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Crockett RA, Wilkins KB, Zeineh MM, McNab JA, Henderson JM, Buch VP, Brontë-Stewart HM. An Individualized Tractography Pipeline for the Nucleus Basalis of Meynert Lateral Tract. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.31.23294922. [PMID: 37693520 PMCID: PMC10491381 DOI: 10.1101/2023.08.31.23294922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Background At the center of the cortical cholinergic network, the nucleus basalis of Meynert (NBM) is crucial for the cognitive domains most vulnerable in PD. Preclinical evidence has demonstrated the positive impact of NBM deep brain stimulation (DBS) on cognition but early human trials have had mixed results. It is possible that DBS of the lateral NBM efferent white matter fiber bundle may be more effective at improving cognitive-motor function. However, precise tractography modelling is required to identify the optimal target for neurosurgical planning. Individualized tractography approaches have been shown to be highly effective for accurately identifying DBS targets but have yet to be developed for the NBM. Methods Using structural and diffusion weighted imaging, we developed a tractography pipeline for precise individualized identification of the lateral NBM target tract. Using dice similarity coefficients, the reliability of the tractography outputs was assessed across three cohorts to investigate: 1) whether this manual pipeline is more reliable than an existing automated pipeline currently used in the literature; 2) the inter- and intra-rater reliability of our pipeline in research scans of patients with PD; and 3) the reliability and practicality of this pipeline in clinical scans of DBS patients. Results The individualized manual pipeline was found to be significantly more reliable than the existing automated pipeline for both the segmentation of the NBM region itself (p<0.001) and the reconstruction of the target lateral tract (p=0.002). There was also no significant difference between the reliability of two different raters in the PD cohort (p=0.25), which showed high inter- (mean Dice coefficient >0.6) and intra-rater (mean Dice coefficient >0.7) reliability across runs. Finally, the pipeline was shown to be highly reliable within the clinical scans (mean Dice coefficient = 0.77). However, accurate reconstruction was only evident in 7/10 tracts. Conclusion We have developed a reliable tractography pipeline for the identification and analysis of the NBM lateral tract in research and clinical grade imaging of healthy young adult and PD patient scans.
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Affiliation(s)
- Rachel A. Crockett
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, California, USA
| | - Kevin B. Wilkins
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, California, USA
| | - Michael M. Zeineh
- Department of Radiology, Stanford University School of Medicine, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, California, USA
- Bio-X, Stanford University, California, USA
| | - Jennifer A. McNab
- Department of Radiology, Stanford University School of Medicine, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, California, USA
- Bio-X, Stanford University, California, USA
| | - Jaimie M. Henderson
- Wu Tsai Neurosciences Institute, Stanford University, California, USA
- Bio-X, Stanford University, California, USA
- Department of Neurosurgery, Stanford University School of Medicine, California, USA
| | - Vivek P. Buch
- Wu Tsai Neurosciences Institute, Stanford University, California, USA
- Bio-X, Stanford University, California, USA
- Department of Neurosurgery, Stanford University School of Medicine, California, USA
| | - Helen M. Brontë-Stewart
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, California, USA
- Bio-X, Stanford University, California, USA
- Department of Neurosurgery, Stanford University School of Medicine, California, USA
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Wang Y, Zhan M, Roebroeck A, De Weerd P, Kashyap S, Roberts MJ. Inconsistencies in atlas-based volumetric measures of the human nucleus basalis of Meynert: A need for high-resolution alternatives. Neuroimage 2022; 259:119421. [PMID: 35779763 DOI: 10.1016/j.neuroimage.2022.119421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 06/10/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022] Open
Abstract
The nucleus basalis of Meynert (nbM) is the major source of cortical acetylcholine (ACh) and has been related to cognitive processes and to neurological disorders. However, spatially delineating the human nbM in MRI studies remains challenging. Due to the absence of a functional localiser for the human nbM, studies to date have localised it using nearby neuroanatomical landmarks or using probabilistic atlases. To understand the feasibility of MRI of the nbM we set our four goals; our first goal was to review current human nbM region-of-interest (ROI) selection protocols used in MRI studies, which we found have reported highly variable nbM volume estimates. Our next goal was to quantify and discuss the limitations of existing atlas-based volumetry of nbM. We found that the identified ROI volume depends heavily on the atlas used and on the probabilistic threshold set. In addition, we found large disparities even for data/studies using the same atlas and threshold. To test whether spatial resolution contributes to volume variability, as our third goal, we developed a novel nbM mask based on the normalized BigBrain dataset. We found that as long as the spatial resolution of the target data was 1.3 mm isotropic or above, our novel nbM mask offered realistic and stable volume estimates. Finally, as our last goal we tried to discern nbM using publicly available and novel high resolution structural MRI ex vivo MRI datasets. We find that, using an optimised 9.4T quantitative T2⁎ ex vivo dataset, the nbM can be visualised using MRI. We conclude caution is needed when applying the current methods of mapping nbM, especially for high resolution MRI data. Direct imaging of the nbM appears feasible and would eliminate the problems we identify, although further development is required to allow such imaging using standard (f)MRI scanning.
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Affiliation(s)
- Yawen Wang
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.
| | - Minye Zhan
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands; U992 (Cognitive neuroimaging unit), NeuroSpin, INSERM-CEA, Gif sur Yvette, France
| | - Alard Roebroeck
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Peter De Weerd
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Sriranga Kashyap
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands; Techna Institute, University Health Network, Toronto, ON, Canada
| | - Mark J Roberts
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.
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Lin CP, Frigerio I, Boon BDC, Zhou Z, Rozemuller AJM, Bouwman FH, Schoonheim MM, van de Berg WDJ, Jonkman LE. OUP accepted manuscript. Brain 2022; 145:2869-2881. [PMID: 35259207 PMCID: PMC9420016 DOI: 10.1093/brain/awac093] [Citation(s) in RCA: 8] [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: 08/06/2021] [Revised: 01/23/2022] [Accepted: 02/13/2022] [Indexed: 11/24/2022] Open
Abstract
Cognitive deficits in Alzheimer’s disease, specifically amnestic (memory dominant) deficits, are associated with cholinergic degeneration in the basal forebrain. The cholinergic nucleus within the basal forebrain, the nucleus basalis of Meynert, exhibits local atrophy and reduced cortical tract integrity on MRI, and reveals amyloid-β and phosphorylated-tau pathology at autopsy. To understand the pathophysiology of nucleus basalis of Meynert atrophy and its neocortical projections in Alzheimer’s disease, we used a combined post-mortem in situ MRI and histopathology approach. A total of 19 Alzheimer’s disease (10 amnestic and nine non-amnestic) and nine non-neurological control donors underwent 3 T T1-weighted MRI for anatomical delineation and volume assessment of the nucleus basalis of Meynert, and diffusion-weighted imaging for microstructural assessment of the nucleus and its projections. At subsequent brain autopsy, tissue dissection and immunohistochemistry were performed for amyloid-β, phosphorylated-tau and choline acetyltransferase. Compared to controls, we observed an MRI-derived volume reduction and altered microstructural integrity of the nucleus basalis of Meynert in Alzheimer’s disease donors. Furthermore, decreased cholinergic cell density was associated with reduced integrity of the nucleus and its tracts to the temporal lobe, specifically to the temporal pole of the superior temporal gyrus, and the parahippocampal gyrus. Exploratory post hoc subgroup analyses indicated that cholinergic cell density could be associated with cortical tract alterations in amnestic Alzheimer’s disease donors only. Our study illustrates that in Alzheimer’s disease, cholinergic degeneration in the nucleus basalis of Meynert may contribute to damaged cortical projections, specifically to the temporal lobe, leading to cognitive deterioration.
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Affiliation(s)
- Chen Pei Lin
- Correspondence to: Chen-Pei Lin De Boelelaan 1117 1081 HV, Amsterdam, The Netherlands E-mail:
| | - Irene Frigerio
- Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Baayla D C Boon
- Amsterdam UMC, location VUmc, Vrije Universiteit Amsterdam, Department of Pathology, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, Department of Neurology, Alzheimer centrum Amsterdam, Amsterdam, The Netherlands
| | - Zihan Zhou
- Zhejiang University, College of Biomedical Engineering and Instrument Science, Zhejiang, China
| | - Annemieke J M Rozemuller
- Amsterdam UMC, location VUmc, Vrije Universiteit Amsterdam, Department of Pathology, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Femke H Bouwman
- Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, Department of Neurology, Alzheimer centrum Amsterdam, Amsterdam, The Netherlands
| | - Menno M Schoonheim
- Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Wilma D J van de Berg
- Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Laura E Jonkman
- Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
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Sheng W, Guo T, Zhou C, Wu J, Gao T, Pu J, Zhang B, Zhang M, Yang Y, Guan X, Xu X. Altered Cortical Cholinergic Network in Parkinson's Disease at Different Stage: A Resting-State fMRI Study. Front Aging Neurosci 2021; 13:723948. [PMID: 34566625 PMCID: PMC8461333 DOI: 10.3389/fnagi.2021.723948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022] Open
Abstract
The cholinergic system is critical in Parkinson’s disease (PD) pathology, which accounts for various clinical symptoms in PD patients. The substantia innominata (SI) provides the main source of cortical cholinergic innervation. Previous studies revealed cholinergic-related dysfunction in PD pathology at early stage. Since PD is a progressive disorder, alterations of cholinergic system function along with the PD progression have yet to be elucidated. Seventy-nine PD patients, including thirty-five early-stage PD patients (PD-E) and forty-four middle-to-late stage PD patients (PD-M), and sixty-four healthy controls (HC) underwent brain magnetic resonance imaging and clinical assessments. We employed seed-based resting-state functional connectivity analysis to explore the cholinergic-related functional alterations. Correlation analysis was used to investigate the relationship between altered functional connectivity and the severity of motor symptoms in PD patients. Results showed that both PD-E and PD-M groups exhibited decreased functional connectivity between left SI and left frontal inferior opercularis areas and increased functional connectivity between left SI and left cingulum middle area as well as right primary motor and sensory areas when comparing with HC. At advanced stages of PD, functional connectivity in the right primary motor and sensory areas was further increased. These altered functional connectivity were also significantly correlated with the Unified Parkinson’s Disease Rating Scale motor scores. In conclusion, this study illustrated that altered cholinergic function plays an important role in the motor disruptions in PD patients both in early stage as well as during the progression of the disease.
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Affiliation(s)
- Wenshuang Sheng
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Tao Guo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Cheng Zhou
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingjing Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ting Gao
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiali Pu
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Baorong Zhang
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yunjun Yang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Lai SSM, Ng KY, Koh RY, Chok KC, Chye SM. Endosomal-lysosomal dysfunctions in Alzheimer's disease: Pathogenesis and therapeutic interventions. Metab Brain Dis 2021; 36:1087-1100. [PMID: 33881723 DOI: 10.1007/s11011-021-00737-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/08/2021] [Indexed: 12/14/2022]
Abstract
The endosomal-lysosomal system mediates the process of protein degradation through endocytic pathway. This system consists of early endosomes, late endosomes, recycling endosomes and lysosomes. Each component in the endosomal-lysosomal system plays individual crucial role and they work concordantly to ensure protein degradation can be carried out functionally. Dysregulation in the endosomal-lysosomal system can contribute to the pathogenesis of neurodegenerative diseases such as Alzheimer's disease (AD). In AD endosomal-lysosomal abnormalities are the earliest pathological features to note and hence it is important to understand the involvement of endosomal-lysosomal dysfunction in the pathogenesis of AD. In-depth understanding of this dysfunction can allow development of new therapeutic intervention to prevent and treat AD.
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Affiliation(s)
- Shereen Shi Min Lai
- School of Health Science, International Medical University, 57000, Kuala Lumpur, Malaysia
| | - Khuen Yen Ng
- School of Pharmacy, Monash University Malaysia, 47500, Selangor, Malaysia
| | - Rhun Yian Koh
- Division of Biomedical Science and Biotechnology, School of Health Science, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Kian Chung Chok
- School of Health Science, International Medical University, 57000, Kuala Lumpur, Malaysia
| | - Soi Moi Chye
- Division of Biomedical Science and Biotechnology, School of Health Science, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
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Plini ERG, O’Hanlon E, Boyle R, Sibilia F, Rikhye G, Kenney J, Whelan R, Melnychuk MC, Robertson IH, Dockree PM. Examining the Role of the Noradrenergic Locus Coeruleus for Predicting Attention and Brain Maintenance in Healthy Old Age and Disease: An MRI Structural Study for the Alzheimer's Disease Neuroimaging Initiative. Cells 2021; 10:1829. [PMID: 34359997 PMCID: PMC8306442 DOI: 10.3390/cells10071829] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 12/18/2022] Open
Abstract
The noradrenergic theory of Cognitive Reserve (Robertson, 2013-2014) postulates that the upregulation of the locus coeruleus-noradrenergic system (LC-NA) originating in the brainstem might facilitate cortical networks involved in attention, and protracted activation of this system throughout the lifespan may enhance cognitive stimulation contributing to reserve. To test the above-mentioned theory, a study was conducted on a sample of 686 participants (395 controls, 156 mild cognitive impairment, 135 Alzheimer's disease) investigating the relationship between LC volume, attentional performance and a biological index of brain maintenance (BrainPAD-an objective measure, which compares an individual's structural brain health, reflected by their voxel-wise grey matter density, to the state typically expected at that individual's age). Further analyses were carried out on reserve indices including education and occupational attainment. Volumetric variation across groups was also explored along with gender differences. Control analyses on the serotoninergic (5-HT), dopaminergic (DA) and cholinergic (Ach) systems were contrasted with the noradrenergic (NA) hypothesis. The antithetic relationships were also tested across the neuromodulatory subcortical systems. Results supported by Bayesian modelling showed that LC volume disproportionately predicted higher attentional performance as well as biological brain maintenance across the three groups. These findings lend support to the role of the noradrenergic system as a key mediator underpinning the neuropsychology of reserve, and they suggest that early prevention strategies focused on the noradrenergic system (e.g., cognitive-attentive training, physical exercise, pharmacological and dietary interventions) may yield important clinical benefits to mitigate cognitive impairment with age and disease.
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Affiliation(s)
- Emanuele R. G. Plini
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
| | - Erik O’Hanlon
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
- Department of Psychiatry, Royal College of Surgeons in Ireland, Hospital Rd, Beaumont, 9QRH+4F Dublin, Ireland
- Department of Psychiatry, School of Medicine Dublin, Trinity College Dublin, 152-160 Pearse St, 8QV3+99 Dublin, Ireland;
| | - Rory Boyle
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
| | - Francesca Sibilia
- Department of Psychiatry, School of Medicine Dublin, Trinity College Dublin, 152-160 Pearse St, 8QV3+99 Dublin, Ireland;
| | - Gaia Rikhye
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
| | - Joanne Kenney
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
| | - Robert Whelan
- Department of Psychology, Global Brain Health Institute, Trinity College Dublin, Lloyd Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland;
| | - Michael C. Melnychuk
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
| | - Ian H. Robertson
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
- Department of Psychology, Global Brain Health Institute, Trinity College Dublin, Lloyd Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland;
| | - Paul M. Dockree
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
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Zheng W, Li H, Cui B, Liang P, Wu Y, Han X, Li CR, Li K, Wang Z. Altered multimodal magnetic resonance parameters of basal nucleus of Meynert in Alzheimer's disease. Ann Clin Transl Neurol 2020; 7:1919-1929. [PMID: 32888399 PMCID: PMC7545587 DOI: 10.1002/acn3.51176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/12/2020] [Accepted: 08/19/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES We aimed to examine how gray matter volume (GMV), regional blood flow (rCBF), and resting-state functional connectivity (FC) of the basal nucleus of Meynert (BNM) are altered in 40 patients with AD, relative to 30 healthy controls (HCs). METHODS We defined the BNM on the basis of a mask histochemically reconstructed from postmortem human brains. We examined GMV with voxel-based morphometry of high-resolution structural images, rCBF with arterial spin labeling imaging, and whole-brain FC with published routines. We performed partial correlations to explore how the imaging metrics related to cognitive and living status in patients with AD. Further, we employed receiver operating characteristic analysis to compute the "diagnostic" accuracy of these imaging markers. RESULTS AD relative to HC showed lower GMV and higher rCBF of the BNM as well as lower BNM connectivity with the right insula and cerebellum. In addition, the GMVs of BNM were correlated with cognitive and daily living status in AD. Finally, these imaging markers predicted AD (vs. HC) with an accuracy (area under the curve) of 0.70 to 0.86. Combination of BNM metrics provided the best prediction accuracy. CONCLUSIONS By combining multimode MR imaging, we demonstrated volumetric atrophy, hyperperfusion, and disconnection of the BNM in AD. These findings support cholinergic dysfunction as an etiological marker of AD and related dementia.
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Affiliation(s)
- Weimin Zheng
- Department of RadiologyAerospace Center HospitalBeijing100049China
| | - Hui Li
- Department of RadiologyChaoyang Hospital of Capital Medical UniversityBeijing100020China
| | - Bin Cui
- Department of RadiologyAerospace Center HospitalBeijing100049China
| | - Peipeng Liang
- School of PsychologyCapital Normal UniversityBeijing Key Laboratory of Learning and CognitionBeijing100037China
| | - Ye Wu
- Department of RadiologyAerospace Center HospitalBeijing100049China
| | - Xu Han
- Department of RadiologyAerospace Center HospitalBeijing100049China
| | - Chiang‐shan R. Li
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
- Department of NeuroscienceYale University School of MedicineNew HavenConnecticutUSA
| | - Kuncheng Li
- Department of RadiologyXuanwu Hospital of Capital Medical UniversityBeijing100053China
| | - Zhiqun Wang
- Department of RadiologyAerospace Center HospitalBeijing100049China
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Jethwa KD, Dhillon P, Meng D, Auer DP. Are Linear Measurements of the Nucleus Basalis of Meynert Suitable as a Diagnostic Biomarker in Mild Cognitive Impairment and Alzheimer Disease? AJNR Am J Neuroradiol 2019; 40:2039-2044. [PMID: 31727757 DOI: 10.3174/ajnr.a6313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 09/03/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Cell loss within the nucleus basalis of Meynert is an early event in Alzheimer disease. The thickness of the nucleus basalis of Meynert (NBM) can be measured on structural MR imaging. We investigated NBM thickness in relation to cognitive state and biochemical markers. MATERIALS AND METHODS Mean bilateral nucleus basalis of Meynert thickness was measured on coronal T1-weighted MR imaging scans from the Alzheimer's Disease Neuroimaging Initiative dataset. Three hundred and fifteen scans (80 controls, 79 cases of early mild cognitive impairment, 77 cases of late mild cognitive impairment and 79 cases of Alzheimer disease) were assessed. Alzheimer's Disease Assessment Scale-Cognitive scores, CSF tau, and amyloid quantification were extracted. Group differences in NBM thickness, their correlates and measurement reliability were assessed. RESULTS Mean NBM thickness ± SD progressively declined from 2.9 ± 0.3, 2.5 ± 0.3, and 2.3 ± 0.3 to 1.8 ± 0.4 mm in healthy controls, patients with early mild cognitive impairment, late mild cognitive impairment and Alzheimer disease respectively (P < .001). NBM thickness was negatively correlated with Alzheimer's Disease Assessment Scale-Cognitive scores (r = -0.53, P < .001) and weakly positively correlated with CSF amyloid (r = 0.250, P < .001) respectively. No association with CSF tau was found. NBM thickness showed excellent diagnostic accuracy to differentiate Alzheimer disease (area under the curve, 0.986) and late mild cognitive impairment from controls (area under the curve, 0.936) with excellent sensitivity, but lower specificity 66.7%. Intra- and interrater reliability for measurements was 0.66 and 0.47 (P < .001). CONCLUSIONS There is progressive NBM thinning across the aging-dementia spectrum, which correlates with cognitive decline and CSF markers of amyloid-β pathology. We show high diagnostic accuracy but limited reliability, representing an area for future improvement. NBM thickness is a promising, readily available MR imaging biomarker of Alzheimer disease warranting diagnostic-accuracy testing in clinical practice.
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Affiliation(s)
- K D Jethwa
- From the Department of Radiological Sciences, Division of Clinical Neuroscience, School of Medicine; Sir Peter Mansfield Imaging Centre, School of Medicine; and National Institute for Health Research Nottingham Biomedical Research Centre (K.D.J., P.D., D.M., D.P.A.), Queen's Medical Centre, University of Nottingham, Nottingham, UK.
| | - P Dhillon
- From the Department of Radiological Sciences, Division of Clinical Neuroscience, School of Medicine; Sir Peter Mansfield Imaging Centre, School of Medicine; and National Institute for Health Research Nottingham Biomedical Research Centre (K.D.J., P.D., D.M., D.P.A.), Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - D Meng
- From the Department of Radiological Sciences, Division of Clinical Neuroscience, School of Medicine; Sir Peter Mansfield Imaging Centre, School of Medicine; and National Institute for Health Research Nottingham Biomedical Research Centre (K.D.J., P.D., D.M., D.P.A.), Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - D P Auer
- From the Department of Radiological Sciences, Division of Clinical Neuroscience, School of Medicine; Sir Peter Mansfield Imaging Centre, School of Medicine; and National Institute for Health Research Nottingham Biomedical Research Centre (K.D.J., P.D., D.M., D.P.A.), Queen's Medical Centre, University of Nottingham, Nottingham, UK
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APOE-ε4 risk variant for Alzheimer's disease modifies the association between cognitive performance and cerebral morphology in healthy middle-aged individuals. NEUROIMAGE-CLINICAL 2019; 23:101818. [PMID: 30991302 PMCID: PMC6463204 DOI: 10.1016/j.nicl.2019.101818] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 04/01/2019] [Accepted: 04/07/2019] [Indexed: 12/18/2022]
Abstract
The APOE-ε4 genotype is the highest genetic risk factor for Alzheimer's disease (AD). In cognitively unimpaired individuals, it has been related to altered brain morphology, function and earlier amyloid beta accumulation. However, its impact on cognitive performance is less evident. Here, we examine the impact of APOE-ε4 allele load in modulating the association between cognitive functioning and brain morphology in middle-aged healthy individuals. A high-resolution structural MRI scan was acquired and episodic memory (EM) as well as executive functions (EFs) were assessed in a sample of 527 middle-aged unimpaired individuals hosting a substantial representation of ε4-homozygous (N = 64). We adopted a voxel-wise unbiased method to assess whether the number of APOE-ε4 alleles significantly modified the associations between gray matter volumes (GMv) and performance in both cognitive domains. Even though the APOE-ε4 allele load did not exert a direct impact on any cognitive measures, it reversed the relationships between GMv and cognitive performance in a highly symmetrical topological pattern. For EM, interactions mapped onto the inferior temporal gyrus and the dorsal anterior cingulate cortex. Regarding EFs, significant interactions were observed for processing speed, working memory, and visuospatial attention in distinct brain regions. These results suggest that APOE-ε4 carriers display a structure-function association corresponding to an older age than their chronological one. Our findings additionally indicate that APOE-ε4 carriers may rely on the integrity of multiple compensatory brain systems in order to preserve their cognitive abilities, possibly due to an incipient neurodegeneration. Overall this study provides novel insights on the mechanisms through which APOE-ε4 posits an increased AD risk.
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Reduced substantia innominata volume mediates contributions of microvascular and macrovascular disease to cognitive deficits in Alzheimer's disease. Neurobiol Aging 2018; 66:23-31. [PMID: 29505952 DOI: 10.1016/j.neurobiolaging.2018.01.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 01/29/2018] [Accepted: 01/31/2018] [Indexed: 01/06/2023]
Abstract
The relationships between cholinergic system damage and cerebrovascular disease are not entirely understood. Here, we investigate associations between atrophy of the substantia innominata (SI; the origin of cortical cholinergic projections) and measures of large and small vessel disease; specifically, elongation of the juxtaposed internal carotid artery termination and Cholinergic Pathways Hyperintensity scores (CHIPS). The study (n = 105) consisted of patients with Alzheimer's disease (AD) and/or subcortical ischemic vasculopathy, and elderly controls. AD and subcortical ischemic vasculopathy groups showed greater impingement of the carotid termination on the SI and smaller SI volumes. Both carotid termination elongation and CHIPS were associated independently with smaller SI volumes in those with and without AD. Atrophy of the SI mediated effects of carotid termination elongation on language and memory functions and the effect of CHIPS on attention/working memory. In conclusion, SI atrophy was related to cerebrovascular disease of the large and small vessels and to cognitive deficits in people with and without AD.
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Grothe MJ, Kilimann I, Grinberg L, Heinsen H, Teipel S. In Vivo Volumetry of the Cholinergic Basal Forebrain. NEUROMETHODS 2018. [DOI: 10.1007/978-1-4939-7674-4_15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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12
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Damaged fiber tracts of the nucleus basalis of Meynert in Parkinson's disease patients with visual hallucinations. Sci Rep 2017; 7:10112. [PMID: 28860465 PMCID: PMC5579278 DOI: 10.1038/s41598-017-10146-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 08/04/2017] [Indexed: 01/29/2023] Open
Abstract
Damage to fiber tracts connecting the nucleus basalis of Meynert (NBM) to the cerebral cortex may underlie the development of visual hallucinations (VH) in Parkinson’s disease (PD), possibly due to a loss of cholinergic innervation. This was investigated by comparing structural connectivity of the NBM using diffusion tensor imaging in 15 PD patients with VH (PD + VH), 40 PD patients without VH (PD − VH), and 15 age- and gender-matched controls. Fractional anisotropy (FA) and mean diffusivity (MD) of pathways connecting the NBM to the whole cerebral cortex and of regional NBM fiber tracts were compared between groups. In PD + VH patients, compared to controls, higher MD values were observed in the pathways connecting the NBM to the cerebral cortex, while FA values were normal. Regional analysis demonstrated a higher MD of parietal (p = 0.011) and occipital tracts (p = 0.027) in PD + VH, compared to PD − VH patients. We suggest that loss of structural connectivity between the NBM and posterior brain regions may contribute to the etiology of VH in PD. Future studies are needed to determine whether these findings could represent a sensitive marker for the hypothesized cholinergic deficit in PD + VH patients.
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Colloby SJ, Elder GJ, Rabee R, O'Brien JT, Taylor J. Structural grey matter changes in the substantia innominata in Alzheimer's disease and dementia with Lewy bodies: a DARTEL-VBM study. Int J Geriatr Psychiatry 2017; 32:615-623. [PMID: 27197956 PMCID: PMC5434823 DOI: 10.1002/gps.4500] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 04/19/2016] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Several cholinergic nuclei, and in particular the nucleus basalis of Meynert, are localised to the substantia innominata in the basal forebrain. These nuclei provide major cholinergic innervation to the cerebral cortex and hippocampus, and have an essential role in cognitive function. The aim of this study was to investigate volumetric grey matter (GM) changes in the substantia innominata from structural T1 images in Alzheimer's disease (AD), dementia with Lewy bodies (DLB) and healthy older participants using voxel-based morphometry. METHODS Participants (41 DLB, 47 AD and 39 controls) underwent 3 T T1 magnetic resonance imaging and cognitive assessments. Voxel-based morphometry analysis used SPM8 with a substantia innominata brain mask to define the subspace for voxel GM analyses. Group differences, and selected behavioural and clinical correlates, were assessed. RESULTS Compared with that in controls, bilateral GM loss in the substantia innominata was apparent in both AD and DLB. Relative to controls, significant bilateral GM loss in the substantia innominata was observed in DLB and AD. In DLB, significant associations were also observed between substantia innominata GM volume loss, and the levels of cognitive impairment and severity of cognitive fluctuations. CONCLUSIONS Relative to that controls, atrophy of the substantia innominata was apparent in DLB and AD, and is associated with specific clinical manifestations in DLB. © 2016 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Sean J. Colloby
- Institute of Neuroscience, Newcastle UniversityCampus for Ageing and VitalityNewcastle upon TyneUK
| | - Greg J. Elder
- Institute of Neuroscience, Newcastle UniversityCampus for Ageing and VitalityNewcastle upon TyneUK
| | - Riham Rabee
- Institute of Neuroscience, Newcastle UniversityCampus for Ageing and VitalityNewcastle upon TyneUK
| | - John T. O'Brien
- Institute of Neuroscience, Newcastle UniversityCampus for Ageing and VitalityNewcastle upon TyneUK,Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - John‐Paul Taylor
- Institute of Neuroscience, Newcastle UniversityCampus for Ageing and VitalityNewcastle upon TyneUK
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14
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Early-onset mild cognitive impairment in Parkinson's disease: Altered corticopetal cholinergic network. Sci Rep 2017; 7:2381. [PMID: 28539629 PMCID: PMC5443757 DOI: 10.1038/s41598-017-02420-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 04/11/2017] [Indexed: 12/25/2022] Open
Abstract
Degeneration of the substantia innominata (SI) is significantly correlated with cognitive performance in Parkinson’s disease (PD). We examined functional and structural patterns of SI degeneration in drug-naïve PD patients according to the duration of parkinsonism before mild cognitive impairment (MCI) diagnosis. Twenty PD patients with a shorter duration (PD-MCI-SD, <1 year), 18 patients with a longer duration (PD-MCI-LD, ≥1 year), and 29 patients with intact cognition (PD-IC) were included. Seed-based resting-state functional connectivity (rsFC) analysis using bilateral SI seed and region-of-interest-based volumetric analysis were performed. Compared to PD-IC, the collapsed PD-MCI group showed altered rsFC in the right frontal and bilateral parietal areas. PD-MCI-SD showed rsFC alteration in broader frontal and parietal areas compared to the other groups. Decreased rsFC in the right frontal area was also significantly correlated with shorter disease duration. No significant SI volume change was found between the groups. Altered rsFC between the SI and the frontal and parietal areas might be relevant to cognitive dysfunction in PD. Decreased rsFC between the SI and frontal area might be associated with early-onset MCI, suggesting that cholinergic deficits in the frontal brain areas might play an important role in the acceleration of cognitive decline in PD.
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15
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Li H, Jia X, Qi Z, Fan X, Ma T, Ni H, Li CSR, Li K. Altered Functional Connectivity of the Basal Nucleus of Meynert in Mild Cognitive Impairment: A Resting-State fMRI Study. Front Aging Neurosci 2017; 9:127. [PMID: 28522971 PMCID: PMC5415557 DOI: 10.3389/fnagi.2017.00127] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 04/18/2017] [Indexed: 11/22/2022] Open
Abstract
Background: Cholinergic dysfunction plays an important role in mild cognitive impairment (MCI). The basal nucleus of Meynert (BNM) provides the main source of cortical cholinergic innervation. Previous studies have characterized structural changes of the cholinergic basal forebrain in individuals at risk of developing Alzheimer’s disease (AD). However, whether and how functional connectivity of the BNM (BNM-FC) is altered in MCI remains unknown. Objective: The aim of this study was to identify alterations in BNM-FC in individuals with MCI as compared to healthy controls (HCs), and to examine the relationship between these alterations with neuropsychological measures in individuals with MCI. Method: One-hundred-and-one MCI patients and 103 HCs underwent resting-state functional magnetic resonance imaging (rs-fMRI). Imaging data were processed with SPM8 and CONN software. BNM-FC was examined via correlation in low frequency fMRI signal fluctuations between the BNM and all other brain voxels. Group differences were examined with a covariance analysis with age, gender, education level, mean framewise displacement (FD) and global correlation (GCOR) as nuisance covariates. Pearson’s correlation was conducted to evaluate the relationship between the BNM-FC and clinical assessments. Result: Compared with HCs, individuals with MCI showed significantly decreased BNM-FC in the left insula extending into claustrum (insula/claustrum). Furthermore, greater decrease in BNM-FC with insula/claustrum was associated with more severe impairment in immediate recall during Auditory Verbal Learning Test (AVLT) in MCI patients. Conclusion: MCI is associated with changes in BNM-FC to the insula/claustrum in relation to cognitive impairments. These new findings may advance research of the cholinergic bases of cognitive dysfunction during healthy aging and in individuals at risk of developing AD.
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Affiliation(s)
- Hui Li
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China.,Beijing Key Lab of MRI and Brain InformaticsBeijing, China
| | - Xiuqin Jia
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China.,Beijing Key Lab of MRI and Brain InformaticsBeijing, China
| | - Zhigang Qi
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China.,Beijing Key Lab of MRI and Brain InformaticsBeijing, China
| | - Xiang Fan
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China
| | - Tian Ma
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China
| | - Hong Ni
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of MedicineNew Haven, CT, USA.,Department of Neuroscience, Yale University School of MedicineNew Haven, CT, USA.,Beijing Huilongguan HospitalBeijing, China
| | - Kuncheng Li
- Department of Radiology, Xuanwu Hospital, Capital Medical UniversityBeijing, China.,Beijing Key Lab of MRI and Brain InformaticsBeijing, China
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Al-Radaideh AM, Rababah EM. The role of magnetic resonance imaging in the diagnosis of Parkinson's disease: a review. Clin Imaging 2016; 40:987-96. [DOI: 10.1016/j.clinimag.2016.05.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 04/09/2016] [Accepted: 05/23/2016] [Indexed: 12/31/2022]
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17
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Mufson EJ, Mahady L, Waters D, Counts SE, Perez SE, DeKosky ST, Ginsberg SD, Ikonomovic MD, Scheff SW, Binder LI. Hippocampal plasticity during the progression of Alzheimer's disease. Neuroscience 2015; 309:51-67. [PMID: 25772787 PMCID: PMC4567973 DOI: 10.1016/j.neuroscience.2015.03.006] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 02/05/2015] [Accepted: 03/04/2015] [Indexed: 11/27/2022]
Abstract
Neuroplasticity involves molecular and structural changes in central nervous system (CNS) throughout life. The concept of neural organization allows for remodeling as a compensatory mechanism to the early pathobiology of Alzheimer's disease (AD) in an attempt to maintain brain function and cognition during the onset of dementia. The hippocampus, a crucial component of the medial temporal lobe memory circuit, is affected early in AD and displays synaptic and intraneuronal molecular remodeling against a pathological background of extracellular amyloid-beta (Aβ) deposition and intracellular neurofibrillary tangle (NFT) formation in the early stages of AD. Here we discuss human clinical pathological findings supporting the concept that the hippocampus is capable of neural plasticity during mild cognitive impairment (MCI), a prodromal stage of AD and early stage AD.
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Affiliation(s)
- E J Mufson
- Barrow Neurological Institute, St. Joseph's Medical Center, Department of Neurobiology, Phoenix, AZ 85013, United States.
| | - L Mahady
- Barrow Neurological Institute, St. Joseph's Medical Center, Department of Neurobiology, Phoenix, AZ 85013, United States
| | - D Waters
- Barrow Neurological Institute, St. Joseph's Medical Center, Department of Neurobiology, Phoenix, AZ 85013, United States
| | - S E Counts
- Department of Translational Science & Molecular Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, United States
| | - S E Perez
- Division of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - S T DeKosky
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - S D Ginsberg
- Center for Dementia Research, Nathan Kline Institute, Departments of Psychiatry and Physiology & Neuroscience, New York University Langone Medical Center, Orangeburg, NY, United States
| | - M D Ikonomovic
- Departments of Neurology and Psychiatry, University of Pittsburgh, Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - S W Scheff
- Sanders Brown Center on Aging, University of Kentucky, Lexington, KY, United States
| | - L I Binder
- Department of Translational Science & Molecular Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, United States
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Kerbler GM, Nedelska Z, Fripp J, Laczó J, Vyhnalek M, Lisý J, Hamlin AS, Rose S, Hort J, Coulson EJ. Basal Forebrain Atrophy Contributes to Allocentric Navigation Impairment in Alzheimer's Disease Patients. Front Aging Neurosci 2015; 7:185. [PMID: 26441643 PMCID: PMC4585346 DOI: 10.3389/fnagi.2015.00185] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/14/2015] [Indexed: 01/28/2023] Open
Abstract
The basal forebrain degenerates in Alzheimer’s disease (AD) and this process is believed to contribute to the cognitive decline observed in AD patients. Impairment in spatial navigation is an early feature of the disease but whether basal forebrain dysfunction in AD is responsible for the impaired navigation skills of AD patients is not known. Our objective was to investigate the relationship between basal forebrain volume and performance in real space as well as computer-based navigation paradigms in an elderly cohort comprising cognitively normal controls, subjects with amnestic mild cognitive impairment and those with AD. We also tested whether basal forebrain volume could predict the participants’ ability to perform allocentric- vs. egocentric-based navigation tasks. The basal forebrain volume was calculated from 1.5 T magnetic resonance imaging (MRI) scans, and navigation skills were assessed using the human analog of the Morris water maze employing allocentric, egocentric, and mixed allo/egocentric real space as well as computerized tests. When considering the entire sample, we found that basal forebrain volume correlated with spatial accuracy in allocentric (cued) and mixed allo/egocentric navigation tasks but not the egocentric (uncued) task, demonstrating an important role of the basal forebrain in mediating cue-based spatial navigation capacity. Regression analysis revealed that, although hippocampal volume reflected navigation performance across the entire sample, basal forebrain volume contributed to mixed allo/egocentric navigation performance in the AD group, whereas hippocampal volume did not. This suggests that atrophy of the basal forebrain contributes to aspects of navigation impairment in AD that are independent of hippocampal atrophy.
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Affiliation(s)
- Georg M Kerbler
- Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute, The University of Queensland , Brisbane, QLD , Australia
| | - Zuzana Nedelska
- Memory Clinic, Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital , Prague , Czech Republic ; International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Jurgen Fripp
- Computational Informatics, Commonwealth Scientific and Industrial Research Organisation , Brisbane, QLD , Australia
| | - Jan Laczó
- Memory Clinic, Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital , Prague , Czech Republic ; International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Martin Vyhnalek
- Memory Clinic, Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital , Prague , Czech Republic ; International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Jiří Lisý
- Department of Radiology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital , Prague , Czech Republic
| | - Adam S Hamlin
- Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute, The University of Queensland , Brisbane, QLD , Australia
| | - Stephen Rose
- Computational Informatics, Commonwealth Scientific and Industrial Research Organisation , Brisbane, QLD , Australia
| | - Jakub Hort
- Memory Clinic, Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital , Prague , Czech Republic ; International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Elizabeth J Coulson
- Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute, The University of Queensland , Brisbane, QLD , Australia
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Grothe MJ, Heinsen H, Amaro E, Grinberg LT, Teipel SJ. Cognitive Correlates of Basal Forebrain Atrophy and Associated Cortical Hypometabolism in Mild Cognitive Impairment. Cereb Cortex 2015; 26:2411-2426. [PMID: 25840425 DOI: 10.1093/cercor/bhv062] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Degeneration of basal forebrain (BF) cholinergic nuclei is associated with cognitive decline, and this effect is believed to be mediated by neuronal dysfunction in the denervated cortical areas. MRI-based measurements of BF atrophy are increasingly being used as in vivo surrogate markers for cholinergic degeneration, but the functional implications of reductions in BF volume are not well understood. We used high-resolution MRI, fluorodeoxyglucose-positron emission tomography (PET), and neuropsychological test data of 132 subjects with mild cognitive impairment (MCI) and 177 cognitively normal controls to determine associations between BF atrophy, cortical hypometabolism, and cognitive deficits. BF atrophy in MCI correlated with both impaired memory function and attentional control deficits, whereas hippocampus volume was more specifically associated with memory deficits. BF atrophy was also associated with widespread cortical hypometabolism, and path analytic models indicated that hypometabolism in domain-specific cortical networks mediated the association between BF volume and cognitive dysfunction. The presence of cortical amyloid pathology, as assessed using AV45-PET, did not significantly interact with the observed associations. These data underline the potential of multimodal imaging markers to study structure-function-cognition relationships in the living human brain and provide important in vivo evidence for an involvement of the human BF in cortical activity and cognitive function.
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Affiliation(s)
- Michel J Grothe
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - Helmut Heinsen
- Laboratory of Morphological Brain Research, Department of Psychiatry, University of Würzburg, Würzburg, Germany
| | | | - Lea T Grinberg
- Aging Brain Study Group, LIM-22, Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil.,UCSF Memory and Aging Center, University of California - San Francisco, San Francisco, CA, USA
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
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20
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Kilimann I, Grothe M, Heinsen H, Alho EJL, Grinberg L, Amaro E, Dos Santos GAB, da Silva RE, Mitchell AJ, Frisoni GB, Bokde ALW, Fellgiebel A, Filippi M, Hampel H, Klöppel S, Teipel SJ. Subregional basal forebrain atrophy in Alzheimer's disease: a multicenter study. J Alzheimers Dis 2014; 40:687-700. [PMID: 24503619 DOI: 10.3233/jad-132345] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Histopathological studies in Alzheimer's disease (AD) suggest severe and region-specific neurodegeneration of the basal forebrain cholinergic system (BFCS). Here, we studied the between-center reliability and diagnostic accuracy of MRI-based BFCS volumetry in a large multicenter data set, including participants with prodromal (n = 41) or clinically manifest AD (n = 134) and 148 cognitively healthy controls. Atrophy was determined using voxel-based and region-of-interest based analyses of high-dimensionally normalized MRI scans using a newly created map of the BFCS based on postmortem in cranio MRI and histology. The AD group showed significant volume reductions of all subregions of the BFCS, which were most pronounced in the posterior nucleus basalis Meynert (NbM). The mild cognitive impairment-AD group showed pronounced volume reductions in the posterior NbM, but preserved volumes of anterior-medial regions. Diagnostic accuracy of posterior NbM volume was superior to hippocampus volume in both groups, despite higher multicenter variability of the BFCS measurements. The data of our study suggest that BFCS morphometry may provide an emerging biomarker in AD.
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Affiliation(s)
- Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Rostock, Germany Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Michel Grothe
- German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Rostock, Germany
| | - Helmut Heinsen
- Laboratory of Morphological Brain Research, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Eduardo Joaquim Lopez Alho
- Laboratory of Morphological Brain Research, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Lea Grinberg
- Department of Neurology, University of California San Francisco, San Francisco, USA Aging Brain Study Group, LIM-22, Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Edson Amaro
- Department of Radiology, University of Sao Paulo, Medical School, Sao Paulo, Brazil
| | | | | | - Alex J Mitchell
- Department of Psycho-oncology, University of Leicester, Leicester, UK
| | - Giovanni B Frisoni
- LENITEM Laboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS Centro San Giovanni di Dio, FBF, Brescia, Italy
| | - Arun L W Bokde
- Cognitive Systems Group, Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland
| | - Andreas Fellgiebel
- Department of Psychiatry, University Medical Center of Mainz, Mainz, Germany
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Scientific Institute and University "Vita-Salute" San Raffaele, Mailand, Italy
| | - Harald Hampel
- Department of Psychiatry, Goethe University, Frankfurt, Germany
| | - Stefan Klöppel
- Department of Psychiatry and Psychotherapy, Freiburg Brain Imaging, University Medical Center Freiburg, Freiburg, Germany
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Rostock, Germany Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
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21
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Kerbler GM, Fripp J, Rowe CC, Villemagne VL, Salvado O, Rose S, Coulson EJ. Basal forebrain atrophy correlates with amyloid β burden in Alzheimer's disease. NEUROIMAGE-CLINICAL 2014; 7:105-13. [PMID: 25610772 PMCID: PMC4299972 DOI: 10.1016/j.nicl.2014.11.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 06/11/2014] [Accepted: 11/18/2014] [Indexed: 12/11/2022]
Abstract
The brains of patients suffering from Alzheimer's disease (AD) have three classical pathological hallmarks: amyloid-beta (Aβ) plaques, tau tangles, and neurodegeneration, including that of cholinergic neurons of the basal forebrain. However the relationship between Aβ burden and basal forebrain degeneration has not been extensively studied. To investigate this association, basal forebrain volumes were determined from magnetic resonance images of controls, subjects with amnestic mild cognitive impairment (aMCI) and AD patients enrolled in the longitudinal Alzheimer's Disease Neuroimaging Initiative (ADNI) and Australian Imaging, Biomarkers and Lifestyle (AIBL) studies. In the AIBL cohort, these volumes were correlated within groups to neocortical gray matter retention of Pittsburgh compound B (PiB) from positron emission tomography images as a measure of Aβ load. The basal forebrain volumes of AD and aMCI subjects were significantly reduced compared to those of control subjects. Anterior basal forebrain volume was significantly correlated to neocortical PiB retention in AD subjects and aMCI subjects with high Aβ burden, whereas posterior basal forebrain volume was significantly correlated to neocortical PiB retention in control subjects with high Aβ burden. Therefore this study provides new evidence for a correlation between neocortical Aβ accumulation and basal forebrain degeneration. In addition, cluster analysis showed that subjects with a whole basal forebrain volume below a determined cut-off value had a 7 times higher risk of having a worse diagnosis within ~18 months. The link between amyloid (Aβ) and basal forebrain degeneration in AD is unclear. We find that basal forebrain volumes are correlated with neocortical Aβ burden. Basal forebrain volume correlates with Aβ burden in at-risk control subjects. Basal forebrain atrophy delineates subjects at increased risk of progressing to AD.
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Key Words
- 3D, 3-dimensional
- AD, Alzheimer's disease
- ADNI, Alzheimer's Disease Neuroimaging Initiative
- AIBL, Australian Imaging, Biomarkers and Lifestyle Flagship Study of Aging
- Alzheimer's disease
- Amyloid
- Aβ, amyloid-beta
- Basal forebrain
- CSF, cerebrospinal fluid
- GM, gray matter
- HC, healthy control
- MCI, mild cognitive impairment
- MNI, Montreal Neurological Institute
- MPM, maximum probability maps
- MPRAGE, magnetization prepared rapid gradient echo
- MRI, magnetic resonance imaging
- Magnetic resonance imaging
- OR, odds ratio
- PET
- PET, positron emission tomography
- PiB, Pittsburgh compound B
- SPSS, statistics software package for the social sciences
- SUVR, standard uptake value ratio
- SyN, symmetric normalization
- T1W, T1-weighted
- TG-ROC, two-graph receiver operating characteristic
- WM, white matter
- aMCI, amnestic mild cognitive impairment
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Affiliation(s)
- Georg M Kerbler
- Queensland Brain Institute, Clem Jones Centre for Ageing Dementia Research, The University of Queensland, Brisbane, Qld 4072, Australia
| | - Jürgen Fripp
- Commonwealth Scientific and Industrial Research Organisation, Computational Informatics, Brisbane, Qld 4029, Australia
| | - Christopher C Rowe
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Vic. 3084, Australia
| | - Victor L Villemagne
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Vic. 3084, Australia ; Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Vic. 3084, Australia
| | - Olivier Salvado
- Commonwealth Scientific and Industrial Research Organisation, Computational Informatics, Brisbane, Qld 4029, Australia
| | - Stephen Rose
- Commonwealth Scientific and Industrial Research Organisation, Computational Informatics, Brisbane, Qld 4029, Australia
| | - Elizabeth J Coulson
- Queensland Brain Institute, Clem Jones Centre for Ageing Dementia Research, The University of Queensland, Brisbane, Qld 4072, Australia
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Grothe MJ, Ewers M, Krause B, Heinsen H, Teipel SJ. Basal forebrain atrophy and cortical amyloid deposition in nondemented elderly subjects. Alzheimers Dement 2014; 10:S344-53. [PMID: 24418052 PMCID: PMC4092050 DOI: 10.1016/j.jalz.2013.09.011] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 08/09/2013] [Accepted: 09/04/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND Both neurodegeneration of the cholinergic basal forebrain (BF) and deposition of β-amyloid are early events in the course of Alzheimer's disease (AD). Associations between increased amyloid pathology and cholinergic atrophy have been described in autopsy studies. METHODS We used structural MRI and AV45-PET amyloid imaging data of 225 cognitively normal or mildly impaired elderly subjects from the Alzheimer's Disease Neuroimaging Initiative to assess in vivo associations between BF atrophy and cortical amyloid deposition. Associations were examined using region-of-interest (ROI) and voxel-based approaches with reference to cytoarchitectonic mappings of the cholinergic BF nuclei. RESULTS ROI- and voxel-based approaches yielded complementary evidence for an association between BF volume and cortical amyloid deposition in presymptomatic and predementia stages of AD, irrespective of age, gender, and APOE genotype. CONCLUSIONS The observed correlations between BF atrophy and cortical amyloid load likely reflect associations between cholinergic degeneration and amyloid pathology as reported in neuropathologic examination studies.
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Affiliation(s)
- Michel J Grothe
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany
| | - Bernd Krause
- Department of Nuclear Medicine, University of Rostock, Rostock, Germany
| | - Helmut Heinsen
- Laboratory of Morphological Brain Research, Department of Psychiatry, University of Würzburg, Würtzburg, Germany
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
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Lee JE, Cho KH, Song SK, Kim HJ, Lee HS, Sohn YH, Lee PH. Exploratory analysis of neuropsychological and neuroanatomical correlates of progressive mild cognitive impairment in Parkinson's disease. J Neurol Neurosurg Psychiatry 2014; 85:7-16. [PMID: 23828835 DOI: 10.1136/jnnp-2013-305062] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Parkinson's disease with mild cognitive impairment (PD-MCI) is a heterogeneous entity in terms of cognitive profiles and conversion to dementia. However, the risk factors for ongoing cognitive decline in patients with PD-MCI are not clearly defined. METHODS 51 patients with PD-MCI were prospectively followed-up for a minimum of 2 years. Subjects were classified as MCI converters (n=15) or MCI non-converters (n=36) based on whether they were subsequently diagnosed with PD dementia. We explored cognitive profiles and neuroanatomical characteristics of PD-MCI converters using voxel based morphometry (VBM) of grey matter (GM) density and region of interest based volumetric analysis of the substantia innominata (SI). RESULTS PD-MCI converters showed more severe cognitive deficits in frontal executive functions, immediate verbal memory and visual recognition memory compared with PD-MCI non-converters. VBM analysis revealed that PD-MCI converters had significantly lower GM density in the left prefrontal areas, left insular cortex and bilateral caudate nucleus compared with that in PD-MCI non-converters. The mean normalised SI volume was significantly smaller in both PD-MCI converters (1.19±0.35, p<0.001) and PD-MCI non-converters (1.52±0.27, p<0.001) compared with that in controls (1.87±0.19). PD-MCI converters had a significantly smaller normalised SI volume than PD-MCI non-converters (p<0.001). CONCLUSIONS Our data show that atrophy in the frontostriatal areas and cholinergic structures, as well as frontal lobe associated cognitive performance, may act as predictors of dementia in PD-MCI patients, suggesting distinctive patterns of cognitive profiles and a neuroanatomical basis for progressive PD-MCI.
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Affiliation(s)
- Ji E Lee
- Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, , Seoul, Korea
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24
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Sunwoo MK, Cho KH, Hong JY, Lee JE, Sohn YH, Lee PH. Thalamic volume and related visual recognition are associated with freezing of gait in non-demented patients with Parkinson's disease. Parkinsonism Relat Disord 2013; 19:1106-9. [PMID: 23938134 DOI: 10.1016/j.parkreldis.2013.07.023] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 07/05/2013] [Accepted: 07/24/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND The pathophysiology of freezing of gait (FOG) in non-demented Parkinson's disease (PD) patients remains poorly understood. Recent studies have suggested that neurochemical alterations in the cholinergic systems play a role in the development of FOG. Here, we evaluated the association between subcortical cholinergic structures and FOG in patients with non-demented PD. METHODS We recruited 46 non-demented patients with PD, categorized into PD with (n = 16) and without FOG (n = 30) groups. We performed neuropsychological test, region-of-interest-based volumetric analysis of the substantia innominata (SI) and automatic analysis of subcortical brain structures using a computerized segmentation procedure. RESULTS The comprehensive neuropsychological assessment showed that PD patients with FOG had lower cognitive performance in the frontal executive and visual-related functions compared with those without freezing of gait. The normalized SI volume did not differ significantly between the two groups (1.65 ± 0.18 vs. 1.68 ± 0.31). The automatic analysis of subcortical structures revealed that the thalamic volumes were significantly reduced in PD patients with FOG compared with those without FOG after adjusting for age, sex, disease duration, the Unified PD Rating Scale scores and total intracranial volume (left: 6.71 vs. 7.16 cm3, p = 0.029, right: 6.47 vs. 6.91 cm3, p = 0.026). Multiple linear regression analysis revealed that thalamic volume showed significant positive correlations with visual recognition memory (left: β = 0.441, p = 0.037, right: β = 0.498, p = 0.04). CONCLUSIONS These data suggest that thalamic volume and related visual recognition, rather than the cortical cholinergic system arising from the SI, may be a major contributor to the development of freezing of gait in non-demented patients with PD.
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Affiliation(s)
- Mun Kyung Sunwoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
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25
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Ziegler DA, Wonderlick JS, Ashourian P, Hansen LA, Young JC, Murphy AJ, Koppuzha CK, Growdon JH, Corkin S. Substantia nigra volume loss before basal forebrain degeneration in early Parkinson disease. JAMA Neurol 2013. [PMID: 23183921 DOI: 10.1001/jamaneurol.2013.597] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To test the hypothesis that degeneration of the substantia nigra pars compacta (SNc) precedes that of the cholinergic basal forebrain (BF) in Parkinson disease (PD) using new multispectral structural magnetic resonance (MR) imaging tools to measure the volumes of the SNc and BF. DESIGN Matched case-control study. SETTING The Athinoula A. Martinos Imaging Center at the McGovern Institute for Brain Research, Massachusetts Institute of Technology (MIT), and the Massachusetts General Hospital/MIT Morris Udall Center of Excellence in Parkinson Disease Research. PATIENTS Participants included 29 patients with PD (Hoehn and Yahr [H&Y] stages 1-3) and 27 matched healthy control subjects. MAIN OUTCOME MEASURES We acquired multiecho T1-weighted, multiecho proton density, T2-weighted, and T2-weighted fluid-attenuated inversion recovery (FLAIR) sequences from each participant. For the SNc, we created a weighted mean of the multiple echoes, yielding a single volume with a high ratio of contrast to noise. We visualized the BF using T2-weighted FLAIR images. For each participant, we manually labeled the 2 structures and calculated their volumes. RESULTS Relative to the controls, 13 patients with H&Y stage 1 PD had significantly decreased SNc volumes. Sixteen patients with H&Y stage 2 or 3 PD showed little additional volume loss. In contrast, the BF volume loss occurred later in the disease, with a significant decrease apparent in patients having H&Y stage 2 or 3 PD compared with the controls and the patients having H&Y stage 1 PD. The latter group did not differ significantly from the controls. CONCLUSION Our results support the proposed neuropathological trajectory in PD and establish novel multispectral methods as MR imaging biomarkers for tracking the degeneration of the SNc and BF.
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Affiliation(s)
- David A Ziegler
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
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Gao FQ, Pettersen JA, Bocti C, Nestor SM, Kiss A, Black SE. Is encroachment of the carotid termination into the substantia innominata associated with its atrophy and cognition in Alzheimer's disease? Neurobiol Aging 2013; 34:1807-14. [PMID: 23414670 DOI: 10.1016/j.neurobiolaging.2013.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 01/16/2013] [Accepted: 01/20/2013] [Indexed: 10/27/2022]
Abstract
The internal carotid artery termination (CAT) ends in a T-shaped bifurcation just below the substantia innominata (SI), which contains cognitively strategic cholinergic neurons and undergoes atrophy in Alzheimer's disease (AD). This study investigated whether an elongated CAT with possible resulting encroachment into the SI would correlate with SI atrophy and with cognitive dysfunction in AD. We rated the degree of CAT encroachment upon the SI and measured SI volume on magnetic resonance imaging in 30 AD patients, 30 AD patients with subcortical small vessel disease, and 30 age-matched controls. CAT encroachment significantly correlated with SI volume after adjusting for age within the overall group and the groups with dementia. AD patients with higher CAT encroachment scores had lower SI volumes and lower attention, memory, and executive test scores. These data suggest that CAT encroachment may mechanically injure the SI, exacerbating cholinergic damage and contributing to cognitive impairment. This process may represent a possible previously underappreciated mechanism for interaction between large-vessel cerebrovascular disease and AD.
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Affiliation(s)
- Fu-qiang Gao
- Linda C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
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Ziegler DA, Corkin S. New MRI Biomarkers Advance the Characterization of Parkinson Disease. EUROPEAN NEUROLOGICAL REVIEW 2013; 8:85-89. [PMID: 24999373 DOI: 10.17925/enr.2013.08.02.85] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The pathophysiology of idiopathic Parkinson disease (PD) is traditionally characterized as substantia nigra degeneration, but careful examination of the widespread neuropathological changes suggests individual differences in neuronal vulnerability. A major limitation to studies of disease progression in PD has been that conventional MRI techniques provide relatively poor contrast for the structures that are affected by the disease, and thus are not typically used in experimental or clinical studies. Here, we review the current state of structural MRI as applied to the analysis of the PD brain. We also describe a new multispectral MRI method that provides improved contrast for the substantia nigra and basal forebrain, which we recently used to show that these structures display different trajectories of volume loss early in the disease.
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Affiliation(s)
- David A Ziegler
- Department of Neurology and the Center for Integrative Neuroscience, University of California San Francisco, San Francisco, CA
| | - Suzanne Corkin
- Department of Brain & Cognitive Sciences, MIT, Cambridge, MA
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Grothe M, Heinsen H, Teipel S. Longitudinal measures of cholinergic forebrain atrophy in the transition from healthy aging to Alzheimer's disease. Neurobiol Aging 2012; 34:1210-20. [PMID: 23158764 DOI: 10.1016/j.neurobiolaging.2012.10.018] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 10/05/2012] [Accepted: 10/20/2012] [Indexed: 01/19/2023]
Abstract
Recent evidence from cross-sectional in vivo imaging studies suggests that atrophy of the cholinergic basal forebrain (BF) in Alzheimer's disease (AD) can be distinguished from normal age-related degeneration even at predementia stages of the disease. Longitudinal study designs are needed to specify the dynamics of BF degeneration in the transition from normal aging to AD. We applied recently developed techniques for in vivo volumetry of the BF to serial magnetic resonance imaging scans of 82 initially healthy elderly individuals (60-93 years) and 50 patients with very mild AD (Clinical Dementia Rating score = 0.5) that were clinically followed over an average of 3 ± 1.5 years. BF atrophy rates were found to be significantly higher than rates of global brain shrinkage even in cognitively stable healthy elderly individuals. Compared with healthy control subjects, very mild AD patients showed reduced BF volumes at baseline and increased volume loss over time. Atrophy of the BF was more pronounced in progressive patients compared with those that remained stable. The cholinergic BF undergoes disproportionate degeneration in the aging process, which is further increased by the presence of AD.
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Affiliation(s)
- Michel Grothe
- Department of Psychiatry, University of Rostock, Germany.
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Diffusion-weighted magnetic resonance imaging detection of basal forebrain cholinergic degeneration in a mouse model. Neuroimage 2012; 66:133-41. [PMID: 23128077 DOI: 10.1016/j.neuroimage.2012.10.075] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 10/19/2012] [Accepted: 10/26/2012] [Indexed: 11/21/2022] Open
Abstract
Loss of basal forebrain cholinergic neurons is an early and key feature of Alzheimer's disease, and magnetic resonance imaging (MRI) volumetric measurement of the basal forebrain has recently gained attention as a potential diagnostic tool for this condition. The aim of this study was to determine whether loss of basal forebrain cholinergic neurons underpins changes which can be detected through diffusion MRI using diffusion tensor imaging (DTI) and probabilistic tractography in a mouse model. To cause selective basal forebrain cholinergic degeneration, the toxin saporin conjugated to a p75 neurotrophin receptor antibody (mu-p75-SAP) was used. This resulted in ~25% loss of the basal forebrain cholinergic neurons and significant loss of terminal cholinergic projections in the hippocampus, as determined by histology. To test whether lesion of cholinergic neurons caused basal forebrain, hippocampal, or whole brain atrophy, we performed manual segmentation analysis, which revealed no significant atrophy in lesioned animals compared to controls (Rb-IgG-SAP). However, analysis by DTI of the basal forebrain area revealed a significant increase in fractional anisotropy (FA; +7.7%), mean diffusivity (MD; +6.1%), axial diffusivity (AD; +8.5%) and radial diffusivity (RD; +4.0%) in lesioned mice compared to control animals. These parameters strongly inversely correlated with the number of choline acetyl transferase-positive neurons, with FA showing the greatest association (r(2)=0.72), followed by MD (r(2)=0.64), AD (r(2)=0.64) and RD (r(2)=0.61). Moreover, probabilistic tractography analysis of the septo-hippocampal tracts originating from the basal forebrain revealed an increase in streamline MD (+5.1%) and RD (+4.3%) in lesioned mice. This study illustrates that moderate loss of basal forebrain cholinergic neurons (representing only a minor proportion of all septo-hippocampal axons) can be detected by measuring either DTI parameters of the basal forebrain nuclei or tractography parameters of the basal forebrain tracts. These findings provide increased support for using DTI and probabilistic tractography as non-invasive tools for diagnosing and/or monitoring the progression of conditions affecting the integrity of the basal forebrain cholinergic system in humans, including Alzheimer's disease.
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30
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Grothe M, Heinsen H, Teipel SJ. Atrophy of the cholinergic Basal forebrain over the adult age range and in early stages of Alzheimer's disease. Biol Psychiatry 2012; 71:805-13. [PMID: 21816388 PMCID: PMC3701122 DOI: 10.1016/j.biopsych.2011.06.019] [Citation(s) in RCA: 198] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 05/31/2011] [Accepted: 06/22/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND The basal forebrain cholinergic system (BFCS) is known to undergo moderate neurodegenerative changes during normal aging as well as severe atrophy in Alzheimer's disease (AD). However, there is a controversy regarding how the cholinergic lesion in AD relates to early and incipient stages of the disease. In vivo imaging studies on the structural integrity of the BFCS in normal and pathologic aging are rare. METHODS We applied automated morphometry techniques in combination with high-dimensional image warping and a cytoarchitectonic map of basal forebrain cholinergic nuclei to a large cross-sectional data set of high-resolution magnetic resonance imaging scans, covering the whole adult age range (20-94 years; n = 211) as well as patients with very mild AD (Clinical Dementia Rating = .5; n = 69) and clinically manifest AD (AD; Clinical Dementia Rating = 1; n = 28). For comparison, we investigated hippocampus volume using automated volumetry. RESULTS Volume of the BFCS declined from early adulthood on, and atrophy aggravated in advanced age. Volume reductions in very mild AD were most pronounced in posterior parts of the nucleus basalis of Meynert, whereas in AD, atrophy was more extensive and included the whole BFCS. In clinically manifest AD, the diagnostic accuracy of BFCS volume reached the diagnostic accuracy of hippocampus volume. CONCLUSIONS Our findings indicate that cholinergic degeneration in AD occurs against a background of age-related atrophy and that exacerbated atrophy in AD can be detected at earliest stages of cognitive impairment. Automated in vivo morphometry of the BFCS may become a useful tool to assess BF cholinergic degeneration in normal and pathologic aging.
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Affiliation(s)
- Michel Grothe
- Department of Psychiatry, University Rostock, Germany.
| | - Helmut Heinsen
- Morphological Brain Research Unit, Department of Psychiatry, University Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany
| | - Stefan J. Teipel
- Department of Psychiatry, University Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany,DZNE, German Center for Neurodegenerative Disorders, Gehlsheimer Str. 20, 18147 Rostock, Germany
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31
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Mufson EJ, Binder L, Counts SE, DeKosky ST, de Toledo-Morrell L, Ginsberg SD, Ikonomovic MD, Perez SE, Scheff SW. Mild cognitive impairment: pathology and mechanisms. Acta Neuropathol 2012; 123:13-30. [PMID: 22101321 PMCID: PMC3282485 DOI: 10.1007/s00401-011-0884-1] [Citation(s) in RCA: 155] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 09/29/2011] [Accepted: 09/30/2011] [Indexed: 10/15/2022]
Abstract
Mild cognitive impairment (MCI) is rapidly becoming one of the most common clinical manifestations affecting the elderly. The pathologic and molecular substrate of people diagnosed with MCI is not well established. Since MCI is a human specific disorder and neither the clinical nor the neuropathological course appears to follow a direct linear path, it is imperative to characterize neuropathology changes in the brains of people who came to autopsy with a well-characterized clinical diagnosis of MCI. Herein, we discuss findings derived from clinical pathologic studies of autopsy cases who died with a clinical diagnosis of MCI. The heterogeneity of clinical MCI imparts significant challenges to any review of this subject. The pathologic substrate of MCI is equally complex and must take into account not only conventional plaque and tangle pathology but also a wide range of cellular, biochemical and molecular deficits, many of which relate to cognitive decline as well as compensatory responses to the progressive disease process. The multifaceted nature of the neuronal disconnection syndrome associated with MCI suggests that there is no single event which precipitates this prodromal stage of AD. In fact, it can be argued that neuronal degeneration initiated at different levels of the central nervous system drives cognitive decline as a final common pathway at this stage of the dementing disease process.
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Affiliation(s)
- Elliott J Mufson
- Department of Neurological Sciences, Rush University Medical Center, 1735 West Harrison St., Suite 300, Chicago, IL 60612, USA.
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32
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Kim HJ, Lee JE, Shin SJ, Sohn YH, Lee PH. Analysis of the substantia innominata volume in patients with Parkinson's disease with dementia, dementia with lewy bodies, and Alzheimer's disease. J Mov Disord 2011; 4:68-72. [PMID: 24868398 PMCID: PMC4027689 DOI: 10.14802/jmd.11014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 10/21/2011] [Indexed: 11/24/2022] Open
Abstract
Background and Purpose The substantia innominata (SI) contains the nucleus basalis of Meynert, which is the major source of cholinergic input to the cerebral cortex. We hypothesized that degeneration of the SI and its relationship to general cognitive performance differs in amyloidopathy and synucleinopathy. Methods We used magnetic resonance imaging (MRI)-based volumetric analysis to evaluate the SI volume in patients with amnestic mild cognitive impairment (aMCI), Alzheimer’s disease (AD), Parkinson’s disease-mild cognitive impairment (PD-MCI), PD with dementia (PDD), dementia with Lewy bodies (DLB), and healthy elderly controls. The correlation between SI volume and general cognitive performance, measured using the Korean version of the Mini-Mental State Examination (K-MMSE), was examined. Results Compared to control subjects, the mean normalized SI volume was significantly decreased in all of the other groups. The normalized SI volume did not differ between the subjects with PDD and DLB, whereas it was significantly smaller in subjects with PDD (p = 0.029) and DLB (p = 0.011) compared with AD. In subjects with PD-related cognitive impairment (PD-MCI, PDD, or DLB), there was a significant positive correlation between the SI volume and K-MMSE score (r = 0.366, p < 0.001), whereas no correlation was seen in subjects with AD-related cognitive impairment (aMCI or AD). Conclusions Our data suggest that the SI loss is greater in synucleinopathy-related dementia (PDD or DLB) than in AD and that the contribution of the SI to cognitive performance is greater in synucleinopathy than in amyloidopathy.
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Affiliation(s)
- Hee Jin Kim
- Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Eun Lee
- Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Jeong Shin
- Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young Ho Sohn
- Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Abstract
Neurological imaging represents a powerful paradigm for investigation of brain structure, physiology and function across different scales. The diverse phenotypes and significant normal and pathological brain variability demand reliable and efficient statistical methodologies to model, analyze and interpret raw neurological images and derived geometric information from these images. The validity, reproducibility and power of any statistical brain map require appropriate inference on large cohorts, significant community validation, and multidisciplinary collaborations between physicians, engineers and statisticians.
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Affiliation(s)
- Ivo D Dinov
- SOCR Resource and Laboratory of Neuro Imaging, UCLA Statistics, 8125 Mathematical Science Bldg, Los Angeles, CA 90095, USA, Tel.: +1 310 825 8430
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