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Riva N, Domi T, Pozzi L, Lunetta C, Schito P, Spinelli EG, Cabras S, Matteoni E, Consonni M, Bella ED, Agosta F, Filippi M, Calvo A, Quattrini A. Update on recent advances in amyotrophic lateral sclerosis. J Neurol 2024:10.1007/s00415-024-12435-9. [PMID: 38802624 DOI: 10.1007/s00415-024-12435-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024]
Abstract
In the last few years, our understanding of disease molecular mechanisms underpinning ALS has advanced greatly, allowing the first steps in translating into clinical practice novel research findings, including gene therapy approaches. Similarly, the recent advent of assistive technologies has greatly improved the possibility of a more personalized approach to supportive and symptomatic care, in the context of an increasingly complex multidisciplinary line of actions, which remains the cornerstone of ALS management. Against this rapidly growing background, here we provide an comprehensive update on the most recent studies that have contributed towards our understanding of ALS pathogenesis, the latest results from clinical trials as well as the future directions for improving the clinical management of ALS patients.
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Affiliation(s)
- Nilo Riva
- 3Rd Neurology Unit and Motor Neuron Disease Centre, Fondazione IRCCS "Carlo Besta" Neurological Insitute, Milan, Italy.
| | - Teuta Domi
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Pozzi
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Christian Lunetta
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Unit of Milan Institute, 20138, Milan, Italy
| | - Paride Schito
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Edoardo Gioele Spinelli
- Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Cabras
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin; SC Neurologia 1U, AOU città della Salute e della Scienza di Torino, Turin, Italy
| | - Enrico Matteoni
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin; SC Neurologia 1U, AOU città della Salute e della Scienza di Torino, Turin, Italy
| | - Monica Consonni
- 3Rd Neurology Unit and Motor Neuron Disease Centre, Fondazione IRCCS "Carlo Besta" Neurological Insitute, Milan, Italy
| | - Eleonora Dalla Bella
- 3Rd Neurology Unit and Motor Neuron Disease Centre, Fondazione IRCCS "Carlo Besta" Neurological Insitute, Milan, Italy
| | - Federica Agosta
- Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute Huniversity, Milan, Italy
| | - Massimo Filippi
- Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute Huniversity, Milan, Italy
| | - Andrea Calvo
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin; SC Neurologia 1U, AOU città della Salute e della Scienza di Torino, Turin, Italy
| | - Angelo Quattrini
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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2
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Nelson AT, Cicardi ME, Markandaiah SS, Han JY, Philp NJ, Welebob E, Haeusler AR, Pasinelli P, Manfredi G, Kawamata H, Trotti D. Glucose hypometabolism prompts RAN translation and exacerbates C9orf72-related ALS/FTD phenotypes. EMBO Rep 2024; 25:2479-2510. [PMID: 38684907 PMCID: PMC11094177 DOI: 10.1038/s44319-024-00140-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 05/02/2024] Open
Abstract
The most prevalent genetic cause of both amyotrophic lateral sclerosis and frontotemporal dementia is a (GGGGCC)n nucleotide repeat expansion (NRE) occurring in the first intron of the C9orf72 gene (C9). Brain glucose hypometabolism is consistently observed in C9-NRE carriers, even at pre-symptomatic stages, but its role in disease pathogenesis is unknown. Here, we show alterations in glucose metabolic pathways and ATP levels in the brains of asymptomatic C9-BAC mice. We find that, through activation of the GCN2 kinase, glucose hypometabolism drives the production of dipeptide repeat proteins (DPRs), impairs the survival of C9 patient-derived neurons, and triggers motor dysfunction in C9-BAC mice. We also show that one of the arginine-rich DPRs (PR) could directly contribute to glucose metabolism and metabolic stress by inhibiting glucose uptake in neurons. Our findings provide a potential mechanistic link between energy imbalances and C9-ALS/FTD pathogenesis and suggest a feedforward loop model with potential opportunities for therapeutic intervention.
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Affiliation(s)
- Andrew T Nelson
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Maria Elena Cicardi
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Shashirekha S Markandaiah
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - John Ys Han
- Department of Pathology and Genomic Medicine, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Nancy J Philp
- Department of Pathology and Genomic Medicine, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Emily Welebob
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Aaron R Haeusler
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Piera Pasinelli
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Giovanni Manfredi
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, 407 East 61st Street, New York, NY, 10065, USA
| | - Hibiki Kawamata
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, 407 East 61st Street, New York, NY, 10065, USA
| | - Davide Trotti
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA, 19107, USA.
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3
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Marrie RA, Maxwell CJ, Rotstein DL, Tsai CC, Tremlett H. Prodromes in demyelinating disorders, amyotrophic lateral sclerosis, Parkinson disease, and Alzheimer's dementia. Rev Neurol (Paris) 2024; 180:125-140. [PMID: 37567819 DOI: 10.1016/j.neurol.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/24/2023] [Accepted: 07/03/2023] [Indexed: 08/13/2023]
Abstract
A prodrome is an early set of symptoms, which indicates the onset of a disease; these symptoms are often non-specific. Prodromal phases are now recognized in multiple central nervous system diseases. The depth of understanding of the prodromal phase varies across diseases, being more nascent for multiple sclerosis for example, than for Parkinson disease or Alzheimer's disease. Key challenges when identifying the prodromal phase of a disease include the lack of specificity of prodromal symptoms, and consequent need for accessible and informative biomarkers. Further, heterogeneity of the prodromal phase may be influenced by age, sex, genetics and other poorly understood factors. Nonetheless, recognition that an individual is in the prodromal phase of disease offers the opportunity for earlier diagnosis and with it the opportunity for earlier intervention.
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Affiliation(s)
- R A Marrie
- Departments of Internal Medicine and Community Health Sciences, Rady Faculty of Health Sciences, Max-Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - C J Maxwell
- Schools of Pharmacy and Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada; ICES, Toronto, Ontario, Canada
| | - D L Rotstein
- Department of Medicine, University of Toronto, 6, Queen's Park Crescent West, 3rd floor, M5S 3H2 Toronto, Ontario, Canada; Saint-Michael's Hospital, 30, Bond Street, M5B 1W8 Toronto, Ontario, Canada
| | - C-C Tsai
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - H Tremlett
- Faculty of Medicine (Neurology), University of British Columbia, Vancouver, BC, Canada
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Van Daele SH, Masrori P, Van Damme P, Van Den Bosch L. The sense of antisense therapies in ALS. Trends Mol Med 2024; 30:252-262. [PMID: 38216448 DOI: 10.1016/j.molmed.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/01/2023] [Accepted: 12/07/2023] [Indexed: 01/14/2024]
Abstract
Treatment of patients with amyotrophic lateral sclerosis (ALS) has entered a new era now that encouraging results about antisense oligonucleotides (ASOs) are becoming available and a first ASO therapy for ALS has been approved by the FDA. Moreover, there is hope not only that ALS can be stopped but also that symptoms can be reversed. Until now, degrading ASOs seemed to be successful mostly for rarer forms of familial ALS. However, the first attempts to correct mis-splicing events in sporadic ALS are underway, as well as a clinical trial examining interference with a genetic modifier. In this review, we discuss the current status of using ASOs in ALS and the possibilities and pitfalls of this therapeutic strategy.
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Affiliation(s)
- Sien H Van Daele
- KU Leuven - University of Leuven, Department of Neurosciences, Leuven Brain Institute (LBI), Leuven, Belgium; Laboratory of Neurobiology, VIB Center for Brain & Disease Research, Leuven, Belgium; Department of Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Pegah Masrori
- KU Leuven - University of Leuven, Department of Neurosciences, Leuven Brain Institute (LBI), Leuven, Belgium; Laboratory of Neurobiology, VIB Center for Brain & Disease Research, Leuven, Belgium; Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Philip Van Damme
- KU Leuven - University of Leuven, Department of Neurosciences, Leuven Brain Institute (LBI), Leuven, Belgium; Laboratory of Neurobiology, VIB Center for Brain & Disease Research, Leuven, Belgium; Department of Neurology, University Hospitals Leuven, Leuven, Belgium.
| | - Ludo Van Den Bosch
- KU Leuven - University of Leuven, Department of Neurosciences, Leuven Brain Institute (LBI), Leuven, Belgium; Laboratory of Neurobiology, VIB Center for Brain & Disease Research, Leuven, Belgium.
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McMackin R, Bede P, Ingre C, Malaspina A, Hardiman O. Biomarkers in amyotrophic lateral sclerosis: current status and future prospects. Nat Rev Neurol 2023; 19:754-768. [PMID: 37949994 DOI: 10.1038/s41582-023-00891-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 11/12/2023]
Abstract
Disease heterogeneity in amyotrophic lateral sclerosis poses a substantial challenge in drug development. Categorization based on clinical features alone can help us predict the disease course and survival, but quantitative measures are also needed that can enhance the sensitivity of the clinical categorization. In this Review, we describe the emerging landscape of diagnostic, categorical and pharmacodynamic biomarkers in amyotrophic lateral sclerosis and their place in the rapidly evolving landscape of new therapeutics. Fluid-based markers from cerebrospinal fluid, blood and urine are emerging as useful diagnostic, pharmacodynamic and predictive biomarkers. Combinations of imaging measures have the potential to provide important diagnostic and prognostic information, and neurophysiological methods, including various electromyography-based measures and quantitative EEG-magnetoencephalography-evoked responses and corticomuscular coherence, are generating useful diagnostic, categorical and prognostic markers. Although none of these biomarker technologies has been fully incorporated into clinical practice or clinical trials as a primary outcome measure, strong evidence is accumulating to support their clinical utility.
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Affiliation(s)
- Roisin McMackin
- Discipline of Physiology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, The University of Dublin, Dublin, Ireland
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Peter Bede
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, The University of Dublin, Dublin, Ireland
- Computational Neuroimaging Group, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
- Department of Neurology, St James's Hospital, Dublin, Ireland
| | - Caroline Ingre
- Department of Neuroscience, Karolinska Institute, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Andrea Malaspina
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Orla Hardiman
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, The University of Dublin, Dublin, Ireland.
- Department of Neurology, Beaumont Hospital, Dublin, Ireland.
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Zilberter Y, Tabuena DR, Zilberter M. NOX-induced oxidative stress is a primary trigger of major neurodegenerative disorders. Prog Neurobiol 2023; 231:102539. [PMID: 37838279 DOI: 10.1016/j.pneurobio.2023.102539] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/10/2023] [Indexed: 10/16/2023]
Abstract
Neurodegenerative diseases (NDDs) causing cognitive impairment and dementia are difficult to treat due to the lack of understanding of primary initiating factors. Meanwhile, major sporadic NDDs share many risk factors and exhibit similar pathologies in their early stages, indicating the existence of common initiation pathways. Glucose hypometabolism associated with oxidative stress is one such primary, early and shared pathology, and a likely major cause of detrimental disease-associated cascades; targeting this common pathology may therefore be an effective preventative strategy for most sporadic NDDs. However, its exact cause and trigger remain unclear. Recent research suggests that early oxidative stress caused by NADPH oxidase (NOX) activation is a shared initiating mechanism among major sporadic NDDs and could prove to be the long-sought ubiquitous NDD trigger. We focus on two major NDDs - Alzheimer's disease (AD) and Parkinson's disease (PD), as well as on acquired epilepsy which is an increasingly recognized comorbidity in NDDs. We also discuss available data suggesting the relevance of the proposed mechanisms to other NDDs. We delve into the commonalities among these NDDs in neuroinflammation and NOX involvement to identify potential therapeutic targets and gain a deeper understanding of the underlying causes of NDDs.
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Affiliation(s)
- Yuri Zilberter
- Aix-Marseille Université, INSERM UMR1106, Institut de Neurosciences des Systèmes, Marseille, France
| | - Dennis R Tabuena
- Gladstone Institute of Neurological Disease, San Francisco, CA, USA
| | - Misha Zilberter
- Gladstone Institute of Neurological Disease, San Francisco, CA, USA.
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Kortazar-Zubizarreta I, Manero-Azua A, Afonso-Agüera J, Perez de Nanclares G. C9ORF72 Gene GGGGCC Hexanucleotide Expansion: A High Clinical Variability from Amyotrophic Lateral Sclerosis to Frontotemporal Dementia. J Pers Med 2023; 13:1396. [PMID: 37763163 PMCID: PMC10532825 DOI: 10.3390/jpm13091396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
The expanded GGGGCC hexanucleotide repeat (HRE) in the non-coding region of the C9ORF72 gene (C9ORF72-HRE) is the most common genetic cause of familial forms of amyotrophic lateral sclerosis (ALS), FTD, and concurrent ALS and FTD (ALS-FTD), in addition to contributing to the sporadic forms of these diseases. Both syndromes overlap not only genetically, but also sharing similar clinical and neuropathological findings, being considered as a spectrum. In this paper we describe the clinical-genetic findings in a Basque family with different manifestations within the spectrum, our difficulties in reaching the diagnosis, and a narrative review, carried out as a consequence, of the main features associated with C9ORF72-HRE. Family members underwent a detailed clinical assessment, neurological examination, and genetic analysis by repeat-primed PCR. We studied 10 relatives of a symptomatic carrier of the C9ORF72-HRE expansion. Two of them presented the expansion in the pathological range, one of them was symptomatic whereas the other one remained asymptomatic at 72 years. Given the great intrafamilial clinical variability of C9ORF72-HRE, the characterization of patients and family members with particular clinical and genetic subgroups within ALS and FTD becomes a bottleneck for medication development, in particular for genetically focused medicines for ALS and FTD.
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Affiliation(s)
- Izaro Kortazar-Zubizarreta
- Department of Neurology, Bioaraba Health Research Institute, Araba University Hospital-Txagorritxu, 01009 Vitoria-Gasteiz, Spain
| | - Africa Manero-Azua
- Molecular (Epi) Genetics Laboratory, Bioaraba Health Research Institute, Araba University Hospital, 01009 Vitoria-Gasteiz, Spain; (A.M.-A.); (G.P.d.N.)
| | - Juan Afonso-Agüera
- Department of Neurology, Central University Hospital of Asturias, 33006 Oviedo, Spain;
| | - Guiomar Perez de Nanclares
- Molecular (Epi) Genetics Laboratory, Bioaraba Health Research Institute, Araba University Hospital, 01009 Vitoria-Gasteiz, Spain; (A.M.-A.); (G.P.d.N.)
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Bede P, Lulé D, Müller HP, Tan EL, Dorst J, Ludolph AC, Kassubek J. Presymptomatic grey matter alterations in ALS kindreds: a computational neuroimaging study of asymptomatic C9orf72 and SOD1 mutation carriers. J Neurol 2023; 270:4235-4247. [PMID: 37178170 PMCID: PMC10421803 DOI: 10.1007/s00415-023-11764-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND The characterisation of presymptomatic disease-burden patterns in asymptomatic mutation carriers has a dual academic and clinical relevance. The understanding of disease propagation mechanisms is of considerable conceptual interests, and defining the optimal time of pharmacological intervention is essential for improved clinical trial outcomes. METHODS In a prospective, multimodal neuroimaging study, 22 asymptomatic C9orf72 GGGGCC hexanucleotide repeat carriers, 13 asymptomatic subjects with SOD1, and 54 "gene-negative" ALS kindreds were enrolled. Cortical and subcortical grey matter alterations were systematically appraised using volumetric, morphometric, vertex, and cortical thickness analyses. Using a Bayesian approach, the thalamus and amygdala were further parcellated into specific nuclei and the hippocampus was segmented into anatomically defined subfields. RESULTS Asymptomatic GGGGCC hexanucleotide repeat carriers in C9orf72 exhibited early subcortical changes with the preferential involvement of the pulvinar and mediodorsal regions of the thalamus, as well as the lateral aspect of the hippocampus. Volumetric approaches, morphometric methods, and vertex analyses were anatomically consistent in capturing focal subcortical changes in asymptomatic C9orf72 hexanucleotide repeat expansion carriers. SOD1 mutation carriers did not exhibit significant subcortical grey matter alterations. In our study, none of the two asymptomatic cohorts exhibited cortical grey matter alterations on either cortical thickness or morphometric analyses. DISCUSSION The presymptomatic radiological signature of C9orf72 is associated with selective thalamic and focal hippocampal degeneration which may be readily detectable before cortical grey matter changes ensue. Our findings confirm selective subcortical grey matter involvement early in the course of C9orf72-associated neurodegeneration.
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Affiliation(s)
- Peter Bede
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, Dublin, D02 RS90, Ireland.
- Department of Neurology, St James's Hospital, Dublin, Ireland.
| | - Dorothée Lulé
- Department of Neurology, University of Ulm, Ulm, Germany
| | | | - Ee Ling Tan
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, Dublin, D02 RS90, Ireland
| | - Johannes Dorst
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Albert C Ludolph
- Department of Neurology, University of Ulm, Ulm, Germany
- German Centre of Neurodegenerative Diseases (DZNE), Ulm, Germany
| | - Jan Kassubek
- Department of Neurology, University of Ulm, Ulm, Germany
- German Centre of Neurodegenerative Diseases (DZNE), Ulm, Germany
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Hendricks E, Quihuis AM, Hung ST, Chang J, Dorjsuren N, Der B, Staats KA, Shi Y, Sta Maria NS, Jacobs RE, Ichida JK. The C9ORF72 repeat expansion alters neurodevelopment. Cell Rep 2023; 42:112983. [PMID: 37590144 PMCID: PMC10757587 DOI: 10.1016/j.celrep.2023.112983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 07/05/2023] [Accepted: 07/31/2023] [Indexed: 08/19/2023] Open
Abstract
Genetic mutations that cause adult-onset neurodegenerative diseases are often expressed during embryonic stages, but it is unclear whether they alter neurodevelopment and how this might influence disease onset. Here, we show that the most common cause of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS), a repeat expansion in C9ORF72, restricts neural stem cell proliferation and reduces cortical and thalamic size in utero. Surprisingly, a repeat expansion-derived dipeptide repeat protein (DPR) not known to reduce neuronal viability plays a key role in impairing neurodevelopment. Pharmacologically mimicking the effects of the repeat expansion on neurodevelopment increases susceptibility of C9ORF72 mice to motor defects. Thus, the C9ORF72 repeat expansion stunts development of the brain regions prominently affected in C9ORF72 FTD/ALS patients.
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Affiliation(s)
- Eric Hendricks
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA 90033, USA; Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Alicia M Quihuis
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Department of Physiology and Neuroscience, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Shu-Ting Hung
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA 90033, USA; Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Jonathan Chang
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA 90033, USA; Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Nomongo Dorjsuren
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA 90033, USA; Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Balint Der
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA 90033, USA
| | - Kim A Staats
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA 90033, USA
| | - Yingxiao Shi
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA 90033, USA; Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Naomi S Sta Maria
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Department of Physiology and Neuroscience, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Russell E Jacobs
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Department of Physiology and Neuroscience, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Justin K Ichida
- Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research, University of Southern California, Los Angeles, CA 90033, USA; Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
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10
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Nelson AT, Cicardi ME, Markandaiah SS, Han J, Philp N, Welebob E, Haeusler AR, Pasinelli P, Manfredi G, Kawamata H, Trotti D. Glucose Hypometabolism Prompts RAN Translation and Exacerbates C9orf72-related ALS/FTD Phenotypes. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.07.544100. [PMID: 37333144 PMCID: PMC10274806 DOI: 10.1101/2023.06.07.544100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
The most prevalent genetic cause of both amyotrophic lateral sclerosis and frontotemporal dementia is a (GGGGCC)n nucleotide repeat expansion (NRE) occurring in the first intron of the C9orf72 gene (C9). Brain glucose hypometabolism is consistently observed in C9-NRE carriers, even at pre-symptomatic stages, although its potential role in disease pathogenesis is unknown. Here, we identified alterations in glucose metabolic pathways and ATP levels in the brain of asymptomatic C9-BAC mice. We found that, through activation of the GCN2 kinase, glucose hypometabolism drives the production of dipeptide repeat proteins (DPRs), impairs the survival of C9 patient-derived neurons, and triggers motor dysfunction in C9-BAC mice. We also found that one of the arginine-rich DPRs (PR) can directly contribute to glucose metabolism and metabolic stress. These findings provide a mechanistic link between energy imbalances and C9-ALS/FTD pathogenesis and support a feedforward loop model that opens several opportunities for therapeutic intervention.
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Affiliation(s)
- A T Nelson
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - M E Cicardi
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - S S Markandaiah
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - J Han
- Department of Pathology and Genomic Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - N Philp
- Department of Pathology and Genomic Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - E Welebob
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - A R Haeusler
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - P Pasinelli
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - G Manfredi
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, 407 East 61st Street, New York, New York 10065, USA
| | - H Kawamata
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, 407 East 61st Street, New York, New York 10065, USA
| | - D Trotti
- Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, Philadelphia, PA 19107, USA
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11
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Castelnovo V, Canu E, De Mattei F, Filippi M, Agosta F. Basal ganglia alterations in amyotrophic lateral sclerosis. Front Neurosci 2023; 17:1133758. [PMID: 37090799 PMCID: PMC10113480 DOI: 10.3389/fnins.2023.1133758] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/09/2023] [Indexed: 04/09/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) has traditionally been associated with brain damage involving the primary motor cortices and corticospinal tracts. In the recent decades, most of the research studies in ALS have focused on extra-motor and subcortical brain regions. The aim of these studies was to detect additional biomarkers able to support the diagnosis and to predict disease progression. The involvement of the frontal cortices, mainly in ALS cases who develop cognitive and/or behavioral impairment, is amply recognized in the field. A potential involvement of fronto-temporal and fronto-striatal connectivity changes in the disease evolution has also been reported. On this latter regard, there is still a shortage of studies which investigated basal ganglia (BG) alterations and their role in ALS clinical manifestation and progression. The present review aims to provide an overview on the magnetic resonance imaging studies reporting structural and/or functional BG alterations in patients with ALS, to clarify the role of BG damage in the disease clinical evolution and to propose potential future developments in this field.
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Affiliation(s)
- Veronica Castelnovo
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Filippo De Mattei
- ALS Center, SC Neurologia 1U, AOU Città della Salute e della Scienza of Torino, Turin, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- *Correspondence: Federica Agosta,
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12
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Liu P, Tang Y, Li W, Liu Z, Zhou M, Li J, Yuan Y, Fang L, Guo J, Shen L, Jiang H, Tang B, Hu S, Wang J. Brain metabolic signatures in patients with genetic and nongenetic amyotrophic lateral sclerosis. CNS Neurosci Ther 2023. [PMID: 36971206 PMCID: PMC10401109 DOI: 10.1111/cns.14193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/31/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
AIMS To study the brain metabolic signature in Chinese amyotrophic lateral sclerosis (ALS) patients and compare the difference in brain metabolic patterns between ALS with and without genetic variants. METHODS We included 146 patients with ALS and 128 healthy controls (HCs). All patients with ALS underwent genetic testing to screen for ALS related genetic variants and were then divided into genetic (n = 22) and nongenetic ALS (n = 93) subgroups. All participants underwent brain 18 F-FDG-PET scans. Group comparisons were performed using the two-sample t-test model of SPM12. RESULTS We identified a large of hypometabolic clusters in ALS patients as compared with HCs, especially in the bilateral basal ganglia, midbrain, and cerebellum. Moreover, hypometabolism in the bilateral temporal lobe, precentral gyrus and hypermetabolism in the left anterior cingulate, occipital lobe, and bilateral frontal lobe were also found in ALS patients as compared with HCs. Compared with nongenetic ALS patients, genetic ALS patients showed hypometabolism in the right postcentral gyrus, precuneus, and middle occipital gyrus. The incidence of sensory disturbance in patients with genetic ALS was higher than that in patients with nongenetic ALS (5 of 22 [22.72%] vs. 7 of 93 [7.52%], p = 0.036). CONCLUSIONS Our investigation provided unprecedented evidence of relative hypometabolism in the midbrain and cerebellum in ALS patients. Genetic ALS patients showed a specific signature of brain metabolism and a higher incidence of sensory disturbance, indicating that genetic factors may be an underlying cause affecting the brain metabolism and increasing the risk of sensory disturbance in ALS.
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13
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De Vocht J, Van Weehaeghe D, Ombelet F, Masrori P, Lamaire N, Devrome M, Van Esch H, Moisse M, Koole M, Dupont P, Van Laere K, Van Damme P. Differences in Cerebral Glucose Metabolism in ALS Patients with and without C9orf72 and SOD1 Mutations. Cells 2023; 12:cells12060933. [PMID: 36980274 PMCID: PMC10047407 DOI: 10.3390/cells12060933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/22/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is characterized by progressive loss of upper and lower motor neurons. In 10% of patients, the disorder runs in the family. Our aim was to study the impact of ALS-causing gene mutations on cerebral glucose metabolism. Between October 2010 and October 2022, 538 patients underwent genetic testing for mutations with strong evidence of causality for ALS and 18F-2-fluoro-2-deoxy-D-glucose-PET (FDG PET), at University Hospitals Leuven. We identified 48 C9orf72-ALS and 22 SOD1-ALS patients. After propensity score matching, two cohorts of 48 and 21 matched sporadic ALS patients, as well as 20 healthy controls were included. FDG PET images were assessed using a voxel-based and volume-of-interest approach. We observed widespread frontotemporal involvement in all ALS groups, in comparison to healthy controls. The degree of relative glucose metabolism in SOD1-ALS in motor and extra-motor regions did not differ significantly from matched sporadic ALS patients. In C9orf72-ALS, we found more pronounced hypometabolism in the peri-rolandic region and thalamus, and hypermetabolism in the medulla extending to the pons, in comparison to matched sporadic ALS patients. Our study revealed C9orf72-dependent differences in glucose metabolism in the peri-rolandic region, thalamus, and brainstem (i.e., medulla, extending to the pons) in relation to matched sporadic ALS patients.
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Affiliation(s)
- Joke De Vocht
- Division of Psychiatry, Division of Neurology, University Hospitals Leuven, VIB-KULeuven Center for Brain & Disease Research, Laboratory of Neurobiology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
- Correspondence: ; Tel.: +32-16-34-13-73
| | | | - Fouke Ombelet
- Division of Neurology, University Hospitals Leuven, VIB-KULeuven Center for Brain & Disease Research, Laboratory of Neurobiology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Pegah Masrori
- Division of Neurology, University Hospitals Leuven, VIB-KULeuven Center for Brain & Disease Research, Laboratory of Neurobiology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Nikita Lamaire
- Division of Neurology, University Hospitals Leuven, VIB-KULeuven Center for Brain & Disease Research, Laboratory of Neurobiology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Martijn Devrome
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Hilde Van Esch
- Center for Human Genetics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Mathieu Moisse
- VIB-KU Leuven Center for Brain & Disease Research, Laboratory of Neurobiology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Michel Koole
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Patrick Dupont
- Laboratory of Cognitive Neurology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Koen Van Laere
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Philip Van Damme
- Division of Neurology, University Hospitals Leuven, VIB-KULeuven Center for Brain & Disease Research, Laboratory of Neurobiology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
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14
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Mead RJ, Shan N, Reiser HJ, Marshall F, Shaw PJ. Amyotrophic lateral sclerosis: a neurodegenerative disorder poised for successful therapeutic translation. Nat Rev Drug Discov 2023; 22:185-212. [PMID: 36543887 PMCID: PMC9768794 DOI: 10.1038/s41573-022-00612-2] [Citation(s) in RCA: 79] [Impact Index Per Article: 79.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2022] [Indexed: 12/24/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a devastating disease caused by degeneration of motor neurons. As with all major neurodegenerative disorders, development of disease-modifying therapies has proven challenging for multiple reasons. Nevertheless, ALS is one of the few neurodegenerative diseases for which disease-modifying therapies are approved. Significant discoveries and advances have been made in ALS preclinical models, genetics, pathology, biomarkers, imaging and clinical readouts over the last 10-15 years. At the same time, novel therapeutic paradigms are being applied in areas of high unmet medical need, including neurodegenerative disorders. These developments have evolved our knowledge base, allowing identification of targeted candidate therapies for ALS with diverse mechanisms of action. In this Review, we discuss how this advanced knowledge, aligned with new approaches, can enable effective translation of therapeutic agents from preclinical studies through to clinical benefit for patients with ALS. We anticipate that this approach in ALS will also positively impact the field of drug discovery for neurodegenerative disorders more broadly.
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Affiliation(s)
- Richard J Mead
- Sheffield Institute for Translational Neuroscience, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, UK
- Neuroscience Institute, University of Sheffield, Sheffield, UK
- Keapstone Therapeutics, The Innovation Centre, Broomhall, Sheffield, UK
| | - Ning Shan
- Aclipse Therapeutics, Radnor, PA, US
| | | | - Fiona Marshall
- MSD UK Discovery Centre, Merck, Sharp and Dohme (UK) Limited, London, UK
| | - Pamela J Shaw
- Sheffield Institute for Translational Neuroscience, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, UK.
- Neuroscience Institute, University of Sheffield, Sheffield, UK.
- Keapstone Therapeutics, The Innovation Centre, Broomhall, Sheffield, UK.
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15
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McKenna MC, Lope J, Bede P, Tan EL. Thalamic pathology in frontotemporal dementia: Predilection for specific nuclei, phenotype-specific signatures, clinical correlates, and practical relevance. Brain Behav 2023; 13:e2881. [PMID: 36609810 PMCID: PMC9927864 DOI: 10.1002/brb3.2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/17/2022] [Accepted: 12/18/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Frontotemporal dementia (FTD) phenotypes are classically associated with distinctive cortical atrophy patterns and regional hypometabolism. However, the spectrum of cognitive and behavioral manifestations in FTD arises from multisynaptic network dysfunction. The thalamus is a key hub of several corticobasal and corticocortical circuits. The main circuits relayed via the thalamic nuclei include the dorsolateral prefrontal circuit, the anterior cingulate circuit, and the orbitofrontal circuit. METHODS In this paper, we have reviewed evidence for thalamic pathology in FTD based on radiological and postmortem studies. Original research papers were systematically reviewed for preferential involvement of specific thalamic regions, for phenotype-associated thalamic disease burden patterns, characteristic longitudinal changes, and genotype-associated thalamic signatures. Moreover, evidence for presymptomatic thalamic pathology was also reviewed. Identified papers were systematically scrutinized for imaging methods, cohort sizes, clinical profiles, clinicoradiological associations, and main anatomical findings. The findings of individual research papers were amalgamated for consensus observations and their study designs further evaluated for stereotyped shortcomings. Based on the limitations of existing studies and conflicting reports in low-incidence FTD variants, we sought to outline future research directions and pressing research priorities. RESULTS FTD is associated with focal thalamic degeneration. Phenotype-specific thalamic traits mirror established cortical vulnerability patterns. Thalamic nuclei mediating behavioral and language functions are preferentially involved. Given the compelling evidence for considerable thalamic disease burden early in the course of most FTD subtypes, we also reflect on the practical relevance, diagnostic role, prognostic significance, and monitoring potential of thalamic metrics in FTD. CONCLUSIONS Cardinal manifestations of FTD phenotypes are likely to stem from thalamocortical circuitry dysfunction and are not exclusively driven by focal cortical changes.
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Affiliation(s)
- Mary Clare McKenna
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,Department of Neurology, St James's Hospital, Dublin, Ireland
| | - Jasmin Lope
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,Department of Neurology, St James's Hospital, Dublin, Ireland
| | - Ee Ling Tan
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
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16
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Wang T, Tian X, Kim HB, Jang Y, Huang Z, Na CH, Wang J. Intracellular energy controls dynamics of stress-induced ribonucleoprotein granules. Nat Commun 2022; 13:5584. [PMID: 36151083 PMCID: PMC9508253 DOI: 10.1038/s41467-022-33079-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 08/26/2022] [Indexed: 12/13/2022] Open
Abstract
Energy metabolism and membraneless organelles have been implicated in human diseases including neurodegeneration. How energy deficiency regulates ribonucleoprotein particles such as stress granules (SGs) is still unclear. Here we identified a unique type of granules induced by energy deficiency under physiological conditions and uncovered the mechanisms by which the dynamics of diverse stress-induced granules are regulated. Severe energy deficiency induced the rapid formation of energy deficiency-induced stress granules (eSGs) independently of eIF2α phosphorylation, whereas moderate energy deficiency delayed the clearance of conventional SGs. The formation of eSGs or the clearance of SGs was regulated by the mTOR-4EBP1-eIF4E pathway or eIF4A1, involving assembly of the eIF4F complex or RNA condensation, respectively. In neurons or brain organoids derived from patients carrying the C9orf72 repeat expansion associated with amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD), the eSG formation was enhanced, and the clearance of conventional SGs was impaired. These results reveal a critical role for intracellular energy in the regulation of diverse granules and suggest that disruptions in energy-controlled granule dynamics may contribute to the pathogenesis of relevant diseases. Stress granules are associated with neurodegenerative diseases. Here, Wang et al. found intracellular energy deficiencies trigger a unique type of granules and disrupt granule disassembly through 4EBP1/eIF4A.
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Affiliation(s)
- Tao Wang
- Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA. .,Department of Neuroscience, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA.
| | - Xibin Tian
- Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.,Department of Neuroscience, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Han Byeol Kim
- Department of Neurology, Institute for Cell Engineering, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Yura Jang
- Department of Neurology, Institute for Cell Engineering, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Zhiyuan Huang
- Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.,Department of Neuroscience, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Chan Hyun Na
- Department of Neurology, Institute for Cell Engineering, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Jiou Wang
- Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA. .,Department of Neuroscience, School of Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA.
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17
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Juengling FD, Wuest F, Kalra S, Agosta F, Schirrmacher R, Thiel A, Thaiss W, Müller HP, Kassubek J. Simultaneous PET/MRI: The future gold standard for characterizing motor neuron disease-A clinico-radiological and neuroscientific perspective. Front Neurol 2022; 13:890425. [PMID: 36061999 PMCID: PMC9428135 DOI: 10.3389/fneur.2022.890425] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 07/20/2022] [Indexed: 01/18/2023] Open
Abstract
Neuroimaging assessment of motor neuron disease has turned into a cornerstone of its clinical workup. Amyotrophic lateral sclerosis (ALS), as a paradigmatic motor neuron disease, has been extensively studied by advanced neuroimaging methods, including molecular imaging by MRI and PET, furthering finer and more specific details of the cascade of ALS neurodegeneration and symptoms, facilitated by multicentric studies implementing novel methodologies. With an increase in multimodal neuroimaging data on ALS and an exponential improvement in neuroimaging technology, the need for harmonization of protocols and integration of their respective findings into a consistent model becomes mandatory. Integration of multimodal data into a model of a continuing cascade of functional loss also calls for the best attempt to correlate the different molecular imaging measurements as performed at the shortest inter-modality time intervals possible. As outlined in this perspective article, simultaneous PET/MRI, nowadays available at many neuroimaging research sites, offers the perspective of a one-stop shop for reproducible imaging biomarkers on neuronal damage and has the potential to become the new gold standard for characterizing motor neuron disease from the clinico-radiological and neuroscientific perspectives.
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Affiliation(s)
- Freimut D. Juengling
- Division of Oncologic Imaging, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
- Faculty of Medicine, University Bern, Bern, Switzerland
| | - Frank Wuest
- Division of Oncologic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Sanjay Kalra
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
- Department of Neurology, University of Alberta, Edmonton, AB, Canada
| | - Federica Agosta
- Division of Neuroscience, San Raffaele Scientific Institute, University Vita Salute San Raffaele, Milan, Italy
| | - Ralf Schirrmacher
- Division of Oncologic Imaging, University of Alberta, Edmonton, AB, Canada
- Medical Isotope and Cyclotron Facility, University of Alberta, Edmonton, AB, Canada
| | - Alexander Thiel
- Lady Davis Institute for Medical Research, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Wolfgang Thaiss
- Department of Nuclear Medicine, University of Ulm Medical Center, Ulm, Germany
- Department of Diagnostic and Interventional Radiology, University of Ulm Medical Center, Ulm, Germany
| | - Hans-Peter Müller
- Department of Neurology, Ulm University Medical Center, Ulm, Germany
| | - Jan Kassubek
- Department of Neurology, Ulm University Medical Center, Ulm, Germany
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18
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Wang R, Gao H, Xie H, Jia Z, Chen Q. Molecular imaging biomarkers in familial frontotemporal lobar degeneration: Progress and prospects. Front Neurol 2022; 13:933217. [PMID: 36051222 PMCID: PMC9424494 DOI: 10.3389/fneur.2022.933217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/25/2022] [Indexed: 12/01/2022] Open
Abstract
Familial frontotemporal lobar degeneration (FTLD) is a pathologically heterogeneous group of neurodegenerative diseases with diverse genotypes and clinical phenotypes. Three major mutations were reported in patients with familial FTLD, namely, progranulin (GRN), microtubule-associated protein tau (MAPT), and the chromosome 9 open reading frame 72 (C9orf72) repeat expansion, which could cause neurodegenerative pathological changes years before symptom onset. Noninvasive quantitative molecular imaging with PET or single-photon emission CT (SPECT) allows for selective visualization of the molecular targets in vivo to investigate brain metabolism, perfusion, neuroinflammation, and pathophysiological changes. There was increasing evidence that several molecular imaging biomarkers tend to serve as biomarkers to reveal the early brain abnormalities in familial FTLD. Tau-PET with 18F-flortaucipir and 11C-PBB3 demonstrated the elevated tau position in patients with FTLD and also showed the ability to differentiate patterns among the different subtypes of the mutations in familial FTLD. Furthermore, dopamine transporter imaging with the 11C-DOPA and 11C-CFT in PET and the 123I-FP-CIT in SPECT revealed the loss of dopaminergic neurons in the asymptomatic and symptomatic patients of familial FTLD. In addition, PET imaging with the 11C-MP4A has demonstrated reduced acetylcholinesterase (AChE) activity in patients with FTLD, while PET with the 11C-DAA1106 and 11C-PK11195 revealed an increased level of microglial activation associated with neuroinflammation even before the onset of symptoms in familial FTLD. 18F-fluorodeoxyglucose (FDG)-PET indicated hypometabolism in FTLD with different mutations preceded the atrophy on MRI. Identifying molecular imaging biomarkers for familial FTLD is important for the in-vivo assessment of underlying pathophysiological changes with disease progression and future disease-modifying therapy. We review the recent progress of molecular imaging in familial FTLD with focused on the possible implication of these techniques and their prospects in specific mutation types.
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Affiliation(s)
- Ruihan Wang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China
| | - Hui Gao
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China
| | - Hongsheng Xie
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Qin Chen
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Qin Chen
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19
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Van den Stock J, Bertoux M, Diehl-Schmid J, Piguet O, Rankin KP, Pasquier F, Ducharme S, Pijnenburg Y, Kumfor F. Current Potential for Clinical Optimization of Social Cognition Assessment for Frontotemporal Dementia and Primary Psychiatric Disorders. Neuropsychol Rev 2022; 33:544-550. [PMID: 35962919 DOI: 10.1007/s11065-022-09554-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 05/10/2022] [Indexed: 11/25/2022]
Abstract
Dodich and colleagues recently reviewed the evidence supporting clinical use of social cognition assessment in behavioral variant frontotemporal dementia (Dodich et al., 2021). Here, we comment on their methods and present an initiative to address some of the limitations that emerged from their study. In particular, we established the social cognition workgroup within the Neuropsychiatric International Consortium Frontotemporal dementia (scNIC-FTD), aiming to validate social cognition assessment for diagnostic purposes and tracking of change across clinical situations.
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Affiliation(s)
- Jan Van den Stock
- Leuven Brain Institute, Department of Neurosciences, Research Group Psychiatry, Neuropsychiatry, KU Leuven, Leuven, Belgium.
- Geriatric Psychiatry, University Psychiatric Centre KU Leuven, Leuven, Belgium.
| | - Maxime Bertoux
- Lille Neurosciences & Cognition Institute, Labex DISTALZ, Univ. Lille, Inserm, CHU Lille, Lille, France
| | - Janine Diehl-Schmid
- School of Medicine, Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Olivier Piguet
- Brain and Mind Centre and School of Psychology, The University of Sydney, Sydney, Australia
| | - Katherine P Rankin
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Florence Pasquier
- Lille Neurosciences & Cognition Institute, Labex DISTALZ, Univ. Lille, Inserm, CHU Lille, Lille, France
| | - Simon Ducharme
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Yolande Pijnenburg
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Fiona Kumfor
- Brain and Mind Centre and School of Psychology, The University of Sydney, Sydney, Australia
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20
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McKenna MC, Lope J, Tan EL, Bede P. Pre-symptomatic radiological changes in frontotemporal dementia: propagation characteristics, predictive value and implications for clinical trials. Brain Imaging Behav 2022; 16:2755-2767. [PMID: 35920960 DOI: 10.1007/s11682-022-00711-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 11/25/2022]
Abstract
Computational imaging and quantitative biomarkers offer invaluable insights in the pre-symptomatic phase of neurodegenerative conditions several years before clinical manifestation. In recent years, there has been a focused effort to characterize pre-symptomatic cerebral changes in familial frontotemporal dementias using computational imaging. Accordingly, a systematic literature review was conducted of original articles investigating pre-symptomatic imaging changes in frontotemporal dementia focusing on study design, imaging modalities, data interpretation, control cohorts and key findings. The review is limited to the most common genotypes: chromosome 9 open reading frame 72 (C9orf72), progranulin (GRN), or microtubule-associated protein tau (MAPT) genotypes. Sixty-eight studies were identified with a median sample size of 15 (3-141) per genotype. Only a minority of studies were longitudinal (28%; 19/68) with a median follow-up of 2 (1-8) years. MRI (97%; 66/68) was the most common imaging modality, and primarily grey matter analyses were conducted (75%; 19/68). Some studies used multimodal analyses 44% (30/68). Genotype-associated imaging signatures are presented, innovative study designs are highlighted, common methodological shortcomings are discussed and lessons for future studies are outlined. Emerging academic observations have potential clinical implications for expediting the diagnosis, tracking disease progression and optimising the timing of pharmaceutical trials.
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Affiliation(s)
- Mary Clare McKenna
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Room 5.43, Pearse Street, Dublin 2, Ireland.,Department of Neurology, St James's Hospital, Dublin, Ireland
| | - Jasmin Lope
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Room 5.43, Pearse Street, Dublin 2, Ireland
| | - Ee Ling Tan
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Room 5.43, Pearse Street, Dublin 2, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Room 5.43, Pearse Street, Dublin 2, Ireland. .,Department of Neurology, St James's Hospital, Dublin, Ireland.
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21
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Nelson AT, Trotti D. Altered Bioenergetics and Metabolic Homeostasis in Amyotrophic Lateral Sclerosis. Neurotherapeutics 2022; 19:1102-1118. [PMID: 35773551 PMCID: PMC9587161 DOI: 10.1007/s13311-022-01262-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 01/07/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease that primarily affects motor neurons and causes muscle atrophy, paralysis, and death. While a great deal of progress has been made in deciphering the underlying pathogenic mechanisms, no effective treatments for the disease are currently available. This is mainly due to the high degree of complexity and heterogeneity that characterizes the disease. Over the last few decades of research, alterations to bioenergetic and metabolic homeostasis have emerged as a common denominator across many different forms of ALS. These alterations are found at the cellular level (e.g., mitochondrial dysfunction and impaired expression of monocarboxylate transporters) and at the systemic level (e.g., low BMI and hypermetabolism) and tend to be associated with survival or disease outcomes in patients. Furthermore, an increasing amount of preclinical evidence and some promising clinical evidence suggests that targeting energy metabolism could be an effective therapeutic strategy. This review examines the evidence both for and against these ALS-associated metabolic alterations and highlights potential avenues for therapeutic intervention.
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Affiliation(s)
- Andrew T Nelson
- Jefferson Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, 900 Walnut Street, JHN Bldg., 4th floor, room 416, Philadelphia, PA, 19107, USA
| | - Davide Trotti
- Jefferson Weinberg ALS Center, Vickie and Jack Farber Institute for Neuroscience, Department of Neuroscience, Thomas Jefferson University, 900 Walnut Street, JHN Bldg., 4th floor, room 416, Philadelphia, PA, 19107, USA.
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22
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How can we define the presymptomatic C9orf72 disease in 2022? An overview on the current definitions of preclinical and prodromal phases. Rev Neurol (Paris) 2022; 178:426-436. [PMID: 35525633 DOI: 10.1016/j.neurol.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/08/2022] [Indexed: 11/24/2022]
Abstract
Repeat expansions in C9orf72 gene are the main genetic cause of frontotemporal dementia, amyotrophic lateral sclerosis and related phenotypes. With the advent of disease-modifying treatments, the presymptomatic disease phase is getting increasing interest as an ideal time window in which innovant therapeutic approaches could be administered. Recommendations issued from international study groups distinguish between a preclinical disease stage, during which lesions accumulate in absence of any symptoms or signs, and a prodromal stage, marked by the appearance the first subtle cognitive, behavioral, psychiatric and motor signs, before the full-blown disease. This paper summarizes the current definitions and criteria for these stages, in particular focusing on how fluid-based, neuroimaging and cognitive biomarkers can be useful to monitor disease trajectory across the presymptomatic phase, as well as to detect the earliest signs of clinical conversion. Continuous advances in the knowledge of C9orf72 pathophysiology, and the integration of biomarkers in the clinical evaluation of mutation carriers will allow a better diagnostic definition of C9orf72 disease spectrum from the earliest stages, with relevant impact on the possibility of disease prevention.
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23
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Sangari S, Peyre I, Lackmy‐Vallée A, Bayen E, Pradat P, Marchand‐Pauvert V. Transient increase in recurrent inhibition in amyotrophic lateral sclerosis as a putative protection from neurodegeneration. Acta Physiol (Oxf) 2022; 234:e13758. [PMID: 34981890 DOI: 10.1111/apha.13758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/15/2021] [Accepted: 01/01/2022] [Indexed: 11/28/2022]
Abstract
AIM Adaptive mechanisms in spinal circuits are likely involved in homeostatic responses to maintain motor output in amyotrophic lateral sclerosis. Given the role of Renshaw cells in regulating the motoneuron input/output gain, we investigated the modulation of heteronymous recurrent inhibition. METHODS Electrical stimulations were used to activate recurrent collaterals resulting in the Hoffmann reflex depression. Inhibitions from soleus motor axons to quadriceps motoneurons, and vice versa, were tested in 38 patients and matched group of 42 controls. RESULTS Compared with controls, the mean depression of quadriceps reflex was larger in patients, while that of soleus was smaller, suggesting that heteronymous recurrent inhibition was enhanced in quadriceps but reduced in soleus. The modulation of recurrent inhibition was linked to the size of maximal direct motor response and lower limb dysfunctions, suggesting a significant relationship with the integrity of the target motoneuron pool and functional abilities. No significant link was found between the integrity of motor axons activating Renshaw cells and the level of inhibition. Enhanced inhibition was particularly observed in patients within the first year after symptom onset and with slow progression of lower limb dysfunctions. Normal or reduced inhibitions were mainly observed in patients with motor weakness first in lower limbs and greater dysfunctions in lower limbs. CONCLUSION We provide the first evidence for enhanced recurrent inhibition and speculate that Renshaw cells might have transient protective role on motoneuron by counteracting hyperexcitability at early stages. Several mechanisms likely participate including cortical influence on Renshaw cell and reinnervation by slow motoneurons.
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Affiliation(s)
- Sina Sangari
- Laboratoire d’Imagerie Biomédicale Sorbonne Université INSERM CNRS Paris France
- Shirley Ryan AbilityLab Chicago Illinois USA
- Department of Physical Medicine and Rehabilitation Northwestern University Chicago Illinois USA
| | - Iseline Peyre
- Laboratoire d’Imagerie Biomédicale Sorbonne Université INSERM CNRS Paris France
| | | | - Eléonore Bayen
- Laboratoire d’Imagerie Biomédicale Sorbonne Université INSERM CNRS Paris France
- Pôle MSN, Hôpital Pitié‐Salpêtrière AP‐HP Paris France
| | - Pierre‐François Pradat
- Laboratoire d’Imagerie Biomédicale Sorbonne Université INSERM CNRS Paris France
- Pôle MSN, Hôpital Pitié‐Salpêtrière AP‐HP Paris France
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24
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Garrett LR, Niccoli T. Frontotemporal Dementia and Glucose Metabolism. Front Neurosci 2022; 16:812222. [PMID: 35281504 PMCID: PMC8906510 DOI: 10.3389/fnins.2022.812222] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/18/2022] [Indexed: 12/02/2022] Open
Abstract
Frontotemporal dementia (FTD), hallmarked by antero-temporal degeneration in the human brain, is the second most common early onset dementia. FTD is a diverse disease with three main clinical presentations, four different identified proteinopathies and many disease-associated genes. The exact pathophysiology of FTD remains to be elucidated. One common characteristic all forms of FTD share is the dysregulation of glucose metabolism in patients’ brains. The brain consumes around 20% of the body’s energy supply and predominantly utilizes glucose as a fuel. Glucose metabolism dysregulation could therefore be extremely detrimental for neuronal health. Research into the association between glucose metabolism and dementias has recently gained interest in Alzheimer’s disease. FTD also presents with glucose metabolism dysregulation, however, this remains largely an unexplored area. A better understanding of the link between FTD and glucose metabolism may yield further insight into FTD pathophysiology and aid the development of novel therapeutics. Here we review our current understanding of FTD and glucose metabolism in the brain and discuss the evidence of impaired glucose metabolism in FTD. Lastly, we review research potentially suggesting a causal relationship between FTD proteinopathies and impaired glucose metabolism in FTD.
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25
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Bruffaerts R, Gors D, Bárcenas Gallardo A, Vandenbulcke M, Van Damme P, Suetens P, van Swieten JC, Borroni B, Sanchez-Valle R, Moreno F, Laforce R, Graff C, Synofzik M, Galimberti D, Rowe JB, Masellis M, Tartaglia MC, Finger E, de Mendonça A, Tagliavini F, Butler CR, Santana I, Gerhard A, Ducharme S, Levin J, Danek A, Otto M, Rohrer JD, Dupont P, Claes P, Vandenberghe R. Hierarchical spectral clustering reveals brain size and shape changes in asymptomatic carriers of C9orf72. Brain Commun 2022; 4:fcac182. [PMID: 35898720 PMCID: PMC9311825 DOI: 10.1093/braincomms/fcac182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 03/17/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Traditional methods for detecting asymptomatic brain changes in neurodegenerative diseases such as Alzheimer's disease or frontotemporal degeneration typically evaluate changes in volume at a predefined level of granularity, e.g. voxel-wise or in a priori defined cortical volumes of interest. Here, we apply a method based on hierarchical spectral clustering, a graph-based partitioning technique. Our method uses multiple levels of segmentation for detecting changes in a data-driven, unbiased, comprehensive manner within a standard statistical framework. Furthermore, spectral clustering allows for detection of changes in shape along with changes in size. We performed tensor-based morphometry to detect changes in the Genetic Frontotemporal dementia Initiative asymptomatic and symptomatic frontotemporal degeneration mutation carriers using hierarchical spectral clustering and compared the outcome to that obtained with a more conventional voxel-wise tensor- and voxel-based morphometric analysis. In the symptomatic groups, the hierarchical spectral clustering-based method yielded results that were largely in line with those obtained with the voxel-wise approach. In asymptomatic C9orf72 expansion carriers, spectral clustering detected changes in size in medial temporal cortex that voxel-wise methods could only detect in the symptomatic phase. Furthermore, in the asymptomatic and the symptomatic phases, the spectral clustering approach detected changes in shape in the premotor cortex in C9orf72. In summary, the present study shows the merit of hierarchical spectral clustering for data-driven segmentation and detection of structural changes in the symptomatic and asymptomatic stages of monogenic frontotemporal degeneration.
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Affiliation(s)
- Rose Bruffaerts
- Correspondence to: Rose Bruffaerts, MD, PhD Computational Neurology, Experimental Neurobiology Unit Department of Biomedical Sciences, University of Antwerp, Campus Drie Eiken Universiteitsplein 1, 2610 Antwerp, Belgium E-mail:
| | | | | | | | - Philip Van Damme
- Department of Neurosciences, KU Leuven—University of Leuven, Experimental Neurology, and Leuven Brain Institute (LBI), Leuven 3000, Belgium
- Laboratory of Neurobiology, VIB, Center for Brain & Disease Research, Leuven 3000, Belgium
| | - Paul Suetens
- Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven 3000, Belgium
- Medical Imaging Research Center, KU Leuven, Leuven 3000, Belgium
| | - John C van Swieten
- Department of Neurology, Erasmus Medical Centre, Rotterdam 3015, Netherlands
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25121, Italy
| | - Raquel Sanchez-Valle
- Alzheimer’s disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clinic, Institut d’Investigacions Biomediques August Pi I Sunyer, University of Barcelona, Barcelona 08036, Spain
| | - Fermin Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia University Hospital, San Sebastian, Gipuzkoa 20014, Spain
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, and Faculté de Médecine, Université Laval, QC G1Z 1J4, Canada
| | - Caroline Graff
- Center for Alzheimer Research, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Bioclinicum, Karolinska Institutet, Solna 17176, Sweden
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen 72076, Germany
| | - Daniela Galimberti
- Fondazione IRCCS Ospedale Policlinico, Neurodegenerative Diseases Unit, Milan 20122, Italy
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, University of Milan, Milan 20122, Italy
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto M4N 3M5, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto M4N 3M5, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario N6A 3K7, Canada
| | | | - Fabrizio Tagliavini
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Neurodegenerative Diseases Unit, Milano 20133, Italy
| | - Chris R Butler
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford OX3 9DU, UK
| | - Isabel Santana
- University Hospital of Coimbra (HUC), Neurology Service, Faculty of Medicine, University of Coimbra, Coimbra 3004, Portugal
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester M20 3LJ, UK
- Department of Geriatric Medicine, Center for Translational Neuro- and Behavioral Sciences, University Medicine Essen, Essen 45147, Germany
- Department of Nuclear Medicine, Center for Translational Neuro- and Behavioral Sciences, University Medicine Essen, Essen 45147, Germany
| | - Simon Ducharme
- Department of Psychiatry, McGill University Health Centre, McGill University, Montreal, Quebec 3801, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Department of Neurology & Neurosurgery, McGill University, Montreal 3801, Canada
| | - Johannes Levin
- Neurologische Klinik, Ludwig-Maximilians-Universität München, Munich 81377, Germany
| | - Adrian Danek
- Neurologische Klinik, Ludwig-Maximilians-Universität München, Munich 81377, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm 89081, Germany
| | - Jonathan D Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Patrick Dupont
- Laboratory for Cognitive Neurology, Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), KU Leuven, Leuven 3000, Belgium
- Alzheimer Research Centre KU Leuven, Leuven Brain Institute, KU Leuven, Leuven 3000, Belgium
| | - Peter Claes
- Correspondence may also be addressed to: Peter Claes, PhD Department of Electrical Engineering, ESAT/PSI, KU Leuven Herestraat 49, box 7003, 3000 Leuven, Belgium E-mail:
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), KU Leuven, Leuven 3000, Belgium
- Alzheimer Research Centre KU Leuven, Leuven Brain Institute, KU Leuven, Leuven 3000, Belgium
- Neurology Department, University Hospitals Leuven, Leuven 3000, Belgium
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26
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Benussi A, Alberici A, Samra K, Russell LL, Greaves CV, Bocchetta M, Ducharme S, Finger E, Fumagalli G, Galimberti D, Jiskoot LC, Le Ber I, Masellis M, Nacmias B, Rowe JB, Sanchez-Valle R, Seelaar H, Synofzik M, Rohrer JD, Borroni B. Conceptual framework for the definition of preclinical and prodromal frontotemporal dementia. Alzheimers Dement 2021; 18:1408-1423. [PMID: 34874596 DOI: 10.1002/alz.12485] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 12/13/2022]
Abstract
The presymptomatic stages of frontotemporal dementia (FTD) are still poorly defined and encompass a long accrual of progressive biological (preclinical) and then clinical (prodromal) changes, antedating the onset of dementia. The heterogeneity of clinical presentations and the different neuropathological phenotypes have prevented a prior clear description of either preclinical or prodromal FTD. Recent advances in therapeutic approaches, at least in monogenic disease, demand a proper definition of these predementia stages. It has become clear that a consensus lexicon is needed to comprehensively describe the stages that anticipate dementia. The goal of the present work is to review existing literature on the preclinical and prodromal phases of FTD, providing recommendations to address the unmet questions, therefore laying out a strategy for operationalizing and better characterizing these presymptomatic disease stages.
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Affiliation(s)
- Alberto Benussi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Antonella Alberici
- Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Kiran Samra
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Caroline V Greaves
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Simon Ducharme
- Department of Psychiatry, Douglas Mental Health University Institute and Douglas Research Centre, McGill University, Montreal, Québec, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
| | - Giorgio Fumagalli
- Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy.,University of Milan, Milan, Italy
| | - Daniela Galimberti
- Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy.,University of Milan, Milan, Italy
| | - Lize C Jiskoot
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,Department of Neurology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Isabelle Le Ber
- Paris Brain Institute - Institut du Cerveau - ICM, Sorbonne Université, Inserm U1127, CNRS UMR, Paris, France.,Centre de référence des démences rares ou précoces, IM2A, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France.,Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France.,Reference Network for Rare Neurological Diseases (ERN-RND), Paris, France
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, and IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - James B Rowe
- Department of Clinical Neurosciences, MRC Cognition and Brain Sciences Unit and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Harro Seelaar
- Department of Neurology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany.,Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | | | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
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27
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Querin G, Grazia Biferi M, Pradat PF. Biomarkers for C9orf7-ALS in Symptomatic and Pre-symptomatic Patients: State-of-the-art in the New Era of Clinical Trials. J Neuromuscul Dis 2021; 9:25-37. [PMID: 34864683 PMCID: PMC8842771 DOI: 10.3233/jnd-210754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The development of new possible treatments for C9orf72-related ALS and the possibility of early identification of subjects genetically at risk of developing the disease is creating a critical need for biomarkers to track neurodegeneration that could be used as outcome measures in clinical trials. Current candidate biomarkers in C9orf72-ALS include neuropsychology tests, imaging, electrophysiology as well as different circulating biomarkers. Neuropsychology tests show early executive and verbal function involvement both in symptomatic and asymptomatic mutation carriers. At brain MRI, C9orf72-ALS patients present diffuse white and grey matter degeneration, which are already identified up to 20 years before symptom onset and that seem to be slowly progressive over time, while regions of altered connectivity at fMRI and of hypometabolism at [18F]FDG PET have been described as well. At the same time, spinal cord MRI has also shown progressive decrease of FA in the cortico-spinal tract over time. On the side of wet biomarkers, neurofilament proteins are increased both in the CSF and serum just before symptom onset and tend to slowly increase over time, while poly(GP) protein can be detected in the CSF and probably used as target engagement marker in clinical trials.
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Affiliation(s)
- Giorgia Querin
- Institut de Myologie, I-Motion Adult ClinicalTrials Platform, Hôpital Pitié-Salpêtrière, Paris, France.,APHP, Centre de référence desmaladies neuromusculaires Nord/Est/Ile de France, HôpitalPitié-Salpêtrière, Paris, France
| | - Maria Grazia Biferi
- Sorbonne Université, Inserm UMRS974, Centre of Research in Myology (CRM), Institut de Myologie, GH PitiéSalpêtrière, Paris, France
| | - Pierre-Francois Pradat
- APHP, Département de Neurologie, Centre Référent SLA, Hôpital Pitié-Salpêtrière, Paris, France.,Laboratoire d'Imagerie Biomédicale, CNRS, INSERM, Sorbonne Université, Paris, France.,Northern Ireland Centre for Stratified Medicine, Biomedical Sciences Research Institute Ulster University, C-TRIC, Altnagelvin Hospital, Londonderry, United Kingdom
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28
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Spinelli EG, Ghirelli A, Basaia S, Cividini C, Riva N, Canu E, Castelnovo V, Domi T, Magnani G, Caso F, Caroppo P, Prioni S, Rossi G, Tremolizzo L, Appollonio I, Silani V, Carrera P, Filippi M, Agosta F. Structural MRI Signatures in Genetic Presentations of the Frontotemporal Dementia/Motor Neuron Disease Spectrum. Neurology 2021; 97:e1594-e1607. [PMID: 34544819 PMCID: PMC8548958 DOI: 10.1212/wnl.0000000000012702] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/09/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To assess cortical, subcortical, and cerebellar gray matter (GM) atrophy using MRI in patients with disorders of the frontotemporal lobar degeneration (FTLD) spectrum with known genetic mutations. METHODS Sixty-six patients carrying FTLD-related mutations were enrolled, including 44 with pure motor neuron disease (MND) and 22 with frontotemporal dementia (FTD). Sixty-one patients with sporadic FTLD (sFTLD) matched for age, sex, and disease severity with genetic FTLD (gFTLD) were also included, as well as 52 healthy controls. A whole-brain voxel-based morphometry (VBM) analysis was performed. GM volumes of subcortical and cerebellar structures were obtained. RESULTS Compared with controls, GM atrophy on VBM was greater and more diffuse in genetic FTD, followed by sporadic FTD and genetic MND cases, whereas patients with sporadic MND (sMND) showed focal motor cortical atrophy. Patients carrying C9orf72 and GRN mutations showed the most widespread cortical volume loss, in contrast with GM sparing in SOD1 and TARDBP. Globally, patients with gFTLD showed greater atrophy of parietal cortices and thalami compared with sFTLD. In volumetric analysis, patients with gFTLD showed volume loss compared with sFTLD in the caudate nuclei and thalami, in particular comparing C9-MND with sMND cases. In the cerebellum, patients with gFTLD showed greater atrophy of the right lobule VIIb than sFTLD. Thalamic volumes of patients with gFTLD with a C9orf72 mutation showed an inverse correlation with Frontal Behavioral Inventory scores. DISCUSSION Measures of deep GM and cerebellar structural involvement may be useful markers of gFTLD, particularly C9orf72-related disorders, regardless of the clinical presentation within the FTLD spectrum.
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Affiliation(s)
- Edoardo Gioele Spinelli
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Alma Ghirelli
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Silvia Basaia
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Camilla Cividini
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Nilo Riva
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Elisa Canu
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Veronica Castelnovo
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Teuta Domi
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Giuseppe Magnani
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Francesca Caso
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Paola Caroppo
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Sara Prioni
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Giacomina Rossi
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Lucio Tremolizzo
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Ildebrando Appollonio
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Vincenzo Silani
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Paola Carrera
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Massimo Filippi
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy
| | - Federica Agosta
- From the Neuroimaging Research Unit (E.G.S., A.G., S.B., C.C., E.C., V.C., M.F., F.A.) and Experimental Neuropathology Unit (N.R., T.D.), Division of Neuroscience, Neurorehabilitation Unit (N.R., M.F.), Neurology Unit (E.G.S., G.M., F.C., M.F., F.A.), Laboratory of Clinical Molecular Biology (P. Carrera), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University (E.G.S., A.G., C.C., V.C., M.F., F.A.); Unit of Neurology 5-Neuropathology (P. Caroppo, S.P., G.R.), Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; Neurology Unit (L.T., I.A.), "San Gerardo" Hospital and University of Milano-Bicocca, Monza; Department of Neurology and Laboratory of Neuroscience (V.S.), IRCCS Istituto Auxologico Italiano; and "Dino Ferrari" Center, Department of Pathophysiology and Transplantation (V.S.), Università degli Studi di Milano, Milan, Italy.
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McKenna MC, Corcia P, Couratier P, Siah WF, Pradat PF, Bede P. Frontotemporal Pathology in Motor Neuron Disease Phenotypes: Insights From Neuroimaging. Front Neurol 2021; 12:723450. [PMID: 34484106 PMCID: PMC8415268 DOI: 10.3389/fneur.2021.723450] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/22/2021] [Indexed: 01/18/2023] Open
Abstract
Frontotemporal involvement has been extensively investigated in amyotrophic lateral sclerosis (ALS) but remains relatively poorly characterized in other motor neuron disease (MND) phenotypes such as primary lateral sclerosis (PLS), progressive muscular atrophy (PMA), spinal muscular atrophy (SMA), spinal bulbar muscular atrophy (SBMA), post poliomyelitis syndrome (PPS), and hereditary spastic paraplegia (HSP). This review focuses on insights from structural, metabolic, and functional neuroimaging studies that have advanced our understanding of extra-motor disease burden in these phenotypes. The imaging literature is limited in the majority of these conditions and frontotemporal involvement has been primarily evaluated by neuropsychology and post mortem studies. Existing imaging studies reveal that frontotemporal degeneration can be readily detected in ALS and PLS, varying degree of frontotemporal pathology may be captured in PMA, SBMA, and HSP, SMA exhibits cerebral involvement without regional predilection, and there is limited evidence for cerebral changes in PPS. Our review confirms the heterogeneity extra-motor pathology across the spectrum of MNDs and highlights the role of neuroimaging in characterizing anatomical patterns of disease burden in vivo. Despite the contribution of neuroimaging to MND research, sample size limitations, inclusion bias, attrition rates in longitudinal studies, and methodological constraints need to be carefully considered. Frontotemporal involvement is a quintessential clinical facet of MND which has important implications for screening practices, individualized management strategies, participation in clinical trials, caregiver burden, and resource allocation. The academic relevance of imaging frontotemporal pathology in MND spans from the identification of genetic variants, through the ascertainment of presymptomatic changes to the design of future epidemiology studies.
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Affiliation(s)
- Mary Clare McKenna
- Computational Neuroimaging Group, Trinity College Dublin, Dublin, Ireland
| | - Philippe Corcia
- Department of Neurology-Neurophysiology, CRMR ALS, Tours, France.,UMR 1253 iBrain, University of Tours, Tours, France.,LITORALS, Federation of ALS Centres: Tours-Limoges, Limoges, France
| | - Philippe Couratier
- LITORALS, Federation of ALS Centres: Tours-Limoges, Limoges, France.,ALS Centre, Limoges University Hospital (CHU de Limoges), Limoges, France
| | - We Fong Siah
- Computational Neuroimaging Group, Trinity College Dublin, Dublin, Ireland
| | | | - Peter Bede
- Computational Neuroimaging Group, Trinity College Dublin, Dublin, Ireland.,Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France
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Neuroinflammation and Its Association with Cognition, Neuronal Markers and Peripheral Inflammation after Chemotherapy for Breast Cancer. Cancers (Basel) 2021; 13:cancers13164198. [PMID: 34439351 PMCID: PMC8391457 DOI: 10.3390/cancers13164198] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/12/2021] [Accepted: 08/17/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Up to 70% of chemotherapy-treated patients experience problems with memory and concentration, potentially caused by direct and indirect neurotoxicity, such as (neuro-)inflammatory processes. Can neuroinflammation changes be detected in chemotherapy-treated patients with breast cancer using translocator protein [18F]DPA714 simultaneous positron emission tomographic- and magnetic resonance imaging? Moreover, what is the association with clinical biomarkers? In a study including 19 chemotherapy-treated breast cancer patients, 18 chemotherapy-naïve and 37 healthy controls, we found significant relative glial overexpression in parietal and occipital brain regions in chemotherapy-treated patients compared to controls, which were associated with cognitive abnormalities and markers of neuronal survival. Shortly after ending chemotherapy, changes in brain neuroinflammation seem to occur, possibly contributing to the cognitive decline seen in breast cancer patients. Additionally, blood levels of an axonal damage marker were 20-fold higher in chemotherapy-treated patients, providing evidence for its use as a biomarker to assess neurotoxic effects of anticancer chemotherapies. Abstract To uncover mechanisms underlying chemotherapy-induced cognitive impairment in breast cancer, we studied new biomarkers of neuroinflammation and neuronal survival. This cohort study included 74 women (47 ± 10 years) from 22 October 2017 until 20 August 2020. Nineteen chemotherapy-treated and 18 chemotherapy-naïve patients with breast cancer were assessed one month after the completion of surgery and/or chemotherapy, and 37 healthy controls were included. Assessments included neuropsychological testing, questionnaires, blood sampling for 17 inflammatory and two neuronal survival markers (neurofilament light-chain (NfL), and brain-derived neurotrophic factor (BDNF) and PET-MR neuroimaging. To investigate neuroinflammation, translocator protein (TSPO) [18F]DPA714-PET-MR was acquired for 15 participants per group, and evaluated by volume of distribution normalized to the cerebellum. Chemotherapy-treated patients showed higher TSPO expression, indicative for neuroinflammation, in the occipital and parietal lobe when compared to healthy controls or chemotherapy-naïve patients. After partial-volume correction, differences with healthy controls persisted (pFWE < 0.05). Additionally, compared to healthy- or chemotherapy-naïve controls, cognitive impairment (17–22%) and altered levels in blood markers (F ≥ 3.7, p ≤ 0.031) were found in chemotherapy-treated patients. NfL, an axonal damage marker, was particularly sensitive in differentiating groups (F = 105, p = 4.2 × 10 −21), with levels 20-fold higher in chemotherapy-treated patients. Lastly, in chemotherapy-treated patients alone, higher local TSPO expression was associated with worse cognitive performance, higher blood levels of BDNF/NfL, and decreased fiber cross-section in the corpus callosum (pFWE < 0.05). These findings suggest that increased neuroinflammation is associated with chemotherapy-related cognitive impairment in breast cancer. Additionally, NfL could be a useful biomarker to assess neurotoxic effects of anticancer chemotherapies.
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Hypermetabolism associated with worse prognosis of amyotrophic lateral sclerosis. J Neurol 2021; 269:1447-1455. [PMID: 34274994 DOI: 10.1007/s00415-021-10716-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Exploration of hypermetabolism in amyotrophic lateral sclerosis (ALS) with different ethnicities is needed to understand its metabolic implications for clinical management. We aimed to evaluate the features of hypermetabolism and investigate its association with clinical characteristics and prognosis of ALS in a prospective Chinese cohort. METHODS This prospective study was conducted at Peking University Third Hospital, China from 2017 to 2020. 343 participants were enrolled initially. After strict screening, 147 matched health controls and 93 patients with ALS were eligible and underwent detailed clinical assessments. Disease severity and progression were evaluated using recognized scales. Metabolic assessments included body composition and metabolic index (MI) [hypermetabolism if MI ≥ 120.0%]. Patients were followed up every 6 months for survival analysis. RESULTS Compared with controls, hypermetabolism was significantly more prevalent in ALS (p = 0.009). MI was consistently higher in ALS than controls (p = 0.009). Further correlation analysis showed that MI significantly decreased with disease progression, as graded by King's College staging system (p < 0.001). MI was significantly correlated with fat-free mass and fat mass (p = 0.005 and 0.007). Survival analysis showed that hypermetabolism independently indicated a worse prognosis for ALS (HR = 1.020, CI = 1.004-1.036, p = 0.013). CONCLUSION A significant increase in the prevalence and degree of hypermetabolism was identified in ALS compared with strictly matched controls. Metabolic index, which is significantly associated with disease progression and body composition, is an independent prognostic indicator for a worse survival of ALS.
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Abstract
PURPOSE OF REVIEW This review draws together the most recent findings in ALS biomarker research from biochemical, imaging and neurophysiology techniques. RECENT FINDINGS The potential of circulating RNA is highlighted, including new retrieval techniques. With ongoing genetic clinical trials, the need for pharmacodynamic biomarkers is essential. There is a strong case for neurofilament proteins being validated in ALS; their biomarker profile is discussed. Oxidative stress and neuroinflammation studies offer insight into disease mechanisms and offer good biomarker potential. Recent metabolic studies include investigation of lipid profiles, creatinine and ferritin. The potential of chitinase proteins as pharmacodynamic and prognostic biomarkers is highlighted. The role of tau and amyloidβ is debated, as evidenced by the articles presented here. Proteomic approaches provide unbiased discoveries of novel biomarkers, together with confirmation of previous findings. The use of imaging techniques is outlined to demonstrate selective atrophy, volume loss, muscle and tract involvement. In-vivo imaging is discussed with reference to histone deacetylase, oxidative stress, neuroinflammation and metabolic changes. New applications of electrophysiology demonstrate objective muscle biomarkers and brain network perturbations. SUMMARY The biomarker research field continues to provide insight into the disease. Multicentre collaborations are needed to validate these promising recent findings.
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Popuri K, Beg MF, Lee H, Balachandar R, Wang L, Sossi V, Jacova C, Baker M, Shahinfard E, Rademakers R, Mackenzie IRA, Hsiung GYR. FDG-PET in presymptomatic C9orf72 mutation carriers. Neuroimage Clin 2021; 31:102687. [PMID: 34049163 PMCID: PMC8170157 DOI: 10.1016/j.nicl.2021.102687] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Our aim is to investigate patterns of brain glucose metabolism using fluorodeoxyglucose positron emission tomography (FDG-PET) in presymptomatic carriers of the C9orf72 repeat expansion to better understand the early preclinical stages of frontotemporal dementia (FTD). METHODS Structural MRI and FDG-PET were performed on clinically asymptomatic members of families with FTD caused by the C9orf72 repeat expansion (15 presymptomatic mutation carriers, C9orf72+; 20 non-carriers, C9orf72-). Regional glucose metabolism in cerebral and cerebellar gray matter was compared between groups. RESULTS The mean age of the C9orf72+ and C9orf72- groups were 45.3 ± 10.6 and 56.0 ± 11.0 years respectively, and the mean age of FTD onset in their families was 56 ± 7 years. Compared to non-carrier controls, the C9orf72+ group exhibited regional hypometabolism, primarily involving the cingulate gyrus, frontal and temporal neocortices (left > right) and bilateral thalami. CONCLUSIONS The C9orf72 repeat expansion is associated with changes in brain glucose metabolism that are demonstrable up to 10 years prior to symptom onset and before changes in gray matter volume become significant. These findings indicate that FDG-PET may be a particularly sensitive and useful method for investigating and monitoring the earliest stages of FTD in individuals with this underlying genetic basis.
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Affiliation(s)
| | | | - Hyunwoo Lee
- Division of Neurology, Department of Medicine, University of British Columbia
| | | | - Lei Wang
- Departments of Psychiatry and Behavioral Sciences and Radiology, Feinberg School of Medicine, Northwestern University
| | - Vesna Sossi
- Department of Physics and Astronomy, University of British Columbia
| | | | | | - Elham Shahinfard
- Department of Physics and Astronomy, University of British Columbia
| | | | - Ian R A Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia
| | - Ging-Yuek R Hsiung
- Division of Neurology, Department of Medicine, University of British Columbia.
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Cognitive dysfunction in amyotrophic lateral sclerosis: can we predict it? Neurol Sci 2021; 42:2211-2222. [PMID: 33772353 PMCID: PMC8159827 DOI: 10.1007/s10072-021-05188-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/15/2021] [Indexed: 01/26/2023]
Abstract
Background and aim Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder characterized by the degeneration of both upper and lower motoneurons in the brain and spinal cord leading to motor and extra-motor symptoms. Although traditionally considered a pure motor disease, recent evidences suggest that ALS is a multisystem disorder. Neuropsychological alterations, in fact, are observed in more than 50% of patients: while executive dysfunctions have been firstly identified, alterations in verbal fluency, behavior, and pragmatic and social cognition have also been described. Detecting and monitoring ALS cognitive and behavioral impairment even at early disease stages is likely to have staging and prognostic implications, and it may impact the enrollment in future clinical trials. During the last 10 years, humoral, radiological, neurophysiological, and genetic biomarkers have been reported in ALS, and some of them seem to potentially correlate to cognitive and behavioral impairment of patients. In this review, we sought to give an up-to-date state of the art of neuropsychological alterations in ALS: we will describe tests used to detect cognitive and behavioral impairment, and we will focus on promising non-invasive biomarkers to detect pre-clinical cognitive decline. Conclusions To date, the research on humoral, radiological, neurophysiological, and genetic correlates of neuropsychological alterations is at the early stage, and no conclusive longitudinal data have been published. Further and longitudinal studies on easily accessible and quantifiable biomarkers are needed to clarify the time course and the evolution of cognitive and behavioral impairments of ALS patients.
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Clarke MTM, St-Onge F, Beauregard JM, Bocchetta M, Todd E, Cash DM, Rohrer JD, Laforce R. Early anterior cingulate involvement is seen in presymptomatic MAPT P301L mutation carriers. ALZHEIMERS RESEARCH & THERAPY 2021; 13:42. [PMID: 33568215 PMCID: PMC7876816 DOI: 10.1186/s13195-021-00777-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/25/2021] [Indexed: 12/12/2022]
Abstract
Background PET imaging of glucose metabolism has revealed presymptomatic abnormalities in genetic FTD but has not been explored in MAPT P301L mutation carriers. This study aimed to explore the patterns of presymptomatic hypometabolism and atrophy in MAPT P301L mutation carriers. Methods Eighteen asymptomatic members from five families with a P301L MAPT mutation were recruited to the study, six mutation carriers, and twelve mutation-negative controls. All participants underwent standard behavioural and cognitive assessment as well as [18F]FDG-PET and 3D T1-weighted MRI brain scans. Regional standardised uptake value ratios (SUVR) for the PET scan and volumes calculated from an automated segmentation for the MRI were obtained and compared between the mutation carrier and control groups. Results The mean (standard deviation) estimated years from symptom onset was 12.5 (3.6) in the mutation carrier group with a range of 7 to 18 years. No differences in cognition were seen between the groups, and all mutation carriers had a global CDR plus NACC FTLD of 0. Significant reduction in [18F] FDG uptake in the anterior cingulate was seen in mutation carriers (mean 1.25 [standard deviation 0.07]) compared to controls (1.36 [0.09]). A similar significant reduction was also seen in grey matter volume in the anterior cingulate in mutation carriers (0.60% [0.06%]) compared to controls (0.68% [0.08%]). No other group differences were seen in other regions. Conclusions Anterior cingulate hypometabolism and atrophy are both apparent presymptomatically in a cohort of P301L MAPT mutation carriers. Such a specific marker may prove to be helpful in stratification of presymptomatic mutation carriers in future trials. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-021-00777-9.
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Affiliation(s)
- Mica T M Clarke
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK.
| | - Frédéric St-Onge
- Centre de Recherche du CHU de Québec, Université Laval, Québec, QC, Canada.,Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec-Université Laval, Québec, QC, Canada.,Faculté de Médecine, Département de médecine, Université Laval, Québec, QC, Canada
| | | | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Emily Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Robert Laforce
- Centre de Recherche du CHU de Québec, Université Laval, Québec, QC, Canada.,Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec-Université Laval, Québec, QC, Canada.,Faculté de Médecine, Département de médecine, Université Laval, Québec, QC, Canada.,CHU de Québec, Québec, QC, Canada
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Abstract
Since many years, magnetic resonance imaging (MRI) and positron emission tomography (PET) have a prominent role in neurodegenerative disorders and dementia, not only in a research setting but also in a clinical setting. For several decades, information from both modalities is combined ranging from individual visual assessments to fully integrating all images. Several tools are available to coregister images from MRI and PET and to covisualize these images. When studying neurodegenerative disorders with PET it is important to perform a partial volume correction and this can be done using the structural information obtained by MRI. With the advent of PET/MR, the question arises in how far this hybrid imaging modality is an added value compared to combining PET and MRI data from two separate modalities. One issue in PET/MR is still not yet completely settled, that is, the attenuation correction. This is of less importance for visual assessments but it can become an issue when combining data from PET/CT and PET/MR scanners in multicenter studies or when using cut-off values to classify patients. Simultaneous imaging has clearly some advantages: for the patient it is beneficial to have only one scan session instead of two but also in cases in which PET data are related to functional of physiological data acquired with MRI (such as functional MRI or arterial spin labeling). However, the most important benefit is currently the more integrated use of PET and MRI. This is also possible with separate measurements but requires more streamlining of the whole process. In that case coregistration of images is mandatory. It needs to be determined in which cases simultaneous PET/MRI leads to new insights or improved diagnosis compared to multimodal imaging using dedicated scanners.
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Affiliation(s)
- Patrick Dupont
- KU Leuven, Leuven Brain Institute, Department of Neurosciences, Laboratory for Cognitive Neurology, Leuven, Belgium; University of Stellenbosch, Department of Nuclear Medicine, Cape Town, South Africa.
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37
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Major advances in amyotrophic lateral sclerosis in 2020. Lancet Neurol 2021; 20:14-15. [PMID: 33340474 DOI: 10.1016/s1474-4422(20)30447-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/11/2020] [Indexed: 12/16/2022]
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Li Hi Shing S, McKenna MC, Siah WF, Chipika RH, Hardiman O, Bede P. The imaging signature of C9orf72 hexanucleotide repeat expansions: implications for clinical trials and therapy development. Brain Imaging Behav 2021; 15:2693-2719. [PMID: 33398779 DOI: 10.1007/s11682-020-00429-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 01/14/2023]
Abstract
While C9orf72-specific imaging signatures have been proposed by both ALS and FTD research groups and considerable presymptomatic alterations have also been confirmed in young mutation carriers, considerable inconsistencies exist in the literature. Accordingly, a systematic review of C9orf72-imaging studies has been performed to identify consensus findings, stereotyped shortcomings, and unique contributions to outline future directions. A formal literature review was conducted according to the STROBE guidelines. All identified papers were individually reviewed for sample size, choice of controls, study design, imaging modalities, statistical models, clinical profiling, and identified genotype-associated pathological patterns. A total of 74 imaging papers were systematically reviewed. ALS patients with GGGGCC repeat expansions exhibit relatively limited motor cortex involvement and widespread extra-motor pathology. C9orf72 positive FTD patients often show preferential posterior involvement. Reports of thalamic involvement are relatively consistent across the various phenotypes. Asymptomatic hexanucleotide repeat carriers often exhibit structural and functional changes decades prior to symptom onset. Common shortcomings included sample size limitations, lack of disease-controls, limited clinical profiling, lack of genetic testing in healthy controls, and absence of post mortem validation. There is a striking paucity of longitudinal studies and existing presymptomatic studies have not evaluated the predictive value of radiological changes with regard to age of onset and phenoconversion. With the advent of antisense oligonucleotide therapies, the meticulous characterisation of C9orf72-associated changes has gained practical relevance. Neuroimaging offers non-invasive biomarkers for future clinical trials, presymptomatic ascertainment, diagnostic and prognostic applications.
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Affiliation(s)
- Stacey Li Hi Shing
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Mary Clare McKenna
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - We Fong Siah
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Rangariroyashe H Chipika
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Orla Hardiman
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.
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Barro C, Chitnis T, Weiner HL. Blood neurofilament light: a critical review of its application to neurologic disease. Ann Clin Transl Neurol 2020; 7:2508-2523. [PMID: 33146954 PMCID: PMC7732243 DOI: 10.1002/acn3.51234] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/12/2020] [Indexed: 02/06/2023] Open
Abstract
Neuronal injury is a universal event that occurs in disease processes that affect both the central and peripheral nervous systems. A blood biomarker linked to neuronal injury would provide a critical measure to understand and treat neurologic diseases. Neurofilament light chain (NfL), a cytoskeletal protein expressed only in neurons, has emerged as such a biomarker. With the ability to quantify neuronal damage in blood, NfL is being applied to a wide range of neurologic conditions to investigate and monitor disease including assessment of treatment efficacy. Blood NfL is not specific for one disease and its release can also be induced by physiological processes. Longitudinal studies in multiple sclerosis, traumatic brain injury, and stroke show accumulation of NfL over days followed by elevated levels over months. Therefore, it may be hard to determine with a single measurement when the peak of NfL is reached and when the levels are normalized. Nonetheless, measurement of blood NfL provides a new blood biomarker for neurologic diseases overcoming the invasiveness of CSF sampling that restricted NfL clinical application. In this review, we examine the use of blood NfL as a biologic test for neurologic disease.
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Affiliation(s)
- Christian Barro
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tanuja Chitnis
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Howard L Weiner
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Chipika RH, Siah WF, McKenna MC, Li Hi Shing S, Hardiman O, Bede P. The presymptomatic phase of amyotrophic lateral sclerosis: are we merely scratching the surface? J Neurol 2020; 268:4607-4629. [PMID: 33130950 DOI: 10.1007/s00415-020-10289-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023]
Abstract
Presymptomatic studies in ALS have consistently captured considerable disease burden long before symptom manifestation and contributed important academic insights. With the emergence of genotype-specific therapies, however, there is a pressing need to address practical objectives such as the estimation of age of symptom onset, phenotypic prediction, informing the optimal timing of pharmacological intervention, and identifying a core panel of biomarkers which may detect response to therapy. Existing presymptomatic studies in ALS have adopted striking different study designs, relied on a variety of control groups, used divergent imaging and electrophysiology methods, and focused on different genotypes and demographic groups. We have performed a systematic review of existing presymptomatic studies in ALS to identify common themes, stereotyped shortcomings, and key learning points for future studies. Existing presymptomatic studies in ALS often suffer from sample size limitations, lack of disease controls and rarely follow their cohort until symptom manifestation. As the characterisation of presymptomatic processes in ALS serves a multitude of academic and clinical purposes, the careful review of existing studies offers important lessons for future initiatives.
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Affiliation(s)
- Rangariroyashe H Chipika
- Computational Neuroimaging Group (CNG), Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Dublin, Ireland
| | - We Fong Siah
- Computational Neuroimaging Group (CNG), Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Dublin, Ireland
| | - Mary Clare McKenna
- Computational Neuroimaging Group (CNG), Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Dublin, Ireland
| | - Stacey Li Hi Shing
- Computational Neuroimaging Group (CNG), Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Dublin, Ireland
| | - Orla Hardiman
- Computational Neuroimaging Group (CNG), Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group (CNG), Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Dublin, Ireland.
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Häkkinen S, Chu SA, Lee SE. Neuroimaging in genetic frontotemporal dementia and amyotrophic lateral sclerosis. Neurobiol Dis 2020; 145:105063. [PMID: 32890771 DOI: 10.1016/j.nbd.2020.105063] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/30/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023] Open
Abstract
Frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) have a strong clinical, genetic and pathological overlap. This review focuses on the current understanding of structural, functional and molecular neuroimaging signatures of genetic FTD and ALS. We overview quantitative neuroimaging studies on the most common genes associated with FTD (MAPT, GRN), ALS (SOD1), and both (C9orf72), and summarize visual observations of images reported in the rarer genes (CHMP2B, TARDBP, FUS, OPTN, VCP, UBQLN2, SQSTM1, TREM2, CHCHD10, TBK1).
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Affiliation(s)
- Suvi Häkkinen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Stephanie A Chu
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Suzee E Lee
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
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