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Licata A, Grimmer T, Winkelmann J, Wagner M, Goldhardt O, Riedl L, Roßmeier C, Yakushev I, Diehl-Schmid J. Variability of clinical syndromes and cerebral glucose metabolism in symptomatic frontotemporal lobar degeneration associated with progranulin mutations. Amyotroph Lateral Scler Frontotemporal Degener 2020; 21:389-395. [PMID: 32567375 DOI: 10.1080/21678421.2020.1779302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The aims of our study were to describe the clinical phenotype and to characterize the cerebral glucose metabolism patterns as measured with fluordesoxyglucose-positron emission tomography (FDG-PET) in symptomatic FTLD-patients with different GRN variants. Methods: For this study, data were included from all patients (n = 10) of a single-center FTLD registry study who had a pathogenic GRN variant and who had undergone a cerebral FDG-PET scan. Results: An overt variability of clinical phenotypes was identified with half of the cases being not unambiguously classifiable into one of the clinical FTLD subtypes. Furthermore, GRN + patients showed a considerable inter-individual variability of FDG uptake pattern. In half of the GRN + patients, metabolic changes expanded from frontal and temporal brain regions to parietal brain regions including the posterior cingulate cortex. Striking asymmetry without a preference for either hemisphere was overt in half of GRN + cases. Conclusion: We conclude that GRN mutations cause variable patterns of neurodegeneration that often exceed the anatomical boundaries of the frontotemporal brain regions and produce clinical syndromes that cannot clearly be classified into one of the subtypes as defined by the diagnostic criteria.
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Affiliation(s)
- Abigail Licata
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Psychology, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Juliane Winkelmann
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Helmholtz Zentrum München, Institute of Neurogenomics, Munich, Germany.,School of Medicine, Technical University of Munich, Institute of Human Genetics, Munich, Germany
| | - Matias Wagner
- Helmholtz Zentrum München, Institute of Neurogenomics, Munich, Germany.,School of Medicine, Technical University of Munich, Institute of Human Genetics, Munich, Germany.,Helmholtz Zentrum München, Institute of Human Genetics, Neuherberg, Germany, and
| | - Oliver Goldhardt
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Lina Riedl
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Carola Roßmeier
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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Chau A, Renella P, Arrieta A. Multimodality cardiovascular imaging in the diagnosis and management of prosthetic valve infective endocarditis in children report of two cases and brief review of the literature. Cardiol Young 2019; 29:1526-9. [PMID: 31590699 DOI: 10.1017/S1047951119002233] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Diagnosing prosthetic valve infective endocarditis in children is challenging. Transthoracic and transesophageal echocardiography can yield false-negative results. Data are lacking in paediatric multimodality imaging in prosthetic valve infective endocarditis. We present two children with repaired CHD where initial echocardiogram was non-diagnostic, while CT angiogram and 18F-fluorodeoxyglucose positron emission tomography in combination with CT angiography, respectively, confirmed the diagnosis of endocarditis affecting clinical management.
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Guerrier L, Cransac C, Pages B, Saint-Aubert L, Payoux P, Péran P, Pariente J. Posterior Cortical Atrophy: Does Complaint Match the Impairment? A Neuropsychological and FDG-PET Study. Front Neurol 2019; 10:1010. [PMID: 31616363 PMCID: PMC6764288 DOI: 10.3389/fneur.2019.01010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 09/04/2019] [Indexed: 12/12/2022] Open
Abstract
Objective: Posterior Cortical Atrophy (PCA) is a neurodegenerative disease characterized predominantly by visual impairment. However, diagnosis of PCA remains complicated with an interval of several years between initial reporting of symptoms and diagnosis. The aim of the present study is to define if patients' visual and gestural complaints are consistent with their clinical profile. Method: An evaluation of daily visual problems as well as a full neuropsychological assessment and FDG-PET were performed in 15 PCA patients. We compared glucose metabolism between these PCA patients and 18 healthy controls. Correlation analyses were conducted in PCA patients between visual and gestural complaint, clinical impairments, and brain glucose metabolism. Results: Major impairment of cognitive functions was detected in PCA patients specifically in visual domains. Positive correlations were found between visual impairments and hypometabolism in the right temporo-parieto-occipital cortices. However, no correlation was found between complaint and visual impairment in PCA patients. Discussion: Our main results suggest a consistent relationship between clinical impairment and brain metabolism. However, the patient's complaint and visual performance are not linked. Combining the literature and our results, it seems that patients are generally aware of difficulties but misinterpret them. This misinterpretation may be responsible for the delayed diagnosis.
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Affiliation(s)
- Laura Guerrier
- ToNIC, Toulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Camille Cransac
- Department of Neurology, University Hospital of Toulouse, Toulouse, France
| | - Bérengère Pages
- Department of Neurology, University Hospital of Toulouse, Toulouse, France
| | - Laure Saint-Aubert
- ToNIC, Toulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, France.,Department of Nuclear Medicine, University Hospital of Toulouse, Toulouse, France
| | - Pierre Payoux
- ToNIC, Toulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, France.,Department of Nuclear Medicine, University Hospital of Toulouse, Toulouse, France
| | - Patrice Péran
- ToNIC, Toulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Jérémie Pariente
- ToNIC, Toulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, France.,Department of Neurology, University Hospital of Toulouse, Toulouse, France
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Wolsztynski E, O'Sullivan F, Keyes E, O'Sullivan J, Eary JF. Positron emission tomography-based assessment of metabolic gradient and other prognostic features in sarcoma. J Med Imaging (Bellingham) 2018; 5:024502. [PMID: 29845091 PMCID: PMC5967597 DOI: 10.1117/1.jmi.5.2.024502] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/30/2018] [Indexed: 11/14/2022] Open
Abstract
Intratumoral heterogeneity biomarkers derived from positron emission tomography (PET) imaging with fluorodeoxyglucose (FDG) are of interest for a number of cancers, including sarcoma. A range of radiomic texture variables, adapted from general methodologies for image analysis, has shown promise in the setting. In the context of sarcoma, our group introduced an alternative model-based approach to the measurement of heterogeneity. In this approach, the heterogeneity of a tumor is characterized by the extent to which the 3-D FDG uptake pattern deviates from a simple elliptically contoured structure. By using a nonparametric analysis of the uptake profile obtained from this spatial model, a variable assessing the metabolic gradient of the tumor is developed. The work explores the prognostic potential of this new variable in the context of FDG-PET imaging of sarcoma. A mature clinical series involving 197 patients, 88 of whom have complete time-to-death information, is used. Texture variables based on the imaging data are also evaluated in this series and a range of appropriate machine learning methodologies are then used to explore the complementary prognostic roles for structure and texture variables. We conclude that both texture-based and model-based variables can be combined to achieve enhanced prognostic assessments of outcome for patients with sarcoma based on FDG-PET imaging information.
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Affiliation(s)
| | | | - Eimear Keyes
- University College Cork, Statistics Department, Cork, Ireland
| | | | - Janet F Eary
- National Cancer Institute, Bethesda, Maryland, United States
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Guerrier L, Le Men J, Gane A, Planton M, Salabert AS, Payoux P, Dumas H, Bonneville F, Péran P, Pariente J. Involvement of the Cingulate Cortex in Anosognosia: A Multimodal Neuroimaging Study in Alzheimer's Disease Patients. J Alzheimers Dis 2018; 65:443-453. [PMID: 30056422 PMCID: PMC6130407 DOI: 10.3233/jad-180324] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Anosognosia is a frequent symptom of Alzheimer's disease (AD), but its neural substrates remain in question. OBJECTIVE In this study, we combined neuroimaging with a neuropsychological evaluation to assess neural substrates of anosognosia. METHODS We prospectively recruited 30 patients with probable early-stage AD and matched healthy controls. Participants underwent MRI, FDG-PET, and a neuropsychological evaluation that includes an assessment of anosognosia. In the AD group, correlations between the anosognosia score, neuroimaging modalities, and neuropsychological performance were performed. RESULTS Atrophy and hypometabolism were correlated with the anosognosia score in the left dorsal anterior cingulate cortex. The anosognosia score was also correlated with atrophy of the cerebellar vermis, the left postcentral gyrus, and the right fusiform gyrus. No relation was found between anosognosia and the neuropsychological assessment. DISCUSSION Structural and metabolic alteration in the dorsal anterior cingulate cortex seems to be associated with a diminution of awareness in patients with early-stage AD.
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Affiliation(s)
- Laura Guerrier
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France
| | - Johanne Le Men
- Department of Neurology, University Hospital of Toulouse, Toulouse, France
| | - Anaıs Gane
- UMR1027 INSERM, University of Toulouse III, Toulouse University Hospital (CHU), Toulouse, France
| | - Mélanie Planton
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France
- Department of Neurology, University Hospital of Toulouse, Toulouse, France
| | - Anne-Sophie Salabert
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France
- Department of Nuclear Medicine, University Hospital of Toulouse, Toulouse, France
| | - Pierre Payoux
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France
- Department of Nuclear Medicine, University Hospital of Toulouse, Toulouse, France
| | - Hervé Dumas
- Department of Neuroradiology, University Hospital of Toulouse, Toulouse, France
| | - Fabrice Bonneville
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France
- Department of Neuroradiology, University Hospital of Toulouse, Toulouse, France
| | - Patrice Péran
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France
| | - Jérémie Pariente
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France
- Department of Neurology, University Hospital of Toulouse, Toulouse, France
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