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Bracca V, Cantoni V, Gadola Y, Rivolta J, Cosseddu M, Turrone R, Caratozzolo S, Di Luca M, Padovani A, Borroni B, Benussi A. Neurophysiological correlates of altered time awareness in Alzheimer's disease and frontotemporal dementia. Neurol Sci 2023; 44:3515-3522. [PMID: 37247033 DOI: 10.1007/s10072-023-06877-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/25/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Alterations in time awareness have been reported in dementia, particularly in Alzheimer's disease (AD) and frontotemporal dementia (FTD). However, the neurophysiological correlates underlying these alterations remain largely unexplored. This study aimed to investigate the neurophysiological correlates of altered time awareness in AD and FTD patients. METHODS A total of 150 participants (50 AD patients, 50 FTD patients, and 50 healthy controls [HC]) underwent a standardized neuropsychological assessment, an altered time awareness survey, and transcranial magnetic stimulation (TMS) to assess cholinergic (short latency afferent inhibition-SAI), GABAergic (short interval intracortical inhibition-SICI), and glutamatergic (intracortical facilitation-ICF) circuits. RESULTS In AD patients, the most frequent symptom was difficulty in ordering past events (52.0%), while FTD patients primarily struggled with estimating temporal intervals between events (40.0%). Significant differences were observed between HC and both patient groups, as well as between AD and FTD patients in their tendency to re-live past events. Binomial logistic regression analysis revealed that impairments in glutamatergic and cholinergic circuits significantly predicted the likelihood of participants manifesting altered time awareness symptoms. CONCLUSIONS This study provides novel insights into the neurophysiological correlates of altered time awareness in AD and FTD patients, highlighting the involvement of specific neurotransmitter circuits, particularly glutamatergic and cholinergic circuits. Further research is needed to explore the potential clinical implications and therapeutic targets arising from these findings.
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Affiliation(s)
- Valeria Bracca
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Valentina Cantoni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Yasmine Gadola
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Jasmine Rivolta
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Maura Cosseddu
- Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Rosanna Turrone
- Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Salvatore Caratozzolo
- Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Monica Di Luca
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
- Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
- Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Alberto Benussi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy.
- Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy.
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Premi E, Dukart J, Mattioli I, Libri I, Pengo M, Gadola Y, Cotelli M, Manenti R, Binetti G, Gazzina S, Alberici A, Magoni M, Koch G, Gasparotti R, Padovani A, Borroni B. Unravelling neurotransmitters impairment in primary progressive aphasias. Hum Brain Mapp 2023; 44:2245-2253. [PMID: 36649260 PMCID: PMC10028634 DOI: 10.1002/hbm.26206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/15/2022] [Accepted: 01/04/2023] [Indexed: 01/18/2023] Open
Abstract
Primary progressive aphasias (PPAs) are a group of neurodegenerative diseases mainly characterized by language impairment, and with variably presence of dysexecutive syndrome, behavioural disturbances and parkinsonism. Detailed knowledge of neurotransmitters impairment and its association with clinical features hold the potential to develop new tailored therapeutic approaches. In the present study, we applied JuSpace toolbox, which allowed for cross-modal correlation of magnetic resonance imaging (MRI)-based measures with nuclear imaging derived estimates covering various neurotransmitter systems including dopaminergic, serotonergic, noradrenergic, GABAergic and glutamatergic neurotransmission. We included 103 PPA patients and 80 age-matched healthy controls (HC). We tested if the spatial patterns of grey matter volume (GMV) alterations in PPA patients (relative to HC) are correlated with specific neurotransmitter systems. As compared to HC, voxel-based brain changes in PPA were significantly associated with spatial distribution of serotonin, dopamine, and glutamatergic pathways (p < .05, False Discovery Rate corrected-corrected). Disease severity was negatively correlated with the strength of GMV colocalization of D1 receptors (p = .035) and serotonin transporter (p = .020). Moreover, we observed a significant negative correlation between positive behavioural symptoms, as measured with Frontal Behavioural Inventory, and GMV colocalization of D1 receptors (p = .007) and serotonin transporter (p < .001). This pilot study suggests that JuSpace is a helpful tool to indirectly assess neurotransmitter deficits in neurodegenerative dementias and may provide novel insight into disease mechanisms and associated clinical features.
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Affiliation(s)
- Enrico Premi
- Stroke Unit, Department of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Juergen Dukart
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM‐7)Research CentreJülichJülichGermany
- Institute of Systems Neuroscience, Medical FacultyHeinrich Heine University DüsseldorfDüsseldorfGermany
| | - Irene Mattioli
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Ilenia Libri
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Marta Pengo
- Department of Molecular and Translational MedicineUniversity of BresciaBresciaItaly
| | - Yasmine Gadola
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Maria Cotelli
- Neuropsychology UnitIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Rosa Manenti
- Neuropsychology UnitIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers LaboratoryIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Stefano Gazzina
- Neurophysiology Unit, Department of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Antonella Alberici
- Neurology Unit, Department of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Mauro Magoni
- Stroke Unit, Department of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Giacomo Koch
- Department of Neuroscience and RehabilitationUniversity of Ferrara and Center for Translational Neurophysiology of Speech and Communication (CTNSC), Italian Institute of Technology (IIT)FerraraItaly
- Department of Clinical and Behavioural NeurologySanta Lucia Foundation IRCCSRomeItaly
| | | | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
- Neurology Unit, Department of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
- Neurology Unit, Department of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
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Premi E, Cotelli M, Gobbi E, Pagnoni I, Binetti G, Gadola Y, Libri I, Mattioli I, Pengo M, Iraji A, Calhoun VD, Alberici A, Borroni B, Manenti R. Neuroanatomical correlates of screening for aphasia in NeuroDegeneration (SAND) battery in non-fluent/agrammatic variant of primary progressive aphasia. Front Aging Neurosci 2022; 14:942095. [DOI: 10.3389/fnagi.2022.942095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundNon-fluent/agrammatic variant of Primary Progressive Aphasia (avPPA) is primarily characterized by language impairment due to atrophy of the inferior frontal gyrus and the insula cortex in the dominant hemisphere. The Screening for Aphasia in NeuroDegeneration (SAND) battery has been recently proposed as a screening tool for PPA, with several tasks designed to be specific for different language features. Applying multivariate approaches to neuroimaging data and verbal fluency tasks, Aachener Aphasie Test (AAT) naming subtest and SAND data may help in elucidating the neuroanatomical correlates of language deficits in avPPA.ObjectiveTo investigate the neuroanatomical correlates of language deficits in avPPA using verbal fluency tasks, AAT naming subtest and SAND scores as proxies of brain structural imaging abnormalities.MethodsThirty-one avPPA patients were consecutively enrolled and underwent extensive neuropsychological assessment and MRI scan. Raw scores of verbal fluency tasks, AAT naming subtest, and SAND subtests, namely living and non-living picture naming, auditory sentence comprehension, single-word comprehension, words and non-words repetition and sentence repetition, were used as proxies to explore structural (gray matter volume) neuroanatomical correlates. We assessed univariate (voxel-based morphometry, VBM) as well as multivariate (source-based morphometry, SBM) approaches. Age, gender, educational level, and disease severity were considered nuisance variables.ResultsSAND picture naming (total, living and non-living scores) and AAT naming scores showed a direct correlation with the left temporal network derived from SBM. At univariate analysis, the left middle temporal gyrus was directly correlated with SAND picture naming (total and non-living scores) and AAT naming score. When words and non-words repetition (total score) was considered, a direct correlation with the left temporal network (SBM) and with the left fusiform gyrus (VBM) was also evident.ConclusionNaming impairments that characterize avPPA are related to specific network-based involvement of the left temporal network, potentially expanding our knowledge on the neuroanatomical basis of this neurodegenerative condition.
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Katisko K, Huber N, Kokkola T, Hartikainen P, Krüger J, Heikkinen AL, Paananen V, Leinonen V, Korhonen VE, Helisalmi S, Herukka SK, Cantoni V, Gadola Y, Archetti S, Remes AM, Haapasalo A, Borroni B, Solje E. Serum total TDP-43 levels are decreased in frontotemporal dementia patients with C9orf72 repeat expansion or concomitant motoneuron disease phenotype. Alzheimers Res Ther 2022; 14:151. [PMID: 36217158 PMCID: PMC9552448 DOI: 10.1186/s13195-022-01091-8] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/29/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Frontotemporal dementia (FTD) covers a spectrum of neurodegenerative disorders with various clinical and neuropathological subtypes. The two major pathological proteins accumulating in the brains of FTD patients, depending on their genetic background, are TDP-43 and tau. We aimed to evaluate whether total TDP-43 levels measured from the serum associate with the genotype or clinical phenotype of the FTD patients and whether serum TDP-43 provides prognostic or diagnostic value in the FTD spectrum disorders. METHODS The study cohort included 254 participants with a clinical diagnosis of FTD (including all major genotypes and clinical phenotypes) and 105 cognitively healthy controls. Serum total TDP-43 levels measured with a single-molecule array (Simoa) were compared within the FTD group according to the genotype, clinical phenotype, and predicted neuropathological subtype of the patients. We also evaluated the associations between the TDP-43 levels and disease severity or survival in FTD. RESULTS Total TDP-43 levels in the serum were significantly lower in the FTD group as compared to the healthy control group (275.3 pg/mL vs. 361.8 pg/mL, B = 0.181, 95%CI = 0.014-0.348, p = 0.034). The lowest TDP-43 levels were observed in the subgroup of FTD patients harboring predicted TDP-43 brain pathology (FTD-TDP, 241.4 pg/mL). The low levels in the FTD-TDP group were especially driven by C9orf72 repeat expansion carriers (169.2 pg/mL) and FTD patients with concomitant motoneuron disease (FTD-MND, 113.3 pg/mL), whereas GRN mutation carriers did not show decreased TDP-43 levels (328.6 pg/mL). Serum TDP-43 levels showed no correlation with disease severity nor progression in FTD. CONCLUSIONS Our results indicate that the total levels of TDP-43 in the serum are decreased especially in FTD patients with the C9orf72 repeat expansion or FTD-MND phenotype, both subtypes strongly associated with TDP-43 type B brain pathology. Serum-based measurement of TDP-43 could represent a useful tool in indicating C9orf72 repeat expansion and FTD-MND-related TDP-43 neuropathology for future diagnostics and intervention studies.
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Affiliation(s)
- Kasper Katisko
- grid.9668.10000 0001 0726 2490Institute of Clinical Medicine – Neurology, University of Eastern Finland, P.O. Box 1627 (Yliopistonranta 1C), FI-70211 Kuopio, Finland
| | - Nadine Huber
- grid.9668.10000 0001 0726 2490A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Tarja Kokkola
- grid.9668.10000 0001 0726 2490Institute of Clinical Medicine – Neurology, University of Eastern Finland, P.O. Box 1627 (Yliopistonranta 1C), FI-70211 Kuopio, Finland
| | - Päivi Hartikainen
- grid.410705.70000 0004 0628 207XNeuro center, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Johanna Krüger
- grid.10858.340000 0001 0941 4873Research Unit of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland ,grid.412326.00000 0004 4685 4917MRC, Oulu University Hospital, Oulu, Finland ,grid.412326.00000 0004 4685 4917Neurology, Neurocenter, Oulu University Hospital, Oulu, Finland
| | - Anna-Leena Heikkinen
- grid.10858.340000 0001 0941 4873Research Unit of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland ,grid.412326.00000 0004 4685 4917MRC, Oulu University Hospital, Oulu, Finland ,grid.412326.00000 0004 4685 4917Neurology, Neurocenter, Oulu University Hospital, Oulu, Finland ,grid.6975.d0000 0004 0410 5926Finnish Institute of Occupational Health, Work Ability and Working Careers, Helsinki, Finland
| | - Veera Paananen
- grid.10858.340000 0001 0941 4873Research Unit of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland ,grid.412326.00000 0004 4685 4917MRC, Oulu University Hospital, Oulu, Finland ,grid.412326.00000 0004 4685 4917Neurology, Neurocenter, Oulu University Hospital, Oulu, Finland
| | - Ville Leinonen
- grid.410705.70000 0004 0628 207XNeuro Center, Neurosurgery, Kuopio University Hospital, 70029 Kuopio, Finland ,grid.9668.10000 0001 0726 2490Institute of Clinical Medicine – Neurosurgery, University of Eastern Finland, 70211 Kuopio, Finland
| | - Ville E. Korhonen
- grid.9668.10000 0001 0726 2490Institute of Clinical Medicine – Neurology, University of Eastern Finland, P.O. Box 1627 (Yliopistonranta 1C), FI-70211 Kuopio, Finland ,grid.410705.70000 0004 0628 207XNeuro Center, Neurosurgery, Kuopio University Hospital, 70029 Kuopio, Finland ,grid.9668.10000 0001 0726 2490Institute of Clinical Medicine – Neurosurgery, University of Eastern Finland, 70211 Kuopio, Finland
| | - Seppo Helisalmi
- grid.9668.10000 0001 0726 2490Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Sanna-Kaisa Herukka
- grid.9668.10000 0001 0726 2490Institute of Clinical Medicine – Neurology, University of Eastern Finland, P.O. Box 1627 (Yliopistonranta 1C), FI-70211 Kuopio, Finland ,grid.410705.70000 0004 0628 207XNeuro center, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Valentina Cantoni
- grid.7637.50000000417571846Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Yasmine Gadola
- grid.7637.50000000417571846Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | - Anne M. Remes
- grid.10858.340000 0001 0941 4873Unit of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland ,grid.412326.00000 0004 4685 4917Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Annakaisa Haapasalo
- grid.9668.10000 0001 0726 2490A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Barbara Borroni
- grid.7637.50000000417571846Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy ,grid.412725.7ASST Spedali Civili, Brescia, Italy
| | - Eino Solje
- grid.9668.10000 0001 0726 2490Institute of Clinical Medicine – Neurology, University of Eastern Finland, P.O. Box 1627 (Yliopistonranta 1C), FI-70211 Kuopio, Finland ,grid.410705.70000 0004 0628 207XNeuro center, Neurology, Kuopio University Hospital, Kuopio, Finland
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Benussi A, Libri I, Premi E, Alberici A, Cantoni V, Gadola Y, Rivolta J, Pengo M, Gazzina S, Calhoun VD, Gasparotti R, Zetterberg H, Ashton NJ, Blennow K, Padovani A, Borroni B. Differences and similarities between familial and sporadic frontotemporal dementia: An Italian single-center cohort study. Alzheimers Dement (N Y) 2022; 8:e12326. [PMID: 35898667 PMCID: PMC9310192 DOI: 10.1002/trc2.12326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/11/2022] [Accepted: 06/17/2022] [Indexed: 06/15/2023]
Abstract
Introduction The possibility to generalize our understandings on treatments and assessments to both familial frontotemporal dementia (f-FTD) and sporadic FTD (s-FTD) is a fundamental perspective for the near future, considering the constant advancement in potential disease-modifying therapies that target particular genetic forms of FTD. We aimed to investigate differences in clinical features, cerebrospinal fluid (CSF), and blood-based biomarkers between f-FTD and s-FTD. Methods In this longitudinal cohort study, we evaluated a consecutive sample of symptomatic FTD patients, classified as f-FTD and s-FTD according to Goldman scores (GS). All patients underwent clinical, behavioral, and neuropsychiatric symptom assessment, CSF biomarkers and serum neurofilament light (NfL) analysis, and brain atrophy evaluation with magnetic resonance imaging. Results Of 570 patients with FTD, 123 were classified as f-FTD, and 447 as s-FTD. In the f-FTD group, 95 had a pathogenic FTD mutation while 28 were classified as GS = 1 or 2; of the s-FTD group, 133 were classified as GS = 3 and 314 with GS = 4. f-FTD and s-FTD cases showed comparable demographic features, except for younger age at disease onset, age at diagnosis, and higher years of education in the f-FTD group (all P < .05). f-FTD showed worse behavioral disturbances as measured with Frontal Behavioral Inventory (FBI) negative behaviors (14.0 ± 7.6 vs. 11.6 ± 7.4, P = .002), and positive behaviors (20.0 ± 11.0 vs. 17.4 ± 11.8, P = .031). Serum NfL concentrations were higher in patients with f-FTD (70.9 ± 37.9 pg/mL) compared to s-FTD patients (37.3 ± 24.2 pg/mL, P < .001), and f-FTD showed greater brain atrophy in the frontal and temporal regions and basal ganglia. Patients with f-FTD had significantly shorter survival than those with s-FTD (P = .004). Discussion f-FTD and s-FTD are very similar clinical entities, but with different biological mechanisms, and different rates of progression. The parallel characterization of both f-FTD and s-FTD will improve our understanding of the disease, and aid in designing future clinical trials for both genetic and sporadic forms of FTD. Highlights Do clinical features and biomarkers differ between patients with familial frontotemporal dementia (f-FTD) and sporadic FTD (s-FTD)?In this cohort study of 570 patients with FTD, f-FTD and s-FTD share similar demographic features, but with younger age at disease onset and diagnosis in the f-FTD group.f-FTD showed higher serum neurofilament light concentrations, greater brain damage, and shorter survival, compared to s-FTD.f-FTD and s-FTD are very similar clinical entities, but with different cognitive reserve mechanisms and different rates of progression.
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Affiliation(s)
- Alberto Benussi
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
- Neurology UnitDepartment of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Ilenia Libri
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Enrico Premi
- Stroke UnitDepartment of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Antonella Alberici
- Neurology UnitDepartment of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Valentina Cantoni
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Yasmine Gadola
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Jasmine Rivolta
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Marta Pengo
- Department of Molecular and Translational MedicineUniversity of BresciaBresciaItaly
| | - Stefano Gazzina
- Neurophysiology UnitDepartment of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Vince D. Calhoun
- The Mind Research NetworkDepartment of Electrical and Computer EngineeringUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | | | - Henrik Zetterberg
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- UK Dementia Research Institute at UCLLondonUK
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
- Hong Kong Center for Neurodegenerative DiseasesHong KongChina
| | - Nicholas J. Ashton
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Wallenberg Centre for Molecular and Translational MedicineUniversity of GothenburgMölndalSweden
- King's College LondonInstitute of PsychiatryPsychology & NeuroscienceMaurice Wohl Clinical Neuroscience InstituteLondonUK
- NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS FoundationLondonUK
| | - Kaj Blennow
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | - Alessandro Padovani
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
- Neurology UnitDepartment of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
| | - Barbara Borroni
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
- Neurology UnitDepartment of Neurological and Vision SciencesASST Spedali CiviliBresciaItaly
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Soppela H, Katisko K, Gadola Y, Krüger J, Hartikainen P, Alberici A, Benussi A, Koivisto A, Haapasalo A, Remes AM, Borroni B, Solje E. Modifiable potential risk factors in familial and sporadic frontotemporal dementia. Ann Clin Transl Neurol 2022; 9:1195-1205. [PMID: 35767471 PMCID: PMC9380159 DOI: 10.1002/acn3.51619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/11/2022] [Accepted: 06/19/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Only a few studies have evaluated modifiable risk factors for frontotemporal dementia (FTD). Here, we evaluated several modifiable factors and their association with disease phenotype, genotype, and prognosis in a large study population including Finnish and Italian patients with FTD and control groups. Methods In this case–control study, we compared the presence of several cardiovascular and other lifestyle‐related diseases and education between Finnish and Italian patients with familial (n = 376) and sporadic (n = 654) FTD, between different phenotypes of FTD, and between a subgroup of Finnish FTD patients (n = 221) and matched Finnish patients with Alzheimer's disease (AD) (n = 214) and cognitively healthy controls (HC) (n = 100). Results Patients with sporadic FTD were less educated (p = 0.042, B = ‐0.560, 95% CI −1.101 to −0.019) and had more heart diseases (p < 0.001, OR = 2.265, 95% CI 1.502–3.417) compared to patients with familial FTD. Finnish FTD patients were less educated (p = 0.032, B = 0.755, 95% CI 0.064–1.466) compared with AD patients. The Finnish FTD group showed lower prevalence of hypertension than the HC group (p = 0.003, OR = 2.162, 95% CI 1.304–3.583) and lower prevalence of hypercholesterolemia than in the HC group (p < 0.001, OR = 2.648, 95%CI 1.548–4.531) or in the AD group (p < 0.001, OR = 1.995, 95% CI 1.333–2.986). Within the FTD group, clinical phenotypes also differed regarding education and lifestyle‐related factors. Interpretation Our study suggests distinct profiles of several modifiable factors in the FTD group depending on the phenotype and familial inheritance history and that especially sporadic FTD may be associated with modifiable risk factors.
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Affiliation(s)
- Helmi Soppela
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland
| | - Kasper Katisko
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland
| | - Yasmine Gadola
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Johanna Krüger
- Research Unit of Clinical Neuroscience - Neurology, University of Oulu, Oulu, Finland.,MRC - Oulu University Hospital, Oulu, Finland
| | - Päivi Hartikainen
- Neuro Center - Neurology, Kuopio University Hospital, Kuopio, Finland
| | | | - Alberto Benussi
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Neurology Unit, ASST Spedali Civili Brescia, Brescia, Italy
| | - Anne Koivisto
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland.,Neuro Center - Neurology, Kuopio University Hospital, Kuopio, Finland.,Neuro Center, Neurology, Helsinki University Hospital, Helsinki, Finland
| | - Annakaisa Haapasalo
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anne M Remes
- Research Unit of Clinical Neuroscience - Neurology, University of Oulu, Oulu, Finland.,MRC - Oulu University Hospital, Oulu, Finland
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Neurology Unit, ASST Spedali Civili Brescia, Brescia, Italy
| | - Eino Solje
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland.,Neuro Center - Neurology, Kuopio University Hospital, Kuopio, Finland
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Benussi A, Cantoni V, Grassi M, Brechet L, Michel CM, Datta A, Thomas C, Gazzina S, Cotelli MS, Bianchi M, Premi E, Gadola Y, Cotelli M, Pengo M, Perrone F, Scolaro M, Archetti S, Solje E, Padovani A, Pascual-Leone A, Borroni B. Increasing brain gamma activity improves episodic memory and restores cholinergic dysfunction in Alzheimer's disease. Ann Neurol 2022; 92:322-334. [PMID: 35607946 PMCID: PMC9546168 DOI: 10.1002/ana.26411] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [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: 10/18/2021] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To assess whether non-invasive brain stimulation with transcranial alternating current stimulation at gamma-frequency (γ-tACS) applied over the precuneus can improve episodic memory and modulate cholinergic transmission by modulating cerebral rhythms in early Alzheimer's disease (AD). METHODS In this randomized, double-blind, sham controlled, crossover study, 60 AD patients underwent a clinical and neurophysiological evaluation including assessment of episodic memory and cholinergic transmission pre- and post- 60 minutes treatment with γ-tACS targeting the precuneus or sham tACS. In a subset of 10 patients, EEG analysis and individualized modelling of electric field distribution were carried out. Predictors to γ-tACS efficacy were evaluated. RESULTS We observed a significant improvement in the Rey auditory verbal learning (RAVL) test immediate recall (p<0.001) and delayed recall scores (p<0.001) after γ-tACS but not after sham tACS. Face-name associations scores improved with γ-tACS (p<0.001) but not after sham tACS. Short latency afferent inhibition, an indirect measure of cholinergic transmission, increased only after γ-tACS (p<0.001). ApoE genotype and baseline cognitive impairment were the best predictors of response to γ-tACS. Clinical improvement correlated with the increase in gamma frequencies in posterior regions and with the amount of predicted electric field distribution in the precuneus. INTERPRETATION Precuneus γ-tACS, able to increase γ-power activity on the posterior brain regions, showed a significant improvement of episodic memory performances, along with restoration of intracortical excitability measures of cholinergic transmission. Response to γ-tACS was dependent on genetic factors and disease stage. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Alberto Benussi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Valentina Cantoni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Mario Grassi
- Department of Brain and Behavioural Sciences, Medical and Genomic Statistics Unit, University of Pavia, Pavia, Italy
| | - Lucie Brechet
- Functional Brain Mapping Laboratory, Department of Fundamental Neuroscience, University of Geneva, Geneva, Switzerland
| | - Christoph M Michel
- Functional Brain Mapping Laboratory, Department of Fundamental Neuroscience, University of Geneva, Geneva, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Abhishek Datta
- Research & Development, Soterix Medical, Inc., New York, USA
| | - Chris Thomas
- Research & Development, Soterix Medical, Inc., New York, USA
| | - Stefano Gazzina
- Neurophysiology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | | | - Marta Bianchi
- Neurology Unit, Valle Camonica Hospital, Esine, Brescia, Italy
| | - Enrico Premi
- Stroke Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Yasmine Gadola
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia
| | - Marta Pengo
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Federica Perrone
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Maria Scolaro
- Neurophysiology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Silvana Archetti
- Clinical Chemistry Laboratory, Diagnostic Department, ASST Spedali Civili Brescia, Brescia, Italy
| | - Eino Solje
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland.,Neuro center, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA, USA.,Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA.,Guttmann Brain Health Institut, Barcelona, Spain
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
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