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Cipriano L, Oliva M, Puoti G, Signoriello E, Bonavita S, Coppola C. Is the pathology of posterior cortical atrophy clinically predictable? Rev Neurosci 2022; 33:849-858. [PMID: 35659868 DOI: 10.1515/revneuro-2022-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/01/2022] [Indexed: 12/14/2022]
Abstract
Posterior cortical atrophy (PCA) is a neurodegenerative disorder characterized by an early prominent deficit of visual functions associated with signs and symptoms that are the expression of dysfunction of posterior brain regions. Although PCA is commonly associated with Alzheimer's disease (AD), in recent years new pathological substrates have emerged. Among them, frontotemporal lobar degeneration (FTLD) is the most commonly reported but, to date, little is known about the clinical features of PCA due to FTLD. We conducted a systematic search in the main biomedical database MEDLINE. We searched for all clinical PCA reports that assessed the pathological basis of such syndrome with at least one of the following: (1) neuropathological examination, (2) cerebrospinal fluid biomarkers, (3) amyloid-PET imaging and (4) genetic testing. Of 369 potentially eligible studies, 40 fulfilled the inclusion criteria with an overall number of 144 patients (127 PCA-AD vs. 17 PCA-FTD/non-AD). We found that hallucinations/illusions were present in none of the probable PCA-FTD/non-AD subjects while were reported in 15 out of 97 PCA-AD individuals. Optic ataxia and Parkinsonism showed a significantly greater prevalence in probable PCA FTD/non-AD than in PCA-AD whereas myoclonus and disorientation in time and space were significantly more frequent in PCA-AD than in probable PCA FTD/non-AD. We also found a predominance of a left-side pattern of atrophy/hypometabolism in the probable PCA FTD/non-AD. Clinical features such as optic ataxia, Parkinsonism, myoclonus, hallucinations and disorientation in time and space suggest the underlying pathological basis of PCA and help in leading the diagnostic protocol consequently.
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Affiliation(s)
- Lorenzo Cipriano
- Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", P.zza L. Miraglia 2, 80138 Naples, Italy
| | - Mariano Oliva
- Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", P.zza L. Miraglia 2, 80138 Naples, Italy
| | - Gianfranco Puoti
- Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", P.zza L. Miraglia 2, 80138 Naples, Italy
| | - Elisabetta Signoriello
- Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", P.zza L. Miraglia 2, 80138 Naples, Italy
| | - Simona Bonavita
- Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", P.zza L. Miraglia 2, 80138 Naples, Italy
| | - Cinzia Coppola
- Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", P.zza L. Miraglia 2, 80138 Naples, Italy.,Second Neurological Clinic, University of Campania "L. Vanvitelli", Isola 8, Edificio 10 Policlinico, "Federico II" via Pansini 5, 80131 Napoli, Italy
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Shea YF, Pan Y, Mak HKF, Bao Y, Lee SC, Chiu PKC, Chan HWF. A systematic review of atypical Alzheimer's disease including behavioural and psychological symptoms. Psychogeriatrics 2021; 21:396-406. [PMID: 33594793 DOI: 10.1111/psyg.12665] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/06/2021] [Accepted: 01/25/2021] [Indexed: 12/20/2022]
Abstract
Alzheimer's disease (AD) is the commonest cause of dementia, characterized by the clinical presentation of progressive anterograde episodic memory impairment. However, atypical presentation of patients is increasingly recognized. These atypical AD include logopenic aphasia, behavioural variant AD, posterior cortical atrophy, and corticobasal syndrome. These atypical AD are more common in patients with young onset AD before the age of 65 years old. Since medical needs (including the behavioural and psychological symptoms of dementia) of atypical AD patients could be different from typical AD patients, it is important for clinicians to be aware of these atypical forms of AD. In addition, disease modifying treatment may be available in the future. This review aims at providing an update on various important subtypes of atypical AD including behavioural and psychological symptoms.
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Affiliation(s)
- Yat-Fung Shea
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Yining Pan
- School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Henry Ka-Fung Mak
- Department of Diagnostic Radiology, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Yiwen Bao
- Department of Diagnostic Radiology, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Shui-Ching Lee
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Patrick Ka-Chun Chiu
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Hon-Wai Felix Chan
- Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
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Brisson M, Brodeur C, Létourneau‐Guillon L, Masellis M, Stoessl J, Tamm A, Zukotynski K, Ismail Z, Gauthier S, Rosa‐Neto P, Soucy J. CCCDTD5: Clinical role of neuroimaging and liquid biomarkers in patients with cognitive impairment. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 6:e12098. [PMID: 33532543 PMCID: PMC7821956 DOI: 10.1002/trc2.12098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 09/11/2020] [Indexed: 04/21/2023]
Abstract
Since 1989, four Canadian Consensus Conferences on the Diagnosis and Treatment of Dementia (CCCDTDs) have provided evidence-based dementia diagnostic and treatment guidelines for Canadian clinicians and researchers. We present the results from the Neuroimaging and Fluid Biomarkers Group of the 5th CCCDTD (CCCDTD5), which addressed topics chosen by the steering committee to reflect advances in the field and build on our previous guidelines. Recommendations on Imaging and Fluid Biomarker Use from this Conference cover a series of different fields. Prior structural imaging recommendations for both computerized tomography (CT) and magnetic resonance imaging (MRI) remain largely unchanged, but MRI is now more central to the evaluation than before, with suggested sequences described here. The use of visual rating scales for both atrophy and white matter anomalies is now included in our recommendations. Molecular imaging with [18F]-fluorodeoxyglucose ([18F]-FDG) Positron Emisson Tomography (PET) or [99mTc]-hexamethylpropyleneamine oxime/ethylene cysteinate dimer ([99mTc]-HMPAO/ECD) Single Photon Emission Tomography (SPECT), should now decidedly favor PET. The value of [18F]-FDG PET in the assessment of neurodegenerative conditions has been established with greater certainty since the previous conference, and it has now been recognized as a useful biomarker to establish the presence of neurodegeneration by a number of professional organizations around the world. Furthermore, the role of amyloid PET has been clarified and our recommendations follow those from other groups in multiple countries. SPECT with [123I]-ioflupane (DaTscanTM) is now included as a useful study in differentiating Alzheimer's disease (AD) from Lewy body disease. Finally, liquid biomarkers are in a rapid phase of development and, could lead to a revolution in the assessment AD and other neurodegenerative conditions at a reasonable cost. We hope these guidelines will be useful for clinicians, researchers, policy makers, and the lay public, to inform a current and evidence-based approach to the use of neuroimaging and liquid biomarkers in clinical dementia evaluation and management.
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Affiliation(s)
- Mélanie Brisson
- Centre hospitalier de l'université de QuébecQuebec CityCanada
| | | | | | | | - Jon Stoessl
- Vancouver Coastal Health, University of British‐ColumbiaVancouverCanada
| | | | | | - Zahinoor Ismail
- Department of Psychiatry, Hotchkiss Brain Institute and O'Brien Institute for Public HealthUniversity of CalgaryCalgaryCanada
| | | | - Pedro Rosa‐Neto
- McGill Center for Studies in AgingCanada
- McConnell Brain Imaging Centre, Montreal Neurological InstituteMontrealCanada
| | - Jean‐Paul Soucy
- Centre hospitalier de l'université de MontréalMontrealCanada
- McConnell Brain Imaging Centre, Montreal Neurological InstituteMontrealCanada
- PERFORM Center, Concordia UniversityMontrealCanada
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4
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Montembeault M, Brambati SM, Lamari F, Michon A, Samri D, Epelbaum S, Lacomblez L, Lehéricy S, Habert MO, Dubois B, Kas A, Migliaccio R. Atrophy, metabolism and cognition in the posterior cortical atrophy spectrum based on Alzheimer's disease cerebrospinal fluid biomarkers. Neuroimage Clin 2018; 20:1018-1025. [PMID: 30340200 PMCID: PMC6197495 DOI: 10.1016/j.nicl.2018.10.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 09/25/2018] [Accepted: 10/08/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION In vivo clinical, anatomical and metabolic differences between posterior cortical atrophy (PCA) patients presenting with different Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers profiles are still unknown. METHODS Twenty-seven PCA patients underwent CSF examination and were classified as 1) PCA with a typical CSF AD profile (PCA-tAD; abnormal amyloid and T-tau/P-tau biomarkers, n = 13); 2) PCA with an atypical AD CSF profile (PCA-aAD; abnormal amyloid biomarker only, n = 9); and 3) PCA not associated with AD (PCA-nonAD; normal biomarkers, n = 5). All patients underwent clinical and cognitive assessment, structural MRI, and a subset of them underwent brain 18F-FDG PET. RESULTS All patients' groups showed a common pattern of posterior GM atrophy and hypometabolism typical of PCA, as well as equivalent demographics and clinical/cognitive profiles. PCA-tAD patients showed a group-specific pattern of hypometabolism in the left fusiform gyrus and inferior temporal gyrus. PCA-aAD did not present a group-specific atrophy pattern. Finally, group-specific gray matter atrophy in the right dorsolateral prefrontal cortex, left caudate nucleus and right medial temporal regions and hypometabolism in the right supplementary motor area and paracentral lobule were observed in PCA-nonAD patients. CONCLUSION Our findings suggest that both PCA-tAD and PCA-aAD patients are on the AD continuum, in agreement with the recently suggested A/T/N model. Furthermore, in PCA, the underlying pathology has an impact at least on the anatomo-functional presentation. Brain damage observed in PCA-tAD and PCA-aAD was mostly consistent with the well-described presentation of the disease, although it was more widespread in PCA-tAD group, especially in the left temporal lobe. Additional fronto-temporal (especially dorsolateral prefrontal) damage seems to be a clue to underlying non-AD pathology in PCA, which warrants the need for longitudinal follow-ups to investigate frontal symptoms in these patients.
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Affiliation(s)
- Maxime Montembeault
- FrontLab, Institut du Cerveau et de la Moelle épinière (ICM), 75013 Paris, France
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, Université Pierre et Marie Curie-Paris 6, UMR S1127, Institut du Cerveau et de la Moelle épinière (ICM), Pitié-Salpêtrière hospital, 75013 Paris, France
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, H3W 1W6 Montréal, QC, Canada
- Department of Psychology, University of Montreal, H2V 2S9 Montréal, QC, Canada
| | - Simona M. Brambati
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, H3W 1W6 Montréal, QC, Canada
- Department of Psychology, University of Montreal, H2V 2S9 Montréal, QC, Canada
| | - Foudil Lamari
- Department of Metabolic biochemistry, Pitié-Salpêtrière hospital, 75013 Paris, France
| | - Agnès Michon
- Department of Nervous system diseases, Institut de la mémoire et de la maladie d’Alzheimer (IM2A), Neurology, Pitié-Salpêtrière hospital, 75013 Paris, France
| | - Dalila Samri
- Department of Nervous system diseases, Institut de la mémoire et de la maladie d’Alzheimer (IM2A), Neurology, Pitié-Salpêtrière hospital, 75013 Paris, France
| | - Stéphane Epelbaum
- Department of Nervous system diseases, Institut de la mémoire et de la maladie d’Alzheimer (IM2A), Neurology, Pitié-Salpêtrière hospital, 75013 Paris, France
| | - Lucette Lacomblez
- LIB, Inserm U1146, Université Pierre et Marie Curie, Paris 6, 75006 Paris, France
- Department of Nervous system diseases, CIC-CET, Pitié-Salpêtrière hospital, 75013 Paris, France
- Pharmacology service, Pitié-Salpêtrière hospital, 75013 Paris, France
| | - Stéphane Lehéricy
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, Université Pierre et Marie Curie-Paris 6, UMR S1127, Institut du Cerveau et de la Moelle épinière (ICM), Pitié-Salpêtrière hospital, 75013 Paris, France
- Centre de Neuro-imagerie de Recherche (CENIR) de l’Institut du Cerveau et de la Moelle Epiniere (ICM), Hôpital de la Pitié-Salpêtrière, 75013 Paris, France
| | - Marie-Odile Habert
- LIB, Inserm U1146, Université Pierre et Marie Curie, Paris 6, 75006 Paris, France
- Department of Nuclear Medicine, Pitié-Salpêtrière hospital, 75013 Paris, France
| | - Bruno Dubois
- FrontLab, Institut du Cerveau et de la Moelle épinière (ICM), 75013 Paris, France
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, Université Pierre et Marie Curie-Paris 6, UMR S1127, Institut du Cerveau et de la Moelle épinière (ICM), Pitié-Salpêtrière hospital, 75013 Paris, France
- Department of Nervous system diseases, Institut de la mémoire et de la maladie d’Alzheimer (IM2A), Neurology, Pitié-Salpêtrière hospital, 75013 Paris, France
| | - Aurélie Kas
- LIB, Inserm U1146, Université Pierre et Marie Curie, Paris 6, 75006 Paris, France
- Department of Nuclear Medicine, Pitié-Salpêtrière hospital, 75013 Paris, France
| | - Raffaella Migliaccio
- FrontLab, Institut du Cerveau et de la Moelle épinière (ICM), 75013 Paris, France
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, Université Pierre et Marie Curie-Paris 6, UMR S1127, Institut du Cerveau et de la Moelle épinière (ICM), Pitié-Salpêtrière hospital, 75013 Paris, France
- Department of Nervous system diseases, Institut de la mémoire et de la maladie d’Alzheimer (IM2A), Neurology, Pitié-Salpêtrière hospital, 75013 Paris, France
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5
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Salvadori N, Russo M, Biscetti L, D' Andrea K, Dottorini ME, Parnetti L. Case of posterior cortical atrophy (PCA) evolved to PCA-CBS. BMJ Case Rep 2018; 2018:bcr-2018-224312. [PMID: 29914902 DOI: 10.1136/bcr-2018-224312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 68-year-old lawyer developed insidious disturbances in topographic orientation and apraxia. He underwent a geriatric evaluation, only documenting slight cognitive disturbances, and a 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), showing mild right-lateralised frontoparietal hypometabolism. After 1 year, because of worsening in spatial orientation and the onset of dressing apraxia, he was referred to our memory clinic. The neuropsychological evaluation documented proeminent visuospatial, praxis deficits and dysgraphia. Cerebrospinal fluid biomarker analysis showed mild increase of total-τ, with normal Aβ1-42, ruling out Alzheimer's disease. Progression of the right parietal hypometabolism at FDG-PET and right superior longitudinal fasciculus damage at high-field MRI revealed a probable neurodegenerative aetiology. The neurological examination disclosed then Gerstmann's and Balint's syndromes, and extrapyramidal signs later appeared, suggesting the diagnosis of posterior cortical atrophy associated with corticobasal syndrome. Genetic analysis for mutations inmicrotubule-associated protein tau (MAPT), C9orf72 and GRN genes was negative. A 1-year follow-up documented significant worsening of the cognitive and functional impairment, revealing a frank dementia.
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Affiliation(s)
- Nicola Salvadori
- Department of Medicine, Centre for Memory Disturbances, Laboratory of Neurochemistry, Section of Neurology, Perugia, Italy
| | - Mirella Russo
- Department of Medicine, Centre for Memory Disturbances, Laboratory of Neurochemistry, Section of Neurology, Perugia, Italy
| | - Leonardo Biscetti
- Department of Medicine, Centre for Memory Disturbances, Laboratory of Neurochemistry, Section of Neurology, Perugia, Italy
| | - Katia D' Andrea
- Department of Medicine, Centre for Memory Disturbances, Laboratory of Neurochemistry, Section of Neurology, Perugia, Italy
| | | | - Lucilla Parnetti
- Department of Medicine, Centre for Memory Disturbances, Laboratory of Neurochemistry, Section of Neurology, Perugia, Italy
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Santangelo R, Cecchetti G, Bernasconi MP, Cardamone R, Barbieri A, Pinto P, Passerini G, Scomazzoni F, Comi G, Magnani G. Cerebrospinal Fluid Amyloid-β 42, Total Tau and Phosphorylated Tau are Low in Patients with Normal Pressure Hydrocephalus: Analogies and Differences with Alzheimer's Disease. J Alzheimers Dis 2018; 60:183-200. [PMID: 28826180 DOI: 10.3233/jad-170186] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Co-existence of Alzheimer's disease (AD) in normal pressure hydrocephalus (NPH) is a frequent finding, thus a common pathophysiological basis between AD and NPH has been postulated. We measured CSF amyloid-β 42 (Aβ42), total tau (t-tau), and phosphorylated tau (p-tau) concentrations in a sample of 294 patients with different types of dementia and 32 subjects without dementia. We then compared scores on neuropsychological tests of NPH patients with pathological and normal CSF Aβ42 values. Aβ42 levels were significantly lower in NPH than in control patients, with no significant differences between AD and NPH. On the contrary, t-tau and p-tau levels were significantly lower in NPH than in AD, with no differences between NPH and controls. NPH patients with pathological Aβ42 levels did not perform worse than NPH patients with normal Aβ42 levels in any cognitive domains. Our data seem to support the hypothesis of amyloid accumulation in brains of NPH patients. Nevertheless, amyloid does not seem to play a pathogenetic role in the development of cognitive deficits in NPH.
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Affiliation(s)
- Roberto Santangelo
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giordano Cecchetti
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Maria Paola Bernasconi
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Rosalinda Cardamone
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Alessandra Barbieri
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Patrizia Pinto
- Department of Neurology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Francesco Scomazzoni
- Department of Neuroradiology, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giuseppe Magnani
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
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7
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Wellington H, Paterson RW, Suárez‐González A, Poole T, Frost C, Sjöbom U, Slattery CF, Magdalinou NK, Lehmann M, Portelius E, Fox NC, Blennow K, Zetterberg H, Schott JM. CSF neurogranin or tau distinguish typical and atypical Alzheimer disease. Ann Clin Transl Neurol 2018; 5:162-171. [PMID: 29468177 PMCID: PMC5817822 DOI: 10.1002/acn3.518] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/15/2017] [Accepted: 11/24/2017] [Indexed: 12/13/2022] Open
Abstract
Objective To assess whether high levels of cerebrospinal fluid neurogranin are found in atypical as well as typical Alzheimer's disease. Methods Immunoassays were used to measure cerebrospinal fluid neurogranin in 114 participants including healthy controls (n = 27), biomarker-proven amnestic Alzheimer's disease (n = 68), and the atypical visual variant of Alzheimer's (n = 19) according to international criteria. CSF total-tau, Aβ42, and neurofilament light concentrations were investigated using commercially available assays. All affected individuals had T1-weighted volumetric MR images available for analysis of whole and regional brain volumes. Associations between neurogranin, brain volumes, total-tau, Aβ42, and neurofilament light were assessed. Results Median cerebrospinal fluid neurogranin concentrations were higher in typical and atypical Alzheimer's compared to controls (P < 0.001 and P = 0.005). Both neurogranin and total-tau concentrations, but not neurofilament light and Aβ42, were higher in typical Alzheimer's compared to atypical patients (P = 0.004 and P = 0.03). There were significant differences in the left hippocampus and right and left superior parietal lobules in atypical patients, which were larger (P = 0.03) and smaller (P = 0.001 and P < 0.001), respectively, compared to typical patients. We found no evidence of associations between neurogranin and brain volumes but a strong association with total-tau (P < 0.001) and a weaker association with neurofilament light (P = 0.005). Interpretation These results show significant differences in neurogranin and total-tau between typical and atypical patients, which may relate to factors other than disease topography. The differential relationships between neurogranin, total-tau and neurofilament light in the Alzheimer's variants, provide evidence for mechanistically distinct and coupled markers of neurodegeneration.
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Affiliation(s)
| | - Ross W. Paterson
- Dementia Research CentreInstitute of Neurology, Queen Square, UCLLondonUK
| | | | - Teresa Poole
- Dementia Research CentreInstitute of Neurology, Queen Square, UCLLondonUK
- Faculty of Epidemiology and Population HealthDepartment of Medical StatisticsLondon School of Hygiene and Tropical MedicineLondonUK
| | - Chris Frost
- Dementia Research CentreInstitute of Neurology, Queen Square, UCLLondonUK
- Faculty of Epidemiology and Population HealthDepartment of Medical StatisticsLondon School of Hygiene and Tropical MedicineLondonUK
| | - Ulrika Sjöbom
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | | | | | - Manja Lehmann
- Dementia Research CentreInstitute of Neurology, Queen Square, UCLLondonUK
| | - Eric Portelius
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
| | - Nick C. Fox
- Dementia Research CentreInstitute of Neurology, Queen Square, UCLLondonUK
- UK Dementia Research Institute at UCLLondonUK
| | - Kaj Blennow
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
| | - Henrik Zetterberg
- Department of Molecular NeuroscienceInstitute of Neurology, UCLLondonUK
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Institute of Neuroscience and PhysiologyDepartment of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- UK Dementia Research Institute at UCLLondonUK
| | - Jonathan M. Schott
- Dementia Research CentreInstitute of Neurology, Queen Square, UCLLondonUK
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8
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The Nature and Natural History of Posterior Cortical Atrophy Syndrome. Alzheimer Dis Assoc Disord 2017; 31:295-306. [DOI: 10.1097/wad.0000000000000207] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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9
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Granadillo E, Paholpak P, Mendez MF, Teng E. Visual Ratings of Medial Temporal Lobe Atrophy Correlate with CSF Tau Indices in Clinical Variants of Early-Onset Alzheimer Disease. Dement Geriatr Cogn Disord 2017; 44:45-54. [PMID: 28675901 PMCID: PMC5575973 DOI: 10.1159/000477718] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND/AIMS Prior studies of late-onset Alzheimer disease (AD) have reported that cerebrospinal fluid (CSF) tau levels correlate with hippocampal/medial temporal lobe atrophy. These findings suggest that CSF tau indices in AD may reflect tau-related neurodegeneration in the medial temporal lobe. However, it remains uncertain whether elevated CSF tau levels in the clinically heterogeneous subtypes of early-onset AD (EOAD; amnestic, posterior cortical atrophy [PCA], and logopenic progressive aphasia [LPA]) are attributable to similar underlying mechanisms. METHODS We identified 41 EOAD patients (18 amnestic, 14 with LPA, and 9 with PCA) with CSF and brain MRI data. Semiquantitative ratings were used to assess medial temporal lobe atrophy and PCA, which were compared to CSF biomarker indices. RESULTS Lower CSF tau levels were seen in PCA relative to amnestic EOAD and LPA, but similar ratings for medial temporal lobe atrophy and PCA were seen across the groups. After adjustments for demographics and cognitive performance, both total (p = 0.004) and hyperphosphorylated (p = 0.026) tau levels correlated with medial temporal lobe atrophy across this EOAD cohort. CONCLUSIONS These results replicate prior findings in late-onset AD and support the hypothesis that CSF tau levels primarily reflect tau-related neurodegenerative changes in the hippocampus/medial temporal lobe across the clinical subtypes of EOAD.
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Affiliation(s)
- Elias Granadillo
- Department of Neurology, David Geffen School of Medicine at
UCLA,Veterans Affairs Greater Los Angeles Healthcare System
| | - Pongsatorn Paholpak
- Department of Neurology, David Geffen School of Medicine at
UCLA,Veterans Affairs Greater Los Angeles Healthcare System,Department of Psychiatry, Faculty of Medicine, Khon Kaen
University
| | - Mario F. Mendez
- Department of Neurology, David Geffen School of Medicine at
UCLA,Department of Psychiatry and Behavioral Sciences, David Geffen
School of Medicine at UCLA,Veterans Affairs Greater Los Angeles Healthcare System
| | - Edmond Teng
- Department of Neurology, David Geffen School of Medicine at
UCLA,Veterans Affairs Greater Los Angeles Healthcare System
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10
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Mazzeo S, Santangelo R, Bernasconi MP, Cecchetti G, Fiorino A, Pinto P, Passerini G, Falautano M, Comi G, Magnani G. Combining Cerebrospinal Fluid Biomarkers and Neuropsychological Assessment: A Simple and Cost-Effective Algorithm to Predict the Progression from Mild Cognitive Impairment to Alzheimer’s Disease Dementia. J Alzheimers Dis 2016; 54:1495-1508. [DOI: 10.3233/jad-160360] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Salvatore Mazzeo
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Roberto Santangelo
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Maria Paola Bernasconi
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giordano Cecchetti
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Agnese Fiorino
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Patrizia Pinto
- Department of Neurology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Monica Falautano
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giuseppe Magnani
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
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11
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Clinical and neuroimaging differences between posterior cortical atrophy and typical amnestic Alzheimer's disease patients at an early disease stage. Sci Rep 2016; 6:29372. [PMID: 27377199 PMCID: PMC4932506 DOI: 10.1038/srep29372] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 06/16/2016] [Indexed: 11/09/2022] Open
Abstract
To identify clinical and neuroimaging characteristics between posterior cortical atrophy (PCA) and typical amnestic Alzheimer's disease (tAD) patients at an early disease stage, 16 PCA and 13 age-matched tAD patients were enrolled. Compared with tAD patients, PCA patients showed higher mean recognition and recall test scores, and lower mean calculation, spatial attention, shape discrimination, and writing test scores. Mean right hippocampal volume was larger in PCA patients compared with tAD patients, while cortical gray matter (GM) volume of bilateral parietal and occipital lobes was smaller in PCA patients. Further, when compared with tAD patients, significant hypometabolism was observed in bilateral parietal and occipital lobes, particularly the right occipitotemporal junction in PCA patients. Additionally, there were significant positive correlations in recognition and recall scores with hippocampal volumes. In PCA patients, calculation and visuospatial ability scores are positively associated with GM volume of parietal and occipital lobes. And only spatial attention and shape discrimination scores are positively associated with regional glucose metabolism of parietal and occipital lobes. Therefore, PCA patients display better recognition and recall scores, which are associated with larger hippocampal volumes and poorer performance in visual spatial tasks because of marked GM atrophy and hypometabolism of parietal and occipital lobes.
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12
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Paterson RW, Toombs J, Slattery CF, Nicholas JM, Andreasson U, Magdalinou NK, Blennow K, Warren JD, Mummery CJ, Rossor MN, Lunn MP, Crutch SJ, Fox NC, Zetterberg H, Schott JM. Dissecting IWG-2 typical and atypical Alzheimer's disease: insights from cerebrospinal fluid analysis. J Neurol 2015; 262:2722-30. [PMID: 26410752 DOI: 10.1007/s00415-015-7904-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/10/2015] [Accepted: 09/11/2015] [Indexed: 10/23/2022]
Abstract
Pathobiological factors underlying phenotypic diversity in Alzheimer's disease (AD) are incompletely understood. We used an extended cerebrospinal fluid (CSF) panel to explore differences between "typical" with "atypical" AD and between amnestic, posterior cortical atrophy, logopenic aphasia and frontal variants. We included 97 subjects fulfilling International Working Group-2 research criteria for AD of whom 61 had "typical" AD and 36 "atypical" syndromes, and 30 controls. CSF biomarkers included total tau (T-tau), phosphorylated tau (P-tau), amyloid β1-42, amyloid βX-38/40/42, YKL-40, neurofilament light (NFL), and amyloid precursor proteins α and β. The typical and atypical groups were matched for age, sex, severity and rate of cognitive decline and had similar biomarker profiles, with the exception of NFL which was higher in the atypical group (p = 0.03). Sub-classifying the atypical group into its constituent clinical syndromes, posterior cortical atrophy was associated with the lowest T-tau [604.4 (436.8-675.8) pg/mL], P-tau (79.8 ± 21.8 pg/L), T-tau/Aβ1-42 ratio [2.3 (1.4-2.6)], AβX-40/X-42 ratio (22.1 ± 5.8) and rate of cognitive decline [1.9 (0.75-4.25) MMSE points/year]. Conversely, the frontal variant group had the highest levels of T-tau [1185.4 (591.7-1329.3) pg/mL], P-tau (116.4 ± 45.4 pg/L), T-tau/Aβ1-42 ratio [5.2 (3.3-6.9)] and AβX-40/X-42 ratio (27.9 ± 7.5), and rate of cognitive decline. Whilst on a group level IWG-2 "typical" and "atypical" AD share similar CSF profiles, which are very different from controls, atypical AD is a heterogeneous entity with evidence for subtle differences in amyloid processing and neurodegeneration between different clinical syndromes. These findings also have practical implications for the interpretation of clinical CSF biomarker results.
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Affiliation(s)
- Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, London, UK.
| | - Jamie Toombs
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | | | - Jennifer M Nicholas
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Ulf Andreasson
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | | | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Cath J Mummery
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Martin N Rossor
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Michael P Lunn
- Department of Clinical Neuroimmunology, National Hospital for Neurology and Neurosurgery, London, UK
| | | | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Henrik Zetterberg
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jonathan M Schott
- Dementia Research Centre, UCL Institute of Neurology, London, UK. .,Box 16 National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK.
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13
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Perani D, Cerami C, Caminiti SP, Santangelo R, Coppi E, Ferrari L, Pinto P, Passerini G, Falini A, Iannaccone S, Cappa SF, Comi G, Gianolli L, Magnani G. Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting. Eur J Nucl Med Mol Imaging 2015; 43:499-508. [PMID: 26341365 DOI: 10.1007/s00259-015-3170-y] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 08/10/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Daniela Perani
- Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy.
- Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy.
- Nuclear Medicine Unit, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy.
| | - Chiara Cerami
- Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy
- Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy
- Clinical Neuroscience Department, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy
| | - Silvia Paola Caminiti
- Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy
- Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy
| | - Roberto Santangelo
- Department of Neurology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy
| | - Elisabetta Coppi
- Department of Neurology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy
| | - Laura Ferrari
- Department of Neurology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy
| | - Patrizia Pinto
- Department of Neurology, Papa Giovanni XXIII Hospital, Piazza OMS, 1, 24127, Bergamo, Italy
| | - Gabriella Passerini
- Servizio di Medicina di Laboratorio OSR, Via Olgettina, 60, 20132, Milan, Italy
| | - Andrea Falini
- Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy
- Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy
- CERMAC - Department of Neuroradiology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy
| | - Sandro Iannaccone
- Clinical Neuroscience Department, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy
| | - Stefano Francesco Cappa
- Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy
- IUSS Pavia, Piazza della Vittoria, 15, 27100, Pavia, Italy
| | - Giancarlo Comi
- Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy
- Department of Neurology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy
| | - Luigi Gianolli
- Nuclear Medicine Unit, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy
| | - Giuseppe Magnani
- Department of Neurology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy.
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14
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Wang XD, Lu H, Shi Z, Cai L, Liu S, Liu S, Han T, Wang Y, Zhou Y, Wang X, Gao S, Ji Y. A Pilot Study on Clinical and Neuroimaging Characteristics of Chinese Posterior Cortical Atrophy: Comparison with Typical Alzheimer's Disease. PLoS One 2015; 10:e0134956. [PMID: 26267071 PMCID: PMC4534411 DOI: 10.1371/journal.pone.0134956] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 07/16/2015] [Indexed: 11/21/2022] Open
Abstract
Posterior cortical atrophy (PCA) is a clinicoradiologic neurodegenerative syndrome characterized by predominant impairment of higher visual functions. Neuroimaging and neuropathological studies show that PCA is probably an atypical presentation of Alzheimer’s disease. However, in China PCA has rarely been studied and remains largely unknown. Our study therefore aimed to analyze the clinical manifestations and patterns of cerebral atrophy, amyloid beta deposition and regional glucose metabolism in Chinese PCA patients, comparing them directly with those of typical Alzheimer’s disease (TAD). Seven PCA patients, 6 TAD patients and 5 controls underwent neuropsychological assessment, MRI scan, 11C-PIB PET scan and 18F-FDG PET scan. Cerebral atrophy including ventricular enlargement, posterior atrophy and medial temporal lobe atrophy were evaluated with MRI. The uptake of 11C-PIB was quantified at the voxel level using the standardized uptake value ratio. Comparisons of regional cerebral glucose metabolism were calculated with statistical parametric mapping. PCA patients showed significant impairment on visuospatial function in neuropsychological assessment. And PCA patients showed more severe posterior atrophy and less severe left medial temporal lobe atrophy compared with TAD patients. The data from 11C-PIB PET scanning showed that amyloid beta deposition in PCA was comparable to TAD. Moreover, in PCA the results from 18F-FDG PET scanning revealed significant hypometabolism in the temporoparietooccipital region and identified specific hypometabolism in the right occipital lobe, compared with TAD. Our study thus provides a preliminary view of PCA in Chinese patients. A further study with a larger number of subjects would be recommended to confirm these findings.
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Affiliation(s)
- Xiao-Dan Wang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Hui Lu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Zhihong Shi
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Li Cai
- PET-CT Center, General Hospital of Tianjin Medical University, Tianjin, 300052, China
| | - Shuai Liu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Shuling Liu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Tong Han
- Department of Radiology, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Ying Wang
- PET-CT Center, General Hospital of Tianjin Medical University, Tianjin, 300052, China
| | - Yuying Zhou
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Xinping Wang
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Shuo Gao
- PET-CT Center, General Hospital of Tianjin Medical University, Tianjin, 300052, China
| | - Yong Ji
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 300060, China
- * E-mail:
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15
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Ossenkoppele R, Mattsson N, Teunissen CE, Barkhof F, Pijnenburg Y, Scheltens P, van der Flier WM, Rabinovici GD. Cerebrospinal fluid biomarkers and cerebral atrophy in distinct clinical variants of probable Alzheimer's disease. Neurobiol Aging 2015; 36:2340-7. [PMID: 25990306 DOI: 10.1016/j.neurobiolaging.2015.04.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 03/27/2015] [Accepted: 04/18/2015] [Indexed: 11/17/2022]
Abstract
Different clinical variants of probable Alzheimer's disease (AD) share underlying plaques and tangles but show distinct atrophy patterns. We included 52 posterior cortical atrophy, 29 logopenic variant primary progressive aphasia, 53 early-onset and 42 late-onset AD patients, selected for abnormal cerebrospinal fluid (CSF)-amyloid-beta42, with CSF and magnetic resonance imaging data available. Bootstrapping revealed no differences in the prevalence of abnormal CSF total-tau and phosphorylated-tau between probable AD variants (range total-tau: 84.9%-92.3%, phosphorylated-tau: 79.2%-93.1%, p > 0.05). Voxelwise linear regressions showed various relationships between lower CSF-Aβ42 and syndrome-specific atrophy, involving precuneus, posterior cingulate, and medial temporal lobe in early-onset AD, occipital cortex and middle temporal gyrus in posterior cortical atrophy; anterior cingulate, insular cortex and precentral gyrus (left > right) in logopenic variant primary progressive aphasia; and medial temporal lobe, thalamus, and temporal pole in late-onset AD (all at p < 0.001 uncorrected). In contrast, CSF-tau was not related to gray matter atrophy in any group. Our findings suggest that lower CSF-amyloid-beta42 - and not increased total-tau and phosphorylated-tau - relates to reduced gray matter volumes, mostly in regions that are typically atrophied in distinct clinical variants of probable AD.
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Affiliation(s)
- Rik Ossenkoppele
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA; Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA; Department of Neurology & Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands; Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
| | - Niklas Mattsson
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative diseases, San Francisco, CA, USA; Institute of Neuroscience and Physiology, Laboratory of Clinical Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Charlotte E Teunissen
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Yolande Pijnenburg
- Department of Neurology & Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology & Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Department of Neurology & Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Gil D Rabinovici
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA; Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
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