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Gan HW, Cerbone M, Dattani MT. Appetite- and Weight-Regulating Neuroendocrine Circuitry in Hypothalamic Obesity. Endocr Rev 2024; 45:309-342. [PMID: 38019584 PMCID: PMC11074800 DOI: 10.1210/endrev/bnad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 10/25/2023] [Accepted: 11/27/2023] [Indexed: 11/30/2023]
Abstract
Since hypothalamic obesity (HyOb) was first described over 120 years ago by Joseph Babinski and Alfred Fröhlich, advances in molecular genetic laboratory techniques have allowed us to elucidate various components of the intricate neurocircuitry governing appetite and weight regulation connecting the hypothalamus, pituitary gland, brainstem, adipose tissue, pancreas, and gastrointestinal tract. On a background of an increasing prevalence of population-level common obesity, the number of survivors of congenital (eg, septo-optic dysplasia, Prader-Willi syndrome) and acquired (eg, central nervous system tumors) hypothalamic disorders is increasing, thanks to earlier diagnosis and management as well as better oncological therapies. Although to date the discovery of several appetite-regulating peptides has led to the development of a range of targeted molecular therapies for monogenic obesity syndromes, outside of these disorders these discoveries have not translated into the development of efficacious treatments for other forms of HyOb. This review aims to summarize our current understanding of the neuroendocrine physiology of appetite and weight regulation, and explore our current understanding of the pathophysiology of HyOb.
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Affiliation(s)
- Hoong-Wei Gan
- Department of Endocrinology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK
- Genetics & Genomic Medicine Research & Teaching Department, University College London Great Ormond Street Institute for Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Manuela Cerbone
- Department of Endocrinology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK
- Genetics & Genomic Medicine Research & Teaching Department, University College London Great Ormond Street Institute for Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Mehul Tulsidas Dattani
- Department of Endocrinology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK
- Genetics & Genomic Medicine Research & Teaching Department, University College London Great Ormond Street Institute for Child Health, 30 Guilford Street, London WC1N 1EH, UK
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2
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Ruggeri A, Nerland S, Mørch-Johnsen L, Jørgensen KN, Barth C, Wortinger LA, Andreou D, Andreassen OA, Agartz I. Hypothalamic Subunit Volumes in Schizophrenia and Bipolar Spectrum Disorders. Schizophr Bull 2024; 50:533-544. [PMID: 38206841 PMCID: PMC11059784 DOI: 10.1093/schbul/sbad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND The hypothalamus is central to many hormonal and autonomous nervous system pathways. Emerging evidence indicates that these pathways may be disrupted in schizophrenia and bipolar disorder. Yet, few studies have examined the volumes of hypothalamic subunits in these patient groups. We compared hypothalamic subunit volumes in individuals with psychotic disorders to healthy controls. STUDY DESIGN We included 344 patients with schizophrenia spectrum disorders (SCZ), 340 patients with bipolar disorders (BPD), and 684 age- and-sex-matched healthy controls (CTR). Total hypothalamus and five hypothalamic subunit volumes were extracted from T1-weighted magnetic resonance imaging (MRI) using an automated Bayesian segmentation method. Regression models, corrected for age, age2, sex, and segmentation-based intracranial volume (sbTIV), were used to examine diagnostic group differences, interactions with sex, and associations with clinical symptoms, antipsychotic medication, antidepressants and mood stabilizers. STUDY RESULTS SCZ had larger volumes in the left inferior tubular subunit and smaller right anterior-inferior, right anterior-superior, and right posterior hypothalamic subunits compared to CTR. BPD did not differ significantly from CTR for any hypothalamic subunit volume, however, there was a significant sex-by-diagnosis interaction. Analyses stratified by sex showed smaller right hypothalamus and right posterior subunit volumes in male patients, but not female patients, relative to same-sex controls. There was a significant association between BPD currently taking antipsychotic medication and the left inferior tubular subunits volumes. CONCLUSIONS Our results show regional-specific alterations in hypothalamus subunit volumes in individuals with SCZ, with relevance to HPA-axis dysregulation, circadian rhythm disruption, and cognition impairment.
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Affiliation(s)
- Aurora Ruggeri
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Stener Nerland
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lynn Mørch-Johnsen
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatry, Østfold Hospital, Grålum, Norway
- Department of Clinical Research, Østfold Hospital, Grålum, Norway
| | - Kjetil Nordbø Jørgensen
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatry, Telemark Hospital, Skien, Norway
| | - Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Laura Anne Wortinger
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dimitrios Andreou
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
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3
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Jensen DEA, Ebmeier KP, Suri S, Rushworth MFS, Klein-Flügge MC. Nuclei-specific hypothalamus networks predict a dimensional marker of stress in humans. Nat Commun 2024; 15:2426. [PMID: 38499548 PMCID: PMC10948785 DOI: 10.1038/s41467-024-46275-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 02/21/2024] [Indexed: 03/20/2024] Open
Abstract
The hypothalamus is part of the hypothalamic-pituitary-adrenal axis which activates stress responses through release of cortisol. It is a small but heterogeneous structure comprising multiple nuclei. In vivo human neuroimaging has rarely succeeded in recording signals from individual hypothalamus nuclei. Here we use human resting-state fMRI (n = 498) with high spatial resolution to examine relationships between the functional connectivity of specific hypothalamic nuclei and a dimensional marker of prolonged stress. First, we demonstrate that we can parcellate the human hypothalamus into seven nuclei in vivo. Using the functional connectivity between these nuclei and other subcortical structures including the amygdala, we significantly predict stress scores out-of-sample. Predictions use 0.0015% of all possible brain edges, are specific to stress, and improve when using nucleus-specific compared to whole-hypothalamus connectivity. Thus, stress relates to connectivity changes in precise and functionally meaningful subcortical networks, which may be exploited in future studies using interventions in stress disorders.
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Affiliation(s)
- Daria E A Jensen
- Department of Experimental Psychology, University of Oxford, Tinsley Building, Mansfield Road, Oxford, OX1 3TA, UK.
- Wellcome Centre for Integrative Neuroimaging (WIN), Centre for Functional MRI of the Brain (FMRIB, University of Oxford, Nuffield Department of Clinical Neurosciences, Level 6, West Wing, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, UK.
- Clinic of Cognitive Neurology, University Medical Center Leipzig and Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstrasse 1a, 04103, Leipzig, Germany.
| | - Klaus P Ebmeier
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, UK
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, UK
- Wellcome Centre for Integrative Neuroimaging (WIN), Oxford Centre for Human Brain Activity (OHBA), University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, UK
| | - Matthew F S Rushworth
- Department of Experimental Psychology, University of Oxford, Tinsley Building, Mansfield Road, Oxford, OX1 3TA, UK
- Wellcome Centre for Integrative Neuroimaging (WIN), Centre for Functional MRI of the Brain (FMRIB, University of Oxford, Nuffield Department of Clinical Neurosciences, Level 6, West Wing, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Miriam C Klein-Flügge
- Department of Experimental Psychology, University of Oxford, Tinsley Building, Mansfield Road, Oxford, OX1 3TA, UK.
- Wellcome Centre for Integrative Neuroimaging (WIN), Centre for Functional MRI of the Brain (FMRIB, University of Oxford, Nuffield Department of Clinical Neurosciences, Level 6, West Wing, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, UK.
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4
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Rasmussen JM, Wang Y, Graham AM, Fair DA, Posner J, O'Connor TG, Simhan HN, Yen E, Madan N, Entringer S, Wadhwa PD, Buss C. Segmenting hypothalamic subunits in human newborn magnetic resonance imaging data. Hum Brain Mapp 2024; 45:e26582. [PMID: 38339904 PMCID: PMC10826633 DOI: 10.1002/hbm.26582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/15/2023] [Accepted: 11/26/2023] [Indexed: 02/12/2024] Open
Abstract
Preclinical evidence suggests that inter-individual variation in the structure of the hypothalamus at birth is associated with variation in the intrauterine environment, with downstream implications for future disease susceptibility. However, scientific advancement in humans is limited by a lack of validated methods for the automatic segmentation of the newborn hypothalamus. N = 215 healthy full-term infants with paired T1-/T2-weighted MR images across four sites were considered for primary analyses (mean postmenstrual age = 44.3 ± 3.5 weeks, nmale /nfemale = 110/106). The outputs of FreeSurfer's hypothalamic subunit segmentation tools designed for adults (segFS) were compared against those of a novel registration-based pipeline developed here (segATLAS) and against manually edited segmentations (segMAN) as reference. Comparisons were made using Dice Similarity Coefficients (DSCs) and through expected associations with postmenstrual age at scan. In addition, we aimed to demonstrate the validity of the segATLAS pipeline by testing for the stability of inter-individual variation in hypothalamic volume across the first year of life (n = 41 longitudinal datasets available). SegFS and segATLAS segmentations demonstrated a wide spread in agreement (mean DSC = 0.65 ± 0.14 SD; range = {0.03-0.80}). SegATLAS volumes were more highly correlated with postmenstrual age at scan than segFS volumes (n = 215 infants; RsegATLAS 2 = 65% vs. RsegFS 2 = 40%), and segATLAS volumes demonstrated a higher degree of agreement with segMAN reference segmentations at the whole hypothalamus (segATLAS DSC = 0.89 ± 0.06 SD; segFS DSC = 0.68 ± 0.14 SD) and subunit levels (segATLAS DSC = 0.80 ± 0.16 SD; segFS DSC = 0.40 ± 0.26 SD). In addition, segATLAS (but not segFS) volumes demonstrated stability from near birth to ~1 years age (n = 41; R2 = 25%; p < 10-3 ). These findings highlight segATLAS as a valid and publicly available (https://github.com/jerodras/neonate_hypothalamus_seg) pipeline for the segmentation of hypothalamic subunits using human newborn MRI up to 3 months of age collected at resolutions on the order of 1 mm isotropic. Because the hypothalamus is traditionally understudied due to a lack of high-quality segmentation tools during the early life period, and because the hypothalamus is of high biological relevance to human growth and development, this tool may stimulate developmental and clinical research by providing new insight into the unique role of the hypothalamus and its subunits in shaping trajectories of early life health and disease.
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Affiliation(s)
- Jerod M. Rasmussen
- Development, Health and Disease Research ProgramUniversity of CaliforniaIrvineCaliforniaUSA
- Department of PediatricsUniversity of CaliforniaIrvineCaliforniaUSA
| | - Yun Wang
- Department of Psychiatry and Behavioral SciencesDuke UniversityDurhamNorth CarolinaUSA
- New York State Psychiatric InstituteNew YorkNew YorkUSA
| | - Alice M. Graham
- Department of Behavioral NeuroscienceOregon Health & Science UniversityPortlandOregonUSA
| | - Damien A. Fair
- Masonic Institute for the Developing BrainUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Jonathan Posner
- Department of Psychiatry and Behavioral SciencesDuke UniversityDurhamNorth CarolinaUSA
- New York State Psychiatric InstituteNew YorkNew YorkUSA
| | - Thomas G. O'Connor
- Departments of Psychiatry, Psychology, Neuroscience and Obstetrics and GynecologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Hyagriv N. Simhan
- Department of Obstetrics and GynecologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Elizabeth Yen
- Department of PediatricsTufts Medical CenterBostonMassachusettsUSA
| | - Neel Madan
- Department of RadiologyTufts Medical CenterBostonMassachusettsUSA
| | - Sonja Entringer
- Development, Health and Disease Research ProgramUniversity of CaliforniaIrvineCaliforniaUSA
- Department of PediatricsUniversity of CaliforniaIrvineCaliforniaUSA
- Department of Medical PsychologyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Pathik D. Wadhwa
- Development, Health and Disease Research ProgramUniversity of CaliforniaIrvineCaliforniaUSA
- Department of PediatricsUniversity of CaliforniaIrvineCaliforniaUSA
- Department of Psychiatry and Human BehaviorUniversity of CaliforniaIrvineCaliforniaUSA
- Department of Obstetrics and GynecologyUniversity of CaliforniaIrvineCaliforniaUSA
- Department of EpidemiologyUniversity of CaliforniaIrvineCaliforniaUSA
| | - Claudia Buss
- Development, Health and Disease Research ProgramUniversity of CaliforniaIrvineCaliforniaUSA
- Department of PediatricsUniversity of CaliforniaIrvineCaliforniaUSA
- Department of Medical PsychologyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
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5
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Haaf R, Brandi ML, Albantakis L, Lahnakoski JM, Henco L, Schilbach L. Peripheral oxytocin levels are linked to hypothalamic gray matter volume in autistic adults: a cross-sectional secondary data analysis. Sci Rep 2024; 14:1380. [PMID: 38228703 PMCID: PMC10791615 DOI: 10.1038/s41598-023-50770-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 12/25/2023] [Indexed: 01/18/2024] Open
Abstract
Oxytocin (OXT) is known to modulate social behavior and cognition and has been discussed as pathophysiological and therapeutic factor for autism spectrum disorder (ASD). An accumulating body of evidence indicates the hypothalamus to be of particular importance with regard to the underlying neurobiology. Here we used a region of interest voxel-based morphometry (VBM) approach to investigate hypothalamic gray matter volume (GMV) in autistic (n = 29, age 36.03 ± 11.0) and non-autistic adults (n = 27, age 30.96 ± 11.2). Peripheral plasma OXT levels and the autism spectrum quotient (AQ) were used for correlation analyses. Results showed no differences in hypothalamic GMV in autistic compared to non-autistic adults but suggested a differential association between hypothalamic GMV and OXT levels, such that a positive association was found for the ASD group. In addition, hypothalamic GMV showed a positive association with autistic traits in the ASD group. Bearing in mind the limitations such as a relatively small sample size, a wide age range and a high rate of psychopharmacological treatment in the ASD sample, these results provide new preliminary evidence for a potentially important role of the HTH in ASD and its relationship to the OXT system, but also point towards the importance of interindividual differences.
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Affiliation(s)
- Raoul Haaf
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany.
- Graduate School, Technical University of Munich, Munich, Germany.
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany.
| | - Marie-Luise Brandi
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
| | - Laura Albantakis
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
- Outpatient and Day Clinic for Disorders of Social Interaction, Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Munich, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Juha M Lahnakoski
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Neurosciences and Medicine, Brain and Behaviour (INM-7), Research Center Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Lara Henco
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
- Graduate School of Systemic Neurosciences, Munich, Germany
| | - Leonhard Schilbach
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
- Outpatient and Day Clinic for Disorders of Social Interaction, Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Munich, Germany
- Graduate School of Systemic Neurosciences, Munich, Germany
- Ludwig-Maximilians-Universität München, Munich, Germany
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6
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Chen SD, You J, Zhang W, Wu BS, Ge YJ, Xiang ST, Du J, Kuo K, Banaschewski T, Barker GJ, Bokde ALW, Desrivières S, Flor H, Grigis A, Garavan H, Gowland P, Heinz A, Brühl R, Martinot JL, Martinot MLP, Artiges E, Nees F, Orfanos DP, Lemaitre H, Paus T, Poustka L, Hohmann S, Millenet S, Baeuchl C, Smolka MN, Vaidya N, Walter H, Whelan R, Schumann G, Feng JF, Dong Q, Cheng W, Yu JT. The genetic architecture of the human hypothalamus and its involvement in neuropsychiatric behaviours and disorders. Nat Hum Behav 2024:10.1038/s41562-023-01792-6. [PMID: 38182882 DOI: 10.1038/s41562-023-01792-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 11/20/2023] [Indexed: 01/07/2024]
Abstract
Despite its crucial role in the regulation of vital metabolic and neurological functions, the genetic architecture of the hypothalamus remains unknown. Here we conducted multivariate genome-wide association studies (GWAS) using hypothalamic imaging data from 32,956 individuals to uncover the genetic underpinnings of the hypothalamus and its involvement in neuropsychiatric traits. There were 23 significant loci associated with the whole hypothalamus and its subunits, with functional enrichment for genes involved in intracellular trafficking systems and metabolic processes of steroid-related compounds. The hypothalamus exhibited substantial genetic associations with limbic system structures and neuropsychiatric traits including chronotype, risky behaviour, cognition, satiety and sympathetic-parasympathetic activity. The strongest signal in the primary GWAS, the ADAMTS8 locus, was replicated in three independent datasets (N = 1,685-4,321) and was strengthened after meta-analysis. Exome-wide association analyses added evidence to the association for ADAMTS8, and Mendelian randomization showed lower ADAMTS8 expression with larger hypothalamic volumes. The current study advances our understanding of complex structure-function relationships of the hypothalamus and provides insights into the molecular mechanisms that underlie hypothalamic formation.
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Affiliation(s)
- Shi-Dong Chen
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Jia You
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Wei Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Bang-Sheng Wu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Yi-Jun Ge
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Shi-Tong Xiang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Jing Du
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Kevin Kuo
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Sylvane Desrivières
- Institute of Psychiatry, Psychology & Neuroscience, Social, Genetic, Developmental Psychiatry Centre, King's College London, London, UK
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Antoine Grigis
- NeuroSpin, CEA, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT, USA
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Rüdiger Brühl
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U 1299 "Trajectoires développementales & psychiatrie", University Paris-Saclay, CNRS, Ecole Normale Supérieure Paris-Saclay, Centre Borelli, Gif-sur-Yvette, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U 1299 "Trajectoires développementales & psychiatrie", University Paris-Saclay, CNRS, Ecole Normale Supérieure Paris-Saclay, Centre Borelli, Gif-sur-Yvette, France
- AP-HP, Sorbonne University, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Eric Artiges
- Institut National de la Santé et de la Recherche Médicale, INSERM U 1299 "Trajectoires développementales & psychiatrie", University Paris-Saclay, CNRS, Ecole Normale Supérieure Paris-Saclay, Centre Borelli, Gif-sur-Yvette, France
- Psychiatry Department, EPS Barthélémy Durand, Etampes, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | | | - Herve Lemaitre
- NeuroSpin, CEA, Université Paris-Saclay, Gif-sur-Yvette, France
- Institut des Maladies Neurodégénératives, UMR 5293, CNRS, CEA, Université de Bordeaux, Bordeaux, France
| | - Tomáš Paus
- Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hosptalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
- Departments of Psychiatry and Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, Göttingen, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Baeuchl
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Nilakshi Vaidya
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China.
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
- Zhangjiang Fudan International Innovation Center, Shanghai, China.
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China.
| | - Wei Cheng
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China.
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China.
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China.
- Shanghai Medical College and Zhongshan Hospital Immunotherapy Technology Transfer Center, Shanghai, China.
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, Shanghai, China.
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Dai S, Qiu L, Veeraraghavan VP, Sheu CL, Mony U. Advances in iPSC Technology in Neural Disease Modeling, Drug Screening, and Therapy. Curr Stem Cell Res Ther 2024; 19:809-819. [PMID: 37291782 DOI: 10.2174/1574888x18666230608105703] [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: 12/12/2022] [Revised: 04/16/2023] [Accepted: 05/11/2023] [Indexed: 06/10/2023]
Abstract
Neurodegenerative disorders (NDs) including Alzheimer's Disease, Parkinson's Disease, Amyotrophic Lateral Sclerosis (ALS), and Huntington's disease are all incurable and can only be managed with drugs for the associated symptoms. Animal models of human illnesses help to advance our understanding of the pathogenic processes of diseases. Understanding the pathogenesis as well as drug screening using appropriate disease models of neurodegenerative diseases (NDs) are vital for identifying novel therapies. Human-derived induced pluripotent stem cell (iPSC) models can be an efficient model to create disease in a dish and thereby can proceed with drug screening and identifying appropriate drugs. This technology has many benefits, including efficient reprogramming and regeneration potential, multidirectional differentiation, and the lack of ethical concerns, which open up new avenues for studying neurological illnesses in greater depth. The review mainly focuses on the use of iPSC technology in neuronal disease modeling, drug screening, and cell therapy.
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Affiliation(s)
- Sihan Dai
- Department of Biomedical Engineering, Shantou University, Shantou, 515063, China
| | - Linhui Qiu
- Department of Biomedical Engineering, Shantou University, Shantou, 515063, China
| | - Vishnu Priya Veeraraghavan
- Centre of Molecular Medicine and Diagnostics (COMManD), Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600077, India
| | - Chia-Lin Sheu
- Department of Biomedical Engineering, Shantou University, Shantou, 515063, China
| | - Ullas Mony
- Centre of Molecular Medicine and Diagnostics (COMManD), Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600077, India
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Juvodden HT, Alnæs D, Lund MJ, Agartz I, Andreassen OIA, Server A, Thorsby PM, Westlye LT, Knudsen Heier S. Larger hypothalamic volume in narcolepsy type 1. Sleep 2023; 46:zsad173. [PMID: 37463428 PMCID: PMC10636249 DOI: 10.1093/sleep/zsad173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 05/18/2023] [Indexed: 07/20/2023] Open
Abstract
STUDY OBJECTIVES Narcolepsy type 1 (NT1) is a neurological sleep disorder. Postmortem studies have shown 75%-90% loss of the 50 000-70 000 hypocretin-producing neurons and 64%-94% increase in the 64 000-120 000 histaminergic neurons and conflicting indications of gliosis in the hypothalamus of NT1 patients. The aim of this study was to compare MRI-based volumes of the hypothalamus in patients with NT1 and controls in vivo. METHODS We used a segmentation tool based on deep learning included in Freesurfer and computed the volume of the whole hypothalamus, left/right part of the hypothalamus, and 10 hypothalamic subregions. We included 54 patients with post-H1N1 NT1 (39 females, mean age 21.8 ± 11.0 years) and 114 controls (77 females, mean age 23.2 ± 9.0 years). Group differences were tested with general linear models using permutation testing in Permutation Analysis of Linear Models and evaluated after 10 000 permutations, yielding two-tailed P-values. Furthermore, a stepwise Bonferroni correction was performed after dividing hypothalamus into smaller regions. RESULTS The analysis revealed larger volume for patients compared to controls for the whole hypothalamus (Cohen's d = 0.71, p = 0.0028) and for the left (d = 0.70, p = 0.0037) and right part of the hypothalamus (d = 0.65, p = 0.0075) and left (d = 0.72, p = 0.0036) and right tubular-inferior (d = 0.71, p = 0.0037) hypothalamic subregions. CONCLUSIONS In conclusion, patients with post-H1N1 NT1 showed significantly larger hypothalamic volume than controls, in particular in the tubular-inferior subregions which could reflect several processes as previous studies have indicated neuroinflammation, gliosis, and changes in the numbers of different cell types.
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Affiliation(s)
- Hilde T Juvodden
- Department of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Ullevål, Oslo, Norway
| | - Dag Alnæs
- Division of Mental Health and Addiction, NORMENT Centre, University of Oslo and Oslo University Hospital, Oslo, Norway
- Departement of Psychology, Pedagogy and Law, Kristiania University College, Oslo, Norway
| | - Martina J Lund
- Division of Mental Health and Addiction, NORMENT Centre, University of Oslo and Oslo University Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - OIe A Andreassen
- Division of Mental Health and Addiction, NORMENT Centre, University of Oslo and Oslo University Hospital, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Andres Server
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Per M Thorsby
- Hormone Laboratory, Department of Medical Biochemistry, Biochemical Endocrinology and Metabolism Research Group, Oslo University Hospital, Aker, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- Division of Mental Health and Addiction, NORMENT Centre, University of Oslo and Oslo University Hospital, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Stine Knudsen Heier
- Department of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Ullevål, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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9
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Konadu ME, Reed MB, Kaufmann U, Handschuh PA, Spurny-Dworak B, Klöbl M, Schmidt C, Godber, Godbersen M, Briem E, Seiger R, Baldinger-Melich P, Kranz GS, Lanzenberger R, Spies M. Changes to hypothalamic volume and associated subunits during gender-affirming hormone therapy. J Psychiatry Neurosci 2023; 48:E369-E375. [PMID: 37751919 PMCID: PMC10521920 DOI: 10.1503/jpn.230017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/30/2023] [Accepted: 08/01/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Among its pleiotropic properties, gender-affirming hormone therapy (GHT) affects regional brain volumes. The hypothalamus, which regulates neuroendocrine function and associated emotional and cognitive processes, is an intuitive target for probing GHT effects. We sought to assess changes to hypothalamus and hypothalamic subunit volumes after GHT, thereby honouring the region's anatomical and functional heterogeneity. METHODS Individuals with gender dysphoria and cisgender controls underwent 2 MRI measurements, with a median interval of 145 days (interquartile range [IQR] 128.25-169.75 d, mean 164.94 d) between the first and second MRI. Transgender women (TW) and transgender men (TM) underwent the first MRI before GHT and the second MRI after approximately 4.5 months of GHT, which comprised estrogen and anti-androgen therapy in TW or testosterone therapy in TM. Hypothalamic volumes were segmented using FreeSurfer, and effects of GHT were tested using repeated-measures analysis of covariance. RESULTS The final sample included 106 participants: 38 TM, 15 TW, 32 cisgender women (CW) and 21 cisgender men (CM). Our analyses revealed group × time interaction effects for total, left and right hypothalamus volume, and for several subunits (left and right inferior tubular, left superior tubular, right anterior inferior, right anterior superior, all p corr < 0.01). In TW, volumes decreased between the first and second MRI in these regions (all p corr ≤ 0.01), and the change from the first to second MRI in TW differed significantly from that in CM and CW in several subunits (p corr < 0.05). LIMITATIONS We did not address the influence of transition-related psychological and behavioural changes. CONCLUSION Our results suggest a subunit-specific effect of GHT on hypothalamus volumes in TW. This finding is in accordance with previous reports of positive and negative effects of androgens and estrogens, respectively, on cerebral volumes.
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Affiliation(s)
- Melisande E Konadu
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - Murray B Reed
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - Ulrike Kaufmann
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - Patricia A Handschuh
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - Benjamin Spurny-Dworak
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - Manfred Klöbl
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - Clemens Schmidt
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - Godber
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - M Godbersen
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - Elisa Briem
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - René Seiger
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - Pia Baldinger-Melich
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - Georg S Kranz
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - Rupert Lanzenberger
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
| | - Marie Spies
- From the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Kranz, Lanzenberger, Spies); the Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria (Konadu, Reed, Handschuh, Spurny-Dworak, Klöbl, Schmidt, Godbersen, Briem, Seiger, Baldinger-Melich, Lanzenberger, Spies); the Department of Obstetrics and Gynecology, Medical University of Vienna, Austria (Kaufmann); the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (Kranz)
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Byrne H, Josev EK, Knight SJ, Scheinberg A, Rowe K, Lubitz L, Seal ML. Hypothalamus volumes in adolescent Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): impact of self-reported fatigue and illness duration. Brain Struct Funct 2023; 228:1741-1754. [PMID: 37537279 PMCID: PMC10471696 DOI: 10.1007/s00429-023-02682-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/06/2023] [Indexed: 08/05/2023]
Abstract
Adolescent Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex illness of unknown aetiology. Emerging theories suggest ME/CFS may reflect a progressive, aberrant state of homeostasis caused by disturbances within the hypothalamus, yet few studies have investigated this using magnetic resonance imaging in adolescents with ME/CFS. We conducted a volumetric analysis to investigate whether whole and regional hypothalamus volumes in adolescents with ME/CFS differed compared to healthy controls, and whether these volumes were associated with fatigue severity and illness duration. 48 adolescents (25 ME/CFS, 23 controls) were recruited. Lateralised whole and regional hypothalamus volumes, including the anterior-superior, superior tubular, posterior, anterior-inferior and inferior tubular subregions, were calculated from T1-weighted images. When controlling for age, sex and intracranial volume, Bayesian linear regression models revealed no evidence for differences in hypothalamus volumes between groups. However, in the ME/CFS group, a weak linear relationship between increased right anterior-superior volumes and fatigue severity was identified, which was absent in controls. In addition, Bayesian quantile regression revealed a likely-positive association between illness duration and right superior tubular volumes in the ME/CFS group. While these findings suggest overall comparability in regional and whole hypothalamus volumes between adolescents with ME/CFS and controls, preliminary evidence was identified to suggest greater fatigue severity and longer illness duration were associated with greater right anterior-superior and superior-tubular volumes, respectively. These regions contain the anterior and superior divisions of the paraventricular nucleus, involved in the neuroendocrine response to stress, suggesting involvement in ME/CFS pathophysiology. However, replication in a larger, longitudinal cohort is required.
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Affiliation(s)
- Hollie Byrne
- Developmental Imaging, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, 3052, Australia.
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, 3052, Australia.
- Department of Paediatrics, The University of Melbourne, Melbourne, 3052, Australia.
| | - Elisha K Josev
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, 3052, Australia
| | - Sarah J Knight
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, 3052, Australia
| | - Adam Scheinberg
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, 3052, Australia
| | - Katherine Rowe
- Department of General Medicine, Royal Children's Hospital, Melbourne, 3052, Australia
| | - Lionel Lubitz
- Department of General Medicine, Royal Children's Hospital, Melbourne, 3052, Australia
| | - Marc L Seal
- Developmental Imaging, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, 3052, Australia
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11
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Brown SSG, Westwater ML, Seidlitz J, Ziauddeen H, Fletcher PC. Hypothalamic volume is associated with body mass index. Neuroimage Clin 2023; 39:103478. [PMID: 37558541 PMCID: PMC10509524 DOI: 10.1016/j.nicl.2023.103478] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/19/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023]
Abstract
The hypothalamus is an important neuroendocrine hub for the control of appetite and satiety. In animal studies it has been established that hypothalamic lesioning or stimulation causes alteration to feeding behaviour and consequently body mass, and exposure to high calorie diets induces hypothalamic inflammation. These findings suggest that alterations in hypothalamic structure and function are both a cause and a consequence of changes to food intake. However, there is limited in vivo human data relating the hypothalamus to obesity or eating disorders, in part due to technical problems relating to its small size. Here, we used a novel automated segmentation algorithm to exploratorily investigate the relationship between hypothalamic volume, normalised to intracranial volume, and body mass index (BMI). The analysis was applied across four independent datasets comprising of young adults (total n = 1,351 participants) spanning a range of BMIs (13.3 - 47.8 kg/m2). We compared underweight (including individuals with anorexia nervosa), healthy weight, overweight and obese individuals in a series of complementary analyses. We report that overall hypothalamic volume is significantly larger in overweight and obese groups of young adults. This was also observed for a number of hypothalamic sub-regions. In the largest dataset (the HCP-Young Adult dataset (n = 1111)) there was a significant relationship between hypothalamic volume and BMI. We suggest that our findings of a positive relationship between hypothalamic volume and BMI is potentially consistent with hypothalamic inflammation as seen in animal models in response to high fat diet, although more research is needed to establish a causal relationship. Overall, we present novel, in vivo findings that link elevated BMI to altered hypothalamic structure. This has important implications for study of the neural mechanisms of obesity in humans.
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Affiliation(s)
- Stephanie S G Brown
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Cambridge CB2 0QQ, United Kingdom.
| | - Margaret L Westwater
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Cambridge CB2 0QQ, United Kingdom; Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, United Kingdom
| | - Jakob Seidlitz
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute of Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Hisham Ziauddeen
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Cambridge CB2 0QQ, United Kingdom
| | - Paul C Fletcher
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Cambridge CB2 0QQ, United Kingdom; Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom; Cambridgeshire and Peterborough NHS Trust, United Kingdom
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12
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Tse NY, Bocchetta M, Todd EG, Devenney EM, Tu S, Caga J, Hodges JR, Halliday GM, Irish M, Kiernan MC, Piguet O, Rohrer JD, Ahmed RM. Distinct hypothalamic involvement in the amyotrophic lateral sclerosis-frontotemporal dementia spectrum. Neuroimage Clin 2023; 37:103281. [PMID: 36495857 PMCID: PMC9731897 DOI: 10.1016/j.nicl.2022.103281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/04/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hypothalamic dysregulation plays an established role in eating abnormalities in behavioural variant frontotemporal dementia (bvFTD) and amyotrophic lateral sclerosis (ALS). Its contribution to cognitive and behavioural impairments, however, remains unexplored. METHODS Correlation between hypothalamic subregion atrophy and cognitive and behavioural impairments was examined in a large sample of 211 participants (52 pure ALS, 42 mixed ALS-FTD, 59 bvFTD, and 58 age- and education- matched healthy controls). RESULTS Graded variation in hypothalamic involvement but relative sparing of the inferior tuberal region was evident across all patient groups. Bilateral anterior inferior, anterior superior, and posterior hypothalamic subregions were selectively implicated in memory, fluency and processing speed impairments in addition to apathy and abnormal eating habits, taking into account disease duration, age, sex, total intracranial volume, and acquisition parameters (all p ≤ .001). CONCLUSIONS These findings revealed that subdivisions of the hypothalamus are differentially affected in the ALS-FTD spectrum and contribute to canonical cognitive and behavioural disturbances beyond eating abnormalities. The anterior superior and superior tuberal subregions containing the paraventricular nucleus (housing oxytocin-producing neurons) displayed the greatest volume loss in bvFTD and ALS-FTD, and ALS, respectively. Importantly, the inferior tuberal subregion housing the arcuate nucleus (containing different groups of neuroendocrine neurons) was selectively preserved across the ALS-FTD spectrum, supporting pathophysiological findings of discrete neuropeptide expression abnormalities that may underlie the pathogenesis of autonomic and metabolic abnormalities and potentially certain cognitive and behavioural symptom manifestations, representing avenues for more refined symptomatic treatment targets.
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Affiliation(s)
- Nga Yan Tse
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; Royal Prince Alfred Hospital, Sydney, Australia
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Emily G Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Emma M Devenney
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; Royal Prince Alfred Hospital, Sydney, Australia
| | - Sicong Tu
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; Royal Prince Alfred Hospital, Sydney, Australia
| | - Jashelle Caga
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; Royal Prince Alfred Hospital, Sydney, Australia
| | - John R Hodges
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; Royal Prince Alfred Hospital, Sydney, Australia; The University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, Australia
| | - Glenda M Halliday
- The University of Sydney, Sydney Medical School and Brain & Mind Centre, Sydney, Australia
| | - Muireann Irish
- The University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, Australia
| | - Matthew C Kiernan
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; Royal Prince Alfred Hospital, Sydney, Australia; The University of Sydney, Sydney Medical School and Brain & Mind Centre, Sydney, Australia
| | - Olivier Piguet
- The University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, Australia
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Rebekah M Ahmed
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; Royal Prince Alfred Hospital, Sydney, Australia; Memory and Cognition Clinic, Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia.
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13
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Chang J, Shaw TB, Holdom CJ, McCombe PA, Henderson RD, Fripp J, Barth M, Guo CC, Ngo ST, Steyn FJ. Lower hypothalamic volume with lower body mass index is associated with shorter survival in patients with amyotrophic lateral sclerosis. Eur J Neurol 2023; 30:57-68. [PMID: 36214080 PMCID: PMC10099625 DOI: 10.1111/ene.15589] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/15/2022] [Accepted: 09/30/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Weight loss in patients with amyotrophic lateral sclerosis (ALS) is associated with faster disease progression and shorter survival. Decreased hypothalamic volume is proposed to contribute to weight loss due to loss of appetite and/or hypermetabolism. We aimed to investigate the relationship between hypothalamic volume and body mass index (BMI) in ALS and Alzheimer's disease (AD), and the associations of hypothalamic volume with weight loss, appetite, metabolism and survival in patients with ALS. METHODS We compared hypothalamic volumes from magnetic resonance imaging scans with BMI for patients with ALS (n = 42), patients with AD (n = 167) and non-neurodegenerative disease controls (n = 527). Hypothalamic volumes from patients with ALS were correlated with measures of appetite and metabolism, and change in anthropomorphic measures and disease outcomes. RESULTS Lower hypothalamic volume was associated with lower and higher BMI in ALS (quadratic association; probability of direction = 0.96). This was not observed in AD patients or controls. Hypothalamic volume was not associated with loss of appetite (p = 0.58) or hypermetabolism (p = 0.49). Patients with lower BMI and lower hypothalamic volume tended to lose weight (p = 0.08) and fat mass (p = 0.06) over the course of their disease, and presented with an increased risk of earlier death (hazard ratio [HR] 3.16, p = 0.03). Lower hypothalamic volume alone trended for greater risk of earlier death (HR 2.61, p = 0.07). CONCLUSION These observations suggest that lower hypothalamic volume in ALS contributes to positive and negative energy balance, and is not universally associated with loss of appetite or hypermetabolism. Critically, lower hypothalamic volume with lower BMI was associated with weight loss and earlier death.
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Affiliation(s)
- Jeryn Chang
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Saint Lucia, Australia
| | - Thomas B Shaw
- Department of Neurology, Royal Brisbane and Women's Hospital, Herston, Australia.,Centre for Advanced Imaging, The University of Queensland, Saint Lucia, Australia.,School of Information Technology and Electrical Engineering, The University of Queensland, Saint Lucia, Australia
| | - Cory J Holdom
- Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Saint Lucia, Australia
| | - Pamela A McCombe
- Department of Neurology, Royal Brisbane and Women's Hospital, Herston, Australia.,UQ Centre for Clinical Research, The University of Queensland, Herston, Australia.,Wesley Medical Research, The Wesley Hospital, Auchenflower, Australia
| | - Robert D Henderson
- Department of Neurology, Royal Brisbane and Women's Hospital, Herston, Australia.,UQ Centre for Clinical Research, The University of Queensland, Herston, Australia.,Wesley Medical Research, The Wesley Hospital, Auchenflower, Australia
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, Herston, Australia
| | - Markus Barth
- Centre for Advanced Imaging, The University of Queensland, Saint Lucia, Australia.,School of Information Technology and Electrical Engineering, The University of Queensland, Saint Lucia, Australia
| | | | - Shyuan T Ngo
- Department of Neurology, Royal Brisbane and Women's Hospital, Herston, Australia.,Australian Institute of Bioengineering and Nanotechnology, The University of Queensland, Saint Lucia, Australia.,Wesley Medical Research, The Wesley Hospital, Auchenflower, Australia
| | - Frederik J Steyn
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Saint Lucia, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Herston, Australia.,Wesley Medical Research, The Wesley Hospital, Auchenflower, Australia
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14
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Rodrigues L, Rezende TJR, Wertheimer G, Santos Y, França M, Rittner L. A benchmark for hypothalamus segmentation on T1-weighted MR images. Neuroimage 2022; 264:119741. [PMID: 36368499 DOI: 10.1016/j.neuroimage.2022.119741] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 09/23/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022] Open
Abstract
The hypothalamus is a small brain structure that plays essential roles in sleep regulation, body temperature control, and metabolic homeostasis. Hypothalamic structural abnormalities have been reported in neuropsychiatric disorders, such as schizophrenia, amyotrophic lateral sclerosis, and Alzheimer's disease. Although mag- netic resonance (MR) imaging is the standard examination method for evaluating this region, hypothalamic morphological landmarks are unclear, leading to subjec- tivity and high variability during manual segmentation. Due to these limitations, it is common to find contradicting results in the literature regarding hypothalamic volumetry. To the best of our knowledge, only two automated methods are available in the literature for hypothalamus segmentation, the first of which is our previous method based on U-Net. However, both methods present performance losses when predicting images from different datasets than those used in training. Therefore, this project presents a benchmark consisting of a diverse T1-weighted MR image dataset comprising 1381 subjects from IXI, CC359, OASIS, and MiLI (the latter created specifically for this benchmark). All data were provided using automatically generated hypothalamic masks and a subset containing manually annotated masks. As a baseline, a method for fully automated segmentation of the hypothalamus on T1-weighted MR images with a greater generalization ability is presented. The pro- posed method is a teacher-student-based model with two blocks: segmentation and correction, where the second corrects the imperfections of the first block. After using three datasets for training (MiLI, IXI, and CC359), the prediction performance of the model was measured on two test sets: the first was composed of data from IXI, CC359, and MiLI, achieving a Dice coefficient of 0.83; the second was from OASIS, a dataset not used for training, achieving a Dice coefficient of 0.74. The dataset, the baseline model, and all necessary codes to reproduce the experiments are available at https://github.com/MICLab-Unicamp/HypAST and https://sites.google.com/ view/calgary-campinas-dataset/hypothalamus-benchmarking. In addition, a leaderboard will be maintained with predictions for the test set submitted by anyone working on the same task.
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Affiliation(s)
- Livia Rodrigues
- Medical Image Computing Lab, School of Electrical and Computer Engineering (FEEC), University of Campinas, Albert Einstein Street, 400, Campinas, SP 13083-887, Brazil.
| | - Thiago Junqueira Ribeiro Rezende
- Department of Neurology, School of Medical Sciences, University of Campinas, Tessalia Vieira de Camargo Street, 126, Campinas, SP 13083-887, Brazil
| | - Guilherme Wertheimer
- Department of Neurology, School of Medical Sciences, University of Campinas, Tessalia Vieira de Camargo Street, 126, Campinas, SP 13083-887, Brazil
| | - Yves Santos
- Department of Neurology, School of Medical Sciences, University of Campinas, Tessalia Vieira de Camargo Street, 126, Campinas, SP 13083-887, Brazil
| | - Marcondes França
- Department of Neurology, School of Medical Sciences, University of Campinas, Tessalia Vieira de Camargo Street, 126, Campinas, SP 13083-887, Brazil
| | - Leticia Rittner
- Medical Image Computing Lab, School of Electrical and Computer Engineering (FEEC), University of Campinas, Albert Einstein Street, 400, Campinas, SP 13083-887, Brazil
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15
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Ali M, Suh JS, Ramonas M, Hassel S, Arnott SR, Strother SC, Minuzzi L, Sassi RB, Lam RW, Milev R, Müller DJ, Taylor VH, Kennedy SH, Frey BN. A detailed manual segmentation procedure for the hypothalamus for 3T T1-weighted MRI. MethodsX 2022; 9:101864. [PMID: 36193115 PMCID: PMC9526169 DOI: 10.1016/j.mex.2022.101864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/13/2022] [Indexed: 10/31/2022] Open
Abstract
The hypothalamus is a small grey matter structure which plays a crucial role in many physiological functions. Some studies have found an association between hypothalamic volume and psychopathology, which stresses the need for a standardized method to maximize segmentation accuracy. Here, we provide a detailed step-by-step method outlining the procedures to manually segment the hypothalamus using anatomical T1w images from 3T scanners, which many neuroimaging studies collect as a standard anatomical reference image. We compared volumes generated by manual segmentation and those generated by an automatic algorithm, observing a significant difference between automatically and manually segmented hypothalamus volumes on both sides (left: U = 222842, p-value < 2.2e-16; right: U = 218520, p- value < 2.2e-16).•Significant difference exists between existing automatic segmentation methods and the manual segmentation procedure.•We discuss potential drift effects, segmentation quality issues, and suggestions on how to mitigate them.•We demonstrate that the present manual segmentation procedure using standard T1-weighted MRI may be significantly more accurate than automatic segmentation outputs.
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Affiliation(s)
- Mohammad Ali
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Jee Su Suh
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Milita Ramonas
- Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Stefanie Hassel
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Luciano Minuzzi
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Roberto B Sassi
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Roumen Milev
- Departments of Psychiatry and Psychology, Queen's University, and Providence Care Hospital, Kingston, ON, Canada
| | - Daniel J Müller
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Valerie H Taylor
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sidney H Kennedy
- Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto ON, Canada
| | - Benicio N Frey
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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16
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Guo J, Jiang Z, Biswal BB, Zhou B, Xie D, Gao Q, Sheng W, Chen H, Zhang Y, Fan Y, Wang J, Liu C, Chen H. Hypothalamic Atrophy, Expanded
CAG
Repeat, and Low Body Mass Index in Spinocerebellar Ataxia Type 3. Mov Disord 2022; 37:1541-1546. [PMID: 35426475 DOI: 10.1002/mds.29029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Jing Guo
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital University of Electronic Science and Technology of China Chengdu China
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- Department of Radiology, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Zhouyu Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province University of Electronic Science and Technology of China Chengdu China
| | - Bharat B. Biswal
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- Department of Biomedical Engineering New Jersey Institute of Technology Newark New Jersey USA
| | - Bo Zhou
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital University of Electronic Science and Technology of China Chengdu China
| | - Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Qing Gao
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province University of Electronic Science and Technology of China Chengdu China
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province University of Electronic Science and Technology of China Chengdu China
| | - Hui Chen
- Department of Radiology, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Yuhan Zhang
- Department of Radiology, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Yunshuang Fan
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province University of Electronic Science and Technology of China Chengdu China
| | - Jian Wang
- Department of Radiology, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Chen Liu
- Department of Radiology, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Huafu Chen
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital University of Electronic Science and Technology of China Chengdu China
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology University of Electronic Science and Technology of China Chengdu China
- Department of Radiology, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province University of Electronic Science and Technology of China Chengdu China
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17
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Ye S, Luo Y, Jin P, Wang Y, Zhang N, Zhang G, Chen L, Shi L, Fan D. MRI Volumetric Analysis of the Thalamus and Hypothalamus in Amyotrophic Lateral Sclerosis. Front Aging Neurosci 2022; 13:610332. [PMID: 35046789 PMCID: PMC8763328 DOI: 10.3389/fnagi.2021.610332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 11/16/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Increasing evidence has shown that amyotrophic lateral sclerosis (ALS) can result in abnormal energy metabolism and sleep disorders, even before motor dysfunction. Although the hypothalamus and thalamus are important structures in these processes, few ALS studies have reported abnormal MRI structural findings in the hypothalamus and thalamus. Purpose: We aimed to investigate volumetric changes in the thalamus and hypothalamus by using the automatic brain structure volumetry tool AccuBrain®. Methods: 3D T1-weighted magnetization-prepared gradient echo imaging (MPRAGE) scans were acquired from 16 patients with ALS with normal cognitive scores and 16 age-, sex- and education-matched healthy controls. Brain tissue and structure volumes were automatically calculated using AccuBrain®. Results: There were no significant differences in bilateral thalamic (F = 1.31, p = 0.287) or hypothalamic volumes (F = 1.65, p = 0.213) between the ALS and control groups by multivariate analysis of covariance (MANCOVA). Left and right hypothalamic volumes were correlated with whole-brain volume in patients with ALS (t = 3.19, p = 0.036; t = 3.03, p = 0.044), while the correlation between age and bilateral thalamic volumes tended to be significant after Bonferroni correction (t = 2.76, p = 0.068; t = 2.83, p = 0.06). In the control group, left and right thalamic volumes were correlated with whole-brain volume (t = 4.26, p = 0.004; t = 4.52, p = 0.004). Conclusion: Thalamic and hypothalamic volumes did not show differences between patients with normal frontotemporal function ALS and healthy controls, but further studies are still needed.
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Affiliation(s)
- Shan Ye
- Department of Neurology, Peking University Third Hospital, Beijing, China.,Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Yishan Luo
- Brain Research Institute, Shenzhen, China.,Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Pingping Jin
- Department of Neurology, Peking University Third Hospital, Beijing, China.,Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Yajun Wang
- Department of Neurology, Peking University Third Hospital, Beijing, China.,Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Nan Zhang
- Department of Neurology, Peking University Third Hospital, Beijing, China.,Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Gan Zhang
- Department of Neurology, Peking University Third Hospital, Beijing, China.,Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Lu Chen
- Department of Neurology, Peking University Third Hospital, Beijing, China.,Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Lin Shi
- Brain Research Institute, Shenzhen, China.,Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Dongsheng Fan
- Department of Neurology, Peking University Third Hospital, Beijing, China.,Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
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18
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Shapiro NL, Todd EG, Billot B, Cash DM, Iglesias JE, Warren JD, Rohrer JD, Bocchetta M. In vivo hypothalamic regional volumetry across the frontotemporal dementia spectrum. Neuroimage Clin 2022; 35:103084. [PMID: 35717886 PMCID: PMC9218583 DOI: 10.1016/j.nicl.2022.103084] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/07/2022] [Accepted: 06/11/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Frontotemporal dementia (FTD) is a spectrum of diseases characterised by language, behavioural and motor symptoms. Among the different subcortical regions implicated in the FTD symptomatology, the hypothalamus regulates various bodily functions, including eating behaviours which are commonly present across the FTD spectrum. The pattern of specific hypothalamic involvement across the clinical, pathological, and genetic forms of FTD has yet to be fully investigated, and its possible associations with abnormal eating behaviours have yet to be fully explored. METHODS Using an automated segmentation tool for volumetric T1-weighted MR images, we measured hypothalamic regional volumes in a cohort of 439 patients with FTD (197 behavioural variant FTD [bvFTD]; 7 FTD with associated motor neurone disease [FTD-MND]; 99 semantic variant primary progressive aphasia [svPPA]; 117 non-fluent variant PPA [nfvPPA]; 19 PPA not otherwise specified [PPA-NOS]) and 118 age-matched controls. We compared volumes across the clinical, genetic (29 MAPT, 32 C9orf72, 23 GRN), and pathological diagnoses (61 tauopathy, 40 TDP-43opathy, 4 FUSopathy). We correlated the volumes with presence of abnormal eating behaviours assessed with the revised version of the Cambridge Behavioural Inventory (CBI-R). RESULTS On average, FTD patients showed 14% smaller hypothalamic volumes than controls. The groups with the smallest hypothalamic regions were FTD-MND (20%), MAPT (25%) and FUS (33%), with differences mainly localised in the anterior and posterior regions. The inferior tuberal region was only significantly smaller in tauopathies (MAPT and Pick's disease) and in TDP-43 type C compared to controls and was the only regions that did not correlate with eating symptoms. PPA-NOS and nfvPPA were the groups with the least frequent eating behaviours and the least hypothalamic involvement. CONCLUSIONS Abnormal hypothalamic volumes are present in all the FTD forms, but different hypothalamic regions might play a different role in the development of abnormal eating behavioural and metabolic symptoms. These findings might therefore help in the identification of different underlying pathological mechanisms, suggesting the potential use of hypothalamic imaging biomarkers and the research of potential therapeutic targets within the hypothalamic neuropeptides.
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Affiliation(s)
- Noah L Shapiro
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, UK
| | - Emily G Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, UK
| | - Benjamin Billot
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, UK
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, UK; Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, UK; UK Dementia Research Institute at UCL, UCL, London, UK
| | - Juan Eugenio Iglesias
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, UK; Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, USA; Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Boston, USA
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, UK
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, UK.
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19
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Piguet O, Ahmed RM, Kumfor F. The Role of Oxytocin in Social Circuits and Social Behavior in Dementia. Methods Mol Biol 2022; 2384:67-80. [PMID: 34550569 DOI: 10.1007/978-1-0716-1759-5_5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Administration of intranasal oxytocin has been found to improve social cognition in a number of brain conditions, including autism spectrum disorder and schizophrenia. Whether this approach is relevant in dementias is currently unknown, particularly in frontotemporal dementia, a younger-onset dementia characterized clinically by marked changes in social cognition and behavior and focal atrophy of the frontal and temporal lobes. This chapter provides an overview of the deficits in social cognition in frontotemporal dementia and reviews the emerging evidence of intranasal oxytocin administration as a potential treatment option for these deficits. Future research directions will also be discussed.
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Affiliation(s)
- Olivier Piguet
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.
- Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.
| | - Rebekah M Ahmed
- Central Sydney Medical School and Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Memory and Cognition Clinic, Department of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Fiona Kumfor
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
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20
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Spindler M, Thiel CM. Quantitative magnetic resonance imaging for segmentation and white matter extraction of the hypothalamus. J Neurosci Res 2021; 100:564-577. [PMID: 34850453 DOI: 10.1002/jnr.24988] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 11/09/2022]
Abstract
Since the hypothalamus is involved in many neuroendocrine, metabolic, and affective disorders, detailed hypothalamic imaging has become of major interest to better characterize disease-induced tissue damages and abnormalities. Still, image contrast of conventional anatomical magnetic resonance imaging lacks morphological detail, thus complicating complete and precise segmentation of the hypothalamus. The hypothalamus' position lateral to the third ventricle and close proximity to white matter tracts including the optic tract, fornix, and mammillothalamic tract display one of the remaining shortcomings of hypothalamic segmentation, as reliable exclusion of white matter is not yet possible. Recent studies found that quantitative magnetic resonance imaging (qMRI), a method to create maps of different standardized tissue contents, improved segmentation of cortical and subcortical brain regions. So far, this has not been tested for the hypothalamus. Therefore, in this study, we investigated the usability of qMRI and diffusion MRI for the purpose of detailed and reproducible manual segmentation of the hypothalamus and data-driven white matter extraction and compared our results to recent state-of-the-art segmentations. Our results show that qMRI presents good contrast for delineation of the hypothalamus and white matter, and that the properties of these images differ between subunits, such that they can be used to reliably exclude white matter from hypothalamic tissue. We propose that qMRI poses a useful addition to detailed hypothalamic segmentation and volumetry.
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Affiliation(s)
- Melanie Spindler
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Christiane M Thiel
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.,Cluster of Excellence "Hearing4all", Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.,Research Centre Neurosensory Science, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
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21
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Suh JS, Fiori LM, Ali M, Harkness KL, Ramonas M, Minuzzi L, Hassel S, Strother SC, Zamyadi M, Arnott SR, Farzan F, Foster JA, Lam RW, MacQueen GM, Milev R, Müller DJ, Parikh SV, Rotzinger S, Sassi RB, Soares CN, Uher R, Kennedy SH, Turecki G, Frey BN. Hypothalamus volume and DNA methylation of stress axis genes in major depressive disorder: A CAN-BIND study report. Psychoneuroendocrinology 2021; 132:105348. [PMID: 34229186 DOI: 10.1016/j.psyneuen.2021.105348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/14/2021] [Accepted: 06/25/2021] [Indexed: 11/28/2022]
Abstract
Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis is considered one of the mechanisms underlying the development of major depressive disorder (MDD), but the exact nature of this dysfunction is unknown. We investigated the relationship between hypothalamus volume (HV) and blood-derived DNA methylation in MDD. We obtained brain MRI, clinical and molecular data from 181 unmedicated MDD and 90 healthy control (HC) participants. MDD participants received a 16-week standardized antidepressant treatment protocol, as part of the first Canadian Biomarker Integration Network in Depression (CAN-BIND) study. We collected bilateral HV measures via manual segmentation by two independent raters. DNA methylation and RNA sequencing were performed for three key HPA axis-regulating genes coding for the corticotropin-binding protein (CRHBP), glucocorticoid receptor (NR3C1) and FK506 binding protein 5 (FKBP5). We used elastic net regression to perform variable selection and assess predictive ability of methylation variables on HV. Left HV was negatively associated with duration of current episode (ρ = -0.17, p = 0.035). We did not observe significant differences in HV between MDD and HC or any associations between HV and treatment response at weeks 8 or 16, overall depression severity, illness duration or childhood maltreatment. We also did not observe any differentially methylated CpG sites between MDD and HC groups. After assessing functionality by correlating methylation levels with RNA expression of the respective genes, we observed that the number of functionally relevant CpG sites differed between MDD and HC groups in FKBP5 (χ2 = 77.25, p < 0.0001) and NR3C1 (χ2 = 7.29, p = 0.007). Cross-referencing functionally relevant CpG sites to those that were highly ranked in predicting HV in elastic net modeling identified one site from FKBP5 (cg03591753) and one from NR3C1 (cg20728768) within the MDD group. Stronger associations between DNA methylation, gene expression and HV in MDD suggest a novel putative molecular pathway of stress-related sensitivity in depression. Future studies should consider utilizing the epigenome and ultra-high field MR data which would allow the investigation of HV sub-fields.
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Affiliation(s)
- Jee Su Suh
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada
| | - Laura M Fiori
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Mohammad Ali
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada
| | - Kate L Harkness
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Milita Ramonas
- Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Stefanie Hassel
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | | | - Mojdeh Zamyadi
- Rotman Research Institute, Baycrest, Toronto, ON, Canada
| | | | - Faranak Farzan
- eBrain Lab, School of Mechatronic Systems Engineering, Simon Fraser University, Surrey, BC, Canada
| | - Jane A Foster
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Glenda M MacQueen
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Roumen Milev
- Departments of Psychiatry and Psychology, Queen's University, and Providence Care Hospital, Kingston, ON, Canada
| | - Daniel J Müller
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Pharmacogenetics Research Clinic, Toronto, ON, Canada
| | - Sagar V Parikh
- University of Michigan Depression Center, Ann Arbor, MI, United States
| | - Susan Rotzinger
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roberto B Sassi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Claudio N Soares
- Departments of Psychiatry and Psychology, Queen's University, and Providence Care Hospital, Kingston, ON, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto, ON, Canada
| | - Gustavo Turecki
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Benicio N Frey
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
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22
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Bocchetta M, Malpetti M, Todd EG, Rowe JB, Rohrer JD. Looking beneath the surface: the importance of subcortical structures in frontotemporal dementia. Brain Commun 2021; 3:fcab158. [PMID: 34458729 PMCID: PMC8390477 DOI: 10.1093/braincomms/fcab158] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 12/15/2022] Open
Abstract
Whilst initial anatomical studies of frontotemporal dementia focussed on cortical involvement, the relevance of subcortical structures to the pathophysiology of frontotemporal dementia has been increasingly recognized over recent years. Key structures affected include the caudate, putamen, nucleus accumbens, and globus pallidus within the basal ganglia, the hippocampus and amygdala within the medial temporal lobe, the basal forebrain, and the diencephalon structures of the thalamus, hypothalamus and habenula. At the most posterior aspect of the brain, focal involvement of brainstem and cerebellum has recently also been shown in certain subtypes of frontotemporal dementia. Many of the neuroimaging studies on subcortical structures in frontotemporal dementia have been performed in clinically defined sporadic cases. However, investigations of genetically- and pathologically-confirmed forms of frontotemporal dementia are increasingly common and provide molecular specificity to the changes observed. Furthermore, detailed analyses of sub-nuclei and subregions within each subcortical structure are being added to the literature, allowing refinement of the patterns of subcortical involvement. This review focuses on the existing literature on structural imaging and neuropathological studies of subcortical anatomy across the spectrum of frontotemporal dementia, along with investigations of brain–behaviour correlates that examine the cognitive sequelae of specific subcortical involvement: it aims to ‘look beneath the surface’ and summarize the patterns of subcortical involvement have been described in frontotemporal dementia.
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Affiliation(s)
- Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Maura Malpetti
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
| | - Emily G Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - James B Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK.,Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
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23
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Chen KX, Worley S, Foster H, Edasery D, Roknsharifi S, Ifrah C, Lipton ML. Oral contraceptive use is associated with smaller hypothalamic and pituitary gland volumes in healthy women: A structural MRI study. PLoS One 2021; 16:e0249482. [PMID: 33882080 PMCID: PMC8059834 DOI: 10.1371/journal.pone.0249482] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 03/18/2021] [Indexed: 11/19/2022] Open
Abstract
The effects of hormonal contraceptives on structural features of the hypothalamus and pituitary are incompletely understood. One prior study reported microstructural changes in the hypothalamus with oral contraceptive pill (OCP) use. However, effects on hypothalamic volume have not been reported. One prior study reported volumetric changes in the pituitary. However, this study was limited by including participants evaluated for neurological symptoms. We sought to determine if OCP use is associated with alteration of hypothalamic or pituitary volume. High-resolution 3T MRI was performed for a prospective cohort of 50 healthy women from 2016 to 2018, which comprised 21 OCP users (age, 19-29) and 29 naturally cycling women (age, 18-36). Participants were excluded if they were pregnant or had significant medical conditions including neurological, psychiatric, and endocrine disorders. After confirming reliability of the image analysis techniques, 5 raters independently performed manual segmentation of the hypothalamus and semi-automated intensity threshold-based segmentation of the pituitary using ITK-SNAP. Total intracranial volume was estimated using FreeSurfer. A general linear model tested the association of OCP use with hypothalamic and pituitary volumes. Hypothalamic (B = -81.2 ± 24.9, p = 0.002) and pituitary (B = -81.2 ± 38.7, p = 0.04) volumes in OCP users were smaller than in naturally cycling women. These findings may be related to interference with known trophic effects of sex hormones and suggest a structural correlate of central OCP effects.
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Affiliation(s)
- Ke Xun Chen
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
| | - Sandie Worley
- Department of Neurology, New York University School of Medicine, New York, NY, United States of America
| | - Henry Foster
- Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
| | - David Edasery
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
| | - Shima Roknsharifi
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
| | - Chloe Ifrah
- Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
| | - Michael L. Lipton
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
- Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine and Montefiore Health, Bronx, NY, United States of America
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24
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Korhonen T, Katisko K, Cajanus A, Hartikainen P, Koivisto AM, Haapasalo A, Remes AM, Solje E. Comparison of Prodromal Symptoms of Patients with Behavioral Variant Frontotemporal Dementia and Alzheimer Disease. Dement Geriatr Cogn Disord 2021; 49:98-106. [PMID: 32485711 DOI: 10.1159/000507544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 03/26/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Behavioral variant frontotemporal dementia (bvFTD) is the most common clinical subtype of frontotemporal lobar degeneration. bvFTD is often characterized by changes in behavior and personality, frequently leading to psychiatric misdiagnoses. On the other hand, substantial clinical overlap with other neurodegenerative diseases, such as Alzheimer disease (AD), further complicates the diagnostics. OBJECTIVE Our aim was to identify the main differences in early symptoms of bvFTD and AD in the prodromal stages of the diseases. In addition, patients with bvFTD were analyzed separately according to whether they carry the C9orf72repeat expansion or not. METHODS Patient records of bvFTD (n = 75) and AD (n = 83) patients were analyzed retrospectively for memory and neuropsychiatric symptoms, sleeping disorders, and somatic complaints before the setting of the accurate diagnosis. RESULTS A total of 84% of bvFTD patients (n = 63) and 98.8% of AD patients (n = 82) reported subjective memory disturbances in the prodromal phases of the disease. bvFTD patients presented significantly more often with sleeping disorders, headache, inexplicable collapses, transient loss of consciousness, somatization, delusions, and hallucinations, suicidality, changes in oral behaviors, and urinary problems. In addition, poor financial judgement was frequently detected in patients with prodromal bvFTD. Aberrant sensations in the nose and throat without any physical explanation, regarded as somatizations, emerged only in bvFTD patients with the C9orf72 repeat expansion. CONCLUSIONS Subjective reporting of impaired episodic memory is a poor indicator in differentiating bvFTD from AD. Sleeping disturbances, delusions, hallucinations, and unexplained somatic complaints in a patient with cognitive disturbances should prompt the clinicians to consider bvFTD as a possible diagnostic option behind these symptoms. The spectrum of symptoms in the prodromal stages of bvFTD may be more diverse than the latest criteria suggest.
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Affiliation(s)
- Titta Korhonen
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Kasper Katisko
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Antti Cajanus
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Päivi Hartikainen
- Neuro Center, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Anne M Koivisto
- Neuro Center, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Annakaisa Haapasalo
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anne M Remes
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland.,Neuro Center, Neurology, Kuopio University Hospital, Kuopio, Finland.,Research Unit of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Eino Solje
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland, .,Neuro Center, Neurology, Kuopio University Hospital, Kuopio, Finland,
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25
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Li Hi Shing S, McKenna MC, Siah WF, Chipika RH, Hardiman O, Bede P. The imaging signature of C9orf72 hexanucleotide repeat expansions: implications for clinical trials and therapy development. Brain Imaging Behav 2021; 15:2693-2719. [PMID: 33398779 DOI: 10.1007/s11682-020-00429-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 01/14/2023]
Abstract
While C9orf72-specific imaging signatures have been proposed by both ALS and FTD research groups and considerable presymptomatic alterations have also been confirmed in young mutation carriers, considerable inconsistencies exist in the literature. Accordingly, a systematic review of C9orf72-imaging studies has been performed to identify consensus findings, stereotyped shortcomings, and unique contributions to outline future directions. A formal literature review was conducted according to the STROBE guidelines. All identified papers were individually reviewed for sample size, choice of controls, study design, imaging modalities, statistical models, clinical profiling, and identified genotype-associated pathological patterns. A total of 74 imaging papers were systematically reviewed. ALS patients with GGGGCC repeat expansions exhibit relatively limited motor cortex involvement and widespread extra-motor pathology. C9orf72 positive FTD patients often show preferential posterior involvement. Reports of thalamic involvement are relatively consistent across the various phenotypes. Asymptomatic hexanucleotide repeat carriers often exhibit structural and functional changes decades prior to symptom onset. Common shortcomings included sample size limitations, lack of disease-controls, limited clinical profiling, lack of genetic testing in healthy controls, and absence of post mortem validation. There is a striking paucity of longitudinal studies and existing presymptomatic studies have not evaluated the predictive value of radiological changes with regard to age of onset and phenoconversion. With the advent of antisense oligonucleotide therapies, the meticulous characterisation of C9orf72-associated changes has gained practical relevance. Neuroimaging offers non-invasive biomarkers for future clinical trials, presymptomatic ascertainment, diagnostic and prognostic applications.
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Affiliation(s)
- Stacey Li Hi Shing
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Mary Clare McKenna
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - We Fong Siah
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Rangariroyashe H Chipika
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Orla Hardiman
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.
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26
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Stewart CA, Finger EC. The supraoptic and paraventricular nuclei in healthy aging and neurodegeneration. HANDBOOK OF CLINICAL NEUROLOGY 2021; 180:105-123. [PMID: 34225924 DOI: 10.1016/b978-0-12-820107-7.00007-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The supraoptic (SON) and paraventricular (PVN) nuclei of the hypothalamus undergo structural and functional changes over the course of healthy aging. These nuclei and their connections are also heterogeneously affected by several different neurodegenerative diseases. This chapter reviews the involvement of the SON and PVN, the hypothalamic-pituitary axes, and the peptide hormones produced in both nuclei in healthy aging and in neurodegeneration, with a focus on Alzheimer's disease (AD), frontotemporal dementia (FTD), amyotrophic lateral sclerosis, progressive supranuclear palsy, Parkinson's disease (PD), dementia with Lewy bodies (DLB), multiple system atrophy, and Huntington's disease. Although age-related changes occur in several regions of the hypothalamus, the SON and PVN are relatively preserved during aging and in many neurodegenerative disorders. With aging, these nuclei do undergo some sexually dimorphic changes including changes in size and levels of vasopressin and corticotropin-releasing hormone, likely due to age-related changes in sex hormones. In contrast, oxytocinergic cells and circulating levels of thyrotropin-releasing hormone remain stable. A relative resistance to many forms of neurodegenerative pathology is also observed, in comparison to other hypothalamic and brain regions. Mirroring the pattern observed in aging, pathologic hallmarks of AD, and some subtypes of FTD are observed in the PVN, though to a milder degree than are observed in other brain regions, while the SON is relatively spared. In contrast, the SON appears more vulnerable to alpha-synuclein pathology of DLB and PD. The consequences of these alterations may help to inform several of the physiologic changes observed in aging and neurodegenerative disease.
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Affiliation(s)
- Chloe A Stewart
- Department of Clinical Neurological Sciences, Lawson Health Research Institute, London, ON, Canada; Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Elizabeth C Finger
- Department of Clinical Neurological Sciences, Lawson Health Research Institute, London, ON, Canada; Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
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27
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Ahmed RM, Halliday G, Hodges JR. Hypothalamic symptoms of frontotemporal dementia disorders. HANDBOOK OF CLINICAL NEUROLOGY 2021; 182:269-280. [PMID: 34266598 DOI: 10.1016/b978-0-12-819973-2.00019-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Frontotemporal dementia (FTD) has traditionally been regarded as a disease of cognition and behavior, but emerging evidence suggests that the disease also affects body functions including changes in eating behavior and metabolism, autonomic function, sleep behavior, and sexual function. Central to these changes are potentially complex neural networks involving the hypothalamus, with hypothalamic atrophy shown in behavioral variant FTD. The physiological changes found in FTD are reviewed and the key neural networks and neuroendocrine changes mediating these changes in function discussed, including the ability to use these changes as biomarkers to aid in disease diagnosis, monitoring disease progression, and as potential treatment targets.
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Affiliation(s)
- Rebekah M Ahmed
- Memory and Cognition Clinic, Department of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Central Sydney Medical School and Brain & Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| | - Glenda Halliday
- Central Sydney Medical School and Brain & Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - John R Hodges
- Central Sydney Medical School and Brain & Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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28
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Bocchetta M, Todd EG, Peakman G, Cash DM, Convery RS, Russell LL, Thomas DL, Eugenio Iglesias J, van Swieten JC, Jiskoot LC, Seelaar H, Borroni B, Galimberti D, Sanchez-Valle R, Laforce R, Moreno F, Synofzik M, Graff C, Masellis M, Carmela Tartaglia M, Rowe JB, Vandenberghe R, Finger E, Tagliavini F, de Mendonça A, Santana I, Butler CR, Ducharme S, Gerhard A, Danek A, Levin J, Otto M, Sorbi S, Le Ber I, Pasquier F, Rohrer JD. Differential early subcortical involvement in genetic FTD within the GENFI cohort. Neuroimage Clin 2021; 30:102646. [PMID: 33895632 PMCID: PMC8099608 DOI: 10.1016/j.nicl.2021.102646] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/08/2021] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Studies have previously shown evidence for presymptomatic cortical atrophy in genetic FTD. Whilst initial investigations have also identified early deep grey matter volume loss, little is known about the extent of subcortical involvement, particularly within subregions, and how this differs between genetic groups. METHODS 480 mutation carriers from the Genetic FTD Initiative (GENFI) were included (198 GRN, 202 C9orf72, 80 MAPT), together with 298 non-carrier cognitively normal controls. Cortical and subcortical volumes of interest were generated using automated parcellation methods on volumetric 3 T T1-weighted MRI scans. Mutation carriers were divided into three disease stages based on their global CDR® plus NACC FTLD score: asymptomatic (0), possibly or mildly symptomatic (0.5) and fully symptomatic (1 or more). RESULTS In all three groups, subcortical involvement was seen at the CDR 0.5 stage prior to phenoconversion, whereas in the C9orf72 and MAPT mutation carriers there was also involvement at the CDR 0 stage. In the C9orf72 expansion carriers the earliest volume changes were in thalamic subnuclei (particularly pulvinar and lateral geniculate, 9-10%) cerebellum (lobules VIIa-Crus II and VIIIb, 2-3%), hippocampus (particularly presubiculum and CA1, 2-3%), amygdala (all subregions, 2-6%) and hypothalamus (superior tuberal region, 1%). In MAPT mutation carriers changes were seen at CDR 0 in the hippocampus (subiculum, presubiculum and tail, 3-4%) and amygdala (accessory basal and superficial nuclei, 2-4%). GRN mutation carriers showed subcortical differences at CDR 0.5 in the presubiculum of the hippocampus (8%). CONCLUSIONS C9orf72 expansion carriers show the earliest and most widespread changes including the thalamus, basal ganglia and medial temporal lobe. By investigating individual subregions, changes can also be seen at CDR 0 in MAPT mutation carriers within the limbic system. Our results suggest that subcortical brain volumes may be used as markers of neurodegeneration even prior to the onset of prodromal symptoms.
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Affiliation(s)
- Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Emily G Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Georgia Peakman
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Rhian S Convery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - David L Thomas
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Juan Eugenio Iglesias
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom; Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, USA; Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, USA
| | - John C van Swieten
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, the Netherlands
| | - Lize C Jiskoot
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, the Netherlands
| | - Harro Seelaar
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, the Netherlands
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Raquel Sanchez-Valle
- Neurology Department, Hospital Clinic, Institut d'Investigacions Biomèdiques, Barcelona, Spain
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, Faculté de Médecine, Université Laval, Québec, Canada
| | - Fermin Moreno
- Hospital Universitario Donostia, San Sebastian, Spain
| | - Matthis Synofzik
- Department of Cognitive Neurology, Center for Neurology, Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - Caroline Graff
- Karolinska Institutet, Department NVS, Division of Neurogeriatrics, Stockholm, Sweden; Unit for Hereditray Dementia, Theme Aging, Karolinska University Hospital-Solna Stockholm Sweden
| | - Mario Masellis
- Campbell Cognitive Neurology Research Unit, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Maria Carmela Tartaglia
- Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, Toronto, ON, Canada
| | - James B Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust and Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
| | - Fabrizio Tagliavini
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Chris R Butler
- Department of Clinical Neurology, University of Oxford, Oxford, United Kingdom
| | - Simon Ducharme
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg-Essen, Germany
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Munich German Center for Neurodegenerative Diseases (DZNE), Munich Munich Cluster of Systems Neurology, Munich, Germany
| | - Johannes Levin
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Munich German Center for Neurodegenerative Diseases (DZNE), Munich Munich Cluster of Systems Neurology, Munich, Germany
| | - Markus Otto
- Department of Neurology, University Hospital Ulm, Ulm, Germany
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Isabelle Le Ber
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau- ICM, Inserm U1127, CNRS UMR 7225, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Centre deréférence des démences rares ou précoces, IM2A, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France
| | - Florence Pasquier
- Univ Lille, France; Inserm 1172 Lille, France; CHU, CNR-MAJ, Labex Distalz, LiCENDLille, France
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
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29
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Ahmed RM, Hodges JR, Piguet O. Behavioural Variant Frontotemporal Dementia: Recent Advances in the Diagnosis and Understanding of the Disorder. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1281:1-15. [PMID: 33433865 DOI: 10.1007/978-3-030-51140-1_1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Frontotemporal dementia (FTD), particularly the behavioural variant (bvFTD) form, has fascinated researchers. Recent years have seen an increasing interest in aspects of bvFTD that extend beyond the initial focus on cognitive changes and frontal executive dysfunction. Changes have been identified in aspects including fundamental changes in physiology and metabolism, and cognitive domains such as episodic memory. Work on social cognition has emphasised the importance of a breakdown in interpreting and expressing emotions, while the overlap between psychiatric disorders and bvFTD has been brought into focus by the finding of high rates of psychotic features in carriers of the c9orf72 gene expansion. We review these aspects in the chapter " Behavioural variant frontotemporal dementia: Recent advances in diagnosis and understanding of the disorder" and also potential markers of disease progression and early diagnosis that may aid in the development of treatment options, which have thus far eluded us.
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Affiliation(s)
- Rebekah M Ahmed
- Memory and Cognition Clinic, Department of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, NSW, Australia. .,Central Sydney Medical School and Brain & Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - John R Hodges
- Central Sydney Medical School and Brain & Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Olivier Piguet
- School of Psychology and Brain & Mind Centre, The University of Sydney, Sydney, NSW, Australia
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Izuhara M, Miura S, Otsuki K, Nagahama M, Hayashida M, Hashioka S, Asou H, Kitagaki H, Inagaki M. Magnetic Resonance Spectroscopy in the Ventral Tegmental Area Distinguishes Responders to Suvorexant Prior to Treatment: A 4-Week Prospective Cohort Study. Front Psychiatry 2021; 12:714376. [PMID: 34497544 PMCID: PMC8419448 DOI: 10.3389/fpsyt.2021.714376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The ventral tegmental area (VTA; a dopaminergic nucleus) plays an important role in the sleep-wake regulation system including orexin system. In addition to neuronal activity, there is increasing evidence for an important role of glial cells (i.e., astrocytes and microglia) in these systems. The present study examined the utility of magnetic resonance spectroscopy (MRS) for detecting neural and/or glial changes in the VTA to distinguish responders from non-responders before treatment with the orexin receptor antagonist suvorexant. Methods: A total of 50 patients were screened and 9 patients were excluded. The remaining 41 patients with insomnia who have or not a psychiatric disease who were expected to receive suvorexant treatment were included in this study. We compared MRS signals in the VTA between responders to suvorexant and non-responders before suvorexant use. Based on previous reports, suvorexant responders were defined as patients who improved ≥3 points on the Pittsburgh Sleep Quality Index after 4 weeks of suvorexant use. MRS data included choline (reflects non-specific cell membrane breakdown, including of glial cells) and N-acetylaspartate (a decrease reflects neuronal degeneration). Results: Among 41 examined patients, 20 patients responded to suvorexant and 21 patients did not. By MRS, the choline/creatine and phosphorylcreatine ratio in the VTA was significantly high in non-responders compared with responders (p = 0.039) before suvorexant treatment. There was no difference in the N-acetylaspartate/creatine and phosphorylcreatine ratio (p = 0.297) between the two groups. Conclusions: Changes in glial viability in the VTA might be used to distinguish responders to suvorexant from non-responders before starting treatment. These findings may help with more appropriate selection of patients for suvorexant treatment in clinical practice. Further, we provide novel possible evidence for a relationship between glial changes in the VTA and the orexin system, which may aid in the development of new hypnotics focusing on the VTA and/or glial cells.
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Affiliation(s)
- Muneto Izuhara
- Department of Clinical Laboratory, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Shoko Miura
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Koji Otsuki
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Michiharu Nagahama
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Maiko Hayashida
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Sadayuki Hashioka
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Hiroya Asou
- Department of Radiology, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Hajime Kitagaki
- Department of Radiology, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Masatoshi Inagaki
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
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Hong AR, Lee M, Lee JH, Kim JH, Kim YH, Choi HJ. Clinical Implication of Individually Tailored Segmentation Method for Distorted Hypothalamus in Craniopharyngioma. Front Endocrinol (Lausanne) 2021; 12:763523. [PMID: 34987474 PMCID: PMC8720929 DOI: 10.3389/fendo.2021.763523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/06/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Several attempts have been done to capture damaged hypothalamus (HT) using volumetric measurements to predict the development of hypothalamic obesity in patients with craniopharyngioma (CP). This study was to develop a novel method of HT volume measurement and examine the associations between postoperative HT volume and clinical parameters in patients with CP. METHODS We included 78 patients with adult-onset CP who underwent surgical resection. Postoperative HT volume was measured using T1- and T2-weighted magnetic resonance imaging (MRI) with a slice thickness of 3 mm, and corrected for temporal lobe volume. We collected data on pre- and postoperative body weights, which were measured at the time of HT volume measurements. RESULTS The corrected postoperative HT volume measured using T1- and T2-weighted images was significantly correlated (r=0.51 [95% confidence interval (CI) 0.32 to 0.67], P<0.01). However, HT volume was overestimated using T1-weighted images owing to obscured MR signal of the thalamus in patients with severe HT damage. Therefore, we used T2-weighted images to evaluate its clinical implications in 72 patients with available medical data. Postoperative HT volume was negatively associated with preoperative body weight and preoperative tumor volume (r=-0.25 [95% CI -0.45 to -0.04], P=0.04 and r=-0.26 [95% CI -0.40 to -0.15], P=0.03, respectively). In the subgroup analysis of CP patients who underwent primary surgery (n=56), pre- and postoperative body weights were negatively associated with HT volume (r=-0.30 [95% CI -0.53 to -0.03], P=0.03 and r=-0.29 [95% CI -0.53 to -0.02], P=0.03, respectively). CONCLUSIONS Adult-onset CP patients showed negative associations between postoperative HT volume and preoperative/postoperative body weight using a new method of HT volume measurement based on T2-weighted images.
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Affiliation(s)
- A Ram Hong
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Miwoo Lee
- Department of Anatomy, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung Hyun Lee
- Department of Pituitary Center, Seoul National University College of Medicine, Seoul, South Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Jung Hee Kim
- Department of Pituitary Center, Seoul National University College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Yong Hwy Kim
- Department of Pituitary Center, Seoul National University College of Medicine, Seoul, South Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyung Jin Choi
- Department of Anatomy, Seoul National University College of Medicine, Seoul, South Korea
- *Correspondence: Hyung Jin Choi,
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Spindler M, Özyurt J, Thiel CM. Automated diffusion-based parcellation of the hypothalamus reveals subunit-specific associations with obesity. Sci Rep 2020; 10:22238. [PMID: 33335266 PMCID: PMC7747731 DOI: 10.1038/s41598-020-79289-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 12/07/2020] [Indexed: 01/10/2023] Open
Abstract
The hypothalamus is a small, yet highly versatile structure mainly involved in bodily functions such as control of food intake and endocrine activity. Functional anatomy of different hypothalamic areas is mainly investigated using structural MRI, validated by ex-vivo histological studies. Based on diffusion-weighted imaging (DWI), recent automated clustering methods provide robust tools for parcellation. Using data of 100 healthy adults provided by the Human Connectome Project Database, we applied DWI-based automated clustering to the hypothalamus and related microstructural properties in these hypothalamic compartments to obesity. Our results suggest that the hypothalamus can be reliably partitioned into four clusters in each hemisphere using diffusion-based parcellation. These correspond to an anterior–superior, anterior-inferior, intermediate, and posterior cluster. Obesity was predicted by mean diffusivity of the anterior–superior cluster, suggesting altered inhibition of food intake. The proposed method provides an automated hypothalamic parcellation technique based on DWI data to explore anatomy and function of hypothalamic subunits in vivo in humans.
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Affiliation(s)
- Melanie Spindler
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.
| | - Jale Özyurt
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Christiane M Thiel
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.,Cluster of Excellence "Hearing4all", Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.,Research Centre Neurosensory Science, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
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Abstract
Since the discovery of functionally competent, energy-consuming brown adipose tissue (BAT) in adult humans, much effort has been devoted to exploring this tissue as a means for increasing energy expenditure to counteract obesity. However, despite promising effects on metabolic rate and insulin sensitivity, no convincing evidence for weight-loss effects of cold-activated human BAT exists to date. Indeed, increasing energy expenditure would naturally induce compensatory feedback mechanisms to defend body weight. Interestingly, BAT is regulated by multiple interactions with the hypothalamus from regions overlapping with centers for feeding behavior and metabolic control. Therefore, in the further exploration of BAT as a potential source of novel drug targets, we discuss the hypothalamic orchestration of BAT activity and the relatively unexplored BAT feedback mechanisms on neuronal regulation. With a holistic view on hypothalamic-BAT interactions, we aim to raise ideas and provide a new perspective on this circuit and highlight its clinical relevance.
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Affiliation(s)
- Jo B Henningsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark;
| | - Camilla Scheele
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark;
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Neudorfer C, Germann J, Elias GJB, Gramer R, Boutet A, Lozano AM. A high-resolution in vivo magnetic resonance imaging atlas of the human hypothalamic region. Sci Data 2020; 7:305. [PMID: 32934244 PMCID: PMC7492465 DOI: 10.1038/s41597-020-00644-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/17/2020] [Indexed: 01/18/2023] Open
Abstract
The study of the hypothalamus and its topological changes provides valuable insights into underlying physiological and pathological processes. Owing to technological limitations, however, in vivo atlases detailing hypothalamic anatomy are currently lacking in the literature. In this work we aim to overcome this shortcoming by generating a high-resolution in vivo anatomical atlas of the human hypothalamic region. A minimum deformation averaging (MDA) pipeline was employed to produce a normalized, high-resolution template from multimodal magnetic resonance imaging (MRI) datasets. This template was used to delineate hypothalamic (n = 13) and extrahypothalamic (n = 12) gray and white matter structures. The reliability of the atlas was evaluated as a measure for voxel-wise volume overlap among raters. Clinical application was demonstrated by superimposing the atlas into datasets of patients diagnosed with a hypothalamic lesion (n = 1) or undergoing hypothalamic (n = 1) and forniceal (n = 1) deep brain stimulation (DBS). The present template serves as a substrate for segmentation of brain structures, specifically those featuring low contrast. Conversely, the segmented hypothalamic atlas may inform DBS programming procedures and may be employed in volumetric studies.
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Affiliation(s)
- Clemens Neudorfer
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - Jürgen Germann
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - Gavin J B Elias
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - Robert Gramer
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - Alexandre Boutet
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Canada.
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35
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Automated segmentation of the hypothalamus and associated subunits in brain MRI. Neuroimage 2020; 223:117287. [PMID: 32853816 PMCID: PMC8417769 DOI: 10.1016/j.neuroimage.2020.117287] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/17/2020] [Accepted: 08/09/2020] [Indexed: 01/19/2023] Open
Abstract
A publicly available deep learning tool to segment the hypothalamus and its subunits. Our tool outperforms inter-rater accuracy and approaches intra-rater precision level. It can robustly generalise to unseen heterogeneous datasets. It yields a rejection rate of less than 1% in a QC analysis performed on 675 scans. It detects subtle subunit-specific hypothalamic atrophy in Alzheimer’s Disease.
Despite the crucial role of the hypothalamus in the regulation of the human body, neuroimaging studies of this structure and its nuclei are scarce. Such scarcity partially stems from the lack of automated segmentation tools, since manual delineation suffers from scalability and reproducibility issues. Due to the small size of the hypothalamus and the lack of image contrast in its vicinity, automated segmentation is difficult and has been long neglected by widespread neuroimaging packages like FreeSurfer or FSL. Nonetheless, recent advances in deep machine learning are enabling us to tackle difficult segmentation problems with high accuracy. In this paper we present a fully automated tool based on a deep convolutional neural network, for the segmentation of the whole hypothalamus and its subregions from T1-weighted MRI scans. We use aggressive data augmentation in order to make the model robust to T1-weighted MR scans from a wide array of different sources, without any need for preprocessing. We rigorously assess the performance of the presented tool through extensive analyses, including: inter- and intra-rater variability experiments between human observers; comparison of our tool with manual segmentation; comparison with an automated method based on multi-atlas segmentation; assessment of robustness by quality control analysis of a larger, heterogeneous dataset (ADNI); and indirect evaluation with a volumetric study performed on ADNI. The presented model outperforms multi-atlas segmentation scores as well as inter-rater accuracy level, and approaches intra-rater precision. Our method does not require any preprocessing and runs in less than a second on a GPU, and approximately 10 seconds on a CPU. The source code as well as the trained model are publicly available at https://github.com/BBillot/hypothalamus_seg, and will also be distributed with FreeSurfer.
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36
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Convery RS, Neason MR, Cash DM, Cardoso MJ, Modat M, Ourselin S, Warren JD, Rohrer JD, Bocchetta M. Basal forebrain atrophy in frontotemporal dementia. NEUROIMAGE-CLINICAL 2020; 26:102210. [PMID: 32143137 PMCID: PMC7058403 DOI: 10.1016/j.nicl.2020.102210] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/22/2020] [Accepted: 02/12/2020] [Indexed: 12/16/2022]
Abstract
Background The basal forebrain is a subcortical structure that plays an important role in learning, attention, and memory. Despite the known subcortical involvement in frontotemporal dementia (FTD), there is little research into the role of the basal forebrain in this disease. We aimed to investigate differences in basal forebrain volumes between clinical, genetic, and pathological diagnoses of FTD. Methods 356 patients with FTD were recruited from the UCL Dementia Research Centre and matched on age and gender with 83 cognitively normal controls. All subjects had a T1-weighted MR scan suitable for analysis. Basal forebrain volumes were calculated using the Geodesic Information Flow (GIF) parcellation method and were compared between clinical (148 bvFTD, 82 svPPA, 103 nfvPPA, 14 PPA–NOS, 9 FTD–MND), genetic (24 MAPT, 15 GRN, 26 C9orf72) and pathological groups (28 tau, 3 FUS, 35 TDP-43) and controls. A subanalysis was also performed comparing pathological subgroups of tau (11 Pick's disease, 6 FTDP-17, 7 CBD, 4 PSP) and TDP-43 (12 type A, 2 type B, 21 type C). Results All clinical subtypes of FTD showed significantly smaller volumes than controls (p ≤ 0.010, ANCOVA), with svPPA (10% volumetric difference) and bvFTD (9%) displaying the smallest volumes. Reduced basal forebrain volumes were also seen in MAPT mutations (18%, p < 0.0005) and in individuals with pathologically confirmed FTDP-17 (17%), Pick's disease (12%), and TDP-43 type C (8%) (p < 0.001). Conclusion Involvement of the basal forebrain is a common feature in FTD, although the extent of volume reduction differs between clinical, genetic, and pathological diagnoses. Tauopathies, particularly those with MAPT mutations, had the smallest volumes. However, atrophy was also seen in those with TDP-43 type C pathology (most of whom have svPPA clinically). This suggests that the basal forebrain is vulnerable to multiple types of FTD-associated protein inclusions.
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Affiliation(s)
- Rhian S Convery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Mollie R Neason
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - M Jorge Cardoso
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Marc Modat
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
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Higher body mass index is linked to altered hypothalamic microstructure. Sci Rep 2019; 9:17373. [PMID: 31758009 PMCID: PMC6874651 DOI: 10.1038/s41598-019-53578-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/01/2019] [Indexed: 01/23/2023] Open
Abstract
Animal studies suggest that obesity-related diets induce structural changes in the hypothalamus, a key brain area involved in energy homeostasis. Whether this translates to humans is however largely unknown. Using a novel multimodal approach with manual segmentation, we here show that a higher body mass index (BMI) selectively predicted higher proton diffusivity within the hypothalamus, indicative of compromised microstructure in the underlying tissue, in a well-characterized population-based cohort (n1 = 338, 48% females, age 21-78 years, BMI 18-43 kg/m²). Results were independent from confounders and confirmed in another independent sample (n2 = 236). In addition, while hypothalamic volume was not associated with obesity, we identified a sexual dimorphism and larger hypothalamic volumes in the left compared to the right hemisphere. Using two large samples of the general population, we showed that a higher BMI specifically relates to altered microstructure in the hypothalamus, independent from confounders such as age, sex and obesity-associated co-morbidities. This points to persisting microstructural changes in a key regulatory area of energy homeostasis occurring with excessive weight. Our findings may help to better understand the pathomechanisms of obesity and other eating-related disorders.
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38
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Sani TP, Bond RL, Marshall CR, Hardy CJ, Russell LL, Moore KM, Slattery CF, Paterson RW, Woollacott IO, Wendi IP, Crutch SJ, Schott JM, Rohrer JD, Eriksson SH, Dijk DJ, Warren JD. Sleep symptoms in syndromes of frontotemporal dementia and Alzheimer's disease: A proof-of-principle behavioural study. eNeurologicalSci 2019; 17:100212. [PMID: 31828228 PMCID: PMC6889070 DOI: 10.1016/j.ensci.2019.100212] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 10/04/2019] [Accepted: 10/28/2019] [Indexed: 11/17/2022] Open
Abstract
Sleep is a key concern in dementias but their sleep phenotypes are not well defined. We addressed this issue in major FTD and AD syndromes versus healthy older controls. We surveyed sleep duration, quality and disruptive events, and daytime somnolence. Sleep symptoms were frequent in FTD and AD and distinguished these diseases. Sleep disturbance is an important clinical issue across major FTD and AD syndromes.
Sleep disruption is a key clinical issue in the dementias but the sleep phenotypes of these diseases remain poorly characterised. Here we addressed this issue in a proof-of-principle study of 67 patients representing major syndromes of frontotemporal dementia (FTD) and Alzheimer’s disease (AD), in relation to 25 healthy older individuals. We collected reports on clinically-relevant sleep characteristics - time spent overnight in bed, sleep quality, excessive daytime somnolence and disruptive sleep events. Difficulty falling or staying asleep at night and excessive daytime somnolence were significantly more frequently reported for patients with both FTD and AD than healthy controls. On average, patients with FTD and AD retired earlier and patients with AD spent significantly longer in bed overnight than did healthy controls. Excessive daytime somnolence was significantly more frequent in the FTD group than the AD group; AD syndromic subgroups showed similar sleep symptom profiles while FTD subgroups showed more variable profiles. Sleep disturbance is a significant clinical issue in major FTD and AD variant syndromes and may be even more salient in FTD than AD. These preliminary findings warrant further systematic investigation with electrophysiological and neuroanatomical correlation in major proteinopathies.
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Affiliation(s)
- Tara P. Sani
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
- Neurology Department, Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Rebecca L. Bond
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Charles R. Marshall
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Chris J.D. Hardy
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Lucy L. Russell
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Katrina M. Moore
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Catherine F. Slattery
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Ross W. Paterson
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Ione O.C. Woollacott
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Indra Putra Wendi
- Department of Chemistry and Biochemistry, Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Sebastian J. Crutch
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jonathan M. Schott
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Jonathan D. Rohrer
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Sofia H. Eriksson
- Department of Clinical and Experiential Epilepsy, UCL Institute of Neurology, University College London, London, UK
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, University of Surrey, UK
- Dementia Research Institute, UK
| | - Jason D. Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
- Corresponding author at: Dementia Research Centre, UCL Institute of Neurology, University College London, London WC1N 3BG, UK.
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Zhou Z, Li X, Jin Y, Zheng Y, Jia S, Jiao J, Zheng X. Regional cerebral blood flow correlates eating abnormalities in frontotemporal dementia. Neurol Sci 2019; 40:1695-1700. [DOI: 10.1007/s10072-019-03910-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 04/19/2019] [Indexed: 11/30/2022]
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40
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Convery R, Mead S, Rohrer JD. Review: Clinical, genetic and neuroimaging features of frontotemporal dementia. Neuropathol Appl Neurobiol 2019; 45:6-18. [DOI: 10.1111/nan.12535] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/10/2018] [Indexed: 12/12/2022]
Affiliation(s)
- R. Convery
- Dementia Research Centre; Department of Neurodegenerative Disease; UCL Queen Square Institute of Neurology; London UK
| | - S. Mead
- UCL Institute of Prion Diseases; MRC Prion Unit at UCL; London UK
| | - J. D. Rohrer
- Dementia Research Centre; Department of Neurodegenerative Disease; UCL Queen Square Institute of Neurology; London UK
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Harrison IF, Whitaker R, Bertelli PM, O’Callaghan JM, Csincsik L, Bocchetta M, Ma D, Fisher A, Ahmed Z, Murray TK, O’Neill MJ, Rohrer JD, Lythgoe MF, Lengyel I. Optic nerve thinning and neurosensory retinal degeneration in the rTg4510 mouse model of frontotemporal dementia. Acta Neuropathol Commun 2019; 7:4. [PMID: 30616676 PMCID: PMC6322294 DOI: 10.1186/s40478-018-0654-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 12/20/2018] [Indexed: 01/09/2023] Open
Abstract
Visual impairments, such as difficulties in reading and finding objects, perceiving depth and structure from motion, and impaired stereopsis, have been reported in tauopathy disorders, such as frontotemporal dementia (FTD). These impairments however have been previously attributed to cortical pathologies rather than changes in the neurosensory retina or the optic nerve. Here, we examined tau pathology in the neurosensory retina of the rTg(tauP301L)4510 mouse model of FTD. Optic nerve pathology in mice was also assessed using MRI, and corresponding measurements taken in a cohort of five FTD sufferers and five healthy controls. rTg(tauP301L)4510 mice were imaged (T2-weighted MRI) prior to being terminally anesthetized and eyes and brains removed for immunohistochemical and histological analysis. Central and peripheral retinal labelling of tau and phosphorylated tau (pTau) was quantified and retinal layer thicknesses and cell numbers assessed. MR volumetric changes of specific brain regions and the optic nerve were compared to tau accumulation and cell loss in the visual pathway. In addition, the optic nerves of a cohort of healthy controls and behavioural variant FTD patients, were segmented from T1- and T2-weighted images for volumetric study. Accumulation of tau and pTau were observed in both the central and peripheral retinal ganglion cell (RGC), inner plexiform and inner nuclear layers of the neurosensory retina of rTg(tauP301L)4510 mice. This pathology was associated with reduced nuclear density (− 24.9 ± 3.4%) of the central RGC layer, and a reduced volume (− 19.3 ± 4.6%) and elevated T2 signal (+ 27.1 ± 1.8%) in the optic nerve of the transgenic mice. Significant atrophy of the cortex (containing the visual cortex) was observed but not in other area associated with visual processing, e.g. the lateral geniculate nucleus or superior colliculus. Atrophic changes in optic nerve volume were similarly observed in FTD patients (− 36.6 ± 2.6%). The association between tau-induced changes in the neurosensory retina and reduced optic nerve volume in mice, combined with the observation of optic nerve atrophy in clinical FTD suggests that ophthalmic tau pathology may also exist in the eyes of FTD patients. If tau pathology and neurodegeneration in the retina were to reflect the degree of cortical tau burden, then cost-effective and non-invasive imaging of the neurosensory retina could provide valuable biomarkers in tauopathy. Further work should aim to validate whether these observations are fully translatable to a clinical scenario, which would recommend follow-up retinal and optic nerve examination in FTD.
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Blanco-Hinojo L, Pujol J, Esteba-Castillo S, Martínez-Vilavella G, Giménez-Palop O, Gabau E, Casamitjana L, Deus J, Novell R, Caixàs A. Lack of response to disgusting food in the hypothalamus and related structures in Prader Willi syndrome. NEUROIMAGE-CLINICAL 2019; 21:101662. [PMID: 30639180 PMCID: PMC6412080 DOI: 10.1016/j.nicl.2019.101662] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 11/22/2018] [Accepted: 01/04/2019] [Indexed: 12/31/2022]
Abstract
Objective To investigate, based on a putative abnormal neural processing of disgusting signals in Prader Willi syndrome (PWS) patients, the brain response to visual representations of disgusting food in PWS using functional MRI (fMRI). Methods Twenty-one genetically-confirmed PWS patients, 30 age- and sex-matched and 28 BMI-matched control subjects viewed a movie depicting disgusting food-related scenes interspersed with scenes of appetizing food while fMRI was acquired. Brain activation maps were compared between groups and correlated with disgust and hunger ratings. Results At the cortical level, the response to disgusting food representations in PWS patients was qualitatively similar to that of control subjects, albeit less extensive, and engaged brain regions typically related to visually-evoked disgust, such as the anterior insula/frontal operculum, the lateral frontal cortex and visual areas. By contrast, activation was almost absent in limbic structures directly concerned with the regulation of instinctive behavior robustly activated in control subjects, such as the hypothalamus, amygdala/hippocampus and periaqueductal gray. Conclusions Our study provides novel insights into the neural substrates of appetite control in a genetically-mediated cause of obesity. The presence of significant cortical changes further indicates that PWS patients consciously process disgusting stimuli, but the virtual absence of response in deep, limbic structures suggests that disgusting signals do not adequately reach the primary brain system for the appetite control. We report an abnormal pattern of brain response to images of disgusting food in PWS. The activation demonstrated by PWS patients was restricted to the cerebral cortex. Higher subjective disgust ratings were associated with greater insula activation. In contrast, the neural response was almost absent in deep subcortical structures. Disgusting signals may not adequately reach a main brain system for appetite control.
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Affiliation(s)
- Laura Blanco-Hinojo
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003 Barcelona, Spain; Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, 08003 Barcelona, Spain
| | - Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003 Barcelona, Spain; Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, 08003 Barcelona, Spain.
| | - Susanna Esteba-Castillo
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain.
| | | | - Olga Giménez-Palop
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT- UAB, 08208 Sabadell, Spain
| | - Elisabeth Gabau
- Clinical Genetics, Pediatrics Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT- UAB, 08208 Sabadell, Spain.
| | - Laia Casamitjana
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT- UAB, 08208 Sabadell, Spain.
| | - Joan Deus
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003 Barcelona, Spain; Department of Clinical and Health Psychology, Autonomous University of Barcelona, 08193 Barcelona, Spain.
| | - Ramón Novell
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain.
| | - Assumpta Caixàs
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT- UAB, 08208 Sabadell, Spain
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Vercruysse P, Vieau D, Blum D, Petersén Å, Dupuis L. Hypothalamic Alterations in Neurodegenerative Diseases and Their Relation to Abnormal Energy Metabolism. Front Mol Neurosci 2018; 11:2. [PMID: 29403354 PMCID: PMC5780436 DOI: 10.3389/fnmol.2018.00002] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/03/2018] [Indexed: 12/11/2022] Open
Abstract
Neurodegenerative diseases (NDDs) are disorders characterized by progressive deterioration of brain structure and function. Selective neuronal populations are affected leading to symptoms which are prominently motor in amyotrophic lateral sclerosis (ALS) or Huntington’s disease (HD), or cognitive in Alzheimer’s disease (AD) and fronto-temporal dementia (FTD). Besides the common existence of neuronal loss, NDDs are also associated with metabolic changes such as weight gain, weight loss, loss of fat mass, as well as with altered feeding behavior. Importantly, preclinical research as well as clinical studies have demonstrated that altered energy homeostasis influences disease progression in ALS, AD and HD, suggesting that identification of the pathways leading to perturbed energy balance might provide valuable therapeutic targets Signals from both the periphery and central inputs are integrated in the hypothalamus, a major hub for the control of energy balance. Recent research identified major hypothalamic changes in multiple NDDs. Here, we review these hypothalamic alterations and seek to identify commonalities and differences in hypothalamic involvement between the different NDDs. These hypothalamic defects could be key in the development of perturbations in energy homeostasis in NDDs and further understanding of the underlying mechanisms might open up new avenues to not only treat weight loss but also to ameliorate overall neurological symptoms.
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Affiliation(s)
- Pauline Vercruysse
- UMR-S 1118, Faculté de Médecine, Institut National de la Santé et de la Recherche Médicale (INSERM), Strasbourg, France.,UMR-S1118, Université de Strasbourg, Strasbourg, France.,Department of Neurology, Ulm University, Ulm, Germany
| | - Didier Vieau
- UMR-S 1172-JPArc, Centre Hospitalier Régional Universitaire de Lille (CHRU de Lille), Alzheimer and Tauopathies, Lille, France
| | - David Blum
- UMR-S 1172-JPArc, Centre Hospitalier Régional Universitaire de Lille (CHRU de Lille), Alzheimer and Tauopathies, Lille, France
| | - Åsa Petersén
- Translational Neuroendocrine Research Unit (TNU), Lund University, Lund, Sweden
| | - Luc Dupuis
- UMR-S 1118, Faculté de Médecine, Institut National de la Santé et de la Recherche Médicale (INSERM), Strasbourg, France.,UMR-S1118, Université de Strasbourg, Strasbourg, France
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Sturm VE, Perry DC, Wood K, Hua AY, Alcantar O, Datta S, Rankin KP, Rosen HJ, Miller BL, Kramer JH. Prosocial deficits in behavioral variant frontotemporal dementia relate to reward network atrophy. Brain Behav 2017; 7:e00807. [PMID: 29075567 PMCID: PMC5651391 DOI: 10.1002/brb3.807] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/07/2017] [Accepted: 07/20/2017] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Empathy and shared feelings of reward motivate individuals to share resources with others when material gain is not at stake. Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative disease that affects emotion- and reward-relevant neural systems. Although there is diminished empathy and altered reward processing in bvFTD, how the disease impacts prosocial behavior is less well understood. METHODS A total of 74 participants (20 bvFTD, 15 Alzheimer's disease [AD], and 39 healthy controls) participated in this study. Inspired by token-based paradigms from animal studies, we developed a novel task to measure prosocial giving (the "Giving Game"). On each trial of the Giving Game, participants decided how much money to offer to the experimenter, and prosocial giving was the total amount that participants gave to the experimenter when it cost them nothing to give. Voxel-based morphometry was then used to identify brain regions that were associated with prosocial giving. RESULTS Prosocial giving was lower in bvFTD than in healthy controls; prosocial giving in AD did not differ significantly from either of the other groups. Whereas lower prosocial giving was associated with atrophy in the right pulvinar nucleus of the thalamus, greater prosocial giving was associated with atrophy in the left ventral striatum. CONCLUSION These findings suggest that simple acts of generosity deteriorate in bvFTD due to lateralized atrophy in reward-relevant neural systems that promote shared feelings of positive affect.
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Affiliation(s)
- Virginia E Sturm
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - David C Perry
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Kristie Wood
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Alice Y Hua
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Oscar Alcantar
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Samir Datta
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Katherine P Rankin
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Howard J Rosen
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Bruce L Miller
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
| | - Joel H Kramer
- Department of Neurology University of California San Francisco CA USA.,Sandler Neurosciences Center San Francisco CA USA
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Koriath CAM, Bocchetta M, Brotherhood E, Woollacott IOC, Norsworthy P, Simón-Sánchez J, Blauwendraat C, Dick KM, Gordon E, Harding SR, Fox NC, Crutch S, Warren JD, Revesz T, Lashley T, Mead S, Rohrer JD. The clinical, neuroanatomical, and neuropathologic phenotype of TBK1-associated frontotemporal dementia: A longitudinal case report. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2016; 6:75-81. [PMID: 28229125 PMCID: PMC5312484 DOI: 10.1016/j.dadm.2016.10.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Mutations in the TANK-binding kinase 1 (TBK1) gene have recently been shown to cause frontotemporal dementia (FTD). However, the phenotype of TBK1-associated FTD is currently unclear. METHODS We performed a single case longitudinal study of a patient who was subsequently found to have a novel A705fs mutation in the TBK1 gene. He was assessed annually over a 7-year period with a series of clinical, cognitive, and magnetic resonance imaging assessments. His brain underwent pathological examination at postmortem. RESULTS The patient presented at the age of 64 years with an 18-month history of personality change including increased rigidity and obsessiveness, apathy, loss of empathy, and development of a sweet tooth. His mother had developed progressive behavioral and cognitive impairment from the age of 57 years. Neuropsychometry revealed intact cognition at first assessment. Magnetic resonance imaging showed focal right temporal lobe atrophy. Over the next few years his behavioral problems progressed and he developed cognitive impairment, initially with anomia and prosopagnosia. Neurological examination remained normal throughout without any features of motor neurone disease. He died at the age of 72 years and postmortem showed TDP-43 type A pathology but with an unusual novel feature of numerous TAR DNA-binding protein 43 (TDP-43)-positive neuritic structures at the cerebral cortex/subcortical white matter junction. There was also associated argyrophilic grain disease not previously reported in other TBK1 mutation cases. DISCUSSION TBK1-associated FTD can be associated with right temporal variant FTD with progressive behavioral change and relatively intact cognition initially. The case further highlights the benefits of next-generation sequencing technologies in the diagnosis of neurodegenerative disorders and the importance of detailed neuropathologic analysis.
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Affiliation(s)
- Carolin A M Koriath
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Martina Bocchetta
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Emilie Brotherhood
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Ione O C Woollacott
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Penny Norsworthy
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Javier Simón-Sánchez
- Genetics and Epigenetics of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), Tübingen, Germany
| | - Cornelis Blauwendraat
- Applied Genomics for Neurodegenerative Diseases, German Centre for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Katrina M Dick
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Elizabeth Gordon
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Sophie R Harding
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Nick C Fox
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Sebastian Crutch
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Jason D Warren
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Tamas Revesz
- Queen Square Brain Bank for Neurological Disorders, Department of Molecular Neuroscience, UCL Institute of Neurology, University College London, London, UK
| | - Tammaryn Lashley
- Queen Square Brain Bank for Neurological Disorders, Department of Molecular Neuroscience, UCL Institute of Neurology, University College London, London, UK
| | - Simon Mead
- Department of Neurodegenerative Disease, MRC Prion Unit, UCL Institute of Neurology, London, UK
| | - Jonathan D Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, UK
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Abstract
Patients with different types of dementia may exhibit pathological eating habits, including food fads, hyperphagia, or even ingestion of inanimate objects. Several findings reveal that such eating alterations are more common in patients with frontotemporal dementia (FTD) than other types of dementia. Moreover, eating alterations may differ between the two variants of the disease, namely the behavioral variant and semantic dementia (SD). In this review, we summarized evidences regarding four areas: eating and body weight alterations in FTD, the most common assessment methods, anatomical correlates of eating disorders, and finally, proposed underlying mechanisms. An increasing understanding of the factors that contribute to eating abnormalities may allow first, a better comprehension of the clinical features of the disease and second, shed light on the mechanism underlying eating behaviors in the normal population.
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Affiliation(s)
| | - Vincenzo Silani
- b Department of Neurology and Laboratory of Neuroscience , IRCCS Istituto Auxologico Italiano, Dino Ferrari Centre , Milan , Italy.,c Department of Pathophysiology and Transplantation , Università degli Studi di Milano , Milan , Italy
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Bocchetta M, Cardoso MJ, Cash DM, Ourselin S, Warren JD, Rohrer JD. Patterns of regional cerebellar atrophy in genetic frontotemporal dementia. NEUROIMAGE-CLINICAL 2016; 11:287-290. [PMID: 26977398 PMCID: PMC4781923 DOI: 10.1016/j.nicl.2016.02.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 02/10/2016] [Accepted: 02/18/2016] [Indexed: 12/13/2022]
Abstract
Background Frontotemporal dementia (FTD) is a heterogeneous neurodegenerative disorder with a strong genetic component. The cerebellum has not traditionally been felt to be involved in FTD but recent research has suggested a potential role. Methods We investigated the volumetry of the cerebellum and its subregions in a cohort of 44 patients with genetic FTD (20 MAPT, 7 GRN, and 17 C9orf72 mutation carriers) compared with 18 cognitively normal controls. All groups were matched for age and gender. On volumetric T1-weighted magnetic resonance brain images we used an atlas propagation and label fusion strategy of the Diedrichsen cerebellar atlas to automatically extract subregions including the cerebellar lobules, the vermis and the deep nuclei. Results The global cerebellar volume was significantly smaller in C9orf72 carriers (mean (SD): 99989 (8939) mm3) compared with controls (108136 (7407) mm3). However, no significant differences were seen in the MAPT and GRN carriers compared with controls (104191 (6491) mm3 and 107883 (6205) mm3 respectively). Investigating the individual subregions, C9orf72 carriers had a significantly lower volume than controls in lobule VIIa-Crus I (15% smaller, p < 0.0005), whilst MAPT mutation carriers had a significantly lower vermal volume (10% smaller, p = 0.001) than controls. All cerebellar subregion volumes were preserved in GRN carriers compared with controls. Conclusion There appears to be a differential pattern of cerebellar atrophy in the major genetic forms of FTD, being relatively spared in GRN, localized to the lobule VIIa-Crus I in the superior-posterior region of the cerebellum in C9orf72, the area connected via the thalamus to the prefrontal cortex and involved in cognitive function, and localized to the vermis in MAPT, the ‘limbic cerebellum’ involved in emotional processing. Different pattern of cerebellar atrophy in the major genetic forms of FTD Involvement of the lobule VIIa-Crus I in C9orf72 carriers, related to cognition MAPT carriers show vermal involvement, linked to emotional processing GRN carriers show relative sparing of the cerebellum
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Affiliation(s)
- Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
| | - M Jorge Cardoso
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK; Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, UK
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK; Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, UK
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, UK
| | - Jason D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.
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48
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Amyotrophic lateral sclerosis and frontotemporal dementia: distinct and overlapping changes in eating behaviour and metabolism. Lancet Neurol 2016; 15:332-42. [PMID: 26822748 DOI: 10.1016/s1474-4422(15)00380-4] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 11/17/2015] [Accepted: 12/02/2015] [Indexed: 12/12/2022]
Abstract
Metabolic changes incorporating fluctuations in weight, insulin resistance, and cholesterol concentrations have been identified in several neurodegenerative disorders. Whether these changes result from the neurodegenerative process affecting brain regions necessary for metabolic regulation or whether they drive the degenerative process is unknown. Emerging evidence from epidemiological, clinical, pathological, and experimental studies emphasises a range of changes in eating behaviours and metabolism in amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). In ALS, metabolic changes have been linked to disease progression and prognosis. Furthermore, changes in eating behaviour that affect metabolism have been incorporated into the diagnostic criteria for FTD, which has some clinical and pathological overlap with ALS. Whether the distinct and shared metabolic and eating changes represent a component of the proposed spectrum of the two diseases is an intriguing possibility. Moreover, future research should aim to unravel the complex connections between eating, metabolism, and neurodegeneration in ALS and FTD, and aim to understand the potential for targeting modifiable risk factors in disease development and progression.
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