wynants S, Baker MC, Borrego – Écija S, Appleby B, Barmada S, Bozoki A, Clark D, Darby RR, Dickerson BC, Domoto-Reilly K, Fields JA, Galasko DR, Ghoshal N, Graff-Radford N, Grant IM, Honig LS, Hsiung GYR, Huey ED, Irwin D, Knopman DS, Kwan JY, Léger GC, Litvan I, Masdeu JC, Mendez MF, Onyike C, Pascual B, Pressman P, Ritter A, Roberson ED, Snyder A, Sullivan AC, Tartaglia MC, Wint D, Heuer HW, Forsberg LK, Boxer AL, Rosen HJ, Boeve BF, Rademakers R. Gene specific effects on brain volume and cognition of TMEM106B in frontotemporal lobar degeneration. medRxiv 2024:2024.04.05.24305253. [PMID: 38633784 PMCID: PMC11023674 DOI: 10.1101/2024.04.05.24305253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Background and Objectives TMEM106B has been proposed as a modifier of disease risk in FTLD-TDP, particularly in GRN mutation carriers. Furthermore, TMEM106B has been investigated as a disease modifier in the context of healthy aging and across multiple neurodegenerative diseases. The objective of this study is to evaluate and compare the effect of TMEM106B on gray matter volume and cognition in each of the common genetic FTD groups and in sporadic FTD patients. Methods Participants were enrolled through the ARTFL/LEFFTDS Longitudinal Frontotemporal Lobar Degeneration (ALLFTD) study, which includes symptomatic and presymptomatic individuals with a pathogenic mutation in C9orf72, GRN, MAPT, VCP, TBK1, TARDBP, symptomatic non-mutation carriers, and non-carrier family controls. All participants were genotyped for the TMEM106B rs1990622 SNP. Cross-sectionally, linear mixed-effects models were fitted to assess an association between TMEM106B and genetic group interaction with each outcome measure (gray matter volume and UDS3-EF for cognition), adjusting for education, age, sex and CDR®+NACC-FTLD sum of boxes. Subsequently, associations between TMEM106B and each outcome measure were investigated within the genetic group. For longitudinal modeling, linear mixed-effects models with time by TMEM106B predictor interactions were fitted. Results The minor allele of TMEM106B rs1990622, linked to a decreased risk of FTD, associated with greater gray matter volume in GRN mutation carriers under the recessive dosage model. This was most pronounced in the thalamus in the left hemisphere, with a retained association when considering presymptomatic GRN mutation carriers only. The minor allele of TMEM106B rs1990622 also associated with greater cognitive scores among all C9orf72 mutation carriers and in presymptomatic C9orf72 mutation carriers, under the recessive dosage model. Discussion We identified associations of TMEM106B with gray matter volume and cognition in the presence of GRN and C9orf72 mutations. This further supports TMEM106B as modifier of TDP-43 pathology. The association of TMEM106B with outcomes of interest in presymptomatic GRN and C9orf72 mutation carriers could additionally reflect TMEM106B's impact on divergent pathophysiological changes before the appearance of clinical symptoms.
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Affiliation(s)
- Marijne Vandebergh
- VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Eliana Marisa Ramos
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Nick Corriveau-Lecavalier
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Carly Mester
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Tyler Kolander
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Danielle Brushaber
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Daniel Geschwind
- Institute for Precision Health, Departments of Neurology, Psychiatry and Human Genetics at David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Amy Wolf
- Department of Neurology, Memory and Aging Center, University of California, San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Kejal Kantarci
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Tania F Gendron
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | - Marleen Van den Broeck
- VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Sarah Wynants
- VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Matthew C Baker
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Sergi Borrego – Écija
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca Biomèdica, Universitat de Barcelona, Barcelona, Spain
| | - Brian Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Sami Barmada
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Andrea Bozoki
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - David Clark
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - R Ryan Darby
- Department of Neurology, Vanderbilt University, Nashville, TN, USA
| | | | | | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Douglas R. Galasko
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Nupur Ghoshal
- Departments of Neurology and Psychiatry, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | | | - Ian M Grant
- Department of Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Lawrence S Honig
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, Columbia University, New York, NY, USA
| | - Ging-Yuek Robin Hsiung
- Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edward D Huey
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - David Irwin
- Department of Neurology and Penn Frontotemporal Degeneration Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David S Knopman
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Justin Y Kwan
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Gabriel C Léger
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Irene Litvan
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Joseph C Masdeu
- Department of Neurology, Houston Methodist, Houston, TX, USA
| | - Mario F Mendez
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chiadi Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Belen Pascual
- Department of Neurology, Houston Methodist, Houston, TX, USA
| | - Peter Pressman
- Department of Neurology, University of Colorado, Aurora, CO, USA
| | - Aaron Ritter
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, 89106, USA
| | - Erik D Roberson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allison Snyder
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Anna Campbell Sullivan
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, UT Health San Antonio
| | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Dylan Wint
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, 89106, USA
| | - Hilary W Heuer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Leah K Forsberg
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco Weill Institute for Neurosciences, San Francisco, CA, USA
| | | | - Rosa Rademakers
- VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
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3
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Staffaroni AM, Clark AL, Taylor JC, Heuer HW, Sanderson-Cimino M, Wise AB, Dhanam S, Cobigo Y, Wolf A, Manoochehri M, Forsberg L, Mester C, Rankin KP, Appleby BS, Bayram E, Bozoki A, Clark D, Darby RR, Domoto-Reilly K, Fields JA, Galasko D, Geschwind D, Ghoshal N, Graff-Radford N, Grossman M, Hsiung GY, Huey ED, Jones DT, Lapid MI, Litvan I, Masdeu JC, Massimo L, Mendez MF, Miyagawa T, Pascual B, Pressman P, Ramanan VK, Ramos EM, Rascovsky K, Roberson ED, Tartaglia MC, Wong B, Miller BL, Kornak J, Kremers W, Hassenstab J, Kramer JH, Boeve BF, Rosen HJ, Boxer AL. Reliability and Validity of Smartphone Cognitive Testing for Frontotemporal Lobar Degeneration. JAMA Netw Open 2024; 7:e244266. [PMID: 38558141 PMCID: PMC10985553 DOI: 10.1001/jamanetworkopen.2024.4266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/04/2024] Open
Abstract
Importance Frontotemporal lobar degeneration (FTLD) is relatively rare, behavioral and motor symptoms increase travel burden, and standard neuropsychological tests are not sensitive to early-stage disease. Remote smartphone-based cognitive assessments could mitigate these barriers to trial recruitment and success, but no such tools are validated for FTLD. Objective To evaluate the reliability and validity of smartphone-based cognitive measures for remote FTLD evaluations. Design, Setting, and Participants In this cohort study conducted from January 10, 2019, to July 31, 2023, controls and participants with FTLD performed smartphone application (app)-based executive functioning tasks and an associative memory task 3 times over 2 weeks. Observational research participants were enrolled through 18 centers of a North American FTLD research consortium (ALLFTD) and were asked to complete the tests remotely using their own smartphones. Of 1163 eligible individuals (enrolled in parent studies), 360 were enrolled in the present study; 364 refused and 439 were excluded. Participants were divided into discovery (n = 258) and validation (n = 102) cohorts. Among 329 participants with data available on disease stage, 195 were asymptomatic or had preclinical FTLD (59.3%), 66 had prodromal FTLD (20.1%), and 68 had symptomatic FTLD (20.7%) with a range of clinical syndromes. Exposure Participants completed standard in-clinic measures and remotely administered ALLFTD mobile app (app) smartphone tests. Main Outcomes and Measures Internal consistency, test-retest reliability, association of smartphone tests with criterion standard clinical measures, and diagnostic accuracy. Results In the 360 participants (mean [SD] age, 54.0 [15.4] years; 209 [58.1%] women), smartphone tests showed moderate-to-excellent reliability (intraclass correlation coefficients, 0.77-0.95). Validity was supported by association of smartphones tests with disease severity (r range, 0.38-0.59), criterion-standard neuropsychological tests (r range, 0.40-0.66), and brain volume (standardized β range, 0.34-0.50). Smartphone tests accurately differentiated individuals with dementia from controls (area under the curve [AUC], 0.93 [95% CI, 0.90-0.96]) and were more sensitive to early symptoms (AUC, 0.82 [95% CI, 0.76-0.88]) than the Montreal Cognitive Assessment (AUC, 0.68 [95% CI, 0.59-0.78]) (z of comparison, -2.49 [95% CI, -0.19 to -0.02]; P = .01). Reliability and validity findings were highly similar in the discovery and validation cohorts. Preclinical participants who carried pathogenic variants performed significantly worse than noncarrier family controls on 3 app tasks (eg, 2-back β = -0.49 [95% CI, -0.72 to -0.25]; P < .001) but not a composite of traditional neuropsychological measures (β = -0.14 [95% CI, -0.42 to 0.14]; P = .32). Conclusions and Relevance The findings of this cohort study suggest that smartphones could offer a feasible, reliable, valid, and scalable solution for remote evaluations of FTLD and may improve early detection. Smartphone assessments should be considered as a complementary approach to traditional in-person trial designs. Future research should validate these results in diverse populations and evaluate the utility of these tests for longitudinal monitoring.
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Affiliation(s)
- Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Annie L Clark
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Jack C Taylor
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Hilary W Heuer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Mark Sanderson-Cimino
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Amy B Wise
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Sreya Dhanam
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Amy Wolf
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | | | - Leah Forsberg
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Carly Mester
- Department of Quantitative Health Sciences, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Katherine P Rankin
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Brian S Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, Ohio
| | - Ece Bayram
- Department of Neurosciences, University of California, San Diego, La Jolla
| | - Andrea Bozoki
- Department of Radiology, University of North Carolina, Chapel Hill
| | - David Clark
- Department of Neurology, Indiana University, Indianapolis
| | - R Ryan Darby
- Department of Neurology, Vanderbilt University, Nashville, Tennessee
| | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Douglas Galasko
- Department of Neurosciences, University of California, San Diego, La Jolla
| | - Daniel Geschwind
- Department of Neurology, Institute for Precision Health, University of California, Los Angeles
| | - Nupur Ghoshal
- Department of Neurology, Knight Alzheimer Disease Research Center, Washington University, Saint Louis, Missouri
- Department of Psychiatry, Knight Alzheimer Disease Research Center, Washington University, Saint Louis, Missouri
| | | | - Murray Grossman
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Ging-Yuek Hsiung
- Division of Neurology, University of British Columbia, Musqueam, Squamish & Tsleil-Waututh Traditional Territory, Vancouver, Canada
| | - Edward D Huey
- Department of Neurology, Columbia University, New York, New York
| | - David T Jones
- Department of Quantitative Health Sciences, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Irene Litvan
- Department of Neurosciences, University of California, San Diego, La Jolla
| | - Joseph C Masdeu
- Department of Neurology, Nantz National Alzheimer Center, Houston Methodist and Weill Cornell Medicine, Houston Methodist, Houston, Texas
| | - Lauren Massimo
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Mario F Mendez
- Department of Neurology, UCLA (University of California, Los Angeles)
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Belen Pascual
- Department of Neurology, Nantz National Alzheimer Center, Houston Methodist and Weill Cornell Medicine, Houston Methodist, Houston, Texas
| | | | | | | | - Katya Rascovsky
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | | | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Bonnie Wong
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Walter Kremers
- Department of Quantitative Health Sciences, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Jason Hassenstab
- Department of Neurology, Knight Alzheimer Disease Research Center, Washington University, Saint Louis, Missouri
- Department of Psychological & Brain Sciences, Washington University, Saint Louis, Missouri
| | - Joel H Kramer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | | | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
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4
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Taghdiri F, Khodadadi M, Sadia N, Mushtaque A, Scott OFT, Hirsch-Reinhagen V, Tator C, Wennberg R, Kovacs GG, Tartaglia MC. Unusual combinations of neurodegenerative pathologies with chronic traumatic encephalopathy (CTE) complicates clinical prediction of CTE. Eur J Neurol 2024:e16259. [PMID: 38404144 DOI: 10.1111/ene.16259] [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] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 01/27/2024] [Accepted: 02/08/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND AND PURPOSE Chronic traumatic encephalopathy (CTE) has gained widespread attention due to its association with multiple concussions and contact sports. However, CTE remains a postmortem diagnosis, and the link between clinical symptoms and CTE pathology is poorly understood. This study aimed to investigate the presence of copathologies and their impact on symptoms in former contact sports athletes. METHODS This was a retrospective case series design of 12 consecutive cases of former contact sports athletes referred for autopsy. Analyses are descriptive and include clinical history as well as the pathological findings of the autopsied brains. RESULTS All participants had a history of multiple concussions, and all but one had documented progressive cognitive, psychiatric, and/or motor symptoms. The results showed that 11 of the 12 participants had evidence of CTE in the brain, but also other copathologies, including different combinations of tauopathies, and other rare entities. CONCLUSIONS The heterogeneity of symptoms after repetitive head injuries and the diverse pathological combinations accompanying CTE complicate the prediction of CTE in clinical practice. It is prudent to consider the possibility of multiple copathologies when clinically assessing patients with repetitive head injuries, especially as they age, and attributing neurological or cognitive symptoms solely to presumptive CTE in elderly patients should be discouraged.
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Affiliation(s)
- Foad Taghdiri
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada
| | - Mozhgan Khodadadi
- Canadian Concussion Centre, Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
| | - Nusrat Sadia
- Canadian Concussion Centre, Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
| | - Asma Mushtaque
- Canadian Concussion Centre, Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
| | - Olivia F T Scott
- Canadian Concussion Centre, Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
| | - Veronica Hirsch-Reinhagen
- Division of Neuropathology, Vancouver General Hospital, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charles Tator
- Canadian Concussion Centre, Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
- Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
| | - Richard Wennberg
- Canadian Concussion Centre, Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
- Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
| | - Gabor G Kovacs
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada
- Canadian Concussion Centre, Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
- Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada
- Canadian Concussion Centre, Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
- Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
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5
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Oertel FC, Casillas D, Cobigo Y, Condor Montes S, Heuer HW, Chapman M, Beaudry-Richard A, Reinsberg H, Abdelhak A, Cordano C, Boeve BF, Dickerson BC, Grossman M, Huey E, Irwin DJ, Litvan I, Pantelyat A, Tartaglia MC, Vandevrede L, Boxer A, Green AJ. Scientific commentary on: "Phosphorylated tau in the retina correlates with tau pathology in the brain in Alzheimer's disease and primary tauopathies". Acta Neuropathol 2024; 147:30. [PMID: 38308717 PMCID: PMC10838223 DOI: 10.1007/s00401-023-02656-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 02/05/2024]
Affiliation(s)
- Frederike C Oertel
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA
| | - Daniel Casillas
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA
| | - Yann Cobigo
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA
- UCSF Memory and Aging Center, San Francisco, CA, USA
| | - Shivany Condor Montes
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA
| | - Hilary W Heuer
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA
- UCSF Memory and Aging Center, San Francisco, CA, USA
| | - Makenna Chapman
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA
| | - Alexandra Beaudry-Richard
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA
| | - Henriette Reinsberg
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA
| | - Ahmed Abdelhak
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA
| | - Christian Cordano
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA
| | - Bradley F Boeve
- Mayo Center for Sleep Medicine, Departments of Neurology and Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Edward Huey
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
- Department of Psychiatry and New York Psychiatric Institute, Columbia University Medical Center, New York, USA
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Irene Litvan
- Department of Neurosciences, University of California San Diego, San Diego, CA, 92093, USA
| | - Alexander Pantelyat
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Lawren Vandevrede
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA
- UCSF Memory and Aging Center, San Francisco, CA, USA
| | - Adam Boxer
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA
- UCSF Memory and Aging Center, San Francisco, CA, USA
| | - Ari J Green
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco (UCSF), 675 Nelson Rising Lane, Sandler Neurosciences Building, San Francisco, CA, USA.
- Department of Ophthalmology, School of Medicine, University of California San Francisco (UCSF), San Francisco, CA, USA.
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6
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Salwierz P, Thapa S, Taghdiri F, Vasilevskaya A, Anastassiadis C, Tang-Wai DF, Golas AC, Tartaglia MC. Investigating the association between a history of depression and biomarkers of Alzheimer's disease, cerebrovascular disease, and neurodegeneration in patients with dementia. GeroScience 2024; 46:783-793. [PMID: 38097855 PMCID: PMC10828163 DOI: 10.1007/s11357-023-01030-x] [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: 08/14/2023] [Accepted: 11/29/2023] [Indexed: 01/31/2024] Open
Abstract
The association between depression and dementia, particularly Alzheimer's disease (AD) and cerebrovascular disease (CVD), remains an active area of research. This study aimed to investigate the relationship between a history of depression and biomarkers of AD and CVD in patients with dementia in a clinical setting. A total of 126 patients from the University Health Network (UHN) Memory Clinic with comprehensive clinical evaluations, including neuropsychological testing and medical examinations, were included. Lumbar puncture was performed to collect cerebrospinal fluid (CSF) for biomarker analysis, and brain magnetic resonance imaging (MRI) scans were obtained to assess white matter hyperintensity (WMH) burden. The presence of depression was determined through medical records. The study findings did not reveal significant differences between participants with and without a history of depression in terms of AD biomarkers, WMH burden, neurofilament light chain levels, cognitive scores, age of symptom onset, disease duration, or vascular risk scores. Logistic regression analysis did not indicate a meaningful predictive value of these variables for depression status. This clinical study contributes to our understanding regarding the association between depression and AD/CVD biomarkers in patients with cognitive impairment. Further research is needed to elucidate the complex relationship between depression and dementia and to explore the potential mechanisms linking depression, AD, and CVD.
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Affiliation(s)
- Patrick Salwierz
- Tanz Centre for Research in Neurodegenerative Diseases, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Simrika Thapa
- Tanz Centre for Research in Neurodegenerative Diseases, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Foad Taghdiri
- Tanz Centre for Research in Neurodegenerative Diseases, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Anna Vasilevskaya
- Tanz Centre for Research in Neurodegenerative Diseases, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Chloe Anastassiadis
- Tanz Centre for Research in Neurodegenerative Diseases, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - David F Tang-Wai
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Memory Clinic University Health Network, Krembil Brain Institute, Toronto, ON, Canada
| | - Angela C Golas
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Memory Clinic University Health Network, Krembil Brain Institute, Toronto, ON, Canada
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7
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Barraclough ML, Diaz-Martinez JP, Knight A, Bingham K, Su J, Kakvan M, Grajales CM, Tartaglia MC, Ruttan L, Wither J, Choi MY, Bonilla D, Anderson N, Appenzeller S, Parker B, Katz P, Beaton D, Green R, Bruce IN, Touma Z. In-person versus virtual administration of the American College of Radiology gold standard cognitive battery in systemic lupus erythematosus: Are they interchangeable? Lupus 2023; 32:737-745. [PMID: 37036020 DOI: 10.1177/09612033231168477] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
OBJECTIVE During the COVID-19 pandemic, many research studies were adapted, including our longitudinal study examining cognitive impairment (CI) in systemic lupus erythematosus (SLE). Cognitive testing was switched from in-person to virtual. This analysis aimed to determine if the administration method (in-person vs. virtual) of the ACR-neuropsychological battery (ACR-NB) affected participant cognitive performance and classification. METHODS Data from our multi-visit, SLE CI study included demographic, clinical, and psychiatric characteristics, and the modified ACR-NB. Three analyses were undertaken for cognitive performance: (1) all visits, (2) non-CI group visits only and (3) intra-individual comparisons. A retrospective preferences questionnaire was given to participants who completed the ACR-NB both in-person and virtually. RESULTS We analysed 328 SLE participants who had 801 visits (696 in-person and 105 virtual). Demographic, clinical, and psychiatric characteristics were comparable except for ethnicity, anxiety and disease-related damage. Across all three comparisons, six tests were consistently statistically significantly different. CI classification changed in 11/71 (15%) participants. 45% of participants preferred the virtual administration method and 33% preferred in-person. CONCLUSIONS Of the 19 tests in the ACR-NB, we identified one or more problems with eight (42%) tests when moving from in-person to virtual administration. As the use of virtual cognitive testing will likely increase, these issues need to be addressed - potentially by validating a virtual version of the ACR-NB. Until then, caution must be taken when directly comparing virtual to in-person test results. If future studies use a mixed administration approach, this should be accounted for during analysis.
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Affiliation(s)
- M L Barraclough
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, 5292The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - J P Diaz-Martinez
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 7938University of Toronto Lupus Clinic, Toronto, ON, Canada
| | - A Knight
- Division of Rheumatology, 7979Hospital for Sick Children, Toronto, ON, Canada
- Neurosciences and Mental Health Program, SickKids Research Institute, Toronto, ON, Canada
| | - K Bingham
- Centre for Mental Health, 7989University Health Network, Toronto, ON, Canada
- Department of Psychiatry, 7938University of Toronto, Toronto, ON, Canada
| | - J Su
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Division of Rheumatology, 7979Hospital for Sick Children, Toronto, ON, Canada
| | - M Kakvan
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 7938University of Toronto Lupus Clinic, Toronto, ON, Canada
| | - C Muñoz Grajales
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 7938University of Toronto Lupus Clinic, Toronto, ON, Canada
| | - M C Tartaglia
- Krembil Research Institute, 7989University Health Network Memory Clinic, Toronto, ON, Canada
| | - L Ruttan
- 7961University Health Network-Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - J Wither
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
| | - M Y Choi
- Cumming School of Medicine, 70401University of Calgary, Calgary, AB, Canada
| | - D Bonilla
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 7938University of Toronto Lupus Clinic, Toronto, ON, Canada
| | - N Anderson
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 7938University of Toronto Lupus Clinic, Toronto, ON, Canada
| | - S Appenzeller
- Department of Orthopaedics, Rheumatology and Traumatology, 7938University of Campinas, São Paulo, Brazil
| | - B Parker
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, 5292The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - P Katz
- 8785University of California, San Francisco, CA, USA
| | - D Beaton
- Institute for Work and Health, 7966University of Toronto, Toronto, ON, Canada
| | - R Green
- Krembil Research Institute, 7989University Health Network Memory Clinic, Toronto, ON, Canada
| | - I N Bruce
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, 5292The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Z Touma
- Schroeder Arthritis Institute, Krembil Research Institute, 7989University Health Network, Toronto, ON, Canada
- Centre for Prognosis Studies in Rheumatic Diseases, Toronto Western Hospital, 7938University of Toronto Lupus Clinic, Toronto, ON, Canada
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8
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Golas AC, Salwierz P, Rajji TK, Bowie CR, Butters MA, Fischer CE, Flint AJ, Herrmann N, Mah L, Mulsant BH, Pollock BG, Taghdiri F, Wang W, Tartaglia MC. Assessing the Role of Past Depression in Patients with Mild Cognitive Impairment, with and without Biomarkers for Alzheimer's Disease. J Alzheimers Dis 2023; 92:1219-1227. [PMID: 36911939 DOI: 10.3233/jad-221097] [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] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Major depressive disorder (MDD) is a risk factor for Alzheimer's disease (AD). Cerebrovascular disease (CVD) is implicated in MDD and AD. Our study compared participants with AD positive and negative cerebrospinal fluid (CSF) biomarkers on neuropsychological performance, remitted MDD status, and CVD burden. Next, we compared AD-CSF biomarkers and white matter hyperintensities (WMH) burden among three groups: mild cognitive impairment (MCI) (n = 12), MCI with remitted MDD (MDD+MCI) (n = 12), and remitted MDD alone (MDD) (n = 7). Few participants (18%) with MCI+MDD exhibited AD(+) biomarkers. Nearly all participants had moderate-severe WMH. WMH may contribute to cognitive impairment or depression in MCI patients with AD(-) biomarkers.
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Affiliation(s)
- Angela C Golas
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Patrick Salwierz
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tarek K Rajji
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Christopher R Bowie
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Corinne E Fischer
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Alastair J Flint
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada
| | - Nathan Herrmann
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Linda Mah
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Bruce G Pollock
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Foad Taghdiri
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Wei Wang
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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9
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Staffaroni AM, Quintana M, Wendelberger B, Heuer HW, Russell LL, Cobigo Y, Wolf A, Goh SYM, Petrucelli L, Gendron TF, Heller C, Clark AL, Taylor JC, Wise A, Ong E, Forsberg L, Brushaber D, Rojas JC, VandeVrede L, Ljubenkov P, Kramer J, Casaletto KB, Appleby B, Bordelon Y, Botha H, Dickerson BC, Domoto-Reilly K, Fields JA, Foroud T, Gavrilova R, Geschwind D, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford N, Grossman M, Hall MGH, Hsiung GY, Huey ED, Irwin D, Jones DT, Kantarci K, Kaufer D, Knopman D, Kremers W, Lago AL, Lapid MI, Litvan I, Lucente D, Mackenzie IR, Mendez MF, Mester C, Miller BL, Onyike CU, Rademakers R, Ramanan VK, Ramos EM, Rao M, Rascovsky K, Rankin KP, Roberson ED, Savica R, Tartaglia MC, Weintraub S, Wong B, Cash DM, Bouzigues A, Swift IJ, Peakman G, Bocchetta M, Todd EG, Convery RS, Rowe JB, Borroni B, Galimberti D, Tiraboschi P, Masellis M, Finger E, van Swieten JC, Seelaar H, Jiskoot LC, Sorbi S, Butler CR, Graff C, Gerhard A, Langheinrich T, Laforce R, Sanchez-Valle R, de Mendonça A, Moreno F, Synofzik M, Vandenberghe R, Ducharme S, Le Ber I, Levin J, Danek A, Otto M, Pasquier F, Santana I, Kornak J, Boeve BF, Rosen HJ, Rohrer JD, Boxer AL. Temporal order of clinical and biomarker changes in familial frontotemporal dementia. Nat Med 2022; 28:2194-2206. [PMID: 36138153 PMCID: PMC9951811 DOI: 10.1038/s41591-022-01942-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [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: 12/11/2021] [Accepted: 07/08/2022] [Indexed: 01/17/2023]
Abstract
Unlike familial Alzheimer's disease, we have been unable to accurately predict symptom onset in presymptomatic familial frontotemporal dementia (f-FTD) mutation carriers, which is a major hurdle to designing disease prevention trials. We developed multimodal models for f-FTD disease progression and estimated clinical trial sample sizes in C9orf72, GRN and MAPT mutation carriers. Models included longitudinal clinical and neuropsychological scores, regional brain volumes and plasma neurofilament light chain (NfL) in 796 carriers and 412 noncarrier controls. We found that the temporal ordering of clinical and biomarker progression differed by genotype. In prevention-trial simulations using model-based patient selection, atrophy and NfL were the best endpoints, whereas clinical measures were potential endpoints in early symptomatic trials. f-FTD prevention trials are feasible but will likely require global recruitment efforts. These disease progression models will facilitate the planning of f-FTD clinical trials, including the selection of optimal endpoints and enrollment criteria to maximize power to detect treatment effects.
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Affiliation(s)
- Adam M Staffaroni
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
| | | | | | - Hilary W Heuer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Amy Wolf
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sheng-Yang Matt Goh
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | | | - Tania F Gendron
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Carolin Heller
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Annie L Clark
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jack Carson Taylor
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Amy Wise
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Elise Ong
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Leah Forsberg
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Danielle Brushaber
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Julio C Rojas
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lawren VandeVrede
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Peter Ljubenkov
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Joel Kramer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Kaitlin B Casaletto
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Brian Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Yvette Bordelon
- Department of Neurology, University of California, Los Angeles, Los Angeles, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Tatiana Foroud
- Indiana University School of Medicine, National Centralized Repository for Alzheimer's, Indianapolis, IN, USA
| | | | - Daniel Geschwind
- Department of Neurology, University of California, Los Angeles, Los Angeles, USA
- Institute for Precision Health, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Nupur Ghoshal
- Departments of Neurology and Psychiatry, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Jill Goldman
- Department of Neurology, Columbia University, New York, NY, USA
| | | | | | - Murray Grossman
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Matthew G H Hall
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Ging-Yuek Hsiung
- Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edward D Huey
- Department of Neurology, Columbia University, New York, NY, USA
| | - David Irwin
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Kejal Kantarci
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Daniel Kaufer
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - David Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Walter Kremers
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Argentina Lario Lago
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Irene Litvan
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Diane Lucente
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ian R Mackenzie
- Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mario F Mendez
- Department of Neurology, University of California, Los Angeles, Los Angeles, USA
| | - Carly Mester
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Chiadi U Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Applied and Translational Neurogenomics Group, VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | | | - Eliana Marisa Ramos
- Department of Neurology, University of California, Los Angeles, Los Angeles, USA
| | - Meghana Rao
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Katya Rascovsky
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Katherine P Rankin
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Erik D Roberson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Sandra Weintraub
- Department of Neurology, Northwestern University, Chicago, IL, USA
| | - Bonnie Wong
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Arabella Bouzigues
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Imogen J Swift
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Georgia Peakman
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Emily G Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Rhian S Convery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - James B Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust and Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Mario Masellis
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
| | | | - Harro Seelaar
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Lize C Jiskoot
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Sandro Sorbi
- Department of Neurofarba, University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Chris R Butler
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Caroline Graff
- Center for Alzheimer Research, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Bioclinicum, Karolinska Institutet, Solna, Sweden
- Unit for Hereditary Dementias, Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK
- Departments of Geriatric Medicine and Nuclear Medicine, Center for Translational Neuro- and Behavioral Sciences, University Medicine Essen, Essen, Germany
| | - Tobias Langheinrich
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK
- Cerebral Function Unit, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, and Faculté de Médecine, Université Laval, Québec City, Québec, Canada
| | - Raquel Sanchez-Valle
- Alzheimer's disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | | | - Fermin Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia University Hospital, San Sebastian, Gipuzkoa, Spain
- Neuroscience Area, Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Neurology Service, University Hospitals Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Simon Ducharme
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Department of Neurology & Neurosurgery, McGill University, Montreal, Québec, Canada
| | - Isabelle Le Ber
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau - ICM, Inserm U1127, CNRS UMR 7225, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France
- Centre de référence des démences rares ou précoces, IM2A, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France
- Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France
| | - Johannes Levin
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Munich, Germany
- Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster of Systems Neurology, Munich, Germany
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Florence Pasquier
- University of Lille, Lille, France
- Inserm, Lille, France
- CHU, CNR-MAJ, Labex Distalz, LiCEND Lille, Lille, France
| | - Isabel Santana
- Neurology Service, Faculty of Medicine, University Hospital of Coimbra (HUC), University of Coimbra, Coimbra, Portugal
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | | | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square London, London, UK
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
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10
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Wilson KM, Katona E, Glaria I, Carcolé M, Swift IJ, Sogorb-Esteve A, Heller C, Bouzigues A, Heslegrave AJ, Keshavan A, Knowles K, Patil S, Mohapatra S, Liu Y, Goyal J, Sanchez-Valle R, Laforce RJ, Synofzik M, Rowe JB, Finger E, Vandenberghe R, Butler CR, Gerhard A, Van Swieten JC, Seelaar H, Borroni B, Galimberti D, de Mendonça A, Masellis M, Tartaglia MC, Otto M, Graff C, Ducharme S, Schott JM, Malaspina A, Zetterberg H, Boyanapalli R, Rohrer JD, Isaacs AM. Development of a sensitive trial-ready poly(GP) CSF biomarker assay for C9orf72-associated frontotemporal dementia and amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2022; 93:761-771. [PMID: 35379698 PMCID: PMC9279742 DOI: 10.1136/jnnp-2021-328710] [Citation(s) in RCA: 10] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/04/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVE A GGGGCC repeat expansion in the C9orf72 gene is the most common cause of genetic frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS). As potential therapies targeting the repeat expansion are now entering clinical trials, sensitive biomarker assays of target engagement are urgently required. Our objective was to develop such an assay. METHODS We used the single molecule array (Simoa) platform to develop an immunoassay for measuring poly(GP) dipeptide repeat proteins (DPRs) generated by the C9orf72 repeat expansion in cerebrospinal fluid (CSF) of people with C9orf72-associated FTD/ALS. RESULTS AND CONCLUSIONS We show the assay to be highly sensitive and robust, passing extensive qualification criteria including low intraplate and interplate variability, a high precision and accuracy in measuring both calibrators and samples, dilutional parallelism, tolerance to sample and standard freeze-thaw and no haemoglobin interference. We used this assay to measure poly(GP) in CSF samples collected through the Genetic FTD Initiative (N=40 C9orf72 and 15 controls). We found it had 100% specificity and 100% sensitivity and a large window for detecting target engagement, as the C9orf72 CSF sample with the lowest poly(GP) signal had eightfold higher signal than controls and on average values from C9orf72 samples were 38-fold higher than controls, which all fell below the lower limit of quantification of the assay. These data indicate that a Simoa-based poly(GP) DPR assay is suitable for use in clinical trials to determine target engagement of therapeutics aimed at reducing C9orf72 repeat-containing transcripts.
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Affiliation(s)
- Katherine M Wilson
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Eszter Katona
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Idoia Glaria
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Mireia Carcolé
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Imogen J Swift
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, London, UK
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Aitana Sogorb-Esteve
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, London, UK
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Carolin Heller
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, London, UK
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Arabella Bouzigues
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Amanda J Heslegrave
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, London, UK
| | - Ashvini Keshavan
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Kathryn Knowles
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, London, UK
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | | | | | - Yuanjing Liu
- Wave Life Sciences, Cambridge, Massachusetts, USA
| | - Jaya Goyal
- Wave Life Sciences, Cambridge, Massachusetts, USA
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Robert Jr Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, and Faculté de Médecine, Université Laval, Quebec City, Quebec, Canada
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- Center for Neurodegenerative Diseases, (DZNE), Tübingen, Germany
| | - James B Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust and Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, University of Western Ontario, London, Ontario, Canada
| | - Rik Vandenberghe
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Neurology Service, University Hospitals, Leuven, Belgium
| | - Christopher R Butler
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, The University of Manchester, Manchester, UK
- Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg- Essen, University of Duisburg- Essen, Essen, Germany
| | | | - Harro Seelaar
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Daniela Galimberti
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Centro Dino Ferrari, University of Milan, Milan, Italy
| | | | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada
- Canadian Sports Concussion Project, Toronto, Ontario, Canada
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Caroline Graff
- Center for Alzheimer Research, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Bioclinicum, Karolinska Institutet, Solna, Sweden
- Unit for Hereditary Dementias, Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Simon Ducharme
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Jonathan M Schott
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Andrea Malaspina
- Barts and The London School of Medicine and Dentistry Blizard Institute, London, UK
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Henrik Zetterberg
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, London, UK
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | | | - Jonathan D Rohrer
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, London, UK
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Adrian M Isaacs
- UK Dementia Research Institute at UCL, UCL Queen Square Institute of Neurology, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
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11
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Anor CJ, Dadar M, Collins DL, Tartaglia MC. The Longitudinal Assessment of Neuropsychiatric Symptoms in Mild Cognitive Impairment and Alzheimer's Disease and Their Association With White Matter Hyperintensities in the National Alzheimer's Coordinating Center's Uniform Data Set. Biol Psychiatry Cogn Neurosci Neuroimaging 2021; 6:70-78. [PMID: 32389747 PMCID: PMC7529680 DOI: 10.1016/j.bpsc.2020.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPSs) are common in Alzheimer's disease (AD). NPSs contribute to patients' distress, caregiver burden, and institutionalization. White matter hyperintensities (WMHs) appear on magnetic resonance imaging, usually indicative of cerebrovascular disease. WMHs have been associated with certain NPSs. We aimed to assess the relationship between WMH and NPS severity in mild cognitive impairment (MCI) due to AD (MCI-AD) and in AD and to assess the ability of WMHs to predict NPS progression. Data were obtained from the National Alzheimer's Coordinating Center. METHODS A total of 252 participants (114 with MCI-AD and 138 with AD) were used in this study. Baseline WMHs were quantified using an automated segmentation technique. NPSs were measured using the Neuropsychiatric Inventory. Mixed-effect models and correlations were used to determine the relationship between WMHs and NPSs. RESULTS Longitudinal mixed-effect models revealed a significant relationship between increase in Neuropsychiatric Inventory total scores and baseline WMHs (p = .014). There was a significant relationship between baseline WMHs and an increase in delusions (p = .023), hallucinations (p = .040), agitation (p = .093), depression (p = .017), and irritability (p = .002). Correlation plot analysis showed that baseline whole-brain WMHs predicted change in future Neuropsychiatric Inventory total scores (r = .169, p = .008) and predicted change in future agitation severity scores (r = .165, p = .009). WMHs in the temporal lobes (r = .169, p = .008) and frontal lobes (r = .153, p = .016) contributed most to this change. CONCLUSIONS Depression, irritability, and agitation are common NPSs and very distressful to patients and caregivers. Our findings of increased NPS severity over time in MCI-AD and AD with increased WMHs have important implications for treatment, arguing for aggressive treatment of vascular risk factors in patients with MCI-AD or AD.
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Affiliation(s)
- Cassandra J Anor
- University Health Network Memory Clinic, Department of Neurology, Toronto, Ontario, Canada; Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Mahsa Dadar
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - D Louis Collins
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - M Carmela Tartaglia
- University Health Network Memory Clinic, Department of Neurology, Toronto, Ontario, Canada; Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada.
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12
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Staffaroni AM, Goh SYM, Cobigo Y, Ong E, Lee SE, Casaletto KB, Wolf A, Forsberg LK, Ghoshal N, Graff-Radford NR, Grossman M, Heuer HW, Hsiung GYR, Kantarci K, Knopman DS, Kremers WK, Mackenzie IR, Miller BL, Pedraza O, Rascovsky K, Tartaglia MC, Wszolek ZK, Kramer JH, Kornak J, Boeve BF, Boxer AL, Rosen HJ. Rates of Brain Atrophy Across Disease Stages in Familial Frontotemporal Dementia Associated With MAPT, GRN, and C9orf72 Pathogenic Variants. JAMA Netw Open 2020; 3:e2022847. [PMID: 33112398 PMCID: PMC7593814 DOI: 10.1001/jamanetworkopen.2020.22847] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/22/2020] [Indexed: 12/12/2022] Open
Abstract
Importance Several clinical trials are planned for familial forms of frontotemporal lobar degeneration (f-FTLD). Precise modeling of brain atrophy in f-FTLD could improve the power to detect a treatment effect. Objective To characterize regions and rates of atrophy in the 3 primary f-FTLD genetic groups (MAPT, GRN, and C9orf72) across all disease stages from asymptomatic to dementia. Design, Setting, and Participants This investigation was a case-control study of participants enrolled in the Advancing Research and Treatment for Frontotemporal Lobar Degeneration or Longitudinal Evaluation of Familial Frontotemporal Dementia studies. The study took place at 18 North American academic medical centers between January 2009 and September 2018. Participants with f-FTLD (n = 100) with a known pathogenic variant (MAPT [n = 28], GRN [n = 33], or C9orf72 [n = 39]) were grouped according to disease stage (ie, Clinical Dementia Rating [CDR] plus National Alzheimer's Coordinating Center [NACC] FTLD module). Included were participants with at least 2 structural magnetic resonance images at presymptomatic (CDR + NACC FTLD = 0 [n = 57]), mild or questionable (CDR + NACC FTLD = 0.5 [n = 15]), or symptomatic (CDR + NACC FTLD = ≥1 [n = 28]) disease stages. The control group included family members of known pathogenic variant carriers who did not carry the pathogenic variant (n = 60). Main Outcomes and Measures This study fitted bayesian linear mixed-effects models in each voxel of the brain to quantify the rate of atrophy in each of the 3 genes, at each of the 3 disease stages, compared with controls. The study also analyzed rates of clinical decline in each of these groups, as measured by the CDR + NACC FTLD box score. Results The sample included 100 participants with f-FTLD with a known pathogenic variant (mean [SD] age, 50.48 [13.78] years; 53 [53%] female) and 60 family members of known pathogenic variant carriers who did not carry the pathogenic variant (mean [SD] age, 47.51 [12.43] years; 36 [60%] female). MAPT and GRN pathogenic variants were associated with increased rates of volume loss compared with controls at all stages of disease. In MAPT pathogenic variant carriers, statistically significant regions of accelerated volume loss compared with controls were identified in temporal regions bilaterally in the presymptomatic stage, with global spread in the symptomatic stage. For example, mean [SD] rates of atrophy in the left temporal were -231 [47] mm3 per year during the presymptomatic stage, -381 [208] mm3 per year during the mild stage, and -1485 [1025] mm3 per year during the symptomatic stage (P < .05). GRN pathogenic variant carriers generally had minimal increases in atrophy rates between the presymptomatic and mild stages, with rapid increases in atrophy rates in the symptomatic stages. For example, in the right frontal lobes, annualized volume loss was -267 [81] mm3 per year in the presymptomatic stage and -182 [90] mm3 per year in the mild stage, but -1169 [555] mm3 per year in the symptomatic stage. Compared with the other groups, C9orf72 expansion carriers showed minimal increases in rate of volume loss with disease progression. For example, the mean (SD) annualized rates of atrophy in the right frontal lobe in C9orf72 expansion carriers was -272 (118) mm3 per year in presymptomatic stages, -310 (189) mm3 per year in mildly symptomatic stages, and -251 (145) mm3 per year in symptomatic stages. Conclusions and Relevance These findings are relevant to clinical trial planning and suggest that the mechanism by which C9orf72 pathogenic variants lead to symptoms may be fundamentally different from the mechanisms associated with other pathogenic variants.
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Affiliation(s)
- Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Sheng-Yang M. Goh
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Elise Ong
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Suzee E. Lee
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Kaitlin B. Casaletto
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Amy Wolf
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Leah K. Forsberg
- Department of Neurology, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Nupur Ghoshal
- Department of Neurology, Washington University School of Medicine in St Louis, St Louis, Missouri
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, Missouri
| | | | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Hilary W. Heuer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Ging-Yuek R. Hsiung
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kejal Kantarci
- Department of Radiology, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - David S. Knopman
- Department of Neurology, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Walter K. Kremers
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Ian R. Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Otto Pedraza
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida
| | - Katya Rascovsky
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - M. Carmela Tartaglia
- Division of Neurology, Department of Medicine, Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | | | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - John Kornak
- Department of Epidemiology and Biostatistics, Memory and Aging Center, University of California, San Francisco
| | - Bradley F. Boeve
- Department of Neurology, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Adam L. Boxer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco
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13
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Olney NT, Ong E, Goh SYM, Bajorek L, Dever R, Staffaroni AM, Cobigo Y, Bock M, Chiang K, Ljubenkov P, Kornak J, Heuer HW, Wang P, Rascovsky K, Wolf A, Appleby B, Bove J, Bordelon Y, Brannelly P, Brushaber D, Caso C, Coppola G, Dickerson BC, Dickinson S, Domoto-Reilly K, Faber K, Ferrall J, Fields J, Fishman A, Fong J, Foroud T, Forsberg LK, Gearhart DJ, Ghazanfari B, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford NR, Grant I, Grossman M, Haley D, Hsiung G, Huey ED, Irwin DJ, Jones DT, Kantarci K, Karydas AM, Kaufer D, Kerwin D, Knopman DS, Kramer JH, Kraft R, Kremers W, Kukull W, Lapid MI, Litvan I, Mackenzie IR, Maldonado M, Manoochehri M, McGinnis SM, McKinley EC, Mendez MF, Miller BL, Onyike C, Pantelyat A, Pearlman R, Petrucelli L, Potter M, Rademakers R, Ramos EM, Rankin KP, Roberson ED, Rogalski E, Sengdy P, Shaw LM, Syrjanen J, Tartaglia MC, Tatton N, Taylor J, Toga A, Trojanowski JQ, Weintraub S, Wong B, Wszolek Z, Boxer AL, Boeve BF, Rosen HJ. Clinical and volumetric changes with increasing functional impairment in familial frontotemporal lobar degeneration. Alzheimers Dement 2020; 16:49-59. [PMID: 31784375 PMCID: PMC6988137 DOI: 10.1016/j.jalz.2019.08.196] [Citation(s) in RCA: 22] [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] [Indexed: 11/24/2022]
Abstract
Introduction: The Advancing Research and Treatment in Frontotemporal Lobar Degeneration and Longitudinal Evaluation of Familial Frontotemporal Dementia Subjects longitudinal studies were designed to describe the natural history of familial-frontotemporal lobar degeneration due to autosomal dominant mutations. Methods: We examined cognitive performance, behavioral ratings, and brain volumes from the first time point in 320 MAPT, GRN, and C9orf72 family members, including 102 non–mutation carriers, 103 asymptomatic carriers, 43 mildly/questionably symptomatic carriers, and 72 carriers with dementia. Results: Asymptomatic carriers showed similar scores on all clinical measures compared with noncarriers but reduced frontal and temporal volumes. Those with mild/questionable impairment showed decreased verbal recall, fluency, and Trail Making Test performance and impaired mood and self-monitoring. Dementia was associated with impairment in all measures. All MAPT carriers with dementia showed temporal atrophy, but otherwise, there was no single cognitive test or brain region that was abnormal in all subjects. Discussion: Imaging changes appear to precede clinical changes in familial-frontotemporal lobar degeneration, but specific early clinical and imaging changes vary across individuals.
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Affiliation(s)
- Nicholas T. Olney
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Elise Ong
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Sheng-Yang M. Goh
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Lynn Bajorek
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Reilly Dever
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Meredith Bock
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Kevin Chiang
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Peter Ljubenkov
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - John Kornak
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Hilary W. Heuer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Ping Wang
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Katya Rascovsky
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amelia Wolf
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Brian Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Jessica Bove
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yvette Bordelon
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Patrick Brannelly
- Tau Consortium, Rainwater Charitable Foundation, Fort Worth, TX, USA
| | | | - Christine Caso
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Giovanni Coppola
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bradford C. Dickerson
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
| | - Susan Dickinson
- Association for Frontotemporal Degeneration, Radnor, PA, USA
| | | | - Kelly Faber
- National Centralized Repository for Alzheimer’s Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, IN, USA
| | - Jessica Ferrall
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Julie Fields
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Ann Fishman
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jamie Fong
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Tatiana Foroud
- National Centralized Repository for Alzheimer’s Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, IN, USA
| | | | | | - Behnaz Ghazanfari
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nupur Ghoshal
- Department of Psychiatry, Washington University, St. Louis, MO, USA
- Department of Neurology, Washington University, St. Louis, MO, USA
| | - Jill Goldman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | | | | | - Ian Grant
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dana Haley
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Gingyuek Hsiung
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edward D. Huey
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - David J. Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David T. Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Kejal Kantarci
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Anna M. Karydas
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Kaufer
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Diana Kerwin
- Department of Neurology and Neurotherapeutics, Center for Alzheimer’s and Neurodegenerative Diseases, The University of Texas, Southwestern Medical Center at Dallas, Dallas, TX, USA
- Department of Internal Medicine, The University of Texas, Southwestern Medical Center at Dallas, Dallas, TX, USA
| | | | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Ruth Kraft
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Walter Kremers
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Walter Kukull
- National Alzheimer Coordinating Center (NACC), University of Washington, Seattle, WA, USA
| | - Maria I. Lapid
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Irene Litvan
- Department of Neurosciences, Parkinson and Other Movement Disorders Center, University of California, San Diego, San Diego, CA, USA
| | - Ian R. Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Miranda Maldonado
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Masood Manoochehri
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - Scott M. McGinnis
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
| | - Emily C. McKinley
- Department of Neurology, Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mario F. Mendez
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Chiadi Onyike
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Alex Pantelyat
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Len Petrucelli
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Madeleine Potter
- National Centralized Repository for Alzheimer’s Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, IN, USA
| | | | - Eliana M. Ramos
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Erik D. Roberson
- Department of Neurology, Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emily Rogalski
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Pheth Sengdy
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie M. Shaw
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jeremy Syrjanen
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - M. Carmela Tartaglia
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Nadine Tatton
- Association for Frontotemporal Degeneration, Radnor, PA, USA
| | - Joanne Taylor
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Arthur Toga
- Laboratory of Neuroimaging (LONI), University of Southern California, Los Angeles, CA, USA
| | - John Q. Trojanowski
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sandra Weintraub
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Bonnie Wong
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
| | | | - Adam L. Boxer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Brad F. Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
- Corresponding author. Tel.: 1 415 476 5567; Fax: 1 415 476 1816.,
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14
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Casaletto KB, Staffaroni AM, Wolf A, Appleby B, Brushaber D, Coppola G, Dickerson B, Domoto-Reilly K, Elahi FM, Fields J, Fong JC, Forsberg L, Ghoshal N, Graff-Radford N, Grossman M, Heuer HW, Hsiung GY, Huey ED, Irwin D, Kantarci K, Kaufer D, Kerwin D, Knopman D, Kornak J, Kramer JH, Litvan I, Mackenzie IR, Mendez M, Miller B, Rademakers R, Ramos EM, Rascovsky K, Roberson ED, Syrjanen JA, Tartaglia MC, Weintraub S, Boeve B, Boxer AL, Rosen H, Yaffe K. Active lifestyles moderate clinical outcomes in autosomal dominant frontotemporal degeneration. Alzheimers Dement 2020; 16:91-105. [PMID: 31914227 PMCID: PMC6953618 DOI: 10.1002/alz.12001] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 02/02/2019] [Revised: 07/31/2019] [Accepted: 09/09/2019] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Leisure activities impact brain aging and may be prevention targets. We characterized how physical and cognitive activities relate to brain health for the first time in autosomal dominant frontotemporal lobar degeneration (FTLD). METHODS A total of 105 mutation carriers (C9orf72/MAPT/GRN) and 69 non-carriers reported current physical and cognitive activities at baseline, and completed longitudinal neurobehavioral assessments and brain magnetic resonance imaging (MRI) scans. RESULTS Greater physical and cognitive activities were each associated with an estimated >55% slower clinical decline per year among dominant gene carriers. There was also an interaction between leisure activities and frontotemporal atrophy on cognition in mutation carriers. High-activity carriers with frontotemporal atrophy (-1 standard deviation/year) demonstrated >two-fold better cognitive performances per year compared to their less active peers with comparable atrophy rates. DISCUSSION Active lifestyles were associated with less functional decline and moderated brain-to-behavior relationships longitudinally. More active carriers "outperformed" brain volume, commensurate with a cognitive reserve hypothesis. Lifestyle may confer clinical resilience, even in autosomal dominant FTLD.
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Affiliation(s)
- K B Casaletto
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - A M Staffaroni
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - A Wolf
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - B Appleby
- Case Western Reserve University, Cleveland, Ohio, USA
| | | | - G Coppola
- University of California, Los Angeles, California, USA
| | - B Dickerson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - F M Elahi
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - J Fields
- Mayo Clinic, Rochester, Minnesota, USA
| | - J C Fong
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - L Forsberg
- Case Western Reserve University, Cleveland, Ohio, USA
| | - N Ghoshal
- Washington University, St. Louis, Illinois, USA
| | | | - M Grossman
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - H W Heuer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - G-Y Hsiung
- University of British Columbia, Vancouver, British Columbia, Canada
| | - E D Huey
- Columbia University, New York, New York, USA
| | - D Irwin
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - D Kaufer
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - D Kerwin
- University of Texas Southwestern, Dallas, Texas, USA
| | - D Knopman
- Mayo Clinic, Rochester, Minnesota, USA
| | - J Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - J H Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - I Litvan
- Parkinson and Other Movement Disorder Center, Department of Neuroscience, University of California, San Diego, San Diego, California, USA
| | - I R Mackenzie
- University of British Columbia, Vancouver, British Columbia, Canada
| | - M Mendez
- University of California, Los Angeles, California, USA
| | - B Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | | | - E M Ramos
- University of California, Los Angeles, USA
| | - K Rascovsky
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | - S Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University, Chicago, Illinois, USA
| | - B Boeve
- Mayo Clinic, Rochester, Minnesota, USA
| | - A L Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - H Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - K Yaffe
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, California, USA
- San Francisco Department of Psychiatry, University of California, San Francisco, California, USA
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15
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Heuer HW, Wang P, Rascovsky K, Wolf A, Appleby B, Bove J, Bordelon Y, Brannelly P, Brushaber DE, Caso C, Coppola G, Dickerson B, Dickinson S, Domoto-Reilly K, Faber K, Ferrall J, Fields J, Fishman A, Fong J, Foroud T, Forsberg LK, Gearhart D, Ghazanfari B, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford N, Grant I, Grossman M, Haley D, Hsiung GY, Huey E, Irwin D, Jones D, Kantarci K, Karydas A, Kaufer D, Kerwin D, Knopman D, Kornak J, Kramer JH, Kraft R, Kremers WK, Kukull W, Litvan I, Ljubenkov P, Mackenzie IR, Maldonado M, Manoochehri M, McGinnis S, McKinley E, Mendez MF, Miller BL, Onyike C, Pantelyat A, Pearlman R, Petrucelli L, Potter M, Rademakers R, Ramos EM, Rankin KP, Roberson ED, Rogalski E, Sengdy P, Shaw L, Syrjanen J, Tartaglia MC, Tatton N, Taylor J, Toga A, Trojanowski J, Weintraub S, Wong B, Wszolek Z, Boeve BF, Rosen HJ, Boxer AL. Comparison of sporadic and familial behavioral variant frontotemporal dementia (FTD) in a North American cohort. Alzheimers Dement 2020; 16:60-70. [PMID: 31914226 PMCID: PMC7192555 DOI: 10.1002/alz.12046] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Behavioral variant frontotemporal dementia (bvFTD) may present sporadically or due to an autosomal dominant mutation. Characterization of both forms will improve understanding of the generalizability of assessments and treatments. METHODS A total of 135 sporadic (s-bvFTD; mean age 63.3 years; 34% female) and 99 familial (f-bvFTD; mean age 59.9; 48% female) bvFTD participants were identified. f-bvFTD cases included 43 with known or presumed chromosome 9 open reading frame 72 (C9orf72) gene expansions, 28 with known or presumed microtubule-associated protein tau (MAPT) mutations, 14 with known progranulin (GRN) mutations, and 14 with a strong family history of FTD but no identified mutation. RESULTS Participants with f-bvFTD were younger and had earlier age at onset. s-bvFTD had higher total Neuropsychiatric Inventory Questionnaire (NPI-Q) scores due to more frequent endorsement of depression and irritability. DISCUSSION f-bvFTD and s-bvFTD cases are clinically similar, suggesting the generalizability of novel biomarkers, therapies, and clinical tools developed in either form to the other.
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Affiliation(s)
- Hilary W Heuer
- University of California, San Francisco, San Francisco, California
| | - P Wang
- University of California, San Francisco, San Francisco, California
| | - K Rascovsky
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - A Wolf
- University of California, San Francisco, San Francisco, California
| | - B Appleby
- Case Western Reserve University, Cleveland, Ohio
| | - J Bove
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - Y Bordelon
- University of California, Los Angeles, Los Angeles, California
| | - P Brannelly
- Tau Consortium, Rainwater Charitable Foundation, Fort Worth, Texas
| | | | - C Caso
- U Washington, Seattle, Washington
| | - G Coppola
- University of California, Los Angeles, Los Angeles, California
| | - B Dickerson
- Harvard University/MGH, Boston, Massachusetts
| | - S Dickinson
- Association for Frontotemporal Degeneration, Radnor, Pennsylvania
| | | | - K Faber
- National Centralized Repository for Alzheimer's Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, Indiana
| | - J Ferrall
- University of North Carolina, Chapel Hill, North Carolina
| | - J Fields
- Mayo Clinic, Rochester, Minnesota
| | - A Fishman
- Johns Hopkins University, Baltimore, Maryland
| | - J Fong
- University of California, San Francisco, San Francisco, California
| | - T Foroud
- National Centralized Repository for Alzheimer's Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, Indiana
| | | | | | | | - N Ghoshal
- Washington University, St. Louis, Missouri
| | - J Goldman
- Columbia University, New York, New York
| | | | | | - I Grant
- Northwestern University, Chicago, Illinois
| | - M Grossman
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - D Haley
- Mayo Clinic, Jacksonville, Florida
| | - G-Y Hsiung
- University of British Columbia, Vancouver, British Columbia, Canada
| | - E Huey
- Columbia University, New York, New York
| | - D Irwin
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - D Jones
- Mayo Clinic, Rochester, Minnesota
| | | | - A Karydas
- University of California, San Francisco, San Francisco, California
| | - D Kaufer
- University of North Carolina, Chapel Hill, North Carolina
| | - D Kerwin
- The University of Texas, Southwestern Medical Center at Dallas, Dallas, Texas
| | | | - J Kornak
- University of California, San Francisco, San Francisco, California
| | - J H Kramer
- University of California, San Francisco, San Francisco, California
| | - R Kraft
- Mayo Clinic, Rochester, Minnesota
| | | | - W Kukull
- National Alzheimer Coordinating Center (NACC), University of Washington, Seattle, Washington
| | - I Litvan
- University of California, San Diego, San Diego, California
| | - P Ljubenkov
- University of California, San Francisco, San Francisco, California
| | - I R Mackenzie
- University of British Columbia, Vancouver, British Columbia, Canada
| | - M Maldonado
- University of California, Los Angeles, Los Angeles, California
| | | | - S McGinnis
- Harvard University/MGH, Boston, Massachusetts
| | - E McKinley
- University of Alabama at Birmingham, Birmingham, Alabama
| | - M F Mendez
- University of California, Los Angeles, Los Angeles, California
| | - B L Miller
- University of California, San Francisco, San Francisco, California
| | - C Onyike
- Johns Hopkins University, Baltimore, Maryland
| | - A Pantelyat
- Johns Hopkins University, Baltimore, Maryland
| | - R Pearlman
- Bluefield Project, San Francisco, California
| | | | - M Potter
- National Centralized Repository for Alzheimer's Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, Indiana
| | | | - E M Ramos
- University of California, Los Angeles, Los Angeles, California
| | - K P Rankin
- University of California, San Francisco, San Francisco, California
| | - E D Roberson
- University of Alabama at Birmingham, Birmingham, Alabama
| | - E Rogalski
- Northwestern University, Chicago, Illinois
| | - P Sengdy
- University of British Columbia, Vancouver, British Columbia, Canada
| | - L Shaw
- University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | - N Tatton
- Association for Frontotemporal Degeneration, Radnor, Pennsylvania
| | - J Taylor
- University of California, San Francisco, San Francisco, California
| | - A Toga
- Laboratory of Neuroimaging (LONI), USC, Los Angeles, California
| | | | | | - B Wong
- Harvard University/MGH, Boston, Massachusetts
| | | | | | - H J Rosen
- University of California, San Francisco, San Francisco, California
| | - A L Boxer
- University of California, San Francisco, San Francisco, California
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16
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Staffaroni AM, Cobigo Y, Goh SYM, Kornak J, Bajorek L, Chiang K, Appleby B, Bove J, Bordelon Y, Brannelly P, Brushaber D, Caso C, Coppola G, Dever R, Dheel C, Dickerson BC, Dickinson S, Dominguez S, Domoto-Reilly K, Faber K, Ferrall J, Fields JA, Fishman A, Fong J, Foroud T, Forsberg LK, Gavrilova R, Gearhart D, Ghazanfari B, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford N, Grant I, Grossman M, Haley D, Heuer HW, Hsiung GY, Huey ED, Irwin DJ, Jones DT, Jones L, Kantarci K, Karydas A, Kaufer DI, Kerwin DR, Knopman DS, Kraft R, Kramer JH, Kremers WK, Kukull WA, Litvan I, Ljubenkov PA, Lucente D, Lungu C, Mackenzie IR, Maldonado M, Manoochehri M, McGinnis SM, McKinley E, Mendez MF, Miller BL, Multani N, Onyike C, Padmanabhan J, Pantelyat A, Pearlman R, Petrucelli L, Potter M, Rademakers R, Ramos EM, Rankin KP, Rascovsky K, Roberson ED, Rogalski E, Sengdy P, Shaw LM, Syrjanen J, Tartaglia MC, Tatton N, Taylor J, Toga A, Trojanowski JQ, Weintraub S, Wang P, Wong B, Wszolek Z, Boxer AL, Boeve BF, Rosen HJ. Individualized atrophy scores predict dementia onset in familial frontotemporal lobar degeneration. Alzheimers Dement 2020; 16:37-48. [PMID: 31272932 PMCID: PMC6938544 DOI: 10.1016/j.jalz.2019.04.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Some models of therapy for neurodegenerative diseases envision starting treatment before symptoms develop. Demonstrating that such treatments are effective requires accurate knowledge of when symptoms would have started without treatment. Familial frontotemporal lobar degeneration offers a unique opportunity to develop predictors of symptom onset. METHODS We created dementia risk scores in 268 familial frontotemporal lobar degeneration family members by entering covariate-adjusted standardized estimates of brain atrophy into a logistic regression to classify asymptomatic versus demented participants. The score's predictive value was tested in a separate group who were followed up longitudinally (stable vs. converted to dementia) using Cox proportional regressions with dementia risk score as the predictor. RESULTS Cross-validated logistic regression achieved good separation of asymptomatic versus demented (accuracy = 90%, SE = 0.06). Atrophy scores predicted conversion from asymptomatic or mildly/questionably symptomatic to dementia (HR = 1.51, 95% CI: [1.16,1.98]). DISCUSSION Individualized quantification of baseline brain atrophy is a promising predictor of progression in asymptomatic familial frontotemporal lobar degeneration mutation carriers.
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Affiliation(s)
- Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Sheng-Yang M. Goh
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco CA, USA
| | - Lynn Bajorek
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Kevin Chiang
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Brian Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Jessica Bove
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yvette Bordelon
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Patrick Brannelly
- Tau Consortium, Rainwater Charitable Foundation, Fort Worth, TX, USA
| | | | - Christina Caso
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Giovanni Coppola
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Reilly Dever
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | | | - Bradford C. Dickerson
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan Dickinson
- Association for Frontotemporal Degeneration, Radnor, PA, USA
| | - Sophia Dominguez
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kelly Faber
- National Cell Repository for Alzheimer’s Disease (NCRAD), Indiana University, Indianapolis, IN, USA
| | - Jessica Ferrall
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Ann Fishman
- Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jamie Fong
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Tatiana Foroud
- National Cell Repository for Alzheimer’s Disease (NCRAD), Indiana University, Indianapolis, IN, USA
| | | | | | - Debra Gearhart
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Behnaz Ghazanfari
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nupur Ghoshal
- Departments of Neurology and Psychiatry, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Jill Goldman
- Department of Neurology, Columbia University, New York, NY, USA
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
| | | | | | - Ian Grant
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dana Haley
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Hilary W. Heuer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Ging-Yuek Hsiung
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edward D. Huey
- Department of Neurology, Columbia University, New York, NY, USA
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - David J. Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David T. Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Lynne Jones
- Department of Radiology, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Anna Karydas
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Daniel I. Kaufer
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Diana R. Kerwin
- Department of Neurology and Neurotherapeutics, Center for Alzheimer’s and Neurodegenerative Diseases, The University of Texas, Southwestern Medical Center at Dallas, Dallas, TX, USA
- Department of Internal Medicine, The University of Texas, Southwestern Medical Center at Dallas, Dallas, TX, USA
| | | | - Ruth Kraft
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Walter K. Kremers
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Walter A. Kukull
- National Alzheimer Coordinating Center (NACC), University of Washington, Seattle, WA, USA
| | - Irene Litvan
- Department of Neurosciences, Parkinson and Other Movement Disorders Center, University of California, San Diego, San Diego, CA, USA
| | - Peter A. Ljubenkov
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Diane Lucente
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Codrin Lungu
- National Institute of Neurological Disorders and Stroke (NINDS), Bethesda, MD, USA
| | - Ian R. Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Miranda Maldonado
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Scott M. McGinnis
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily McKinley
- Department of Neurology, Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mario F. Mendez
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Namita Multani
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Chiadi Onyike
- Department of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - Jaya Padmanabhan
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alex Pantelyat
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Len Petrucelli
- Department of Neurosciences, Mayo Clinic, Jacksonville, FL, USA
| | - Madeline Potter
- National Cell Repository for Alzheimer’s Disease (NCRAD), Indiana University, Indianapolis, IN, USA
| | - Rosa Rademakers
- Department of Neurosciences, Mayo Clinic, Jacksonville, FL, USA
| | - Eliana Marisa Ramos
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Katya Rascovsky
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erik D. Roberson
- Department of Neurology, Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emily Rogalski
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Pheth Sengdy
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jeremy Syrjanen
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - M. Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nadine Tatton
- Association for Frontotemporal Degeneration, Radnor, PA, USA
| | - Joanne Taylor
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Arthur Toga
- Departments of Ophthalmology, Neurology, Psychiatry and the Behavioral Sciences, Radiology and Engineering, Laboratory of Neuroimaging (LONI), USC, Los Angeles, CA, USA
| | - John Q. Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sandra Weintraub
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ping Wang
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Bonnie Wong
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Adam L. Boxer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
| | - Brad F. Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco CA, USA
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17
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Staffaroni AM, Bajorek L, Casaletto KB, Cobigo Y, Goh SYM, Wolf A, Heuer HW, Elahi FM, Ljubenkov PA, Dever R, Kornak J, Appleby B, Bove J, Bordelon Y, Brannelly P, Brushaber D, Caso C, Coppola G, Dheel C, Dickerson BC, Dickinson S, Dominguez S, Domoto-Reilly K, Faber K, Ferrall J, Fields JA, Fishman A, Fong J, Foroud T, Forsberg LK, Gavrilova R, Gearhart D, Ghazanfari B, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford N, Grant I, Grossman M, Haley D, Hsiung GY, Huey ED, Irwin DJ, Jones DT, Jones L, Kantarci K, Karydas A, Kaufer DI, Kerwin DR, Knopman DS, Kraft R, Kremers WK, Kukull WA, Litvan I, Lucente D, Lungu C, Mackenzie IR, Maldonado M, Manoochehri M, McGinnis SM, McKinley E, Mendez MF, Miller BL, Multani N, Onyike C, Padmanabhan J, Pantelyat A, Pearlman R, Petrucelli L, Potter M, Rademakers R, Ramos EM, Rankin KP, Rascovsky K, Roberson ED, Rogalski E, Sengdy P, Shaw LM, Syrjanen J, Tartaglia MC, Tatton N, Taylor J, Toga A, Trojanowski JQ, Weintraub S, Wang P, Wong B, Wszolek Z, Boxer AL, Boeve BF, Kramer JH, Rosen HJ. Assessment of executive function declines in presymptomatic and mildly symptomatic familial frontotemporal dementia: NIH-EXAMINER as a potential clinical trial endpoint. Alzheimers Dement 2020; 16:11-21. [PMID: 31914230 PMCID: PMC6842665 DOI: 10.1016/j.jalz.2019.01.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Identifying clinical measures that track disease in the earliest stages of frontotemporal lobar degeneration (FTLD) is important for clinical trials. Familial FTLD provides a unique paradigm to study early FTLD. Executive dysfunction is a clinically relevant hallmark of FTLD and may be a marker of disease progression. METHODS Ninety-three mutation carriers with no symptoms or minimal/questionable symptoms (MAPT, n = 31; GRN, n = 28; C9orf72, n = 34; Clinical Dementia Rating scale plus NACC FTLD Module < 1) and 78 noncarriers enrolled through Advancing Research and Treatment in Frontotemporal Lobar Degeneration/Longitudinal Evaluation of Familial Frontotemporal Dementia Subjects studies completed the Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (NIH-EXAMINER) and the UDS neuropsychological battery. Linear mixed-effects models were used to identify group differences in cognition at baseline and longitudinally. We examined associations between cognition, clinical functioning, and magnetic resonance imaging volumes. RESULTS NIH-EXAMINER scores detected baseline and differences in slopes between carriers and noncarriers, even in carriers with a baseline Clinical Dementia Rating scale plus NACC FTLD Module = 0. NIH-EXAMINER declines were associated with worsening clinical symptoms and brain volume loss. DISCUSSION The NIH-EXAMINER is sensitive to cognitive changes in presymptomatic familial FTLD and is a promising surrogate endpoint.
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Affiliation(s)
- Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Lynn Bajorek
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Kaitlin B. Casaletto
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Sheng-Yang M. Goh
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Amy Wolf
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Hilary W. Heuer
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Fanny M. Elahi
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Peter A. Ljubenkov
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Reilly Dever
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of
California, San Francisco, San Francisco, CA, USA
| | - Brian Appleby
- Department of Neurology, Case Western Reserve University,
Cleveland, OH, USA
| | - Jessica Bove
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - Yvette Bordelon
- Department of Neurology, University of California, Los
Angeles, Los Angeles, CA, USA
| | - Patrick Brannelly
- Tau Consortium, Rainwater Charitable Foundation, Fort
Worth, TX, USA
| | | | - Christina Caso
- Department of Neurology, University of Washington, Seattle,
WA, USA
| | - Giovanni Coppola
- Department of Neurology, University of California, Los
Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Bradford C. Dickerson
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan Dickinson
- Association for Frontotemporal Degeneration, Radnor, PA,
USA
| | - Sophia Dominguez
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kelly Faber
- National Cell Repository for Alzheimer’s Disease
(NCRAD), Indiana University, Indianapolis, IN, USA
| | - Jessica Ferrall
- Department of Neurology, University of North Carolina,
Chapel Hill, NC, USA
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic,
Rochester, MN, USA
| | - Ann Fishman
- School of Medicine, Department of Psychiatry, Johns
Hopkins University, Baltimore, MD, USA
| | - Jamie Fong
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Tatiana Foroud
- National Cell Repository for Alzheimer’s Disease
(NCRAD), Indiana University, Indianapolis, IN, USA
| | | | | | - Debra Gearhart
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Behnaz Ghazanfari
- Tanz Centre for Research in Neurodegenerative Diseases,
University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University
of Toronto, Toronto, Ontario, Canada
| | - Nupur Ghoshal
- Departments of Neurology and Psychiatry, Washington
University School of Medicine, Washington University, St. Louis, MO, USA
| | - Jill Goldman
- Department of Neurology, Columbia University, New York,
NY, USA
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Columbia University, New York, NY, USA
| | | | | | - Ian Grant
- Feinberg School of Medicine, Department of Neurology,
Northwestern University, Chicago, IL, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - Dana Haley
- Department of Neurology, Mayo Clinic, Jacksonville, FL,
USA
| | - Ging-Yuek Hsiung
- Division of Neurology, Deptartment of Medicine, University
of British Columbia, Vancouver, British Columbia, Canada
| | - Edward D. Huey
- Department of Neurology, Columbia University, New York,
NY, USA
- Taub Institute for Research on Alzheimer’s Disease
and the Aging Brain, Columbia University, New York, NY, USA
| | - David J. Irwin
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - David T. Jones
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Lynne Jones
- Department of Radiology, Washington University School of
Medicine, Washington University, St. Louis, MO, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN,
USA
| | - Anna Karydas
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Daniel I. Kaufer
- Department of Neurology, University of North Carolina,
Chapel Hill, NC, USA
| | - Diana R. Kerwin
- Department of Neurology and Neurotherapeutics, Center for
Alzheimer’s and Neurodegenerative Diseases, The University of Texas,
Southwestern Medical Center at Dallas, Dallas, TX, USA
- Department of Internal Medicine, The University of Texas,
Southwestern Medical Center at Dallas, Dallas, TX, USA
| | | | - Ruth Kraft
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Walter K. Kremers
- Department of Health Sciences Research, Mayo Clinic,
Rochester, MN, USA
| | - Walter A. Kukull
- National Alzheimer Coordinating Center (NACC), University
of Washington, Seattle, WA, USA
| | - Irene Litvan
- Department of Neurosciences, Parkinson and Other Movement
Disorders Center, University of California, San Diego, San Diego, CA, USA
| | - Diane Lucente
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Codrin Lungu
- National Institute of Neurological Disorders and Stroke
(NINDS), Bethesda, MD, USA
| | - Ian R. Mackenzie
- Department of Pathology and Laboratory Medicine,
University of British Columbia, Vancouver, British Columbia, Canada
| | - Miranda Maldonado
- Department of Neurology, University of California, Los
Angeles, Los Angeles, CA, USA
| | | | - Scott M. McGinnis
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily McKinley
- Department of Neurology, Alzheimer’s Disease
Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mario F. Mendez
- Department of Neurology, University of California, Los
Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, Los Angeles, CA, USA
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Namita Multani
- Tanz Centre for Research in Neurodegenerative Diseases,
University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University
of Toronto, Toronto, Ontario, Canada
| | - Chiadi Onyike
- Department of Geriatric Psychiatry and Neuropsychiatry,
Johns Hopkins University, Baltimore, MD, USA
| | - Jaya Padmanabhan
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alex Pantelyat
- School of Medicine, Department of Neurology, Johns
Hopkins University, Baltimore, MD, USA
| | | | - Len Petrucelli
- Department of Neurosciences, Mayo Clinic, Jacksonville,
FL, USA
| | - Madeline Potter
- National Cell Repository for Alzheimer’s Disease
(NCRAD), Indiana University, Indianapolis, IN, USA
| | - Rosa Rademakers
- Department of Neurosciences, Mayo Clinic, Jacksonville,
FL, USA
| | - Eliana Marisa Ramos
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, Los Angeles, CA, USA
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Katya Rascovsky
- Department of Neurology, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, USA
| | - Erik D. Roberson
- Department of Neurology, Alzheimer’s Disease
Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emily Rogalski
- Feinberg School of Medicine, Department of Psychiatry and
Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Pheth Sengdy
- Division of Neurology, Deptartment of Medicine, University
of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie M. Shaw
- Perelman School of Medicine, Department of Pathology and
Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jeremy Syrjanen
- Department of Health Sciences Research, Mayo Clinic,
Rochester, MN, USA
| | - M. Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases,
University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University
of Toronto, Toronto, Ontario, Canada
| | - Nadine Tatton
- Association for Frontotemporal Degeneration, Radnor, PA,
USA
| | - Joanne Taylor
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Arthur Toga
- Departments of Ophthalmology, Neurology, Psychiatry and
the Behavioral Sciences, Radiology and Engineering, Laboratory of Neuroimaging
(LONI), USC, Los Angeles, CA, USA
| | - John Q. Trojanowski
- Perelman School of Medicine, Department of Pathology and
Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sandra Weintraub
- Feinberg School of Medicine, Department of Neurology,
Northwestern University, Chicago, IL, USA
| | - Ping Wang
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Bonnie Wong
- Department of Neurology, Frontotemporal Disorders Unit,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Adam L. Boxer
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Brad F. Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN,
USA
| | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco, San Francisco, CA, US
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18
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Freedman M, Leach L, Carmela Tartaglia M, Stokes KA, Goldberg Y, Spring R, Nourhaghighi N, Gee T, Strother SC, Alhaj MO, Borrie M, Darvesh S, Fernandez A, Fischer CE, Fogarty J, Greenberg BD, Gyenes M, Herrmann N, Keren R, Kirstein J, Kumar S, Lam B, Lena S, McAndrews MP, Naglie G, Partridge R, Rajji TK, Reichmann W, Uri Wolf M, Verhoeff NPLG, Waserman JL, Black SE, Tang-Wai DF. Correction to: The Toronto cognitive assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment. Alzheimers Res Ther 2018; 10:120. [PMID: 30526675 PMCID: PMC6286597 DOI: 10.1186/s13195-018-0446-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Upon publication of this article [1], it was brought to our attention that one of the 303 participants in the normative study should have been deleted from the database.
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Affiliation(s)
- Morris Freedman
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada. .,Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada. .,Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada. .,Toronto Dementia Research Alliance, Toronto, ON, Canada. .,Mt. Sinai Hospital, Toronto, ON, Canada.
| | - Larry Leach
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Psychology, Glendon College, Toronto, ON, Canada
| | - M Carmela Tartaglia
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Toronto Western Hospital, University Health Network, Toronto, ON, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, Toronto, ON, Canada
| | - Kathryn A Stokes
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Yael Goldberg
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Robyn Spring
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
| | - Nima Nourhaghighi
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,Sunnybrook Research Institute, Toronto, ON, Canada
| | - Tom Gee
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
| | - Stephen C Strother
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Mohammad O Alhaj
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada.,Canada International Scientific Exchange Program, Toronto, ON, Canada
| | - Michael Borrie
- Lawson Health Research Institute, London, ON, Canada.,Parkwood Institute, London, ON, Canada
| | - Sultan Darvesh
- Department of Medicine (Neurology and Geriatric Medicine) and Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Alita Fernandez
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Corinne E Fischer
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jennifer Fogarty
- Lawson Health Research Institute, London, ON, Canada.,Parkwood Institute, London, ON, Canada
| | - Barry D Greenberg
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada
| | - Michelle Gyenes
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Nathan Herrmann
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,Sunnybrook Research Institute, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ron Keren
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Josh Kirstein
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Sanjeev Kumar
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Benjamin Lam
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Suvendrini Lena
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Mary Pat McAndrews
- Toronto Western Hospital, University Health Network, Toronto, ON, Canada.,Krembil Research Institute, University Health Network, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Gary Naglie
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada.,Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Medicine (Geriatric Medicine) and Institute of Health Policy, University of Toronto, Toronto, ON, Canada
| | - Robert Partridge
- Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Tarek K Rajji
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Toronto, ON, Canada
| | - William Reichmann
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - M Uri Wolf
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nicolaas P L G Verhoeff
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jordana L Waserman
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Sandra E Black
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Sunnybrook Research Institute, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,LC Campbell Cognitive Neurology Research Unit, Toronto, ON, Canada
| | - David F Tang-Wai
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Toronto Western Hospital, University Health Network, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada.,Krembil Research Institute, University Health Network, Toronto, ON, Canada
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19
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Freedman M, Leach L, Carmela Tartaglia M, Stokes KA, Goldberg Y, Spring R, Nourhaghighi N, Gee T, Strother SC, Alhaj MO, Borrie M, Darvesh S, Fernandez A, Fischer CE, Fogarty J, Greenberg BD, Gyenes M, Herrmann N, Keren R, Kirstein J, Kumar S, Lam B, Lena S, McAndrews MP, Naglie G, Partridge R, Rajji TK, Reichmann W, Uri Wolf M, Verhoeff NPLG, Waserman JL, Black SE, Tang-Wai DF. The Toronto Cognitive Assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment. Alzheimers Res Ther 2018; 10:65. [PMID: 30021658 PMCID: PMC6052695 DOI: 10.1186/s13195-018-0382-y] [Citation(s) in RCA: 24] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/08/2018] [Indexed: 11/10/2022]
Abstract
Background A need exists for easily administered assessment tools to detect mild cognitive changes that are more comprehensive than screening tests but shorter than a neuropsychological battery and that can be administered by physicians, as well as any health care professional or trained assistant in any medical setting. The Toronto Cognitive Assessment (TorCA) was developed to achieve these goals. Methods We obtained normative data on the TorCA (n = 303), determined test reliability, developed an iPad version, and validated the TorCA against neuropsychological assessment for detecting amnestic mild cognitive impairment (aMCI) (n = 50/57, aMCI/normal cognition). For the normative study, healthy volunteers were recruited from the Rotman Research Institute registry. For the validation study, the sample was comprised of participants with aMCI or normal cognition based on neuropsychological assessment. Cognitively normal participants were recruited from both healthy volunteers in the normative study sample and the community. Results The TorCA provides a stable assessment of multiple cognitive domains. The total score correctly classified 79% of participants (sensitivity 80%; specificity 79%). In an exploratory logistic regression analysis, indices of Immediate Verbal Recall, Delayed Verbal and Visual Recall, Visuospatial Function, and Working Memory/Attention/Executive Control, a subset of the domains assessed by the TorCA, correctly classified 92% of participants (sensitivity 92%; specificity 91%). Paper and iPad version scores were equivalent. Conclusions The TorCA can improve resource utilization by identifying patients with aMCI who may not require more resource-intensive neuropsychological assessment. Future studies will focus on cross-validating the TorCA for aMCI, and validation for disorders other than aMCI.
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Affiliation(s)
- Morris Freedman
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada. .,Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada. .,Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada. .,Toronto Dementia Research Alliance, Toronto, ON, Canada. .,Mt. Sinai Hospital, Toronto, ON, Canada.
| | - Larry Leach
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Psychology, Glendon College, Toronto, ON, Canada
| | - M Carmela Tartaglia
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Toronto Western Hospital, University Health Network, Toronto, ON, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, Toronto, ON, Canada
| | - Kathryn A Stokes
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Yael Goldberg
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Robyn Spring
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
| | - Nima Nourhaghighi
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,Sunnybrook Research Institute, Toronto, ON, Canada
| | - Tom Gee
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
| | - Stephen C Strother
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Mohammad O Alhaj
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada.,Canada International Scientific Exchange Program, Toronto, ON, Canada
| | - Michael Borrie
- Lawson Health Research Institute, London, ON, Canada.,Parkwood Institute, London, ON, Canada
| | - Sultan Darvesh
- Department of Medicine (Neurology and Geriatric Medicine) and Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Alita Fernandez
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Corinne E Fischer
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jennifer Fogarty
- Lawson Health Research Institute, London, ON, Canada.,Parkwood Institute, London, ON, Canada
| | - Barry D Greenberg
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada
| | - Michelle Gyenes
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Nathan Herrmann
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,Sunnybrook Research Institute, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ron Keren
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Josh Kirstein
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Sanjeev Kumar
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Benjamin Lam
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Suvendrini Lena
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Mary Pat McAndrews
- Toronto Western Hospital, University Health Network, Toronto, ON, Canada.,Krembil Research Institute, University Health Network, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Gary Naglie
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada.,Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Medicine (Geriatric Medicine) and Institute of Health Policy, University of Toronto, Toronto, ON, Canada
| | - Robert Partridge
- Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Tarek K Rajji
- Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Toronto, ON, Canada
| | - William Reichmann
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - M Uri Wolf
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nicolaas P L G Verhoeff
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jordana L Waserman
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada
| | - Sandra E Black
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Sunnybrook Research Institute, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,LC Campbell Cognitive Neurology Research Unit, Toronto, ON, Canada
| | - David F Tang-Wai
- Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.,Toronto Dementia Research Alliance, Toronto, ON, Canada.,Toronto Western Hospital, University Health Network, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada.,Krembil Research Institute, University Health Network, Toronto, ON, Canada
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Dadar M, Pascoal TA, Manitsirikul S, Misquitta K, Fonov VS, Tartaglia MC, Breitner J, Rosa-Neto P, Carmichael OT, Decarli C, Collins DL. Validation of a Regression Technique for Segmentation of White Matter Hyperintensities in Alzheimer's Disease. IEEE Trans Med Imaging 2017; 36:1758-1768. [PMID: 28422655 DOI: 10.1109/tmi.2017.2693978] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Segmentation and volumetric quantification of white matter hyperintensities (WMHs) is essential in assessment and monitoring of the vascular burden in aging and Alzheimer's disease (AD), especially when considering their effect on cognition. Manually segmenting WMHs in large cohorts is technically unfeasible due to time and accuracy concerns. Automated tools that can detect WMHs robustly and with high accuracy are needed. Here, we present and validate a fully automatic technique for segmentation and volumetric quantification of WMHs in aging and AD. The proposed technique combines intensity and location features frommultiplemagnetic resonance imaging contrasts and manually labeled training data with a linear classifier to perform fast and robust segmentations. It provides both a continuous subject specific WMH map reflecting different levels of tissue damage and binary segmentations. Themethodwas used to detectWMHs in 80 elderly/AD brains (ADC data set) as well as 40 healthy subjects at risk of AD (PREVENT-AD data set). Robustness across different scanners was validated using ten subjects from ADNI2/GO study. Voxel-wise and volumetric agreements were evaluated using Dice similarity index (SI) and intra-class correlation (ICC), yielding ICC=0.96 , SI = 0.62±0.16 for ADC data set and ICC=0.78 , SI=0.51±0.15 for PREVENT-AD data set. The proposed method was robust in the independent sample yielding SI=0.64±0.17 with ICC=0.93 for ADNI2/GO subjects. The proposed method provides fast, accurate, and robust segmentations on previously unseen data from different models of scanners, making it ideal to study WMHs in large scale multi-site studies.
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21
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Dadar M, Maranzano J, Misquitta K, Anor CJ, Fonov VS, Tartaglia MC, Carmichael OT, Decarli C, Collins DL. Performance comparison of 10 different classification techniques in segmenting white matter hyperintensities in aging. Neuroimage 2017; 157:233-249. [PMID: 28602597 DOI: 10.1016/j.neuroimage.2017.06.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [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: 04/27/2017] [Revised: 05/30/2017] [Accepted: 06/02/2017] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION White matter hyperintensities (WMHs) are areas of abnormal signal on magnetic resonance images (MRIs) that characterize various types of histopathological lesions. The load and location of WMHs are important clinical measures that may indicate the presence of small vessel disease in aging and Alzheimer's disease (AD) patients. Manually segmenting WMHs is time consuming and prone to inter-rater and intra-rater variabilities. Automated tools that can accurately and robustly detect these lesions can be used to measure the vascular burden in individuals with AD or the elderly population in general. Many WMH segmentation techniques use a classifier in combination with a set of intensity and location features to segment WMHs, however, the optimal choice of classifier is unknown. METHODS We compare 10 different linear and nonlinear classification techniques to identify WMHs from MRI data. Each classifier is trained and optimized based on a set of features obtained from co-registered MR images containing spatial location and intensity information. We further assess the performance of the classifiers using different combinations of MRI contrast information. The performances of the different classifiers were compared on three heterogeneous multi-site datasets, including images acquired with different scanners and different scan-parameters. These included data from the ADC study from University of California Davis, the NACC database and the ADNI study. The classifiers (naïve Bayes, logistic regression, decision trees, random forests, support vector machines, k-nearest neighbors, bagging, and boosting) were evaluated using a variety of voxel-wise and volumetric similarity measures such as Dice Kappa similarity index (SI), Intra-Class Correlation (ICC), and sensitivity as well as computational burden and processing times. These investigations enable meaningful comparisons between the performances of different classifiers to determine the most suitable classifiers for segmentation of WMHs. In the spirit of open-source science, we also make available a fully automated tool for segmentation of WMHs with pre-trained classifiers for all these techniques. RESULTS Random Forests yielded the best performance among all classifiers with mean Dice Kappa (SI) of 0.66±0.17 and ICC=0.99 for the ADC dataset (using T1w, T2w, PD, and FLAIR scans), SI=0.72±0.10, ICC=0.93 for the NACC dataset (using T1w and FLAIR scans), SI=0.66±0.23, ICC=0.94 for ADNI1 dataset (using T1w, T2w, and PD scans) and SI=0.72±0.19, ICC=0.96 for ADNI2/GO dataset (using T1w and FLAIR scans). Not using the T2w/PD information did not change the performance of the Random Forest classifier (SI=0.66±0.17, ICC=0.99). However, not using FLAIR information in the ADC dataset significantly decreased the Dice Kappa, but the volumetric correlation did not drastically change (SI=0.47±0.21, ICC=0.95). CONCLUSION Our investigations showed that with appropriate features, most off-the-shelf classifiers are able to accurately detect WMHs in presence of FLAIR scan information, while Random Forests had the best performance across all datasets. However, we observed that the performances of most linear classifiers and some nonlinear classifiers drastically decline in absence of FLAIR information, with Random Forest still retaining the best performance.
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Affiliation(s)
- Mahsa Dadar
- NeuroImaging and Surgical Tools Laboratory, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
| | - Josefina Maranzano
- Magnetic Resonance Studies Laboratory, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
| | - Karen Misquitta
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada.
| | - Cassandra J Anor
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada.
| | - Vladimir S Fonov
- NeuroImaging and Surgical Tools Laboratory, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
| | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada.
| | | | | | - D Louis Collins
- NeuroImaging and Surgical Tools Laboratory, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
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22
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Goswami R, Dufort P, Tartaglia MC, Green RE, Crawley A, Tator CH, Wennberg R, Mikulis DJ, Keightley M, Davis KD. Frontotemporal correlates of impulsivity and machine learning in retired professional athletes with a history of multiple concussions. Brain Struct Funct 2015; 221:1911-25. [PMID: 25721800 PMCID: PMC4853456 DOI: 10.1007/s00429-015-1012-0] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [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: 08/22/2014] [Accepted: 02/11/2015] [Indexed: 12/15/2022]
Abstract
The frontotemporal cortical network is associated with behaviours such as impulsivity and aggression. The health of the uncinate fasciculus (UF) that connects the orbitofrontal cortex (OFC) with the anterior temporal lobe (ATL) may be a crucial determinant of behavioural regulation. Behavioural changes can emerge after repeated concussion and thus we used MRI to examine the UF and connected gray matter as it relates to impulsivity and aggression in retired professional football players who had sustained multiple concussions. Behaviourally, athletes had faster reaction times and an increased error rate on a go/no-go task, and increased aggression and mania compared to controls. MRI revealed that the athletes had (1) cortical thinning of the ATL, (2) negative correlations of OFC thickness with aggression and task errors, indicative of impulsivity, (3) negative correlations of UF axial diffusivity with error rates and aggression, and (4) elevated resting-state functional connectivity between the ATL and OFC. Using machine learning, we found that UF diffusion imaging differentiates athletes from healthy controls with significant classifiers based on UF mean and radial diffusivity showing 79–84 % sensitivity and specificity, and 0.8 areas under the ROC curves. The spatial pattern of classifier weights revealed hot spots at the orbitofrontal and temporal ends of the UF. These data implicate the UF system in the pathological outcomes of repeated concussion as they relate to impulsive behaviour. Furthermore, a support vector machine has potential utility in the general assessment and diagnosis of brain abnormalities following concussion.
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Affiliation(s)
- R Goswami
- Canadian Sports Concussion Project, Toronto Western Hospital, Toronto, Canada.,Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Research Institute, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Room MP14-306, Toronto, ON, M5T 2S8, Canada
| | - P Dufort
- Canadian Sports Concussion Project, Toronto Western Hospital, Toronto, Canada.,Department of Medical Imaging, Toronto Western Hospital and University of Toronto, Toronto, Canada
| | - M C Tartaglia
- Canadian Sports Concussion Project, Toronto Western Hospital, Toronto, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Canada.,Division of Neurology, Krembil Neuroscience Centre, Toronto, Canada
| | - R E Green
- Canadian Sports Concussion Project, Toronto Western Hospital, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - A Crawley
- Canadian Sports Concussion Project, Toronto Western Hospital, Toronto, Canada.,Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Research Institute, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Room MP14-306, Toronto, ON, M5T 2S8, Canada.,Department of Medical Imaging, Toronto Western Hospital and University of Toronto, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada
| | - C H Tator
- Canadian Sports Concussion Project, Toronto Western Hospital, Toronto, Canada.,Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Research Institute, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Room MP14-306, Toronto, ON, M5T 2S8, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada.,Division of Neurosurgery, Krembil Neuroscience Centre, Toronto Western Hospital, Toronto, Canada.,Department of Surgery, University of Toronto, Toronto, Canada
| | - R Wennberg
- Canadian Sports Concussion Project, Toronto Western Hospital, Toronto, Canada.,Division of Neurology, Krembil Neuroscience Centre, Toronto, Canada
| | - D J Mikulis
- Canadian Sports Concussion Project, Toronto Western Hospital, Toronto, Canada.,Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Research Institute, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Room MP14-306, Toronto, ON, M5T 2S8, Canada.,Department of Medical Imaging, Toronto Western Hospital and University of Toronto, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada
| | - M Keightley
- Canadian Sports Concussion Project, Toronto Western Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto and Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Karen D Davis
- Canadian Sports Concussion Project, Toronto Western Hospital, Toronto, Canada. .,Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Research Institute, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Room MP14-306, Toronto, ON, M5T 2S8, Canada. .,Institute of Medical Science, University of Toronto, Toronto, Canada. .,Department of Surgery, University of Toronto, Toronto, Canada.
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23
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Rosenbloom MH, Tartaglia MC, Forner SA, Wong KK, Kuo A, Johnson DY, Colacurcio V, Andrews BD, Miller BL, DeArmond SJ, Geschwind MD. Metabolic disorders with clinical and radiologic features of sporadic Creutzfeldt-Jakob disease. Neurol Clin Pract 2015; 5:108-115. [PMID: 26137419 DOI: 10.1212/cpj.0000000000000114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Two patients with metabolic disorders presented with clinical and radiologic features suggestive of sporadic Creutzfeldt-Jakob disease (sCJD). Case 1 was a 50-year-old man with rapid decline in cognitive, behavioral, and motor function following new-onset seizures. MRI was read as consistent with CJD, and he was referred for a treatment trial, but it was determined that he recently experienced rapid correction of hyponatremia resulting in extrapontine myelinolysis. Case 2 was a 66-year-old woman with poorly controlled diabetes mellitus who was found unconscious after a suspected insulin overdose. Examination showed altered mental status and neuroimaging was remarkable for cortical/striatal hyperintensities suggestive of sCJD. On autopsy, she had hypoglycemic/hypoxic nerve cell loss. Although characteristic MRI findings have high sensitivity and specificity for sCJD, potentially reversible metabolic disorders sometimes present rapidly and can resemble sCJD both clinically and radiologically. These cases highlight the importance of establishing a broad differential diagnosis when evaluating a patient with suspected sCJD.
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Affiliation(s)
- Michael H Rosenbloom
- Center for Memory and Aging (MHR), HealthPartners Department of Neurology, St. Paul, MN; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Ontario, Canada; Memory and Aging Center (SAF, KKW, AK, DYJ, BLM, SJD, MDG), Department of Neurology, University of California, San Francisco; Department of Internal Medicine (VC) and Department of Neurology (BDA), Kaiser Permanente, Oakland, CA
| | - M Carmela Tartaglia
- Center for Memory and Aging (MHR), HealthPartners Department of Neurology, St. Paul, MN; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Ontario, Canada; Memory and Aging Center (SAF, KKW, AK, DYJ, BLM, SJD, MDG), Department of Neurology, University of California, San Francisco; Department of Internal Medicine (VC) and Department of Neurology (BDA), Kaiser Permanente, Oakland, CA
| | - Sven A Forner
- Center for Memory and Aging (MHR), HealthPartners Department of Neurology, St. Paul, MN; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Ontario, Canada; Memory and Aging Center (SAF, KKW, AK, DYJ, BLM, SJD, MDG), Department of Neurology, University of California, San Francisco; Department of Internal Medicine (VC) and Department of Neurology (BDA), Kaiser Permanente, Oakland, CA
| | - Katherine K Wong
- Center for Memory and Aging (MHR), HealthPartners Department of Neurology, St. Paul, MN; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Ontario, Canada; Memory and Aging Center (SAF, KKW, AK, DYJ, BLM, SJD, MDG), Department of Neurology, University of California, San Francisco; Department of Internal Medicine (VC) and Department of Neurology (BDA), Kaiser Permanente, Oakland, CA
| | - Amy Kuo
- Center for Memory and Aging (MHR), HealthPartners Department of Neurology, St. Paul, MN; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Ontario, Canada; Memory and Aging Center (SAF, KKW, AK, DYJ, BLM, SJD, MDG), Department of Neurology, University of California, San Francisco; Department of Internal Medicine (VC) and Department of Neurology (BDA), Kaiser Permanente, Oakland, CA
| | - David Y Johnson
- Center for Memory and Aging (MHR), HealthPartners Department of Neurology, St. Paul, MN; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Ontario, Canada; Memory and Aging Center (SAF, KKW, AK, DYJ, BLM, SJD, MDG), Department of Neurology, University of California, San Francisco; Department of Internal Medicine (VC) and Department of Neurology (BDA), Kaiser Permanente, Oakland, CA
| | - Valerie Colacurcio
- Center for Memory and Aging (MHR), HealthPartners Department of Neurology, St. Paul, MN; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Ontario, Canada; Memory and Aging Center (SAF, KKW, AK, DYJ, BLM, SJD, MDG), Department of Neurology, University of California, San Francisco; Department of Internal Medicine (VC) and Department of Neurology (BDA), Kaiser Permanente, Oakland, CA
| | - Bret D Andrews
- Center for Memory and Aging (MHR), HealthPartners Department of Neurology, St. Paul, MN; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Ontario, Canada; Memory and Aging Center (SAF, KKW, AK, DYJ, BLM, SJD, MDG), Department of Neurology, University of California, San Francisco; Department of Internal Medicine (VC) and Department of Neurology (BDA), Kaiser Permanente, Oakland, CA
| | - Bruce L Miller
- Center for Memory and Aging (MHR), HealthPartners Department of Neurology, St. Paul, MN; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Ontario, Canada; Memory and Aging Center (SAF, KKW, AK, DYJ, BLM, SJD, MDG), Department of Neurology, University of California, San Francisco; Department of Internal Medicine (VC) and Department of Neurology (BDA), Kaiser Permanente, Oakland, CA
| | - Stephen J DeArmond
- Center for Memory and Aging (MHR), HealthPartners Department of Neurology, St. Paul, MN; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Ontario, Canada; Memory and Aging Center (SAF, KKW, AK, DYJ, BLM, SJD, MDG), Department of Neurology, University of California, San Francisco; Department of Internal Medicine (VC) and Department of Neurology (BDA), Kaiser Permanente, Oakland, CA
| | - Michael D Geschwind
- Center for Memory and Aging (MHR), HealthPartners Department of Neurology, St. Paul, MN; Tanz Centre for Research in Neurodegenerative Disease (MCT), University of Toronto, Ontario, Canada; Memory and Aging Center (SAF, KKW, AK, DYJ, BLM, SJD, MDG), Department of Neurology, University of California, San Francisco; Department of Internal Medicine (VC) and Department of Neurology (BDA), Kaiser Permanente, Oakland, CA
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24
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Tartaglia MC, Zhang Y, Racine C, Laluz V, Neuhaus J, Chao L, Kramer J, Rosen H, Miller B, Weiner M. Executive dysfunction in frontotemporal dementia is related to abnormalities in frontal white matter tracts. J Neurol 2011; 259:1071-80. [PMID: 22037958 DOI: 10.1007/s00415-011-6300-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2011] [Revised: 10/17/2011] [Accepted: 10/19/2011] [Indexed: 11/26/2022]
Abstract
Cognitive deficits in behavioral-variant frontotemporal dementia (bvFTD) and AD are linked to frontal and temporal lobe gray matter (GM) pathology. The aim of this study was to assess the relative contribution of white (WM) and GM abnormalities to cognitive dysfunction in bvFTD and AD. Fractional anisotropy (FA) for the corpus callosum, cingulum (Cg), and uncinate fasciculus (Unc) was determined in 17 bvFTD and 10 AD patients who underwent neuropsychological testing. Regressions were performed to assess the relative contribution of WM and GM abnormalities to cognitive deficits. Multiple regression analysis revealed that in bvFTD, the left anterior Cg FA was related to executive function, the right anterior Cg FA to visual-spatial attention and working memory, the right posterior Cg to visual-constructional abilities and the left Unc FA to Modified Trails Errors. After adding corresponding GM volumes, the left anterior Cg FA, the right anterior cingulate FA, the right posterior cingulate FA and the left uncinate FA remained significant predictors of the cognitive tasks. In the AD group, the left posterior Cg FA and right descending Cg FA were related to visual recall performance but did not remain significant predictors when GM volumes were added to the regression. These results suggest that reduced integrity of specific WM tracts contribute to cognitive deficits observed in bvFTD after accounting for GM atrophy. In AD, memory impairment was related to WM tract injury but this relationship was no longer observed when GM volumes were included.
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Affiliation(s)
- M C Tartaglia
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA.
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25
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Suárez J, Tartaglia MC, Vitali P, Erbetta A, Neuhaus J, Laluz V, Miller BL. Characterizing radiology reports in patients with frontotemporal dementia. Neurology 2009; 73:1073-4. [PMID: 19786700 DOI: 10.1212/wnl.0b013e3181b9c8a6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [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)
- J Suárez
- University of Puerto Rico School of Medicine
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Trojan DA, Arnold D, Collet JP, Shapiro S, Bar-Or A, Robinson A, Le Cruguel JP, Ducruet T, Narayanan S, Arcelin K, Wong AN, Tartaglia MC, Lapierre Y, Caramanos Z, Da Costa D. Fatigue in multiple sclerosis: association with disease-related, behavioural and psychosocial factors. Mult Scler 2007; 13:985-95. [PMID: 17468448 DOI: 10.1177/1352458507077175] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [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: 11/17/2022]
Abstract
We determined biopsychosocial correlates of general, physical, and mental fatigue in MS patients, by evaluating the additional contribution of potentially modifiable factors after accounting for non-modifiable disease-related factors. Fifty-three ambulatory MS patients, along with 28 normal controls were recruited for a cross-sectional study. Subjects completed the Multidimensional Fatigue Inventory (MFI) and Fatigue Severity Scale. Potential correlates evaluated were: disease-related factors (disease duration and type, immunomodulating treatment, muscle strength, pain, forced vital capacity (FVC), respiratory muscle strength, body mass index, disability, fibromyalgia), behavioural factors (physical activity, sleep quality) and psychosocial factors (depression, stress, self-efficacy). Multivariate models were calculated for MFI General, Physical, and Mental Fatigue. Age-adjusted multivariate models with non-modifiable factors included the following predictors (P < or = 0.10) of 1) MFI General and Mental Fatigue: none; and 2) MFI Physical Fatigue: FVC and disability. The following potentially modifiable predictors (P < or = 0.10) made an additional contribution to the models 1) MFI General Fatigue: sleep quality, self-efficacy, pain; 2) MFI Physical Fatigue: self-efficacy, physical activity; and 3) MFI Mental Fatigue: stress, self-efficacy. Fatigue in MS is multidimensional. Correlates of general and physical fatigue are disease-related, behavioural and psychosocial factors. Correlates of mental fatigue are psychosocial factors. Potentially modifiable factors account for a considerable portion of fatigue.
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Affiliation(s)
- D A Trojan
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
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Tartaglia MC, Narayanan S, De Stefano N, Arnaoutelis R, Antel SB, Francis SJ, Santos AC, Lapierre Y, Arnold DL. Choline is increased in pre-lesional normal appearing white matter in multiple sclerosis. J Neurol 2002; 249:1382-90. [PMID: 12382153 DOI: 10.1007/s00415-002-0846-6] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.0] [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: 11/29/2022]
Abstract
OBJECTIVE Our aim was to determine if the resonance intensity of choline-containing compounds (Cho) measured using proton magnetic resonance spectroscopy (MRS) was increased in pre-lesional normal appearing white matter (NAWM) in patients with multiple sclerosis (MS) relative to NAWM that remained stable in subsequent scans. BACKGROUND The Cho peak in MR spectra is associated with membrane phospholipids and increases in acute MS plaques, possibly even before the appearance of MRI-visible MS lesions. METHODS Three combined proton MRI and MRS imaging examinations of the corpus callosum and adjacent periventricular white matter were performed on 12 MS patients at intervals of 6 months. Proton density (PD) images were visually matched across 3 time points and the lesion volume in each voxel of the volume of interest was determined. The voxels were subdivided into four groups based on the presence or absence of lesion at baseline and change or no change in lesion volume on the subsequent scan. RESULTS We found a significantly higher baseline Cho/Creatine (Cr) ratio in NAWM voxels that displayed MRI visible lesions 6 months later than NAWM voxels that remained unchanged (1.57 +/- 0.30 and 1.37 +/- 0.33, respectively, p < 0.001). The 12-month interval data revealed similar pre-lesional elevated Cho/Cr, (1.51 +/- 0.29 versus 1.39 +/- 0.32, p = 0.009). Voxels that contained lesion at baseline and increased in lesion volume at 6 months also showed a significantly higher Cho/Cr ratio than those whose lesion volume did not change (1.60 +/- 0.32 and 1.49 +/- 0.36, respectively, p = 0.043). CONCLUSIONS The results of this study are consistent with focal pre-lesional myelin membrane pathology in the NAWM at least 12 months before lesions become visible on conventional MRI. This could reflect altered myelin chemistry or the presence of inflammation as seen in experimental allergic encephalomyelitis.
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Affiliation(s)
- M C Tartaglia
- Magnetic Resonance Spectroscopy Unit, Montreal Neurological Institute, 3801 University Street, Montreal, Quebec, H3A 2B4, Canada
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De Stefano N, Narayanan S, Francis SJ, Smith S, Mortilla M, Tartaglia MC, Bartolozzi ML, Guidi L, Federico A, Arnold DL. Diffuse axonal and tissue injury in patients with multiple sclerosis with low cerebral lesion load and no disability. Arch Neurol 2002; 59:1565-71. [PMID: 12374493 DOI: 10.1001/archneur.59.10.1565] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Although in situ pathological studies and in vivo magnetic resonance (MR) investigations have shown that axonal injury can be significant in the early stages of multiple sclerosis (MS), diffuse axonal injury is generally considered a secondary event. Cerebral axonal damage can be specifically assessed in vivo by measuring levels of brain N-acetylaspartate (NAA, a specific index of axonal integrity detected by MR spectroscopy). Other new MR measurements such as magnetization transfer ratio (MTr) or computed estimation of brain volume can provide less specific indexes of tissue damage. OBJECTIVE To determine whether diffuse axonal and tissue injury is present in patients with definite MS who do not show clinically significant disability. METHODS We measured brain NAA levels (normalized to creatine [Cr]), MTr values, and cerebral volumes in patients with definite MS who had low T2-weighted MR imaging lesion volumes and no clinical disability, and also in age-matched healthy control subjects. RESULTS Values of central brain NAA/Cr and MTr in normal-appearing white matter were significantly lower in the MS patients than in controls (P<.001). In contrast, total brain volumes were not significantly different between these groups. Similar results were found for MS patients with early disease (duration, <3 years) and with a particularly low cerebral T2-weighted MR imaging lesion load (< or = 2 cm(3)). CONCLUSIONS Cerebral NAA/Cr and MTr values are diffusely decreased in MS patients with early disease, low demyelinating lesion load, and no significant disability. This suggests that axonal and/or tissue injury begins very early in the course of MS and might be at least partially independent of cerebral demyelination.
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Affiliation(s)
- Nicola De Stefano
- Institute of Neurological Sciences, University of Siena, Viale Bracci 2, 53100, Siena, Italy.
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Santos AC, Narayanan S, de Stefano N, Tartaglia MC, Francis SJ, Arnaoutelis R, Caramanos Z, Antel JP, Pike GB, Arnold DL. Magnetization transfer can predict clinical evolution in patients with multiple sclerosis. J Neurol 2002; 249:662-8. [PMID: 12111296 DOI: 10.1007/s00415-002-0686-4] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [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: 11/28/2022]
Abstract
The clinical course of multiple sclerosis (MS) is highly variable ranging from benign to aggressive, and is difficult to predict. Since magnetization transfer (MT) imaging can detect focal abnormalities in normal-appearing white matter (NAWM) before the appearance of lesions on conventional MRI, we hypothesized that changes in MT might be able to predict the clinical evolution of MS. We assessed MR data from MS patients who were subsequently followed clinically for 5 years. We computed the mean MT ratio (MTr) in gray matter, in lesions identified on T2-weighted MRI, and in NAWM, as well as in a thick central brain slice for each patient. Patients were divided into stable and worsening groups according to their change in Expanded Disability Status Scale (EDSS) scores over 5 years. We calculated the sensitivity, specificity, predictive value, and odds ratio of the baseline MTr measures in order to assess their prognostic utility. We found significant differences in baseline MTr values in NAWM (p = 0.005) and brain slice (p = 0.03) between clinically stable and worsening MS patients. When these MTr values were compared with changes in EDSS over 5 years, a strong correlation was found between the EDSS changes and MTr values in both NAWM (SRCC = -0.76, p < 0.001) and in the brain slice (SRCC = 0.59, p = 0.01). Baseline NAWM MTr correctly predicted clinical evolution in 15/18 patients (1 false positive and 2 false negatives), yielding a positive predictive value of 77.78 %, a negative predictive value of 88.89 %, and an odds ratio of 28. The relationship between 5-year changes in EDSS and MTr values in T2 weighted MRI lesions was weaker (SRCC = -0.43, p = 0.07). Our data support the notion that the quantification of MTr in the NAWM can predict the clinical evolution of MS. Lower MTr values predict poorer long-term clinical outcome. Abnormalities of MTr values in the NAWM are more relevant to the development of future patient disability than those in the T2-weighted MRI lesions.
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Affiliation(s)
- A Carlos Santos
- Montreal Neurological Institute, 3801 University Street, WB 321, Montreal, Quebec, H3A 2B4, Canada
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De Stefano N, Narayanan S, Francis GS, Arnaoutelis R, Tartaglia MC, Antel JP, Matthews PM, Arnold DL. Evidence of axonal damage in the early stages of multiple sclerosis and its relevance to disability. Arch Neurol 2001; 58:65-70. [PMID: 11176938 DOI: 10.1001/archneur.58.1.65] [Citation(s) in RCA: 353] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To assess axonal damage and its contribution to disability at different stages of multiple sclerosis (MS). BACKGROUND Recent in vivo imaging and in situ pathologic studies have demonstrated that substantial axonal damage accompanies the inflammatory lesions of MS. However, the relation of axonal damage to the duration of MS and its contribution to disability at different stages of the disease remain poorly defined. DESIGN We performed proton magnetic resonance spectroscopic imaging in 88 patients with a wide range of clinical disability and disease duration to measure N-acetylaspartate (NAA, an index of axonal integrity) relative to creatine (Cr) in a large central brain volume that included mostly normal-appearing white matter on magnetic resonance imaging. RESULTS We observed that the NAA/Cr values were abnormally low in the early stages of MS, even before significant disability (measured using the Expanded Disability Status Scale [EDSS]) was evident clinically, and declined more rapidly with respect to EDSS at lower than at higher EDSS scores (P<.001). The correlation of NAA/Cr values with EDSS score was significantly (P<.03) stronger in patients with mild disability (EDSS score <5, Spearman rank order correlation = -0.54, P<.001) than in patients with more severe disability (EDSS score >/=5, Spearman rank order correlation = -0.1, P<.9). When similar analyses were performed in patients with MS grouped for duration of disease, the subgroup with early disease duration (<5 years) also showed central brain NAA/Cr resonance intensity ratios significantly lower than healthy controls (P<.001). CONCLUSION Cerebral axonal damage begins and contributes to disability from the earliest stages of the disease.
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Affiliation(s)
- N De Stefano
- Institute of Neurological Science, Viale Bracci 2, 53100, Siena, Italy.
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Abstract
The purpose of this study was to assess the effect of physical deconditioning on skeletal muscle's oxidative metabolism as evaluated by phosphorus-31 magnetic resonance spectroscopy ((31)P MRS). Twenty-seven subjects without muscle disease, representing a wide range of fitness levels, were evaluated with (31)P MRS. Spectra were obtained at rest and during recovery from in-magnet exercise. The data show a significant correlation between maximum resting metabolic equivalent (MET) score and the following (31)P MRS recovery indices: adenosine diphosphate and phosphocreatine recovery half-time; initial phosphocreatine resynthesis rate; calculated estimation of mitochondrial capacity; pH at end of exercise; and phosphocreatine depletion. In addition, significant differences between the deconditioned and conditioned group were found for all of the aforementioned recovery indices. At rest, only the inorganic phosphate concentration was significantly different between the two groups. These data indicate that physical activity level should be taken into account when assessing patients' oxidative metabolism with (31)P MRS.
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Affiliation(s)
- M C Tartaglia
- Magnetic Resonance Spectroscopy Unit, Montreal Neurological Institute & Hospital, 3801 University Street, Montreal, Quebec H3A 2B4, Canada
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