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Garcia-Guaqueta DP, Botha H, Utianski RL, Duffy JR, Clark HM, Goodrich AW, Pham NTT, Machulda MM, Baker M, Rademakers R, Whitwell JL, Josephs KA. Progression to corticobasal syndrome: a longitudinal study of patients with nonfluent primary progressive aphasia and primary progressive apraxia of speech. J Neurol 2024:10.1007/s00415-024-12344-x. [PMID: 38583104 DOI: 10.1007/s00415-024-12344-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND AND OBJECTIVES Nonfluent variant primary progressive aphasia (nfvPPA) and primary progressive apraxia of speech (PPAOS) can be precursors to corticobasal syndrome (CBS). Details on their progression remain unclear. We aimed to examine the clinical and neuroimaging evolution of nfvPPA and PPAOS into CBS. METHODS We conducted a retrospective longitudinal study in 140 nfvPPA or PPAOS patients and applied the consensus criteria for possible and probable CBS for every visit, evaluating limb rigidity, akinesia, limb dystonia, myoclonus, ideomotor apraxia, alien limb phenomenon, and nonverbal oral apraxia (NVOA). Given the association of NVOA with AOS, we also modified the CBS criteria by excluding NVOA and assigned every patient to either a progressors or non-progressors group. We evaluated the frequency of every CBS feature by year from disease onset, and assessed gray and white matter volume loss using SPM12. RESULTS Asymmetric akinesia, NVOA, and limb apraxia were the most common CBS features that developed; while limb dystonia, myoclonus, and alien limb were rare. Eighty-two patients progressed to possible CBS; only four to probable CBS. nfvPPA and PPAOS had a similar proportion of progressors, although nfvPPA progressed to CBS earlier (p-value = 0.046), driven by an early appearance of limb apraxia (p-value = 0.0041). The non-progressors and progressors both showed premotor/motor cortex involvement at baseline, with spread into prefrontal cortex over time. DISCUSSION An important proportion of patients with nfvPPA and PPAOS progress to possible CBS, while they rarely develop features of probable CBS even after long follow-up.
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Affiliation(s)
- Danna P Garcia-Guaqueta
- Department of Neurology, Behavioral Neurology & Movement Disorders, Mayo Clinic, College of Medicine and Science, Rochester, MN, 55905, USA
| | - Hugo Botha
- Department of Neurology, Behavioral Neurology & Movement Disorders, Mayo Clinic, College of Medicine and Science, Rochester, MN, 55905, USA
| | - Rene L Utianski
- Department of Neurology, Behavioral Neurology & Movement Disorders, Mayo Clinic, College of Medicine and Science, Rochester, MN, 55905, USA
| | - Joseph R Duffy
- Department of Neurology, Behavioral Neurology & Movement Disorders, Mayo Clinic, College of Medicine and Science, Rochester, MN, 55905, USA
| | - Heather M Clark
- Department of Neurology, Behavioral Neurology & Movement Disorders, Mayo Clinic, College of Medicine and Science, Rochester, MN, 55905, USA
| | - Austin W Goodrich
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, 55905, USA
| | | | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Matt Baker
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- VIB Center for Molecular Neurology, University of Antwerp, Antwerp, Belgium
| | | | - Keith A Josephs
- Department of Neurology, Behavioral Neurology & Movement Disorders, Mayo Clinic, College of Medicine and Science, Rochester, MN, 55905, USA.
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Isella V, Licciardo D, Ferri F, Crivellaro C, Morzenti S, Appollonio IM, Ferrarese C. Left and right corticobasal syndrome: comparison of cognitive profiles between metabolic imaging - matched groups. Neurol Sci 2024; 45:1499-1506. [PMID: 37889380 PMCID: PMC10942890 DOI: 10.1007/s10072-023-07148-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Corticobasal syndrome (CBS) is typically asymmetric. Case reports suggest that left-hemisphere CBS (lhCBS) is associated with major language impairment, and right-hemisphere CBS (rhCBS) is associated with major visuospatial deficits, but no group study has ever verified these observations. In our study, we enrolled 49 patients with CBS, classified them as lhCBS or rhCBS based on asymmetry of hypometabolism on brain FDG-PET and compared their cognitive and behavioural profiles. METHODS We defined asymmetry of hypometabolism upon visual inspection of qualitative PET images and confirmed it through paired comparison of left- and right-hemisphere FDG uptake values. The two groups were also matched for severity of hypometabolism within the more affected and more preserved hemispheres, to unravel differences in the cognitive profiles ascribable specifically to each hemisphere's functional specializations. All patients were assessed for memory, language, executive and visuospatial deficits, apraxia, neglect, dyscalculia, agraphia and behavioural disturbances. RESULTS LhCBS (n. 26) and rhCBS (n. 23) patients did not differ for demographics, disease duration and severity of global cognitive impairment. The two cognitive profiles were largely overlapping, with two exceptions: Digit span forward was poorer in lhCBS, and visual neglect was more frequent in rhCBS. CONCLUSIONS After balancing out patients for hemispheric hypometabolism, we did not confirm worse language or visuospatial deficits in, respectively, lhCBS and rhCBS. However, verbal short-term memory was more impaired in lhCBS, and spatial attention was more impaired in rhCBS. Both of these functions reflect the functional specialization of the left and right fronto-parietal pathways, i.e. of the main loci of neurodegeneration in CBS.
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Affiliation(s)
- Valeria Isella
- School of Medicine and Surgery (Neurology), University of Milano-Bicocca, Via Cadore 48, 20900, Monza(MB), Italy.
| | - Daniele Licciardo
- School of Medicine and Surgery (Neurology), University of Milano-Bicocca, Via Cadore 48, 20900, Monza(MB), Italy
- Fondazione IRCCS San Gerardo Dei Tintori (Neurology), Monza, Italy
| | - Francesca Ferri
- Fondazione IRCCS San Gerardo Dei Tintori (Neurology), Monza, Italy
| | - Cinzia Crivellaro
- Fondazione IRCCS San Gerardo Dei Tintori (Nuclear Medicine), Monza, Italy
| | - Sabrina Morzenti
- Fondazione IRCCS San Gerardo Dei Tintori (Medical Physics), Monza, Italy
| | - Ildebrando Marco Appollonio
- School of Medicine and Surgery (Neurology), University of Milano-Bicocca, Via Cadore 48, 20900, Monza(MB), Italy
- Fondazione IRCCS San Gerardo Dei Tintori (Neurology), Monza, Italy
| | - Carlo Ferrarese
- School of Medicine and Surgery (Neurology), University of Milano-Bicocca, Via Cadore 48, 20900, Monza(MB), Italy
- Fondazione IRCCS San Gerardo Dei Tintori (Neurology), Monza, Italy
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Urso D, Nigro S, Tafuri B, De Blasi R, Pereira JB, Logroscino G. Nucleus Basalis of Meynert Degeneration Predicts Cognitive Decline in Corticobasal Syndrome. Biol Psychiatry 2024:S0006-3223(24)00061-1. [PMID: 38309321 DOI: 10.1016/j.biopsych.2024.01.018] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Cognitive changes are common in corticobasal syndrome (CBS) and significantly impact quality of life and caregiver burden. However, relatively few studies have investigated the neural substrates of cognitive changes in CBS, and reliable predictors of cognitive impairment are currently lacking. The nucleus basalis of Meynert (NbM), which serves as the primary source of cortical cholinergic innervation, has been functionally associated with cognition. This study aimed to explore whether patients with CBS exhibit reduced NbM volumes compared with healthy control participants and whether NbM degeneration can serve as a predictor of cognitive impairment in patients with CBS. METHODS In this study, we investigated in vivo volumetric changes of the NbM in 38 patients with CBS and 84 healthy control participants. Next, we assessed whether gray matter degeneration of the NbM evaluated at baseline could predict cognitive impairment during a 12-month follow-up period in patients with CBS. All volumetric analyses were performed using 3T T1-weighted images obtained from the 4-Repeat Tauopathy Neuroimaging Initiative. RESULTS Patients with CBS displayed significantly lower NbM volumes than control participants (p < .001). Structural damage of the NbM also predicted the development of cognitive impairment in patients with CBS as assessed by longitudinal measurements of the Clinical Dementia Rating Sum of Boxes (p < .001) and Mini-Mental State Examination (p = .035). CONCLUSIONS Our findings suggest that NbM atrophy may represent a promising noninvasive in vivo marker of cognitive decline in CBS and provide new insights into the neural mechanisms that underlie cognitive impairment in CBS.
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Affiliation(s)
- Daniele Urso
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Italy; Department of Neurosciences, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
| | - Salvatore Nigro
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Italy; Institute of Nanotechnology, National Research Council, Lecce, Italy
| | - Benedetta Tafuri
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Italy; Department of Translational Biomedicine and Neurosciences, University of Bari Aldo Moro, Bari, Italy
| | - Roberto De Blasi
- Department of Diagnostic Imaging, Pia Fondazione di Culto e Religione Card. G. Panico, Tricase, Italy
| | - Joana B Pereira
- Department of Clinical Neurosciences, Neuro Division, Karolinska Institute, Solna, Sweden
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Italy; Department of Translational Biomedicine and Neurosciences, University of Bari Aldo Moro, Bari, Italy.
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Remoli G, Schilke ED, Magi A, Ancidoni A, Negro G, Da Re F, Frigo M, Giordano M, Vanacore N, Canevelli M, Ferrarese C, Tremolizzo L, Appollonio I. Neuropathological hints from CSF and serum biomarkers in corticobasal syndrome (CBS): a systematic review. Neurol Res Pract 2024; 6:1. [PMID: 38173024 PMCID: PMC10765833 DOI: 10.1186/s42466-023-00294-0] [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: 05/29/2023] [Accepted: 10/23/2023] [Indexed: 01/05/2024] Open
Abstract
Corticobasal syndrome (CBS) is a clinical syndrome determined by various underlying neurodegenerative disorders requiring a pathological assessment for a definitive diagnosis. A literature review was performed following the methodology described in the Cochrane Handbook for Systematic Reviews to investigate the additional value of traditional and cutting-edge cerebrospinal fluid (CSF) and serum/plasma biomarkers in profiling CBS. Four databases were screened applying predefined inclusion criteria: (1) recruiting patients with CBS; (2) analyzing CSF/plasma biomarkers in CBS. The review highlights the potential role of the association of fluid biomarkers in diagnostic workup of CBS, since they may contribute to a more accurate diagnosis and patient selection for future disease-modifying agent; for example, future trial designs should consider baseline CSF Neurofilament Light Chains (NfL) or progranulin dosage to stratify treatment arms according to neuropathological substrates, and serum NfL dosage might be used to monitor the evolution of CBS. In this scenario, prospective cohort studies, starting with neurological examination and neuropsychological tests, should be considered to assess the correlations of clinical profiles and various biomarkers.
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Affiliation(s)
- Giulia Remoli
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
- Department of Neuroscience, Sapienza University of Roma, Roma, Italy
| | - Edoardo Dalmato Schilke
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy.
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy.
| | - Andrea Magi
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
| | - Antonio Ancidoni
- National Institute of Health, Roma, Italy
- Department of Neuroscience, Sapienza University of Roma, Roma, Italy
| | - Giulia Negro
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
| | - Fulvio Da Re
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
| | - Maura Frigo
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
| | - Martina Giordano
- Neurosurgery Unit, Department of Neuroscience, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
- University of Milan, Milano, Italy
| | - Nicola Vanacore
- National Institute of Health, Roma, Italy
- Department of Neuroscience, Sapienza University of Roma, Roma, Italy
| | - Marco Canevelli
- National Institute of Health, Roma, Italy
- Department of Neuroscience, Sapienza University of Roma, Roma, Italy
| | - Carlo Ferrarese
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
| | - Lucio Tremolizzo
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
| | - Ildebrando Appollonio
- Neurology Department, Fondazione IRCCS San Gerardi dei Tintori, San Gerardo Hospital, Monza. Via G. Pergolesi, 33, 20900, Monza, Italy
- School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milano, Italy
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Nakamura K, Kuroha Y, Hatakeyama M, Kimura AM, Nakamura Y, Murakami Y, Watanabe M, Igarashi H, Takahashi T, Shimada H. Corticobasal syndrome mimicking Foix-Chavany-Marie syndrome with suggested 4-repeat tauopathy by tau PET. BMC Geriatr 2023; 23:838. [PMID: 38087192 PMCID: PMC10714444 DOI: 10.1186/s12877-023-04564-z] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Corticobasal syndrome (CBS) is a neurodegenerative disease diagnosed based on clinical manifestations such as asymmetrical parkinsonism, limb apraxia, and speech and language impairment. The background pathology of CBS is commonly a variety of proteinopathies, but association with cerebrovascular disease has also been reported. Foix-Chavany-Marie syndrome (FCMS) is a rare neurological disorder characterized by facio-pharyngo-glossal diplegia with automatic-voluntary movement dissociation presenting with bilateral paresis of the facial, lingual, pharyngeal and masticatory muscles. FCMS is commonly attributable to stroke. Transactive response DNA binding protein of 43 kD (TDP-43) proteinopathy is also known as the pathological background of FCMS, while the pathological background of the majority of CBS cases consists of diverse tauopathies instead of TDP-43 proteinopathy. In this report, we describe a case mimicking FCMS that was finally diagnosed as CBS with suggested 4-repeat tauopathy. CASE PRESENTATION A 68-year-old female started experiencing difficulty speaking followed by difficulty writing, and especially texting, several years before her visit. Her impairment had been gradually worsening, and she came to our hospital. On neurological examination, she demonstrated the facial apraxia, frontal lobe dysfunction, and upper motor neuron signs. She presented some characteristics suggestive of FCMS. Her symptoms exhibited rapid progression and myoclonus, parkinsonism, and left-side dominant cortical sensory deficit occurred, resulting in the fulfillment of diagnostic criteria for CBS after 9 months. Tau PET imaging displayed notable ligand uptake in the brainstem, subthalamic nuclei, basal ganglia, and bilateral subcortical frontal lobe, suggesting that her pathological background was 4-repeat tauopathy. As a result of her progressive dysphagia, she became unable to eat and passed away after 12 months. CONCLUSION We hereby present an atypical case of CBS showing clinical features mimicking FCMS at first presentation. TDP-43 proteinopathy was suspected based on the clinical symptoms in the early stages of the disease; however, the clinical course and imaging findings including tau PET suggested that her pathological background was 4-repeat tauopathy.
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Affiliation(s)
- Kosei Nakamura
- Department of Neurology, Clinical Neuroscience Branch, Brain Research Institute, Niigata University, Niigata, Japan
- Department of Functional Neurology & Neurosurgery, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, 1-757 Asahimachi-Dohri, Niigata, 951-8585, Japan
| | - Yasuko Kuroha
- Department of Neurology, NHO Nishiniigata Chuo Hospital, Niigata, Japan
| | - Masahiro Hatakeyama
- Department of Neurology, Clinical Neuroscience Branch, Brain Research Institute, Niigata University, Niigata, Japan
- Department of Functional Neurology & Neurosurgery, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, 1-757 Asahimachi-Dohri, Niigata, 951-8585, Japan
| | - Atsushi Michael Kimura
- Department of Functional Neurology & Neurosurgery, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, 1-757 Asahimachi-Dohri, Niigata, 951-8585, Japan
| | - Yukimi Nakamura
- Department of Integrated Neuroscience, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, Niigata, Japan
| | - Yoshihiro Murakami
- Department of Functional Neurology & Neurosurgery, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, 1-757 Asahimachi-Dohri, Niigata, 951-8585, Japan
| | - Masaki Watanabe
- Department of Biological Magnetic Resonance, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, Niigata, Japan
| | - Hironaka Igarashi
- Department of Biological Magnetic Resonance, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, Niigata, Japan
| | - Tetsuya Takahashi
- Department of Neurology, NHO Nishiniigata Chuo Hospital, Niigata, Japan
| | - Hitoshi Shimada
- Department of Functional Neurology & Neurosurgery, Center for Integrated Human Brain Science, Brain Research Institute, Niigata University, 1-757 Asahimachi-Dohri, Niigata, 951-8585, Japan.
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba, Japan.
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El Ouartassi A, Giordana C, Schiazza A, Chardin D, Darcourt J. [ 18F]-FDopa positron emission tomography imaging in corticobasal syndrome. Brain Imaging Behav 2023; 17:619-627. [PMID: 37474673 DOI: 10.1007/s11682-023-00789-z] [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] [Accepted: 06/30/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE First, to investigate the patterns of [18F]-FDOPA positron emission tomography imaging in corticobasal syndrome using visual and semi-quantitative analysis and to compare them with patterns found in Parkinson's disease and progressive supranuclear palsy. Then, to search for correlations with clinical features and [18F]-FDG positron emission tomography imaging. METHODS 27 corticobasal syndrome patients who underwent [18F]-FDOPA positron emission tomography imaging were retrospectively studied. They were compared to 27 matched Parkinson's disease patients, 12 progressive supranuclear palsy patients and 53 normal controls. Scans were visually assigned to one of the following patterns: normal; unilateral homogeneous striatal uptake reduction; putamen uptake reduction with putamen-caudate gradient. A semi-quantitative analysis of striatal regional uptake and asymmetry was performed and correlated to clinical features and [18F]-FDG positron emission tomography patterns. RESULTS [18F]-FDOPA positron emission tomography appeared visually abnormal in only 33.5% of corticobasal syndrome patients. However, semi-quantitative analysis found putaminal asymmetry in 63%. Striatal uptake was homogeneously reduced in both putamen and caudate nucleus in corticobasal syndrome patients unlike in Parkinson's disease and progressive supranuclear palsy. No correlation was found between [18F]-FDOPA positron emission tomography and clinical features. Half of corticobasal syndrome patients presented a corticobasal degeneration pattern on [18F]-FDG positron emission tomography. CONCLUSION: [18F]-FDOPA positron emission tomography can often be normal in corticobasal syndrome patients. Semi-quantitative analysis is useful to unmask a significant asymmetry in many of them. Homogeneous striatal uptake reduction contralateral to the clinical signs is highly suggestive of corticobasal syndrome. This finding can be helpful to better characterize this syndrome with respect to Parkinson's disease and progressive supranuclear palsy.
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Affiliation(s)
- Anaïs El Ouartassi
- Movement Disorders Unit, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France.
- Neurology Department, Centre Hospitalier d'Antibes, 107 Avenue de Nice, Antibes, France.
| | - Caroline Giordana
- Movement Disorders Unit, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Aurélie Schiazza
- Nuclear Medicine Department, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
- Research Group, UMR 4320, CEA-Université Côte d'Azur, Nice, France
| | - David Chardin
- Nuclear Medicine Department, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
- Research Group, UMR 4320, CEA-Université Côte d'Azur, Nice, France
| | - Jacques Darcourt
- Nuclear Medicine Department, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
- Research Group, UMR 4320, CEA-Université Côte d'Azur, Nice, France
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Saito Y, Kamagata K, Andica C, Uchida W, Takabayashi K, Yoshida S, Nakaya M, Tanaka Y, Kamio S, Sato K, Nishizawa M, Akashi T, Shimoji K, Wada A, Aoki S. Glymphatic system impairment in corticobasal syndrome: diffusion tensor image analysis along the perivascular space (DTI-ALPS). Jpn J Radiol 2023; 41:1226-1235. [PMID: 37273112 DOI: 10.1007/s11604-023-01454-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/19/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE This study aimed to evaluate the along the perivascular space (ALPS) index based on the diffusion tensor image ALPS (DTI-ALPS) in corticobasal degeneration with corticobasal syndrome (CBD-CBS) and investigate its correlation with motor and cognitive functions. MATERIALS AND METHODS The data of 21 patients with CBD-CBS and 17 healthy controls (HCs) were obtained from the 4-Repeat Tauopathy Neuroimaging Initiative and the Frontotemporal Lobar Degeneration Neuroimaging Initiative databases. Diffusion magnetic resonance imaging was performed using a 3-Tesla MRI scanner. The ALPS index based on DTI-ALPS was automatically calculated after preprocessing. The ALPS index was compared between the CBD-CBS and HC groups via a general linear model analysis, with covariates such as age, sex, years of education, and intracranial volume (ICV). Furthermore, to confirm the relation between the ALPS index and the motor and cognitive score in CBD-CBS, the partial Spearman's rank correlation coefficient was calculated with covariates such as age, sex, years of education, and ICV. A p value of < 0.05 was considered as statistically significant in all statistical analyses. RESULTS The ALPS index of CBD-CBS was significantly lower than that of HC (Cohen's d = - 1.53, p < 0.005). Moreover, the ALPS index had a significant positive correlation with the mini mental state evaluation score (rs = 0.65, p < 0.005) and a significant negative correlation with the unified Parkinson's Disease Rating Scale III score (rs = - 0.75, p < 0.001). CONCLUSION The ALPS index of patients with CBD-CBS, which is significantly lower than that of HCs, is significantly associated with motor and cognitive functions.
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Affiliation(s)
- Yuya Saito
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Christina Andica
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Faculty of Health Data Science, Juntendo University, Chiba, Japan
| | - Wataru Uchida
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
| | - Kaito Takabayashi
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
| | - Seina Yoshida
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Moto Nakaya
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Department of Radiology, The University of Tokyo, Tokyo, Japan
| | - Yuya Tanaka
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Department of Radiology, The University of Tokyo, Tokyo, Japan
| | - Satoru Kamio
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Department of Radiology, The University of Tokyo, Tokyo, Japan
| | - Kanako Sato
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
| | - Mitsuo Nishizawa
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Faculty of Health Data Science, Juntendo University, Chiba, Japan
| | - Toshiaki Akashi
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
| | - Keigo Shimoji
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
- Faculty of Health Data Science, Juntendo University, Chiba, Japan
| | - Akihiko Wada
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan
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Calikusu FZ, Akkus S, Kochan Kizilkilic E, Poyraz BC, Altunç AT, Kiziltan G, Gunduz A. Atypical findings: Atypical parkinsonian syndromes or Atypical parkinsonian syndromes look-alikes. Clin Neurol Neurosurg 2023; 233:107975. [PMID: 37734268 DOI: 10.1016/j.clineuro.2023.107975] [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: 06/25/2023] [Revised: 09/09/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE In parkinsonian syndromes, presentations other than current diagnostic criteria are considered atypical findings. Our goal was to identify and describe the frequency and features of uncommon manifestations of atypical parkinsonian syndromes within our group. METHODS We retrospectively retrieved the medical records of all patients admitted to our clinic with parkinsonism between January 2011 and January 2022. We only included patients with atypical parkinsonian syndromes, in which the diagnosis was based on current clinical criteria. We retrospectively analyzed neurological, psychiatric, radiological, and electrophysiological characteristics. Typical and atypical features were classified according to the current clinical criteria and previous reports. RESULTS We determined 51 patients with atypical parkinsonian syndromes; 46 were included, whereas five were excluded due to insufficient follow-up. The probable diagnoses were multiple system atrophy (MSA, n = 19), dementia with Lewy bodies (DLB, n = 10), frontotemporal dementia (FTD, n = 10), corticobasal syndrome (CBS, n = 3), progressive supranuclear palsy (PSP, n = 4). The prevalence of atypical findings was similar among different types of atypical parkinsonian syndromes (p = 0.847). Atypical findings were eyelid myoclonus, double vision in MSA; ataxia, myoclonus, and a typical hummingbird sign on MRI in DLB; pyramidal findings and family history in FTD; early onset, family history, and onset with psychiatric findings in PSP-like phenotype. Genetic causes were identified in the FTD-like phenotype with pyramidal findings, whereas symptom onset was early with myoclonus in the PSP-like phenotype. CONCLUSION Atypical findings such as abnormal saccades, myoclonus, and ataxia may be a part of degenerative syndromes. However, family history, onset at an earlier age, and specific neurological findings suggest genetic syndromes.
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Affiliation(s)
- Fatma Zehra Calikusu
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurology, Istanbul, Turkey
| | - Sema Akkus
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurology, Istanbul, Turkey
| | - Esra Kochan Kizilkilic
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurology, Istanbul, Turkey
| | - Burc Cagri Poyraz
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Psychiatry, Istanbul, Turkey
| | - Ali Tarik Altunç
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Psychiatry, Istanbul, Turkey
| | - Gunes Kiziltan
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurology, Istanbul, Turkey
| | - Aysegul Gunduz
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurology, Istanbul, Turkey.
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Paslawski W, Khosousi S, Hertz E, Markaki I, Boxer A, Svenningsson P. Large-scale proximity extension assay reveals CSF midkine and DOPA decarboxylase as supportive diagnostic biomarkers for Parkinson's disease. Transl Neurodegener 2023; 12:42. [PMID: 37667404 PMCID: PMC10476347 DOI: 10.1186/s40035-023-00374-w] [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] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND There is a need for biomarkers to support an accurate diagnosis of Parkinson's disease (PD). Cerebrospinal fluid (CSF) has been a successful biofluid for finding neurodegenerative biomarkers, and modern highly sensitive multiplexing methods offer the possibility to perform discovery studies. Using a large-scale multiplex proximity extension assay (PEA) approach, we aimed to discover novel diagnostic protein biomarkers allowing accurate discrimination of PD from both controls and atypical Parkinsonian disorders (APD). METHODS CSF from patients with PD, corticobasal syndrome (CBS), progressive supranuclear palsy (PSP), multiple system atrophy and controls, were analysed with Olink PEA panels. Three cohorts were used in this study, comprising 192, 88 and 36 cases, respectively. All samples were run on the Cardiovascular II, Oncology II and Metabolism PEA panels. RESULTS Our analysis revealed that 26 and 39 proteins were differentially expressed in the CSF of test and validation PD cohorts, respectively, compared to controls. Among them, 6 proteins were changed in both cohorts. Midkine (MK) was increased in PD with the strongest effect size and results were validated with ELISA. Another most increased protein in PD, DOPA decarboxylase (DDC), which catalyses the decarboxylation of DOPA (L-3,4-dihydroxyphenylalanine) to dopamine, was strongly correlated with dopaminergic treatment. Moreover, Kallikrein 10 was specifically changed in APD compared with both PD and controls, but unchanged between PD and controls. Wnt inhibitory factor 1 was consistently downregulated in CBS and PSP patients in two independent cohorts. CONCLUSIONS Using the large-scale PEA approach, we have identified potential novel PD diagnostic biomarkers, most notably MK and DDC, in the CSF of PD patients.
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Affiliation(s)
- Wojciech Paslawski
- Laboratory of Translational Neuropharmacology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Shervin Khosousi
- Laboratory of Translational Neuropharmacology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ellen Hertz
- Laboratory of Translational Neuropharmacology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ioanna Markaki
- Laboratory of Translational Neuropharmacology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Adam Boxer
- Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Per Svenningsson
- Laboratory of Translational Neuropharmacology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
- Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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10
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Jatale V, Tiwari A, Kumar M, Gupta R, Kumar N. Migraine and Tension-type Headache in Parkinson's Disease and Progressive Supranuclear Palsy/ Corticobasal Syndrome. Ann Indian Acad Neurol 2023; 26:708-714. [PMID: 38022458 PMCID: PMC10666869 DOI: 10.4103/aian.aian_604_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/19/2023] [Accepted: 08/19/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To compare the prevalence and characteristics of migraine and tension-type headache (TTH) among patients with Parkinson's disease (PD), progressive supranuclear palsy/corticobasal syndrome (PSP/CBS), and healthy controls (HCs). Methods This cross-sectional study involved the collection of data from consecutive PD (n = 81) and PSP/CBS (n = 21) patients along with 104 HCs. Migraine and TTH were diagnosed using the International Classification of Headache Disorders 3rd edition criteria. Demographic data, PD or PSP/CBS details, and the presence and characteristics of migraine and TTH were collected. Montreal Cognitive Assessment Scale, Patient Health Questionnaire-9, and Pittsburgh Sleep-Quality Index were used to assess cognition, depression, and sleep quality, respectively. Results A comparable proportion of PD and PSP/CBS patients reported lifetime headache (46.9% vs 23.8%; P = 0.06). TTH was more common, observed in 84.3%, 100%, and 93.5% of PD, PSP/CBS, and HCs with lifetime headache, respectively. A comparable proportion of participants in all three groups had bilateral (P = 0.10), dull-aching headache (P = 0.09), and occurring <5/month (P > 0.99). The mean severity score of headache among three groups was comparable (P = 0.39). Although the demographic and clinical characteristics of PSP/CBS patients with and without headache were comparable, PD patients with headache had a higher MDS-UPDRS-III score than those without. More than two-third PD and all PSP/CBS patients with lifetime headache reported headache improvement following parkinsonism onset. Conclusion The prevalence and characteristics of migraine and TTH were comparable in PD, PSP/CBS, and HCs. Headache was associated with greater motor severity in PD. Following parkinsonism onset, headache improved in the majority of PD and PSP/CBS patients with lifetime headache.
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Affiliation(s)
- Vinayak Jatale
- Department of Neurology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashutosh Tiwari
- Department of Neurology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Mritunjai Kumar
- Department of Neurology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Gupta
- Department of Psychiatry and Division of Sleep Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Niraj Kumar
- Department of Neurology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
- Department of Neurology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
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Lyons S, Trépel D, Lynch T, Walsh R, O'Dowd S. The prevalence and incidence of progressive supranuclear palsy and corticobasal syndrome: a systematic review and meta-analysis. J Neurol 2023; 270:4451-4465. [PMID: 37289323 PMCID: PMC10421779 DOI: 10.1007/s00415-023-11791-2] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/19/2023] [Accepted: 05/20/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) are progressive neurodegenerative syndromes characterised by Parkinsonism with additional features including cognitive dysfunction, falls, and oculomotor abnormalities. Understanding the epidemiology of these conditions is critical to planning for future service provision. METHODS We conducted a systematic review of studies reporting incidence and prevalence of CBS and PSP. A search of the PubMed and EMBASE data bases was conducted from their date of inception to 13th July 2021. Meta-analysis of studies sharing similar methodologies was carried out to generate estimated pooled prevalence and incidence. RESULTS We found 32 studies meeting our criteria for inclusion. There were 20 studies with data on prevalence and 12 with incidence data of PSP. Prevalence of CBS was reported in eight studies while seven studies reported incidence. Reported estimates of prevalence for PSP ranged from 1.00 (0.9-1.1) to 18 (8-28) per 100,000 while prevalence rates for CBS ranged from 0.83 (0.1-3.0) to 25 (0-59). Incidence rates for PSP and CBS respectively ranged from 0.16 (0.07-0.39) to 2.6 per 100,000 person-years and 0.03 (0-0.18) to 0.8 (0.4-1.3) per 100,000 person-years. A random effects model meta-analysis of studies with similar methodologies yielded a pooled prevalence estimate for PSP of 6.92 (4.33-11.06, I2 = 89%, τ2 = 0.3907) and 3.91 (2.03-7.51, I2 = 72%, τ2 = 0.2573) per 100,000 for CBS. CONCLUSION Studies of the epidemiology of PSP and CBS report highly heterogeneous findings. There is a need for further studies using rigorous phenotyping and the most recent diagnostic criteria to understand the true burden of these conditions.
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Affiliation(s)
- Shane Lyons
- Department of Neurology, Tallaght University Hospital, Dublin, Ireland.
- The Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland.
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland.
| | - Dominic Trépel
- Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Tim Lynch
- The Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland
- Health Affairs, University College Dublin, Dublin, Ireland
| | - Richard Walsh
- Department of Neurology, Tallaght University Hospital, Dublin, Ireland
- The Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
| | - Sean O'Dowd
- Department of Neurology, Tallaght University Hospital, Dublin, Ireland
- Institute of Memory and Cognition, Tallaght University Hospital, Dublin, Ireland
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
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12
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Utianski RL, Josephs KA. An Update on Apraxia of Speech. Curr Neurol Neurosci Rep 2023; 23:353-359. [PMID: 37269450 PMCID: PMC10629164 DOI: 10.1007/s11910-023-01275-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE OF REVIEW Apraxia of speech (AOS) is a motor speech disorder that has long been recognized to occur secondary to acute neurologic insults and, more recently, to neurodegenerative diseases as a harbinger for progressive supranuclear palsy and corticobasal syndrome. This article reviews recent findings regarding the clinic phenotypes of AOS, neuroimaging correlates, and the underlying disease processes. RECENT FINDINGS Two clinical subtypes of AOS map onto two underlying 4-repeat tauopathies. New imaging techniques have recently been applied to the study of progressive AOS. There is no data on the impact of behavioral intervention, although studies of nonfluent/agrammatic primary progressive aphasia that include patients with AOS suggest some benefit in speech intelligibility and maintenance. While recent findings suggest subtypes of AOS exist that are linked to molecular pathology and have important implications for disease progression, further research is needed to assess outcome of behavioral and other types of intervention.
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Affiliation(s)
- Rene L Utianski
- Department of Neurology, Mayo Clinic College of Medicine and Science, 200 1St Street S.W., Rochester, MN, 55905, USA
| | - Keith A Josephs
- Department of Neurology, Mayo Clinic College of Medicine and Science, 200 1St Street S.W., Rochester, MN, 55905, USA.
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13
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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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Constantinides VC, Tentolouris-Piperas V, Paraskevas GP, Pyrgelis ES, Velonakis G, Karavasilis E, Toulas P, Boufidou F, Stefanis L, Kapaki E. Hippocampal subfield volumetry in corticobasal syndrome of diverse underlying pathologies. J Neurol 2023; 270:2059-2068. [PMID: 36565349 DOI: 10.1007/s00415-022-11538-5] [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: 11/13/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Multiple pathologies may underlie corticobasal syndrome (CBS), including Alzheimer's disease (AD). Typical amnestic AD is characterized by early selective hippocampal atrophy. The profile of hippocampal atrophy in AD patients presenting as CBS (CBS-AD), compared to CBS patients of non-AD pathologies (CBS-nAD) and amnestic AD patients, has not been studied. OBJECTIVES To compare hippocampal subfield atrophy patterns between CBS-AD, CBS-nAD, typical amnestic AD patients, and control subjects. METHODS Automated hippocampal subfield volumetry was performed via the hippocampal subfield segmentation pipeline of Freesurfer 6.0 on 3D T1-weighted images. CBS patients were classified as CBS-AD or CBS-nAD based on CSF AD biomarkers by applying the AT(N) classification system. Mean volumes of nine hippocampal subfields, head-body-tail segments, total hippocampus, and entorhinal and parahippocampal gyrus cortical thickness were measured. RESULTS Eighty-three subjects were included (CBS-AD: n = 14; CBS-nAD: n = 17; amnestic AD: n = 29; controls: n = 23). CBS-AD patients had greater whole hippocampal and hippocampal subfield atrophy compared to CBS-nAD. CBS-AD and amnestic AD patients did not differ in subfield volumes. CBS-nAD did not exhibit hippocampal atrophy compared to controls, with the exception of fimbria. (Cohen's d = 1.27; p = 0.038). Presubiculum (Cohen's d = 1.00; p = 0.002) and hippocampal body (Cohen's d = 0.95; p = 0.001) volumes exhibited the greatest differences between CBS-AD and CBS-nAD. Hippocampal subfield volume provided combined sensitivity and specificity < 80% for the discrimination of CBS-AD from CBS-nAD. CONCLUSION CBS-AD and amnestic AD patients exhibit comparable, and significantly greater hippocampal atrophy compared to CBS-nAD patients. Hippocampal subfield volumetry in CBS is indicative of an AD underlying pathology.
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Affiliation(s)
- Vasilios C Constantinides
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece.
| | - Vasileios Tentolouris-Piperas
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
| | - George P Paraskevas
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
- Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Attikon Hospital, Athens, Greece
| | - Efstratios-Stylianos Pyrgelis
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
| | - Georgios Velonakis
- Second Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Efstratios Karavasilis
- Second Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Panagiotis Toulas
- Second Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Fotini Boufidou
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
| | - Leonidas Stefanis
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
| | - Elisabeth Kapaki
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
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Dal SR, Lee Ong T, Martin AJ, Halpern JP, Fung VS. A late-onset neurological disorder: is progression inevitable? Parkinsonism Relat Disord 2023; 108:105092. [PMID: 35811228 DOI: 10.1016/j.parkreldis.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/16/2022] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Affiliation(s)
- Shoaib R Dal
- Movement Disorder Unit, Neurology Department, Westmead Hospital, Westmead, NSW, Australia
| | - Tien Lee Ong
- Movement Disorder Unit, Neurology Department, Westmead Hospital, Westmead, NSW, Australia
| | - Andrew J Martin
- Movement Disorder Unit, Neurology Department, Westmead Hospital, Westmead, NSW, Australia; Blacktown Hospital, Blacktown, NSW, Australia
| | | | - Victor Sc Fung
- Movement Disorder Unit, Neurology Department, Westmead Hospital, Westmead, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
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Armstrong MJ, Wilson CA. A late-onset neurological disorder: Is progression inevitable? Expert Commentary. Parkinsonism Relat Disord 2023; 108:105321. [PMID: 36792462 DOI: 10.1016/j.parkreldis.2023.105321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Affiliation(s)
- Melissa J Armstrong
- Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA; Norman Fixel Institute for Neurologic Diseases, University of Florida, Gainesville, FL, USA.
| | - Christina A Wilson
- Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA
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Sasikumar S, Strafella AP. The challenging quest of neuroimaging: From clinical to molecular-based subtyping of Parkinson disease and atypical parkinsonisms. Handb Clin Neurol 2023; 192:231-58. [PMID: 36796945 DOI: 10.1016/B978-0-323-85538-9.00004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The current framework of Parkinson disease (PD) focuses on phenotypic classification despite its considerable heterogeneity. We argue that this method of classification has restricted therapeutic advances and therefore limited our ability to develop disease-modifying interventions in PD. Advances in neuroimaging have identified several molecular mechanisms relevant to PD, variation within and between clinical phenotypes, and potential compensatory mechanisms with disease progression. Magnetic resonance imaging (MRI) techniques can detect microstructural changes, disruptions in neural pathways, and metabolic and blood flow alterations. Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging have informed the neurotransmitter, metabolic, and inflammatory dysfunctions that could potentially distinguish disease phenotypes and predict response to therapy and clinical outcomes. However, rapid advancements in imaging techniques make it challenging to assess the significance of newer studies in the context of new theoretical frameworks. As such, there needs to not only be a standardization of practice criteria in molecular imaging but also a rethinking of target approaches. In order to harness precision medicine, a coordinated shift is needed toward divergent rather than convergent diagnostic approaches that account for interindividual differences rather than similarities within an affected population, and focus on predictive patterns rather than already lost neural activity.
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18
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Kang K, Stenum J, Roemmich RT, Heller NH, Jouny C, Pantelyat A. Neurologic music therapy combined with EEG-tDCS for upper motor extremity performance in patients with corticobasal syndrome: Study protocol for a novel approach. Contemp Clin Trials 2023; 125:107058. [PMID: 36549380 DOI: 10.1016/j.cct.2022.107058] [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: 09/16/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Corticobasal syndrome (CBS) is an atypical parkinsonian disorder that involves degeneration of brain regions associated with motor coordination and sensory processing. Combining transcranial direct current stimulation (tDCS) with rehabilitation training has been shown to improve upper-limb performance in other disease models. Here, we describe the protocol investigating whether tDCS with neurologic music therapy (NMT) (patterned sensory enhancement and therapeutic instrumental music performance) enhances functional arm/hand performance in individuals with CBS. METHODS Study participants are randomly assigned to six 30-min sessions (twice per week for 3 weeks) of NMT + either sham tDCS or active tDCS. We aim to stimulate the frontoparietal cortex, which is associated with movement execution/coordination and sensory processing. The hemisphere contralateral to the more affected arm is stimulated (total stimulation current of 2 mA from 5 dime-sized electrodes). Individualized NMT sessions designed to exercise the upper limb are provided. Participants undergo gross/fine motor, cognitive and emotional assessments at baseline and follow-up (one month after the final session). To investigate the immediate effects of tDCS and NMT training, gross /fine motor, affective level, and kinematic parameter measurements using motion sensors are collected before and after each session. Electroencephalography is used to collect electrical neurophysiological responses before, during, and after tDCS+NMT sessions. The study participants, neurologic music therapist and outcome assessor are blinded to whether participants are in the sham or active tDCS group. CONCLUSION This noninvasive and patient-centered clinical trial for CBS may provide insight into rehabilitation options that are sorely lacking in this population.
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Affiliation(s)
- Kyurim Kang
- School of Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America; Center for Music and Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America
| | - Jan Stenum
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States of America; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Ryan T Roemmich
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States of America; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Nathan H Heller
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States of America
| | - Christophe Jouny
- School of Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America
| | - Alexander Pantelyat
- School of Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America; Center for Music and Medicine, Department of Neurology, Johns Hopkins University, Baltimore, MD, United States of America.
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von Arnim CAF, Uttner I. [Rare forms of dementia-Atypical variants of Alzheimer's dementia]. Inn Med (Heidelb) 2023; 64:121-6. [PMID: 36662356 DOI: 10.1007/s00108-022-01461-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 01/21/2023]
Abstract
In Germany, around 1.8 million people currently suffer from dementia and the numbers are increasing. The main cause of dementia is Alzheimer's disease. This is classically manifested in the form of an amnestic syndrome but also encompasses various atypical variants, especially in younger patients and in the clinical routine are not always easy to recognize. These are described in this narrative review with case studies. Posterior cortical atrophy (PCA) presents with visual disorders, in the logopenic variants of primary progressive aphasia (lvPPA) impaired word retrieval is the main symptom, in the frontal variant of Alzheimer's disease behavioral disorders are prominent and in corticobasal syndrome (CBS) an akinetic rigid Parkinson's syndrome with alien limb phenomenon. As the clinical presentation of these atypical variants shows an overlap with other dementia disorders, the differential diagnosis is often challenging. In this context amyloid biomarkers can provide valuable services.
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Corcoran J, Huang AH, Miyasaki JM, Tarolli CG. Palliative care in Parkinson disease and related disorders. Handb Clin Neurol 2023; 191:107-128. [PMID: 36599503 DOI: 10.1016/b978-0-12-824535-4.00017-3] [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] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Although neuropalliative care is a relatively new field, there is increasing evidence for its use among the degenerative parkinsonian syndromes, including idiopathic Parkinson disease, progressive supranuclear palsy, multiple system atrophy, dementia with Lewy bodies, and corticobasal syndrome. This chapter outlines the current state of evidence for palliative care among individuals with the degenerative parkinsonian syndromes with discussion surrounding: (1) disease burden and needs across the conditions; (2) utility, timing, and methods for advance care planning; (3) novel care models for the provision of palliative care; and 4) end-of-life care issues. We also discuss currently unmet needs and unanswered questions in the field, proposing priorities for research and the assessment of implemented care models.
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Affiliation(s)
- Jennifer Corcoran
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States
| | - Andrew H Huang
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States
| | - Janis M Miyasaki
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Christopher G Tarolli
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States.
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21
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Baiardi S, Quadalti C, Mammana A, Dellavalle S, Zenesini C, Sambati L, Pantieri R, Polischi B, Romano L, Suffritti M, Bentivenga GM, Randi V, Stanzani-Maserati M, Capellari S, Parchi P. Diagnostic value of plasma p-tau181, NfL, and GFAP in a clinical setting cohort of prevalent neurodegenerative dementias. Alzheimers Res Ther 2022; 14:153. [PMID: 36221099 PMCID: PMC9555092 DOI: 10.1186/s13195-022-01093-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
Abstract
Background Increasing evidence supports the use of plasma biomarkers of neurodegeneration and neuroinflammation to screen and diagnose patients with dementia. However, confirmatory studies are required to demonstrate their usefulness in the clinical setting. Methods We evaluated plasma and cerebrospinal fluid (CSF) samples from consecutive patients with frontotemporal dementia (FTD) (n = 59), progressive supranuclear palsy (PSP) (n = 31), corticobasal syndrome (CBS) (n = 29), dementia with Lewy bodies (DLB) (n = 49), Alzheimer disease (AD) (n = 97), and suspected non-AD physiopathology (n = 51), as well as plasma samples from 60 healthy controls (HC). We measured neurofilament light chain (NfL), phospho-tau181 (p-tau181), and glial fibrillary acid protein (GFAP) using Simoa (all plasma biomarkers and CSF GFAP), CLEIA (CSF p-tau181), and ELISA (CSF NfL) assays. Additionally, we stratified patients according to the A/T/N classification scheme and the CSF α-synuclein real-time quaking-induced conversion assay (RT-QuIC) results. Results We found good correlations between CSF and plasma biomarkers for NfL (rho = 0.668, p < 0.001) and p-tau181 (rho = 0.619, p < 0.001). Plasma NfL was significantly higher in disease groups than in HC and showed a greater increase in FTD than in AD [44.9 (28.1–68.6) vs. 21.9 (17.0–27.9) pg/ml, p < 0.001]. Conversely, plasma p-tau181 and GFAP levels were significantly higher in AD than in FTD [3.2 (2.4–4.3) vs. 1.1 (0.7–1.6) pg/ml, p < 0.001; 404.7 (279.7–503.0) vs. 198.2 (143.9–316.8) pg/ml, p < 0.001]. GFAP also allowed discriminating disease groups from HC. In the distinction between FTD and AD, plasma p-tau181 showed better accuracy (AUC 0.964) than NfL (AUC 0.791) and GFAP (AUC 0.818). In DLB and CBS, CSF amyloid positive (A+) subjects had higher plasma p-tau181 and GFAP levels than A− individuals. CSF RT-QuIC showed positive α-synuclein seeding activity in 96% DLB and 15% AD patients with no differences in plasma biomarker levels in those stratified by RT-QuIC result. Conclusions In a single-center clinical cohort, we confirm the high diagnostic value of plasma p-tau181 for distinguishing FTD from AD and plasma NfL for discriminating degenerative dementias from HC. Plasma GFAP alone differentiates AD from FTD and neurodegenerative dementias from HC but with lower accuracy than p-tau181 and NfL. In CBS and DLB, plasma p-tau181 and GFAP levels are significantly influenced by beta-amyloid pathology. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01093-6.
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Affiliation(s)
- Simone Baiardi
- grid.6292.f0000 0004 1757 1758Department of Experimental, Diagnostic and Specialty Medicine (DIMES) University of Bologna, Bologna, Italy ,grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Corinne Quadalti
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Angela Mammana
- grid.6292.f0000 0004 1757 1758Department of Experimental, Diagnostic and Specialty Medicine (DIMES) University of Bologna, Bologna, Italy ,grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Sofia Dellavalle
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Corrado Zenesini
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Luisa Sambati
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Roberta Pantieri
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Barbara Polischi
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Luciano Romano
- grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences University of Bologna (DIBINEM), Bologna, Italy
| | - Matteo Suffritti
- grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences University of Bologna (DIBINEM), Bologna, Italy
| | - Giuseppe Mario Bentivenga
- grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences University of Bologna (DIBINEM), Bologna, Italy
| | - Vanda Randi
- Emilia-Romagna Regional Blood Bank, Immunohematology and Transfusion Medicine Service, Bologna Metropolitan Area, Bologna, Italy
| | | | - Sabina Capellari
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy ,grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences University of Bologna (DIBINEM), Bologna, Italy
| | - Piero Parchi
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy ,grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences University of Bologna (DIBINEM), Bologna, Italy
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22
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Malik RA, Galang CM, Finger E. The sense of agency for brain disorders: A comprehensive review and proposed framework. Neurosci Biobehav Rev 2022; 139:104759. [PMID: 35780975 DOI: 10.1016/j.neubiorev.2022.104759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/24/2022] [Accepted: 06/26/2022] [Indexed: 11/21/2022]
Abstract
Sense of Agency (SoA) refers to the feeling of control over voluntary actions and the outcomes of those actions. Several brain disorders are characterized by an abnormal SoA. To date, there is no robust treatment for aberrant agency across disorders; this is, in large part, due to gaps in our understanding of the cognitive mechanisms and neural correlates of the SoA. This apparent gap stems from a lack of synthesis in established findings. As such, the current review reconciles previously established findings into a novel neurocognitive framework for future investigations of the SoA in brain disorders, which we term the Agency in Brain Disorders Framework (ABDF). In doing so, we highlight key top-down and bottom-up cues that contribute to agency prospectively (i.e., prior to action execution) and retrospectively (i.e., after action execution). We then examine brain disorders, including schizophrenia, autism spectrum disorders (ASD), obsessive-compulsive disorders (OCD), and cortico-basal syndrome (CBS), within the ABDF, to demonstrate its potential utility in investigating neurocognitive mechanisms underlying phenotypically variable presentations of the SoA in brain disorders.
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23
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Donzuso G, Sciacca G, Luca A, Cicero CE, Mostile G, Nicoletti A, Zappia M. Corticobasal syndrome and Parkinson's disease at the beginning: asymmetrical patterns of MRI and Blink Reflex for early diagnosis. J Neural Transm (Vienna) 2022; 129:1427-1433. [PMID: 36308548 PMCID: PMC9649477 DOI: 10.1007/s00702-022-02557-7] [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: 08/23/2022] [Accepted: 10/19/2022] [Indexed: 01/20/2023]
Abstract
Differential diagnosis between Parkinson's disease (PD) and corticobasal syndrome (CBS) could be challenging at the early stage, due to the asymmetric onset of both diseases. Despite the clinical overlap, the anatomical circuits involved in these disorders are different. We evaluated R2 Blink Reflex Recovery Cycle (R2BRRC) and cortical thickness (CTh) in drug-naïve PD and CBS patients for characterizing pathophysiological mechanisms underlying these conditions. Patients with a clinically probable diagnosis of PD and possible CBS were recruited. R2BRRC was evaluated bilaterally at interstimulus intervals (ISIs) of 100-150-200-300-400-500-750 ms. Asymmetry index (AI) of R2BRRC for each ISI was computed. Patients underwent a structural brain MRI and hemisphere CTh and AI of MRI was calculated. Fourteen drug-naïve PD patients and 10 patients with early CBS diagnosis were enrolled. R2BRRC of PD patients showed an increased brainstem excitability for less affected side (LAS) stimulation at ISIs of 100 and 150 ms (p < 0.001) compared to most affected side (MAS), whereas no differences between LAS and MAS were found in CBS. AI of R2BRRC at ISI-100 ms showed significant difference, being higher in PD. CTh analysis showed significant differences between groups in hemisphere cortical volume contralateral to MAS, and, conversely, AI of MRI was significantly higher in CBS. PD patients exhibited an asymmetric pattern of brainstem excitability, compared to CBS. Conversely, CBS patients showed an asymmetric pattern of cortical atrophy. This opposite pattern of neurophysiological and structural abnormalities involving cortical and subcortical brain structures could highlight the different pathophysiological mechanisms underlying these disorders.
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Affiliation(s)
- Giulia Donzuso
- grid.8158.40000 0004 1757 1969Department of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy
| | - Giorgia Sciacca
- grid.8158.40000 0004 1757 1969Department of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy
| | - Antonina Luca
- grid.8158.40000 0004 1757 1969Department of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy
| | - Calogero E. Cicero
- grid.8158.40000 0004 1757 1969Department of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy
| | - Giovanni Mostile
- grid.8158.40000 0004 1757 1969Department of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy
| | - Alessandra Nicoletti
- grid.8158.40000 0004 1757 1969Department of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy
| | - Mario Zappia
- grid.8158.40000 0004 1757 1969Department of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy
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Sainouchi M, Tada M, Fitrah YA, Hara N, Tanaka K, Idezuka J, Aida I, Nakajima T, Miyashita A, Akazawa K, Ikeuchi T, Onodera O, Kakita A. Brain TDP-43 pathology in corticobasal degeneration: topographical correlation with neuronal loss. Neuropathol Appl Neurobiol 2021; 48:e12786. [PMID: 34913181 DOI: 10.1111/nan.12786] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/18/2021] [Accepted: 12/12/2021] [Indexed: 11/30/2022]
Abstract
AIMS Neuronal and glial inclusions comprising transactive response DNA-binding protein of 43 kDa (TDP-43) have been identified in the brains of patients with corticobasal degeneration (CBD), and a possible correlation between the presence of these inclusions and clinical phenotypes has been speculated. However, the significance of TDP-43 pathology in the pathomechanism of CBD has remained unclear. Here we investigated the topographical relationship between TDP-43 inclusions and neuronal loss in CBD. METHODS We estimated semi-quantitatively neuronal loss and TDP-43 pathology in the form of neuronal cytoplasmic inclusions (NCIs), astrocytic inclusions (AIs), oligodendroglial cytoplasmic inclusions (GCIs), and dystrophic neurites in 22 CNS regions in 10 patients with CBD. Then, the degree of correlation between the severity of neuronal loss and the quantity of each type of TDP-43 inclusion was assessed. We also investigated tau pathology in a similar manner. RESULTS TDP-43 pathology was evident in 9 patients. The putamen and globus pallidus were the regions most frequently affected (80%). NCIs were the most prominent form, and their quantity was significantly correlated with the severity of neuronal loss in more than half of the regions examined. The quantities of TDP-43 NCIs and tau NCIs were correlated in only a few regions. The number of regions where the quantities of TDP-43 AIs and GCIs were correlated with the severity of neuronal loss was apparently small in comparison with that of NCIs. CONCLUSIONS TDP-43 alterations in neurons, not closely associated with tau pathology, may be involved in the pathomechanism underlying neuronal loss in CBD.
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Affiliation(s)
- Makoto Sainouchi
- Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Mari Tada
- Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Yusran Ady Fitrah
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Norikazu Hara
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Kou Tanaka
- Department of Psychiatry, Mishima Hospital, Nagaoka, Niigata, Japan
| | - Jiro Idezuka
- Department of Neurology, Ojiya Sakura Hospital, Ojiya, Niigata, Japan
| | - Izumi Aida
- Department of Neurology, National Hospital Organization Niigata National Hospital, Kashiwazaki, Niigata, Japan
| | - Takashi Nakajima
- Department of Neurology, National Hospital Organization Niigata National Hospital, Kashiwazaki, Niigata, Japan
| | - Akinori Miyashita
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Kohei Akazawa
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Osamu Onodera
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan
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Prado MB Jr, Adiao KJ. Corticobasal syndrome etiologies in a young Filipino patient: A case report and literature review. Clin Neurol Neurosurg 2021; 210:107002. [PMID: 34717235 DOI: 10.1016/j.clineuro.2021.107002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 11/21/2022]
Abstract
While corticobasal syndrome (CBS) has long been associated with corticobasal degeneration (CBD), only 24-57% of CBS patients will have the classic histopathologic findings of CBD postmortem. Here, we present a 28-year-old male who had a 3-year history of progressive right sided predominant, atypical parkinsonism, limb dystonia, stimulus sensitive myoclonus, apraxia, aphasia, alien limb phenomenon, and cognitive impairment, typical of CBS, who, based on Armstrong criteria will qualify as possible CBD. In conclusion, among young patients presenting with CBS, tauopathies are still the most common causes, but inherited metabolic and white matter diseases as well as other non-tau associated neurodegenerative conditions should also be ruled out. Nevertheless, since most of these are diagnosed histopathologically, accurate and complete clinical findings, in addition to extensive metabolic work ups, imaging and genetic tests may be needed to clinch the cause of this syndrome.
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26
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Seghezzi S, Convertino L, Zapparoli L. Sense of agency disturbances in movement disorders: A comprehensive review. Conscious Cogn 2021; 96:103228. [PMID: 34715456 DOI: 10.1016/j.concog.2021.103228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/08/2021] [Accepted: 10/19/2021] [Indexed: 11/20/2022]
Abstract
Sense of agency refers to the experience that one's self-generated action causes an event in the external environment. Here, we review the behavioural and brain evidence of aberrant experiences of agency in movement disorders, clinical conditions characterized by either a paucity or an excess of movements unrelated to the patient's intention. We show that specific abnormal agency experiences characterize several movement disorders. Those manifestations are typically associated with structural and functional brain abnormalities. However, the evidence is sometimes conflicting, especially when considering results obtained through different agency measures. The present review aims to create order in the existing literature on sense of agency investigations in movement disorders and to provide a coherent overview framed within current neurocognitive models of motor awareness.
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27
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Murley AG, Tsvetanov KA, Rouse MA, Jones PS, Sværke K, Li W, Carpenter A, Rowe JB. Proton magnetic resonance spectroscopy in frontotemporal lobar degeneration-related syndromes. Neurobiol Aging 2021; 111:64-70. [PMID: 34971846 PMCID: PMC8776136 DOI: 10.1016/j.neurobiolaging.2021.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/11/2021] [Accepted: 10/23/2021] [Indexed: 12/13/2022]
Abstract
There is an urgent need for a better understanding of the pathophysiology of cognitive impairment in syndromes associated with frontotemporal lobar degeneration. Here, we used magnetic resonance spectroscopy to quantify metabolite deficits in sixty patients with a clinical syndrome associated with frontotemporal lobar degeneration (behavioral variant frontotemporal dementia n = 11, progressive supranuclear palsy n = 26, corticobasal syndrome n = 11, primary progressive aphasias n = 12), and 38 age- and sex-matched healthy controls. We measured nine metabolites in the right inferior frontal gyrus, superior temporal gyrus and right primary visual cortex. Metabolite concentrations were corrected for age, sex, and partial volume then compared with cognitive and behavioral measures using canonical correlation analysis. Metabolite concentrations varied significantly by brain region and diagnosis (region x metabolite x diagnosis interaction F(64) = 1.73, p < 0.001, corrected for age, sex, and atrophy within the voxel). N-acetyl aspartate and glutamate concentrations were reduced in the right prefrontal cortex in behavioral variant frontotemporal dementia and progressive supranuclear palsy, even after partial volume correction. The reduction of these metabolites was associated with executive dysfunction and behavioral impairment (canonical correlation analysis R = 0.85, p < 0.001).
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Affiliation(s)
- Alexander G Murley
- Department of Clinical Neurosciences, University of Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, UK.
| | | | - Matthew A Rouse
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - P Simon Jones
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Katrine Sværke
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Win Li
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Adrian Carpenter
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, UK; MRC Cognition and Brain, Sciences Unit, University of Cambridge, UK
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28
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Karantzoulis A, Susani E, Ferrarese C, Appollonio I, Tremolizzo L. Coming to Terms with a Conundrum: A Case of Primary Progressive Apraxia of Speech due to Corticobasal Degeneration? Case Rep Neurol 2021; 13:483-489. [PMID: 34413751 PMCID: PMC8339446 DOI: 10.1159/000517367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/17/2021] [Indexed: 11/25/2022] Open
Abstract
Primary progressive apraxia of speech (PPAOS) is a progressive disorder impairing the motor speech act leaving linguistic function unattained. Although apraxia of speech frequently co-occurs with other neurodegenerative conditions, PPAOS defines a clinical syndrome where apraxia of speech is the sole or prominent symptom for much of the disease's natural history. Mounting evidence is beginning to fully define this disease as the epiphenomenon of 4-repeat (4R) tau pathology although other pathologic signatures have been reported. Indeed, PPAOS patients generally present a parkinsonian syndrome late into their natural history mostly qualifying for either corticobasal syndrome (CBS) or progressive supranuclear palsy (PSP). This is starting to be reflected in diagnostic criteria for PSP, namely, in the PSP speech and language (SL) subcategory; however, this inclusion is not reflected for CBS. Here, we present a single case of a patient with PPAOS and her clinical follow-up lasting 6 years, from the time she sought our attention to her death which occurred 8 years into the disease. PPAOS was the only and prominent symptom for most of the illness with extrapyramidal signs overtly presenting in the last months of its course. Clinical evaluation, imaging, genetic, and cerebrospinal fluid biomarkers all pointed toward an underlying CBD pathology, albeit the eventual anatomopathological confirmation was not performed. Had her clinical course been more suggestive of PSP, she would have qualified for criteria as PSP-SL. Our case therefore suggests the hypothetic need to discuss the broadening of the existing CBS criteria to encompass isolated PPAOS.
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Affiliation(s)
| | | | - Carlo Ferrarese
- Neurology Unit "San Gerardo" Hospital and University of Milano-Bicocca, Monza, Italy
| | - Ildebrando Appollonio
- Neurology Unit "San Gerardo" Hospital and University of Milano-Bicocca, Monza, Italy
| | - Lucio Tremolizzo
- Neurology Unit "San Gerardo" Hospital and University of Milano-Bicocca, Monza, Italy
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Kellermair L, Fuchs A, Eggers C, Schwingenschuh P, Kögl M, Fellner F, Forstner T, Mangesius S, Guger M, Ransmayr G. Caregiver strain in progressive supranuclear palsy and corticobasal syndromes. J Neural Transm (Vienna) 2021. [PMID: 34296340 DOI: 10.1007/s00702-021-02379-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/01/2021] [Indexed: 12/04/2022]
Abstract
Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) progress relentlessly and lead to a need for care. Caregiving is often burdensome. Little is known about the course of caregiver burden (CB) in PSP and CBS patients. Longitudinal analysis of CB in family members caring for PSP and CBS patients. Single-center longitudinal pilot study in 68 newly diagnosed patients with probable PSP and CBS (52 Richardson’s syndrome; 1 progressive gait freezing of PSP; 15 CBS). Demographic, educational, occupational parameters, family status, motor functions (UPDRSIII, Hoehn and Yahr Score, Tinetti) and neuropsychological performance (CERAD Plus, Frontal Assessment Battery) were assessed, as well as behavioral and neuropsychiatric impairments (Frontal Behavioral Inventory, Neuropsychiatric Inventory), activities of daily living (ADL) and caregiver burden using the Caregiver Strain Index (CSI), in most patients also the Zarit Burden Interview (ZBI). Patients were followed up every 6 months for up to 2 years. Caregivers reported mild to moderate CB at baseline, which increased by 25–30% in 2 years and was significantly greater in PSP than in CBS. Risk for mental health problems increased over time, especially in female caregivers (depression). Important patient-related factors were apathy, aspontaneity, depression, irritability, disorganization, poor judgment, impairment of language, impairments in ADL, a high educational level of the patient and close family relationship. Behavioral symptoms and impaired ADL are the main patient-related factors of CB in PSP and CBS. CB can be severe and needs to be assessed repeatedly from the time of diagnosis to provide comprehensive support.
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Mutlay F, Kaya D, Isik AT. Ogilvie's syndrome presented with delirium in an older lady with corticobasal syndrome. Palliat Support Care 2021;:1-3. [PMID: 34218843 DOI: 10.1017/S1478951521001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Corticobasal syndrome (CBS) is one of an atypical parkinsonian syndromes characterized by extrapyramidal features as well as cortical involvement signs. A variety of factors may lead to delirium in older adults with chronic progressive life-limiting neurological illnesses like CBS. Ogilvie's syndrome (OS) is an acute colonic pseudo-obstruction in which abdominal distension, nausea, vomiting, and constipation can be seen. We report a case of OS identified as the underlying possible cause of delirium in an 80-year-old woman with CBS. We also discuss the importance of holistic approach which is essential to manage the underlying cause and to preserve the quality of life in particular for the frail geriatric population who potentially needs palliative care or already benefits from palliative care. METHOD An older patient with CBS presented with symptoms similar to that of acute colonic obstruction and subsequently developed delirium. The patient was found to have colonic pseudo-obstruction (OS). RESULT Neostigmin infusion was therefore given to treat it and delirium was resolved. SIGNIFICANCE OF RESULTS To the best of our knowledge, clinical manifestation of delirium as OS in a patient with CBS has not been previously reported. OS may be superimposed to CBS in older patients, and OS in such patients may play a role as a precipitating factor for the development of delirium. Given the fact that CBS is progressive and rare neurodegenerative disease and almost all of these patients need palliative care, eventually, health-care professionals, especially in palliative care, should be aware of distinctive challenges of life-limiting chronic neurological illnesses, such as conditions that may lead to the development of acute colonic pseudo-obstruction because the rapid treatment of them prevents the use of potentially harmful drugs, surgical procedures, or inappropriate interventions.
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Parjane N, Cho S, Ash S, Cousins KAQ, Shellikeri S, Liberman M, Shaw LM, Irwin DJ, Grossman M, Nevler N. Digital Speech Analysis in Progressive Supranuclear Palsy and Corticobasal Syndromes. J Alzheimers Dis 2021; 82:33-45. [PMID: 34219738 DOI: 10.3233/jad-201132] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Progressive supranuclear palsy syndrome (PSPS) and corticobasal syndrome (CBS) as well as non-fluent/agrammatic primary progressive aphasia (naPPA) are often associated with misfolded 4-repeat tau pathology, but the diversity of the associated speech features is poorly understood. OBJECTIVE Investigate the full range of acoustic and lexical properties of speech to test the hypothesis that PSPS-CBS show a subset of speech impairments found in naPPA. METHODS Acoustic and lexical measures, extracted from natural, digitized semi-structured speech samples using novel, automated methods, were compared in PSPS-CBS (n = 87), naPPA (n = 25), and healthy controls (HC, n = 41). We related these measures to grammatical performance and speech fluency, core features of naPPA, to neuropsychological measures of naming, executive, memory and visuoconstructional functioning, and to cerebrospinal fluid (CSF) phosphorylated tau (pTau) levels in patients with available biofluid analytes. RESULTS Both naPPA and PSPS-CBS speech produced shorter speech segments, longer pauses, higher pause rates, reduced fundamental frequency (f0) pitch ranges, and slower speech rate compared to HC. naPPA speech was distinct from PSPS-CBS with shorter speech segments, more frequent pauses, slower speech rate, reduced verb production, and higher partial word production. In both groups, acoustic duration measures generally correlated with speech fluency, measured as words per minute, and grammatical performance. Speech measures did not correlate with standard neuropsychological measures. CSF pTau levels correlated with f0 range in PSPS-CBS and naPPA. CONCLUSION Lexical and acoustic speech features of PSPS-CBS overlaps those of naPPA and are related to CSF pTau levels.
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Affiliation(s)
- Natalia Parjane
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Sunghye Cho
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, USA
| | - Sharon Ash
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Katheryn A Q Cousins
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Sanjana Shellikeri
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Liberman
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia, PA, USA
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - David J Irwin
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.,Penn Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Naomi Nevler
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
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Jo S, Oh JS, Cheong EN, Kim HJ, Lee S, Oh M, Kim JS, Chung SJ, Lee CS, Kwon M, Kang D, Lee JH. FDG-PET patterns associated with ideomotor apraxia and imitation apraxia in patients with corticobasal syndrome. Parkinsonism Relat Disord 2021; 88:96-101. [PMID: 34166866 DOI: 10.1016/j.parkreldis.2021.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/09/2021] [Accepted: 06/09/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Apraxia is a core clinical feature of corticobasal syndrome (CBS). Among the subtypes of apraxia, ideomotor and imitation apraxia are frequently found in CBS. However, little is known about the brain networks that are characteristic of each apraxia subtype or their clinical implication. In this study, we used 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) to explore the specific patterns of glucose hypometabolism that are characteristic of apraxia subtypes by focusing on ideomotor and imitation apraxia. METHODS We compared the areas of glucose hypometabolism in the brains of 52 patients with CBS and 13 healthy controls, both as a whole and according to apraxia subtypes. In addition, we investigated the relationship between the apraxia subtypes and the clinical phenotype of CBS. RESULTS In patients with CBS, common hypometabolism was observed in the frontal gyrus, precentral gyrus and caudate regardless of apraxia subtypes. In particular, ideomotor apraxia was associated with hypometabolism in the angular gyrus, while imitation apraxia was associated with hypometabolism in the posterior part including the postcentral gyrus, precuneus, and posterior cingulate gyrus. Patients who showed both ideomotor and imitation apraxia were more likely to show the typical features of CBS and progressive supranuclear palsy compared with patients showing only one type of apraxia. CONCLUSION Group comparison analysis using FDG-PET revealed distinct pathways of ideomotor and imitation apraxia in CBS. These findings add to our understanding of the brain networks underlying apraxia in association with the clinical features of CBS.
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Affiliation(s)
- Sungyang Jo
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jungsu S Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - E-Nae Cheong
- Department of Medical Science and Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyung Ji Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sunju Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Minyoung Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chong S Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Miseon Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dongwha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Abstract
Corticobasal syndrome (CBS) is associated with diverse pathological substrates such as tau, prion protein, transactive response and, rarely, alpha synuclein. We report the case of a54-year-old man, who presented with asymmetric levodopa-poor-responsive parkinsonism, frontal lobe signs and behavioral changes. He was diagnosed with CBS, and postmortem analyses revealed Lewy body disease Braak stage VI without comorbid pathologies. Retrospectively, the clinical course of our patient and previous reports indicate that CBS plus mood changes and autonomic dysfunction, including reduced uptake of metaiodobenzylguanidine, are predictive factors of Lewy body pathology, even if the clinical picture is atypical.
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Affiliation(s)
- Keiko Ichinose
- Department of Neurology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Mutsufusa Watanabe
- Department of Neurology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Saneyuki Mizutani
- Department of Neurology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Toru Tanizawa
- Department of Clinical Examination, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Toshiki Uchihara
- Department of Neurology and Neurological Science Tokyo Medical and Dental University, Tokyo, Japan.,Department of Neurology, Nitobe Memorial Nakano General Hospital, Tokyo, Japan
| | - Hiroto Fujigasaki
- Department of Neurology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
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Kikuchi A, Yoneda M, Hasegawa T, Matsunaga A, Ikawa M, Nakamura T, Ezura M, Baba T, Sugeno N, Ishiyama S, Nakamoto Y, Takeda A, Aoki M. High prevalence of serum anti-NH 2-terminal of α-enolase antibodies in patients with multiple system atrophy and corticobasal syndrome. J Neurol 2021; 268:4291-4295. [PMID: 33856546 DOI: 10.1007/s00415-021-10553-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/04/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hashimoto's encephalopathy with serum anti-NH2-terminal of α-enolase (NAE) antibodies occasionally displays clinical symptoms such as cerebellar ataxia and parkinsonism. We studied the frequency of anti-NAE antibodies in patients with Parkinson-plus syndrome. METHODS We examined the positive rates of anti-NAE antibodies in 47 patients with multiple system atrophy (MSA), 29 patients with Parkinson's disease (PD), eight patients with corticobasal syndrome (CBS), and 18 patients with progressive supranuclear palsy (PSP) using conventional immunoblot analysis. RESULTS Positive anti-NAE antibody rates of 31.9%, 10.3%, 50.0%, and 11.1% were reported in the MSA, PD, CBS, and PSP patients, respectively. The duration from onset to a wheelchair-bound state in seropositive MSA patients tended to be shorter than that in seronegative MSA patients. CONCLUSIONS Anti-NAE antibodies are detected in some patients clinically diagnosed with MSA and CBS. Although its pathophysiological significance remains uncertain, serum anti-NAE antibodies might represent a prognostic marker in the clinical course of MSA.
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Affiliation(s)
- Akio Kikuchi
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Makoto Yoneda
- Faculty of Nursing and Social Welfare Sciences, Fukui Prefectural University, 4-1-1 Kenjojima, Matsuoka, Eiheiji, Fukui, 910-1195, Japan.
| | - Takafumi Hasegawa
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Akiko Matsunaga
- Second Department of Internal Medicine, University of Fukui, Fukui, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, University of Fukui, Fukui, Japan
| | - Takaaki Nakamura
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Michinori Ezura
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Toru Baba
- Department of Neurology, National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Naoto Sugeno
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Shun Ishiyama
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, University of Fukui, Fukui, Japan
| | - Atsushi Takeda
- Department of Neurology, National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - Masashi Aoki
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
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Abstract
PURPOSE OF REVIEW There has been an exponential growth in functional connectomics research in neurodegenerative disorders. This review summarizes the recent findings and limitations of the field in Parkinson's disease (PD) and atypical parkinsonian syndromes. RECENT FINDINGS Increasingly more sophisticated methods ranging from seed-based to network and whole-brain dynamic functional connectivity have been used. Results regarding the disruption in the functional connectome vary considerably based on disease severity and phenotypes, and treatment status in PD. Non-motor symptoms of PD also link to the dysfunction in heterogeneous networks. Studies in atypical parkinsonian syndromes are relatively scarce. An important clinical goal of functional connectomics in neurodegenerative disorders is to establish the presence of pathology, track disease progression, predict outcomes, and monitor treatment response. The obstacles of reliability and reproducibility in the field need to be addressed to improve the potential of the functional connectome as a biomarker for these purposes in PD and atypical parkinsonian syndromes.
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Affiliation(s)
- Sule Tinaz
- Department of Neurology, Division of Movement Disorders, Yale University School of Medicine, 15 York St, LCI 710, New Haven, CT, 06510, USA.
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36
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Rau A, Koschel J, Egger K, Jost WH. The final diagnoses of patients with clinically suspected atypical parkinsonian syndromes. Parkinsonism Relat Disord 2021; 85:57-58. [PMID: 33740702 DOI: 10.1016/j.parkreldis.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/01/2021] [Accepted: 03/07/2021] [Indexed: 11/29/2022]
Abstract
We report on 189 patients who were evaluated for APS. Final diagnoses included 77 cases of PSP, 32 patients with MSA and 11 patients with CBS. 35 patients were diagnosed or confirmed with iPD, while in 26 cases a differentiation between iPD and APS could not be definitely made.
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Affiliation(s)
- Alexander Rau
- Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Jiri Koschel
- Parkinson-Klinik Ortenau, Center for Movement Disorders, 77709, Wolfach, Germany
| | - Karl Egger
- Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Wolfgang H Jost
- Parkinson-Klinik Ortenau, Center for Movement Disorders, 77709, Wolfach, Germany
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Peterson KA, Patterson K, Rowe JB. Language impairment in progressive supranuclear palsy and corticobasal syndrome. J Neurol 2021; 268:796-809. [PMID: 31321513 PMCID: PMC7914167 DOI: 10.1007/s00415-019-09463-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/06/2019] [Accepted: 07/09/2019] [Indexed: 12/11/2022]
Abstract
Although commonly known as movement disorders, progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) may present with changes in speech and language alongside or even before motor symptoms. The differential diagnosis of these two disorders can be challenging, especially in the early stages. Here we review their impact on speech and language. We discuss the neurobiological and clinical-phenomenological overlap of PSP and CBS with each other, and with other disorders including non-fluent agrammatic primary progressive aphasia and primary progressive apraxia of speech. Because language impairment is often an early and persistent problem in CBS and PSP, there is a need for improved methods for language screening in primary and secondary care, and more detailed language assessments in tertiary healthcare settings. Improved language assessment may aid differential diagnosis as well as inform clinical management decisions.
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Affiliation(s)
- Katie A Peterson
- Department of Clinical Neurosciences and MRC Cognition and Brain Sciences Unit, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK.
| | - Karalyn Patterson
- Department of Clinical Neurosciences and MRC Cognition and Brain Sciences Unit, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK
| | - James B Rowe
- Department of Clinical Neurosciences and MRC Cognition and Brain Sciences Unit, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK
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38
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Abstract
Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are neurodegenerative tauopathies with neuronal and glial lesions composed of tau that is composed predominantly of isomers with four repeats in the microtubule-binding domain (4R tau). The brain regions vulnerable to pathology in PSP and CBD overlap, but there are differences, particularly with respect to distribution of neuronal loss, the relative abundance of neuronal and glial lesions, the morphologic features of glial lesions, and the frequency of comorbid pathology. Both PSP and CBD have a wide spectrum of clinical manifestations, including disorders of movement and cognition. Recognition of phenotypic diversity in PSP and CBD may improve antemortem diagnostic accuracy, which tends to be very good for the most common presentation of PSP (Richardson syndrome), but poor for the most characteristic presentation of CBD (corticobasal syndrome: CBS). Development of molecular and imaging biomarkers may improve antemortem diagnostic accuracy. Currently, multidisciplinary symptomatic and supportive treatment with pharmacological and non-pharmacological strategies remains the standard of care. In the future, experimental therapeutic trials will be important to slow disease progression.
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Affiliation(s)
| | | | | | - Irene Litvan
- UC San Diego Department of Neurosciences, La Jolla, CA, USA.
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Miyata M, Kakeda S, Yoneda T, Ide S, Okada K, Adachi H, Korogi Y. Signal intensity of cerebral gyri in corticobasal syndrome on phase difference enhanced magnetic resonance images: Comparison of progressive supranuclear palsy and Parkinson's disease. J Neurol Sci 2020; 419:117210. [PMID: 33130433 DOI: 10.1016/j.jns.2020.117210] [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: 05/16/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 10/23/2022]
Abstract
We evaluated cerebral gyri (CG) on phase difference enhanced imaging (PADRE) of corticobasal syndrome (CBS), progressive supranuclear palsy (PSP), and Parkinson's disease (PD) patients to determine whether it is possible to discriminate among them on an individual basis. Two radiologists reviewed appearance of the normal CG and that of CBS patients on PADRE, and deviations from the appearance of the normal CG were recorded. Next, based on the CG abnormalities, two other reviewers reviewed PADRE images from 12 CBS, 14 PSP, and 30 PD patients. In healthy subjects on the PADRE images, the signal intensity (SI) of the gray matter (GM) was homogeneously, slightly hyperintense to the subcortical white matter (SCWM), and the SI of the SCWM was homogeneously hypointense. In CBS patients, hypointense layer in superficial GM and disappearance of hypointense in SCWM. The frequency of the abnormal findings on PADRE in the blinded manner by two readers was 100% (12/12), 3% (1/30), and 29% (4/14 in Reader 1) or 36% (5/14 in Reader 2) in CBS PD, and PSP patients, respectively. Laterality of the PADRE findings was showed in 12 (100%) CBS patients and 3 (21%) PSP, but not in any PD patients. The previously reported typical findings in CBS on conventional magnetic resonance image (MRIs) were observed in only 42% (5/12) of CBS patients. In conclusion, the abnormal findings in CG on PADRE appears more useful than conventional MRI findings for discriminating CBS from PD on an individual basis.
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Affiliation(s)
- Mari Miyata
- Department of Radiology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
| | - Shingo Kakeda
- Department of Radiology, Hirosaki University, Aomori, Japan
| | - Tetsuya Yoneda
- Department of Medical Physics in Advanced Biomedical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Satoru Ide
- Department of Radiology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Kazumasa Okada
- Department of Neurology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Hiroaki Adachi
- Department of Neurology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Yukunori Korogi
- Department of Radiology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
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Constantinides VC, Paraskevas GP, Boufidou F, Bourbouli M, Stefanis L, Kapaki E. Cerebrospinal fluid biomarker profiling in corticobasal degeneration: Application of the AT(N) and other classification systems. Parkinsonism Relat Disord 2020; 82:44-49. [PMID: 33246219 DOI: 10.1016/j.parkreldis.2020.11.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/09/2020] [Accepted: 11/15/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Total tau (τT), phosphorylated tau (τP-181) and amyloid beta (Aβ42) are cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD). There is no consensus on the interpretation criteria of these biomarkers. The aim of this study was to apply three different sets of criteria for CSF AD biomarker interpretation in a cohort of corticobasal degeneration (CBD) patients. METHOD SForty patients fulfilling diagnostic criteria for "probable CBD" were included. The AT(N), BIOMARKAPD/ABSI and the τP-181/Aβ42 ratio criteria were applied. RESULTS The AT(N) criteria categorized 50% of "probable CBD" patients as AD, and 62.5% as harboring amyloid pathology. The BIOMARKAPD/ABSI and τP- 181/Aβ42 criteria categorized ~40% of "probable CBD" patients as AD. DISCUSSION Use of different interpretation criteria for CSF AD biomarkers produces diverse results. AD pathology is common in patients fulfilling "probable" CBD criteria. CBD diagnostic criteria may have suboptimal positive predictive value. A consensus regarding interpretation criteria of CSF AD biomarkers is pivotal.
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Affiliation(s)
- Vasilios C Constantinides
- Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Neurochemistry and Biomarkers Unit, Greece; Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Division of Cognitive, Movement Disorders and Epilepsy, Greece.
| | - George P Paraskevas
- Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Neurochemistry and Biomarkers Unit, Greece; Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Attikon University General Hospital, Division of Cognitive and Movement Disorders, Greece
| | - Fotini Boufidou
- Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Neurochemistry and Biomarkers Unit, Greece
| | - Mara Bourbouli
- Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Neurochemistry and Biomarkers Unit, Greece
| | - Leonidas Stefanis
- Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Division of Cognitive, Movement Disorders and Epilepsy, Greece
| | - Elisabeth Kapaki
- Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Neurochemistry and Biomarkers Unit, Greece; Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Division of Cognitive, Movement Disorders and Epilepsy, Greece
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Haeri G, Saeedi Y, Haji Akhoundi F, Shoeibi A, Aghavali S, Emamikhah M, Rohani M. Alien Leg Syndrome in Two Cases of Corticobasal Syndrome. Can J Neurol Sci 2021; 48:579-81. [PMID: 33100234 DOI: 10.1017/cjn.2020.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Seckin ZI, Duffy JR, Strand EA, Clark HM, Utianski RL, Machulda MM, Botha H, Ali F, Thu Pham NT, Lowe VJ, Whitwell JL, Josephs KA. The evolution of parkinsonism in primary progressive apraxia of speech: A 6-year longitudinal study. Parkinsonism Relat Disord 2020; 81:34-40. [PMID: 33045651 DOI: 10.1016/j.parkreldis.2020.09.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 09/11/2020] [Accepted: 09/27/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Primary progressive apraxia of speech (PPAOS) is a neurodegenerative syndrome in which patients present with an isolated motor speech disorder. Some PPAOS patients develop parkinsonism and other features of progressive supranuclear palsy (PSP) and/or corticobasal syndrome (CBS) over time. We aimed to assess the evolution of parkinsonian characteristics in PPAOS patients who had been followed yearly for at least six years. METHODS From a large cohort of 46 PPAOS patients, eight were followed yearly for > 6-years in multiple NIH-funded grants. Parkinsonian and other features, including bradykinesia, tremor, rigidity, postural instability, apraxia, ocular motor function and cognition were assessed at each visit, and research criteria applied for PSP and CBS diagnosis. Neurological, speech-language test scores, and [18F]fluorodeoxyglucose PET (FDG-PET) and MRI midbrain volumes were assessed. RESULTS A Parkinson's plus syndrome developed in all eight patients (100%). Bradykinesia was the earliest feature, followed by rigidity and postural instability. Tremor was not a significant feature. Parkinsonism, limb apraxia and ocular motor impairment tended to develop four-to-five years after onset with some patients having slight asymmetric parkinsonism. Six patients (75%) met research criteria for probable PSP, although only one for PSP-Richardson's syndrome; three patients met criteria for possible CBS. Slightly asymmetric, left-sided, hypometabolism was observed on FDG-PET, not matching asymmetry of Parkinsonism. Midbrain hypometabolism was absent-minimal. Three patients had progressive midbrain volumes in the PSP-Richardson's syndrome range. CONCLUSIONS A Parkinson's plus syndrome may inevitably develop in PPAOS supporting PPAOS as an early presentation of a Parkinson's plus disorder.
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Affiliation(s)
- Zeynep Idil Seckin
- Department of Neurology, Movement Disorders, Mayo Clinic, Rochester, MN, USA
| | - Joseph R Duffy
- Department of Neurology, Speech Pathology, Mayo Clinic, Rochester, MN, USA
| | - Edythe A Strand
- Department of Neurology, Speech Pathology, Mayo Clinic, Rochester, MN, USA
| | - Heather M Clark
- Department of Neurology, Speech Pathology, Mayo Clinic, Rochester, MN, USA
| | - Rene L Utianski
- Department of Neurology, Speech Pathology, Mayo Clinic, Rochester, MN, USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Behavioral Neurology, Mayo Clinic, Rochester, MN, USA
| | - Farwa Ali
- Department of Neurology, Movement Disorders, Mayo Clinic, Rochester, MN, USA
| | - Nha Trang Thu Pham
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Val J Lowe
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Jennifer L Whitwell
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Keith A Josephs
- Department of Neurology, Movement Disorders, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Behavioral Neurology, Mayo Clinic, Rochester, MN, USA.
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Sakamoto S, Kimura T, Kajiyama K, Ando K, Takeda M, Yoshikawa H. Dentatorubrothalamic tract reduction using fixel-based analysis in corticobasal syndrome. Neuroradiology 2021; 63:529-38. [PMID: 32989557 DOI: 10.1007/s00234-020-02559-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The word "fixel" refers to the specific fiber population within each voxel, and fixel-based analysis (FBA) is a recently developed technique that facilitates fiber tract-specific statistical analysis. The aim of the paper is to apply FBA to detect impaired fibers for corticobasal syndrome (CBS) especially in regions that contain multiple crossed fibers. METHODS FBA was performed in cohorts of participants clinically diagnosed with CBS (n = 10) and Parkinson's disease (n = 15) or in healthy controls (n = 9). The parameters of the diffusion weighted image were echo time, 83 ms; time, 8123.6 ms; flip angle, 90°; section thickness, 2 mm; b = 1000 s/mm2; and 32 axes. Diffusion tensor analysis was conducted using tract-based spatial statistics (TBSS), and white matter volume was estimated via voxel-based morphometry. RESULTS A comparison of PD or HC to CBS revealed a significant difference in the dentatorubrothalamic tract of the brainstem in FBA in addition to the affected regions in voxel-based morphometry and TBSS (family-wise error-corrected p < 0.05). Reduction of the white matter fibers crossing the brainstem could not be detected via microstructural changes identified using TBSS, but it was detected using FBA. CONCLUSION FBA has some advantages in determining the distribution of corticobasal syndrome lesions.
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Hajebrahimi F, Cakir T, Hanoglu L. Virtual Reality Training Helpful in Motor and Cognition in Corticobasal Syndrome: A Case Report PET Study. Case Rep Neurol 2020; 12:238-246. [PMID: 32774281 PMCID: PMC7383208 DOI: 10.1159/000508492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/05/2020] [Indexed: 12/04/2022] Open
Abstract
Corticobasal syndrome (CBS) is a rare progressive neurodegenerative disease characterized by a combination of asymmetric motor symptoms and non-motor symptoms. CBS is poorly responsive to levodopa. Non-pharmacological strategies have been found to be useful as components of a multidisciplinary therapeutic approach for patients with CBS. The purpose of this study was to investigate the effects of virtual reality training in addressing symptoms of CBS. A 64-year-old man was clinically diagnosed as CBS one year after the onset of complaints. Positron emission tomography (PET) scan showed asymmetrical hypometabolism in the right thalamus and basal ganglia. The patient was evaluated for balance, gait, mobility, and cognition 1 week before, 1 week after, and 1 year after 6 weeks of training, 3 times weekly (18 sessions in total). All clinical outcomes and PET result had improved after the intervention; cognition and balance were maintained after 1 year. Additionally, the asymmetric hypometabolism, which had been detectable on the PET scan, became normal, and a relative improvement was noted in the visual evaluation of cortical involvement. Virtual reality may address different aspects of motor and cognition and possibly brain metabolic changes that can affect the course of the disease in patients with CBS.
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Affiliation(s)
- Farzin Hajebrahimi
- Department of Physical Therapy and Rehabilitation, School of Health Sciences, Istanbul Medipol University, Istanbul, Turkey.,Physical Therapy and Rehabilitation PhD Program, Graduate School of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Tansel Cakir
- Department of Nuclear Medicine, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Lutfu Hanoglu
- Department of Neurology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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Tjokrowijoto P, Ceslis A, Sullivan JDO, Adam R, Mellick G, Silburn P, Robinson GA. Differential patterns of internally generated responses in parkinsonian disorders. Neuropsychologia 2020; 146:107569. [PMID: 32707163 DOI: 10.1016/j.neuropsychologia.2020.107569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 07/07/2020] [Accepted: 07/17/2020] [Indexed: 11/29/2022]
Abstract
Internally generated responses are centrally affected in parkinsonian disorders. This study investigated the cognitive components crucial for response generation as reflected in performance on verbal and non-verbal fluency tasks, which require voluntary internal generation of multiple responses. Participants with parkinsonian disorders (N = 58: 29 Parkinson's disease [PD], 22 corticobasal syndrome [CBS], 8 progressive supranuclear palsy [PSP]) and 89 age-matched controls completed baseline cognitive assessments and eight fluency tasks of four types: word, design, gesture, and ideational. We analysed the total number of correct responses generated and error rates (including repetitions and rule breaks) for PD, CBS and Control groups. The small PSP patient group's performance is reported for comparative purposes only. CBS patients were significantly reduced in the number of correct responses generated across all fluency tasks, without incurring significant errors. The only exception was that CBS patients produced a significantly higher number of repetitions on one nonverbal task (design fluency). By contrast, PD patients' generation was reduced on only three fluency tasks (phonemic word, meaningless gesture, conventional idea). However, they also produced a high error rate on four fluency tasks (rule-break errors: phonemic/semantic word; repetitions: semantic word, meaningless gestures). Overall, the pattern of fluency task performance differs between patient groups. Specifically, the quantity of responses generated is differentially and primarily affected in CBS patients, whereas the quality of responses generated is primarily affected in PD patients. This suggests potentially different patterns of performance for parkinsonian disorders and has implications for the cognitive processes crucial for internally-guided response generation.
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Affiliation(s)
- Priscilla Tjokrowijoto
- Neuropsychology Research Unit, School of Psychology, University of Queensland, St Lucia, Australia
| | - Amelia Ceslis
- Neuropsychology Research Unit, School of Psychology, University of Queensland, St Lucia, Australia
| | - John D O Sullivan
- Neurology Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia; Centre for Clinical Research, Faculty of Medicine, University of Queensland, Herston, Australia
| | - Robert Adam
- Neurology Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia; Centre for Clinical Research, Faculty of Medicine, University of Queensland, Herston, Australia
| | - George Mellick
- Griffith Institute for Drug Discovery, Nathan Campus, Griffith University, Brisbane, Australia
| | - Peter Silburn
- Neurosciences Queensland, St Andrew's War Memorial Hospital, Spring Hill, Australia; Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia
| | - Gail A Robinson
- Neuropsychology Research Unit, School of Psychology, University of Queensland, St Lucia, Australia; Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia.
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Samotus O, Parrent A, Jog M. Spinal Cord Stimulation Therapy for Gait Dysfunction in Two Corticobasal Syndrome Patients. Can J Neurol Sci 2021; 48:278-80. [PMID: 32646537 DOI: 10.1017/cjn.2020.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Dinkelbach L, Südmeyer M, Hartmann CJ, Roeber S, Arzberger T, Felsberg J, Ferrea S, Moldovan AS, Amunts K, Schnitzler A, Caspers S. Somatosensory area 3b is selectively unaffected in corticobasal syndrome: combining MRI and histology. Neurobiol Aging 2020; 94:89-100. [PMID: 32593032 DOI: 10.1016/j.neurobiolaging.2020.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/15/2019] [Revised: 04/04/2020] [Accepted: 05/14/2020] [Indexed: 10/24/2022]
Abstract
An increasing number of neuroimaging studies addressing patients with corticobasal syndrome use macroscopic definitions of brain regions. As a closer link to functionally relevant units, we aimed at identifying magnetic resonance-based atrophy patterns in regions defined by probability maps of cortical microstructure. For this purpose, three analyses were conducted: (1) Whole-brain cortical thickness was compared between 36 patients with corticobasal syndrome and 24 controls. A pattern of pericentral atrophy was found, covering primary motor area 4, premotor area 6, and primary somatosensory areas 1, 2, and 3a. Within the central region, only area 3b was without atrophy. (2) In 18 patients, longitudinal measures with follow-ups of up to 59 months (mean 21.3 ± 15.4) were analyzed. Areas 1, 2, and 6 showed significantly faster atrophy rates than primary somatosensory area 3b. (3) In an individual autopsy case, longitudinal in vivo morphometry and postmortem pathohistology were conducted. The rate of magnetic resonance-based atrophy was significantly correlated with tufted-astrocyte load in those cytoarchitectonically defined regions also seen in the group study, with area 3b being selectively unaffected.
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Affiliation(s)
- Lars Dinkelbach
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany; Institute for Anatomy I, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Martin Südmeyer
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany; Department of Neurology, Ernst von Bergmann Klinikum, Potsdam, Germany
| | - Christian Johannes Hartmann
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany; Department of Neurology, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Sigrun Roeber
- Center for Neuropathology and Prion Research, Ludwig Maximilian University of Munich, Munich, Germany
| | - Thomas Arzberger
- Center for Neuropathology and Prion Research, Ludwig Maximilian University of Munich, Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Jörg Felsberg
- Department of Neuropathology, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Stefano Ferrea
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Alexia-Sabine Moldovan
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany; Department of Neurology, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Katrin Amunts
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany; JARA-BRAIN, Jülich-Aachen Research Alliance, Research Centre Jülich, Jülich, Germany; C. & O. Vogt Institute for Brain Research, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany; Department of Neurology, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Svenja Caspers
- Institute for Anatomy I, Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany; Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany; JARA-BRAIN, Jülich-Aachen Research Alliance, Research Centre Jülich, Jülich, Germany.
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Takahashi-Iwata I, Yabe I, Kudo A, Eguchi K, Wakita M, Shirai S, Matsushima M, Toyoshima T, Chiba S, Tanikawa S, Tanaka S, Satoh K, Kitamoto T, Sasaki H. MM2 cortical form of sporadic Creutzfeldt-Jakob disease without progressive dementia and akinetic mutism: A case deviating from current diagnostic criteria. J Neurol Sci 2020; 412:116759. [PMID: 32114028 DOI: 10.1016/j.jns.2020.116759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/16/2020] [Accepted: 02/23/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Ikuko Takahashi-Iwata
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Ichiro Yabe
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
| | - Akihiko Kudo
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Katsuya Eguchi
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Masahiro Wakita
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Shinichi Shirai
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Masaaki Matsushima
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Takanobu Toyoshima
- Department of Neurology, Nishimaruyama Hospital, 7-25, 4 chou-me, Maruyama Nishimachi, Chuou-ku, Sapporo 064-8557, Japan
| | - Susumu Chiba
- Department of Neurology, Nishimaruyama Hospital, 7-25, 4 chou-me, Maruyama Nishimachi, Chuou-ku, Sapporo 064-8557, Japan
| | - Satoshi Tanikawa
- Department of Pathology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Shinya Tanaka
- Department of Pathology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Katsuya Satoh
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Science, 7-1, 1 chou-me, Sakamoto, Nagasaki 852-8501, Japan
| | - Tetsuyuki Kitamoto
- Department of Neurological Science, Tohoku University Graduate School of Medicine, 2-1, seiryouchou, Aoba-ku, Sendai 980-8575, Japan
| | - Hidenao Sasaki
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
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Lewis-Smith DJ, Wolpe N, Ghosh BCP, Rowe JB. Alien limb in the corticobasal syndrome: phenomenological characteristics and relationship to apraxia. J Neurol 2020; 267:1147-57. [PMID: 31919566 DOI: 10.1007/s00415-019-09672-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/08/2019] [Accepted: 12/09/2019] [Indexed: 12/29/2022]
Abstract
Alien limb refers to movements that seem purposeful but are independent of patients’ reported intentions. Alien limb often co-occurs with apraxia in the corticobasal syndrome, and anatomical and phenomenological comparisons have led to the suggestion that alien limb and apraxia may be causally related as failures of goal-directed movements. Here, we characterised the nature of alien limb symptoms in patients with the corticobasal syndrome (n = 30) and their relationship to limb apraxia. Twenty-five patients with progressive supranuclear palsy Richardson syndrome served as a disease control group. Structured examinations of praxis, motor function, cognition and alien limb were undertaken in patients attending a regional specialist clinic. Twenty-eight patients with corticobasal syndrome (93%) demonstrated significant apraxia and this was often asymmetrical, with the left hand preferentially affected in 23/30 (77%) patients. Moreover, 25/30 (83%) patients reported one or more symptoms consistent with alien limb. The range of these phenomena was broad, including changes in the sense of ownership and control as well as unwanted movements. Regression analyses showed no significant association between the severity of limb apraxia and either the occurrence of an alien limb or the number of alien limb phenomena reported. Bayesian estimation showed a low probability for a positive association between alien limb and apraxia, suggesting that alien limb phenomena are not likely to be related to severity apraxia. Our results shed light on the phenomenology of these disabling and as yet untreatable clinical features, with relevance to theoretical models of voluntary action.
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Murley AG, Jones PS, Coyle Gilchrist I, Bowns L, Wiggins J, Tsvetanov KA, Rowe JB. Metabolomic changes associated with frontotemporal lobar degeneration syndromes. J Neurol 2020; 267:2228-2238. [PMID: 32277260 PMCID: PMC7359154 DOI: 10.1007/s00415-020-09824-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Widespread metabolic changes are seen in neurodegenerative disease and could be used as biomarkers for diagnosis and disease monitoring. They may also reveal disease mechanisms that could be a target for therapy. In this study we looked for blood-based biomarkers in syndromes associated with frontotemporal lobar degeneration. METHODS Plasma metabolomic profiles were measured from 134 patients with a syndrome associated with frontotemporal lobar degeneration (behavioural variant frontotemporal dementia n = 30, non fluent variant primary progressive aphasia n = 26, progressive supranuclear palsy n = 45, corticobasal syndrome n = 33) and 32 healthy controls. RESULTS Forty-nine of 842 metabolites were significantly altered in frontotemporal lobar degeneration syndromes (after false-discovery rate correction for multiple comparisons). These were distributed across a wide range of metabolic pathways including amino acids, energy and carbohydrate, cofactor and vitamin, lipid and nucleotide pathways. The metabolomic profile supported classification between frontotemporal lobar degeneration syndromes and controls with high accuracy (88.1-96.6%) while classification accuracy was lower between the frontotemporal lobar degeneration syndromes (72.1-83.3%). One metabolic profile, comprising a range of different pathways, was consistently identified as a feature of each disease versus controls: the degree to which a patient expressed this metabolomic profile was associated with their subsequent survival (hazard ratio 0.74 [0.59-0.93], p = 0.0018). CONCLUSIONS The metabolic changes in FTLD are promising diagnostic and prognostic biomarkers. Further work is required to replicate these findings, examine longitudinal change, and test their utility in differentiating between FTLD syndromes that are pathologically distinct but phenotypically similar.
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Affiliation(s)
- Alexander G Murley
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
| | - P Simon Jones
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - Lucy Bowns
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Julie Wiggins
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Kamen A Tsvetanov
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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