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Sarto J, Esteller-Gauxax D, Tort-Merino A, Guillén N, Pérez-Millan A, Falgàs N, Borrego-Écija S, Fernández-Villullas G, Bosch B, Juncà-Parella J, Antonell A, Naranjo L, Ruiz-García R, Augé JM, Sánchez-Valle R, Lladó A, Balasa M. Impact of demographics and comorbid conditions on plasma biomarkers concentrations and their diagnostic accuracy in a memory clinic cohort. J Neurol 2024; 271:1973-1984. [PMID: 38151575 DOI: 10.1007/s00415-023-12153-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/29/2023]
Abstract
Plasma biomarkers have emerged as promising tools for identifying amyloid beta (Aβ) pathology. Before implementation in routine clinical practice, confounding factors modifying their concentration beyond neurodegenerative diseases should be identified. We studied the association of a comprehensive list of demographics, comorbidities, medication and laboratory parameters with plasma p-tau181, glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) on a prospective memory clinic cohort and studied their impact on diagnostic accuracy for discriminating CSF/amyloid PET-defined Aβ status. Three hundred sixty patients (mean age 66.5 years, 55% females, 53% Aβ positive) were included. Sex, age and Aβ status-adjusted models showed that only estimated glomerular filtration rate (eGFR, standardized β -0.115 [-0.192 to -0.035], p = 0.005) was associated with p-tau181 levels, although with a much smaller effect than Aβ status (0.685 [0.607-0.763], p < 0.001). Age, sex, body mass index (BMI), Charlson comorbidity index (CCI) and eGFR significantly modified GFAP concentration. Age, blood volume (BV) and eGFR were associated with NfL levels. p-tau181 predicted Aβ status with 87% sensitivity and specificity with no relevant increase in diagnostic performance by adding any of the confounding factors. Using two cut-offs, plasma p-tau181 could have spared 62% of amyloid-PET/CSF testing. Excluding patients with chronic kidney disease did not change the proposed cut-offs nor the diagnostic performance. In conclusion, in a memory clinic cohort, age, sex, eGFR, BMI, BV and CCI slightly modified plasma p-tau181, GFAP and NfL concentrations but their impact on the diagnostic accuracy of plasma biomarkers for Aβ status discrimination was minimal.
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Affiliation(s)
- Jordi Sarto
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Diana Esteller-Gauxax
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Adrià Tort-Merino
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Núria Guillén
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Agnès Pérez-Millan
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Neus Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Sergi Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Guadalupe Fernández-Villullas
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Beatriz Bosch
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Jordi Juncà-Parella
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Anna Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Laura Naranjo
- Immunology Service, Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Raquel Ruiz-García
- Immunology Service, Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Josep María Augé
- Biochemistry and Molecular Genetics Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Mircea Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain.
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Pérez-Millan A, Borrego-Écija S, Falgàs N, Juncà-Parella J, Bosch B, Tort-Merino A, Antonell A, Bargalló N, Rami L, Balasa M, Lladó A, Sala-Llonch R, Sánchez-Valle R. Cortical thickness modeling and variability in Alzheimer's disease and frontotemporal dementia. J Neurol 2024; 271:1428-1438. [PMID: 38012398 PMCID: PMC10896866 DOI: 10.1007/s00415-023-12087-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/29/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND AND OBJECTIVE Alzheimer's disease (AD) and frontotemporal dementia (FTD) show different patterns of cortical thickness (CTh) loss compared with healthy controls (HC), even though there is relevant heterogeneity between individuals suffering from each of these diseases. Thus, we developed CTh models to study individual variability in AD, FTD, and HC. METHODS We used the baseline CTh measures of 379 participants obtained from the structural MRI processed with FreeSurfer. A total of 169 AD patients (63 ± 9 years, 65 men), 88 FTD patients (64 ± 9 years, 43 men), and 122 HC (62 ± 10 years, 47 men) were studied. We fitted region-wise temporal models of CTh using Support Vector Regression. Then, we studied associations of individual deviations from the model with cerebrospinal fluid levels of neurofilament light chain (NfL) and 14-3-3 protein and Mini-Mental State Examination (MMSE). Furthermore, we used real longitudinal data from 144 participants to test model predictivity. RESULTS We defined CTh spatiotemporal models for each group with a reliable fit. Individual deviation correlated with MMSE for AD and with NfL for FTD. AD patients with higher deviations from the trend presented higher MMSE values. In FTD, lower NfL levels were associated with higher deviations from the CTh prediction. For AD and HC, we could predict longitudinal visits with the presented model trained with baseline data. For FTD, the longitudinal visits had more variability. CONCLUSION We highlight the value of CTh models for studying AD and FTD longitudinal changes and variability and their relationships with cognitive features and biomarkers.
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Affiliation(s)
- Agnès Pérez-Millan
- Alzheimer's Disease and Other Cognitive Disorders Unit. Service of Neurology, Hospital Clínic de Barcelona. Fundació Recerca Clínic Barcelona-IDIBAPS, Villarroel, 170, 08036, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, 08036, Barcelona, Spain
- Department of Biomedicine, Faculty of Medicine, University of Barcelona, 08036, Barcelona, Spain
| | - Sergi Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders Unit. Service of Neurology, Hospital Clínic de Barcelona. Fundació Recerca Clínic Barcelona-IDIBAPS, Villarroel, 170, 08036, Barcelona, Spain
| | - Neus Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit. Service of Neurology, Hospital Clínic de Barcelona. Fundació Recerca Clínic Barcelona-IDIBAPS, Villarroel, 170, 08036, Barcelona, Spain
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, University of California San Francisco, San Francisco, 94143, USA
| | - Jordi Juncà-Parella
- Alzheimer's Disease and Other Cognitive Disorders Unit. Service of Neurology, Hospital Clínic de Barcelona. Fundació Recerca Clínic Barcelona-IDIBAPS, Villarroel, 170, 08036, Barcelona, Spain
| | - Beatriz Bosch
- Alzheimer's Disease and Other Cognitive Disorders Unit. Service of Neurology, Hospital Clínic de Barcelona. Fundació Recerca Clínic Barcelona-IDIBAPS, Villarroel, 170, 08036, Barcelona, Spain
| | - Adrià Tort-Merino
- Alzheimer's Disease and Other Cognitive Disorders Unit. Service of Neurology, Hospital Clínic de Barcelona. Fundació Recerca Clínic Barcelona-IDIBAPS, Villarroel, 170, 08036, Barcelona, Spain
| | - Anna Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit. Service of Neurology, Hospital Clínic de Barcelona. Fundació Recerca Clínic Barcelona-IDIBAPS, Villarroel, 170, 08036, Barcelona, Spain
| | - Nuria Bargalló
- Image Diagnostic Centre, CIBER de Salud Mental, Instituto de Salud Carlos III, Magnetic Resonance Image Core Facility, IDIBAPS, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit. Service of Neurology, Hospital Clínic de Barcelona. Fundació Recerca Clínic Barcelona-IDIBAPS, Villarroel, 170, 08036, Barcelona, Spain
| | - Mircea Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit. Service of Neurology, Hospital Clínic de Barcelona. Fundació Recerca Clínic Barcelona-IDIBAPS, Villarroel, 170, 08036, Barcelona, Spain
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, University of California San Francisco, San Francisco, 94143, USA
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit. Service of Neurology, Hospital Clínic de Barcelona. Fundació Recerca Clínic Barcelona-IDIBAPS, Villarroel, 170, 08036, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, 08036, Barcelona, Spain
| | - Roser Sala-Llonch
- Institut de Neurociències, University of Barcelona, 08036, Barcelona, Spain
- Department of Biomedicine, Faculty of Medicine, University of Barcelona, 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 08036, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit. Service of Neurology, Hospital Clínic de Barcelona. Fundació Recerca Clínic Barcelona-IDIBAPS, Villarroel, 170, 08036, Barcelona, Spain.
- Institut de Neurociències, University of Barcelona, 08036, Barcelona, Spain.
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036, Barcelona, Spain.
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Carbayo Á, Borrego-Écija S, Turon-Sans J, Cortés-Vicente E, Molina-Porcel L, Gascón-Bayarri J, Rubio MÁ, Povedano M, Gámez J, Sotoca J, Juntas-Morales R, Almendrote M, Marquié M, Sánchez-Valle R, Illán-Gala I, Dols-Icardo O, Rubio-Guerra S, Bernal S, Caballero-Ávila M, Vesperinas A, Gelpi E, Rojas-García R. Clinicopathological correlates in frontotemporal lobar degeneration: motor neuron disease spectrum. Brain 2024:awae011. [PMID: 38227807 DOI: 10.1093/brain/awae011] [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: 10/06/2023] [Revised: 12/05/2023] [Accepted: 01/15/2024] [Indexed: 01/18/2024] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a devastating motor neuron disease (MND) that shares a common clinical, genetic and pathologic spectrum with frontotemporal dementia (FTD). It is highly heterogeneous in its presentation and features. Up to 50% of patients with MND develop cognitive-behavioural symptoms during the course of the disease, meeting criteria for FTD in 10-15% of cases. In the absence of a precise biomarker, neuropathology is still a valuable tool to understand disease nosology, reach a definite diagnostic confirmation and help define specific subgroups of patients with common phenotypic, genetic and biomarker profiles. However, few neuropathological series have been published, and the frequency of FTLD in MND is difficult to estimate. In this work we describe a large clinicopathologic series of MND, analysing the frequency of concurrent FTLD changes and trying to define specific subgroups of patients based on their clinical, genetic and pathological characteristics. We performed an observational, retrospective, multi-centre case study. We included all cases meeting neuropathological criteria for MND from the Neurological Tissue Bank of the FRCB-IDIBAPS-Hospital Clínic Barcelona Biobank between 1994 and 2022, regardless of their last clinical diagnosis. While brain donation is encouraged in all patients, it is performed in very few, and representativeness of the cohort might not be precise for all patients with MND. We retrospectively reviewed clinical and neuropathological data, and describe the main clinical, genetic and pathogenic features, comparing neuropathologic groups between MND with and without FTLD changes and aiming to define specific subgroups. We included brain samples from 124 patients, 44 of whom (35.5%) had FTLD neuropathologic features (i.e. FTLD-MND). Pathologic TDP-43 aggregates were present in 93.6% of the cohort and were more extensive (higher Brettschneider stage) in those with concurrent FTLD (p < 0.001). Motor symptom onset was more frequent in the bulbar region in FTLD-MND cases than in those with isolated MND (p = 0.023), with no differences in survival. We observed a better clinicopathological correlation in the MND group than in the FTLD-MND group (93.8% vs 61.4%; p < 0.001). Pathogenic genetic variants were more common in the FTLD-MND group, especially C9orf72. We describe a frequency of FTLD of 35.5% in our series of neuropathologically confirmed cases of MND. The FTLD-MND spectrum is highly heterogeneous in all aspects, especially in patients with FTLD, in whom it is particularly difficult to define specific subgroups. In the absence of definite biomarkers, neuropathology remains a valuable tool for a definite diagnosis, increasing our knowledge in disease nosology.
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Affiliation(s)
- Álvaro Carbayo
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau) Sant Pau. Barcelona, 08025, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Medicine. Barcelona, 08025, Spain
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergi Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Department, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer, University of Barcelona, Barcelona, 08036, Spain
| | - Janina Turon-Sans
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau) Sant Pau. Barcelona, 08025, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Medicine. Barcelona, 08025, Spain
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Cortés-Vicente
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau) Sant Pau. Barcelona, 08025, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Medicine. Barcelona, 08025, Spain
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Molina-Porcel
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Department, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer, University of Barcelona, Barcelona, 08036, Spain
- Neurological Tissue Bank, Biobanc-Hospital Clínic-FRCB-IDIBAPS, Barcelona, 08036, Spain
| | - Jordi Gascón-Bayarri
- Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907, Spain
| | - Miguel Ángel Rubio
- Neuromuscular Unit, Department of Neurology, Hospital del Mar, Barcelona, 08003, Spain
| | - Mónica Povedano
- Department of Neurology, Motor Neuron Unit, IDIBELL, Bellvitge University Hospital, Hospitalet de Llobregat, 08907, Spain
| | - Josep Gámez
- GMA Clinic. Neurology Department. ERN EURO-NMD. Barcelona, 08029, Spain
| | - Javier Sotoca
- Neuromuscular Diseases Unit, Department of Neurology, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, 08035, Spain
| | - Raúl Juntas-Morales
- Neuromuscular Diseases Unit, Department of Neurology, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, 08035, Spain
| | - Miriam Almendrote
- Neurology Department, Hospital Germans Trias i Pujol, Badalona, 08916, Spain
| | - Marta Marquié
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, 08028, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Department, Hospital Clínic, Institut d'Investigacions Biomediques August Pi i Sunyer, University of Barcelona, Barcelona, 08036, Spain
| | - Ignacio Illán-Gala
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, 08025, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Oriol Dols-Icardo
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, 08025, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Sara Rubio-Guerra
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, 08025, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Sara Bernal
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Genetics Department Hospital de la Santa Creu i Sant Pau Barcelona, 08025, Spain
| | - Marta Caballero-Ávila
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau) Sant Pau. Barcelona, 08025, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Medicine. Barcelona, 08025, Spain
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Vesperinas
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau) Sant Pau. Barcelona, 08025, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Medicine. Barcelona, 08025, Spain
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Ellen Gelpi
- Neurological Tissue Bank, Biobanc-Hospital Clínic-FRCB-IDIBAPS, Barcelona, 08036, Spain
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, 1090, Austria
| | - Ricard Rojas-García
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau) Sant Pau. Barcelona, 08025, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Medicine. Barcelona, 08025, Spain
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
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Borrego-Écija S, Montagut N, Martín-Trias P, Vaqué-Alcázar L, Illán-Gala I, Balasa M, Lladó A, Casanova-Mollà J, Bargalló N, Valls-Solé J, Lleó A, Bartrés-Faz D, Sánchez-Valle R. Multifocal Transcranial Direct Current Stimulation in Primary Progressive Aphasia Does Not Provide a Clinical Benefit Over Speech Therapy. J Alzheimers Dis 2023:JAD230069. [PMID: 37182884 DOI: 10.3233/jad-230069] [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: 05/16/2023]
Abstract
BACKGROUND Primary progressive aphasia (PPA) is a group of neurodegenerative disorders including Alzheimer's disease and frontotemporal dementia characterized by language deterioration. Transcranial direct current stimulation (tDCS) is a non-invasive intervention for brain dysfunction. OBJECTIVE To evaluate the tolerability and efficacy of tDCS combined with speech therapy in the three variants of PPA. We evaluate changes in fMRI activity in a subset of patients. METHODS Double-blinded, randomized, cross-over, and sham-controlled tDCS study. 15 patients with PPA were included. Each patient underwent two interventions: a) speech therapy + active tDCS and b) speech therapy + sham tDCS stimulation. A multifocal strategy with anodes placed in the left frontal and parietal regions was used to stimulate the entire language network. Efficacy was evaluated by comparing the results of two independent sets of neuropsychological assessments administered at baseline, immediately after the intervention, and at 1 month and 3 months after the intervention. In a subsample, fMRI scanning was performed before and after each intervention. RESULTS The interventions were well tolerated. Participants in both arms showed clinical improvement, but no differences were found between active and sham tDCS interventions in any of the evaluations. There were trends toward better outcomes in the active tDCS group for semantic association and reading skills. fMRI identified an activity increase in the right frontal medial cortex and the bilateral paracingulate gyrus after the active tDCS intervention. CONCLUSION We did not find differences between active and sham tDCS stimulation in clinical scores of language function in PPA patients.
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Affiliation(s)
- Sergi Borrego-Écija
- Alzheimer's disease and other cognitive disorders Unit. Neurology Service, Hospital Clinic de Barcelona, Institutd'Investigació Biomèdica August Pi i Sunyer, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Nuria Montagut
- Alzheimer's disease and other cognitive disorders Unit. Neurology Service, Hospital Clinic de Barcelona, Institutd'Investigació Biomèdica August Pi i Sunyer, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Pablo Martín-Trias
- Medical Psychology Unit, Department of Medicine, Faculty of Medicine and Health Sciences, Insitute of Neurosciences, University of Barcelona; Institut d'Investigació Biomèdica August Pi i Sunyer, Barcelona, Spain
| | - Lídia Vaqué-Alcázar
- Medical Psychology Unit, Department of Medicine, Faculty of Medicine and Health Sciences, Insitute of Neurosciences, University of Barcelona; Institut d'Investigació Biomèdica August Pi i Sunyer, Barcelona, Spain
| | - Ignacio Illán-Gala
- Memory Unit, Service of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Centro de Investigación en Red en enfermedadesneurogenerativas (CIBERNED), Madrid, Spain
| | - Mircea Balasa
- Alzheimer's disease and other cognitive disorders Unit. Neurology Service, Hospital Clinic de Barcelona, Institutd'Investigació Biomèdica August Pi i Sunyer, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Albert Lladó
- Alzheimer's disease and other cognitive disorders Unit. Neurology Service, Hospital Clinic de Barcelona, Institutd'Investigació Biomèdica August Pi i Sunyer, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Jordi Casanova-Mollà
- Clinical Neurophysiology Unit, Institutd'Investigació Biomèdica August Pi i Sunyer, NeurologyService, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Nuria Bargalló
- Radiology Service, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Josep Valls-Solé
- Clinical Neurophysiology Unit, Institutd'Investigació Biomèdica August Pi i Sunyer, NeurologyService, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Alberto Lleó
- Memory Unit, Service of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Centro de Investigación en Red en enfermedadesneurogenerativas (CIBERNED), Madrid, Spain
| | - David Bartrés-Faz
- Medical Psychology Unit, Department of Medicine, Faculty of Medicine and Health Sciences, Insitute of Neurosciences, University of Barcelona; Institut d'Investigació Biomèdica August Pi i Sunyer, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's disease and other cognitive disorders Unit. Neurology Service, Hospital Clinic de Barcelona, Institutd'Investigació Biomèdica August Pi i Sunyer, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
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Valentino RR, Scotton WJ, Roemer SF, Lashley T, Heckman MG, Shoai M, Martinez-Carrasco A, Tamvaka N, Walton RL, Baker MC, Macpherson HL, Real R, Soto-Beasley AI, Mok K, Revesz T, Warner TT, Jaunmuktane Z, Boeve BF, Christopher EA, DeTure M, Duara R, Graff-Radford NR, Josephs KA, Knopman DS, Koga S, Murray ME, Lyons KE, Pahwa R, Parisi JE, Petersen RC, Whitwell J, Grinberg LT, Miller B, Schlereth A, Seeley WW, Spina S, Grossman M, Irwin DJ, Lee EB, Suh E, Trojanowski JQ, Van Deerlin VM, Wolk DA, Connors TR, Dooley PM, Frosch MP, Oakley DH, Aldecoa I, Balasa M, Gelpi E, Borrego-Écija S, de Eugenio Huélamo RM, Gascon-Bayarri J, Sánchez-Valle R, Sanz-Cartagena P, Piñol-Ripoll G, Molina-Porcel L, Bigio EH, Flanagan ME, Gefen T, Rogalski EJ, Weintraub S, Redding-Ochoa J, Chang K, Troncoso JC, Prokop S, Newell KL, Ghetti B, Jones M, Richardson A, Robinson AC, Roncaroli F, Snowden J, Allinson K, Green O, Rowe JB, Singh P, Beach TG, Serrano GE, Flowers XE, Goldman JE, Heaps AC, Leskinen SP, Teich AF, Black SE, Keith JL, Masellis M, Bodi I, King A, Sarraj SA, Troakes C, Halliday GM, Hodges JR, Kril JJ, Kwok JB, Piguet O, Gearing M, Arzberger T, Roeber S, Attems J, Morris CM, Thomas AJ, Evers BM, White CL, Mechawar N, Sieben AA, Cras PP, De Vil BB, De Deyn PPP, Duyckaerts C, Le Ber I, Seihean D, Turbant-Leclere S, MacKenzie IR, McLean C, Cykowski MD, Ervin JF, Wang SHJ, Graff C, Nennesmo I, Nagra RM, Riehl J, Kovacs GG, Giaccone G, Nacmias B, Neumann M, Ang LC, Finger EC, Blauwendraat C, Nalls MA, Singleton AB, Vitale D, Cunha C, Carvalho A, Wszolek ZK, Morris HR, Rademakers R, Hardy JA, Dickson DW, Rohrer JD, Ross OA. Creating the Pick's disease International Consortium: Association study of MAPT H2 haplotype with risk of Pick's disease. medRxiv 2023:2023.04.17.23288471. [PMID: 37163045 PMCID: PMC10168402 DOI: 10.1101/2023.04.17.23288471] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background Pick's disease (PiD) is a rare and predominantly sporadic form of frontotemporal dementia that is classified as a primary tauopathy. PiD is pathologically defined by argyrophilic inclusion Pick bodies and ballooned neurons in the frontal and temporal brain lobes. PiD is characterised by the presence of Pick bodies which are formed from aggregated, hyperphosphorylated, 3-repeat tau proteins, encoded by the MAPT gene. The MAPT H2 haplotype has consistently been associated with a decreased disease risk of the 4-repeat tauopathies of progressive supranuclear palsy and corticobasal degeneration, however its role in susceptibility to PiD is unclear. The primary aim of this study was to evaluate the association between MAPT H2 and risk of PiD. Methods We established the Pick's disease International Consortium (PIC) and collected 338 (60.7% male) pathologically confirmed PiD brains from 39 sites worldwide. 1,312 neurologically healthy clinical controls were recruited from Mayo Clinic Jacksonville, FL (N=881) or Rochester, MN (N=431). For the primary analysis, subjects were directly genotyped for MAPT H1-H2 haplotype-defining variant rs8070723. In secondary analysis, we genotyped and constructed the six-variant MAPT H1 subhaplotypes (rs1467967, rs242557, rs3785883, rs2471738, rs8070723, and rs7521). Findings Our primary analysis found that the MAPT H2 haplotype was associated with increased risk of PiD (OR: 1.35, 95% CI: 1.12-1.64 P=0.002). In secondary analysis involving H1 subhaplotypes, a protective association with PiD was observed for the H1f haplotype (0.0% vs. 1.2%, P=0.049), with a similar trend noted for H1b (OR: 0.76, 95% CI: 0.58-1.00, P=0.051). The 4-repeat tauopathy risk haplotype MAPT H1c was not associated with PiD susceptibility (OR: 0.93, 95% CI: 0.70-1.25, P=0.65). Interpretation The PIC represents the first opportunity to perform relatively large-scale studies to enhance our understanding of the pathobiology of PiD. This study demonstrates that in contrast to its protective role in 4R tauopathies, the MAPT H2 haplotype is associated with an increased risk of PiD. This finding is critical in directing isoform-related therapeutics for tauopathies.
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Affiliation(s)
| | - William J Scotton
- Dementia Research Centre, Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, UK
| | - Shanu F Roemer
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Tammaryn Lashley
- Queen Square Brain Bank for Neurological Disorders, University College London, Queen Square Institute of Neurology London, UK
- Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, UK
| | - Michael G Heckman
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Maryam Shoai
- Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, UK
| | - Alejandro Martinez-Carrasco
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
| | - Nicole Tamvaka
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Ronald L Walton
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Matthew C Baker
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Hannah L Macpherson
- Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, UK
| | - Raquel Real
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
| | | | - Kin Mok
- Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
| | - Tamas Revesz
- Queen Square Brain Bank for Neurological Disorders, University College London, Queen Square Institute of Neurology London, UK
- Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, UK
| | - Thomas T Warner
- Queen Square Brain Bank for Neurological Disorders, University College London, Queen Square Institute of Neurology London, UK
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
| | - Zane Jaunmuktane
- Queen Square Brain Bank for Neurological Disorders, University College London, Queen Square Institute of Neurology London, UK
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Michael DeTure
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center Miami Beach, FL
| | | | - Keith A Josephs
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Shunsuke Koga
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Melissa E Murray
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Kelly E Lyons
- University of Kansas Medical Center, Parkinson’s Disease & Movement Disorder Division, Kansas City, KS. 66160
| | - Rajesh Pahwa
- University of Kansas Medical Center, Parkinson’s Disease & Movement Disorder Division, Kansas City, KS. 66160
| | - Joseph E Parisi
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | | | | | - Lea T Grinberg
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
| | - Bruce Miller
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
| | - Athena Schlereth
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
| | - William W Seeley
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
| | - Salvatore Spina
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Edward B Lee
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - EunRan Suh
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David A Wolk
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Theresa R Connors
- Neuropathology Service, C.S. Kubik Laboratory for Neuropathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Patrick M Dooley
- Neuropathology Service, C.S. Kubik Laboratory for Neuropathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Matthew P Frosch
- Neuropathology Service, C.S. Kubik Laboratory for Neuropathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Derek H Oakley
- Neuropathology Service, C.S. Kubik Laboratory for Neuropathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Iban Aldecoa
- Pathology, BDC, Hospital Clinic de Barcelona, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- Neurological Tissue Bank, Biobanc-Hospital Clínic-FRCB-IDIBAPS, Barcelona, Spain
| | - Mircea Balasa
- Alzheimer’s Disease and other Cognitive Disorders Unit, Neurology Department, Hospital Clinic, Barcelona, Spain
- Barcelona Clinical Research Foundation-August Pi i Sunyer Biomedical Research Institute (FRCB-IDIBAPS), Barcelona, Spain
| | - Ellen Gelpi
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Sergi Borrego-Écija
- University of Barcelona, Barcelona, Spain
- Alzheimer’s Disease and other Cognitive Disorders Unit, Neurology Department, Hospital Clinic, Barcelona, Spain
- Barcelona Clinical Research Foundation-August Pi i Sunyer Biomedical Research Institute (FRCB-IDIBAPS), Barcelona, Spain
| | | | - Jordi Gascon-Bayarri
- Servei de Neurologia, Hospital Universitari de Bellvitge. Institut d’Investigació Biomèdica de Bellvitge (Idibell). L’Hospitalet de Llobregat, Spain
| | - Raquel Sánchez-Valle
- University of Barcelona, Barcelona, Spain
- Alzheimer’s Disease and other Cognitive Disorders Unit, Neurology Department, Hospital Clinic, Barcelona, Spain
- Barcelona Clinical Research Foundation-August Pi i Sunyer Biomedical Research Institute (FRCB-IDIBAPS), Barcelona, Spain
| | | | - Gerard Piñol-Ripoll
- Unitat Trastorns Cognitius (Cognitive Disorders Unit), Clinical Neuroscience Research, IRBLleida, Santa Maria University Hospital, Lleida, Spain
| | - Laura Molina-Porcel
- Neurological Tissue Bank, Biobanc-Hospital Clínic-FRCB-IDIBAPS, Barcelona, Spain
- Alzheimer’s Disease and other Cognitive Disorders Unit, Neurology Department, Hospital Clinic, Barcelona, Spain
- Barcelona Clinical Research Foundation-August Pi i Sunyer Biomedical Research Institute (FRCB-IDIBAPS), Barcelona, Spain
| | - Eileen H Bigio
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Margaret E Flanagan
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tamar Gefen
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily J Rogalski
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology & Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Koping Chang
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Stefan Prokop
- Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Kathy L Newell
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
| | - Bernardino Ghetti
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
| | - Matthew Jones
- Cerebral Function Unit, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, UK
- Division of Neuroscience, School of Biological Sciences, University of Manchester, UK
| | - Anna Richardson
- Cerebral Function Unit, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, UK
- Division of Neuroscience, School of Biological Sciences, University of Manchester, UK
| | - Andrew C Robinson
- Division of Neuroscience, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, M6 8HD, UK
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Federico Roncaroli
- Division of Neuroscience, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, M6 8HD, UK
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Julie Snowden
- Cerebral Function Unit, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, UK
- Division of Neuroscience, School of Biological Sciences, University of Manchester, UK
| | - Kieren Allinson
- Histopathology Box 235 Cambridge University Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ
| | - Oliver Green
- Histopathology Box 235 Cambridge University Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ
| | - James B Rowe
- Cambridge University Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, Cambridge, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| | - Poonam Singh
- Histopathology Box 235 Cambridge University Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ
| | - Thomas G Beach
- Civin Laboratory of Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Geidy E Serrano
- Civin Laboratory of Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Xena E Flowers
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - James E Goldman
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Allison C Heaps
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Sandra P Leskinen
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Andrew F Teich
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
- Department of Pathology and Cell Biology, Columbia University, New York, NY, USA
| | - Sandra E Black
- Department of Medicine, Division of Neurology, Sunnybrook Health Sciences Centre and University of Toronto, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute
| | - Julia L Keith
- Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, and Laboratory Medicine and Pathobiology, University of Toronto
| | - Mario Masellis
- Department of Medicine, Division of Neurology, Sunnybrook Health Sciences Centre and University of Toronto, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute
| | - Istvan Bodi
- Clinical Neuropathology Department, King’s College Hospital NHS Foundation Trust, London, UK
- London Neurodegenerative Diseases Brain Bank, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Andrew King
- Clinical Neuropathology Department, King’s College Hospital NHS Foundation Trust, London, UK
- London Neurodegenerative Diseases Brain Bank, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Safa-Al Sarraj
- Clinical Neuropathology Department, King’s College Hospital NHS Foundation Trust, London, UK
- London Neurodegenerative Diseases Brain Bank, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Claire Troakes
- London Neurodegenerative Diseases Brain Bank, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Glenda M Halliday
- University of Sydney Brain and Mind Centre and Faculty of Medicine and Health School of Medical Sciences
| | - John R Hodges
- University of Sydney Brain and Mind Centre and Faculty of Medicine and Health School of Medical Sciences
| | - Jillian J Kril
- University of Sydney Faculty of Medicine and Health School of Medical Sciences
| | - John B Kwok
- University of Sydney Brain and Mind Centre and Faculty of Medicine and Health School of Medical Sciences
| | - Olivier Piguet
- University of Sydney Brain and Mind Centre and Faculty of Science School of Psychology
| | - Marla Gearing
- Dept. of Pathology and Laboratory Medicine, Dept. of Neurology, and Goizueta Alzheimer’s Disease Center Brain Bank; Emory University School of Medicine, Atlanta, GA USA
| | - Thomas Arzberger
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Germany
| | - Sigrun Roeber
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-University Munich, Germany
| | - Johannes Attems
- Newcastle Brain Tissue Resource, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Christopher M Morris
- Newcastle Brain Tissue Resource, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Alan J Thomas
- Newcastle Brain Tissue Resource, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Bret M. Evers
- University of Texas Southwestern Medical Center, Dallas, TX 75390
| | - Charles L White
- University of Texas Southwestern Medical Center, Dallas, TX 75390
| | | | - Anne A Sieben
- Laboratory of Neurology, Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- IBB-NeuroBiobank BB190113, Born Bunge Institute, Antwerp, Belgium
- Department of Pathology, Antwerp University Hospital, Antwerp, Belgium
- Department of Neurology, Ghent University Hospital, Ghent University, Belgium
| | - Patrick P Cras
- Laboratory of Neurology, Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- IBB-NeuroBiobank BB190113, Born Bunge Institute, Antwerp, Belgium
- Department of Neurology, Antwerp University Hospital - UZA, Antwerp, Belgium
| | - Bart B De Vil
- Laboratory of Neurology, Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- IBB-NeuroBiobank BB190113, Born Bunge Institute, Antwerp, Belgium
- Department of Neurology, Antwerp University Hospital - UZA, Antwerp, Belgium
| | - Peter Paul P.P. De Deyn
- Laboratory of Neurochemistry and Behavior, Experimental Neurobiology Unit, University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium
| | - Charles Duyckaerts
- Laboratoire de Neuropathologie Escourolle, Hôpital de la Salpêtrière, AP-HP, & Alzheimer Prion Team, ICM, 47 Bd de l’Hôpital, 75651 CEDEX 13 Paris, France
| | - Isabelle Le Ber
- Inserm U1127, CNRS UMR 7225, Sorbonne Université, Paris Brain Institute (ICM), Hôpital Pitié-Salpêtrière, Paris, France
- Centre de référence des démences rares ou précoces, Hôpital Pitié-Salpêtrière, Paris, France
| | - Danielle Seihean
- Laboratoire de Neuropathologie Escourolle, Hôpital de la Salpêtrière, AP-HP, & ICM, 47 Bd de l’Hôpital, 75651 CEDEX 13 Paris, France
| | - Sabrina Turbant-Leclere
- Inserm U1127, CNRS UMR 7225, Sorbonne Université, Paris Brain Institute (ICM) Hôpital Pitié-Salpêtrière, Paris, France
| | - Ian R MacKenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC Canada V6T 2B5
| | - Catriona McLean
- Department of Anatomical Pathology Alfred Heath, Melbourne, Victoria, 3004, Australia
- Victorian Brain Bank, The Florey Institute of Neuroscience of Mental Health, Parkville, Victoria, 3052, Australia
| | - Matthew D Cykowski
- Department of Pathology and Genomic Medicine, Houston Methodist Research Institute and Weill Cornell Medicine, Houston, TX
| | - John F Ervin
- Department of Neurology, Duke University Medical Center, Durham, USA
| | - Shih-Hsiu J Wang
- Department of Neurology, Duke University Medical Center, Durham, USA
| | - Caroline Graff
- Division for Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Unit for Hereditary Dementias, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Inger Nennesmo
- Dept of laboratory Medicine Huddinge Karolinska Institutet, Stockholm Sweden
- Dept of Pathology, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Rashed M Nagra
- Human Brain and Spinal Fluid Resource Center, Brentwood Biomedical Research Institute, Los Angeles, CA, United States
| | | | - Gabor G Kovacs
- Tanz Centre for Research in Neurodegenerative Disease (CRND) and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Laboratory Medicine Program and Krembil Brain Institute, University Health Network, Toronto, ON, Canada
| | | | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Manuela Neumann
- Molecular Neuropathology of Neurodegenerative Diseases, German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Department of Neuropathology, University Hospital of Tübingen, Tübingen, Germany
| | - Lee-Cyn Ang
- Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, ON, Canada
- Schulich School of Medicine and Dentistry, Western University, London. ON, Canada
| | - Elizabeth C Finger
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Cornelis Blauwendraat
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Mike A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer’s and Related Dementias, National Institutes of Health, Bethesda, MD, USA
- Data Tecnica International LLC, Washington, DC, USA
| | - Andrew B Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Dan Vitale
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer’s and Related Dementias, National Institutes of Health, Bethesda, MD, USA
- Data Tecnica International LLC, Washington, DC, USA
| | - Cristina Cunha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | | | - Huw R Morris
- Department of Clinical and Movement Neurosciences, University College London, Queen Square Institute of Neurology, London, UK
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
- VIBUAntwerp Center for Molecular Neurology, University of Antwerp, Antwerp 2610, Belgium
| | - John A Hardy
- Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Reta Lila Weston Institute, University College London, Queen Square Institute of Neurology, London, UK
- Institute for Advanced Study, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, UK
| | - Owen A Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
- Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL 32224, USA
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Pérez-Millan A, Contador J, Juncà-Parella J, Bosch B, Borrell L, Tort-Merino A, Falgàs N, Borrego-Écija S, Bargalló N, Rami L, Balasa M, Lladó A, Sánchez-Valle R, Sala-Llonch R. Classifying Alzheimer's disease and frontotemporal dementia using machine learning with cross-sectional and longitudinal magnetic resonance imaging data. Hum Brain Mapp 2023; 44:2234-2244. [PMID: 36661219 PMCID: PMC10028671 DOI: 10.1002/hbm.26205] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/01/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023] Open
Abstract
Alzheimer's disease (AD) and frontotemporal dementia (FTD) are common causes of dementia with partly overlapping, symptoms and brain signatures. There is a need to establish an accurate diagnosis and to obtain markers for disease tracking. We combined unsupervised and supervised machine learning to discriminate between AD and FTD using brain magnetic resonance imaging (MRI). We included baseline 3T-T1 MRI data from 339 subjects: 99 healthy controls (CTR), 153 AD and 87 FTD patients; and 2-year follow-up data from 114 subjects. We obtained subcortical gray matter volumes and cortical thickness measures using FreeSurfer. We used dimensionality reduction to obtain a single feature that was later used in a support vector machine for classification. Discrimination patterns were obtained with the contribution of each region to the single feature. Our algorithm differentiated CTR versus AD and CTR versus FTD at the cross-sectional level with 83.3% and 82.1% of accuracy. These increased up to 90.0% and 88.0% with longitudinal data. When we studied the classification between AD versus FTD we obtained an accuracy of 63.3% at the cross-sectional level and 75.0% for longitudinal data. The AD versus FTD versus CTR classification has reached an accuracy of 60.7%, and 71.3% for cross-sectional and longitudinal data respectively. Disease discrimination brain maps are in concordance with previous results obtained with classical approaches. By using a single feature, we were capable to classify CTR, AD, and FTD with good accuracy, considering the inherent overlap between diseases. Importantly, the algorithm can be used with cross-sectional and longitudinal data.
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Affiliation(s)
- Agnès Pérez-Millan
- 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
- Department of Biomedicine, Faculty of Medicine, Institute of Neurosciences, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - José Contador
- 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
| | - Jordi Juncà-Parella
- 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
| | - Beatriz Bosch
- 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
| | - Laia Borrell
- Department of Biomedicine, Faculty of Medicine, Institute of Neurosciences, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Adrià Tort-Merino
- 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
| | - Neus Falgàs
- 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
- Atlantic Fellow for Equity in Brain Health, Global Brain Heath Institute, University of California San Francisco, Trinity College Dublin, San Francisco, California, 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
| | - Nuria Bargalló
- Image Diagnostic Centre, Hospital Clínic de Barcelona, CIBER de Salud Mental, Instituto de Salud Carlos III. Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain
| | - Lorena Rami
- 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
| | - Mircea Balasa
- 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
- Atlantic Fellow for Equity in Brain Health, Global Brain Heath Institute, University of California San Francisco, Trinity College Dublin, San Francisco, California, USA
| | - Albert Lladó
- 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
| | - Raquel Sánchez-Valle
- 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
| | - Roser Sala-Llonch
- Department of Biomedicine, Faculty of Medicine, Institute of Neurosciences, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
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7
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Pérez-Millan A, Borrego-Écija S, van Swieten JC, Jiskoot L, Moreno F, Laforce R, Graff C, Masellis M, Tartaglia MC, Rowe JB, Borroni B, Finger E, Synofzik M, Galimberti D, Vandenberghe R, de Mendonça A, Butler CR, Gerhard A, Ducharme S, Le Ber I, Santana I, Pasquier F, Levin J, Otto M, Sorbi S, Tiraboschi P, Seelaar H, Langheinrich T, Rohrer JD, Sala-Llonch R, Sánchez-Valle R. Loss of brainstem white matter predicts onset and motor neuron symptoms in C9orf72 expansion carriers: a GENFI study. J Neurol 2023; 270:1573-1586. [PMID: 36443488 DOI: 10.1007/s00415-022-11435-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES The C9orf72 expansion is the most common genetic cause of frontotemporal dementia (FTD) and/or motor neuron disease (MND). Corticospinal degeneration has been described in post-mortem neuropathological studies in these patients, especially in those with MND. We used MRI to analyze white matter (WM) volumes in presymptomatic and symptomatic C9orf72 expansion carriers and investigated whether its measure may be helpful in predicting the onset of symptoms. METHODS We studied 102 presymptomatic C9orf72 mutation carriers, 52 symptomatic carriers: 42 suffering from FTD and 11 from MND, and 75 non-carriers from the Genetic Frontotemporal dementia Initiative (GENFI). All subjects underwent T1-MRI acquisition. We used FreeSurfer to estimate the volume proportion of WM in the brainstem regions (midbrain, pons, and medulla oblongata). We calculated group differences with ANOVA tests and performed linear and non-linear regressions to assess group-by-age interactions. RESULTS A reduced WM ratio was found in all brainstem subregions in symptomatic carriers compared to both noncarriers and pre-symptomatic carriers. Within symptomatic carriers, MND patients presented a lower ratio in pons and medulla oblongata compared with FTD patients. No differences were found between presymptomatic carriers and non-carriers. Clinical severity was negatively associated with the WM ratio. C9orf72 carriers presented greater age-related WM loss than non-carriers, with MND patients showing significantly more atrophy in pons and medulla oblongata. DISCUSSION We find consistent brainstem WM loss in C9orf72 symptomatic carriers with differences related to the clinical phenotype supporting the use of brainstem measures as neuroimaging biomarkers for disease tracking.
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Affiliation(s)
- Agnès Pérez-Millan
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Villarroel, 170, 08036, Barcelona, Spain
- Department of Biomedicine, Faculty of Medicine, Institute of Neurosciences, University of Barcelona, 08036, Barcelona, Spain
| | - 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, University of Barcelona, Villarroel, 170, 08036, Barcelona, Spain
| | - John C van Swieten
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Lize Jiskoot
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, UK
| | - 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
| | - Robert Laforce
- Département des Sciences Neurologiques, Clinique Interdisciplinaire de Mémoire, CHU de Québec, and Faculté de Médecine, Université Laval, Quebec City, QC, Canada
| | - Caroline Graff
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Bioclinicum, Center for Alzheimer Research, Karolinska Institutet, Solna, Sweden
- Unit for Hereditary Dementias, Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Canada
| | - 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
- Department of Clinical and Experimental Sciences, Centre for Neurodegenerative Disorders, University of Brescia, Brescia, Italy
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, 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
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Neurology Service, University Hospitals Leuven, Leuven, Belgium
| | | | - 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
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK
- Department of Geriatric Medicine and Nuclear Medicine, Center for Translational Neuro- and Behavioral Sciences, University Medicine Essen, Essen, Germany
| | - Simon Ducharme
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada
- Department of Neurology and Neurosurgery, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Isabelle Le Ber
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau - ICM, Inserm U1127, CNRS UMR 7225, AP-HP - Hôpital Pitié-Salpêtrière (DMU Neurosciences Paris 6), Paris, France
- Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière (DMU Neurosciences Paris 6), Paris, 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
| | - Florence Pasquier
- Univ Lille, Lille, France
- CHU, CNR-MAJ, Labex Distalz, LiCEND, Lille, France
| | - Johannes Levin
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Sandro Sorbi
- Department of Neurofarba, University of Florence, Florence, Italy
| | | | - Harro Seelaar
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Tobias Langheinrich
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK
| | - Jonathan D Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, UK
| | - Roser Sala-Llonch
- Department of Biomedicine, Faculty of Medicine, Institute of Neurosciences, University of Barcelona, 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Villarroel, 170, 08036, Barcelona, Spain.
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8
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Sarto J, Ruiz-García R, Guillén N, Ramos-Campoy Ó, Falgàs N, Esteller D, Contador J, Fernández G, González Y, Tort-Merino A, Juncà-Parella J, Bosch B, Borrego-Écija S, Molina-Porcel L, Castellví M, Vergara M, Antonell A, Augé JM, Naranjo L, Sanchez-Valle R, Lladó A, Balasa M. Diagnostic Performance and Clinical Applicability of Blood-Based Biomarkers in a Prospective Memory Clinic Cohort. Neurology 2023; 100:e860-e873. [PMID: 36450604 PMCID: PMC9984216 DOI: 10.1212/wnl.0000000000201597] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/06/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Blood-based biomarkers have emerged as minimally invasive options for evaluating cognitive impairment. Most studies to date have assessed them in research cohorts, limiting their generalization to everyday clinical practice. We evaluated their diagnostic performance and clinical applicability in a prospective, real-world, memory clinic cohort. METHODS All patients referred with suspected cognitive impairment between July 2019 and June 2021 were prospectively invited to participate. Five plasma biomarkers (tau phosphorylated at threonine 181 [p-tau181], glial fibrillary acidic protein [GFAP], neurofilament light chain [NfL], total tau [t-tau], and ubiquitin C-terminal hydrolase L1 [UCH-L1]) were determined with single-molecule array. Performance was assessed in comparison to clinical diagnosis (blinded to plasma results) and amyloid status (CSF/PET). A group of cognitively unimpaired (CU) controls was also included. RESULTS Three hundred forty-nine participants (mean age 68, SD 8.3 years) and 36 CU controls (mean age 61.7, SD 8.2 years) were included. In the subcohort with available Alzheimer disease (AD) biomarkers (n = 268), plasma p-tau181 and GFAP had a high diagnostic accuracy to differentiate AD from non-neurodegenerative causes (area under the receiver operating characteristic curve 0.94 and 0.92, respectively), with p-tau181 systematically outperforming GFAP. Plasma p-tau181 levels predicted amyloid status (85% sensitivity and specificity) with accurate individual prediction in approximately 60% of the patients. Plasma NfL differentiated frontotemporal dementia (FTD) syndromes from CU (0.90) and non-neurodegenerative causes (0.93), whereas the discriminative capacity with AD and between all neurodegenerative and non-neurodegenerative causes was less accurate. A combination of p-tau181 and NfL identified FTD with 82% sensitivity and 85% specificity and had a negative predictive value for neurodegenerative diagnosis of 86%, ruling out half of the non-neurodegenerative diagnoses. In the subcohort without AD biomarkers, similar results were obtained. T-tau and UCH-L1 did not offer added diagnostic value. DISCUSSION Plasma p-tau181 predicted amyloid status with high accuracy and could have potentially avoided CSF/amyloid PET testing in approximately 60% of subjects in a memory clinic setting. NfL was useful for identifying FTD from non-neurodegenerative causes but behaved worse than p-tau181 in all other comparisons. Combining p-tau181 and NfL improved diagnostic performance for FTD and non-neurodegenerative diagnoses. However, the 14% false-negative results suggest that further improvement is needed before implementation outside memory clinics. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that plasma p-tau181 correlates with the presence or absence of AD and a combination of plasma p-tau181 and NfL correlates moderately well with a diagnosis of FTD.
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Affiliation(s)
- Jordi Sarto
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Raquel Ruiz-García
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Núria Guillén
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Óscar Ramos-Campoy
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Neus Falgàs
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Diana Esteller
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - José Contador
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Guadalupe Fernández
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Yolanda González
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Adrià Tort-Merino
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Jordi Juncà-Parella
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Bea Bosch
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Sergi Borrego-Écija
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Laura Molina-Porcel
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Magda Castellví
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Miguel Vergara
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Anna Antonell
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Josep María Augé
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Laura Naranjo
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Raquel Sanchez-Valle
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Albert Lladó
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain
| | - Mircea Balasa
- From the Alzheimer's Disease and Other Cognitive Disorders Unit (J.S., N.G., O.R.-C., N.F., D.E., J.C., G.F., Y.G., A.T.-M., J.J.-P., B.B., S.B.-É., L.M.-P., M.C., M.V., A.A., R.S.-V., A.L., M.B.), Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona; Immunology Service (R.R.-G., L.N.), Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Spain; Atlantic Fellow for Equity in Brain Health (N.F., M.B.), Global Brain Health Institute, University of California, San Francisco and Trinity College, Dublin, Ireland; Neurological Tissue Bank of the Biobank-Hospital Clinic-IDIBAPS (L.M.-P.); and Biochemistry and Molecular Genetics Department (J.M.A.), Hospital Clínic de Barcelona, Spain.
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9
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Illán-Gala I, Montal V, Borrego-Écija S, Mandelli ML, Falgàs N, Welch AE, Pegueroles J, Santos-Santos M, Bejanin A, Alcolea D, Dols-Icardo O, Belbin O, Sánchez-Saudinós MB, Bargalló N, González-Ortiz S, Lladó A, Blesa R, Dickerson BC, Rosen HJ, Miller BL, Lleó A, Gorno-Tempini ML, Sánchez-Valle R, Fortea J. Correction: Cortical microstructure in primary progressive aphasia: a multicenter study. Alzheimers Res Ther 2023; 15:29. [PMID: 36739431 PMCID: PMC9898884 DOI: 10.1186/s13195-023-01179-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Ignacio Illán-Gala
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.
- Atlantic Fellow for Equity in Brain Health at the University of California San Francisco, San Francisco, CA, 94115, USA.
| | - Victor Montal
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Sergi Borrego-Écija
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer, University of Barcelona, 08036, Barcelona, Spain
| | - Maria Luisa Mandelli
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94115, USA
| | - Neus Falgàs
- Atlantic Fellow for Equity in Brain Health at the University of California San Francisco, San Francisco, CA, 94115, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94115, USA
| | - Ariane E Welch
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94115, USA
| | - Jordi Pegueroles
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Miguel Santos-Santos
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Alexandre Bejanin
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Daniel Alcolea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Oriol Dols-Icardo
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Olivia Belbin
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Mª Belén Sánchez-Saudinós
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
| | - Nuria Bargalló
- Radiology Department, Hospital Clinic Barcelona and Magnetic Resonance Image Core facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Albert Lladó
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer, University of Barcelona, 08036, Barcelona, Spain
| | - Rafael Blesa
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Massachusetts Alzheimer's Disease Research Center, Boston, MA, USA
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94115, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94115, USA
| | - Alberto Lleó
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94115, USA
| | - Raquel Sánchez-Valle
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer, University of Barcelona, 08036, Barcelona, Spain
| | - Juan Fortea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.
- Barcelona Down Medical Center. Fundació Catalana de Síndrome de Down, Barcelona, Spain.
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Montagut N, Borrego-Écija S, Herrero J, Lladó A, Balasa M, Muñoz E, Valldeoriola F, Sánchez-Valle R. Escala Barcelona para la apraxia bucofonatoria: instrumento de evaluación cuantitativo. Neurologia 2022. [DOI: 10.1016/j.nrl.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Montagut N, Borrego-Écija S, Herrero J, Lladó A, Balasa M, Muñoz E, Valldeoriola F, Sánchez-Valle R. Barcelona scale for buccophonatory apraxia: Quantitative assessment tool. Neurologia 2022:S2173-5808(22)00140-7. [PMID: 36272532 DOI: 10.1016/j.nrleng.2022.09.006] [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: 06/23/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Currently there is no tool to quantify buccophonatory apraxia to stratify, compare and monitor patients longitudinally in an objective manner. Our aim in this study is to create a quantitative scale for buccophonatory apraxia and evaluate it in patients with the non-fluent/grammatical variant of primary progressive aphasia (nfvPPA) and other neurodegenerative diseases that occur with speech and/or language problems. METHODS The scale was designed based on useful elements in the assessment of buccophonatory apraxia and the total was quantified in seconds. The scale was administered to 64 participants with diagnoses of: nfvPPA, semantic variant of primary progressive aphasia (svPPA), logopenic variant of primary progressive aphasia (lvPPA), Huntington's disease, Parkinson's disease, as well as a group of healthy controls. RESULTS Patients showed a significantly higher score compared to controls. The nfvPPA group had the highest mean score on the scale (429 seconds ± 278). The scale was useful to differentiate vnfPPA from svPPA and Parkinson's disease (area under curve [AUC] of 0.956 and 0.989, respectively), but less to differentiate it from Huntington's disease (AUC = 0.67) and lvPPA. There was a statistically significant relationship between total score and disease severity in nfvPPA (P < .029). CONCLUSIONS The Barcelona scale for buccophonatory apraxia could be useful to quantitatively evaluate buccophonatory apraxia in different neurodegenerative diseases, and compare patients, especially in nfvPPA.
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Affiliation(s)
- N Montagut
- Unidad de Alzheimer y Otros Trastornos Cognitivos, Servicio de Neurología, Hospital Clínic de Barcelona, Barcelona, Spain; Unidad de Parkinson y Trastornos del Movimiento, Servicio de Neurología, Hospital Clínic de Barcelona, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain
| | - S Borrego-Écija
- Unidad de Alzheimer y Otros Trastornos Cognitivos, Servicio de Neurología, Hospital Clínic de Barcelona, Barcelona, Spain
| | - J Herrero
- Unidad de Alzheimer y Otros Trastornos Cognitivos, Servicio de Neurología, Hospital Clínic de Barcelona, Barcelona, Spain; Unidad de Parkinson y Trastornos del Movimiento, Servicio de Neurología, Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Lladó
- Unidad de Alzheimer y Otros Trastornos Cognitivos, Servicio de Neurología, Hospital Clínic de Barcelona, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain; Institut d'Investigació Biomédica August Pi i Sunyer, Barcelona, Spain
| | - M Balasa
- Unidad de Alzheimer y Otros Trastornos Cognitivos, Servicio de Neurología, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigació Biomédica August Pi i Sunyer, Barcelona, Spain
| | - E Muñoz
- Unidad de Parkinson y Trastornos del Movimiento, Servicio de Neurología, Hospital Clínic de Barcelona, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain; Institut d'Investigació Biomédica August Pi i Sunyer, Barcelona, Spain
| | - F Valldeoriola
- Unidad de Parkinson y Trastornos del Movimiento, Servicio de Neurología, Hospital Clínic de Barcelona, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain; Institut d'Investigació Biomédica August Pi i Sunyer, Barcelona, Spain
| | - R Sánchez-Valle
- Unidad de Alzheimer y Otros Trastornos Cognitivos, Servicio de Neurología, Hospital Clínic de Barcelona, Barcelona, Spain.
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12
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Contador J, Pérez-Millan A, Guillen N, Sarto J, Tort-Merino A, Balasa M, Falgàs N, Castellví M, Borrego-Écija S, Juncà-Parella J, Bosch B, Fernández-Villullas G, Ramos-Campoy O, Antonell A, Bargalló N, Sanchez-Valle R, Sala Llonch R, Lladó A. Sex differences in early-onset Alzheimer's disease. Eur J Neurol 2022; 29:3623-3632. [PMID: 36005384 DOI: 10.1111/ene.15531] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 08/10/2022] [Accepted: 08/13/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Sex is believed to drive heterogeneity in Alzheimer's disease (AD), although evidence in early-onset AD (<65 years, EOAD) is scarce. METHODS We included 62 EOAD patients and 44 healthy controls (HC) with cerebrospinal fluid (CSF) AD's core biomarkers and neurofilament light chain levels, neuropsychological assessment, and 3T-MRI. We measured cortical thickness (CTh) and hippocampal subfield volumes (HpS) using Freesurfer. Adjusted linear models were used to analyze sex-differences and the relationship between atrophy and cognition. RESULTS Compared to same-sex HC, female-EOAD showed greater cognitive impairment and broader atrophy burden than male-EOAD. In a direct female-EOAD and male-EOAD comparison, there were slight differences in temporal CTh, with no differences in cognition or HpS. CSF tau levels were higher in female-EOAD than in male-EOAD. Greater atrophy was associated with worse cognition in female-EOAD. CONCLUSIONS At diagnosis, there are sex-differences in the pattern of cognitive impairment, atrophy burden and CSF tau in EOAD, suggesting there is an influence of sex on pathology spreading and susceptibility to the disease in EOAD.
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Affiliation(s)
- José Contador
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Agnès Pérez-Millan
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Institute of Neurosciences. Department of Biomedicine, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Nuria Guillen
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Jordi Sarto
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Adrià Tort-Merino
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Mircea Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Atlantic Fellow for Equity in Brain Health, Global Brain Heath Institute
| | - Neus Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Atlantic Fellow for Equity in Brain Health, Global Brain Heath Institute
| | - Magdalena Castellví
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - 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), Universitat de Barcelona, Barcelona, Spain
| | - Jordi Juncà-Parella
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Beatriz Bosch
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Guadalupe Fernández-Villullas
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Oscar Ramos-Campoy
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Anna Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Nuria Bargalló
- Image Diagnostic Centre Radiology Department, Hospital Clínic de Barcelona, Magnetic Resonance Image Core facility Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM., Spain
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Roser Sala Llonch
- Institute of Neurosciences. Department of Biomedicine, Faculty of Medicine, University of Barcelona, Barcelona, Spain.,Biomedical Imaging Group, Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
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Sarto J, Mayà G, Molina-Porcel L, Balasa M, Gelpi E, Aldecoa I, Borrego-Écija S, Contador J, Ximelis T, Vergara M, Antonell A, Sánchez-Valle R, Albert L. Evolution of Clinical-Pathological Correlations in Early-Onset Alzheimer's Disease Over a 25-Year Period in an Academic Brain Bank. J Alzheimers Dis 2022; 87:1659-1669. [PMID: 35723108 DOI: 10.3233/jad-220045] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Early onset Alzheimer's disease (EOAD) represents a diagnostic challenge and is associated with a high diagnostic delay and misdiagnosis. OBJECTIVE To describe clinical and pathological data from a pathologically confirmed EOAD cohort and evaluate evolving trends in clinical-pathological correlation accuracy. METHODS Retrospective review of clinical and neuropathological data of pathologically confirmed EOAD patients (age at onset [AAO] < 60). Comparison between two periods: 1994- 2009 and 2010- 2018. RESULTS Eighty brain donors were included. Mean AAO, age at death, and diagnostic delay was 55, 66, and 3 years, respectively. Twenty-nine percent had a nonamnestic presentation. Sixteen percent were given a non-AD initial clinical diagnosis (initial misdiagnosis) and 14% received a final misdiagnosis. Nonamnestic presentation patients received more misdiagnoses than amnestic presentation ones (39% versus 7% and 39% versus 3.5%, on initial and final misdiagnosis, respectively). When comparing both time periods, a trend towards a higher diagnostic accuracy in the 2010- 2018 period was observed, mainly on initial misdiagnosis in nonamnestic presentation patients (53% versus 13%, p = 0.069). Diagnostic delay was similar between both periods. Cerebral amyloid angiopathy (96%) and Lewy body co-pathology (55%) were very frequent, while limbic-predominant age-related TDP-43 encephalopathy pathologic changes were only present in 12.5%. CONCLUSION In the last decade, there has been a trend towards improved diagnostic accuracy in EOAD, which might be explained by improved diagnostic criteria, increasing experience on EOAD and the beginning of the use of biomarkers, although diagnostic delay remains similar. Concomitant neuropathology was very frequent despite the relatively young age of brain donors.
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Affiliation(s)
- Jordi Sarto
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Gerard Mayà
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Laura Molina-Porcel
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Neurological Tissue Bank, Biobanc-Hospital Clínic Barcelona-IDIBAPS, Barcelona, Spain
| | - Mircea Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ellen Gelpi
- Neurological Tissue Bank, Biobanc-Hospital Clínic Barcelona-IDIBAPS, Barcelona, Spain.,Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Iban Aldecoa
- Neurological Tissue Bank, Biobanc-Hospital Clínic Barcelona-IDIBAPS, Barcelona, Spain.,Pathology Service, Biomedical Diagnostic Center, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - 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), University of Barcelona, Barcelona, Spain.,Neurological Tissue Bank, Biobanc-Hospital Clínic Barcelona-IDIBAPS, Barcelona, Spain
| | - Jose Contador
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Teresa Ximelis
- Neurological Tissue Bank, Biobanc-Hospital Clínic Barcelona-IDIBAPS, Barcelona, Spain
| | - Miguel Vergara
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Anna Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Neurological Tissue Bank, Biobanc-Hospital Clínic Barcelona-IDIBAPS, Barcelona, Spain
| | - Lladó Albert
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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14
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Illán-Gala I, Montal V, Borrego-Écija S, Mandelli ML, Falgàs N, Welch AE, Pegueroles J, Santos-Santos M, Bejanin A, Alcolea D, Dols-Icardo O, Belbin O, Sánchez-Saudinós MB, Bargalló N, González-Ortiz S, Lladó A, Blesa R, Dickerson BC, Rosen HJ, Miller BL, Lleó A, Gorno-Tempini ML, Sánchez-Valle R, Fortea J. Cortical microstructure in primary progressive aphasia: a multicenter study. Alzheimers Res Ther 2022; 14:27. [PMID: 35139897 PMCID: PMC8830043 DOI: 10.1186/s13195-022-00974-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/02/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cortical mean diffusivity is a novel imaging metric sensitive to early changes in neurodegenerative syndromes. Higher cortical mean diffusivity values reflect microstructural disorganization and have been proposed as a sensitive biomarker that might antedate macroscopic cortical changes. We aimed to test the hypothesis that cortical mean diffusivity is more sensitive than cortical thickness to detect cortical changes in primary progressive aphasia (PPA). METHODS In this multicenter, case-control study, we recruited 120 patients with PPA (52 non-fluent, 31 semantic, and 32 logopenic variants; and 5 GRN-related PPA) as well as 89 controls from three centers. The 3-Tesla MRI protocol included structural and diffusion-weighted sequences. Disease severity was assessed with the Clinical Dementia Rating scale. Cortical thickness and cortical mean diffusivity were computed using a surface-based approach. RESULTS The comparison between each PPA variant and controls revealed cortical mean diffusivity increases and cortical thinning in overlapping regions, reflecting the canonical loci of neurodegeneration of each variant. Importantly, cortical mean diffusivity increases also expanded to other PPA-related areas and correlated with disease severity in all PPA groups. Cortical mean diffusivity was also increased in patients with very mild PPA when only minimal cortical thinning was observed and showed a good correlation with measures of disease severity. CONCLUSIONS Cortical mean diffusivity shows promise as a sensitive biomarker for the study of the neurodegeneration-related microstructural changes in PPA.
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Affiliation(s)
- Ignacio Illán-Gala
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.
- Atlantic Fellow for Equity in Brain Health at the University of California San Francisco, San Francisco, CA, 94115, USA.
| | - Victor Montal
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Sergi Borrego-Écija
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer, University of Barcelona, 08036, Barcelona, Spain
| | - Maria Luisa Mandelli
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94115, USA
| | - Neus Falgàs
- Atlantic Fellow for Equity in Brain Health at the University of California San Francisco, San Francisco, CA, 94115, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94115, USA
| | - Ariane E Welch
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94115, USA
| | - Jordi Pegueroles
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Miguel Santos-Santos
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Alexandre Bejanin
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Daniel Alcolea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Oriol Dols-Icardo
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Olivia Belbin
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Mª Belén Sánchez-Saudinós
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
| | - Nuria Bargalló
- Radiology Department, Hospital Clinic Barcelona and Magnetic Resonance Image Core facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Albert Lladó
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer, University of Barcelona, 08036, Barcelona, Spain
| | - Rafael Blesa
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Massachusetts Alzheimer's Disease Research Center, Boston, MA, USA
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94115, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94115, USA
| | - Alberto Lleó
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94115, USA
| | - Raquel Sánchez-Valle
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer, University of Barcelona, 08036, Barcelona, Spain
| | - Juan Fortea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.
- Barcelona Down Medical Center. Fundació Catalana de Síndrome de Down, Barcelona, Spain.
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15
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Montagut N, Borrego-Écija S, Castellví M, Rico I, Reñé R, Balasa M, Lladó A, Sánchez-Valle R. Errorless Learning Therapy in Semantic Variant of Primary Progressive Aphasia. J Alzheimers Dis 2021; 79:415-422. [PMID: 33285632 DOI: 10.3233/jad-200904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/15/2022]
Abstract
BACKGROUND The semantic variant of primary progressive aphasia (svPPA) is characterized by a progressive loss of semantic knowledge impairing the ability to name and to recognize the meaning of words. OBJECTIVE We aimed to evaluate the immediate and short-term effect of errorless learning speech therapy on the naming and recognition of commonly used words in patients with svPPA. METHODS Eight participants diagnosed with svPPA received 16 sessions of intensive errorless learning speech therapy. Naming and word comprehension tasks were evaluated at baseline, immediately postintervention, and at follow-up after 1, 3, and 6 months. These evaluations were performed using two item sets (a trained list and an untrained list). RESULTS In the naming tasks, patients showed a significant improvement in trained items immediately after the intervention, but that improvement decayed progressively when therapy ended. No improvements were found either in trained comprehension or in untrained tasks. CONCLUSION Errorless learning therapy could improve naming ability in patients with svPPA. This effect may be due to the relative preservation of episodic memory, but the benefit is not maintained over time, presumably because there is no consolidation.
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Affiliation(s)
- Núria Montagut
- Alzheimer's disease and other cognitive disorders Unit, Neurology Service, Hospital Clinic, Barcelona, Spain
| | - Sergi Borrego-Écija
- Alzheimer's disease and other cognitive disorders Unit, Neurology Service, Hospital Clinic, Barcelona, Spain.,Institut d'Investigació Biomèdica August Pi i Sunyer, Barcelona, Spain
| | - Magdalena Castellví
- Alzheimer's disease and other cognitive disorders Unit, Neurology Service, Hospital Clinic, Barcelona, Spain
| | - Immaculada Rico
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Ramón Reñé
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.,University of Barcelona, Barcelona, Spain
| | - Mircea Balasa
- Alzheimer's disease and other cognitive disorders Unit, Neurology Service, Hospital Clinic, Barcelona, Spain.,Institut d'Investigació Biomèdica August Pi i Sunyer, Barcelona, Spain
| | - Albert Lladó
- Alzheimer's disease and other cognitive disorders Unit, Neurology Service, Hospital Clinic, Barcelona, Spain.,Institut d'Investigació Biomèdica August Pi i Sunyer, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's disease and other cognitive disorders Unit, Neurology Service, Hospital Clinic, Barcelona, Spain.,Institut d'Investigació Biomèdica August Pi i Sunyer, Barcelona, Spain.,University of Barcelona, Barcelona, Spain
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16
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Contador J, Pérez-Millán A, Tort-Merino A, Balasa M, Falgàs N, Olives J, Castellví M, Borrego-Écija S, Bosch B, Fernández-Villullas G, Ramos-Campoy O, Antonell A, Bargalló N, Sanchez-Valle R, Sala-Llonch R, Lladó A. Longitudinal brain atrophy and CSF biomarkers in early-onset Alzheimer's disease. Neuroimage Clin 2021; 32:102804. [PMID: 34474317 PMCID: PMC8405839 DOI: 10.1016/j.nicl.2021.102804] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 04/19/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 01/09/2023]
Abstract
There is evidence of longitudinal atrophy in posterior brain areas in early-onset Alzheimer's disease (EOAD; aged < 65 years), but no studies have been conducted in an EOAD cohort with fluid biomarkers characterization. We used 3T-MRI and Freesurfer 6.0 to investigate cortical and subcortical gray matter loss at two years in 12 EOAD patients (A + T + N + ) compared to 19 controls (A-T-N-) from the Hospital Clínic Barcelona cohort. We explored group differences in atrophy patterns and we correlated atrophy and baseline CSF-biomarkers levels in EOAD. We replicated the correlation analyses in 14 EOAD (A + T + N + ) and 55 late-onset AD (LOAD; aged ≥ 75 years; A + T + N + ) participants from the Alzheimer's disease Neuroimaging Initiative. We found that EOAD longitudinal atrophy spread with a posterior-to-anterior gradient and beyond hippocampus/amygdala. In EOAD, higher initial CSF NfL levels correlated with higher ventricular volumes at baseline. On the other hand, higher initial CSF Aβ42 levels (within pathological range) predicted higher rates of cortical loss in EOAD. In EOAD and LOAD subjects, higher CSF t-tau values at baseline predicted higher rates of subcortical atrophy. CSF p-tau did not show any significant correlation. In conclusion, posterior cortices, hippocampus and amygdala capture EOAD atrophy from early stages. CSF Aβ42 might predict cortical thinning and t-tau/NfL subcortical atrophy.
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Affiliation(s)
- José Contador
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain
| | - Agnès Pérez-Millán
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain
| | - Adrià Tort-Merino
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain
| | - Mircea Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain; Atlantic Fellow for Equity in Brain Health, Global Brain Heath Institute
| | - Neus Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain; Atlantic Fellow for Equity in Brain Health, Global Brain Heath Institute; Department of Neurology, Memory & Aging Center, Weill Institute for Neurosciences, University of California, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, USA
| | - Jaume Olives
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain
| | - Magdalena Castellví
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain
| | - Sergi Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain
| | - Beatriz Bosch
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain
| | - Guadalupe Fernández-Villullas
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain
| | - Oscar Ramos-Campoy
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain
| | - Anna Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain
| | - Nuria Bargalló
- Image Diagnostic Centre, IDIBAPS, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
| | - Roser Sala-Llonch
- Institute of Neurosciences. Department of Biomedicine, Faculty of Medicine, University of Barcelona, Barcelona, 08036, Spain; Biomedical Imaging Group, Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona 08036, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain.
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17
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Illán-Gala I, Falgàs N, Friedberg A, Castro-Suárez S, Keret O, Rogers N, Oz D, Nigro S, Quattrone A, Quattrone A, Wolf A, Younes K, Santos-Santos M, Borrego-Écija S, Cobigo Y, Dols-Icardo O, Lladó A, Sánchez-Valle R, Clarimon J, Blesa R, Alcolea D, Fortea J, Lleó A, Grinberg LT, Spina S, Kramer JH, Rabinovici GD, Boxer A, Gorno Tempini ML, Miller BL, Seeley WW, Rosen HJ, Perry DC. Diagnostic Utility of Measuring Cerebral Atrophy in the Behavioral Variant of Frontotemporal Dementia and Association With Clinical Deterioration. JAMA Netw Open 2021; 4:e211290. [PMID: 33704477 PMCID: PMC7953307 DOI: 10.1001/jamanetworkopen.2021.1290] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE The presence of atrophy on magnetic resonance imaging can support the diagnosis of the behavioral variant of frontotemporal dementia (bvFTD), but reproducible measurements are lacking. OBJECTIVE To assess the diagnostic and prognostic utility of 6 visual atrophy scales (VAS) and the Magnetic Resonance Parkinsonism Index (MRPI). DESIGN, SETTING, AND PARTICIPANTS In this diagnostic/prognostic study, data from 235 patients with bvFTD and 225 age- and magnetic resonance imaging-matched control individuals from 3 centers were collected from December 1, 1998, to September 30, 2019. One hundred twenty-one participants with bvFTD had high confidence of frontotemporal lobar degeneration (FTLD) (bvFTD-HC), and 19 had low confidence of FTLD (bvFTD-LC). Blinded clinicians applied 6 previously validated VAS, and the MRPI was calculated with a fully automated approach. Cortical thickness and subcortical volumes were also measured for comparison. Data were analyzed from February 1 to June 30, 2020. MAIN OUTCOMES AND MEASURES The main outcomes of this study were bvFTD-HC or a neuropathological diagnosis of 4-repeat (4R) tauopathy and the clinical deterioration rate (assessed by longitudinal measurements of Clinical Dementia Rating Sum of Boxes). Measures of cerebral atrophy included VAS scores, the bvFTD atrophy score (sum of VAS scores in orbitofrontal, anterior cingulate, anterior temporal, medial temporal lobe, and frontal insula regions), the MRPI, and other computerized quantifications of cortical and subcortical volumes. The areas under the receiver operating characteristic curve (AUROC) were calculated for the differentiation of participants with bvFTD-HC and bvFTD-LC and controls. Linear mixed models were used to evaluate the ability of atrophy measures to estimate longitudinal clinical deterioration. RESULTS Of the 460 included participants, 296 (64.3%) were men, and the mean (SD) age was 62.6 (11.4) years. The accuracy of the bvFTD atrophy score for the differentiation of bvFTD-HC from controls (AUROC, 0.930; 95% CI, 0.903-0.957) and bvFTD-HC from bvFTD-LC (AUROC, 0.880; 95% CI, 0.787-0.972) was comparable to computerized measures (AUROC, 0.973 [95% CI, 0.954-0.993] and 0.898 [95% CI, 0.834-0.962], respectively). The MRPI was increased in patients with bvFTD and underlying 4R tauopathies compared with other FTLD subtypes (14.1 [2.0] vs 11.2 [2.6] points; P < .001). Higher bvFTD atrophy scores were associated with faster clinical deterioration in bvFTD (1.86-point change in Clinical Dementia Rating Sum of Boxes score per bvFTD atrophy score increase per year; 95% CI, 0.99-2.73; P < .001). CONCLUSIONS AND RELEVANCE Based on these study findings, in bvFTD, VAS increased the diagnostic certainty of underlying FTLD, and the MRPI showed potential for the detection of participants with underlying 4R tauopathies. These widely available measures of atrophy can also be useful to estimate longitudinal clinical deterioration.
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Affiliation(s)
- Ignacio Illán-Gala
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Atlantic Fellow for Equity in Brain Health, Department of Neurology, University of California, San Francisco
| | - Neus Falgàs
- Atlantic Fellow for Equity in Brain Health, Department of Neurology, University of California, San Francisco
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Department of Neurology, Hospital Clínic, Institut d’Investigació Biomèdica August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Adit Friedberg
- Atlantic Fellow for Equity in Brain Health, Department of Neurology, University of California, San Francisco
| | - Sheila Castro-Suárez
- Atlantic Fellow for Equity in Brain Health, Department of Neurology, University of California, San Francisco
| | - Ophir Keret
- Atlantic Fellow for Equity in Brain Health, Department of Neurology, University of California, San Francisco
| | - Nicole Rogers
- Atlantic Fellow for Equity in Brain Health, Department of Neurology, University of California, San Francisco
| | - Didem Oz
- Atlantic Fellow for Equity in Brain Health, Department of Neurology, University of California, San Francisco
| | - Salvatore Nigro
- Neuroscience Centre, Magna Graecia University, Catanzaro, Italy
| | - Andrea Quattrone
- Department of Medical and Surgical Sciences, Institute of Neurology, Magna Graecia University, Catanzaro, Italy
| | - Aldo Quattrone
- Neuroscience Centre, Magna Graecia University, Catanzaro, Italy
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Amy Wolf
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Kyan Younes
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Miguel Santos-Santos
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergi Borrego-Écija
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Department of Neurology, Hospital Clínic, Institut d’Investigació Biomèdica August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Yann Cobigo
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Oriol Dols-Icardo
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Albert Lladó
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Department of Neurology, Hospital Clínic, Institut d’Investigació Biomèdica August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Department of Neurology, Hospital Clínic, Institut d’Investigació Biomèdica August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Jordi Clarimon
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rafael Blesa
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Daniel Alcolea
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Juan Fortea
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alberto Lleó
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lea T. Grinberg
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Salvatore Spina
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Joel H. Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Gil D. Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Adam Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | | | - Bruce L. Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - William W. Seeley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Howard J. Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - David C. Perry
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
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18
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Borrego-Écija S, Sala-Llonch R, van Swieten J, Borroni B, Moreno F, Masellis M, Tartaglia C, Graff C, Galimberti D, Laforce R, Rowe JB, Finger E, Vandenberghe R, Tagliavini F, de Mendonça A, Santana I, Synofzik M, Ducharme S, Levin J, Danek A, Gerhard A, Otto M, Butler C, Frisoni G, Sorbi S, Heller C, Bocchetta M, Cash DM, Convery RS, Moore KM, Rohrer JD, Sanchez-Valle R. Disease-related cortical thinning in presymptomatic granulin mutation carriers. Neuroimage Clin 2020; 29:102540. [PMID: 33418170 PMCID: PMC7804836 DOI: 10.1016/j.nicl.2020.102540] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 06/23/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022]
Abstract
No differences in cortical thickness were found between presymptomatic GRN mutation carriers and non-carriers at the group-wise comparison. Presymptomatic GRN mutations carriers present distinct age-related CTh loss in frontal areas. We do not fount influence of the TMEM106B genotype in the age-related CTh of GRN carriers.
Mutations in the granulin gene (GRN) cause familial frontotemporal dementia. Understanding the structural brain changes in presymptomatic GRN carriers would enforce the use of neuroimaging biomarkers for early diagnosis and monitoring. We studied 100 presymptomatic GRN mutation carriers and 94 noncarriers from the Genetic Frontotemporal dementia initiative (GENFI), with MRI structural images. We analyzed 3T MRI structural images using the FreeSurfer pipeline to calculate the whole brain cortical thickness (CTh) for each subject. We also perform a vertex-wise general linear model to assess differences between groups in the relationship between CTh and diverse covariables as gender, age, the estimated years to onset and education. We also explored differences according to TMEM106B genotype, a possible disease modifier. Whole brain CTh did not differ between carriers and noncarriers. Both groups showed age-related cortical thinning. The group-by-age interaction analysis showed that this age-related cortical thinning was significantly greater in GRN carriers in the left superior frontal cortex. TMEM106B did not significantly influence the age-related cortical thinning. Our results validate and expand previous findings suggesting an increased CTh loss associated with age and estimated proximity to symptoms onset in GRN carriers, even before the disease onset.
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Affiliation(s)
- Sergi Borrego-Écija
- Alzheimer's disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain
| | - Roser Sala-Llonch
- Departament de Biomedicina, Institute of Neuroscience, University of Barcelona, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain
| | - John van Swieten
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fermín Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia University Hospital, San Sebastian, Gipuzkoa, Spain
| | - Mario Masellis
- LC Campbell Cognitive Neurology Research Unit, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Carmela Tartaglia
- Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Caroline Graff
- Department of Geriatric Medicine, Karolinska University Hospital-Huddinge, Stockholm, Sweden
| | - Daniela Galimberti
- Biomedical, Surgical and Dental Sciences, University of Milan, Centro Dino Ferrari, Milan, Italy; Fondazione IRCCS Ca' Granda, Ospedale Policlinico, Neurodegenerative Diseases Unit, Milan, Italy
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, Université Laval, Québec, Canada
| | - James B Rowe
- Department of Clinical Neurosciences and Medical Research Council, Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Fabrizio Tagliavini
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologica Carlo Besta, Milano, Italy
| | | | - Isabel Santana
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Simon Ducharme
- Department of Psychiatry, McGill University Health Centre, McGill University, Montreal, Québec, Canada; McConnell Brain Imaging Centre, Montreal Neurological Institut, McGill University, Montreal, Québec, Canada
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Site Munich, Munich, Germany; SyNergy,Munich Cluster for Systems Neurology, Munich, Germany
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | - Alex Gerhard
- Faculty of Medical and Human Sciences, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Chris Butler
- Department of Clinical Neurology, University of Oxford, Oxford, United Kingdom
| | - Giovanni Frisoni
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Memory Clinic LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy; Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Don Carlo Gnocchi, Florence, Italy
| | - Carolin Heller
- Dementia Research Centre, Department of Neurodegenerative Disease, Queen Square UCL Institute of Neurology, London, UK
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, Queen Square UCL Institute of Neurology, London, UK
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, Queen Square UCL Institute of Neurology, London, UK
| | - Rhian S Convery
- Dementia Research Centre, Department of Neurodegenerative Disease, Queen Square UCL Institute of Neurology, London, UK
| | - Katrina M Moore
- Dementia Research Centre, Department of Neurodegenerative Disease, Queen Square UCL Institute of Neurology, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, Queen Square UCL Institute of Neurology, London, UK
| | - Raquel Sanchez-Valle
- Alzheimer's disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Departament de Biomedicina, Institute of Neuroscience, University of Barcelona, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain.
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19
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Falgàs N, Balasa M, Bargalló N, Borrego-Écija S, Ramos-Campoy O, Fernández-Villullas G, Bosch B, Olives J, Tort-Merino A, Antonell A, Castellví M, Allen IE, Sánchez-Valle R, Lladó A. Diagnostic Accuracy of MRI Visual Rating Scales in the Diagnosis of Early Onset Cognitive Impairment. J Alzheimers Dis 2020; 73:1575-1583. [DOI: 10.3233/jad-191167] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Neus Falgàs
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, University of California, San Francisco, CA, USA
| | - Mircea Balasa
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
- Senior Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, Trinity College, Dublin, Ireland
| | - Núria Bargalló
- Imaging Diagnostic Center, Hospital Clínic, Barcelona, Spain
- Magnetic Resonance Image Core Facility, IDIBAPS, Spain
| | - Sergi Borrego-Écija
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Oscar Ramos-Campoy
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Guadalupe Fernández-Villullas
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Beatriz Bosch
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Jaume Olives
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Adrià Tort-Merino
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Anna Antonell
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Magdalena Castellví
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Isabel E. Allen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Raquel Sánchez-Valle
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Albert Lladó
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
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20
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Antonell A, Tort-Merino A, Ríos J, Balasa M, Borrego-Écija S, Auge JM, Muñoz-García C, Bosch B, Falgàs N, Rami L, Ramos-Campoy O, Blennow K, Zetterberg H, Molinuevo JL, Lladó A, Sánchez-Valle R. Synaptic, axonal damage and inflammatory cerebrospinal fluid biomarkers in neurodegenerative dementias. Alzheimers Dement 2020; 16:262-272. [PMID: 31668967 DOI: 10.1016/j.jalz.2019.09.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [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: 12/13/2022]
Abstract
INTRODUCTION Synaptic damage, axonal neurodegeneration, and neuroinflammation are common features in Alzheimer's disease (AD), frontotemporal dementia (FTD), and Creutzfeldt-Jakob disease (CJD). METHODS Unicentric cohort of 353 participants included healthy control (HC) subjects, AD continuum stages, genetic AD and FTD, and FTD and CJD. We measured cerebrospinal fluid neurofilament light (NF-L), neurogranin (Ng), 14-3-3, and YKL-40 proteins. RESULTS Biomarkers showed differences in HC subjects versus AD, FTD, and CJD. Disease groups differed between them except AD versus FTD for YKL-40. Only NF-L differed between all stages within the AD continuum. AD and FTD symptomatic mutation carriers presented differences with respect to HC subjects. Applying the AT(N) system, 96% subjects were positive for neurodegeneration if 14-3-3 was used, 94% if NF-L was used, 62% if Ng was used, and 53% if YKL-40 was used. DISCUSSION Biomarkers of synapse and neurodegeneration differentiate HC subjects from neurodegenerative dementias and between AD, FTD, and CJD. NF-L and 14-3-3 performed similar to total tau when AT(N) system was applied.
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Affiliation(s)
- Anna Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Adrià Tort-Merino
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - José Ríos
- Medical Statistics Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Hospital Clínic, Barcelona, Spain.,Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mircea Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Sergi Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Josep M Auge
- Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Center, Hospital Clínic, Barcelona, Spain
| | - Cristina Muñoz-García
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Beatriz Bosch
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Neus Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Oscar Ramos-Campoy
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, University College London, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - José L Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
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21
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Illán-Gala I, Pegueroles J, Montal V, Alcolea D, Vilaplana E, Bejanin A, Borrego-Écija S, Sampedro F, Subirana A, Sánchez-Saudinós MB, Rojas-García R, Vanderstichele H, Blesa R, Clarimón J, Antonell A, Lladó A, Sánchez-Valle R, Fortea J, Lleó A. APP-derived peptides reflect neurodegeneration in frontotemporal dementia. Ann Clin Transl Neurol 2019; 6:2518-2530. [PMID: 31789459 PMCID: PMC6917306 DOI: 10.1002/acn3.50948] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 10/25/2019] [Indexed: 12/12/2022] Open
Abstract
Objective We aimed to investigate the relationship between cerebrospinal fluid levels (CSF) of amyloid precursor protein (APP)‐derived peptides related to the amyloidogenic pathway, cortical thickness, neuropsychological performance, and cortical gene expression profiles in frontotemporal lobar degeneration (FTLD)‐related syndromes, Alzheimer’s disease (AD), and healthy controls. Methods We included 214 participants with CSF available recruited at two centers: 93 with FTLD‐related syndromes, 57 patients with AD, and 64 healthy controls. CSF levels of amyloid β (Aβ)1‐42, Aβ1‐40, Aβ1‐38, and soluble β fragment of APP (sAPPβ) were centrally analyzed. We compared CSF levels of APP‐derived peptides between groups and, we studied the correlation between CSF biomarkers, cortical thickness, and domain‐specific cognitive composites in each group. Then, we explored the relationship between cortical thickness, CSF levels of APP‐derived peptides, and regional gene expression profile using a brain‐wide regional gene expression data in combination with gene set enrichment analysis. Results The CSF levels of Aβ1‐40, Aβ1‐38, and sAPPβ were lower in the FTLD‐related syndromes group than in the AD and healthy controls group. CSF levels of all APP‐derived peptides showed a positive correlation with cortical thickness and the executive cognitive composite in the FTLD‐related syndromes group but not in the healthy control or AD groups. In the cortical regions where we observed a significant association between cortical thickness and CSF levels of APP‐derived peptides, we found a reduced expression of genes related to synaptic function. Interpretation APP‐derived peptides in CSF may reflect FTLD‐related neurodegeneration. This observation has important implications as Aβ1‐42 levels are considered an indirect biomarker of cerebral amyloidosis.
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Affiliation(s)
- Ignacio Illán-Gala
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Jordi Pegueroles
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Victor Montal
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Daniel Alcolea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Eduard Vilaplana
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Alexandre Bejanin
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Sergi Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders, Neurology Department, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Frederic Sampedro
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Andrea Subirana
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María-Belén Sánchez-Saudinós
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ricard Rojas-García
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Rafael Blesa
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Jordi Clarimón
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Anna Antonell
- Alzheimer's Disease and Other Cognitive Disorders, Neurology Department, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders, Neurology Department, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders, Neurology Department, Hospital Clínic, Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Juan Fortea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain.,Barcelona Down Medical Center, Fundació Catalana de Síndrome de Down, Barcelona, Spain
| | - Alberto Lleó
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
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22
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Borrego-Écija S, Antonell A, Puig-Butillé JA, Pericot I, Prat-Bravo C, Abellan-Vidal MT, Mallada J, Olives J, Falgàs N, Oliva R, Lladó A, Sánchez-Valle R. Novel P397S MAPT variant associated with late onset and slow progressive frontotemporal dementia. Ann Clin Transl Neurol 2019; 6:1559-1565. [PMID: 31402617 PMCID: PMC6689677 DOI: 10.1002/acn3.50844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 12/17/2022] Open
Abstract
Mutations in the MAPT gene cause frontotemporal dementia with tau deposits. We report the novel p.P397S MAPT variant in eight subjects from five apparently nonrelated families suffering from frontotemporal dementia with autosomal dominant pattern of inheritance. In silico analysis reported conflicting evidence of pathogenicity. The segregation analysis support that this variant is likely pathogenic. The mean age at onset (61.4 years) and mean disease duration (13.9 years) of these subjects and their affected relatives were significantly higher compared with our series of p.P301L MAPT mutation carriers. These findings suggest that p.P397S variant could be a new MAPT mutation associated with a less aggressive phenotype than other MAPT mutations.
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Affiliation(s)
- Sergi Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Anna Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Joan Anton Puig-Butillé
- Biochemistry and Molecular Genetics Department, Hospital Clinic, Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Barcelona, Spain
| | | | | | - Maria Teresa Abellan-Vidal
- Unit of Cognitive Disorders and Psychogeriatrics, Institut de Neuropsiquiatria i Addiccions, Centre Emili Mira, Parc de Salut Mar, Barcelona, Spain
| | - Javier Mallada
- Neurology Department, Hospital General Universitario de Elda, Alicante, Spain
| | - Jaume Olives
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Neus Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Rafael Oliva
- Biochemistry and Molecular Genetics Service, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDBAPS), University of Barcelona, Barcelona, Spain.,Genetics Unit, Department of Biosciences, University of Barcelona, Barcelona, Spain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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23
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Illán-Gala I, Montal V, Borrego-Écija S, Vilaplana E, Pegueroles J, Alcolea D, Sánchez-Saudinós B, Clarimón J, Turón-Sans J, Bargalló N, González-Ortiz S, Rosen HJ, Gorno-Tempini ML, Miller BL, Lladó A, Rojas-García R, Blesa R, Sánchez-Valle R, Lleó A, Fortea J. Cortical microstructure in the behavioural variant of frontotemporal dementia: looking beyond atrophy. Brain 2019; 142:1121-1133. [PMID: 30906945 PMCID: PMC6439330 DOI: 10.1093/brain/awz031] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 12/04/2018] [Accepted: 12/21/2018] [Indexed: 12/11/2022] Open
Abstract
Cortical mean diffusivity has been proposed as a novel biomarker for the study of the cortical microstructure in Alzheimer's disease. In this multicentre study, we aimed to assess the cortical microstructural changes in the behavioural variant of frontotemporal dementia (bvFTD); and to correlate cortical mean diffusivity with clinical measures of disease severity and CSF biomarkers (neurofilament light and the soluble fraction beta of the amyloid precursor protein). We included 148 participants with a 3 T MRI and appropriate structural and diffusion weighted imaging sequences: 70 patients with bvFTD and 78 age-matched cognitively healthy controls. The modified frontotemporal lobar degeneration clinical dementia rating was obtained as a measure of disease severity. A subset of patients also underwent a lumbar puncture for CSF biomarker analysis. Two independent raters blind to the clinical data determined the presence of significant frontotemporal atrophy to dichotomize the participants into possible or probable bvFTD. Cortical thickness and cortical mean diffusivity were computed using a surface-based approach. We compared cortical thickness and cortical mean diffusivity between bvFTD (both using the whole sample and probable and possible bvFTD subgroups) and controls. Then we computed the Cohen's d effect size for both cortical thickness and cortical mean diffusivity. We also performed correlation analyses with the modified frontotemporal lobar degeneration clinical dementia rating score and CSF neuronal biomarkers. The cortical mean diffusivity maps, in the whole cohort and in the probable bvFTD subgroup, showed widespread areas with increased cortical mean diffusivity that partially overlapped with cortical thickness, but further expanded to other bvFTD-related regions. In the possible bvFTD subgroup, we found increased cortical mean diffusivity in frontotemporal regions, but only minimal loss of cortical thickness. The effect sizes of cortical mean diffusivity were notably higher than the effect sizes of cortical thickness in the areas that are typically involved in bvFTD. In the whole bvFTD group, both cortical mean diffusivity and cortical thickness correlated with measures of disease severity and CSF biomarkers. However, the areas of correlation with cortical mean diffusivity were more extensive. In the possible bvFTD subgroup, only cortical mean diffusivity correlated with the modified frontotemporal lobar degeneration clinical dementia rating. Our data suggest that cortical mean diffusivity could be a sensitive biomarker for the study of the neurodegeneration-related microstructural changes in bvFTD. Further longitudinal studies should determine the diagnostic and prognostic utility of this novel neuroimaging biomarker.
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Affiliation(s)
- Ignacio Illán-Gala
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
| | - Victor Montal
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
| | - Sergi Borrego-Écija
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Department of Neurology, Hospital Clínic, Institut d’Investigació Biomèdica August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Eduard Vilaplana
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
| | - Jordi Pegueroles
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
| | - Daniel Alcolea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
| | - Belén Sánchez-Saudinós
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Clarimón
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
| | - Janina Turón-Sans
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nuria Bargalló
- Radiology Department, Hospital Clínic de Barcelona and Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Howard J Rosen
- Memory and Aging Centre, Department of Neurology, University of California San Francisco, San Francisco, USA
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Centre, Department of Neurology, University of California San Francisco, San Francisco, USA
| | - Bruce L Miller
- Memory and Aging Centre, Department of Neurology, University of California San Francisco, San Francisco, USA
| | - Albert Lladó
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Department of Neurology, Hospital Clínic, Institut d’Investigació Biomèdica August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Ricard Rojas-García
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rafael Blesa
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
| | - Raquel Sánchez-Valle
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Department of Neurology, Hospital Clínic, Institut d’Investigació Biomèdica August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Alberto Lleó
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
| | - Juan Fortea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas. CIBERNED, Spain
- Barcelona Down Medical Centre, Fundació Catalana de Síndrome de Down, Barcelona, Spain
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24
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Falgàs N, Tort-Merino A, Balasa M, Borrego-Écija S, Castellví M, Olives J, Bosch B, Férnandez-Villullas G, Antonell A, Augé JM, Lomeña F, Perissinotti A, Bargalló N, Sánchez-Valle R, Lladó A. Clinical applicability of diagnostic biomarkers in early-onset cognitive impairment. Eur J Neurol 2019; 26:1098-1104. [PMID: 30793432 DOI: 10.1111/ene.13945] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 10/19/2018] [Accepted: 02/19/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Several diagnostic biomarkers are currently available for clinical use in early-onset cognitive impairment. The decision on which biomarker is used in each patient depends on several factors such as its predictive value or tolerability. METHODS There were a total of 40 subjects with early-onset cognitive complaints (<65 years of age): 26 with Alzheimer's disease (AD), five with frontotemporal dementia and nine with diagnostic suspicion of non-neurodegenerative disorder. Clinical and neuropsychological evaluation, lumbar puncture for cerebrospinal fluid (CSF) AD core biochemical marker determination, medial temporal atrophy evaluation on magnetic resonance imaging, amyloid-positron emission tomography (PET) and 18 F-fluorodeoxyglucose-PET were performed. Neurologists provided pre- and post-biomarker diagnosis, together with diagnostic confidence and clinical/therapeutic management. Patients scored the tolerability of each procedure. RESULTS Cerebrospinal fluid biomarkers and amyloid-PET increased diagnostic confidence in AD (77.4%-86.2% after CSF, 92.4% after amyloid-PET, P < 0.01) and non-neurodegenerative conditions (53.6%-75% after CSF, 95% after amyloid-PET, P < 0.05). Biomarker results led to diagnostic (32.5%) and treatment (32.5%) changes. All tests were well tolerated. CONCLUSIONS Biomarker procedures are well tolerated and have an important diagnostic/therapeutic impact on early-onset cognitive impairment.
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Affiliation(s)
- N Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Tort-Merino
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain.,Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - S Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Castellví
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - J Olives
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - B Bosch
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - G Férnandez-Villullas
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - J M Augé
- Biochemistry and Molecular Genetics Department, Hospital Clínic de Barcelona, Barcelona
| | - F Lomeña
- Nuclear Medicine Department, Hospital Clínic de Barcelona, Barcelona
| | - A Perissinotti
- Nuclear Medicine Department, Hospital Clínic de Barcelona, Barcelona
| | - N Bargalló
- Image Diagnostic Centre, IDIBAPS, Hospital Clínic de Barcelona, Barcelona, Spain
| | - R Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
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25
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Borrego-Écija S, Cortés-Vicente E, Cervera-Carles L, Clarimón J, Gámez J, Batlle J, Ricken G, Molina-Porcel L, Aldecoa I, Sánchez-Valle R, Rojas-García R, Gelpi E. Does ALS-FUS without FUS mutation represent ALS-FET? Report of three cases. Neuropathol Appl Neurobiol 2018; 45:421-426. [PMID: 30375034 PMCID: PMC7380051 DOI: 10.1111/nan.12527] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/10/2018] [Indexed: 01/29/2023]
Affiliation(s)
- S Borrego-Écija
- Neurology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain.,Neurological Tissue Bank of the Biobanc-Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - E Cortés-Vicente
- Neurology Department, Institut d'Investigacions Biomèdiques-Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Cervera-Carles
- Neurology Department, Institut d'Investigacions Biomèdiques-Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - J Clarimón
- Neurology Department, Institut d'Investigacions Biomèdiques-Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - J Gámez
- Neurology Department, Hospital de la Vall d'Hebron, Barcelona, Spain
| | - J Batlle
- Neurology Department, Hospital Sant Pau y Santa Tecla, Tarragona, Spain
| | - G Ricken
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - L Molina-Porcel
- Neurological Tissue Bank of the Biobanc-Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - I Aldecoa
- Neurological Tissue Bank of the Biobanc-Hospital Clínic-IDIBAPS, Barcelona, Spain.,Pathology Department, CDB, Hospital Clinic Barcelona, Barcelona, Spain
| | - R Sánchez-Valle
- Neurology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain.,Neurological Tissue Bank of the Biobanc-Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - R Rojas-García
- Neurology Department, Institut d'Investigacions Biomèdiques-Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - E Gelpi
- Neurological Tissue Bank of the Biobanc-Hospital Clínic-IDIBAPS, Barcelona, Spain.,Institute of Neurology, Medical University of Vienna, Vienna, Austria
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26
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Cortés-Vicente E, Turon-Sans J, Gelpi E, Clarimón J, Borrego-Écija S, Dols-Icardo O, Illán-Gala I, Lleó A, Illa I, Blesa R, Al-Chalabi A, Rojas-García R. Distinct Clinical Features and Outcomes in Motor Neuron Disease Associated with Behavioural Variant Frontotemporal Dementia. Dement Geriatr Cogn Disord 2018; 45:220-231. [PMID: 29886477 DOI: 10.1159/000488528] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 03/16/2018] [Indexed: 11/19/2022] Open
Abstract
AIM To determine the motor phenotype and outcome in a clinically ascertained group of patients with motor neuron disease (MND) and frontotemporal dementia (FTD). METHODS This is an observational retrospective clinical study of patients fulfilling the clinical criteria for MND-FTD. A contemporary series of patients with amyotrophic lateral sclerosis (ALS) without dementia were included for comparison. Demographic, clinical, genetic, and neuropathological data were collected. A descriptive and comparative data analysis was performed. RESULTS We identified 22 patients with MND-FTD. Selective distal upper limb muscle weakness and atrophy with non-significant lower limb weakness during follow-up was the most frequent motor pattern, present in 18 patients - in 15 of them associated with severe dysphagia. Aspiration pneumonia was the most common cause of death (12/19; 63%) despite gastrostomy. One-third of the patients did not develop upper motor neuron dysfunction. When compared to classic ALS without dementia (n = 162), these features were significantly different. A neuro-pathological examination was performed on 7 patients, and it confirmed the presence of MND with TDP43 protein aggregates in all patients. CONCLUSIONS The MND-FTD patients frequently displayed a distinctive motor pattern characterized by weakness and atrophy in distal upper limb muscles and dysphagia, with no or little spreading to other regions. These features may help to define specific subgroups of patients, which is important with regard to clinical management, outcome, and research.
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Affiliation(s)
- Elena Cortés-Vicente
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Rare Diseases (CIBERER), Madrid, Spain
| | - Janina Turon-Sans
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Rare Diseases (CIBERER), Madrid, Spain
| | - Ellen Gelpi
- Neurological Tissue Bank of the Biobanc Hospital Clínic IDIBAPS, Barcelona, Spain.,Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Jordi Clarimón
- Institute of Neurology, Medical University of Vienna, Vienna, Austria.,Memory Unit, Department of Neurology, and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergi Borrego-Écija
- Alzheimer and Other Cognitive Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Oriol Dols-Icardo
- Memory Unit, Department of Neurology, and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Ignacio Illán-Gala
- Memory Unit, Department of Neurology, and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Alberto Lleó
- Memory Unit, Department of Neurology, and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Isabel Illa
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Rare Diseases (CIBERER), Madrid, Spain
| | - Rafael Blesa
- Memory Unit, Department of Neurology, and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Ammar Al-Chalabi
- Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, King's College London, London, United Kingdom
| | - Ricard Rojas-García
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center for Networked Biomedical Research into Rare Diseases (CIBERER), Madrid, Spain
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27
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Borrego-Écija S, Morgado J, Palencia-Madrid L, Grau-Rivera O, Reñé R, Hernández I, Almenar C, Balasa M, Antonell A, Molinuevo JL, Lladó A, Martínez de Pancorbo M, Gelpi E, Sánchez-Valle R. Frontotemporal Dementia Caused by the P301L Mutation in the MAPT Gene: Clinicopathological Features of 13 Cases from the Same Geographical Origin in Barcelona, Spain. Dement Geriatr Cogn Disord 2018; 44:213-221. [PMID: 28934750 DOI: 10.1159/000480077] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS We identified and studied 13 patients carrying the P301L mutation in the MAPT gene from the same area (Baix Llobregat County) in Barcelona, Spain. METHODS The demographic and clinical features were reviewed retrospectively. Detailed neuropathological characterization was obtained in 9 subjects. To investigate the origin of the P301L mutation in these families, 20 single nucleotide polymorphisms (SNPs) in the MAPT gene were analyzed. RESULTS The mean age at disease onset was 51 years and the mean disease duration was 7 years. The most common initial symptoms were behavioral changes (54%), followed by language disturbances (31%) and memory loss (15%). 46% developed parkinsonism. Neuropathology showed an extensive neuronal and glial 4-repeat (4R) tauopathy with "mini-Pick"-like bodies in the dentate gyrus as the characteristic underlying pathology in all cases. In 1 subject, additional 4R globular glial inclusions were observed. All the mutation carriers showed the same haplotype for the SNPs analyzed, suggesting a common ancestor. CONCLUSION These findings suggest a relative homogeneous clinicopathological phenotype in P301L MAPT mutation carriers in our series. This phenotype might help in the differential diagnosis from other tauopathies and be a morphological hint for genetic testing. The haplotype analysis results suggest a founder effect of the P301L mutation in this area.
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Affiliation(s)
- Sergi Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Department, Hospital Clínic-Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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28
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Borrego-Écija S, Grau-Rivera O, Colom-Cadena M, Molinuevo JL, Tolosa E, Sánchez-Valle R, Gelpi E. Tauopathy with Hippocampal 4-Repeat Tau Immunoreactive Spherical Inclusions in a Patient with PSP. Brain Pathol 2018. [PMID: 29516660 DOI: 10.1111/bpa.12506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Sergi Borrego-Écija
- Neurological Tissue Bank of the Biobanc-Hospital Clinic-IDIBAPS, Barcelona, Spain.,Department of Neurology, Alzheimer and Cognitive Disorders Unit, Hospital Clinic de Barcelona, Spain
| | - Oriol Grau-Rivera
- Neurological Tissue Bank of the Biobanc-Hospital Clinic-IDIBAPS, Barcelona, Spain.,Department of Neurology, Alzheimer and Cognitive Disorders Unit, Hospital Clinic de Barcelona, Spain
| | - Martí Colom-Cadena
- Department of Neurology and Hospital de St Pau Research Center, Barcelona, Spain
| | - José Luis Molinuevo
- Department of Neurology, Alzheimer and Cognitive Disorders Unit, Hospital Clinic de Barcelona, Spain
| | - Eduard Tolosa
- Neurological Tissue Bank of the Biobanc-Hospital Clinic-IDIBAPS, Barcelona, Spain.,Department of Neurology, Movement Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Neurological Tissue Bank of the Biobanc-Hospital Clinic-IDIBAPS, Barcelona, Spain.,Department of Neurology, Alzheimer and Cognitive Disorders Unit, Hospital Clinic de Barcelona, Spain
| | - Ellen Gelpi
- Neurological Tissue Bank of the Biobanc-Hospital Clinic-IDIBAPS, Barcelona, Spain
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