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Chenain L, Riad R, Fraisse N, Jubin C, Morgado G, Youssov K, Lunven M, Bachoud-Levi AC. Graph methods to infer spatial disturbances: Application to Huntington's Disease's speech. Cortex 2024; 176:144-160. [PMID: 38795650 DOI: 10.1016/j.cortex.2024.04.014] [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: 11/19/2023] [Revised: 03/07/2024] [Accepted: 04/25/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE Huntington's Disease (HD) is an inherited neurodegenerative disease caused by the mutation of the Htt gene, impacting all aspects of living and functioning. Among cognitive disabilities, spatial capacities are impaired, but their monitoring remains scarce as limited by lengthy experts' assessments. Language offers an alternative medium to evaluate patients' performance in HD. Yet, its capacities to assess HD's spatial abilities are unknown. Here, we aimed to bring proof-of-concept that HD's spatial deficits can be assessed through speech. METHODS We developed the Spatial Description Model to graphically represent spatial relations described during the Cookie Theft Picture (CTP) task. We increased the sensitivity of our model by using only sentences with spatial terms, unlike previous studies in Alzheimer's disease. 78 carriers of the mutant Htt, including 56 manifest and 22 premanifest individuals, as well as 25 healthy controls were included from the BIOHD & (NCT01412125) & Repair-HD (NCT03119246) cohorts. The convergence and divergence of the model were validated using the SelfCog battery. RESULTS Our Spatial Description Model was the only one among the four assessed approaches, revealing that individuals with manifest HD expressed fewer spatial relations and engaged in less spatial exploration compared to healthy controls. Their graphs correlated with both visuospatial and language SelfCog performances, but not with motor, executive nor memory functions. CONCLUSIONS We provide the proof-of-concept using our Spatial Description Model that language can grasp HD patient's spatial disturbances. By adding spatial capabilities to the panel of functions tested by the language, it paves the way for eventual remote clinical application.
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Affiliation(s)
- Lucie Chenain
- Département d'Etudes Cognitives, École normale supérieure, PSL University, NeuroPsychologie Interventionnelle, 75005 Paris, France; Univ Paris Est Créteil, INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, F-94010 Créteil, France; NeurATRIS Créteil, France; ALMAnaCH, INRIA, 75012 Paris, France; Learning Planet Institute, Université de Paris, 75004 Paris, France
| | - Rachid Riad
- Département d'Etudes Cognitives, École normale supérieure, PSL University, NeuroPsychologie Interventionnelle, 75005 Paris, France; Univ Paris Est Créteil, INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, F-94010 Créteil, France; NeurATRIS Créteil, France
| | - Nicolas Fraisse
- Département d'Etudes Cognitives, École normale supérieure, PSL University, NeuroPsychologie Interventionnelle, 75005 Paris, France; Univ Paris Est Créteil, INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, F-94010 Créteil, France; NeurATRIS Créteil, France; AP-HP, Hôpital Henri Mondor-Albert Chenevier, Centre de référence Maladie de Huntington, Service de Neurologie, F-94010 Créteil, France
| | - Cécilia Jubin
- Département d'Etudes Cognitives, École normale supérieure, PSL University, NeuroPsychologie Interventionnelle, 75005 Paris, France; Univ Paris Est Créteil, INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, F-94010 Créteil, France; NeurATRIS Créteil, France; AP-HP, Hôpital Henri Mondor-Albert Chenevier, Centre de référence Maladie de Huntington, Service de Neurologie, F-94010 Créteil, France
| | - Graça Morgado
- Inserm, Centre d'Investigation Clinique 1430, AP-HP, Hôpital Henri Mondor, Créteil, France
| | - Katia Youssov
- Département d'Etudes Cognitives, École normale supérieure, PSL University, NeuroPsychologie Interventionnelle, 75005 Paris, France; Univ Paris Est Créteil, INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, F-94010 Créteil, France; NeurATRIS Créteil, France; AP-HP, Hôpital Henri Mondor-Albert Chenevier, Centre de référence Maladie de Huntington, Service de Neurologie, F-94010 Créteil, France; Inserm, Centre d'Investigation Clinique 1430, AP-HP, Hôpital Henri Mondor, Créteil, France
| | - Marine Lunven
- Département d'Etudes Cognitives, École normale supérieure, PSL University, NeuroPsychologie Interventionnelle, 75005 Paris, France; Univ Paris Est Créteil, INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, F-94010 Créteil, France; NeurATRIS Créteil, France.
| | - Anne-Catherine Bachoud-Levi
- Département d'Etudes Cognitives, École normale supérieure, PSL University, NeuroPsychologie Interventionnelle, 75005 Paris, France; Univ Paris Est Créteil, INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, F-94010 Créteil, France; NeurATRIS Créteil, France; AP-HP, Hôpital Henri Mondor-Albert Chenevier, Centre de référence Maladie de Huntington, Service de Neurologie, F-94010 Créteil, France; Inserm, Centre d'Investigation Clinique 1430, AP-HP, Hôpital Henri Mondor, Créteil, France
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Rossetti MA, Anderson KM, Hay KR, Del Bene VA, Celka AS, Piccolino A, Nelson Sheese AL, Huynh M, Zhu L, Claassen DO, Furr Stimming E, Considine CM. An Exploratory Pilot Study of Neuropsychological Performance in Two Huntington Disease Centers of Excellence Clinics. Arch Clin Neuropsychol 2024; 39:24-34. [PMID: 37530515 DOI: 10.1093/arclin/acad054] [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] [Accepted: 05/08/2023] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVES To describe the characteristics of patients receiving a clinical referral for neuropsychological evaluation in two Huntington's Disease Society of America Centers of Excellence (HDSA COE). In this exploratory pilot study, we used an empirically supported clinical neuropsychological battery to assess differences in cognitive performance between premanifest and manifest HD patient groups (compared with each other and normative expectations). METHOD Clinical data from 76 adult genetically confirmed patients referred for neuropsychological evaluations was retrospectively collected from two HDSA COEs. ANOVA and Chi-square tests were used to compare variables between pre-manifest (n = 14) and manifest (n = 62) groups for demographic, cognitive, neuropsychiatric, and disease severity variables. RESULTS Our clinics serviced a disproportionate number of motor manifest patients. Six measures were excluded from analyses due to infrequent administration. The full WAIS-IV Digit Span was disproportionately administered to the manifest group. The premanifest group showed stronger cognitive performance with effect sizes in the large range on subtests of the WAIS-IV Digit Span, HVLT-R, SDMT, and verbal fluency. CONCLUSIONS This is the first study to assess an empirically supported neuropsychological research battery in a clinical setting with a relatively large sample size given the rarity of HD. The battery adequately captured areas of impairment across the disease spectrum. Application of the current battery with larger premanifest samples is warranted.
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Affiliation(s)
- M Agustina Rossetti
- Department of Neurology, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | - Kendra M Anderson
- Department of Neurology, McGovern Medical School UT Health, The University of Texas Health, Science Center, Houston, TX 77054, USA
| | - Kaitlyn R Hay
- Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Victor A Del Bene
- Department of Neurology, University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL 35244,USA
| | - Andrea S Celka
- Department of Neurology, University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL 35244,USA
| | - Adam Piccolino
- Piccolino Psychological Services, Burnsville, MN 55337, USA
| | - Amelia L Nelson Sheese
- Department of Neurological Sciences, University of Nebraska Medical Center College of Medicine, Omaha, NE 68198, USA
| | - Melissa Huynh
- Department of Neurology, University of Texas Southwestern Medical School, Dallas, TX 75390, USA
| | - Liang Zhu
- Department of Neurology, McGovern Medical School UT Health, The University of Texas Health, Science Center, Houston, TX 77054, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Erin Furr Stimming
- Department of Neurology, McGovern Medical School UT Health, The University of Texas Health, Science Center, Houston, TX 77054, USA
| | - Ciaran M Considine
- Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
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3
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Morris L, O'Callaghan C, Le Heron C. Disordered Decision Making: A Cognitive Framework for Apathy and Impulsivity in Huntington's Disease. Mov Disord 2022; 37:1149-1163. [PMID: 35491758 PMCID: PMC9322688 DOI: 10.1002/mds.29013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/17/2022] [Accepted: 03/15/2022] [Indexed: 01/12/2023] Open
Abstract
A caregiver's all‐too‐familiar narrative ‐ “He doesn't think through what he does, but mostly he does nothing.” Apathy and impulsivity, debilitating and poorly understood, commonly co‐occur in Huntington's disease (HD). HD is a neurodegenerative disease with manifestations bridging clinical neurology and psychiatry. In addition to movement and cognitive symptoms, neurobehavioral disturbances, particularly apathy and impulsivity, are prevalent features of HD, occurring early in the disease course, often worsening with disease progression, and substantially reducing quality of life. Treatments remain limited, in part because of limited mechanistic understanding of these behavioral disturbances. However, emerging work within the field of decision‐making neuroscience and beyond points to common neurobiological mechanisms underpinning these seemingly disparate problems. These insights bridge the gap between underlying disease pathology and clinical phenotype, offering new treatment strategies, novel behavioral and physiological biomarkers of HD, and deeper understanding of human behavior. In this review, we apply the neurobiological framework of cost‐benefit decision making to the problems of apathy and impulsivity in HD. Through this decision‐making lens, we develop a mechanistic model that elucidates the occurrence of these behavioral disturbances and points to potential treatment strategies and crucial research priorities. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson Movement Disorder Society.
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Affiliation(s)
- Lee‐Anne Morris
- Department of Medicine University of Otago Christchurch New Zealand
- New Zealand Brain Research Institute Christchurch New Zealand
| | - Claire O'Callaghan
- Brain and Mind Centre and School of Medical Sciences, Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia
| | - Campbell Le Heron
- Department of Medicine University of Otago Christchurch New Zealand
- New Zealand Brain Research Institute Christchurch New Zealand
- Department of Neurology Canterbury District Health Board Christchurch New Zealand
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4
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Guekht AB, Kryukov AI, Kazakova AA, Akzhigitov RG, Gulyaeva NV, Druzhkova TA. [Olfactory disorders as a multidisciplinary problem]. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:32-38. [PMID: 36537628 DOI: 10.17116/jnevro202212212132] [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] [Indexed: 06/17/2023]
Abstract
Olfactory dysfunction is a serious symptom that requires careful differential diagnosis. The article presents convincing evidence that dysosmia is not only a symptom of rinological pathology, but also a manifestation of various neurodegenerative diseases. Some patients with SARS-CoV-2 have neurological symptoms. Modern studies show that olfactory and gustatory dysfunctions are significant symptoms in the clinical presentation of the COVID-19 infection. The importance of olfactory diagnostics in relatives of patients with hereditary neurodegenerative diseases for the purpose of early detection of pathology is noted. We consider the possibility of introducing new methods for the diagnosis of olfactory dysfunction, which is a promising task both in the field of neurology and otorhinolaryngology, in order to prevent the development of neurodegenerative diseases at an early stage, improve the quality of life and social adaptation of patients.
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Affiliation(s)
- A B Guekht
- Solov'ev Scientific-Applied Psychoneurology Center, Moscow, Russia
| | - A I Kryukov
- Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow, Russia
| | - A A Kazakova
- Solov'ev Scientific-Applied Psychoneurology Center, Moscow, Russia
| | - R G Akzhigitov
- Solov'ev Scientific-Applied Psychoneurology Center, Moscow, Russia
| | - N V Gulyaeva
- Solov'ev Scientific-Applied Psychoneurology Center, Moscow, Russia
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
| | - T A Druzhkova
- Solov'ev Scientific-Applied Psychoneurology Center, Moscow, Russia
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5
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Kinnunen KM, Schwarz AJ, Turner EC, Pustina D, Gantman EC, Gordon MF, Joules R, Mullin AP, Scahill RI, Georgiou-Karistianis N. Volumetric MRI-Based Biomarkers in Huntington's Disease: An Evidentiary Review. Front Neurol 2021; 12:712555. [PMID: 34621236 PMCID: PMC8490802 DOI: 10.3389/fneur.2021.712555] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/10/2021] [Indexed: 01/02/2023] Open
Abstract
Huntington's disease (HD) is an autosomal-dominant inherited neurodegenerative disorder that is caused by expansion of a CAG-repeat tract in the huntingtin gene and characterized by motor impairment, cognitive decline, and neuropsychiatric disturbances. Neuropathological studies show that disease progression follows a characteristic pattern of brain atrophy, beginning in the basal ganglia structures. The HD Regulatory Science Consortium (HD-RSC) brings together diverse stakeholders in the HD community—biopharmaceutical industry, academia, nonprofit, and patient advocacy organizations—to define and address regulatory needs to accelerate HD therapeutic development. Here, the Biomarker Working Group of the HD-RSC summarizes the cross-sectional evidence indicating that regional brain volumes, as measured by volumetric magnetic resonance imaging, are reduced in HD and are correlated with disease characteristics. We also evaluate the relationship between imaging measures and clinical change, their longitudinal change characteristics, and within-individual longitudinal associations of imaging with disease progression. This analysis will be valuable in assessing pharmacodynamics in clinical trials and supporting clinical outcome assessments to evaluate treatment effects on neurodegeneration.
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Affiliation(s)
| | - Adam J Schwarz
- Takeda Pharmaceuticals, Ltd., Cambridge, MA, United States
| | | | - Dorian Pustina
- CHDI Management/CHDI Foundation, Princeton, NJ, United States
| | - Emily C Gantman
- CHDI Management/CHDI Foundation, Princeton, NJ, United States
| | - Mark F Gordon
- Teva Pharmaceuticals, West Chester, PA, United States
| | | | - Ariana P Mullin
- Critical Path Institute, Tucson, AZ, United States.,Wave Life Sciences, Ltd., Cambridge, MA, United States
| | - Rachael I Scahill
- Huntington's Disease Research Centre, UCL Institute of Neurology, London, United Kingdom
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
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6
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Heim B, Valent D, Carbone F, Spielberger S, Krismer F, Djamshidian-Tehrani A, Seppi K. Extending the Spectrum of Nonmotor Symptoms with Olfaction in Premotor Huntington's Disease: A Pilot Study. NEURODEGENER DIS 2021; 20:207-211. [PMID: 34348324 DOI: 10.1159/000518136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 06/25/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this pilot study was to investigate change of olfactory functions in Huntington's disease (HD). BACKGROUND HD is a neurodegenerative disease characterized by motor, cognitive, and behavioral abnormalities. There are several studies reporting olfactory dysfunction in manifest and some studies in premanifest HD carriers, and a recent neuropathological study demonstrated HD-specific protein aggregation in the anterior olfactory nucleus in HD patients. In this study, we wanted to assess olfactory functions as a possible early nonmotor symptom of HD mutation carriers without disease-specific motor symptoms and HD patients. METHODS All participants had genetic confirmed HD and were prospectively recruited during their routine control in a specialized outpatient clinic of the Medical University of Innsbruck, Department of Neurology, Austria. Healthy controls (HCs) were caregivers from patients. They were only included if they were younger than 70 years, scored more than 24/30 points on the Mini Mental State Examination, and had no other disease compromising olfactory function. Furthermore, all participants were tested on the Sniffin' sticks 16-items identification test. RESULTS We included 23 patients with manifest HD, 13 HD mutation carriers, and 19 HCs. Mutation carriers showed significant impaired odor identification compared to HCs (p < 0.001), as well as Huntington's patients compared with both mutation carriers (p = 0.003) and HCs (p < 0.001). CONCLUSIONS The results of this pilot study suggest that olfactory dysfunction may be an early nonmotor symptom of HD and could be a potential marker to assess disease progression.
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Affiliation(s)
- Beatrice Heim
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Dora Valent
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Federico Carbone
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sabine Spielberger
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Florian Krismer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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7
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Johnson EB, Ziegler G, Penny W, Rees G, Tabrizi SJ, Scahill RI, Gregory S. Dynamics of Cortical Degeneration Over a Decade in Huntington's Disease. Biol Psychiatry 2021; 89:807-816. [PMID: 33500176 PMCID: PMC7986936 DOI: 10.1016/j.biopsych.2020.11.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 10/14/2020] [Accepted: 11/08/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Characterizing changing brain structure in neurodegeneration is fundamental to understanding long-term effects of pathology and ultimately providing therapeutic targets. It is well established that Huntington's disease (HD) gene carriers undergo progressive brain changes during the course of disease, yet the long-term trajectory of cortical atrophy is not well defined. Given that genetic therapies currently tested in HD are primarily expected to target the cortex, understanding atrophy across this region is essential. METHODS Capitalizing on a unique longitudinal dataset with a minimum of 3 and maximum of 7 brain scans from 49 HD gene carriers and 49 age-matched control subjects, we implemented a novel dynamical systems approach to infer patterns of regional neurodegeneration over 10 years. We use Bayesian hierarchical modeling to map participant- and group-level trajectories of atrophy spatially and temporally, additionally relating atrophy to the genetic marker of HD (CAG-repeat length) and motor and cognitive symptoms. RESULTS We show, for the first time, that neurodegenerative changes exhibit complex temporal dynamics with substantial regional variation around the point of clinical diagnosis. Although widespread group differences were seen across the cortex, the occipital and parietal regions undergo the greatest rate of cortical atrophy. We have established links between atrophy and genetic markers of HD while demonstrating that specific cortical changes predict decline in motor and cognitive performance. CONCLUSIONS HD gene carriers display regional variability in the spatial pattern of cortical atrophy, which relates to genetic factors and motor and cognitive symptoms. Our findings indicate a complex pattern of neuronal loss, which enables greater characterization of HD progression.
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Affiliation(s)
- Eileanoir B Johnson
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Gabriel Ziegler
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany; German Center for Neurodegenerative Diseases, Magdeburg, Germany.
| | - William Penny
- School of Psychology, University of East Anglia, Norwich, United Kingdom
| | - Geraint Rees
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sarah J Tabrizi
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Dementia Research Institute at University College London, London, United Kingdom
| | - Rachael I Scahill
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sarah Gregory
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
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Estevez-Fraga C, Scahill RI, Durr A, Leavitt BR, Roos RAC, Langbehn DR, Rees G, Gregory S, Tabrizi SJ. Composite UHDRS Correlates With Progression of Imaging Biomarkers in Huntington's Disease. Mov Disord 2021; 36:1259-1264. [PMID: 33471951 DOI: 10.1002/mds.28489] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 11/10/2020] [Accepted: 12/07/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The composite Unified Huntington's Disease Rating Scale (cUHDRS) is a multidimensional measure of progression in Huntington's disease (HD) being used as a primary outcome in clinical trials investigating potentially disease-modifying huntingtin-lowering therapies. OBJECTIVE Evaluating volumetric and structural connectivity correlates of the cUHDRS. METHODS One hundred and nineteen premanifest and 119 early-HD participants were included. Gray and white matter (WM) volumes were correlated with cUHDRS cross-sectionally and longitudinally using voxel-based morphometry. Correlations between baseline fractional anisotropy (FA); mean, radial, and axial diffusivity; and baseline cUHDRS were examined using tract-based spatial statistics. RESULTS Worse performance in the cUHDRS over time correlated with longitudinal volume decreases in the occipito-parietal cortex and centrum semiovale, whereas lower baseline scores correlated with decreased volume in the basal ganglia and surrounding WM. Lower cUHDRS scores were also associated with reduced FA and increased diffusivity at baseline. CONCLUSION The cUHDRS correlates with imaging biomarkers and tracks atrophy progression in HD supporting its biological relevance. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Carlos Estevez-Fraga
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Rachael I Scahill
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Alexandra Durr
- Sorbonne Université, Paris Brain Institute (ICM), AP-HP, Inserm, CNRS, Pitié-Salpêtrière University Hospital, Paris, France
| | - Blair R Leavitt
- Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Raymund A C Roos
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Geraint Rees
- Wellcome Centre for Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sarah Gregory
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Sarah J Tabrizi
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
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9
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Langbehn DR, Hersch S. Clinical Outcomes and Selection Criteria for Prodromal Huntington's Disease Trials. Mov Disord 2020; 35:2193-2200. [PMID: 32686867 PMCID: PMC7818458 DOI: 10.1002/mds.28222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/04/2020] [Accepted: 06/30/2020] [Indexed: 11/08/2022] Open
Abstract
Background Huntington's disease (HD) develops in individuals with extended cytosine‐adenine‐guanine (CAG) repeats within the huntingtin (HTT) gene, causing neurodegeneration and progressive motor and cognitive symptoms. The inclusion of mutant HTT carriers in whom overt symptoms are not yet fully manifest in therapeutic trials would enable the development of treatments that delay or halt the accumulation of significant disability. Objectives The present analyses assess whether screening prediagnosis (preHD) individuals based on a normalized prognostic index (PIN) score would enable the selection of prodromal preHD subjects in whom longitudinal changes in established outcome measures might provide robust signals. It also compares the relative statistical effect size of longitudinal change for these measures. Methods Individual participant data from 2 studies were used to develop mixed effect linear models to assess longitudinal changes in clinical metrics for participants with preHD and PIN‐stratified subcohorts. Relative effect sizes were calculated in 5 preHD studies and internally normalized to evaluate the strength and consistency of each metric across cohorts. Results Longitudinal modeling data demonstrate the amplification of effect sizes when preHD subcohorts were selected by PIN score thresholds of >0.0 and >0.4. These models and relative effect sizes across 5 studies consistently indicate that the Unified Huntington's Disease Rating Scale total motor score exhibits the greatest change in preHD. Conclusions These analyses suggest that the employment of PIN scores to homogenize and stratify preHD cohorts could improve the efficiency of current outcome measures, the most robust of which is the total motor score. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Douglas R Langbehn
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Steven Hersch
- Voyager Therapeutics, Inc., Cambridge, Massachusetts, USA.,Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
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10
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Mangin JF, Rivière D, Duchesnay E, Cointepas Y, Gaura V, Verny C, Damier P, Krystkowiak P, Bachoud-Lévi AC, Hantraye P, Remy P, Douaud G. Neocortical morphometry in Huntington's disease: Indication of the coexistence of abnormal neurodevelopmental and neurodegenerative processes. NEUROIMAGE-CLINICAL 2020; 26:102211. [PMID: 32113174 PMCID: PMC7044794 DOI: 10.1016/j.nicl.2020.102211] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 02/05/2020] [Accepted: 02/12/2020] [Indexed: 12/14/2022]
Abstract
We found shallower central, intraparietal and left intermediate frontal sulci in HD. Shallow calcarine fissure is further evidence of primary cortical degeneration in HD. Healthy subjects show strong asymmetry in length of posterior Sylvian fissure (pSF). Absence of pSF asymmetry in HD indicates genetic interplay with neurodevelopment.
Huntington's disease (HD) is an inherited, autosomal dominant disorder that is characteristically thought of as a degenerative disorder. Despite cellular and molecular grounds suggesting HD could also impact normal development, there has been scarce systems-level data obtained from in vivo human studies supporting this hypothesis. Sulcus-specific morphometry analysis may help disentangle the contribution of coexisting neurodegenerative and neurodevelopmental processes, but such an approach has never been used in HD. Here, we investigated cortical sulcal depth, related to degenerative process, as well as cortical sulcal length, related to developmental process, in early-stage HD and age-matched healthy controls. This morphometric analysis revealed significant differences in the HD participants compared with the healthy controls bilaterally in the central and intra-parietal sulcus, but also in the left intermediate frontal sulcus and calcarine fissure. As the primary visual cortex is not connected to the striatum, the latter result adds to the increasing in vivo evidence for primary cortical degeneration in HD. Those sulcal measures that differed between HD and healthy populations were mainly atrophy-related, showing shallower sulci in HD. Conversely, the sulcal morphometry also revealed a crucial difference in the imprint of the Sylvian fissure that could not be related to loss of grey matter volume: an absence of asymmetry in the length of this fissure in HD. Strong asymmetry in that cortical region is typically observed in healthy development. As the formation of the Sylvian fissure appears early in utero, and marked asymmetry is specifically found in this area of the neocortex in newborns, this novel finding likely indicates the foetal timing of a disease-specific, genetic interplay with neurodevelopment.
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Affiliation(s)
| | - Denis Rivière
- Université Paris-Saclay, CEA, CNRS, Baobab, Neurospin, Gif-sur-Yvette, France
| | - Edouard Duchesnay
- Université Paris-Saclay, CEA, CNRS, Baobab, Neurospin, Gif-sur-Yvette, France
| | - Yann Cointepas
- Université Paris-Saclay, CEA, CNRS, Baobab, Neurospin, Gif-sur-Yvette, France
| | - Véronique Gaura
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département des Sciences du Vivant (DSV), Institut d'Imagerie Biomédicale (I2BM), MIRCen, France
| | - Christophe Verny
- Centre national de référence des maladies neurogénétiques, Service de neurologie, CHU, 49000 Angers, France, UMR CNRS 6214 - INSERM U1083, France
| | | | | | | | - Philippe Hantraye
- MIRCen, Institut d'Imagerie Biomédicale, Direction de la Recherche Fondamentale, Commissariat à l'Energie Atomique et aux Energies Alternatives, France
| | - Philippe Remy
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), Département des Sciences du Vivant (DSV), Institut d'Imagerie Biomédicale (I2BM), MIRCen, France
| | - Gwenaëlle Douaud
- Functional Magnetic Resonance Imaging of the Brain (FMRIB) Centre, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom.
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11
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Garcia-Gorro C, Llera A, Martinez-Horta S, Perez-Perez J, Kulisevsky J, Rodriguez-Dechicha N, Vaquer I, Subira S, Calopa M, Muñoz E, Santacruz P, Ruiz-Idiago J, Mareca C, Beckmann CF, de Diego-Balaguer R, Camara E. Specific patterns of brain alterations underlie distinct clinical profiles in Huntington's disease. Neuroimage Clin 2019; 23:101900. [PMID: 31255947 PMCID: PMC6606833 DOI: 10.1016/j.nicl.2019.101900] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 12/16/2022]
Abstract
Huntington's disease (HD) is a genetic neurodegenerative disease which involves a triad of motor, cognitive and psychiatric disturbances. However, there is great variability in the prominence of each type of symptom across individuals. The neurobiological basis of such variability remains poorly understood but would be crucial for better tailored treatments. Multivariate multimodal neuroimaging approaches have been successful in disentangling these profiles in other disorders. Thus we applied for the first time such approach to HD. We studied the relationship between HD symptom domains and multimodal measures sensitive to grey and white matter structural alterations. Forty-three HD gene carriers (23 manifest and 20 premanifest individuals) were scanned and underwent behavioural assessments evaluating motor, cognitive and psychiatric domains. We conducted a multimodal analysis integrating different structural neuroimaging modalities measuring grey matter volume, cortical thickness and white matter diffusion indices - fractional anisotropy and radial diffusivity. All neuroimaging measures were entered into a linked independent component analysis in order to obtain multimodal components reflecting common inter-subject variation across imaging modalities. The relationship between multimodal neuroimaging independent components and behavioural measures was analysed using multiple linear regression. We found that cognitive and motor symptoms shared a common neurobiological basis, whereas the psychiatric domain presented a differentiated neural signature. Behavioural measures of different symptom domains correlated with different neuroimaging components, both the brain regions involved and the neuroimaging modalities most prominently associated with each type of symptom showing differences. More severe cognitive and motor signs together were associated with a multimodal component consisting in a pattern of reduced grey matter, cortical thickness and white matter integrity in cognitive and motor related networks. In contrast, depressive symptoms were associated with a component mainly characterised by reduced cortical thickness pattern in limbic and paralimbic regions. In conclusion, using a multivariate multimodal approach we were able to disentangle the neurobiological substrates of two distinct symptom profiles in HD: one characterised by cognitive and motor features dissociated from a psychiatric profile. These results open a new view on a disease classically considered as a uniform entity and initiates a new avenue for further research considering these qualitative individual differences.
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Affiliation(s)
- Clara Garcia-Gorro
- Cognition and Brain Plasticity Unit, L'Hospitalet de Llobregat (Barcelona), IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), Spain
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Alberto Llera
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, the Netherlands
| | - Saul Martinez-Horta
- Movement Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
- CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain
| | - Jesus Perez-Perez
- Movement Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
- CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
- CIBERNED (Center for Networked Biomedical Research on Neurodegenerative Diseases), Carlos III Institute, Madrid, Spain
- Universidad Autónoma de Barcelona, Barcelona, Spain
| | | | - Irene Vaquer
- Hestia Duran i Reynals, Hospital Duran i Reynals, Hospitalet de Llobregat (Barcelona), Spain
| | - Susana Subira
- Hestia Duran i Reynals, Hospital Duran i Reynals, Hospitalet de Llobregat (Barcelona), Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Matilde Calopa
- Movement Disorders Unit, Neurology Service, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Esteban Muñoz
- Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
- IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain
- Facultat de Medicina, University of Barcelona, Barcelona, Spain
| | - Pilar Santacruz
- Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Jesus Ruiz-Idiago
- Hospital Mare de Deu de la Mercè, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Celia Mareca
- Hospital Mare de Deu de la Mercè, Barcelona, Spain
| | - Christian F. Beckmann
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ruth de Diego-Balaguer
- Cognition and Brain Plasticity Unit, L'Hospitalet de Llobregat (Barcelona), IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), Spain
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
- The Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- ICREA (Catalan Institute for Research and Advanced Studies), Barcelona, Spain
| | - Estela Camara
- Cognition and Brain Plasticity Unit, L'Hospitalet de Llobregat (Barcelona), IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), Spain
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12
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D'Aurizio G, Migliore S, Curcio G, Squitieri F. Safer Attitude to Risky Decision-Making in Premanifest Huntington's Disease Subjects. Front Psychol 2019; 10:846. [PMID: 31057466 PMCID: PMC6477566 DOI: 10.3389/fpsyg.2019.00846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 03/29/2019] [Indexed: 01/18/2023] Open
Abstract
Huntington’s disease (HD) is an inherited neurodegenerative disorder characterized by involuntary, jerky movements, incoordination, behavioral changes and subtle executive and cognitive impairment starting before motor symptoms. Our study aimed to assess the risky decision-making process in premanifest (pre) HD subjects, by means Game of Dice Task (GDT). As dependent variables, several GDT outcomes have been taken into consideration. We recruited 30 subjects (15 females) with preHD (i.e., Diagnosis Confidence Level < 4; Total Motor Score < 10), and 21 age, gender and education matched neurologically normal subjects (11 females). GDT is a computer-guided task where subjects are invited to watch the digits on which to bet and to evaluate the related potential risk to win or loss. Our results showed that decision and feedback times were longer in preHD than in neurologically normal group in both disadvantageous and advantageous choices. PreHD subjects provided a greater number of “safe” strategies, taken with longer decision-making time than neurologically normal subjects, showing a reduced propensity to risk. Such behavior, characterized by increased slowness in acting and providing answers, might contribute to delineate a behavioral and cognitive profile in preHD.
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Affiliation(s)
- Giulia D'Aurizio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Simone Migliore
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Giuseppe Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ferdinando Squitieri
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
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13
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Taoufik E, Kouroupi G, Zygogianni O, Matsas R. Synaptic dysfunction in neurodegenerative and neurodevelopmental diseases: an overview of induced pluripotent stem-cell-based disease models. Open Biol 2019; 8:rsob.180138. [PMID: 30185603 PMCID: PMC6170506 DOI: 10.1098/rsob.180138] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 08/14/2018] [Indexed: 12/12/2022] Open
Abstract
Synaptic dysfunction in CNS disorders is the outcome of perturbations in physiological synapse structure and function, and can be either the cause or the consequence in specific pathologies. Accumulating data in the field of neuropsychiatric disorders, including autism spectrum disorders, schizophrenia and bipolar disorder, point to a neurodevelopmental origin of these pathologies. Due to a relatively early onset of behavioural and cognitive symptoms, it is generally acknowledged that mental illness initiates at the synapse level. On the other hand, synaptic dysfunction has been considered as an endpoint incident in neurodegenerative diseases, such as Alzheimer's, Parkinson's and Huntington's, mainly due to the considerably later onset of clinical symptoms and progressive appearance of cognitive deficits. This dichotomy has recently been challenged, particularly since the discovery of cell reprogramming technologies and the generation of induced pluripotent stem cells from patient somatic cells. The creation of 'disease-in-a-dish' models for multiple CNS pathologies has revealed unexpected commonalities in the molecular and cellular mechanisms operating in both developmental and degenerative conditions, most of which meet at the synapse level. In this review we discuss synaptic dysfunction in prototype neurodevelopmental and neurodegenerative diseases, emphasizing overlapping features of synaptopathy that have been suggested by studies using induced pluripotent stem-cell-based systems. These valuable disease models have highlighted a potential neurodevelopmental component in classical neurodegenerative diseases that is worth pursuing and investigating further. Moving from demonstration of correlation to understanding mechanistic causality forms the basis for developing novel therapeutics.
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Affiliation(s)
- Era Taoufik
- Laboratory of Cellular and Molecular Neurobiology-Stem Cells, Department of Neurobiology, Hellenic Pasteur Institute, 127 Vassilissis Sofias Avenue, 11521 Athens, Greece
| | - Georgia Kouroupi
- Laboratory of Cellular and Molecular Neurobiology-Stem Cells, Department of Neurobiology, Hellenic Pasteur Institute, 127 Vassilissis Sofias Avenue, 11521 Athens, Greece
| | - Ourania Zygogianni
- Laboratory of Cellular and Molecular Neurobiology-Stem Cells, Department of Neurobiology, Hellenic Pasteur Institute, 127 Vassilissis Sofias Avenue, 11521 Athens, Greece
| | - Rebecca Matsas
- Laboratory of Cellular and Molecular Neurobiology-Stem Cells, Department of Neurobiology, Hellenic Pasteur Institute, 127 Vassilissis Sofias Avenue, 11521 Athens, Greece
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14
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Zhu L, Shu H, Liu D, Guo Q, Wang Z, Zhang Z. Apolipoprotein E ε4 Specifically Modulates the Hippocampus Functional Connectivity Network in Patients With Amnestic Mild Cognitive Impairment. Front Aging Neurosci 2018; 10:289. [PMID: 30319395 PMCID: PMC6170627 DOI: 10.3389/fnagi.2018.00289] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 09/03/2018] [Indexed: 11/16/2022] Open
Abstract
The presence of both apolipoprotein E (APOE) ε4 allele and amnestic mild cognitive impairment (aMCI) are considered to be risk factors for Alzheimer’s disease (AD). Numerous neuroimaging studies have suggested that the modulation of APOE ε4 affects intrinsic functional brain networks, both in healthy populations and in AD patients. However, it remains largely unclear whether and how ε4 allele modulates the brain’s functional network architecture in subjects with aMCI. Using resting-state functional magnetic resonance imaging (fMRI) and graph-theory approaches-functional connectivity strength (FCS), we investigate the topological organization of the whole-brain functional network in 28 aMCI ε4 carriers and 38 aMCI ε3ε3 carriers. In the present study, we first observe that ε4-related FCS increases in the right hippocampus/parahippocampal gyrus (HIP/PHG). Subsequent seed-based resting-state functional connectivity (RSFC) analysis revealed that, compared with the ε3ε3 carriers, the ε4 carriers had lower or higher RSFCs between the right HIP/PHG seed and the bilateral medial prefrontal cortex (MPFC) or the occipital cortex, respectively. Further correlation analyses have revealed that the FCS values in the right HIP/PHG and lower HIP/PHG-RSFCs with the bilateral MPFC were significantly correlated with the impairment of episodic memory and executive function in the aMCI ε4 carriers. Importantly, the logistic regression analysis showed that the HIP/PHG-RSFC with the bilateral MPFC predicted aMCI-conversion to AD. These findings suggest that the APOE ε4 allele may modulate the large-scale brain network in aMCI subjects, facilitating our understanding of how the entire assembly of the brain network reorganizes in response to APOE variants in aMCI. Further longitudinal studies need to be conducted, in order to examine whether these network measures could serve as primary predictors of conversion from aMCI ε4 carriers to AD.
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Affiliation(s)
- Lin Zhu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Hao Shu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Duan Liu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Qihao Guo
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zan Wang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhijun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
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15
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Le Heron C, Apps MAJ, Husain M. The anatomy of apathy: A neurocognitive framework for amotivated behaviour. Neuropsychologia 2018; 118:54-67. [PMID: 28689673 PMCID: PMC6200857 DOI: 10.1016/j.neuropsychologia.2017.07.003] [Citation(s) in RCA: 192] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/19/2017] [Accepted: 07/06/2017] [Indexed: 12/23/2022]
Abstract
Apathy is a debilitating syndrome associated with many neurological disorders, including several common neurodegenerative diseases such as Parkinson's disease and Alzheimer's disease, and focal lesion syndromes such as stroke. Here, we review neuroimaging studies to identify anatomical correlates of apathy, across brain disorders. Our analysis reveals that apathy is strongly associated with disruption particularly of dorsal anterior cingulate cortex (dACC), ventral striatum (VS) and connected brain regions. Remarkably, these changes are consistent across clinical disorders and imaging modalities. Review of the neuroimaging findings allows us to develop a neurocognitive framework to consider potential mechanisms underlying apathy. According to this perspective, an interconnected group of brain regions - with dACC and VS at its core - plays a crucial role in normal motivated behaviour. Specifically we argue that motivated behaviour requires a willingness to work, to keep working, and to learn what is worth working for. We propose that deficits in any one or more of these processes can lead to the clinical syndrome of apathy, and outline specific approaches to test this hypothesis. A richer neurobiological understanding of the mechanisms underlying apathy should ultimately facilitate development of effective therapies for this disabling condition.
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Affiliation(s)
- C Le Heron
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom.
| | - M A J Apps
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
| | - M Husain
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
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16
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Bi XA, Zhao J, Xu Q, Sun Q, Wang Z. Abnormal Functional Connectivity of Resting State Network Detection Based on Linear ICA Analysis in Autism Spectrum Disorder. Front Physiol 2018; 9:475. [PMID: 29867534 PMCID: PMC5952255 DOI: 10.3389/fphys.2018.00475] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 04/16/2018] [Indexed: 11/24/2022] Open
Abstract
Some functional magnetic resonance imaging (fMRI) researches in autism spectrum disorder (ASD) patients have shown that ASD patients have significant impairment in brain response. However, few researchers have studied the functional structure changes of the eight resting state networks (RSNs) in ASD patients. Therefore, research on statistical differences of RSNs between 42 healthy controls (HC) and 50 ASD patients has been studied using linear independent component analysis (ICA) in this paper. Our researches showed that there was abnormal functional connectivity (FC) of RSNs in ASD patients. The RSNs with the decreased FC and increased FC in ASD patients included default mode network (DMN), central executive network (CEN), core network (CN), visual network (VN), self-referential network (SRN) compared to HC. The RSNs with the increased FC in ASD patients included auditory network (AN), somato-motor network (SMN). The dorsal attention network (DAN) in ASD patients showed the decreased FC. Our findings indicate that the abnormal FC in RSNs extensively exists in ASD patients. Our results have important contribution for the study of neuro-pathophysiological mechanisms in ASD patients.
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Affiliation(s)
- Xia-An Bi
- College of Mathematics and Computer Science, Hunan Normal University, Changsha, China
| | - Junxia Zhao
- College of Mathematics and Computer Science, Hunan Normal University, Changsha, China
| | - Qian Xu
- College of Mathematics and Computer Science, Hunan Normal University, Changsha, China
| | - Qi Sun
- College of Mathematics and Computer Science, Hunan Normal University, Changsha, China
| | - Zhigang Wang
- College of Mathematics and Computer Science, Hunan Normal University, Changsha, China
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17
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Faulty neuronal determination and cell polarization are reverted by modulating HD early phenotypes. Proc Natl Acad Sci U S A 2018; 115:E762-E771. [PMID: 29311338 DOI: 10.1073/pnas.1715865115] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Increasing evidence suggests that early neurodevelopmental defects in Huntington's disease (HD) patients could contribute to the later adult neurodegenerative phenotype. Here, by using HD-derived induced pluripotent stem cell lines, we report that early telencephalic induction and late neural identity are affected in cortical and striatal populations. We show that a large CAG expansion causes complete failure of the neuro-ectodermal acquisition, while cells carrying shorter CAGs repeats show gross abnormalities in neural rosette formation as well as disrupted cytoarchitecture in cortical organoids. Gene-expression analysis showed that control organoid overlapped with mature human fetal cortical areas, while HD organoids correlated with the immature ventricular zone/subventricular zone. We also report that defects in neuroectoderm and rosette formation could be rescued by molecular and pharmacological approaches leading to a recovery of striatal identity. These results show that mutant huntingtin precludes normal neuronal fate acquisition and highlights a possible connection between mutant huntingtin and abnormal neural development in HD.
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18
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Vaca-Palomares I, Coe BC, Brien DC, Campos-Romo A, Munoz DP, Fernandez-Ruiz J. Voluntary saccade inhibition deficits correlate with extended white-matter cortico-basal atrophy in Huntington's disease. NEUROIMAGE-CLINICAL 2017. [PMID: 28649493 PMCID: PMC5472191 DOI: 10.1016/j.nicl.2017.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The ability to inhibit automatic versus voluntary saccade commands in demanding situations can be impaired in neurodegenerative diseases such as Huntington's disease (HD). These deficits could result from disruptions in the interaction between basal ganglia and the saccade control system. To investigate voluntary oculomotor control deficits related to the cortico-basal circuitry, we evaluated early HD patients using an interleaved pro- and anti-saccade task that requires flexible executive control to generate either an automatic response (look at a peripheral visual stimulus) or a voluntary response (look away from the stimulus in the opposite direction). The impairments of HD patients in this task are mainly attributed to degeneration in the striatal medium spiny neurons leading to an over-activation of the indirect-pathway thorough the basal ganglia. However, some studies have proposed that damage outside the indirect-pathway also contribute to executive and saccade deficits. We used the interleaved pro- and anti-saccade task to study voluntary saccade inhibition deficits, Voxel-based morphometry and Tract-based spatial statistic to map cortico-basal ganglia circuitry atrophy in HD. HD patients had voluntary saccade inhibition control deficits, including increased regular-latency anti-saccade errors and increased anticipatory saccades. These deficits correlated with white-matter atrophy in the inferior fronto-occipital fasciculus, anterior thalamic radiation, anterior corona radiata and superior longitudinal fasciculus. These findings suggest that cortico-basal ganglia white-matter atrophy in HD, disrupts the normal connectivity in a network controlling voluntary saccade inhibitory behavior beyond the indirect-pathway. This suggests that in vivo measures of white-matter atrophy can be a reliable marker of the progression of cognitive deficits in HD.
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Affiliation(s)
| | - Brian C Coe
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Donald C Brien
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Aurelio Campos-Romo
- Unidad Periférica de Neurociencias, Facultad de Medicina, Universidad Nacional Autónoma de México, en el Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Ciudad de México, Mexico
| | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - Juan Fernandez-Ruiz
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico.
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19
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Developmental alterations in Huntington's disease neural cells and pharmacological rescue in cells and mice. Nat Neurosci 2017; 20:648-660. [PMID: 28319609 PMCID: PMC5610046 DOI: 10.1038/nn.4532] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 02/23/2017] [Indexed: 12/11/2022]
Abstract
Neural cultures derived from Huntington's disease (HD) patient-derived induced pluripotent stem cells were used for 'omics' analyses to identify mechanisms underlying neurodegeneration. RNA-seq analysis identified genes in glutamate and GABA signaling, axonal guidance and calcium influx whose expression was decreased in HD cultures. One-third of gene changes were in pathways regulating neuronal development and maturation. When mapped to stages of mouse striatal development, the profiles aligned with earlier embryonic stages of neuronal differentiation. We observed a strong correlation between HD-related histone marks, gene expression and unique peak profiles associated with dysregulated genes, suggesting a coordinated epigenetic program. Treatment with isoxazole-9, which targets key dysregulated pathways, led to amelioration of expanded polyglutamine repeat-associated phenotypes in neural cells and of cognitive impairment and synaptic pathology in HD model R6/2 mice. These data suggest that mutant huntingtin impairs neurodevelopmental pathways that could disrupt synaptic homeostasis and increase vulnerability to the pathologic consequence of expanded polyglutamine repeats over time.
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20
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Holtbernd F, Tang CC, Feigin A, Dhawan V, Ghilardi MF, Paulsen JS, Guttman M, Eidelberg D. Longitudinal Changes in the Motor Learning-Related Brain Activation Response in Presymptomatic Huntington's Disease. PLoS One 2016; 11:e0154742. [PMID: 27192167 PMCID: PMC4871440 DOI: 10.1371/journal.pone.0154742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 04/18/2016] [Indexed: 11/19/2022] Open
Abstract
Neurocognitive decline, including deficits in motor learning, occurs in the presymptomatic phase of Huntington's disease (HD) and precedes the onset of motor symptoms. Findings from recent neuroimaging studies have linked these deficits to alterations in fronto-striatal and fronto-parietal brain networks. However, little is known about the temporal dynamics of these networks when subjects approach phenoconversion. Here, 10 subjects with presymptomatic HD were scanned with 15O-labeled water at baseline and again 1.5 years later while performing a motor sequence learning task and a kinematically matched control task. Spatial covariance analysis was utilized to characterize patterns of change in learning-related neural activation occurring over time in these individuals. Pattern expression was compared to corresponding values in 10 age-matched healthy control subjects. Spatial covariance analysis revealed significant longitudinal changes in the expression of a specific learning-related activation pattern characterized by increasing activity in the right orbitofrontal cortex, with concurrent reductions in the right medial prefrontal and posterior cingulate regions, the left insula, left precuneus, and left cerebellum. Changes in the expression of this pattern over time correlated with baseline measurements of disease burden and learning performance. The network changes were accompanied by modest improvement in learning performance that took place concurrently in the gene carriers. The presence of increased network activity in the setting of stable task performance is consistent with a discrete compensatory mechanism. The findings suggest that this effect is most pronounced in the late presymptomatic phase of HD, as subjects approach clinical onset.
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Affiliation(s)
- Florian Holtbernd
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, United States of America
| | - Chris C. Tang
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, United States of America
| | - Andrew Feigin
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, United States of America
- Department of Neurology, Northwell Health, Manhasset, New York, United States of America
| | - Vijay Dhawan
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, United States of America
| | - Maria Felice Ghilardi
- Department of Physiology, Pharmacology, and Neuroscience, City University of New York Medical School, New York, New York, United States of America
| | - Jane S. Paulsen
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States of America
| | - Mark Guttman
- Department of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, United States of America
- Department of Neurology, Northwell Health, Manhasset, New York, United States of America
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21
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Minkova L, Eickhoff SB, Abdulkadir A, Kaller CP, Peter J, Scheller E, Lahr J, Roos RA, Durr A, Leavitt BR, Tabrizi SJ, Klöppel S. Large-scale brain network abnormalities in Huntington's disease revealed by structural covariance. Hum Brain Mapp 2016; 37:67-80. [PMID: 26453902 PMCID: PMC6867397 DOI: 10.1002/hbm.23014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 08/10/2015] [Accepted: 09/24/2015] [Indexed: 01/05/2023] Open
Abstract
Huntington's disease (HD) is a progressive neurodegenerative disorder that can be diagnosed with certainty decades before symptom onset. Studies using structural MRI have identified grey matter (GM) loss predominantly in the striatum, but also involving various cortical areas. So far, voxel-based morphometric studies have examined each brain region in isolation and are thus unable to assess the changes in the interrelation of brain regions. Here, we examined the structural covariance in GM volumes in pre-specified motor, working memory, cognitive flexibility, and social-affective networks in 99 patients with manifest HD (mHD), 106 presymptomatic gene mutation carriers (pre-HD), and 108 healthy controls (HC). After correction for global differences in brain volume, we found that increased GM volume in one region was associated with increased GM volume in another. When statistically comparing the groups, no differences between HC and pre-HD were observed, but increased positive correlations were evident for mHD, relative to pre-HD and HC. These findings could be explained by a HD-related neuronal loss heterogeneously affecting the examined network at the pre-HD stage, which starts to dominate structural covariance globally at the manifest stage. Follow-up analyses identified structural connections between frontoparietal motor regions to be linearly modified by disease burden score (DBS). Moderator effects of disease load burden became significant at a DBS level typically associated with the onset of unequivocal HD motor signs. Together with existing findings from functional connectivity analyses, our data indicates a critical role of these frontoparietal regions for the onset of HD motor signs.
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Affiliation(s)
- Lora Minkova
- Department of Psychiatry and PsychotherapyUniversity Medical Center FreiburgFreiburgGermany
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
- Department of PsychologyLaboratory for Biological and Personality Psychology, University of FreiburgFreiburgGermany
| | - Simon B. Eickhoff
- Department of Clinical Neuroscience and Medical PsychiatryHeinrich‐Heine UniversityDüsseldorfGermany
- Research Center Jülich, Institute of Neuroscience and Medicine (INM‐1), Department of Psychiatry, Psychotherapy and Psychosomatics, University HospitalJülichGermany
| | - Ahmed Abdulkadir
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
- Department of Computer ScienceUniversity of FreiburgFreiburgGermany
| | - Christoph P. Kaller
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
- Department of NeurologyUniversity Medical Center FreiburgFreiburgGermany
- BrainLinks‐BrainTools Cluster of Excellence, University of FreiburgFreiburgGermany
| | - Jessica Peter
- Department of Psychiatry and PsychotherapyUniversity Medical Center FreiburgFreiburgGermany
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
| | - Elisa Scheller
- Department of Psychiatry and PsychotherapyUniversity Medical Center FreiburgFreiburgGermany
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
| | - Jacob Lahr
- Department of Psychiatry and PsychotherapyUniversity Medical Center FreiburgFreiburgGermany
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
| | - Raymund A. Roos
- Department of NeurologyLeiden University Medical CentreLeidenNetherlands
| | - Alexandra Durr
- Department of Genetics and CytogeneticsPitié‐ Salpêtrière University HospitalParisFrance
| | - Blair R. Leavitt
- Department of Medical GeneticsCentre for Molecular Medicine and Therapeutics, University of British ColumbiaVancouverCanada
| | - Sarah J. Tabrizi
- Department of Neurodegenerative DiseaseUniversity College London, Institute of NeurologyLondonUnited Kingdom
| | - Stefan Klöppel
- Department of Psychiatry and PsychotherapyUniversity Medical Center FreiburgFreiburgGermany
- Freiburg Brain Imaging CenterUniversity Medical Center FreiburgFreiburgGermany
- Department of NeurologyUniversity Medical Center FreiburgFreiburgGermany
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22
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Collins LM, Begeti F, Panin F, Lazar AS, Cruickshank T, Ziman M, Mason SL, Barker RA. Novel Nut and Bolt Task Quantifies Motor Deficits in Premanifest and Manifest Huntington's Disease. PLOS CURRENTS 2015; 7. [PMID: 26421223 PMCID: PMC4570842 DOI: 10.1371/currents.hd.ded251617ae62a1364506b0521bd3761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: We investigated the use of a simple novel nut and bolt task in premanifest and manifest Huntington’s disease (HD) patients to detect and quantify motor impairments at all stages of the disease. Methods: Premanifest HD (n=24), manifest HD (n=27) and control (n=32) participants were asked to screw a nut onto a bolt in one direction, using three different sized bolts with their left and right hand in turn. Results: We identified some impairments at all stages of HD and in the premanifest individuals, deficits in the non-dominant hand correlated with disease burden scores. Conclusion: This simple, cheap motor task was able to detect motor impairments in both premanifest and manifest HD and as such might be a useful quantifiable measure of motor function for use in clinical studies.
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Affiliation(s)
| | | | - Francesca Panin
- John van Geest Centre for Brain Repair, Cambridge, United Kingdom; Faculty of Medical Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Alpar S Lazar
- John van Geest Centre for Brain Repair, Cambridge, United Kingdom
| | - Travis Cruickshank
- School of Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Mel Ziman
- School of Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Sarah L Mason
- John van Geest Centre for Brain Repair, Cambridge, United Kingdom
| | - Roger A Barker
- John van Geest Centre for Brain Repair, Cambridge, United Kingdom; School of Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia
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23
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Coexistence of Gait Disturbances and Chorea in Experimental Huntington's Disease. Behav Neurol 2015; 2015:970204. [PMID: 26063966 PMCID: PMC4438172 DOI: 10.1155/2015/970204] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 04/06/2015] [Accepted: 04/17/2015] [Indexed: 01/13/2023] Open
Abstract
Huntington's disease (HD) is an autosomal dominant neurodegenerative disease caused by an expanded CAG repeat. The clinical features are progressive motor dysfunction, cognitive deterioration, and psychiatric disturbances. Unpredictable choreic movements, among the most characteristic hallmarks, may contribute to gait disturbances and loss of balance in HD individuals. In this study, we aimed to investigate and characterize the gait abnormalities and choreic movements in a transgenic rat model of HD (tgHD). TgHD presents typical neuropathological, neurophysiological, and behavioral aspects mimicking some of the key features of human HD and is the only described experimental model for HD that exhibits choreiform movements. We used the Catwalk, with emphasis on static and dynamic gait parameters, to test the hypothesis that at symptomatic age (9 months) the dynamic measures of gait in HD are altered and coexist with choreiform movements. Our results showed that the dynamic parameters seem to be more affected than static parameters at this age in tgHD rats. The number of steps and step cycles and swing speed of the paws were increased in tgHD rat in comparison to wild-type controls. Our study demonstrates that gait abnormalities coexist with chorea rather than being caused by it. These symptoms may originate from distinct networks in the basal ganglia and downstream connections.
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24
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Reilmann R, Rouzade‐Dominguez M, Saft C, Süssmuth SD, Priller J, Rosser A, Rickards H, Schöls L, Pezous N, Gasparini F, Johns D, Landwehrmeyer GB, Gomez‐Mancilla B. A randomized, placebo‐controlled trial of AFQ056 for the treatment of chorea in Huntington's disease. Mov Disord 2015; 30:427-31. [DOI: 10.1002/mds.26174] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 01/13/2015] [Accepted: 01/15/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ralf Reilmann
- George‐Huntington‐InstituteMünster Germany
- Institute for Clinical Radiology, University of MünsterMünster Germany
- Department of Neurodegenerative Diseases and Hertie‐Institute for Clinical Brain ResearchUniversity of TübingenTübingen Germany
| | | | - Carsten Saft
- Department of NeurologyHuntington Center NRW, Ruhr‐University Bochum, St. Josef‐HospitalBochum Germany
| | | | - Josef Priller
- Department of NeuropsychiatryCharité‐Universitätsmedizin BerlinBerlin Germany
| | - Anne Rosser
- Cardiff University Schools of Medicine and Biosciences, Neuroscience and Mental Health Research InstituteCardiff United Kingdom
| | - Hugh Rickards
- Department of NeuropsychiatryThe Barberry Birmingham United Kingdom
| | - Ludger Schöls
- Clinical Neurogenetics Unit, Center of Neurology and Hertie‐Institute for Clinical Brain ResearchTübingen Germany
- German Center for Neurodegenerative Diseases (DZNE)Tübingen Germany
| | - Nicole Pezous
- IIS Translational Sciences–Early Development Statistical Research, Novartis Pharma AGBasel Switzerland
| | - Fabrizio Gasparini
- Novartis Institutes for Biomedical Research, Novartis Pharma AGBasel Switzerland
| | - Donald Johns
- Neuroscience Translational Medicine, Novartis Institutes for Biomedical Research Inc.Cambridge Massachusetts USA
| | | | - Baltazar Gomez‐Mancilla
- Novartis Institutes for Biomedical Research, Novartis Pharma AGBasel Switzerland
- Department of Neurology and NeurosurgeryMcGill UniversityMontréal Québec Canada
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25
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Cruickshank TM, Thompson JA, Domínguez D JF, Reyes AP, Bynevelt M, Georgiou-Karistianis N, Barker RA, Ziman MR. The effect of multidisciplinary rehabilitation on brain structure and cognition in Huntington's disease: an exploratory study. Brain Behav 2015; 5:e00312. [PMID: 25642394 PMCID: PMC4309878 DOI: 10.1002/brb3.312] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 12/05/2014] [Accepted: 12/08/2014] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND There is a wealth of evidence detailing gray matter degeneration and loss of cognitive function over time in individuals with Huntington's disease (HD). Efforts to attenuate disease-related brain and cognitive changes have been unsuccessful to date. Multidisciplinary rehabilitation, comprising motor and cognitive intervention, has been shown to positively impact on functional capacity, depression, quality of life and some aspects of cognition in individuals with HD. This exploratory study aimed to evaluate, for the first time, whether multidisciplinary rehabilitation can slow further deterioration of disease-related brain changes and related cognitive deficits in individuals with manifest HD. METHODS Fifteen participants who manifest HD undertook a multidisciplinary rehabilitation intervention spanning 9 months. The intervention consisted of once-weekly supervised clinical exercise, thrice-weekly self-directed home based exercise and fortnightly occupational therapy. Participants were assessed using MR imaging and validated cognitive measures at baseline and after 9 months. RESULTS Participants displayed significantly increased gray matter volume in the right caudate and bilaterally in the dorsolateral prefrontal cortex after 9 months of multidisciplinary rehabilitation. Volumetric increases in gray matter were accompanied by significant improvements in verbal learning and memory (Hopkins Verbal Learning-Test). A significant association was found between gray matter volume increases in the dorsolateral prefrontal cortex and performance on verbal learning and memory. CONCLUSIONS This study provides preliminary evidence that multidisciplinary rehabilitation positively impacts on gray matter changes and cognitive functions relating to verbal learning and memory in individuals with manifest HD. Larger controlled trials are required to confirm these preliminary findings.
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Affiliation(s)
- Travis M Cruickshank
- School of Medical Sciences, Edith Cowan UniversityPerth, Western Australia, Australia
| | - Jennifer A Thompson
- School of Medical Sciences, Edith Cowan UniversityPerth, Western Australia, Australia
| | - Juan F Domínguez D
- School of Psychological Sciences, Monash UniversityMelbourne, Victoria, Australia
| | - Alvaro P Reyes
- School of Medical Sciences, Edith Cowan UniversityPerth, Western Australia, Australia
| | - Mike Bynevelt
- Department of Surgery, UWA and Neurological Intervention and Imaging Service of Western AustraliaPerth, Western Australia, Australia
| | | | | | - Mel R Ziman
- School of Medical Sciences, Edith Cowan UniversityPerth, Western Australia, Australia
- School of Pathology and Laboratory Medicine, University of Western AustraliaPerth, Western Australia, Australia
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26
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Adanyeguh IM, Rinaldi D, Henry PG, Caillet S, Valabregue R, Durr A, Mochel F. Triheptanoin improves brain energy metabolism in patients with Huntington disease. Neurology 2015; 84:490-5. [PMID: 25568297 DOI: 10.1212/wnl.0000000000001214] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Based on our previous work in Huntington disease (HD) showing improved energy metabolism in muscle by providing substrates to the Krebs cycle, we wished to obtain a proof-of-concept of the therapeutic benefit of triheptanoin using a functional biomarker of brain energy metabolism validated in HD. METHODS We performed an open-label study using (31)P brain magnetic resonance spectroscopy (MRS) to measure the levels of phosphocreatine (PCr) and inorganic phosphate (Pi) before (rest), during (activation), and after (recovery) a visual stimulus. We performed (31)P brain MRS in 10 patients at an early stage of HD and 13 controls. Patients with HD were then treated for 1 month with triheptanoin after which they returned for follow-up including (31)P brain MRS scan. RESULTS At baseline, we confirmed an increase in Pi/PCr ratio during brain activation in controls-reflecting increased adenosine triphosphate synthesis-followed by a return to baseline levels during recovery (p = 0.013). In patients with HD, we validated the existence of an abnormal brain energy profile as previously reported. After 1 month, this profile remained abnormal in patients with HD who did not receive treatment. Conversely, the MRS profile was improved in patients with HD treated with triheptanoin for 1 month with the restoration of an increased Pi/PCr ratio during visual stimulation (p = 0.005). CONCLUSION This study suggests that triheptanoin is able to correct the bioenergetic profile in the brain of patients with HD at an early stage of the disease. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that, for patients with HD, treatment with triheptanoin for 1 month restores an increased MRS Pi/PCr ratio during visual stimulation.
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Affiliation(s)
- Isaac Mawusi Adanyeguh
- From Inserm U 1127 (I.M.A., D.R., R.V., A.D., F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC University Paris 06, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France; Center for Magnetic Resonance Research (P.-G.H.), University of Minnesota, Minneapolis; Departments of Dietetics (S.C.) and Genetics (A.D., F.M.), AP-HP, Pitié-Salpêtrière University Hospital, Paris; and Center for NeuroImaging Research (R.V.), Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Daisy Rinaldi
- From Inserm U 1127 (I.M.A., D.R., R.V., A.D., F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC University Paris 06, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France; Center for Magnetic Resonance Research (P.-G.H.), University of Minnesota, Minneapolis; Departments of Dietetics (S.C.) and Genetics (A.D., F.M.), AP-HP, Pitié-Salpêtrière University Hospital, Paris; and Center for NeuroImaging Research (R.V.), Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Pierre-Gilles Henry
- From Inserm U 1127 (I.M.A., D.R., R.V., A.D., F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC University Paris 06, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France; Center for Magnetic Resonance Research (P.-G.H.), University of Minnesota, Minneapolis; Departments of Dietetics (S.C.) and Genetics (A.D., F.M.), AP-HP, Pitié-Salpêtrière University Hospital, Paris; and Center for NeuroImaging Research (R.V.), Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Samantha Caillet
- From Inserm U 1127 (I.M.A., D.R., R.V., A.D., F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC University Paris 06, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France; Center for Magnetic Resonance Research (P.-G.H.), University of Minnesota, Minneapolis; Departments of Dietetics (S.C.) and Genetics (A.D., F.M.), AP-HP, Pitié-Salpêtrière University Hospital, Paris; and Center for NeuroImaging Research (R.V.), Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Romain Valabregue
- From Inserm U 1127 (I.M.A., D.R., R.V., A.D., F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC University Paris 06, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France; Center for Magnetic Resonance Research (P.-G.H.), University of Minnesota, Minneapolis; Departments of Dietetics (S.C.) and Genetics (A.D., F.M.), AP-HP, Pitié-Salpêtrière University Hospital, Paris; and Center for NeuroImaging Research (R.V.), Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Alexandra Durr
- From Inserm U 1127 (I.M.A., D.R., R.V., A.D., F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC University Paris 06, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France; Center for Magnetic Resonance Research (P.-G.H.), University of Minnesota, Minneapolis; Departments of Dietetics (S.C.) and Genetics (A.D., F.M.), AP-HP, Pitié-Salpêtrière University Hospital, Paris; and Center for NeuroImaging Research (R.V.), Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Fanny Mochel
- From Inserm U 1127 (I.M.A., D.R., R.V., A.D., F.M.), CNRS UMR 7225, Sorbonne Universités, UPMC University Paris 06, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France; Center for Magnetic Resonance Research (P.-G.H.), University of Minnesota, Minneapolis; Departments of Dietetics (S.C.) and Genetics (A.D., F.M.), AP-HP, Pitié-Salpêtrière University Hospital, Paris; and Center for NeuroImaging Research (R.V.), Institut du Cerveau et de la Moelle épinière, Paris, France.
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27
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Musso M, Westervelt HJ, Long JD, Morgan E, Woods SP, Smith MM, Lu W, Paulsen JS. Intra-individual Variability in Prodromal Huntington Disease and Its Relationship to Genetic Burden. J Int Neuropsychol Soc 2015; 21:8-21. [PMID: 26304055 PMCID: PMC4549971 DOI: 10.1017/s1355617714001076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The current study sought to examine the utility of intra-individual variability (IIV) in distinguishing participants with prodromal Huntington disease (HD) from nongene-expanded controls. IIV across 15 neuropsychological tasks and within-task IIV using a self-paced timing task were compared as a single measure of processing speed (Symbol Digit Modalities Test [SDMT]) in 693 gene-expanded and 191 nongene-expanded participants from the PREDICT-HD study. After adjusting for depressive symptoms and motor functioning, individuals estimated to be closest to HD diagnosis displayed higher levels of across- and within-task variability when compared to controls and those prodromal HD participants far from disease onset (F ICV(3,877)=11.25; p<.0001; F PacedTiming(3,877)=22.89; p<.0001). When prodromal HD participants closest to HD diagnosis were compared to controls, Cohen's d effect sizes were larger in magnitude for the within-task variability measure, paced timing (-1.01), and the SDMT (-0.79) and paced tapping coefficient of variation (CV) (-0.79) compared to the measures of across-task variability [CV (0.55); intra-individual standard deviation (0.26)]. Across-task variability may be a sensitive marker of cognitive decline in individuals with prodromal HD approaching disease onset. However, individual neuropsychological tasks, including a measure of within-task variability, produced larger effect sizes than an index of across-task IIV in this sample.
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Affiliation(s)
- Mandi Musso
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Holly James Westervelt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island
| | - Jeffrey D. Long
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa
| | - Erin Morgan
- Department of Psychiatry, University of California, San Diego, San Diego, California
| | - Steven Paul Woods
- Department of Psychiatry, University of California, San Diego, San Diego, California
| | - Megan M. Smith
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Wenjing Lu
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa
| | - Jane S. Paulsen
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
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28
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Aylward EH, Harrington DL, Mills JA, Nopoulos PC, Ross CA, Long JD, Liu D, Westervelt HK, Paulsen JS. Regional atrophy associated with cognitive and motor function in prodromal Huntington disease. J Huntingtons Dis 2014; 2:477-89. [PMID: 25062732 DOI: 10.3233/jhd-130076] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Neuroimaging studies suggest that volumetric MRI measures of specific brain structures may serve as excellent biomarkers in future clinical trials of Huntington disease (HD). OBJECTIVE Demonstration of the clinical significance of these measures is an important step in determining their appropriateness as potential outcome measures. METHODS Measures of gray- and white-matter lobular volumes and subcortical volumes (caudate, putamen, globus pallidus, thalamus, nucleus accumbens, hippocampus) were obtained from MRI scans of 516 individuals who tested positive for the HD gene expansion, but were not yet exhibiting signs or symptoms severe enough to warrant diagnosis ("pre-HD"). MRI volumes (corrected for intracranial volume) were correlated with cognitive, motor, psychiatric, and functional measures known to be sensitive to subtle changes in pre-HD. RESULTS Caudate, putamen, and globus pallidus volumes consistently correlated with cognitive and motor, but not psychiatric or functional measures in pre-HD. Volumes of white matter, nucleus accumbens, and thalamus, but not cortical gray matter, also correlated with some of the motor and cognitive measures. CONCLUSIONS Results of regression analyses suggest that volumes of basal ganglia structures contributed more highly to the prediction of most motor and cognitive variables than volumes of other brain regions. These results support the use of volumetric measures, especially of the basal ganglia, as outcome measures in future clinical trials in pre-HD. Results may also assist investigators in selecting the most appropriate measures for treatment trials that target specific clinical features or regions of neuropathology.
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Affiliation(s)
- Elizabeth H Aylward
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Deborah L Harrington
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA VA San Diego Healthcare System, Research Service, San Diego, CA, USA
| | - James A Mills
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Peggy C Nopoulos
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Christopher A Ross
- Departments of Psychiatry, Neurology and Neuroscience, Johns Hopkins University, Baltimore, MD, USA
| | - Jeffrey D Long
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Dawei Liu
- Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Holly K Westervelt
- Division of Biology and Medicine, Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Jane S Paulsen
- Departments of Psychiatry, Neurology, Psychology and Neuroscience, The University of Iowa Carver College of Medicine, Iowa City, IA, USA
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29
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Koenig KA, Lowe MJ, Harrington DL, Lin J, Durgerian S, Mourany L, Paulsen JS, Rao SM. Functional connectivity of primary motor cortex is dependent on genetic burden in prodromal Huntington disease. Brain Connect 2014; 4:535-46. [PMID: 25072408 PMCID: PMC4146393 DOI: 10.1089/brain.2014.0271] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Subtle changes in motor function have been observed in individuals with prodromal Huntington disease (prHD), but the underlying neural mechanisms are not well understood nor is the cumulative effect of the disease (disease burden) on functional connectivity. The present study examined the resting-state functional magnetic resonance imaging (rs-fMRI) connectivity of the primary motor cortex (M1) in 16 gene-negative (NEG) controls and 48 gene-positive prHD participants with various levels of disease burden. The results showed that the strength of the left M1 connectivity with the ipsilateral M1 and somatosensory areas decreased as disease burden increased and correlated with motor symptoms. Weakened M1 connectivity within the motor areas was also associated with abnormalities in long-range connections that evolved with disease burden. In this study, M1 connectivity was decreased with visual centers (bilateral cuneus), but increased with a hub of the default mode network (DMN; posterior cingulate cortex). Changes in connectivity measures were associated with worse performance on measures of cognitive-motor functioning. Short- and long-range functional connectivity disturbances were also associated with volume loss in the basal ganglia, suggesting that weakened M1 connectivity is partly a manifestation of striatal atrophy. Altogether, the results indicate that the prodromal phase of HD is associated with abnormal interhemispheric interactions among motor areas and disturbances in the connectivity of M1 with visual centers and the DMN. These changes may, respectively, contribute to increased motor symptoms, visuomotor integration problems, and deficits in the executive control of movement as individuals approach a manifest diagnosis.
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Affiliation(s)
| | - Mark J. Lowe
- Imaging Institute, Cleveland Clinic, Cleveland, Ohio
| | - Deborah L. Harrington
- VA San Diego Healthcare System, San Diego, California
- Department of Radiology, University of California, San Diego, California
| | - Jian Lin
- Imaging Institute, Cleveland Clinic, Cleveland, Ohio
| | - Sally Durgerian
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Lyla Mourany
- Schey Center for Cognitive Neuroimaging, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jane S. Paulsen
- Carver College of Medicine, The University of Iowa, Iowa City, Iowa
| | - Stephen M. Rao
- Schey Center for Cognitive Neuroimaging, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
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30
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Aylward EH. Magnetic resonance imaging striatal volumes: a biomarker for clinical trials in Huntington's disease. Mov Disord 2014; 29:1429-33. [PMID: 25164586 DOI: 10.1002/mds.26013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 07/25/2014] [Accepted: 08/03/2014] [Indexed: 11/06/2022] Open
Abstract
An abundance of research shows that magnetic resonance imaging (MRI) striatal volumes decrease long before diagnosis of Huntington's disease (HD) and closely track disease progression. Additional research indicates that these volumetric measures meet important criteria for a biomarker that can be used in clinical trials: They are 1) objectively measureable; 2) able to predict known endpoints; and 3) associated with known mechanisms of pathology of the disease. Researchers should consider formal application to regulatory agencies for biomarker status of volumetric MRI striatal measures, because these measures are anticipated to contribute significantly in the assessment of treatment effectiveness in HD.
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31
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Efficacy of selective PDE4D negative allosteric modulators in the object retrieval task in female cynomolgus monkeys (Macaca fascicularis). PLoS One 2014; 9:e102449. [PMID: 25050979 PMCID: PMC4106781 DOI: 10.1371/journal.pone.0102449] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 05/19/2014] [Indexed: 11/19/2022] Open
Abstract
Cyclic adenosine monophosphate (cAMP) signalling plays an important role in synaptic plasticity and information processing in the hippocampal and basal ganglia systems. The augmentation of cAMP signalling through the selective inhibition of phosphodiesterases represents a viable strategy to treat disorders associated with dysfunction of these circuits. The phosphodiesterase (PDE) type 4 inhibitor rolipram has shown significant pro-cognitive effects in neurological disease models, both in rodents and primates. However, competitive non-isoform selective PDE4 inhibitors have a low therapeutic index which has stalled their clinical development. Here, we demonstrate the pro-cognitive effects of selective negative allosteric modulators (NAMs) of PDE4D, D159687 and D159797 in female Cynomolgous macaques, in the object retrieval detour task. The efficacy displayed by these NAMs in a primate cognitive task which engages the corticostriatal circuitry, together with their suitable pharmacokinetic properties and safety profiles, suggests that clinical development of these allosteric modulators should be considered for the treatment of a variety of brain disorders associated with cognitive decline.
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Kim EY, Magnotta VA, Liu D, Johnson HJ. Stable Atlas-based Mapped Prior (STAMP) machine-learning segmentation for multicenter large-scale MRI data. Magn Reson Imaging 2014; 32:832-44. [PMID: 24818817 DOI: 10.1016/j.mri.2014.04.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 03/12/2014] [Accepted: 04/15/2014] [Indexed: 01/15/2023]
Abstract
Machine learning (ML)-based segmentation methods are a common technique in the medical image processing field. In spite of numerous research groups that have investigated ML-based segmentation frameworks, there remains unanswered aspects of performance variability for the choice of two key components: ML algorithm and intensity normalization. This investigation reveals that the choice of those elements plays a major part in determining segmentation accuracy and generalizability. The approach we have used in this study aims to evaluate relative benefits of the two elements within a subcortical MRI segmentation framework. Experiments were conducted to contrast eight machine-learning algorithm configurations and 11 normalization strategies for our brain MR segmentation framework. For the intensity normalization, a Stable Atlas-based Mapped Prior (STAMP) was utilized to take better account of contrast along boundaries of structures. Comparing eight machine learning algorithms on down-sampled segmentation MR data, it was obvious that a significant improvement was obtained using ensemble-based ML algorithms (i.e., random forest) or ANN algorithms. Further investigation between these two algorithms also revealed that the random forest results provided exceptionally good agreement with manual delineations by experts. Additional experiments showed that the effect of STAMP-based intensity normalization also improved the robustness of segmentation for multicenter data sets. The constructed framework obtained good multicenter reliability and was successfully applied on a large multicenter MR data set (n>3000). Less than 10% of automated segmentations were recommended for minimal expert intervention. These results demonstrate the feasibility of using the ML-based segmentation tools for processing large amount of multicenter MR images. We demonstrated dramatically different result profiles in segmentation accuracy according to the choice of ML algorithm and intensity normalization chosen.
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Affiliation(s)
- Eun Young Kim
- Department of Biomedical Engineering, University of Iowa, Iowa, IA 52242, USA.
| | - Vincent A Magnotta
- Department of Biomedical Engineering, University of Iowa, Iowa, IA 52242, USA; Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
| | - Dawei Liu
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
| | - Hans J Johnson
- Department of Biomedical Engineering, University of Iowa, Iowa, IA 52242, USA; Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
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Ross CA, Aylward EH, Wild EJ, Langbehn DR, Long JD, Warner JH, Scahill RI, Leavitt BR, Stout JC, Paulsen JS, Reilmann R, Unschuld PG, Wexler A, Margolis RL, Tabrizi SJ. Huntington disease: natural history, biomarkers and prospects for therapeutics. Nat Rev Neurol 2014; 10:204-16. [PMID: 24614516 DOI: 10.1038/nrneurol.2014.24] [Citation(s) in RCA: 659] [Impact Index Per Article: 65.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Huntington disease (HD) can be seen as a model neurodegenerative disorder, in that it is caused by a single genetic mutation and is amenable to predictive genetic testing, with estimation of years to predicted onset, enabling the entire range of disease natural history to be studied. Structural neuroimaging biomarkers show that progressive regional brain atrophy begins many years before the emergence of diagnosable signs and symptoms of HD, and continues steadily during the symptomatic or 'manifest' period. The continued development of functional, neurochemical and other biomarkers raises hopes that these biomarkers might be useful for future trials of disease-modifying therapeutics to delay the onset and slow the progression of HD. Such advances could herald a new era of personalized preventive therapeutics. We describe the natural history of HD, including the timing of emergence of motor, cognitive and emotional impairments, and the techniques that are used to assess these features. Building on this information, we review recent progress in the development of biomarkers for HD, and potential future roles of these biomarkers in clinical trials.
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Affiliation(s)
- Christopher A Ross
- Division of Neurobiology, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | - Russell L Margolis
- Division of Neurobiology, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD 21287, USA
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Chan AW, Xu Y, Jiang J, Rahim T, Zhao D, Kocerha J, Chi T, Moran S, Engelhardt H, Larkin K, Neumann A, Cheng H, Li C, Nelson K, Banta H, Zola SM, Villinger F, Yang J, Testa CM, Mao H, Zhang X, Bachevalier J. A two years longitudinal study of a transgenic Huntington disease monkey. BMC Neurosci 2014; 15:36. [PMID: 24581271 PMCID: PMC4015530 DOI: 10.1186/1471-2202-15-36] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 02/05/2014] [Indexed: 01/18/2023] Open
Abstract
Background A two-year longitudinal study composed of morphometric MRI measures and cognitive behavioral evaluation was performed on a transgenic Huntington’s disease (HD) monkey. rHD1, a transgenic HD monkey expressing exon 1 of the human gene encoding huntingtin (HTT) with 29 CAG repeats regulated by a human polyubiquitin C promoter was used together with four age-matched wild-type control monkeys. This is the first study on a primate model of human HD based on longitudinal clinical measurements. Results Changes in striatal and hippocampal volumes in rHD1 were observed with progressive impairment in motor functions and cognitive decline, including deficits in learning stimulus-reward associations, recognition memory and spatial memory. The results demonstrate a progressive cognitive decline and morphometric changes in the striatum and hippocampus in a transgenic HD monkey. Conclusions This is the first study on a primate model of human HD based on longitudinal clinical measurements. While this study is based a single HD monkey, an ongoing longitudinal study with additional HD monkeys will be important for the confirmation of our findings. A nonhuman primate model of HD could complement other animal models of HD to better understand the pathogenesis of HD and future development of diagnostics and therapeutics through longitudinal assessment.
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Affiliation(s)
- Anthony Ws Chan
- Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia.
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Harrington DL, Liu D, Smith MM, Mills JA, Long JD, Aylward EH, Paulsen JS. Neuroanatomical correlates of cognitive functioning in prodromal Huntington disease. Brain Behav 2014; 4:29-40. [PMID: 24653952 PMCID: PMC3937704 DOI: 10.1002/brb3.185] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 09/10/2013] [Accepted: 09/13/2013] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The brain mechanisms of cognitive impairment in prodromal Huntington disease (prHD) are not well understood. Although striatal atrophy correlates with some cognitive abilities, few studies of prHD have investigated whether cortical gray matter morphometry correlates in a regionally specific manner with functioning in different cognitive domains. This knowledge would inform the selection of cognitive measures for clinical trials that would be most sensitive to the target of a treatment intervention. METHOD In this study, random forest analysis was used to identify neuroanatomical correlates of functioning in five cognitive domains including attention and information processing speed, working memory, verbal learning and memory, negative emotion recognition, and temporal processing. Participants included 325 prHD individuals with varying levels of disease progression and 119 gene-negative controls with a family history of HD. In intermediate analyses, we identified brain regions that showed significant differences between the prHD and the control groups in cortical thickness and striatal volume. Brain morphometry in these regions was then correlated with cognitive functioning in each of the domains in the prHD group using random forest methods. We hypothesized that different regional patterns of brain morphometry would be associated with performances in distinct cognitive domains. RESULTS The results showed that performances in different cognitive domains that are vulnerable to decline in prHD were correlated with regionally specific patterns of cortical and striatal morphometry. Putamen and/or caudate volumes were top-ranked correlates of performance across all cognitive domains, as was cortical thickness in regions related to the processing demands of each domain. CONCLUSIONS The results underscore the importance of identifying structural magnetic resonance imaging (sMRI) markers of functioning in different cognitive domains, as their relative sensitivity depends on the extent to which processing is called upon by different brain networks. The findings have implications for identifying neuroimaging and cognitive outcome measures for use in clinical trials.
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Affiliation(s)
- Deborah L Harrington
- Department of Radiology, University of California San Diego, California ; Research Service, VA San Diego Healthcare System San Diego, California
| | - Dawei Liu
- Department of Psychiatry, University of Iowa Carver College of Medicine Iowa City, Iowa
| | - Megan M Smith
- Department of Psychiatry, University of Iowa Carver College of Medicine Iowa City, Iowa
| | - James A Mills
- Department of Psychiatry, University of Iowa Carver College of Medicine Iowa City, Iowa
| | - Jeffrey D Long
- Department of Psychiatry, University of Iowa Carver College of Medicine Iowa City, Iowa
| | | | - Jane S Paulsen
- Department of Psychiatry, University of Iowa Carver College of Medicine Iowa City, Iowa ; Department of Neurology, University of Iowa Carver College of Medicine Iowa City, Iowa
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Janssens J, Etienne H, Idriss S, Azmi A, Martin B, Maudsley S. Systems-Level G Protein-Coupled Receptor Therapy Across a Neurodegenerative Continuum by the GLP-1 Receptor System. Front Endocrinol (Lausanne) 2014; 5:142. [PMID: 25225492 PMCID: PMC4150252 DOI: 10.3389/fendo.2014.00142] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 08/14/2014] [Indexed: 12/31/2022] Open
Abstract
With our increasing appreciation of the true complexity of diseases and pathophysiologies, it is clear that this knowledge needs to inform the future development of pharmacotherapeutics. For many disorders, the disease mechanism itself is a complex process spanning multiple signaling networks, tissues, and organ systems. Identifying the precise nature and locations of the pathophysiology is crucial for the creation of systemically effective drugs. Diseases once considered constrained to a limited range of organ systems, e.g., central neurodegenerative disorders such as Alzheimer's disease (AD), Parkinson's disease (PD), and Huntington' disease (HD), the role of multiple central and peripheral organ systems in the etiology of such diseases is now widely accepted. With this knowledge, it is increasingly clear that these seemingly distinct neurodegenerative disorders (AD, PD, and HD) possess multiple pathophysiological similarities thereby demonstrating an inter-related continuum of disease-related molecular alterations. With this systems-level appreciation of neurodegenerative diseases, it is now imperative to consider that pharmacotherapeutics should be developed specifically to address the systemic imbalances that create the disorders. Identification of potential systems-level signaling axes may facilitate the generation of therapeutic agents with synergistic remedial activity across multiple tissues, organ systems, and even diseases. Here, we discuss the potentially therapeutic systems-level interaction of the glucagon-like peptide 1 (GLP-1) ligand-receptor axis with multiple aspects of the AD, PD, and HD neurodegenerative continuum.
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Affiliation(s)
- Jonathan Janssens
- Translational Neurobiology Group, VIB Department of Molecular Genetics, University of Antwerp, Antwerp, Belgium
| | - Harmonie Etienne
- Translational Neurobiology Group, VIB Department of Molecular Genetics, University of Antwerp, Antwerp, Belgium
| | - Sherif Idriss
- Translational Neurobiology Group, VIB Department of Molecular Genetics, University of Antwerp, Antwerp, Belgium
| | - Abdelkrim Azmi
- Translational Neurobiology Group, VIB Department of Molecular Genetics, University of Antwerp, Antwerp, Belgium
| | - Bronwen Martin
- Metabolism Unit, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Stuart Maudsley
- Translational Neurobiology Group, VIB Department of Molecular Genetics, University of Antwerp, Antwerp, Belgium
- *Correspondence: Stuart Maudsley, Translational Neurobiology Group, VIB Department of Molecular Genetics, University of Antwerp, Universiteitsplein 1, Building V, Antwerpen B2610, Belgium e-mail:
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Scharmüller W, Ille R, Schienle A. Cerebellar contribution to anger recognition deficits in Huntington's disease. CEREBELLUM (LONDON, ENGLAND) 2013; 12:819-25. [PMID: 23709228 PMCID: PMC4495283 DOI: 10.1007/s12311-013-0492-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although there is increasing evidence that cerebellar loss of grey matter volume (GMV) is associated with affective deficits, this has not been tested for patients suffering from Huntington's disease (HD), who show a pronounced impairment in the recognition of anger. We assessed GMV in 18 symptomatic HD patients and 18 healthy controls using voxel-based morphometry. The GMV of cerebellar subregions was correlated with participants' intensity and accuracy ratings for facial expressions of basic emotions from the Karolinska Directed Emotional Faces (Lundqvist et al. 1998). The patients gave lower and less accurate anger ratings for angry faces than controls. This anger recognition deficit was correlated with atrophy of selected hemispheric and vermal regions of the cerebellum. Furthermore, cerebellar volume reductions of the HD patients were associated with longer disease duration and greater functional impairment. The data imply that anger recognition deficits could potentially serve as indicators of disease onset and progression in HD. Furthermore, the patients might profit from specific affect trainings.
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Affiliation(s)
- Wilfried Scharmüller
- Clinical Psychology, Department of Psychology, University of Graz, Universitätsplatz 2/III, 8010, Graz, Austria
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Scheller E, Abdulkadir A, Peter J, Tabrizi SJ, Frackowiak RSJ, Klöppel S. Interregional compensatory mechanisms of motor functioning in progressing preclinical neurodegeneration. Neuroimage 2013; 75:146-154. [PMID: 23501047 PMCID: PMC3899022 DOI: 10.1016/j.neuroimage.2013.02.058] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 01/30/2013] [Accepted: 02/28/2013] [Indexed: 11/18/2022] Open
Abstract
Understanding brain reserve in preclinical stages of neurodegenerative disorders allows determination of which brain regions contribute to normal functioning despite accelerated neuronal loss. Besides the recruitment of additional regions, a reorganisation and shift of relevance between normally engaged regions are a suggested key mechanism. Thus, network analysis methods seem critical for investigation of changes in directed causal interactions between such candidate brain regions. To identify core compensatory regions, fifteen preclinical patients carrying the genetic mutation leading to Huntington's disease and twelve controls underwent fMRI scanning. They accomplished an auditory paced finger sequence tapping task, which challenged cognitive as well as executive aspects of motor functioning by varying speed and complexity of movements. To investigate causal interactions among brain regions a single Dynamic Causal Model (DCM) was constructed and fitted to the data from each subject. The DCM parameters were analysed using statistical methods to assess group differences in connectivity, and the relationship between connectivity patterns and predicted years to clinical onset was assessed in gene carriers. In preclinical patients, we found indications for neural reserve mechanisms predominantly driven by bilateral dorsal premotor cortex, which increasingly activated superior parietal cortices the closer individuals were to estimated clinical onset. This compensatory mechanism was restricted to complex movements characterised by high cognitive demand. Additionally, we identified task-induced connectivity changes in both groups of subjects towards pre- and caudal supplementary motor areas, which were linked to either faster or more complex task conditions. Interestingly, coupling of dorsal premotor cortex and supplementary motor area was more negative in controls compared to gene mutation carriers. Furthermore, changes in the connectivity pattern of gene carriers allowed prediction of the years to estimated disease onset in individuals. Our study characterises the connectivity pattern of core cortical regions maintaining motor function in relation to varying task demand. We identified connections of bilateral dorsal premotor cortex as critical for compensation as well as task-dependent recruitment of pre- and caudal supplementary motor area. The latter finding nicely mirrors a previously published general linear model-based analysis of the same data. Such knowledge about disease specific inter-regional effective connectivity may help identify foci for interventions based on transcranial magnetic stimulation designed to stimulate functioning and also to predict their impact on other regions in motor-associated networks. Connectivity of a motor network is altered in preclinical neurodegeneration. Dynamic Causal Modelling reveals task-dependent recruitment of pre- and caudal SMA. Connectivity of the dorsal premotor cortex reveals compensatory mechanisms. DCM allows prediction of years to clinical onset in preclinical patients.
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Affiliation(s)
- Elisa Scheller
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany; Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany; Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Stefan-Meier-Str. 8, D-79104 Freiburg, Germany.
| | - Ahmed Abdulkadir
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany; Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany; Department of Computer Science, University of Freiburg, Georges-Koehler-Allee, 79110 Freiburg, Germany
| | - Jessica Peter
- Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany; Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Stefan-Meier-Str. 8, D-79104 Freiburg, Germany; Department of Neurology, University Medical Center Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany
| | - Sarah J Tabrizi
- UCL Institute of Neurology, University College London, Queen Square, London WC1N3BG, UK
| | - Richard S J Frackowiak
- Département des Neurosciences Cliniques, CHUV, University of Lausanne, 1011 Lausanne, Switzerland
| | - Stefan Klöppel
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany; Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany; Department of Neurology, University Medical Center Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany
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Dogan I, Saß C, Mirzazade S, Kleiman A, Werner CJ, Pohl A, Schiefer J, Binkofski F, Schulz JB, Shah NJ, Reetz K. Neural correlates of impaired emotion processing in manifest Huntington's disease. Soc Cogn Affect Neurosci 2013; 9:671-80. [PMID: 23482620 DOI: 10.1093/scan/nst029] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The complex phenotype of Huntington's disease (HD) encompasses motor, psychiatric and cognitive dysfunctions, including early impairments in emotion recognition. In this first functional magnetic resonance imaging study, we investigated emotion-processing deficits in 14 manifest HD patients and matched controls. An emotion recognition task comprised short video clips displaying one of six basic facial expressions (sadness, happiness, disgust, fear, anger and neutral). Structural changes between patients and controls were assessed by means of voxel-based morphometry. Along with deficient recognition of negative emotions, patients exhibited predominantly lower neural response to stimuli of negative valences in the amygdala, hippocampus, striatum, insula, cingulate and prefrontal cortices, as well as in sensorimotor, temporal and visual areas. Most of the observed reduced activity patterns could not be explained merely by regional volume loss. Reduced activity in the thalamus during fear correlated with lower thalamic volumes. During the processing of sadness, patients exhibited enhanced amygdala and hippocampal activity along with reduced recruitment of the medial prefrontal cortex. Higher amygdala activity was related to more pronounced amygdala atrophy and disease burden. Overall, the observed emotion-related dysfunctions in the context of structural neurodegeneration suggest both disruptions of striatal-thalamo-cortical loops and potential compensation mechanism with greater disease severity in manifest HD.
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Affiliation(s)
- Imis Dogan
- Department of Neurology, RWTH Aachen University, Pauwelsstrasse 30, D-52074 Aachen, Germany. Tel.: +49-241-80-36516; Fax: +49-241-80-33-36516.
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Putkhao K, Kocerha J, Cho IK, Yang J, Parnpai R, Chan AWS. Pathogenic cellular phenotypes are germline transmissible in a transgenic primate model of Huntington's disease. Stem Cells Dev 2013. [PMID: 23190281 DOI: 10.1089/scd.2012.0469] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
A transgenic primate model for Huntington's Disease (HD) first reported by our group that (HD monkeys) carry the mutant Huntingtin (HTT) gene with expanded polyglutamine (CAG) repeats and, develop chorea, dystonia, and other involuntary motor deficiencies similar to HD [ 1 ]. More recently, we have found that longitudinal magnetic resonance imaging of the HD monkey brain revealed significant atrophy in regions associated with cognitive deficits symptomatic in HD patients, providing the first animal model which replicates clinical phenotypes of diagnosed humans. Here we report germline transmission of the pathogenic mutant HTT in HD monkey by the production of embryos and subsequent derivation of HD monkey embryonic stem cells (rHD-ESCs) using HD monkey sperm. rHD-ESCs inherit mutant HTT and green fluorescent protein (GFP) genes through the gametes of HD monkey. rHD-ESCs express mutant HTT and form intranuclear inclusion, a classical cellular feature of HD. Notably, mosaicism of the pathogenic polyQ region in the sperm as well as derived ESCs were also observed, consistent with intraindividual and intergenerational reports of mosaic CAG repeats [ 2 , 3 ]and CAG expansion in HD patients [ 4-7 ]. The confirmation of transgene inheritability and development of pathogenic HD phenotype in derived rHD-ESCs reported in this study is a milestone in the pursuit of a transgenic primate model with inherited mutant HTT for development of novel disease biomarkers and therapeutics.
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