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Petersen M, Coenen M, DeCarli C, De Luca A, van der Lelij E, Barkhof F, Benke T, Chen CPLH, Dal-Bianco P, Dewenter A, Duering M, Enzinger C, Ewers M, Exalto LG, Fletcher EF, Franzmeier N, Hilal S, Hofer E, Koek HL, Maier AB, Maillard PM, McCreary CR, Papma JM, Pijnenburg YAL, Schmidt R, Smith EE, Steketee RME, van den Berg E, van der Flier WM, Venkatraghavan V, Venketasubramanian N, Vernooij MW, Wolters FJ, Xu X, Horn A, Patil KR, Eickhoff SB, Thomalla G, Biesbroek JM, Biessels GJ, Cheng B. Enhancing Cognitive Performance Prediction through White Matter Hyperintensity Connectivity Assessment: A Multicenter Lesion Network Mapping Analysis of 3,485 Memory Clinic Patients. medRxiv 2024:2024.03.28.24305007. [PMID: 38586023 PMCID: PMC10996741 DOI: 10.1101/2024.03.28.24305007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Introduction White matter hyperintensities of presumed vascular origin (WMH) are associated with cognitive impairment and are a key imaging marker in evaluating cognitive health. However, WMH volume alone does not fully account for the extent of cognitive deficits and the mechanisms linking WMH to these deficits remain unclear. We propose that lesion network mapping (LNM), enables to infer if brain networks are connected to lesions, and could be a promising technique for enhancing our understanding of the role of WMH in cognitive disorders. Our study employed this approach to test the following hypotheses: (1) LNM-informed markers surpass WMH volumes in predicting cognitive performance, and (2) WMH contributing to cognitive impairment map to specific brain networks. Methods & results We analyzed cross-sectional data of 3,485 patients from 10 memory clinic cohorts within the Meta VCI Map Consortium, using harmonized test results in 4 cognitive domains and WMH segmentations. WMH segmentations were registered to a standard space and mapped onto existing normative structural and functional brain connectome data. We employed LNM to quantify WMH connectivity across 480 atlas-based gray and white matter regions of interest (ROI), resulting in ROI-level structural and functional LNM scores. The capacity of total and regional WMH volumes and LNM scores in predicting cognitive function was compared using ridge regression models in a nested cross-validation. LNM scores predicted performance in three cognitive domains (attention and executive function, information processing speed, and verbal memory) significantly better than WMH volumes. LNM scores did not improve prediction for language functions. ROI-level analysis revealed that higher LNM scores, representing greater disruptive effects of WMH on regional connectivity, in gray and white matter regions of the dorsal and ventral attention networks were associated with lower cognitive performance. Conclusion Measures of WMH-related brain network connectivity significantly improve the prediction of current cognitive performance in memory clinic patients compared to WMH volume as a traditional imaging marker of cerebrovascular disease. This highlights the crucial role of network effects, particularly in attentionrelated brain regions, improving our understanding of vascular contributions to cognitive impairment. Moving forward, refining WMH information with connectivity data could contribute to patient-tailored therapeutic interventions and facilitate the identification of subgroups at risk of cognitive disorders.
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Affiliation(s)
- Marvin Petersen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mirthe Coenen
- University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
| | | | - Alberto De Luca
- University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
- Image Sciences Institute, Division Imaging and Oncology, UMC Utrecht
| | | | | | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine, Amsterdam UMC, Vrije Universiteit, the Netherlands
- Queen Square Institute of Neurology and Centre for Medical Image Computing, University College London, UK
| | - Thomas Benke
- Clinic of Neurology, Medical University Innsbruck, Austria
| | - Christopher P. L. H. Chen
- Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Memory, Aging and Cognition Center, National University Health System, Singapore
| | | | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Munich, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Munich, Germany
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Christian Enzinger
- Division of General Neurology, Department of Neurology, Medical University Graz, Austria
- Division of Neuroradiology, Interventional and Vascular Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Munich, Germany
| | - Lieza G. Exalto
- University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
| | | | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Munich, Germany
| | - Saima Hilal
- Memory, Aging and Cognition Center, National University Health System, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Edith Hofer
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Austria
| | - Huiberdina L. Koek
- University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
- Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Andrea B. Maier
- Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Memory, Aging and Cognition Center, National University Health System, Singapore
| | | | - Cheryl R. McCreary
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Janne M. Papma
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Yolande A. L. Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Reinhold Schmidt
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Austria
| | - Eric E. Smith
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Rebecca M. E. Steketee
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Esther van den Berg
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Vikram Venkatraghavan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Narayanaswamy Venketasubramanian
- Memory, Aging and Cognition Center, National University Health System, Singapore
- Raffles Neuroscience Center, Raffles Hospital, Singapore, Singapore
| | - Meike W. Vernooij
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Frank J. Wolters
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Xin Xu
- Memory, Aging and Cognition Center, National University Health System, Singapore
- School of Public Health and the Second Affiliated Hospital of School of Medicine, Zhejiang University, China
| | - Andreas Horn
- Charité - Universitätsmedizin Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology with Experimental Neurology, 10117 Berlin, Germany
- Center for Brain Circuit Therapeutics, Department of Neurology, Psychiatry, and Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
| | - Kaustubh R. Patil
- Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Center Jülich, Germany
| | - Simon B. Eickhoff
- Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Center Jülich, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J. Matthijs Biesbroek
- University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
- Department of Neurology, Diakonessenhuis Hospital, Utrecht, The Netherlands
| | - Geert Jan Biessels
- University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Biesbroek JM, Coenen M, DeCarli C, Fletcher EM, Maillard PM, Barkhof F, Barnes J, Benke T, Chen CPLH, Dal‐Bianco P, Dewenter A, Duering M, Enzinger C, Ewers M, Exalto LG, Franzmeier N, Hilal S, Hofer E, Koek HL, Maier AB, McCreary CR, Papma JM, Paterson RW, Pijnenburg YAL, Rubinski A, Schmidt R, Schott JM, Slattery CF, Smith EE, Sudre CH, Steketee RME, Teunissen CE, van den Berg E, van der Flier WM, Venketasubramanian N, Venkatraghavan V, Vernooij MW, Wolters FJ, Xin X, Kuijf HJ, Biessels GJ. Amyloid pathology and vascular risk are associated with distinct patterns of cerebral white matter hyperintensities: A multicenter study in 3132 memory clinic patients. Alzheimers Dement 2024; 20:2980-2989. [PMID: 38477469 PMCID: PMC11032573 DOI: 10.1002/alz.13765] [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: 10/30/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION White matter hyperintensities (WMH) are associated with key dementia etiologies, in particular arteriolosclerosis and amyloid pathology. We aimed to identify WMH locations associated with vascular risk or cerebral amyloid-β1-42 (Aβ42)-positive status. METHODS Individual patient data (n = 3,132; mean age 71.5 ± 9 years; 49.3% female) from 11 memory clinic cohorts were harmonized. WMH volumes in 28 regions were related to a vascular risk compound score (VRCS) and Aß42 status (based on cerebrospinal fluid or amyloid positron emission tomography), correcting for age, sex, study site, and total WMH volume. RESULTS VRCS was associated with WMH in anterior/superior corona radiata (B = 0.034/0.038, p < 0.001), external capsule (B = 0.052, p < 0.001), and middle cerebellar peduncle (B = 0.067, p < 0.001), and Aß42-positive status with WMH in posterior thalamic radiation (B = 0.097, p < 0.001) and splenium (B = 0.103, p < 0.001). DISCUSSION Vascular risk factors and Aß42 pathology have distinct signature WMH patterns. This regional vulnerability may incite future studies into how arteriolosclerosis and Aß42 pathology affect the brain's white matter. HIGHLIGHTS Key dementia etiologies may be associated with specific patterns of white matter hyperintensities (WMH). We related WMH locations to vascular risk and cerebral Aβ42 status in 11 memory clinic cohorts. Aβ42 positive status was associated with posterior WMH in splenium and posterior thalamic radiation. Vascular risk was associated with anterior and infratentorial WMH. Amyloid pathology and vascular risk have distinct signature WMH patterns.
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Levin F, Grothe MJ, Dyrba M, Franzmeier N, Teipel SJ. Longitudinal trajectories of cognitive reserve in hypometabolic subtypes of Alzheimer's disease. Neurobiol Aging 2024; 135:26-38. [PMID: 38157587 DOI: 10.1016/j.neurobiolaging.2023.12.003] [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: 05/30/2023] [Revised: 11/16/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
Previous studies have demonstrated resilience to AD-related neuropathology in a form of cognitive reserve (CR). In this study we investigated a relationship between CR and hypometabolic subtypes of AD, specifically the typical and the limbic-predominant subtypes. We analyzed data from 59 Aβ-positive cognitively normal (CN), 221 prodromal Alzheimer's disease (AD) and 174 AD dementia participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) from ADNI and ADNIGO/2 phases. For replication, we analyzed data from 5 Aβ-positive CN, 89 prodromal AD and 43 AD dementia participants from ADNI3. CR was estimated as standardized residuals in a model predicting cognition from temporoparietal grey matter volumes and covariates. Higher CR estimates predicted slower cognitive decline. Typical and limbic-predominant hypometabolic subtypes demonstrated similar baseline CR, but the results suggested a faster decline of CR in the typical subtype. These findings support the relationship between subtypes and CR, specifically longitudinal trajectories of CR. Results also underline the importance of longitudinal analyses in research on CR.
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Affiliation(s)
- Fedor Levin
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany.
| | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Martin Dyrba
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Stefan J Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
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Rubinski A, Dewenter A, Zheng L, Franzmeier N, Stephenson H, Deming Y, Duering M, Gesierich B, Denecke J, Pham AV, Bendlin B, Ewers M. Florbetapir PET-assessed demyelination is associated with faster tau accumulation in an APOE ε4-dependent manner. Eur J Nucl Med Mol Imaging 2024; 51:1035-1049. [PMID: 38049659 PMCID: PMC10881623 DOI: 10.1007/s00259-023-06530-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/14/2023] [Indexed: 12/06/2023]
Abstract
PURPOSE The main objectives were to test whether (1) a decrease in myelin is associated with enhanced rate of fibrillar tau accumulation and cognitive decline in Alzheimer's disease, and (2) whether apolipoprotein E (APOE) ε4 genotype is associated with worse myelin decrease and thus tau accumulation. METHODS To address our objectives, we repurposed florbetapir-PET as a marker of myelin in the white matter (WM) based on previous validation studies showing that beta-amyloid (Aβ) PET tracers bind to WM myelin. We assessed 43 Aβ-biomarker negative (Aβ-) cognitively normal participants and 108 Aβ+ participants within the AD spectrum with florbetapir-PET at baseline and longitudinal flortaucipir-PET as a measure of fibrillar tau (tau-PET) over ~ 2 years. In linear regression analyses, we tested florbetapir-PET in the whole WM and major fiber tracts as predictors of tau-PET accumulation in a priori defined regions of interest (ROIs) and fiber-tract projection areas. In mediation analyses we tested whether tau-PET accumulation mediates the effect of florbetapir-PET in the whole WM on cognition. Finally, we assessed the role of myelin alteration on the association between APOE and tau-PET accumulation. RESULTS Lower florbetapir-PET in the whole WM or at a given fiber tract was predictive of faster tau-PET accumulation in Braak stages or the connected grey matter areas in Aβ+ participants. Faster tau-PET accumulation in higher cortical brain areas mediated the association between a decrease in florbetapir-PET in the WM and a faster rate of decline in global cognition and episodic memory. APOE ε4 genotype was associated with a worse decrease in the whole WM florbetapir-PET and thus enhanced tau-PET accumulation. CONCLUSION Myelin alterations are associated in an APOE ε4 dependent manner with faster tau progression and cognitive decline, and may therefore play a role in the etiology of AD.
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Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Lukai Zheng
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Henry Stephenson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin- Madison, Madison, WI, USA
| | - Yuetiva Deming
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin- Madison, Madison, WI, USA
| | - Marco Duering
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Benno Gesierich
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Jannis Denecke
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - An-Vi Pham
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Barbara Bendlin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin- Madison, Madison, WI, USA
| | - Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
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5
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Stockbauer A, Beyer L, Huber M, Kreuzer A, Palleis C, Katzdobler S, Rauchmann BS, Morbelli S, Chincarini A, Bruffaerts R, Vandenberghe R, Kramberger MG, Trost M, Garibotto V, Nicastro N, Lathuilière A, Lemstra AW, van Berckel BNM, Pilotto A, Padovani A, Ochoa-Figueroa MA, Davidsson A, Camacho V, Peira E, Bauckneht M, Pardini M, Sambuceti G, Aarsland D, Nobili F, Gross M, Vöglein J, Perneczky R, Pogarell O, Buerger K, Franzmeier N, Danek A, Levin J, Höglinger GU, Bartenstein P, Cumming P, Rominger A, Brendel M. Metabolic network alterations as a supportive biomarker in dementia with Lewy bodies with preserved dopamine transmission. Eur J Nucl Med Mol Imaging 2024; 51:1023-1034. [PMID: 37971501 PMCID: PMC10881642 DOI: 10.1007/s00259-023-06493-w] [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: 03/09/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Metabolic network analysis of FDG-PET utilizes an index of inter-regional correlation of resting state glucose metabolism and has been proven to provide complementary information regarding the disease process in parkinsonian syndromes. The goals of this study were (i) to evaluate pattern similarities of glucose metabolism and network connectivity in dementia with Lewy bodies (DLB) subjects with subthreshold dopaminergic loss compared to advanced disease stages and to (ii) investigate metabolic network alterations of FDG-PET for discrimination of patients with early DLB from other neurodegenerative disorders (Alzheimer's disease, Parkinson's disease, multiple system atrophy) at individual patient level via principal component analysis (PCA). METHODS FDG-PETs of subjects with probable or possible DLB (n = 22) without significant dopamine deficiency (z-score < 2 in putamen binding loss on DaT-SPECT compared to healthy controls (HC)) were scaled by global-mean, prior to volume-of-interest-based analyses of relative glucose metabolism. Single region metabolic changes and network connectivity changes were compared against HC (n = 23) and against DLB subjects with significant dopamine deficiency (n = 86). PCA was applied to test discrimination of patients with DLB from disease controls (n = 101) at individual patient level. RESULTS Similar patterns of hypo- (parietal- and occipital cortex) and hypermetabolism (basal ganglia, limbic system, motor cortices) were observed in DLB patients with and without significant dopamine deficiency when compared to HC. Metabolic connectivity alterations correlated between DLB patients with and without significant dopamine deficiency (R2 = 0.597, p < 0.01). A PCA trained by DLB patients with dopamine deficiency and HC discriminated DLB patients without significant dopaminergic loss from other neurodegenerative parkinsonian disorders at individual patient level (area-under-the-curve (AUC): 0.912). CONCLUSION Disease-specific patterns of altered glucose metabolism and altered metabolic networks are present in DLB subjects without significant dopaminergic loss. Metabolic network alterations in FDG-PET can act as a supporting biomarker in the subgroup of DLB patients without significant dopaminergic loss at symptoms onset.
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Affiliation(s)
- Anna Stockbauer
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Maria Huber
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Annika Kreuzer
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Carla Palleis
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Sabrina Katzdobler
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Department of Neuroradiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Silvia Morbelli
- Nuclear Medicine Uni, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Andrea Chincarini
- National Institute of Nuclear Physics (INFN), Genoa Section, Genoa, Italy
| | - Rose Bruffaerts
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Louvain, Belgium
- Neurology Department, University Hospitals Leuven, Louvain, Belgium
- Biomedical Research Institute, Hasselt University, Hasselt, Belgium
- Experimental Neurobiology Unit, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Louvain, Belgium
- Neurology Department, University Hospitals Leuven, Louvain, Belgium
| | - Milica G Kramberger
- Department of Neurology and Department for Nuclear Medicine, University Medical Centre, Ljubljana, Slovenia
| | - Maja Trost
- Department of Neurology and Department for Nuclear Medicine, University Medical Centre, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals and NIMTLab, Geneva University, Geneva, Switzerland
| | - Nicolas Nicastro
- Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Aurélien Lathuilière
- LANVIE (Laboratoire de Neuroimagerie du Vieillissement), Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Afina W Lemstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Parkinson's Disease Rehabilitation Centre, FERB ONLUS - S. Isidoro Hospital, Trescore Balneario, BG, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Miguel A Ochoa-Figueroa
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Diagnostic Radiology, Linköping University Hospital, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Anette Davidsson
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Valle Camacho
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Enrico Peira
- National Institute of Nuclear Physics (INFN), Genoa Section, Genoa, Italy
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Matteo Bauckneht
- Nuclear Medicine Uni, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- Clinical Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine Uni, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Dag Aarsland
- Centre of Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- Clinical Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mattes Gross
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Jonathan Vöglein
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, S10 2HQ, UK
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College, London, UK
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institut for Stroke and Dementia Research, University of Munich, Munich, Germany
| | | | - Adrian Danek
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Johannes Levin
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Günter U Höglinger
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Paul Cumming
- Department of Nuclear Medicine, University of Bern, Inselspital Bern, Bern, Switzerland
- School of Psychology and Counselling and IHBI, Queensland University of Technology, Brisbane, Australia
| | - Axel Rominger
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
- Department of Nuclear Medicine, University of Bern, Inselspital Bern, Bern, Switzerland
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
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6
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Ferschmann C, Messerschmidt K, Gnörich J, Barthel H, Marek K, Palleis C, Katzdobler S, Stockbauer A, Fietzek U, Finze A, Biechele G, Rumpf JJ, Saur D, Schroeter ML, Rullmann M, Beyer L, Eckenweber F, Wall S, Schildan A, Patt M, Stephens A, Classen J, Bartenstein P, Seibyl J, Franzmeier N, Levin J, Höglinger GU, Sabri O, Brendel M, Scheifele M. Tau accumulation is associated with dopamine deficiency in vivo in four-repeat tauopathies. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06637-6. [PMID: 38366196 DOI: 10.1007/s00259-024-06637-6] [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: 07/11/2023] [Accepted: 02/04/2024] [Indexed: 02/18/2024]
Abstract
PURPOSE We hypothesized that severe tau burden in brain regions involved in direct or indirect pathways of the basal ganglia correlate with more severe striatal dopamine deficiency in four-repeat (4R) tauopathies. Therefore, we correlated [18F]PI-2620 tau-positron-emission-tomography (PET) imaging with [123I]-Ioflupane single-photon-emission-computed tomography (SPECT) for dopamine transporter (DaT) availability. METHODS Thirty-eight patients with clinically diagnosed 4R-tauopathies (21 male; 69.0 ± 8.5 years) and 15 patients with clinically diagnosed α-synucleinopathies (8 male; 66.1 ± 10.3 years) who underwent [18F]PI-2620 tau-PET and DaT-SPECT imaging with a time gap of 3 ± 5 months were evaluated. Regional Tau-PET signals and DaT availability as well as their principal components were correlated in patients with 4R-tauopathies and α-synucleinopathies. Both biomarkers and the residuals of their association were correlated with clinical severity scores in 4R-tauopathies. RESULTS In patients with 4R-tauopathies, [18F]PI-2620 binding in basal ganglia and midbrain regions was negatively associated with striatal DaT availability (i.e. globus pallidus internus and putamen (β = - 0.464, p = 0.006, Durbin-Watson statistics = 1.824) in a multiple regression model. Contrarily, [18F]PI-2620 binding in the dentate nucleus showed no significant regression factor with DaT availability in the striatum (β = 0.078, p = 0.662, Durbin-Watson statistics = 1.686). Patients with α-synucleinopathies did not indicate any regional associations between [18F]PI-2620-binding and DaT availability. Higher DaT-SPECT binding relative to tau burden was associated with better clinical performance (β = - 0.522, p = 0.011, Durbin-Watson statistics = 2.663) in patients with 4R-tauopathies. CONCLUSION Tau burden in brain regions involved in dopaminergic pathways is associated with aggravated dopaminergic dysfunction in patients with clinically diagnosed primary tauopathies. The ability to sustain dopamine transmission despite tau accumulation may preserve motor function.
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Affiliation(s)
- Christian Ferschmann
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - Johannes Gnörich
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Ken Marek
- InviCRO, LLC, Boston, MA, USA
- Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | - Carla Palleis
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sabrina Katzdobler
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Anna Stockbauer
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Urban Fietzek
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Anika Finze
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Gloria Biechele
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Jost-Julian Rumpf
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Dorothee Saur
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Matthias L Schroeter
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Michael Rullmann
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Florian Eckenweber
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Stephan Wall
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Andreas Schildan
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | | | - Joseph Classen
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - John Seibyl
- InviCRO, LLC, Boston, MA, USA
- Molecular Neuroimaging, A Division of inviCRO, New Haven, CT, USA
| | - Nicolai Franzmeier
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Institute for Stroke and Dementia Research, LMU University Hospital, LMU Munich, Munich, Germany
| | - Johannes Levin
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Günter U Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
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7
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Zheng L, Rubinski A, Denecke J, Luan Y, Smith R, Strandberg O, Stomrud E, Ossenkoppele R, Svaldi DO, Higgins IA, Shcherbinin S, Pontecorvo MJ, Hansson O, Franzmeier N, Ewers M. Combined Connectomics, MAPT Gene Expression, and Amyloid Deposition to Explain Regional Tau Deposition in Alzheimer Disease. Ann Neurol 2024; 95:274-287. [PMID: 37837382 DOI: 10.1002/ana.26818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/07/2023] [Accepted: 10/03/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE We aimed to test whether region-specific factors, including spatial expression patterns of the tau-encoding gene MAPT and regional levels of amyloid positron emission tomography (PET), enhance connectivity-based modeling of the spatial variability in tau-PET deposition in the Alzheimer disease (AD) spectrum. METHODS We included 685 participants (395 amyloid-positive participants within AD spectrum and 290 amyloid-negative controls) with tau-PET and amyloid-PET from 3 studies (Alzheimer's Disease Neuroimaging Initiative, 18 F-AV-1451-A05, and BioFINDER-1). Resting-state functional magnetic resonance imaging was obtained in healthy controls (n = 1,000) from the Human Connectome Project, and MAPT gene expression from the Allen Human Brain Atlas. Based on a brain-parcellation atlas superimposed onto all modalities, we obtained region of interest (ROI)-to-ROI functional connectivity, ROI-level PET values, and MAPT gene expression. In stepwise regression analyses, we tested connectivity, MAPT gene expression, and amyloid-PET as predictors of group-averaged and individual tau-PET ROI values in amyloid-positive participants. RESULTS Connectivity alone explained 21.8 to 39.2% (range across 3 studies) of the variance in tau-PET ROI values averaged across amyloid-positive participants. Stepwise addition of MAPT gene expression and amyloid-PET increased the proportion of explained variance to 30.2 to 46.0% and 45.0 to 49.9%, respectively. Similarly, for the prediction of patient-level tau-PET ROI values, combining all 3 predictors significantly improved the variability explained (mean adjusted R2 range across studies = 0.118-0.148, 0.156-0.196, and 0.251-0.333 for connectivity alone, connectivity plus MAPT expression, and all 3 modalities combined, respectively). INTERPRETATION Across 3 study samples, combining the functional connectome and molecular properties substantially enhanced the explanatory power compared to single modalities, providing a valuable tool to explain regional susceptibility to tau deposition in AD. ANN NEUROL 2024;95:274-287.
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Affiliation(s)
- Lukai Zheng
- Institute for Stroke and Dementia Research, University Hospital, LMU, Munich, Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research, University Hospital, LMU, Munich, Germany
| | - Jannis Denecke
- Institute for Stroke and Dementia Research, University Hospital, LMU, Munich, Germany
| | - Ying Luan
- Institute for Stroke and Dementia Research, University Hospital, LMU, Munich, Germany
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | | | | | | | - Michael J Pontecorvo
- Eli Lilly and Company, Indianapolis, IN, USA
- Avid Radiopharmaceuticals, Philadelphia, PA, USA
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, University Hospital, LMU, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, LMU, Munich, Germany
- German Center for Neurodegenerative Diseases, Munich, Germany
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8
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Biechele G, Rauchmann BS, Janowitz D, Buerger K, Franzmeier N, Weidinger E, Guersel S, Schuster S, Finze A, Harris S, Lindner S, Albert NL, Wetzel C, Rupprecht R, Rominger A, Palleis C, Katzdobler S, Burow L, Kurz C, Zaganjori M, Trappmann LK, Goldhardt O, Grimmer T, Haeckert J, Keeser D, Stoecklein S, Morenas-Rodriguez E, Bartenstein P, Levin J, Höglinger GU, Simons M, Perneczky R, Brendel M. Associations between sex, body mass index and the individual microglial response in Alzheimer's disease. J Neuroinflammation 2024; 21:30. [PMID: 38263017 PMCID: PMC10804830 DOI: 10.1186/s12974-024-03020-y] [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: 10/25/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES 18-kDa translocator protein position-emission-tomography (TSPO-PET) imaging emerged for in vivo assessment of neuroinflammation in Alzheimer's disease (AD) research. Sex and obesity effects on TSPO-PET binding have been reported for cognitively normal humans (CN), but such effects have not yet been systematically evaluated in patients with AD. Thus, we aimed to investigate the impact of sex and obesity on the relationship between β-amyloid-accumulation and microglial activation in AD. METHODS 49 patients with AD (29 females, all Aβ-positive) and 15 Aβ-negative CN (8 female) underwent TSPO-PET ([18F]GE-180) and β-amyloid-PET ([18F]flutemetamol) imaging. In 24 patients with AD (14 females), tau-PET ([18F]PI-2620) was additionally available. The brain was parcellated into 218 cortical regions and standardized-uptake-value-ratios (SUVr, cerebellar reference) were calculated. Per region and tracer, the regional increase of PET SUVr (z-score) was calculated for AD against CN. The regression derived linear effect of regional Aβ-PET on TSPO-PET was used to determine the Aβ-plaque-dependent microglial response (slope) and the Aβ-plaque-independent microglial response (intercept) at the individual patient level. All read-outs were compared between sexes and tested for a moderation effect of sex on associations with body mass index (BMI). RESULTS In AD, females showed higher mean cortical TSPO-PET z-scores (0.91 ± 0.49; males 0.30 ± 0.75; p = 0.002), while Aβ-PET z-scores were similar. The Aβ-plaque-independent microglial response was stronger in females with AD (+ 0.37 ± 0.38; males with AD - 0.33 ± 0.87; p = 0.006), pronounced at the prodromal stage. On the contrary, the Aβ-plaque-dependent microglial response was not different between sexes. The Aβ-plaque-independent microglial response was significantly associated with tau-PET in females (Braak-II regions: r = 0.757, p = 0.003), but not in males. BMI and the Aβ-plaque-independent microglial response were significantly associated in females (r = 0.44, p = 0.018) but not in males (BMI*sex interaction: F(3,52) = 3.077, p = 0.005). CONCLUSION While microglia response to fibrillar Aβ is similar between sexes, women with AD show a stronger Aβ-plaque-independent microglia response. This sex difference in Aβ-independent microglial activation may be associated with tau accumulation. BMI is positively associated with the Aβ-plaque-independent microglia response in females with AD but not in males, indicating that sex and obesity need to be considered when studying neuroinflammation in AD.
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Affiliation(s)
- Gloria Biechele
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, University of Munich, Marchioninstraße 15, 81377, Munich, Germany
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Institute of Neuroradiology, LMU University Hospital, LMU Munich, Munich, Germany
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research, LMU University Hospital, LMU Munich, Munich, Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research, LMU University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Gothenburg, Sweden
| | - Endy Weidinger
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Selim Guersel
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sebastian Schuster
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, University of Munich, Marchioninstraße 15, 81377, Munich, Germany
| | - Anika Finze
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, University of Munich, Marchioninstraße 15, 81377, Munich, Germany
| | - Stefanie Harris
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, University of Munich, Marchioninstraße 15, 81377, Munich, Germany
| | - Simon Lindner
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, University of Munich, Marchioninstraße 15, 81377, Munich, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, University of Munich, Marchioninstraße 15, 81377, Munich, Germany
| | - Christian Wetzel
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, University of Munich, Marchioninstraße 15, 81377, Munich, Germany
- Department of Nuclear Medicine, University of Bern, Inselspital, Bern, Switzerland
| | - Carla Palleis
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sabrina Katzdobler
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lena Burow
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Carolin Kurz
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Mirlind Zaganjori
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, University of Munich, Marchioninstraße 15, 81377, Munich, Germany
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lena-Katharina Trappmann
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Oliver Goldhardt
- Department of Psychiatry and Psychotherapy, School of Medicine and Health, Technical University Munich, Klinikum Rechts Der Isar, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, School of Medicine and Health, Technical University Munich, Klinikum Rechts Der Isar, Munich, Germany
| | - Jan Haeckert
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sophia Stoecklein
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - Peter Bartenstein
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, University of Munich, Marchioninstraße 15, 81377, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Günter U Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Mikael Simons
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Institute of Neuronal Cell Biology, TU Munich, Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
| | - Matthias Brendel
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, University of Munich, Marchioninstraße 15, 81377, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
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9
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Palleis C, Franzmeier N, Weidinger E, Bernhardt AM, Katzdobler S, Wall S, Ferschmann C, Harris S, Schmitt J, Schuster S, Gnörich J, Finze A, Biechele G, Lindner S, Albert NL, Bartenstein P, Sabri O, Barthel H, Rupprecht R, Nuscher B, Stephens AW, Rauchmann BS, Perneczky R, Haass C, Brendel M, Levin J, Höglinger GU. Association of Neurofilament Light Chain, [ 18F]PI-2620 Tau-PET, TSPO-PET, and Clinical Progression in Patients With β-Amyloid-Negative CBS. Neurology 2024; 102:e207901. [PMID: 38165362 PMCID: PMC10834119 DOI: 10.1212/wnl.0000000000207901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/24/2023] [Accepted: 10/03/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Corticobasal syndrome (CBS) with underlying 4-repeat tauopathy is a progressive neurodegenerative disease characterized by declining cognitive and motor functions. Biomarkers for assessing pathologic brain changes in CBS including tau-PET, 18 kDa translocator protein (TSPO)-PET, structural MRI, neurofilament light chain (NfL), or glial fibrillary acidic protein (GFAP) have recently been evaluated for differential diagnosis and disease staging, yet their association with disease trajectories remains unclear. Therefore, we performed a head-to-head comparison of neuroimaging (tau-PET, TSPO-PET, structural MRI) and plasma biomarkers (NfL, GFAP) as prognostic tools for longitudinal clinical trajectories in β-amyloid (Aβ)-negative CBS. METHODS We included patients with clinically diagnosed Aβ-negative CBS with clinical follow-up data who underwent baseline structural MRI and plasma-NfL analysis for assessing neurodegeneration, [18F]PI-2620-PET for assessing tau pathology, [18F]GE-180-PET for assessing microglia activation, and plasma-GFAP analysis for assessing astrocytosis. To quantify tau and microglia load, we assessed summary scores of whole-brain, cortical, and subcortical PET signal. For structural MRI analysis, we quantified subcortical and cortical gray matter volume. Plasma NfL and GFAP values were assessed using Simoa-based immunoassays. Symptom progression was determined using a battery of cognitive and motor tests (i.e., Progressive Supranuclear Palsy Rating Scale [PSPRS]). Using linear mixed models, we tested whether the assessed biomarkers at baseline were associated with faster symptom progression over time (i.e., time × biomarker interaction). RESULTS Overall, 21 patients with Aβ-negative CBS with ∼2-year clinical follow-up data were included. Patients with CBS with more widespread global tau-PET signal showed faster clinical progression (PSPRS: B/SE = 0.001/0.0005, p = 0.025), driven by cortical rather than subcortical tau-PET. By contrast, patients with higher global [18F]GE-180-PET readouts showed slower clinical progression (PSPRS: B/SE = -0.056/0.023, p = 0.019). No association was found between gray matter volume and clinical progression. Concerning fluid biomarkers, only higher plasma-NfL (PSPRS: B/SE = 0.176/0.046, p < 0.001) but not GFAP was associated with faster clinical deterioration. In a subsequent sensitivity analysis, we found that tau-PET, TSPO-PET, and plasma-NfL showed significant interaction effects with time on clinical trajectories when tested in the same model. DISCUSSION [18F]PI-2620 tau-PET, [18F]GE-180 TSPO-PET, and plasma-NfL show prognostic potential for clinical progression in patients with Aβ-negative CBS with probable 4-repeat tauopathy, which can be useful for clinical decision-making and stratifying patients in clinical trials.
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Affiliation(s)
- Carla Palleis
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Nicolai Franzmeier
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Endy Weidinger
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Alexander M Bernhardt
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Sabrina Katzdobler
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Stephan Wall
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Christian Ferschmann
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Stefanie Harris
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Julia Schmitt
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Sebastian Schuster
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Johannes Gnörich
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Anika Finze
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Gloria Biechele
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Simon Lindner
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Nathalie L Albert
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Peter Bartenstein
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Osama Sabri
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Henryk Barthel
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Rainer Rupprecht
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Brigitte Nuscher
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Andrew W Stephens
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Boris-Stephan Rauchmann
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Robert Perneczky
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Christian Haass
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Matthias Brendel
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Johannes Levin
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Günter U Höglinger
- From the Departments of Neurology (C.P., E.W., A.M.B., S.K., J.L., G.U.H.), Nuclear Medicine (S.W., C.F., S.H., J.S., S.S., J.G., A.F., G.B., S.L., N.L.A., P.B., M.B.), and Psychiatry and Psychotherapy (B.-S.R., R.P.) and the Institutes for Stroke and Dementia Research (N.F.) and Neuroradiology (B.-S.R.), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (C.P., N.F., S.K., P.B., R.P., C.H., M.B., J.L.), SyNergy, Germany; German Center for Neurodegenerative Diseases (C.P., E.W., A.M.B., S.K., B.N., B.-S.R., R.P., C.H., M.B., J.L., G.U.H.), DZNE-Munich, Germany; Department of Nuclear Medicine (O.S., H.B.), Leipzig University Medical Centre; Department of Psychiatry and Psychotherapy (R.R.), University of Regensburg, Germany; Life Molecular Imaging GmbH (A.W.S.), Berlin, Germany; Sheffield Institute for Translational Neuroscience (SITraN) (B.-S.R., R.P.), University of Sheffield, United Kingdom; Ageing Epidemiology Research Unit (AGE) (R.P.), School of Public Health, Imperial College London, United Kingdom; and Chair of Metabolic Biochemistry (C.H.), Biomedical Center (BMC), Ludwig-Maximilians-Universität LMU, Munich, Germany
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Franzmeier N, Dehsarvi A, Steward A, Biel D, Dewenter A, Roemer SN, Wagner F, Groß M, Brendel M, Moscoso A, Arunachalam P, Blennow K, Zetterberg H, Ewers M, Schöll M. Elevated CSF GAP-43 is associated with accelerated tau accumulation and spread in Alzheimer's disease. Nat Commun 2024; 15:202. [PMID: 38172114 PMCID: PMC10764818 DOI: 10.1038/s41467-023-44374-w] [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: 08/08/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
In Alzheimer's disease, amyloid-beta (Aβ) triggers the trans-synaptic spread of tau pathology, and aberrant synaptic activity has been shown to promote tau spreading. Aβ induces aberrant synaptic activity, manifesting in increases in the presynaptic growth-associated protein 43 (GAP-43), which is closely involved in synaptic activity and plasticity. We therefore tested whether Aβ-related GAP-43 increases, as a marker of synaptic changes, drive tau spreading in 93 patients across the aging and Alzheimer's spectrum with available CSF GAP-43, amyloid-PET and longitudinal tau-PET assessments. We found that (1) higher GAP-43 was associated with faster Aβ-related tau accumulation, specifically in brain regions connected closest to subject-specific tau epicenters and (2) that higher GAP-43 strengthened the association between Aβ and connectivity-associated tau spread. This suggests that GAP-43-related synaptic changes are linked to faster Aβ-related tau spread across connected regions and that synapses could be key targets for preventing tau spreading in Alzheimer's disease.
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Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
- University of Gothenburg, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Mölndal and Gothenburg, Sweden.
| | - Amir Dehsarvi
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Anna Steward
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Sebastian Niclas Roemer
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Fabian Wagner
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Mattes Groß
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Matthias Brendel
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Alexis Moscoso
- University of Gothenburg, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Mölndal and Gothenburg, Sweden
| | - Prithvi Arunachalam
- University of Gothenburg, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Mölndal and Gothenburg, Sweden
| | - Kaj Blennow
- University of Gothenburg, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Mölndal and Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- University of Gothenburg, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Mölndal and Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Michael Schöll
- University of Gothenburg, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Mölndal and Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
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Malpetti M, Franzmeier N, Brendel M. PET Imaging to Measure Neuroinflammation In Vivo. Methods Mol Biol 2024; 2785:177-193. [PMID: 38427195 DOI: 10.1007/978-1-0716-3774-6_12] [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] [Indexed: 03/02/2024]
Abstract
This paper provides an overview of the role of neuroinflammation in Alzheimer's disease and other neurodegenerative diseases, highlighting the potential of anti-inflammatory treatments to slow or prevent decline. This research focuses on the use of positron emission tomography (PET) imaging to visualize and quantify molecular brain changes in patients, specifically microglial activation and reactive astrogliosis. We discuss the development and application of several PET radioligands, including first-generation ligands like PK11195 and Ro5-4864, as well as second- and third-generation ligands such as [11C]PBR28, [18F]DPA-714, [18F]GE-180, and [11C]ER176. These ligands target the 18-kDa translocator protein (TSPO), which is overexpressed in activated microglia and upregulated in astrocytes. We also address the limitations of these ligands, such as low brain uptake, poor penetration of the blood-brain barrier, short half-life, and variable kinetic behavior. Furthermore, we demonstrate the impact of genetic polymorphisms on ligand binding.
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Affiliation(s)
- Maura Malpetti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal and Gothenburg, Sweden
| | - Matthias Brendel
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
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12
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Steward A, Biel D, Dewenter A, Roemer S, Wagner F, Dehsarvi A, Rathore S, Otero Svaldi D, Higgins I, Brendel M, Dichgans M, Shcherbinin S, Ewers M, Franzmeier N. ApoE4 and Connectivity-Mediated Spreading of Tau Pathology at Lower Amyloid Levels. JAMA Neurol 2023; 80:1295-1306. [PMID: 37930695 PMCID: PMC10628846 DOI: 10.1001/jamaneurol.2023.4038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/16/2023] [Accepted: 09/07/2023] [Indexed: 11/07/2023]
Abstract
Importance For the Alzheimer disease (AD) therapies to effectively attenuate clinical progression, it may be critical to intervene before the onset of amyloid-associated tau spreading, which drives neurodegeneration and cognitive decline. Time points at which amyloid-associated tau spreading accelerates may depend on individual risk factors, such as apolipoprotein E ε4 (ApoE4) carriership, which is linked to faster disease progression; however, the association of ApoE4 with amyloid-related tau spreading is unclear. Objective To assess if ApoE4 carriers show accelerated amyloid-related tau spreading and propose amyloid positron emission tomography (PET) thresholds at which tau spreading accelerates in ApoE4 carriers vs noncarriers. Design, Setting, and Participants This cohort study including combined ApoE genotyping, amyloid PET, and longitudinal tau PET from 2 independent samples: the Alzheimer's Disease Neuroimaging Initiative (ADNI; n = 237; collected from April 2015 to August 2022) and Avid-A05 (n = 130; collected from December 2013 to July 2017) with a mean (SD) tau PET follow-up time of 1.9 (0.96) years in ADNI and 1.4 (0.23) years in Avid-A05. ADNI is an observational multicenter Alzheimer disease neuroimaging initiative and Avid-A05 an observational clinical trial. Participants classified as cognitively normal (152 in ADNI and 77 in Avid-A05) or mildly cognitively impaired (107 in ADNI and 53 in Avid-A05) were selected based on ApoE genotyping, amyloid-PET, and longitudinal tau PET data availability. Participants with ApoE ε2/ε4 genotype or classified as having dementia were excluded. Resting-state functional magnetic resonance imaging connectivity templates were based on 42 healthy participants in ADNI. Main Outcomes and Measures Mediation of amyloid PET on the association between ApoE4 status and subsequent tau PET increase through Braak stage regions and interaction between ApoE4 status and amyloid PET with annual tau PET increase through Braak stage regions and connectivity-based spreading stages (tau epicenter connectivity ranked regions). Results The mean (SD) age was 73.9 (7.35) years among the 237 ADNI participants and 70.2 (9.7) years among the 130 Avid-A05 participants. A total of 107 individuals in ADNI (45.1%) and 45 in Avid-A05 (34.6%) were ApoE4 carriers. Across both samples, we found that higher amyloid PET-mediated ApoE4-related tau PET increased globally (ADNI b, 0.15; 95% CI, 0.05-0.28; P = .001 and Avid-A05 b, 0.33; 95% CI, 0.14-0.54; P < .001) and in earlier Braak regions. Further, we found a significant association between ApoE4 status by amyloid PET interaction and annual tau PET increases consistently through early Braak- and connectivity-based stages where amyloid-related tau accumulation was accelerated in ApoE4carriers vs noncarriers at lower centiloid thresholds, corrected for age and sex. Conclusions and Relevance The findings in this study indicate that amyloid-related tau accumulation was accelerated in ApoE4 carriers at lower amyloid levels, suggesting that ApoE4 may facilitate earlier amyloid-driven tau spreading across connected brain regions. Possible therapeutic implications might be further investigated to determine when best to prevent tau spreading and thus cognitive decline depending on ApoE4 status.
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Affiliation(s)
- Anna Steward
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Sebastian Roemer
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
- Department of Neurology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Fabian Wagner
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Amir Dehsarvi
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | | | | | | | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
| | | | - Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
- German Center for Neurodegenerative Diseases, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden
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13
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Coenen M, Biessels GJ, DeCarli C, Fletcher EF, Maillard PM, Barkhof F, Barnes J, Benke T, Boomsma JMF, P L H Chen C, Dal-Bianco P, Dewenter A, Duering M, Enzinger C, Ewers M, Exalto LG, Franzmeier N, Groeneveld O, Hilal S, Hofer E, Koek HL, Maier AB, McCreary CR, Papma JM, Paterson RW, Pijnenburg YAL, Rubinski A, Schmidt R, Schott JM, Slattery CF, Smith EE, Sudre CH, Steketee RME, van den Berg E, van der Flier WM, Venketasubramanian N, Vernooij MW, Wolters FJ, Xin X, Biesbroek JM, Kuijf HJ. Spatial distributions of white matter hyperintensities on brain MRI: A pooled analysis of individual participant data from 11 memory clinic cohorts. Neuroimage Clin 2023; 40:103547. [PMID: 38035457 PMCID: PMC10698002 DOI: 10.1016/j.nicl.2023.103547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/03/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION The spatial distribution of white matter hyperintensities (WMH) on MRI is often considered in the diagnostic evaluation of patients with cognitive problems. In some patients, clinicians may classify WMH patterns as "unusual", but this is largely based on expert opinion, because detailed quantitative information about WMH distribution frequencies in a memory clinic setting is lacking. Here we report voxel wise 3D WMH distribution frequencies in a large multicenter dataset and also aimed to identify individuals with unusual WMH patterns. METHODS Individual participant data (N = 3525, including 777 participants with subjective cognitive decline, 1389 participants with mild cognitive impairment and 1359 patients with dementia) from eleven memory clinic cohorts, recruited through the Meta VCI Map Consortium, were used. WMH segmentations were provided by participating centers or performed in Utrecht and registered to the Montreal Neurological Institute (MNI)-152 brain template for spatial normalization. To determine WMH distribution frequencies, we calculated WMH probability maps at voxel level. To identify individuals with unusual WMH patterns, region-of-interest (ROI) based WMH probability maps, rule-based scores, and a machine learning method (Local Outlier Factor (LOF)), were implemented. RESULTS WMH occurred in 82% of voxels from the white matter template with large variation between subjects. Only a small proportion of the white matter (1.7%), mainly in the periventricular areas, was affected by WMH in at least 20% of participants. A large portion of the total white matter was affected infrequently. Nevertheless, 93.8% of individual participants had lesions in voxels that were affected in less than 2% of the population, mainly located in subcortical areas. Only the machine learning method effectively identified individuals with unusual patterns, in particular subjects with asymmetric WMH distribution or with WMH at relatively rarely affected locations despite common locations not being affected. DISCUSSION Aggregating data from several memory clinic cohorts, we provide a detailed 3D map of WMH lesion distribution frequencies, that informs on common as well as rare localizations. The use of data-driven analysis with LOF can be used to identify unusual patterns, which might serve as an alert that rare causes of WMH should be considered.
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Affiliation(s)
- Mirthe Coenen
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands.
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, USA
| | - Evan F Fletcher
- Department of Neurology, University of California at Davis, USA
| | | | - Frederik Barkhof
- Radiology & Nuclear Medicine, Amsterdam UMC, Location Vrije Universiteit, the Netherlands; UCL Institute of Neurology, London, UK
| | - Josephine Barnes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Thomas Benke
- Clinic of Neurology, Medical University Innsbruck, Austria
| | - Jooske M F Boomsma
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Christopher P L H Chen
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | | | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany; Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Christian Enzinger
- Division of General Neurology, Department of Neurology, Medical University Graz, Austria; Division of Neuroradiology, Interventional and Vascular Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Lieza G Exalto
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Onno Groeneveld
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands; Department of Neurology, Isala, Meppel, the Netherlands
| | - Saima Hilal
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Edith Hofer
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Austria; Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Austria
| | - Huiberdina L Koek
- Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Andrea B Maier
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore; Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Cheryl R McCreary
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Janne M Papma
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Ross W Paterson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Reinhold Schmidt
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Austria
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Eric E Smith
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Carole H Sudre
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK; Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Rebecca M E Steketee
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Esther van den Berg
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Narayanaswamy Venketasubramanian
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Raffles Neuroscience Center, Raffles Hospital, Singapore, Singapore
| | - Meike W Vernooij
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Frank J Wolters
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Xu Xin
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands; Department of Neurology, Diakonessenhuis Hospital, Utrecht, the Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
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14
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Vlegels N, Gonzalez-Ortiz F, Knuth NL, Khalifeh N, Gesierich B, Müller F, Müller P, Klein M, Dimitriadis K, Franzmeier N, Liebig T, Duering M, Reidler P, Dichgans M, Karikari TK, Blennow K, Tiedt S. Brain-derived Tau for Monitoring Brain Injury in Acute Ischemic Stroke. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.18.23298728. [PMID: 38014197 PMCID: PMC10680879 DOI: 10.1101/2023.11.18.23298728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
The evolution of infarcts varies widely among patients with acute ischemic stroke (IS) and influences treatment decisions. Neuroimaging is not applicable for frequent monitoring and there is no blood-based biomarker to track ongoing brain injury in acute IS. Here, we examined the utility of plasma brain-derived tau (BD-tau) as a biomarker for brain injury in acute IS. We conducted the prospective, observational Precision Medicine in Stroke [PROMISE] study with serial blood sampling upon hospital admission and at days 2, 3, and 7 in patients with acute ischemic stroke (IS) and for comparison, in patients with stroke mimics (SM). We determined the temporal course of plasma BD-tau, its relation to infarct size and admission imaging-based metrics of brain injury, and its value to predict functional outcome. Upon admission (median time-from-onset, 4.4h), BD-tau levels in IS patients correlated with ASPECTS (ρ=-0.21, P<.0001) and were predictive of final infarct volume (ρ=0.26, P<.0001). In contrast to SM patients, BD-tau levels in IS patients increased from admission (median, 2.9 pg/ml [IQR, 1.8-4.8]) to day 2 (median time-from-onset, 22.7h; median BD-tau, 5.0 pg/ml [IQR, 2.6-10.3]; P<.0001). The rate of change of BD-tau from admission to day 2 was significantly associated with collateral supply (R2=0.10, P<.0001) and infarct progression (ρ=0.58, P<.0001). At day 2, BD-tau was predictive of final infarct volume (ρ=0.59, P<.0001) and showed superior value for predicting the 90-day mRS score compared with final infarct volume. In conclusion, in 502 patients with acute IS, plasma BD-tau was associated with imaging-based metrics of brain injury upon admission, increased within the first 24 hours in correlation with infarct progression, and at 24 hours was superior to final infarct volume in predicting 90-day functional outcome. Further research is needed to determine whether BD-tau assessments can inform decision-making in stroke care.
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Affiliation(s)
- Naomi Vlegels
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Germany
| | - Fernando Gonzalez-Ortiz
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Nicoló Luca Knuth
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Germany
| | - Nada Khalifeh
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Germany
| | - Benno Gesierich
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Germany
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Franziska Müller
- Department of Radiology, LMU University Hospital, LMU Munich, Germany
| | - Philipp Müller
- Department of Radiology, LMU University Hospital, LMU Munich, Germany
| | - Matthias Klein
- Department of Neurology, LMU University Hospital, LMU Munich, Germany
| | | | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Germany
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Thomas Liebig
- Institute of Neuroradiology, LMU University Hospital, LMU Munich, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Germany
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Paul Reidler
- Department of Radiology, LMU University Hospital, LMU Munich, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany
- German Centre for Cardiovascular Research (DZHK, Munich), Munich, Germany
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Steffen Tiedt
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Germany
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15
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Finze A, Biechele G, Rauchmann BS, Franzmeier N, Palleis C, Katzdobler S, Weidinger E, Guersel S, Schuster S, Harris S, Schmitt J, Beyer L, Gnörich J, Lindner S, Albert NL, Wetzel CH, Rupprecht R, Rominger A, Danek A, Burow L, Kurz C, Tato M, Utecht J, Papazov B, Zaganjori M, Trappmann LK, Goldhardt O, Grimmer T, Haeckert J, Janowitz D, Buerger K, Keeser D, Stoecklein S, Dietrich O, Morenas-Rodriguez E, Barthel H, Sabri O, Bartenstein P, Simons M, Haass C, Höglinger GU, Levin J, Perneczky R, Brendel M. Individual regional associations between Aβ-, tau- and neurodegeneration (ATN) with microglial activation in patients with primary and secondary tauopathies. Mol Psychiatry 2023; 28:4438-4450. [PMID: 37495886 PMCID: PMC10827660 DOI: 10.1038/s41380-023-02188-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 07/28/2023]
Abstract
β-amyloid (Aβ) and tau aggregation as well as neuronal injury and atrophy (ATN) are the major hallmarks of Alzheimer's disease (AD), and biomarkers for these hallmarks have been linked to neuroinflammation. However, the detailed regional associations of these biomarkers with microglial activation in individual patients remain to be elucidated. We investigated a cohort of 55 patients with AD and primary tauopathies and 10 healthy controls that underwent TSPO-, Aβ-, tau-, and perfusion-surrogate-PET, as well as structural MRI. Z-score deviations for 246 brain regions were calculated and biomarker contributions of Aβ (A), tau (T), perfusion (N1), and gray matter atrophy (N2) to microglial activation (TSPO, I) were calculated for each individual subject. Individual ATN-related microglial activation was correlated with clinical performance and CSF soluble TREM2 (sTREM2) concentrations. In typical and atypical AD, regional tau was stronger and more frequently associated with microglial activation when compared to regional Aβ (AD: βT = 0.412 ± 0.196 vs. βA = 0.142 ± 0.123, p < 0.001; AD-CBS: βT = 0.385 ± 0.176 vs. βA = 0.131 ± 0.186, p = 0.031). The strong association between regional tau and microglia reproduced well in primary tauopathies (βT = 0.418 ± 0.154). Stronger individual associations between tau and microglial activation were associated with poorer clinical performance. In patients with 4RT, sTREM2 levels showed a positive association with tau-related microglial activation. Tau pathology has strong regional associations with microglial activation in primary and secondary tauopathies. Tau and Aβ related microglial response indices may serve as a two-dimensional in vivo assessment of neuroinflammation in neurodegenerative diseases.
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Grants
- EXC 2145 SyNergy - ID 390857198 Deutsche Forschungsgemeinschaft (German Research Foundation)
- EXC 2155 - project number 39087428 Deutsche Forschungsgemeinschaft (German Research Foundation)
- HO2402/18-1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- FOR-2858 project numbers 403161218, 421887978 and 422188432 Deutsche Forschungsgemeinschaft (German Research Foundation)
- 19063p Alzheimer Forschung Initiative (Alzheimer Forschung Initiative e.V.)
- GUH was additionally funded by the German Federal Ministry of Education and Research (BMBF, 01KU1403A EpiPD; 01EK1605A HitTau; 01DH18025 TauTherapy); European Joint Programme on Rare Diseases (Improve-PSP); VolkswagenStiftung (Niedersächsisches Vorab); Petermax-Müller Foundation (Etiology and Therapy of Synucleinopathies and Tauopathies). The Lüneburg Heritage and Friedrich-Baur-Stiftung have supported the work of CP. The Hirnliga e.V. supported recruitment and imaging of the ActiGliA cohort (Manfred-Strohscheer-Stiftung) by a grant to BSR and MB.
- TG received consulting fees from AbbVie, Alector, Anavex, Biogen, Eli Lilly, Functional Neuromodulation, Grifols, Iqvia, Noselab, Novo Nordisk, NuiCare, Orphanzyme, Roche Diagnostics, Roche Pharma, UCB, and Vivoryon; lecture fees from Grifols, Medical Tribune, Novo Nordisk, Roche Pharma, and Schwabe; and has received grants to his institution from Roche Diagnostics.
- CH collaborates with Denali Therapeutics. CH is chief advisor of ISAR Bioscience and a member of the advisory board of AviadoBio.
- Günter Höglinger participated in industry-sponsored research projects from Abbvie, Biogen, Biohaven, Novartis, Roche, Sanofi, UCB; serves as a consultant for Abbvie, Alzprotect, Aprineua, Asceneuron, Bial, Biogen, Biohaven, Kyowa Kirin, Lundbeck, Novartis, Retrotope, Roche, Sanofi, UCB; received honoraria for scientific presentations from Abbvie, Bayer Vital, Bial, Biogen, Bristol Myers Squibb, Kyowa Kirin, Roche, Teva, UCB, Zambon; holds a patent on Treatment of Synucleinopathies. United States Patent No.: US 10,918,628 B2: EP 17 787 904.6-1109 / 3 525 788; received publication royalties from Academic Press, Kohlhammer, and Thieme.
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Affiliation(s)
- Anika Finze
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Gloria Biechele
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), LMU University Hospital, LMU Munich, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Carla Palleis
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sabrina Katzdobler
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Endy Weidinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Selim Guersel
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sebastian Schuster
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Stefanie Harris
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Julia Schmitt
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Johannes Gnörich
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Simon Lindner
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Christian H Wetzel
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Nuclear Medicine, University Hospital, Inselspital Bern, Bern, Switzerland
| | - Adrian Danek
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lena Burow
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Carolin Kurz
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Maia Tato
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Julia Utecht
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Boris Papazov
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), LMU University Hospital, LMU Munich, Munich, Germany
| | - Mirlind Zaganjori
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lena-Katharina Trappmann
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Oliver Goldhardt
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Jan Haeckert
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | | | | | - Daniel Keeser
- NeuroImaging Core Unit Munich (NICUM), LMU University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sophia Stoecklein
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Olaf Dietrich
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Mikael Simons
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institute of Neuronal Cell Biology, Technical University of Munich, Munich, Germany
| | - Christian Haass
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Chair of Metabolic Biochemistry, Biomedical Center (BMC), Faculty of Medicine, LMU Munich, Munich, Germany
| | - Günter U Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Johannes Levin
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Robert Perneczky
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
- Sheffield Institute for Translational Neurosciences (SITraN), University of Sheffield, Sheffield, UK
| | - Matthias Brendel
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
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16
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Vogel JW, Corriveau-Lecavalier N, Franzmeier N, Pereira JB, Brown JA, Maass A, Botha H, Seeley WW, Bassett DS, Jones DT, Ewers M. Connectome-based modelling of neurodegenerative diseases: towards precision medicine and mechanistic insight. Nat Rev Neurosci 2023; 24:620-639. [PMID: 37620599 DOI: 10.1038/s41583-023-00731-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/26/2023]
Abstract
Neurodegenerative diseases are the most common cause of dementia. Although their underlying molecular pathologies have been identified, there is substantial heterogeneity in the patterns of progressive brain alterations across and within these diseases. Recent advances in neuroimaging methods have revealed that pathological proteins accumulate along specific macroscale brain networks, implicating the network architecture of the brain in the system-level pathophysiology of neurodegenerative diseases. However, the extent to which 'network-based neurodegeneration' applies across the wide range of neurodegenerative disorders remains unclear. Here, we discuss the state-of-the-art of neuroimaging-based connectomics for the mapping and prediction of neurodegenerative processes. We review findings supporting brain networks as passive conduits through which pathological proteins spread. As an alternative view, we also discuss complementary work suggesting that network alterations actively modulate the spreading of pathological proteins between connected brain regions. We conclude this Perspective by proposing an integrative framework in which connectome-based models can be advanced along three dimensions of innovation: incorporating parameters that modulate propagation behaviour on the basis of measurable biological features; building patient-tailored models that use individual-level information and allowing model parameters to interact dynamically over time. We discuss promises and pitfalls of these strategies for improving disease insights and moving towards precision medicine.
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Affiliation(s)
- Jacob W Vogel
- Department of Clinical Sciences, SciLifeLab, Lund University, Lund, Sweden.
| | - Nick Corriveau-Lecavalier
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Acadamy, University of Gothenburg, Mölndal and Gothenburg, Sweden
| | - Joana B Pereira
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Neuro Division, Department of Clinical Neurosciences, Karolinska Institute, Stockholm, Sweden
| | - Jesse A Brown
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Anne Maass
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, CA, USA
| | - Dani S Bassett
- Departments of Bioengineering, Electrical and Systems Engineering, Physics and Astronomy, Neurology and Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Santa Fe Institute, Santa Fe, NM, USA
| | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.
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17
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Kolabas ZI, Kuemmerle LB, Perneczky R, Förstera B, Ulukaya S, Ali M, Kapoor S, Bartos LM, Büttner M, Caliskan OS, Rong Z, Mai H, Höher L, Jeridi D, Molbay M, Khalin I, Deligiannis IK, Negwer M, Roberts K, Simats A, Carofiglio O, Todorov MI, Horvath I, Ozturk F, Hummel S, Biechele G, Zatcepin A, Unterrainer M, Gnörich J, Roodselaar J, Shrouder J, Khosravani P, Tast B, Richter L, Díaz-Marugán L, Kaltenecker D, Lux L, Chen Y, Zhao S, Rauchmann BS, Sterr M, Kunze I, Stanic K, Kan VWY, Besson-Girard S, Katzdobler S, Palleis C, Schädler J, Paetzold JC, Liebscher S, Hauser AE, Gokce O, Lickert H, Steinke H, Benakis C, Braun C, Martinez-Jimenez CP, Buerger K, Albert NL, Höglinger G, Levin J, Haass C, Kopczak A, Dichgans M, Havla J, Kümpfel T, Kerschensteiner M, Schifferer M, Simons M, Liesz A, Krahmer N, Bayraktar OA, Franzmeier N, Plesnila N, Erener S, Puelles VG, Delbridge C, Bhatia HS, Hellal F, Elsner M, Bechmann I, Ondruschka B, Brendel M, Theis FJ, Erturk A. Distinct molecular profiles of skull bone marrow in health and neurological disorders. Cell 2023; 186:3706-3725.e29. [PMID: 37562402 PMCID: PMC10443631 DOI: 10.1016/j.cell.2023.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/24/2023] [Accepted: 07/07/2023] [Indexed: 08/12/2023]
Abstract
The bone marrow in the skull is important for shaping immune responses in the brain and meninges, but its molecular makeup among bones and relevance in human diseases remain unclear. Here, we show that the mouse skull has the most distinct transcriptomic profile compared with other bones in states of health and injury, characterized by a late-stage neutrophil phenotype. In humans, proteome analysis reveals that the skull marrow is the most distinct, with differentially expressed neutrophil-related pathways and a unique synaptic protein signature. 3D imaging demonstrates the structural and cellular details of human skull-meninges connections (SMCs) compared with veins. Last, using translocator protein positron emission tomography (TSPO-PET) imaging, we show that the skull bone marrow reflects inflammatory brain responses with a disease-specific spatial distribution in patients with various neurological disorders. The unique molecular profile and anatomical and functional connections of the skull show its potential as a site for diagnosing, monitoring, and treating brain diseases.
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Affiliation(s)
- Zeynep Ilgin Kolabas
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany; Graduate School of Systemic Neurosciences (GSN), Munich, Germany
| | - Louis B Kuemmerle
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Institute of Computational Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Robert Perneczky
- Division of Mental Health in Older Adults and Alzheimer Therapy and Research Center, Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University Munich, 80336 Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Benjamin Förstera
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Selin Ulukaya
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany
| | - Mayar Ali
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Graduate School of Systemic Neurosciences (GSN), Munich, Germany; Institute of Computational Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Saketh Kapoor
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany
| | - Laura M Bartos
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Maren Büttner
- Institute of Computational Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Ozum Sehnaz Caliskan
- Institute for Diabetes and Obesity, Helmholtz Center Munich and German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Zhouyi Rong
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany; Munich Medical Research School (MMRS), 80336 Munich, Germany
| | - Hongcheng Mai
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany; Munich Medical Research School (MMRS), 80336 Munich, Germany
| | - Luciano Höher
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany
| | - Denise Jeridi
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany
| | - Muge Molbay
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany
| | - Igor Khalin
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | | | - Moritz Negwer
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany
| | | | - Alba Simats
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Olga Carofiglio
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Mihail I Todorov
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Izabela Horvath
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; School of Computation, Information and Technology (CIT), TUM, Boltzmannstr. 3, 85748 Garching, Germany
| | - Furkan Ozturk
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany
| | - Selina Hummel
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Gloria Biechele
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Artem Zatcepin
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Marcus Unterrainer
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany; Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Johannes Gnörich
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Jay Roodselaar
- Charité - Universitätsmedizin Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; Immune Dynamics, Deutsches Rheuma-Forschungszentrum (DRFZ), a Leibniz Institute, Berlin, Germany
| | - Joshua Shrouder
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Pardis Khosravani
- Biomedical Center (BMC), Core Facility Flow Cytometry, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Benjamin Tast
- Biomedical Center (BMC), Core Facility Flow Cytometry, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Lisa Richter
- Biomedical Center (BMC), Core Facility Flow Cytometry, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Laura Díaz-Marugán
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Doris Kaltenecker
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Institute for Diabetes and Cancer, Helmholtz Munich, Munich, Germany
| | - Laurin Lux
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany
| | - Ying Chen
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Shan Zhao
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Division of Mental Health in Older Adults and Alzheimer Therapy and Research Center, Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University Munich, 80336 Munich, Germany; Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK; Institute of Neuroradiology, University Hospital LMU, Munich, Germany
| | - Michael Sterr
- Institute of Diabetes and Regeneration Research, Helmholtz Diabetes Center, Helmholtz Zentrum München, Neuherberg, Germany; Institute of Stem Cell Research, Helmholtz Zentrum München, Neuherberg, Germany
| | - Ines Kunze
- Institute of Diabetes and Regeneration Research, Helmholtz Diabetes Center, Helmholtz Zentrum München, Neuherberg, Germany; Institute of Stem Cell Research, Helmholtz Zentrum München, Neuherberg, Germany
| | - Karen Stanic
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Vanessa W Y Kan
- Institute of Clinical Neuroimmunology, University Hospital Munich, Ludwig-Maximilians University Munich, Munich, Germany
| | - Simon Besson-Girard
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany; Graduate School of Systemic Neurosciences (GSN), Munich, Germany
| | - Sabrina Katzdobler
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Carla Palleis
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Julia Schädler
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johannes C Paetzold
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Department of Computing, Imperial College London, London, UK
| | - Sabine Liebscher
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Institute of Clinical Neuroimmunology, University Hospital Munich, Ludwig-Maximilians University Munich, Munich, Germany; Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians Universität Munich, Munich, Germany
| | - Anja E Hauser
- Charité - Universitätsmedizin Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany; Immune Dynamics, Deutsches Rheuma-Forschungszentrum (DRFZ), a Leibniz Institute, Berlin, Germany
| | - Ozgun Gokce
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Heiko Lickert
- Institute of Diabetes and Regeneration Research, Helmholtz Diabetes Center, Helmholtz Zentrum München, Neuherberg, Germany; Institute of Stem Cell Research, Helmholtz Zentrum München, Neuherberg, Germany; TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Hanno Steinke
- Institute of Anatomy, University of Leipzig, 04109 Leipzig, Germany
| | - Corinne Benakis
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Christian Braun
- Institute of Legal Medicine, Faculty of Medicine, LMU Munich, Germany
| | - Celia P Martinez-Jimenez
- Helmholtz Pioneer Campus (HPC), Helmholtz Munich, Neuherberg, Germany; TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Günter Höglinger
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christian Haass
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Metabolic Biochemistry, Biomedical Center (BMC), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Anna Kopczak
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Joachim Havla
- Institute of Clinical Neuroimmunology, University Hospital Munich, Ludwig-Maximilians University Munich, Munich, Germany; Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians Universität Munich, Munich, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, University Hospital Munich, Ludwig-Maximilians University Munich, Munich, Germany; Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians Universität Munich, Munich, Germany
| | - Martin Kerschensteiner
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Institute of Clinical Neuroimmunology, University Hospital Munich, Ludwig-Maximilians University Munich, Munich, Germany; Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians Universität Munich, Munich, Germany
| | - Martina Schifferer
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Mikael Simons
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Arthur Liesz
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany; Graduate School of Systemic Neurosciences (GSN), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Natalie Krahmer
- Institute for Diabetes and Obesity, Helmholtz Center Munich and German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | | | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Nikolaus Plesnila
- Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Suheda Erener
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany
| | - Victor G Puelles
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Hamburg Center for Kidney Health (HCKH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Claire Delbridge
- Institute of Pathology, Department of Neuropathology, Technical University Munich, TUM School of Medicine, Munich, Germany
| | - Harsharan Singh Bhatia
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Farida Hellal
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Markus Elsner
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany
| | - Ingo Bechmann
- Institute of Anatomy, University of Leipzig, 04109 Leipzig, Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Brendel
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Fabian J Theis
- Institute of Computational Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Department of Mathematics, Technische Universität München, Garching bei München, Germany
| | - Ali Erturk
- Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Center, Neuherberg, Munich, Germany; Institute for Stroke and Dementia Research, LMU University Hospital, Ludwig-Maximilians University Munich, Munich, Germany; Graduate School of Systemic Neurosciences (GSN), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
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18
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Coenen M, Kuijf HJ, Huenges Wajer IMC, Duering M, Wolters FJ, Fletcher EF, Maillard PM, Barkhof F, Barnes J, Benke T, Boomsma JMF, Chen CPLH, Dal-Bianco P, Dewenter A, Enzinger C, Ewers M, Exalto LG, Franzmeier N, Groeneveld O, Hilal S, Hofer E, Koek DL, Maier AB, McCreary CR, Padilla CS, Papma JM, Paterson RW, Pijnenburg YAL, Rubinski A, Schmidt R, Schott JM, Slattery CF, Smith EE, Steketee RME, Sudre CH, van den Berg E, van der Flier WM, Venketasubramanian N, Vernooij MW, Xin X, DeCarli C, Biessels GJ, Biesbroek JM. Strategic white matter hyperintensity locations for cognitive impairment: A multicenter lesion-symptom mapping study in 3525 memory clinic patients. Alzheimers Dement 2023; 19:2420-2432. [PMID: 36504357 DOI: 10.1002/alz.12827] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 04/19/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Impact of white matter hyperintensities (WMH) on cognition likely depends on lesion location, but a comprehensive map of strategic locations is lacking. We aimed to identify these locations in a large multicenter study. METHODS Individual patient data (n = 3525) from 11 memory clinic cohorts were harmonized. We determined the association of WMH location with attention and executive functioning, information processing speed, language, and verbal memory performance using voxel-based and region of interest tract-based analyses. RESULTS WMH in the left and right anterior thalamic radiation, forceps major, and left inferior fronto-occipital fasciculus were significantly related to domain-specific impairment, independent of total WMH volume and atrophy. A strategic WMH score based on these tracts inversely correlated with performance in all domains. DISCUSSION The data show that the impact of WMH on cognition is location-dependent, primarily involving four strategic white matter tracts. Evaluation of WMH location may support diagnosing vascular cognitive impairment. HIGHLIGHTS We analyzed white matter hyperintensities (WMH) in 3525 memory clinic patients from 11 cohorts The impact of WMH on cognition depends on location We identified four strategic white matter tracts A single strategic WMH score was derived from these four strategic tracts The strategic WMH score was an independent determinant of four cognitive domains.
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Affiliation(s)
- Mirthe Coenen
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Irene M C Huenges Wajer
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Frank J Wolters
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Evan F Fletcher
- Department of Neurology, University of California at Davis, Davis, California, USA
| | - Pauline M Maillard
- Department of Neurology, University of California at Davis, Davis, California, USA
| | - Frederik Barkhof
- Radiology & Nuclear Medicine, Amsterdam UMC, location Vrije Universiteit, Amsterdam, The Netherlands
- UCL Institute of Neurology, London, UK
| | - Josephine Barnes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Thomas Benke
- Clinic of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Jooske M F Boomsma
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Christopher P L H Chen
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - Peter Dal-Bianco
- Department of Neurology, Medical University Vienna, Vienna, Austria
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Christian Enzinger
- Division of General Neurology, Department of Neurology, Medical University Graz, Graz, Austria
- Division of Neuroradiology, Interventional and Vascular Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Lieza G Exalto
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Onno Groeneveld
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
- Department of Neurology, Isala MS Centre, Isala Hospital, Meppel, The Netherlands
| | - Saima Hilal
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Edith Hofer
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Dineke L Koek
- Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Andrea B Maier
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
- Department of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheryl R McCreary
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Catarina S Padilla
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
| | - Janne M Papma
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Ross W Paterson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Reinhold Schmidt
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Eric E Smith
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Rebecca M E Steketee
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Carole H Sudre
- MRC Unit for Lifelong Health and Ageing, the Centre for Medical Image Computing, UCL, London, UK
| | - Esther van den Berg
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Narayanaswamy Venketasubramanian
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
- Raffles Neuroscience Center, Raffles Hospital, Singapore, Singapore
| | - Meike W Vernooij
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Xu Xin
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, Davis, California, USA
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
- Department of Neurology, Diakonessenhuis Hospital, Utrecht, The Netherlands
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19
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Schönecker S, Palleis C, Franzmeier N, Katzdobler S, Ferschmann C, Schuster S, Finze A, Scheifele M, Prix C, Fietzek U, Weidinger E, Nübling G, Vöglein J, Patt M, Barthel H, Sabri O, Danek A, Höglinger GU, Brendel M, Levin J. Symptomatology in 4-repeat tauopathies is associated with data-driven topology of [ 18F]-PI-2620 tau-PET signal. Neuroimage Clin 2023; 38:103402. [PMID: 37087820 PMCID: PMC10300609 DOI: 10.1016/j.nicl.2023.103402] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/06/2022] [Revised: 03/05/2023] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
In recent years in vivo visualization of tau deposits has become possible with various PET radiotracers. The tau tracer [18F]PI-2620 proved high affinity both to 3-repeat/4-repeat tau in Alzheimer's disease as well as to 4-repeat tau in progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). However, to be clinically relevant, biomarkers should not only correlate with pathological changes but also with disease stage and progression. Therefore, we aimed to investigate the correlation between topology of [18F]PI-2620 uptake and symptomatology in 4-repeat tauopathies. 72 patients with possible or probable 4-repeat tauopathy, i.e. 31 patients with PSP-Richardson's syndrome (PSP-RS), 30 with amyloid-negative CBS and 11 with PSP-non-RS/CBS, underwent [18F]PI-2620-PET. Principal component analysis was performed to identify groups of similar brain regions based on 20-40 min p.i. regional standardized uptake value ratio z-scores. Correlations between component scores and the items of the PSP Rating Scale were explored. Motor signs like gait, arising from chair and postural instability showed a positive correlation with tracer uptake in mesial frontoparietal lobes and the medial superior frontal gyrus and adjacent anterior cingulate cortex. While the signs disorientation and bradyphrenia showed a positive correlation with tracer uptake in the parietooccipital junction, the signs disorientation and arising from chair were negatively correlated with tau-PET signal in the caudate nucleus and thalamus. Total PSP Rating Scale Score showed a trend towards a positive correlation with mesial frontoparietal lobes and a negative correlation with caudate nucleus and thalamus. While in CBS patients, the main finding was a negative correlation of tracer binding in the caudate nucleus and thalamus and a positive correlation of tracer binding in medial frontal cortex with gait and motor signs, in PSP-RS patients various correlations of clinical signs with tracer binding in specific cerebral regions could be detected. Our data reveal [18F]PI-2620 tau-PET topology to correlate with symptomatology in 4-repeat tauopathies. Longitudinal studies will be needed to address whether a deterioration of signs and symptoms over time can be monitored by [18F]PI-2620 in 4-repeat tauopathies and whether [18F]PI-2620 may serve as a marker of disease progression in future therapeutic trials. The detected negative correlation of tracer binding in the caudate nucleus and thalamus with the signs disorientation and arising from chair may be due to an increasing atrophy in these regions leading to partial volume effects and a relative decrease of tracer uptake in the disease course. As cerebral regions correlating with symptomatology differ depending on the clinical phenotype, a precise knowledge of clinical signs and symptoms is necessary when interpreting [18F]PI-2620 PET results.
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Affiliation(s)
- Sonja Schönecker
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Carla Palleis
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Nicolai Franzmeier
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Institute for Stroke and Dementia Research, Ludwig-Maximilians-Universität München, LMU München, Munich, Germany
| | - Sabrina Katzdobler
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Christian Ferschmann
- Department of Nuclear Medicine, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Sebastian Schuster
- Department of Nuclear Medicine, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Anika Finze
- Department of Nuclear Medicine, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Catharina Prix
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Urban Fietzek
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Department of Neurology and Clinical Neurophysiology, Schön Klinik München Schwabing, Munich, Germany
| | - Endy Weidinger
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Georg Nübling
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Jonathan Vöglein
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Günter U Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; European Reference Network for Rare Neurological Diseases (ERN-RND), Munich, Germany; Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Matthias Brendel
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Department of Nuclear Medicine, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; European Reference Network for Rare Neurological Diseases (ERN-RND), Munich, Germany.
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20
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Völter F, Beyer L, Eckenweber F, Scheifele M, Bui N, Patt M, Barthel H, Katzdobler S, Palleis C, Franzmeier N, Levin J, Perneczky R, Rauchmann BS, Sabri O, Hong J, Cumming P, Rominger A, Shi K, Bartenstein P, Brendel M. Assessment of perfusion deficit with early phases of [ 18F]PI-2620 tau-PET versus [ 18F]flutemetamol-amyloid-PET recordings. Eur J Nucl Med Mol Imaging 2023; 50:1384-1394. [PMID: 36572740 PMCID: PMC10027797 DOI: 10.1007/s00259-022-06087-y] [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: 08/24/2022] [Accepted: 12/11/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE Characteristic features of amyloid-PET (A), tau-PET (T), and FDG-PET (N) can serve for the A/T/N classification of neurodegenerative diseases. Recent studies showed that the early, perfusion-weighted phases of amyloid- or tau-PET recordings serve to detect cerebrometabolic deficits equally to FDG-PET, therefore providing a surrogate of neuronal injury. As such, two channels of diagnostic information can be obtained in the setting of a single PET scan. However, there has hitherto been no comparison of early-phase amyloid- and tau-PET as surrogates for deficits in perfusion/metabolism. Therefore, we undertook to compare [18F]flutemetamol-amyloid-PET and [18F]PI-2620 tau-PET as "one-stop shop" dual purpose tracers for the detection of neurodegenerative disease. METHODS We obtained early-phase PET recordings with [18F]PI-2620 (0.5-2.5 min p.i.) and [18F]flutemetamol (0-10 min p.i.) in 64 patients with suspected neurodegenerative disease. We contrasted global mean normalized images (SUVr) in the patients with a normal cohort of 15 volunteers without evidence of increased pathology to β-amyloid- and tau-PET examinations. Regional group differences of tracer uptake (z-scores) of 246 Brainnetome volumes of interest were calculated for both tracers, and the correlations of the z-scores were evaluated using Pearson's correlation coefficient. Lobar compartments, regions with significant neuronal injury (z-scores < - 3), and patients with different neurodegenerative disease entities (e.g., Alzheimer's disease or 4R-tauopathies) served for subgroup analysis. Additionally, we used partial regression to correlate regional perfusion alterations with clinical scores in cognition tests. RESULTS The z-scores of perfusion-weighted images of both tracers showed high correlations across the brain, especially in the frontal and parietal lobes, which were the brain regions with pronounced perfusion deficit in the patient group (R = 0.83 ± 0.08; range, 0.61-0.95). Z-scores of individual patients correlated well by region (R = 0.57 ± 0.15; range, 0.16-0.90), notably when significant perfusion deficits were present (R = 0.66 ± 0.15; range, 0.28-0.90). CONCLUSION The early perfusion phases of [18F]PI-2620 tau- and [18F]flutemetamol-amyloid-PET are roughly equivalent indices of perfusion defect indicative of regional and lobar neuronal injury in patients with various neurodegenerative diseases. As such, either tracer may serve for two diagnostic channels by assessment of amyloid/tau status and neuronal activity.
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Affiliation(s)
- Friederike Völter
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Florian Eckenweber
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Maximilian Scheifele
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Ngoc Bui
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Sabrina Katzdobler
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Carla Palleis
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | | | - Johannes Levin
- Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | | | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Jimin Hong
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Paul Cumming
- Department of Nuclear Medicine, Bern University Hospital, Bern, Switzerland
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Axel Rominger
- Department of Nuclear Medicine, Bern University Hospital, Bern, Switzerland
| | - Kuangyu Shi
- Department of Nuclear Medicine, Bern University Hospital, Bern, Switzerland
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
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21
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Vöglein J, Franzmeier N, Morris JC, Dieterich M, McDade E, Simons M, Preische O, Hofmann A, Hassenstab J, Benzinger TL, Fagan A, Noble JM, Berman SB, Graff-Radford NR, Ghetti B, Farlow MR, Chhatwal JP, Salloway S, Xiong C, Karch CM, Cairns N, Perrin RJ, Day G, Martins R, Sanchez-Valle R, Mori H, Shimada H, Ikeuchi T, Suzuki K, Schofield PR, Masters CL, Goate A, Buckles V, Fox NC, Chrem P, Allegri R, Ringman JM, Yakushev I, Laske C, Jucker M, Höglinger G, Bateman RJ, Danek A, Levin J. Pattern and implications of neurological examination findings in autosomal dominant Alzheimer disease. Alzheimers Dement 2023; 19:632-645. [PMID: 35609137 PMCID: PMC9684350 DOI: 10.1002/alz.12684] [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: 09/21/2021] [Revised: 03/21/2022] [Accepted: 03/27/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION As knowledge about neurological examination findings in autosomal dominant Alzheimer disease (ADAD) is incomplete, we aimed to determine the frequency and significance of neurological examination findings in ADAD. METHODS Frequencies of neurological examination findings were compared between symptomatic mutation carriers and non mutation carriers from the Dominantly Inherited Alzheimer Network (DIAN) to define AD neurological examination findings. AD neurological examination findings were analyzed regarding frequency, association with and predictive value regarding cognitive decline, and association with brain atrophy in symptomatic mutation carriers. RESULTS AD neurological examination findings included abnormal deep tendon reflexes, gait disturbance, pathological cranial nerve examination findings, tremor, abnormal finger to nose and heel to shin testing, and compromised motor strength. The frequency of AD neurological examination findings was 65.1%. Cross-sectionally, mutation carriers with AD neurological examination findings showed a more than two-fold faster cognitive decline and had greater parieto-temporal atrophy, including hippocampal atrophy. Longitudinally, AD neurological examination findings predicted a significantly greater decline over time. DISCUSSION ADAD features a distinct pattern of neurological examination findings that is useful to estimate prognosis and may inform clinical care and therapeutic trial designs.
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Affiliation(s)
- Jonathan Vöglein
- Department of Neurology, Ludwig-Maximilians-Universität München, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Ludwig-Maximilians-Universität München, Germany
| | - John C. Morris
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Marianne Dieterich
- Department of Neurology, Ludwig-Maximilians-Universität München, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Germany
| | - Eric McDade
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Mikael Simons
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Oliver Preische
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Anna Hofmann
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Jason Hassenstab
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Tammie L. Benzinger
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Anne Fagan
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - James M. Noble
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, and Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, 710 West 168 Street Box 176, New York, NY 10032, USA
| | - Sarah B. Berman
- University of Pittsburgh, 3471 Fifth Ave #900, Pittsburgh, PA 15213, USA
| | | | | | - Martin R. Farlow
- Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Jasmeer P. Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Stephen Salloway
- Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Celeste M. Karch
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Nigel Cairns
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
- Medical School and Living Systems Institute, University of Exeter, Stocker Road, Exeter, EX4 4QD, United Kingdom
| | - Richard J. Perrin
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Gregory Day
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Ralph Martins
- Edith Cowan University, 270 Joondalup Drive, Joondalup WA 6027, Australia
| | - Raquel Sanchez-Valle
- Alzheimer’s disease and other cognitive disorders group. Service of Neurology, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Hiroshi Mori
- Osaka City University Medical School, Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Hiroyuki Shimada
- Osaka City University Medical School, Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Takeshi Ikeuchi
- Brain Research Institute, Niigata University, 1-757 Asahimachi, Niigata 951-8585, Japan
| | | | - Peter R. Schofield
- Neuroscience Research Australia, Sydney 2031 Australia
- School of Medical Sciences, University of New South Wales, Sydney 2052 Australia
| | - Colin L. Masters
- Florey Institute, University of Melbourne, Level 5, Kenneth Myer Building, 30 Royal Parade, Parkville, Victoria, 3010, Australia
| | - Alison Goate
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave, B1065, New York, NY 10029,USA
| | - Virginia Buckles
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Nick C. Fox
- Dementia Research Centre, Institute of Neurology, University College London, Queen Square, London WC1 3BG United Kingdom
| | | | | | - John M. Ringman
- Keck School of Medicine of University of Southern California, Center for the Health Professionals, 1540 Alcazar Street, Suite 209F, Los Angeles, CA 90089, USA
| | - Igor Yakushev
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, 72076 Tübingen, Germany
| | - Mathias Jucker
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Günter Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Neurology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Randall J. Bateman
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians-Universität München, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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22
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Biel D, Suárez‐Calvet M, Hager P, Rubinski A, Dewenter A, Steward A, Roemer S, Ewers M, Haass C, Brendel M, Franzmeier N. sTREM2 is associated with amyloid-related p-tau increases and glucose hypermetabolism in Alzheimer's disease. EMBO Mol Med 2023; 15:e16987. [PMID: 36620941 PMCID: PMC9906389 DOI: 10.15252/emmm.202216987] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 01/10/2023] Open
Abstract
Microglial activation occurs early in Alzheimer's disease (AD) and previous studies reported both detrimental and protective effects of microglia on AD progression. Here, we used CSF sTREM2 to investigate disease stage-dependent drivers of microglial activation and to determine downstream consequences on AD progression. We included 402 patients with measures of earliest beta-amyloid (CSF Aβ1-42 ) and late-stage fibrillary Aβ pathology (amyloid-PET centiloid), as well as sTREM2, p-tau181 , and FDG-PET. To determine disease stage, we stratified participants into early Aβ-accumulators (Aβ CSF+/PET-; n = 70) or late Aβ-accumulators (Aβ CSF+/PET+; n = 201) plus 131 controls. In early Aβ-accumulators, higher centiloid was associated with cross-sectional/longitudinal sTREM2 and p-tau181 increases. Further, higher sTREM2 mediated the association between centiloid and cross-sectional/longitudinal p-tau181 increases and higher sTREM2 was associated with FDG-PET hypermetabolism. In late Aβ-accumulators, we found no association between centiloid and sTREM2 but a cross-sectional association between higher sTREM2, higher p-tau181 and glucose hypometabolism. Our findings suggest that a TREM2-related microglial response follows earliest Aβ fibrillization, manifests in inflammatory glucose hypermetabolism and may facilitate subsequent p-tau181 increases in earliest AD.
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Affiliation(s)
- Davina Biel
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany
| | - Marc Suárez‐Calvet
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain,IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain,Servei de NeurologiaHospital del MarBarcelonaSpain,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
| | - Paul Hager
- Institute of Radiology and Artificial Intelligence and Informatics in MedicineTU MunichMunichGermany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany
| | - Anna Steward
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany
| | - Sebastian Roemer
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany,Department of Neurology, University HospitalLMU MunichMunichGermany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany,German Center for Neurodegenerative Diseases (DZNE)MunichGermany
| | - Christian Haass
- German Center for Neurodegenerative Diseases (DZNE)MunichGermany,Munich Cluster for Systems Neurology (SyNergy)MunichGermany,Chair of Metabolic Biochemistry, Biomedical Center (BMC), Faculty of MedicineLMU MunichMunichGermany
| | - Matthias Brendel
- German Center for Neurodegenerative Diseases (DZNE)MunichGermany,Munich Cluster for Systems Neurology (SyNergy)MunichGermany,Department of Nuclear Medicine, University HospitalLMU MunichMunichGermany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany,Munich Cluster for Systems Neurology (SyNergy)MunichGermany,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska AcademyUniversity of GothenburgGothenburgGermany
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23
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Katzdobler S, Nitschmann A, Barthel H, Bischof G, Beyer L, Marek K, Song M, Wagemann O, Palleis C, Weidinger E, Nack A, Fietzek U, Kurz C, Häckert J, Stapf T, Ferschmann C, Scheifele M, Eckenweber F, Biechele G, Franzmeier N, Dewenter A, Schönecker S, Saur D, Schroeter ML, Rumpf JJ, Rullmann M, Schildan A, Patt M, Stephens AW, van Eimeren T, Neumaier B, Drzezga A, Danek A, Classen J, Bürger K, Janowitz D, Rauchmann BS, Stöcklein S, Perneczky R, Schöberl F, Zwergal A, Höglinger GU, Bartenstein P, Villemagne V, Seibyl J, Sabri O, Levin J, Brendel M. Additive value of [ 18F]PI-2620 perfusion imaging in progressive supranuclear palsy and corticobasal syndrome. Eur J Nucl Med Mol Imaging 2023; 50:423-434. [PMID: 36102964 PMCID: PMC9816230 DOI: 10.1007/s00259-022-05964-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 09/01/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Early after [18F]PI-2620 PET tracer administration, perfusion imaging has potential for regional assessment of neuronal injury in neurodegenerative diseases. This is while standard late-phase [18F]PI-2620 tau-PET is able to discriminate the 4-repeat tauopathies progressive supranuclear palsy and corticobasal syndrome (4RTs) from disease controls and healthy controls. Here, we investigated whether early-phase [18F]PI-2620 PET has an additive value for biomarker based evaluation of 4RTs. METHODS Seventy-eight patients with 4RTs (71 ± 7 years, 39 female), 79 patients with other neurodegenerative diseases (67 ± 12 years, 35 female) and twelve age-matched controls (69 ± 8 years, 8 female) underwent dynamic (0-60 min) [18F]PI-2620 PET imaging. Regional perfusion (0.5-2.5 min p.i.) and tau load (20-40 min p.i.) were measured in 246 predefined brain regions [standardized-uptake-value ratios (SUVr), cerebellar reference]. Regional SUVr were compared between 4RTs and controls by an ANOVA including false-discovery-rate (FDR, p < 0.01) correction. Hypoperfusion in resulting 4RT target regions was evaluated at the patient level in all patients (mean value - 2SD threshold). Additionally, perfusion and tau pattern expression levels were explored regarding their potential discriminatory value of 4RTs against other neurodegenerative disorders, including validation in an independent external dataset (n = 37), and correlated with clinical severity in 4RTs (PSP rating scale, MoCA, activities of daily living). RESULTS Patients with 4RTs had significant hypoperfusion in 21/246 brain regions, most dominant in thalamus, caudate nucleus, and anterior cingulate cortex, fitting to the topology of the 4RT disease spectrum. However, single region hypoperfusion was not specific regarding the discrimination of patients with 4RTs against patients with other neurodegenerative diseases. In contrast, perfusion pattern expression showed promise for discrimination of patients with 4RTs from other neurodegenerative diseases (AUC: 0.850). Discrimination by the combined perfusion-tau pattern expression (AUC: 0.903) exceeded that of the sole tau pattern expression (AUC: 0.864) and the discriminatory power of the combined perfusion-tau pattern expression was replicated in the external dataset (AUC: 0.917). Perfusion but not tau pattern expression was associated with PSP rating scale (R = 0.402; p = 0.0012) and activities of daily living (R = - 0.431; p = 0.0005). CONCLUSION [18F]PI-2620 perfusion imaging mirrors known topology of regional hypoperfusion in 4RTs. Single region hypoperfusion is not specific for 4RTs, but perfusion pattern expression may provide an additive value for the discrimination of 4RTs from other neurodegenerative diseases and correlates closer with clinical severity than tau pattern expression.
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Affiliation(s)
- Sabrina Katzdobler
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Alexander Nitschmann
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Henryk Barthel
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Gerard Bischof
- grid.411097.a0000 0000 8852 305XDepartment of Nuclear Medicine, University Hospital Cologne, Cologne, Germany ,Molecular Organization of the Brain, Institute for Neuroscience and Medicine, INM-2), Jülich, Germany
| | - Leonie Beyer
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Ken Marek
- grid.452597.8InviCRO, LLC, Boston, MA USA ,grid.452597.8Molecular Neuroimaging, A Division of inviCRO, New Haven, CT USA
| | - Mengmeng Song
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Olivia Wagemann
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Carla Palleis
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Endy Weidinger
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Anne Nack
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Urban Fietzek
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Carolin Kurz
- grid.411095.80000 0004 0477 2585Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Jan Häckert
- grid.411095.80000 0004 0477 2585Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,grid.7307.30000 0001 2108 9006Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany
| | - Theresa Stapf
- grid.411095.80000 0004 0477 2585Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Christian Ferschmann
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Maximilian Scheifele
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Florian Eckenweber
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Gloria Biechele
- grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Nicolai Franzmeier
- grid.411095.80000 0004 0477 2585Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Anna Dewenter
- grid.411095.80000 0004 0477 2585Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sonja Schönecker
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Dorothee Saur
- grid.9647.c0000 0004 7669 9786Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Matthias L. Schroeter
- grid.9647.c0000 0004 7669 9786Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany ,grid.9647.c0000 0004 7669 9786LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany ,grid.419524.f0000 0001 0041 5028Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jost-Julian Rumpf
- grid.9647.c0000 0004 7669 9786Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Michael Rullmann
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Andreas Schildan
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Marianne Patt
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | | | - Thilo van Eimeren
- grid.411097.a0000 0000 8852 305XDepartment of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Bernd Neumaier
- grid.411097.a0000 0000 8852 305XDepartment of Nuclear Medicine, University Hospital Cologne, Cologne, Germany ,grid.8385.60000 0001 2297 375XInstitute for Neuroscience and Medicine (INM-3), Cognitive Neuroscience, Research Centre Juelich, Juelich, Germany
| | - Alexander Drzezga
- grid.411097.a0000 0000 8852 305XDepartment of Nuclear Medicine, University Hospital Cologne, Cologne, Germany ,Molecular Organization of the Brain, Institute for Neuroscience and Medicine, INM-2), Jülich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Adrian Danek
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Joseph Classen
- grid.9647.c0000 0004 7669 9786Department of Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Katharina Bürger
- grid.411095.80000 0004 0477 2585Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Daniel Janowitz
- grid.411095.80000 0004 0477 2585Institute for Stroke and Dementia Research, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- grid.7307.30000 0001 2108 9006Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany ,grid.411095.80000 0004 0477 2585Department of Radiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sophia Stöcklein
- grid.411095.80000 0004 0477 2585Department of Radiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Robert Perneczky
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ,grid.7307.30000 0001 2108 9006Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany ,grid.7445.20000 0001 2113 8111Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College, London, UK
| | - Florian Schöberl
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Andreas Zwergal
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Günter U. Höglinger
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ,grid.10423.340000 0000 9529 9877Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Peter Bartenstein
- grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ,grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Victor Villemagne
- grid.410678.c0000 0000 9374 3516Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, VIC Australia ,grid.1008.90000 0001 2179 088XDepartment of Medicine, Austin Health, The University of Melbourne, Melbourne, VIC Australia ,grid.21925.3d0000 0004 1936 9000Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA USA
| | - John Seibyl
- grid.452597.8InviCRO, LLC, Boston, MA USA ,grid.452597.8Molecular Neuroimaging, A Division of inviCRO, New Haven, CT USA
| | - Osama Sabri
- grid.411339.d0000 0000 8517 9062Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Johannes Levin
- grid.411095.80000 0004 0477 2585Department of Neurology, University Hospital of Munich, LMU Munich, Munich, Germany ,grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Matthias Brendel
- grid.424247.30000 0004 0438 0426German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ,grid.452617.3Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ,grid.411095.80000 0004 0477 2585Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany
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24
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Rubinski A, Frerich S, Malik R, Franzmeier N, Ramirez A, Dichgans M, Ewers M. Polygenic Effect on Tau Pathology Progression in Alzheimer's Disease. Ann Neurol 2022; 93:819-829. [PMID: 36571564 DOI: 10.1002/ana.26588] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/02/2022] [Accepted: 12/19/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Polygenic variation accounts for a substantial portion of the risk of Alzheimer's disease (AD), but its effect on the rate of fibrillar-tau accumulation as a key driver of dementia symptoms is unclear. METHODS We combined the to-date largest number of genetic risk variants of AD (n = 85 lead single-nucleotide polymorphisms [SNPs]) from recent genome-wide association studies (GWAS) to generate a polygenic score (PGS). We assessed longitudinal tau-positron emission tomography (PET), amyloid-PET, and cognition in 231 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Using the PGS, together with global amyloid-PET, we predicted the rate of tau-PET increases in Braak-stage regions-of-interest and cognitive decline. We also assessed PGS-risk enrichment effects on the required sample size in clinical trials targeting tau pathology. RESULTS We found that a higher PGS was associated with higher rates of tau-PET accumulation, in particular at elevated amyloid-PET levels. The tau-PET increases mediated the association between PGS and faster cognitive decline. Risk enrichment through high PGS afforded sample size savings by 34%. INTERPRETATION Our results demonstrate that the PGS predicts faster tau progression and thus cognitive decline, showing utility to enhance statistical power in clinical trials. ANN NEUROL 2023.
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Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Simon Frerich
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany.,Graduate School of Systemic Neurosciences, Ludwig Maximilian University, Munich, Germany
| | - Rainer Malik
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Alfredo Ramirez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Neurodegenerative diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, Bonn, Germany.,Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Cluster of Excellence Cellular Stress Responses in Aging-associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
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25
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Franzmeier N, Ewers M, Brendel M, Biel D, Ossenkoppele R, Hager P, Steward A, Dewenter A, Rubinski A, Buerger K, Janowitz D, Binette AP, Smith R, Strandberg O, Mattsson‐Carlgren N, Dichgans M, Frontzkowski L, Hansson O. Earlier Alzheimer's disease onset is associated with a shift of tau pathology towards brain hubs which facilitates tau spreading. Alzheimers Dement 2022. [DOI: 10.1002/alz.067043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Amsterdam University Medical Center Amsterdam Netherlands
| | - Paul Hager
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Anna Steward
- Institute for Stroke and Dementia Research, LMU, Munich Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | | | | | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Lukas Frontzkowski
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig Maximilian University Munich Munich Germany
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
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26
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Rubinski A, Franzmeier N, Dewenter A, Luan Y, Smith R, Strandberg O, Ossenkoppele R, Dichgans M, Hansson O, Ewers M. Higher fiber‐tract myelin levels predict lower longitudinal rates of fibrillar tau independent of amyloid. Alzheimers Dement 2022. [DOI: 10.1002/alz.061179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Ying Luan
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Neurology Clinic, Skåne University Hospital Lund Sweden
| | | | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam UMC Amsterdam Amsterdam Netherlands
- Clinical Memory Research Unit, Lund University, Sweden Lund Sweden
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital, Malmö Sweden
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
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27
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Steward A, Biel D, Luan Y, Brendel M, Dewenter A, Roemer SN, Rubinski A, Dichgans M, Ewers M, Franzmeier N. Brain network segregation attenuates tau spreading in Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.067501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Anna Steward
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Ying Luan
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Sebastian Niclas Roemer
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- Department of Neurology, University Hospital, LMU Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Institute for Stroke and Dementia Research, University Hospital, Ludwig‐Maximilian‐University Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
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28
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Binette AP, Franzmeier N, Spotorno N, Ewers M, Brendel M, Biel D, Strandberg O, Janelidze S, Palmqvist S, Mattsson‐Carlgren N, Smith R, Stomrud E, Ossenkoppele R, Hansson O. Amyloid‐associated increases in soluble tau is a key driver in accumulation of tau aggregates and cognitive decline in early Alzheimer. Alzheimers Dement 2022. [DOI: 10.1002/alz.061624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | | | - Sebastian Palmqvist
- Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Niklas Mattsson‐Carlgren
- Lund University Lund Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Malmö Sweden
- Wallenberg Center for Molecular Medicine, Lund University Lund Sweden
| | - Ruben Smith
- Lund University Lund Sweden
- Neurology Clinic, Skåne University Hospital Lund Sweden
| | - Erik Stomrud
- Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Rik Ossenkoppele
- Lund University Lund Sweden
- VU University Amsterdam Amsterdam Netherlands
| | - Oskar Hansson
- Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
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29
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Dewenter A, Gesierich B, Hager P, Biel D, Ewers M, Franzmeier N, Duering M. Distinct signatures of white matter damage in cerebral small vessel disease and Alzheimer’s disease: a fixel‐based analysis study. Alzheimers Dement 2022. [DOI: 10.1002/alz.067176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Benno Gesierich
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel Basel Switzerland
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Paul Hager
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Marco Duering
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel Basel Switzerland
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
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30
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Rubinski A, Frerich S, Malik R, Franzmeier N, Ramirez A, Dichgans M, Ewers M. Polygenic score is associated with accelerated tau pathology accumulation in Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.061627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Simon Frerich
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Alfredo Ramirez
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn Medical Center Bonn Germany
- Department of Psychiatry & Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases San Antonio TX USA
- German Center for Neurodegenerative Diseases (DZNE) Cologne Germany
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, University of Cologne, Medical Faculty Cologne Germany
- Excellence Cluster on Cellular Stress Responses in Aging‐Associated Diseases (CECAD), University of Cologne Cologne Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
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31
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Biel D, Ewers M, Suárez‐Calvet M, Hager P, Rubinski A, Dewenter A, Steward A, Roemer SN, Haass C, Brendel M, Franzmeier N. Soluble TREM2 drives earliest amyloid‐related p‐tau increase in Alzheimer’s disease but attenuates neurodegeneration in advanced disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.063088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Marc Suárez‐Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
| | - Paul Hager
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Anna Steward
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Christian Haass
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
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32
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Binette AP, Franzmeier N, Spotorno N, Ewers M, Brendel M, Biel D, Strandberg O, Janelidze S, Palmqvist S, Mattsson‐Carlgren N, Smith R, Stomrud E, Ossenkoppele R, Hansson O. Amyloid‐associated increases in soluble tau is a key driver in accumulation of tau aggregates and cognitive decline in early Alzheimer. Alzheimers Dement 2022. [DOI: 10.1002/alz.065080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | | | - Sebastian Palmqvist
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Niklas Mattsson‐Carlgren
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Malmö Sweden
- Wallenberg Center for Molecular Medicine, Lund University Lund Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Neurology Clinic, Skåne University Hospital Lund Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Clinical Memory Research Unit, Lund University, Sweden Lund Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
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33
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Dewenter A, Gesierich B, Hager P, Biel D, Ewers M, Franzmeier N, Duering M. Distinct signatures of white matter damage in cerebral small vessel disease and Alzheimer’s disease: a fixel‐based analysis study. Alzheimers Dement 2022. [DOI: 10.1002/alz.060445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Benno Gesierich
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel Basel Switzerland
| | - Paul Hager
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel Basel Switzerland
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34
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Steward A, Biel D, Brendel M, Dewenter A, Roemer S, Rubinski A, Luan Y, Dichgans M, Ewers M, Franzmeier N. Functional network segregation is associated with attenuated tau spreading in Alzheimer's disease. Alzheimers Dement 2022; 19:2034-2046. [PMID: 36433865 DOI: 10.1002/alz.12867] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/01/2022] [Accepted: 10/05/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Lower network segregation is associated with accelerated cognitive decline in Alzheimer's disease (AD), yet it is unclear whether less segregated brain networks facilitate connectivity-mediated tau spreading. METHODS We combined resting state functional magnetic resonance imaging (fMRI) with longitudinal tau positron emission tomography (PET) in 42 betamyloid-negative controls and 81 amyloid beta positive individuals across the AD spectrum. Network segregation was determined using resting-state fMRI-assessed connectivity among 400 cortical regions belonging to seven networks. RESULTS AD subjects with higher network segregation exhibited slower brain-wide tau accumulation relative to their baseline entorhinal tau PET burden (typical onset site of tau pathology). Second, by identifying patient-specific tau epicenters with highest baseline tau PET we found that stronger epicenter segregation was associated with a slower rate of tau accumulation in the rest of the brain in relation to baseline epicenter tau burden. DISCUSSION Our results indicate that tau spreading is facilitated by a more diffusely organized connectome, suggesting that brain network topology modulates tau spreading in AD. HIGHLIGHTS Higher brain network segregation is associated with attenuated tau pathology accumulation in Alzheimer's disease (AD). A patient-tailored approach allows for the more precise localization of tau epicenters. The functional segregation of subject-specific tau epicenters predicts the rate of future tau accumulation.
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Affiliation(s)
- Anna Steward
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine University Hospital LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
| | - Sebastian Roemer
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
- Department of Neurology University Hospital LMU Munich Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
| | - Ying Luan
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
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Biel D, Luan Y, Brendel M, Hager P, Dewenter A, Moscoso A, Otero Svaldi D, Higgins IA, Pontecorvo M, Römer S, Steward A, Rubinski A, Zheng L, Schöll M, Shcherbinin S, Ewers M, Franzmeier N. Combining tau-PET and fMRI meta-analyses for patient-centered prediction of cognitive decline in Alzheimer’s disease. Alzheimers Res Ther 2022; 14:166. [PMID: 36345046 PMCID: PMC9639286 DOI: 10.1186/s13195-022-01105-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022]
Abstract
Background Tau-PET is a prognostic marker for cognitive decline in Alzheimer’s disease, and the heterogeneity of tau-PET patterns matches cognitive symptom heterogeneity. Thus, tau-PET may allow precision-medicine prediction of individual tau-related cognitive trajectories, which can be important for determining patient-specific cognitive endpoints in clinical trials. Here, we aimed to examine whether tau-PET in cognitive-domain-specific brain regions, identified via fMRI meta-analyses, allows the prediction of domain-specific cognitive decline. Further, we aimed to determine whether tau-PET-informed personalized cognitive composites capture patient-specific cognitive trajectories more sensitively than conventional cognitive measures. Methods We included Alzheimer’s Disease Neuroimaging Initiative (ADNI) participants classified as controls (i.e., amyloid-negative, cognitively normal, n = 121) or Alzheimer’s disease-spectrum (i.e., amyloid-positive, cognitively normal to dementia, n = 140), plus 111 AVID-1451-A05 participants for independent validation (controls/Alzheimer’s disease-spectrum=46/65). All participants underwent baseline 18F-flortaucipir tau-PET, amyloid-PET, and longitudinal cognitive testing to assess annual cognitive changes (i.e., episodic memory, language, executive functioning, visuospatial). Cognitive changes were calculated using linear mixed models. Independent meta-analytical task-fMRI activation maps for each included cognitive domain were obtained from the Neurosynth database and applied to tau-PET to determine tau-PET signal in cognitive-domain-specific brain regions. In bootstrapped linear regression, we assessed the strength of the relationship (i.e., partial R2) between cognitive-domain-specific tau-PET vs. global or temporal-lobe tau-PET and cognitive changes. Further, we used tau-PET-based prediction of domain-specific decline to compose personalized cognitive composites that were tailored to capture patient-specific cognitive decline. Results In both amyloid-positive cohorts (ADNI [age = 75.99±7.69] and A05 [age = 74.03±9.03]), cognitive-domain-specific tau-PET outperformed global and temporal-lobe tau-PET for predicting future cognitive decline in episodic memory, language, executive functioning, and visuospatial abilities. Further, a tau-PET-informed personalized cognitive composite across cognitive domains enhanced the sensitivity to assess cognitive decline in amyloid-positive subjects, yielding lower sample sizes required for detecting simulated intervention effects compared to conventional cognitive endpoints (i.e., memory composite, global cognitive composite). However, the latter effect was less strong in A05 compared to the ADNI cohort. Conclusion Combining tau-PET with task-fMRI-derived maps of major cognitive domains facilitates the prediction of domain-specific cognitive decline. This approach may help to increase the sensitivity to detect Alzheimer’s disease-related cognitive decline and to determine personalized cognitive endpoints in clinical trials. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01105-5.
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Pichet Binette A, Franzmeier N, Spotorno N, Ewers M, Brendel M, Biel D, Strandberg O, Janelidze S, Palmqvist S, Mattsson-Carlgren N, Smith R, Stomrud E, Ossenkoppele R, Hansson O. Amyloid-associated increases in soluble tau relate to tau aggregation rates and cognitive decline in early Alzheimer's disease. Nat Commun 2022; 13:6635. [PMID: 36333294 PMCID: PMC9636262 DOI: 10.1038/s41467-022-34129-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [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: 02/26/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
For optimal design of anti-amyloid-β (Aβ) and anti-tau clinical trials, we need to better understand the pathophysiological cascade of Aβ- and tau-related processes. Therefore, we set out to investigate how Aβ and soluble phosphorylated tau (p-tau) relate to the accumulation of tau aggregates assessed with PET and subsequent cognitive decline across the Alzheimer's disease (AD) continuum. Using human cross-sectional and longitudinal neuroimaging and cognitive assessment data, we show that in early stages of AD, increased concentration of soluble CSF p-tau is strongly associated with accumulation of insoluble tau aggregates across the brain, and CSF p-tau levels mediate the effect of Aβ on tau aggregation. Further, higher soluble p-tau concentrations are mainly related to faster accumulation of tau aggregates in the regions with strong functional connectivity to individual tau epicenters. In this early stage, higher soluble p-tau concentrations is associated with cognitive decline, which is mediated by faster increase of tau aggregates. In contrast, in AD dementia, when Aβ fibrils and soluble p-tau levels have plateaued, cognitive decline is related to the accumulation rate of insoluble tau aggregates. Our data suggest that therapeutic approaches reducing soluble p-tau levels might be most favorable in early AD, before widespread insoluble tau aggregates.
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Affiliation(s)
- Alexa Pichet Binette
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden.
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Nicola Spotorno
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Olof Strandberg
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
- Department of Neurology, Skåne University Hospital, Lund, 205 02, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
- Department of Neurology, Skåne University Hospital, Lund, 205 02, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden.
- Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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Rubinski A, Franzmeier N, Dewenter A, Luan Y, Smith R, Strandberg O, Ossenkoppele R, Dichgans M, Hansson O, Ewers M. Higher levels of myelin are associated with higher resistance against tau pathology in Alzheimer’s disease. Alzheimers Res Ther 2022; 14:139. [PMID: 36153607 PMCID: PMC9508747 DOI: 10.1186/s13195-022-01074-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/28/2022] [Indexed: 11/10/2022]
Abstract
Background In Alzheimer’s disease (AD), fibrillar tau initially occurs locally and progresses preferentially between closely connected regions. However, the underlying sources of regional vulnerability to tau pathology remain unclear. Previous brain-autopsy findings suggest that the myelin levels—which differ substantially between white matter tracts in the brain—are a key modulating factor of region-specific susceptibility to tau deposition. Here, we investigated whether myelination differences between fiber tracts of the human connectome are predictive of the interregional spreading of tau pathology in AD. Methods We included two independently recruited samples consisting of amyloid-PET-positive asymptomatic and symptomatic elderly individuals, in whom tau-PET was obtained at baseline (ADNI: n = 275; BioFINDER-1: n = 102) and longitudinally in a subset (ADNI: n = 123, mean FU = 1.53 [0.69–3.95] years; BioFINDER-1: n = 39, mean FU = 1.87 [1.21–2.78] years). We constructed MRI templates of the myelin water fraction (MWF) in 200 gray matter ROIs and connecting fiber tracts obtained from adult cognitively normal participants. Using the same 200 ROI brain-parcellation atlas, we obtained tau-PET ROI values from each individual in ADNI and BioFINDER-1. In a spatial regression analysis, we first tested the association between cortical myelin and group-average tau-PET signal in the amyloid-positive and control groups. Secondly, employing a previously established approach of modeling tau-PET spreading based on functional connectivity between ROIs, we estimated in a linear regression analysis, whether the level of fiber-tract myelin modulates the association between functional connectivity and longitudinal tau-PET spreading (i.e., covariance) between ROIs. Results We found that higher myelinated cortical regions show lower tau-PET uptake (ADNI: rho = − 0.267, p < 0.001; BioFINDER-1: rho = − 0.175, p = 0.013). Fiber-tract myelin levels modulated the association between functional connectivity and tau-PET spreading, such that at higher levels of fiber-tract myelin, the association between stronger connectivity and higher covariance of tau-PET between the connected ROIs was attenuated (interaction fiber-tract myelin × functional connectivity: ADNI: β = − 0.185, p < 0.001; BioFINDER-1: β = − 0.166, p < 0.001). Conclusion Higher levels of myelin are associated with lower susceptibility of the connected regions to accumulate fibrillar tau. These results enhance our understanding of brain substrates that explain regional variation in tau accumulation and encourage future studies to investigate potential underlying mechanisms. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01074-9.
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Schönecker S, Martinez-Murcia FJ, Rauchmann BS, Franzmeier N, Prix C, Wlasich E, Loosli SV, Bochmann K, Gorriz Saez JM, Laforce R, Ducharme S, Tartaglia MC, Finger E, de Mendonça A, Santana I, Sanchez-Valle R, Moreno F, Sorbi S, Tagliavini F, Borroni B, Otto M, Synofzik M, Galimberti D, Vandenberghe R, van Swieten J, Butler C, Gerhard A, Graff C, Danek A, Rohrer JD, Masellis M, Rowe J, Levin J. Frequency and Longitudinal Course of Motor Signs in Genetic Frontotemporal Dementia. Neurology 2022; 99:e1032-e1044. [PMID: 35948443 PMCID: PMC9519250 DOI: 10.1212/wnl.0000000000200828] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 04/21/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Frontotemporal dementia (FTD) is a highly heritable disorder. The majority of genetic cases are caused by autosomal dominant pathogenic variants in the chromosome 9 open reading frame 72 (c9orf72), progranulin (GRN), and microtubule-associated protein tau (MAPT) gene. As motor disorders are increasingly recognized as part of the clinical spectrum, the current study aimed to describe motor phenotypes caused by genetic FTD, quantify their temporal association, and investigate their regional association with brain atrophy. METHODS We analyzed baseline visit data of known carriers of a pathogenic variant in the c9orf72, GRN, or MAPT gene from the Genetic Frontotemporal Dementia Initiative cohort study. Principal component analysis with varimax rotation was performed to identify motor sign clusters that were compared with respect to frequency and severity between groups. Associations with cross-sectional atrophy patterns were determined using voxel-wise regression. We applied linear mixed effects models to assess whether groups differed in the association between motor signs and estimated time to symptom onset. RESULTS A total of 322 pathogenic variant carriers were included in the analysis: 122 c9orf72 (79 presymptomatic), 143 GRN (112 presymptomatic), and 57 MAPT (43 presymptomatic) pathogenic variant carriers. Principal component analysis revealed 5 motor clusters, which we call progressive supranuclear palsy (PSP)-like, bulbar amyotrophic lateral sclerosis (ALS)-like, mixed/ALS-like, Parkinson disease (PD) like, and corticobasal syndrome-like motor phenotypes. There was no significant group difference in the frequency of signs of different motor phenotypes. However, mixed/ALS-like motor signs were most frequent, followed by PD-like motor signs. Although the PSP-like phenotype was associated with mesencephalic atrophy, the mixed/ALS-like phenotype was associated with motor cortex and corticospinal tract atrophy. The PD-like phenotype was associated with widespread cortical and subcortical atrophy. Estimated time to onset, genetic group and their interaction influenced motor signs. In c9orf72 pathogenic variant carriers, motor signs could be detected up to 25 years before expected symptom onset. DISCUSSION These results indicate the presence of multiple natural clusters of motor signs in genetic FTD, each correlated with specific atrophy patterns. Their motor severity depends on time and the affected gene. These clinicogenetic associations can guide diagnostic evaluations and the design of clinical trials for new disease-modifying and preventive treatments.
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Affiliation(s)
- Sonja Schönecker
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Francisco J Martinez-Murcia
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Boris-Stephan Rauchmann
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Nicolai Franzmeier
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Catharina Prix
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Elisabeth Wlasich
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Sandra V Loosli
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Katja Bochmann
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Juan-Manuel Gorriz Saez
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Robert Laforce
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Simon Ducharme
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Maria Carmela Tartaglia
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Elizabeth Finger
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Alexandre de Mendonça
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Isabel Santana
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Raquel Sanchez-Valle
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Fermin Moreno
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Sandro Sorbi
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Fabrizio Tagliavini
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Barbara Borroni
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Markus Otto
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Matthis Synofzik
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Daniela Galimberti
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Rik Vandenberghe
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - John van Swieten
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Christopher Butler
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Alexander Gerhard
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Caroline Graff
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Adrian Danek
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Jonathan D Rohrer
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Mario Masellis
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - James Rowe
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany
| | - Johannes Levin
- From the Department of Neurology (S. Schönecker, C.P., E.W., S.V.L., A.D., J.L.), Ludwig-Maximilians-Universität München, Germany; Department of Signal Theory Networking and Communications (F.J.M.-M., J.-M.G.S.), Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Spain; Institute for Clinical Radiology (B.-S.R.), Institute for Stroke and Dementia Research (N.F.), and Institute of Neuroradiology (K.B.), Ludwig-Maximilians-Universität München, Germany; Département des Sciences Neurologiques (R.L.), Clinique Interdisciplinaire de Mémoire (CIME); McConnell Brain Imaging Centre (S.D.), Montreal Neurological Institute, McGill University; Department of Psychiatry (S.D.), McGill University Health Centre, McGill University, Montreal, Quebec; Tanz Centre for Research in Neurodegenerative Diseases (M.C.T.), University of Toronto; Department of Clinical Neurological Sciences (E.F.), University of Western Ontario, London, Canada; Department of Neurology and Laboratory of Neurosciences (A.M.), Faculty of Medicine, University of Lisbon; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra; Center for Neuroscience and Cell Biology (I.S.), Faculty of Medicine, University of Coimbra, Portugal; Alzheimer's Disease and Other Cognitive Disorders Unit (R.S.-V.), Neurology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer; Institut d'Investigació Biomèdica August Pi I Sunyer (R.S.-V.), Barcelona; Department of Neurology (F.M.), Donostio University Hospital, San Sebastian; Neuroscience Area (F.M.), Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain; Department of Neuroscience, Psychology, Drug Research and Child Health (S. Sorbi), University of Florence; IRCCS Fondazione Don Carlo Gnocchi (S. Sorbi), Florence; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologica Carlo Besta (F.T.), Milano; Centre for Neurodegenerative Disorders (B.B.), Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurology (M.O.), University Hospital Ulm; Department of Neurology (M.O.), Martin-Luther-University Halle-Wittenberg, Germany Department of Neurodegenerative Diseases (M.S.), Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen; Center for Neurodegenerative Diseases (M.S.), Tübingen, Germany; Fondazione IRCCS Ospediale Policlinico (D.G.), Milan; Centro Dino Ferrari (D.G.), University of Milan, Italy; Leuven Brain Institute (LBI) (R.V.), KU Leuven; Laboratory for Cognitive Neurology (R.V.), Department of Neurosciences, KU Leuven; Neurology Department (R.V.), UZ Leuven, Belgium; Department of Neurology (J.S.), Erasmus Medical Centre, Rotterdam, the Netherlands; Nuffield Department of Clinical Neurosciences (C.B.), Medical Sciences Division, University of Oxford; Department of Brain Sciences (C.B.), Imperial College London; Wolfson Molecular Imaging Centre (A.G.), Faculty of Medicine, Biology and Health, University of Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine (A.G.), Essen University Hospital, Germany; Swedish FTD Initiative (C.G.), Stockholm; Division of Neurogeriatrics (C.G.), Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Solna; Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm, Sweden; Dementia Research Centre (J.D.R.), University College London, United Kingdom; Hurvitz Brain Sciences Program (M.M.), Sunnybrook Research Institute, University of Toronto; Division of Neurology (M.M.), Department of Medicine, University of Toronto; Cognitive and Movement Disorders Clinic (M.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Cognition and Brain Sciences Unit (J.R.), Medical Research Council; Department of Clinical Neurosciences (J.R.), University of Cambridge; Cambridge University Hospitals NHS Trust (J.R.), United Kingdom; German Center for Neurodegenerative Diseases (DZNE) (J.L.); Munich Cluster for Systems Neurology (SyNergy) (J.L.); and European Reference Network for Rare Neurological Diseases (ERN-RND) (J.L.), Munich, Germany.
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Frontzkowski L, Ewers M, Brendel M, Biel D, Ossenkoppele R, Hager P, Steward A, Dewenter A, Römer S, Rubinski A, Buerger K, Janowitz D, Binette AP, Smith R, Strandberg O, Carlgren NM, Dichgans M, Hansson O, Franzmeier N. Earlier Alzheimer’s disease onset is associated with tau pathology in brain hub regions and facilitated tau spreading. Nat Commun 2022; 13:4899. [PMID: 35987901 PMCID: PMC9392750 DOI: 10.1038/s41467-022-32592-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 08/08/2022] [Indexed: 12/20/2022] Open
Abstract
AbstractIn Alzheimer’s disease (AD), younger symptom onset is associated with accelerated disease progression and tau spreading, yet the mechanisms underlying faster disease manifestation are unknown. To address this, we combined resting-state fMRI and longitudinal tau-PET in two independent samples of controls and biomarker-confirmed AD patients (ADNI/BioFINDER, n = 240/57). Consistent across both samples, we found that younger symptomatic AD patients showed stronger tau-PET in globally connected fronto-parietal hubs, i.e., regions that are critical for maintaining cognition in AD. Stronger tau-PET in hubs predicted faster subsequent tau accumulation, suggesting that tau in globally connected regions facilitates connectivity-mediated tau spreading. Further, stronger tau-PET in hubs mediated the association between younger age and faster tau accumulation in symptomatic AD patients, which predicted faster cognitive decline. These independently validated findings suggest that younger AD symptom onset is associated with stronger tau pathology in brain hubs, and accelerated tau spreading throughout connected brain regions and cognitive decline.
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Rauchmann B, Brendel M, Franzmeier N, Trappmann L, Zaganjori M, Ersoezlue E, Morenas‐Rodriguez E, Guersel S, Burow L, Kurz C, Haeckert J, Tatò M, Utecht J, Papazov B, Pogarell O, Janowitz D, Buerger K, Ewers M, Palleis C, Weidinger E, Biechele G, Schuster S, Finze A, Eckenweber F, Rupprecht R, Rominger A, Goldhardt O, Grimmer T, Keeser D, Stoecklein S, Dietrich O, Bartenstein P, Levin J, Höglinger G, Perneczky R. Microglial activation and connectivity in Alzheimer's disease and aging. Ann Neurol 2022; 92:768-781. [DOI: 10.1002/ana.26465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Boris‐Stephan Rauchmann
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
- Sheffield Institute for Translational Neuroscience (SITraN) University of Sheffield Sheffield UK
- Department of Neuroradiology University Hospital LMU Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich Munich Germany
| | - Lena Trappmann
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Mirlind Zaganjori
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Ersin Ersoezlue
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Estrella Morenas‐Rodriguez
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
- Chair of Metabolic Biochemistry, Biomedical Center (BMC), Faculty of Medicine, LMU Munich Munich Germany
| | - Selim Guersel
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
| | - Lena Burow
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Carolin Kurz
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Jan Haeckert
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics University of Augsburg, Bezirkskrankenhaus Augsburg Augsburg Germany
| | - Maia Tatò
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Julia Utecht
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Boris Papazov
- Department of Radiology University Hospital, LMU Munich Munich Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich Munich Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich Munich Germany
| | - Carla Palleis
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
- Department of Neurology University Hospital, LMU Munich Munich Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich Germany
| | - Endy Weidinger
- Department of Neurology University Hospital, LMU Munich Munich Germany
| | - Gloria Biechele
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
| | - Sebastian Schuster
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
| | - Anika Finze
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
| | - Florian Eckenweber
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy University of Regensburg Regensburg Germany
| | - Axel Rominger
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
- Department of Nuclear Medicine University of Bern, Inselspital Bern Switzerland
| | - Oliver Goldhardt
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar Technical University Munich Munich Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar Technical University Munich Munich Germany
| | - Daniel Keeser
- Department of Radiology University Hospital, LMU Munich Munich Germany
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- Department of Neuroradiology University Hospital LMU Munich Germany
| | - Sophia Stoecklein
- Department of Radiology University Hospital, LMU Munich Munich Germany
| | - Olaf Dietrich
- Department of Radiology University Hospital, LMU Munich Munich Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
- Department of Neurology University Hospital, LMU Munich Munich Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich Germany
| | - Günter Höglinger
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
- Department of Neurology Hannover Medical School Hannover Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
- Ageing Epidemiology (AGE) Research Unit, School of Public Health Imperial College London London UK
- Munich Cluster for Systems Neurology (SyNergy), Munich Germany
- Sheffield Institute for Translational Neuroscience (SITraN) University of Sheffield Sheffield UK
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Dewenter A, Jacob MA, Cai M, Gesierich B, Hager P, Kopczak A, Biel D, Ewers M, Tuladhar AM, de Leeuw FE, Dichgans M, Franzmeier N, Duering M. Disentangling the effects of Alzheimer's and small vessel disease on white matter fibre tracts. Brain 2022; 146:678-689. [PMID: 35859352 PMCID: PMC9924910 DOI: 10.1093/brain/awac265] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/30/2022] [Accepted: 06/25/2022] [Indexed: 12/27/2022] Open
Abstract
Alzheimer's disease and cerebral small vessel disease are the two leading causes of cognitive decline and dementia and coexist in most memory clinic patients. White matter damage as assessed by diffusion MRI is a key feature in both Alzheimer's and cerebral small vessel disease. However, disease-specific biomarkers of white matter alterations are missing. Recent advances in diffusion MRI operating on the fixel level (fibre population within a voxel) promise to advance our understanding of disease-related white matter alterations. Fixel-based analysis allows derivation of measures of both white matter microstructure, measured by fibre density, and macrostructure, measured by fibre-bundle cross-section. Here, we evaluated the capacity of these state-of-the-art fixel metrics to disentangle the effects of cerebral small vessel disease and Alzheimer's disease on white matter integrity. We included three independent samples (total n = 387) covering genetically defined cerebral small vessel disease and age-matched controls, the full spectrum of biomarker-confirmed Alzheimer's disease including amyloid- and tau-PET negative controls and a validation sample with presumed mixed pathology. In this cross-sectional analysis, we performed group comparisons between patients and controls and assessed associations between fixel metrics within main white matter tracts and imaging hallmarks of cerebral small vessel disease (white matter hyperintensity volume, lacune and cerebral microbleed count) and Alzheimer's disease (amyloid- and tau-PET), age and a measure of neurodegeneration (brain volume). Our results showed that (i) fibre density was reduced in genetically defined cerebral small vessel disease and strongly associated with cerebral small vessel disease imaging hallmarks; (ii) fibre-bundle cross-section was mainly associated with brain volume; and (iii) both fibre density and fibre-bundle cross-section were reduced in the presence of amyloid, but not further exacerbated by abnormal tau deposition. Fixel metrics were only weakly associated with amyloid- and tau-PET. Taken together, our results in three independent samples suggest that fibre density captures the effect of cerebral small vessel disease, while fibre-bundle cross-section is largely determined by neurodegeneration. The ability of fixel-based imaging markers to capture distinct effects on white matter integrity can propel future applications in the context of precision medicine.
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Affiliation(s)
- Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany
| | - Mina A Jacob
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mengfei Cai
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Benno Gesierich
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Paul Hager
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany
- Institute for AI and Informatics in Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Anna Kopczak
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany
- German Center for Neurodegenerative Disease (DZNE), Munich, Germany
| | - Anil M Tuladhar
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany
- German Center for Neurodegenerative Disease (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | | | - Marco Duering
- Correspondence to: Marco Duering Medical Image Analysis Center (MIAC AG) Marktgasse 8 CH-4051 Basel Switzerland E-mail:
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Dewenter A, Gesierich B, Ter Telgte A, Wiegertjes K, Cai M, Jacob MA, Marques JP, Norris DG, Franzmeier N, de Leeuw FE, Tuladhar AM, Duering M. Systematic validation of structural brain networks in cerebral small vessel disease. J Cereb Blood Flow Metab 2022; 42:1020-1032. [PMID: 34929104 PMCID: PMC9125482 DOI: 10.1177/0271678x211069228] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cerebral small vessel disease (SVD) is considered a disconnection syndrome, which can be quantified using structural brain network analysis obtained from diffusion MRI. Network analysis is a demanding analysis approach and the added benefit over simpler diffusion MRI analysis is largely unexplored in SVD. In this pre-registered study, we assessed the clinical and technical validity of network analysis in two non-overlapping samples of SVD patients from the RUN DMC study (n = 52 for exploration and longitudinal analysis and n = 105 for validation). We compared two connectome pipelines utilizing single-shell or multi-shell diffusion MRI, while also systematically comparing different node and edge definitions. For clinical validation, we assessed the added benefit of network analysis in explaining processing speed and in detecting short-term disease progression. For technical validation, we determined test-retest repeatability.Our findings in clinical validation show that structural brain networks provide only a small added benefit over simpler global white matter diffusion metrics and do not capture short-term disease progression. Test-retest reliability was excellent for most brain networks. Our findings question the added value of brain network analysis in clinical applications in SVD and highlight the utility of simpler diffusion MRI based markers.
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Affiliation(s)
- Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Benno Gesierich
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Annemieke Ter Telgte
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,VASCage - Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
| | - Kim Wiegertjes
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mengfei Cai
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mina A Jacob
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - José P Marques
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - David G Norris
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anil M Tuladhar
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.,Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
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Franzmeier N, Höglinger GU. Inferring the sequence of brain volume changes in progressive supranuclear palsy using MRI. Brain Commun 2022; 4:fcac113. [PMID: 35602651 PMCID: PMC9118098 DOI: 10.1093/braincomms/fcac113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 03/18/2022] [Accepted: 05/10/2022] [Indexed: 11/17/2022] Open
Abstract
This scientific commentary refers to 'A data-driven model of brain volume changes in progressive supranuclear palsy' by Scotton et al. (https://doi.org/10.1093/braincomms/fcac098).
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Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München,
Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Günter U. Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich,
Germany
- Department of Neurology, Hannover Medical School, Hannover,
Germany
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Morenas-Rodríguez E, Li Y, Nuscher B, Franzmeier N, Xiong C, Suárez-Calvet M, Fagan AM, Schultz S, Gordon BA, Benzinger TLS, Hassenstab J, McDade E, Feederle R, Karch CM, Schlepckow K, Morris JC, Kleinberger G, Nellgard B, Vöglein J, Blennow K, Zetterberg H, Ewers M, Jucker M, Levin J, Bateman RJ, Haass C, Allegri R, Araki A, Barthelemy N, Bechara J, Berman S, Bodge C, Brandon S, Brooks W(B, Brosch J, Buck J, Buckles V, Carter K, Cash L, Chen C, Chhatwal J, Chrem P, Chua J, Chui H, Cruchaga C, Day GS, De La Cruz C, Denner D, Diffenbacher A, Dincer A, Donahue T, Douglas J, Duong D, Egido N, Esposito B, Farlow M, Feldman B, Fitzpatrick C, Flores S, Fox N, Franklin E, Friedrichsen N, Fujii H, Gardener S, Ghetti B, Goate A, Goldberg S, Goldman J, Gonzalez A, Gräber-Sultan S, Graff-Radford N, Graham M, Gray J, Gremminger E, Grilo M, Groves A, Häsler L, Hellm C, Herries E, Hoechst-Swisher L, Hofmann A, Holtzman D, Hornbeck R, Igor Y, Ihara R, Ikeuchi T, Ikonomovic S, Ishii K, Jack C, Jerome G, Johnson E, Käser S, Kasuga K, Keefe S, Klunk W(B, Koeppe R, Koudelis D, Kuder-Buletta E, Laske C, Levey A, Lopez O, Marsh J, Martinez R, Martins R, Mason NS, Masters C, Mawuenyega K, McCullough A, Mejia A, MountzMD J, Mummery C, Nadkarni N, Nagamatsu A, Neimeyer K, Niimi Y, Noble J, Norton J, Nuscher B, O'Connor A, Obermüller U, Patira R, Perrin R, Ping L, Preische O, Renton A, Ringman J, Salloway S, Schofield P, Senda M, Seyfried N, Shady K, Shimada H, Sigurdson W, Smith J, Smith L, Snitz B, Sohrabi H, Stephens S, Taddei K, Thompson S, Wang P, Wang Q, Weamer E, Xu J, Xu X. Soluble TREM2 in CSF and its association with other biomarkers and cognition in autosomal-dominant Alzheimer's disease: a longitudinal observational study. Lancet Neurol 2022; 21:329-341. [PMID: 35305339 PMCID: PMC8926925 DOI: 10.1016/s1474-4422(22)00027-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/05/2022] [Accepted: 01/10/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Therapeutic modulation of TREM2-dependent microglial function might provide an additional strategy to slow the progression of Alzheimer's disease. Although studies in animal models suggest that TREM2 is protective against Alzheimer's pathology, its effect on tau pathology and its potential beneficial role in people with Alzheimer's disease is still unclear. Our aim was to study associations between the dynamics of soluble TREM2, as a biomarker of TREM2 signalling, and amyloid β (Aβ) deposition, tau-related pathology, neuroimaging markers, and cognitive decline, during the progression of autosomal dominant Alzheimer's disease. METHODS We did a longitudinal analysis of data from the Dominantly Inherited Alzheimer Network (DIAN) observational study, which includes families with a history of autosomal dominant Alzheimer's disease. Participants aged over 18 years who were enrolled in DIAN between Jan 1, 2009, and July 31, 2019, were categorised as either carriers of pathogenic variants in PSEN1, PSEN2, and APP genes (n=155) or non-carriers (n=93). We measured amounts of cleaved soluble TREM2 using a novel immunoassay in CSF samples obtained every 2 years from participants who were asymptomatic (Clinical Dementia Rating [CDR]=0) and annually for those who were symptomatic (CDR>0). CSF concentrations of Aβ40, Aβ42, total tau (t-tau), and tau phosphorylated on threonine 181 (p-tau) were measured by validated immunoassays. Predefined neuroimaging measurements were total cortical uptake of Pittsburgh compound B PET (PiB-PET), cortical thickness in the precuneus ascertained by MRI, and hippocampal volume determined by MRI. Cognition was measured using a validated cognitive composite (including DIAN word list test, logical memory delayed recall, digit symbol coding test [total score], and minimental status examination). We based our statistical analysis on univariate and bivariate linear mixed effects models. FINDINGS In carriers of pathogenic variants, a high amyloid burden at baseline, represented by low CSF Aβ42 (β=-4·28 × 10-2 [SE 0·013], p=0·0012), but not high cortical uptake in PiB-PET (β=-5·51 × 10-3 [0·011], p=0·63), was the only predictor of an augmented annual rate of subsequent increase in soluble TREM2. Augmented annual rates of increase in soluble TREM2 were associated with a diminished rate of decrease in amyloid deposition, as measured by Aβ42 in CSF (r=0·56 [0·22], p=0·011), in presymptomatic carriers of pathogenic variants, and with diminished annual rate of increase in PiB-PET (r=-0·67 [0·25], p=0·0060) in symptomatic carriers of pathogenic variants. Presymptomatic carriers of pathogenic variants with annual rates of increase in soluble TREM2 lower than the median showed a correlation between enhanced annual rates of increase in p-tau in CSF and augmented annual rates of increase in PiB-PET signal (r=0·45 [0·21], p=0·035), that was not observed in those with rates of increase in soluble TREM2 higher than the median. Furthermore, presymptomatic carriers of pathogenic variants with rates of increase in soluble TREM2 above or below the median had opposite associations between Aβ42 in CSF and PiB-PET uptake when assessed longitudinally. Augmented annual rates of increase in soluble TREM2 in presymptomatic carriers of pathogenic variants correlated with decreased cortical shrinkage in the precuneus (r=0·46 [0·22]), p=0·040) and diminished cognitive decline (r=0·67 [0·22], p=0·0020). INTERPRETATION Our findings in autosomal dominant Alzheimer's disease position the TREM2 response within the amyloid cascade immediately after the first pathological changes in Aβ aggregation and further support the role of TREM2 on Aβ plaque deposition and compaction. Furthermore, these findings underpin a beneficial effect of TREM2 on Aβ deposition, Aβ-dependent tau pathology, cortical shrinkage, and cognitive decline. Soluble TREM2 could, therefore, be a key marker for clinical trial design and interpretation. Efforts to develop TREM2-boosting therapies are ongoing. FUNDING German Research Foundation, US National Institutes of Health.
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Affiliation(s)
- Estrella Morenas-Rodríguez
- German Center for Neurodegenerative Diseases, Munich, Germany; Metabolic Biochemistry, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany.
| | - Yan Li
- Division of Biostatistics, Washington University School of Medicine, St Louis, MO, USA
| | - Brigitte Nuscher
- German Center for Neurodegenerative Diseases, Munich, Germany,Metabolic Biochemistry, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians University, Munich, Germany
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, St Louis, MO, USA
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain,Servei de Neurologia, Hospital del Mar Medical Research Institute, Barcelona, Spain,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Madrid, Spain
| | - Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Stephanie Schultz
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Brian A Gordon
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Tammie L S Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Eric McDade
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Regina Feederle
- German Center for Neurodegenerative Diseases, Munich, Germany,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany,Institute for Diabetes and Obesity, Monoclonal Antibody Core Facility, Helmholtz Center, Munich, Germany,German Research Center for Environmental Health, Neuherberg, Germany
| | - Celeste M Karch
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Kai Schlepckow
- German Center for Neurodegenerative Diseases, Munich, Germany,Metabolic Biochemistry, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Gernot Kleinberger
- German Center for Neurodegenerative Diseases, Munich, Germany,Metabolic Biochemistry, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Bengt Nellgard
- Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Mölndal, Sweden,Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jonathan Vöglein
- German Center for Neurodegenerative Diseases, Munich, Germany,Department of Neurology, University Hospital of Munich, Ludwig-Maximilians University, Munich, Germany
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden,Department of Neurodegenerative Disease, UCL Queens Square Institute of Neurology, University College London, London, UK,UK Dementia Research Institute, University College London, London, UK,Hong Kong Center for Neurodegenerative Diseases, Hong Kong Special Administrative Region, China
| | - Michael Ewers
- German Center for Neurodegenerative Diseases, Munich, Germany,Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians University, Munich, Germany
| | - Mathias Jucker
- German Center for Neurodegenerative Diseases, Tübingen, Germany,Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, Tübingen, Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases, Munich, Germany,Department of Neurology, University Hospital of Munich, Ludwig-Maximilians University, Munich, Germany,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Christian Haass
- German Center for Neurodegenerative Diseases, Munich, Germany,Metabolic Biochemistry, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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Blume T, Deussing M, Biechele G, Peters F, Zott B, Schmidt C, Franzmeier N, Wind K, Eckenweber F, Sacher C, Shi Y, Ochs K, Kleinberger G, Xiang X, Focke C, Lindner S, Gildehaus FJ, Beyer L, von Ungern-Sternberg B, Bartenstein P, Baumann K, Adelsberger H, Rominger A, Cumming P, Willem M, Dorostkar MM, Herms J, Brendel M. Chronic PPARγ Stimulation Shifts Amyloidosis to Higher Fibrillarity but Improves Cognition. Front Aging Neurosci 2022; 14:854031. [PMID: 35431893 PMCID: PMC9007038 DOI: 10.3389/fnagi.2022.854031] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/25/2022] [Indexed: 11/30/2022] Open
Abstract
We undertook longitudinal β-amyloid positron emission tomography (Aβ-PET) imaging as a translational tool for monitoring of chronic treatment with the peroxisome proliferator-activated receptor gamma (PPARγ) agonist pioglitazone in Aβ model mice. We thus tested the hypothesis this treatment would rescue from increases of the Aβ-PET signal while promoting spatial learning and preservation of synaptic density. Here, we investigated longitudinally for 5 months PS2APP mice (N = 23; baseline age: 8 months) and AppNL–G–F mice (N = 37; baseline age: 5 months) using Aβ-PET. Groups of mice were treated with pioglitazone or vehicle during the follow-up interval. We tested spatial memory performance and confirmed terminal PET findings by immunohistochemical and biochemistry analyses. Surprisingly, Aβ-PET and immunohistochemistry revealed a shift toward higher fibrillary composition of Aβ-plaques during upon chronic pioglitazone treatment. Nonetheless, synaptic density and spatial learning were improved in transgenic mice with pioglitazone treatment, in association with the increased plaque fibrillarity. These translational data suggest that a shift toward higher plaque fibrillarity protects cognitive function and brain integrity. Increases in the Aβ-PET signal upon immunomodulatory treatments targeting Aβ aggregation can thus be protective.
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Affiliation(s)
- Tanja Blume
- DZNE – German Center for Neurodegenerative Diseases, Munich, Germany
| | - Maximilian Deussing
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Gloria Biechele
- Department of Radiology, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Finn Peters
- DZNE – German Center for Neurodegenerative Diseases, Munich, Germany
| | - Benedikt Zott
- Institute of Neuroscience, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Claudio Schmidt
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Karin Wind
- DZNE – German Center for Neurodegenerative Diseases, Munich, Germany
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Florian Eckenweber
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Christian Sacher
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Yuan Shi
- DZNE – German Center for Neurodegenerative Diseases, Munich, Germany
| | - Katharina Ochs
- DZNE – German Center for Neurodegenerative Diseases, Munich, Germany
| | - Gernot Kleinberger
- Metabolic Biochemistry, Faculty of Medicine, Biomedical Center (BMC), Ludwig Maximilian University of Munich, Munich, Germany
- ISAR Bioscience GmbH, Planegg, Germany
| | - Xianyuan Xiang
- Metabolic Biochemistry, Faculty of Medicine, Biomedical Center (BMC), Ludwig Maximilian University of Munich, Munich, Germany
| | - Carola Focke
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Simon Lindner
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Franz-Josef Gildehaus
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Barbara von Ungern-Sternberg
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Karlheinz Baumann
- Roche Pharma Research and Early Development, Neuroscience Discovery, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Helmuth Adelsberger
- Department of Radiology, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Axel Rominger
- SyNergy, Ludwig Maximilian University of Munich, Munich, Germany
- Department of Nuclear Medicine, Inselspital Bern, Bern, Switzerland
| | - Paul Cumming
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Michael Willem
- Metabolic Biochemistry, Faculty of Medicine, Biomedical Center (BMC), Ludwig Maximilian University of Munich, Munich, Germany
| | - Mario M. Dorostkar
- DZNE – German Center for Neurodegenerative Diseases, Munich, Germany
- Center for Neuropathology and Prion Research, Ludwig Maximilian University of Munich, Munich, Germany
| | - Jochen Herms
- DZNE – German Center for Neurodegenerative Diseases, Munich, Germany
- SyNergy, Ludwig Maximilian University of Munich, Munich, Germany
- Center for Neuropathology and Prion Research, Ludwig Maximilian University of Munich, Munich, Germany
| | - Matthias Brendel
- DZNE – German Center for Neurodegenerative Diseases, Munich, Germany
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig Maximilian University of Munich, Munich, Germany
- SyNergy, Ludwig Maximilian University of Munich, Munich, Germany
- *Correspondence: Matthias Brendel,
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Franzmeier N, Ossenkoppele R, Brendel M, Rubinski A, Smith R, Kumar A, Mattsson‐Carlgren N, Strandberg O, Duering M, Buerger K, Dichgans M, Hansson O, Ewers M. The
BIN1
rs744373 Alzheimer’s disease risk SNP is associated with faster Aβ‐associated tau accumulation and cognitive decline. Alzheimers Dement 2021. [DOI: 10.1002/alz.055113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München Munich Germany
| | - Rik Ossenkoppele
- VU University Medical Center, Amsterdam UMC Amsterdam Netherlands
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | | | - Atul Kumar
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Malmö Sweden
| | | | | | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Malmö Sweden
| | - Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, Ludwig‐Maximilian‐University Munich Germany
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Neitzel J, Franzmeier N, Rubinski A, Dichgans M, Brendel M, Malik R, Ewers M. Klotho‐VS heterozygosity modifies amyloid‐dependent tau accumulation and memory impairment in Alzheimer’s disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.051343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Julia Neitzel
- Erasmus MC University Medical Center Rotterdam Netherlands
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Rainer Malik
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
- German Center of Neurodegenerative Diseases Munich Germany
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48
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Biel D, Brendel M, Rubinski A, Buerger K, Janowitz D, Dichgans M, Franzmeier N. In vivo Braak‐staging using
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F‐Flortaucipir‐tau‐PET as a predictive marker for future cognitive decline in Alzheimer’s disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.054957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
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49
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Rubinski A, Franzmeier N, Dewenter A, Luan Y, Biel D, Ewers M. Higher myelination of grey matter and white matter is associated with lower tau spreading and tau‐associated cortical thinning in Alzheimer’s. Alzheimers Dement 2021. [DOI: 10.1002/alz.052031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Ying Luan
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
- German Center of Neurodegenerative Diseases Munich Germany
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50
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Franzmeier N, Brendel M, Beyer L, Arzberger T, Kovacs GG, Rubinski A, Palleis C, Katzdobler S, Finze A, Song M, Biechele G, Kern M, Scheifele M, Rauchmann B, Perneczky R, Rullmann M, Schildan A, Barthel H, Sabri O, Classen J, Lukic MJ, Irwin DJ, Lee EB, Coughlin D, Giese A, Grossman M, Kurz C, McMillan CT, Gelpi E, Compta Y, Swieten JC, Troakes C, Al‐Sarraj S, Roeber S, Xie SX, Lee VM, Herms J, Bartenstein P, Haass C, Dichgans M, Trojanowski JQ, Levin J, Höglinger G, Ewers M. Tau spreads across connected brain regions in progressive supranuclear palsy and corticobasal syndrome. Alzheimers Dement 2021. [DOI: 10.1002/alz.051668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Matthias Brendel
- Department of Nuclear Medicine University Hospital LMU Munich Munich Germany
- Department of Nuclear Medicine University Hospital LMU Munich Munich Germany
| | | | | | | | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Munich Germany
| | | | | | - Anika Finze
- University Hospital LMU Munich Munich Germany
| | - Mengmeng Song
- Ludwig‐Maximilians‐Universität Munich Munich Germany
| | | | - Maike Kern
- University Hospital of Munich Munich Germany
| | | | | | | | - Michael Rullmann
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Andreas Schildan
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Henryk Barthel
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Osama Sabri
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | | | | | - David J. Irwin
- Digital Neuropathology Laboratory Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | - Eddie B. Lee
- Center for Neurodegenerative Disease Research University of Pennsylvania Philadelphia PA USA
| | | | | | - Murray Grossman
- Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | - Carolin Kurz
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | | | - Ellen Gelpi
- Neurological Tissue Bank‐IDIBAPS/Hospital Clínic Barcelona Barcelona Spain
| | | | - John C. Swieten
- Department of Neurology Erasmus Medical Center Rotterdam Netherlands
| | - Claire Troakes
- King's College London MRC London Neurodegenerative Diseases Brain Bank London United Kingdom
| | - Safa Al‐Sarraj
- Kings College NHS Foundation Trust London United Kingdom
| | | | | | - Virginia M‐Y Lee
- Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA
| | | | | | - Christian Haass
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Munich Germany
| | | | | | - Günter Höglinger
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
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