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Antonioni A, Raho EM, Spampinato DA, Granieri E, Fadiga L, Di Lorenzo F, Koch G. The cerebellum in frontotemporal dementia: From neglected bystander to potential neuromodulatory target. A narrative review. Neurosci Biobehav Rev 2025; 174:106194. [PMID: 40324708 DOI: 10.1016/j.neubiorev.2025.106194] [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: 03/11/2024] [Revised: 05/29/2024] [Accepted: 04/30/2025] [Indexed: 05/07/2025]
Abstract
BACKGROUND Though cortical changes in frontotemporal dementia (FTD) are well-documented, the cerebellum's role, closely linked to these areas, remains unclear. OBJECTIVES To provide evidence on cerebellar involvement in FTD across clinical, genetic, imaging, neuropathological, and neurophysiological perspectives. Additionally, we sought evidence supporting the application of cerebellar non-invasive brain stimulation (NIBS) in FTD for both diagnostic and therapeutic purposes. METHODS We performed a literature review using MEDLINE (via PubMed), Scopus, and Web of Science databases. RESULTS We emphasized the involvement of specific cerebellar regions which differentiate each FTD subtypes and may account for some of the characteristic symptoms. Furthermore, we highlighted peculiarities in FTD genetic alterations. Finally, we outlined neurophysiological evidence supporting a role for the cerebellum in FTD pathogenesis. CONCLUSION The cerebellum is critically involved in the FTD spectrum. Moreover, it can be speculated that cerebellar modulation, as already shown in other neurodegenerative disorders, could restore the interneuronal intracortical circuits typically impaired in FTD patients, providing clinical improvements and fundamental outcome measures in clinical trials.
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Affiliation(s)
- Annibale Antonioni
- Doctoral Program in Translational Neurosciences and Neurotechnologies, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara 44121, Italy.
| | - Emanuela Maria Raho
- University Unit of Neurology, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara 44121, Italy
| | - Danny Adrian Spampinato
- Non Invasive Brain Stimulation Unit, Istituto di Ricovero e Cura a Carattere Scientifico Santa Lucia, Rome 00179, Italy
| | - Enrico Granieri
- University Unit of Neurology, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara 44121, Italy
| | - Luciano Fadiga
- Center for Translational Neurophysiology, Istituto Italiano di Tecnologia, Ferrara 44121, Italy; Section of Physiology, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara 44121, Italy
| | - Francesco Di Lorenzo
- Non Invasive Brain Stimulation Unit, Istituto di Ricovero e Cura a Carattere Scientifico Santa Lucia, Rome 00179, Italy
| | - Giacomo Koch
- Non Invasive Brain Stimulation Unit, Istituto di Ricovero e Cura a Carattere Scientifico Santa Lucia, Rome 00179, Italy; Center for Translational Neurophysiology, Istituto Italiano di Tecnologia, Ferrara 44121, Italy; Section of Physiology, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara 44121, Italy
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Coulborn S, Schafer R, Roy ARK, Sokolowski A, Cryns NG, Leichter D, Lago AL, Ramos EM, Cobigo Y, Spina S, Grinberg LT, Geschwind DH, Gorno‐Tempini ML, Kramer JH, Rosen HJ, Miller BL, Seeley WW, Perry DC. Clinical and Imaging Features of Sporadic and Genetic Frontotemporal Lobar Degeneration TDP-43 A and B. Ann Clin Transl Neurol 2025; 12:947-957. [PMID: 40063407 PMCID: PMC12093333 DOI: 10.1002/acn3.70014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Revised: 01/16/2025] [Accepted: 01/30/2025] [Indexed: 05/22/2025] Open
Abstract
OBJECTIVE Certain frontotemporal lobar degeneration subtypes, including TDP-A and B, can either occur sporadically or in association with specific genetic mutations. It is uncertain whether syndromic or imaging features previously associated with these patient groups are subtype or genotype specific. Our study sought to discern the similarities and differences between sporadic and genetic TDP-A and TDP-B. METHODS We generated individual atrophy maps and extracted mean atrophy scores for regions of interest-frontotemporal, occipitoparietal, thalamus, and cerebellum-in 54 patients with FTLD-TDP types A or B. We calculated asymmetry as the absolute difference in atrophy between right and left frontotemporal regions, and dorsality as the difference in atrophy between dorsal and ventral frontotemporal regions. We used ANCOVAs adjusted for disease severity to compare atrophy extent or imbalance, neuropsychological tests, and behavioral measures. RESULTS For some regions, volumetric differences were found either between TDP subtypes (e.g., worse occipitoparietal and cerebellum atrophy in TDP-A than B), or within subtypes depending on genetic status (e.g., worse thalamic and occipitoparietal atrophy in C9orf72-associated TDP-B than sporadic TDP-B). While progranulin mutation-associated TDP-A and sporadic TDP-A cases can be strongly asymmetric, TDP-A and TDP-B associated with C9orf72 tended to be symmetric. TDP-A was more dorsal in atrophy than TDP-B, regardless of genetic status. INTERPRETATION While some neuroimaging features are FTLD-TDP subtype-specific and do not significantly differ based on genotype, other features differ between sporadic and genetic forms within the same subtype and could decrease accuracy of classification algorithms that group genetic and sporadic cases.
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Affiliation(s)
- Sean Coulborn
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Rhiana Schafer
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Ashlin R. K. Roy
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Andrzej Sokolowski
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Noah G. Cryns
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Dana Leichter
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Argentina Lario Lago
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | | | - Yann Cobigo
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Salvatore Spina
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Lea T. Grinberg
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of PathologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Daniel H. Geschwind
- Department of NeurologyUniversity of CaliforniaLos AngelesCaliforniaUSA
- Department of Human GeneticsUniversity of CaliforniaLos AngelesCaliforniaUSA
- Program in Neurobehavioral Genetics, Semel Institute, David Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Maria L. Gorno‐Tempini
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Joel H. Kramer
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Howard J. Rosen
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Bruce L. Miller
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - William W. Seeley
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of PathologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - David C. Perry
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
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3
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Ravasia K, Hirsch-Reinshagen V. Selective cellular and regional vulnerability in frontotemporal lobar degeneration: a scoping review. FREE NEUROPATHOLOGY 2025; 6:11. [PMID: 40207209 PMCID: PMC11980436 DOI: 10.17879/freeneuropathology-2025-5812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Accepted: 03/13/2025] [Indexed: 04/11/2025]
Abstract
The three main types of frontotemporal lobar degeneration (FTLD) are characterized by the accumulation of abnormal proteins, namely tau, TDP-43 and FUS. The distribution of these proteins within different human brain regions is well known, as is the range of morphological variability of the cellular inclusions they form. Compared to the extensive knowledge that exists about distinct protein aggregates in FTLD, surprisingly little is known about the specific cell (sub)types that these inclusions affect. Even less is known about disease-specific abnormalities other than protein inclusions in affected and unaffected areas. These are non-trivial knowledge gaps. First, knowing which cell subtypes are vulnerable or resilient to the development of pathological protein inclusions is crucial to understand the cellular disease mechanisms. Second, mounting evidence suggests that non-cell autonomous mechanisms may play important roles in neurodegenerative conditions. For example, astrocytic tau pathology is associated with synaptic loss in corticobasal degeneration but not in progressive supranuclear palsy. Furthermore, changes that are more difficult and time-consuming to quantify, for example loss of a specific neuronal subtype that does not develop pathological inclusions, remain virtually unexplored and their relevance for disease progression are unknown. This scoping review is an attempt to collate all histological evidence from human studies that address the question of cell-specific vulnerability in the most common FTLD subtypes. By taking a systematic approach including various brain cell types such as neurons and their subtypes as well as astrocytes, microglia and oligodendrocytes and the entire central nervous system with its affected and unaffected regions, this review summarizes the current status in the field and highlights important knowledge gaps.
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Affiliation(s)
- Kashif Ravasia
- School of Medicine, University of British Columbia,
Vancouver, Canada
| | - Veronica Hirsch-Reinshagen
- Division of Neuropathology, Vancouver General Hospital
and University of British Columbia, Vancouver, Canada
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Liu X, de Boer SCM, Cortez K, Poos JM, Illán‐Gala I, Heuer H, Forsberg LK, Casaletto K, Memel M, Appleby BS, Barmada S, Bozoki A, Clark D, Cobigo Y, Darby R, Dickerson BC, Domoto‐Reilly K, Galasko DR, Geschwind DH, Ghoshal N, Graff‐Radford NR, Grant IM, Hsiung GR, Honig LS, Huey ED, Irwin D, Kantarci K, Léger GC, Litvan I, Mackenzie IR, Masdeu JC, Mendez MF, Onyike CU, Pascual B, Pressman P, Bayram E, Ramos EM, Roberson ED, Rogalski E, Bouzigues A, Russell LL, Foster PH, Ferry‐Bolder E, Masellis M, van Swieten J, Jiskoot L, Seelaar H, Sanchez‐Valle R, Laforce R, Graff C, Galimberti D, Vandenberghe R, de Mendonça A, Tiraboschi P, Santana I, Gerhard A, Levin J, Sorbi S, Otto M, Pasquier F, Ducharme S, Butler CR, Ber IL, Finger E, Rowe JB, Synofzik M, Moreno F, Borroni B, Boeve BF, Boxer AL, Rosen HJ, Pijnenburg YAL, Rohrer JD, Tartaglia MC, the ALLFTD Consortium and the GENFI Consortium. Sex differences in clinical phenotypes of behavioral variant frontotemporal dementia. Alzheimers Dement 2025; 21:e14608. [PMID: 40277074 PMCID: PMC12022892 DOI: 10.1002/alz.14608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 01/14/2025] [Accepted: 01/17/2025] [Indexed: 04/26/2025]
Abstract
INTRODUCTION Higher male prevalence in sporadic behavioral variant frontotemporal dementia (bvFTD) has been reported. We hypothesized differences in phenotypes between genetic and sporadic bvFTD females resulting in underdiagnosis of sporadic bvFTD females. METHODS We included genetic and sporadic bvFTD patients from two multicenter cohorts. We compared behavioral and cognitive symptoms, and gray matter volumes, between genetic and sporadic cases in each sex. RESULTS Females with sporadic bvFTD showed worse compulsive behavior (p = 0.026) and language impairments (p = 0.024) compared to females with genetic bvFTD (n = 152). Genetic bvFTD females had smaller gray matter volumes than sporadic bvFTD females, particularly in the parietal lobe. DISCUSSION Females with sporadic bvFTD exhibit a distinct clinical phenotype compared to females with genetic bvFTD. This difference may explain the discrepancy in prevalence between genetic and sporadic cases, as some females without genetic mutations may be misdiagnosed due to atypical bvFTD symptom presentation. HIGHLIGHTS Sex ratio is equal in genetic behavioral variant of frontotemporal dementia (bvFTD), whereas more males are present in sporadic bvFTD. Distinct neuropsychiatric phenotypes exist between sporadic and genetic bvFTD in females. Phenotype might explain the sex ratio difference between sporadic and genetic cases.
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Affiliation(s)
- Xulin Liu
- Krembil Research InstituteUniversity Health NetworkTorontoCanada
- Tanz Centre for Research in Neurodegenerative DiseasesUniversity of TorontoTorontoCanada
| | - Sterre C. M. de Boer
- Alzheimer Center AmsterdamNeurologyVrije Universiteit AmsterdamAmsterdam UMC location VUmcAmsterdamAmsterdamthe Netherlands
- Amsterdam Neuroscience, NeurodegenerationAmsterdamthe Netherlands
- The University of SydneySchool of Psychology and Brain & Mind CentreSydneyAustralia
| | - Kasey Cortez
- Krembil Research InstituteUniversity Health NetworkTorontoCanada
| | - Jackie M. Poos
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Ignacio Illán‐Gala
- Sant Pau Memory UnitDepartment of NeurologyBiomedical Research Institute Sant PauHospital de la Santa Creu i Sant PauUniversitat Autònoma de BarcelonaHospital de la Santa Creu i Sant PauBarcelonaSpain
| | - Hilary Heuer
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSandler Neurosciences Center, San FranciscoSan FranciscoUSA
| | | | - Kaitlin Casaletto
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSandler Neurosciences Center, San FranciscoSan FranciscoUSA
| | - Molly Memel
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSandler Neurosciences Center, San FranciscoSan FranciscoUSA
| | - Brian S. Appleby
- Department of NeurologyCase Western Reserve UniversityClevelandUSA
| | | | | | | | - Yann Cobigo
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSandler Neurosciences Center, San FranciscoSan FranciscoUSA
| | | | - Bradford C. Dickerson
- Department of NeurologyMassachusetts General Hospital and Harvard Medical SchoolBostonUSA
| | | | | | - Daniel H. Geschwind
- Department of NeurologyDavid Geffen School of MedicineUniversity of CaliforniaLos AngelesUSA
| | - Nupur Ghoshal
- Departments of Neurology and PsychiatryWashington University School of Medicine in St LouisSt. LouisUSA
| | | | - Ian M. Grant
- Department of Psychiatry and Behavioral SciencesMesulam Center for Cognitive Neurology and Alzheimer's DiseaseNorthwestern Feinberg School of MedicineChicagoUSA
| | | | - Lawrence S. Honig
- Neurology Department and Taub InstituteColumbia University Irving Medical CenterNew YorkUSA
| | - Edward D. Huey
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown UniversityProvidenceUSA
| | - David Irwin
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
| | | | | | | | - Ian R. Mackenzie
- Department of PathologyUniversity of British ColumbiaVancouverCanada
| | | | - Mario F. Mendez
- Department of NeurologyDavid Geffen School of MedicineUniversity of CaliforniaLos AngelesUSA
| | - Chiadi U. Onyike
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreUSA
| | - Belen Pascual
- Nantz National Alzheimer CenterHouston MethodistHoustonUSA
| | | | | | - Eliana Marisa Ramos
- Department of NeurologyDavid Geffen School of MedicineUniversity of CaliforniaLos AngelesUSA
| | - Erik D. Roberson
- Department of NeurologyUniversity of Alabama at BirminghamSparks CenterBirminghamUSA
| | - Emily Rogalski
- Department of NeurologyHealthy Aging & Alzheimer's Care CenterUniversity of ChicagoChicagoUSA
| | - Arabella Bouzigues
- Dementia Research CentreDepartment of Neurodegenerative DiseaseUCL Institute of NeurologyQueen SquareLondonUK
| | - Lucy L. Russell
- Dementia Research CentreDepartment of Neurodegenerative DiseaseUCL Institute of NeurologyQueen SquareLondonUK
| | - Phoebe H. Foster
- Dementia Research CentreDepartment of Neurodegenerative DiseaseUCL Institute of NeurologyQueen SquareLondonUK
| | - Eve Ferry‐Bolder
- Dementia Research CentreDepartment of Neurodegenerative DiseaseUCL Institute of NeurologyQueen SquareLondonUK
| | - Mario Masellis
- Sunnybrook Health Sciences CentreSunnybrook Research InstituteTorontoCanada
| | - John van Swieten
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Lize Jiskoot
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Harro Seelaar
- Department of Neurology and Alzheimer Center Erasmus MCErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Raquel Sanchez‐Valle
- Alzheimer's Disease and Other Cognitive Disorders UnitNeurology ServiceHospital Clínic, Institut d'Investigacións Biomèdiques August Pi I SunyerUniversity of BarcelonaBarcelonaSpain
| | - Robert Laforce
- Clinique Interdisciplinaire de MémoireDépartement des Sciences NeurologiquesCHU de Québec, and Faculté de Médecine, Université LavalQuebecCanada
| | - Caroline Graff
- Karolinska InstituteDepartment NVSCentre for Alzheimer ResearchDivision of NeurogeneticsStockholmSweden
- Unit for Hereditary DementiasTheme AgingKarolinska University HospitalStockholmSweden
| | - Daniela Galimberti
- Fondazione IRCCS Ospedale PoliclinicoMilanoItaly
- University of MilanCentro Dino FerrariMilanoItaly
| | - Rik Vandenberghe
- Laboratory for Cognitive NeurologyDepartment of NeurosciencesKU LeuvenLeuvenBelgium
- Neurology ServiceUniversity Hospitals LeuvenLeuvenBelgium
| | | | - Pietro Tiraboschi
- Fondazione IRCCS Istituto Neurologico Carlo BestaVia Giovanni CeloriaMilanoItaly
| | - Isabel Santana
- University Hospital of Coimbra (HUC)Neurology ServiceFaculty of MedicineUniversity of CoimbraCoimbraPortugal
- Centre of Neurosciences and Cell biologyUniversity of CoimbraCoimbraPortugal
| | - Alexander Gerhard
- Division of Psychology Communication and Human NeuroscienceWolfson Molecular Imaging CentreUniversity of ManchesterManchesterUK
- Department of Nuclear MedicineCentre for Translational Neuro‐ and Behavioral SciencesUniversity Medicine EssenEssenGermany
- Department of Geriatric MedicineKlinikum HochsauerlandArnsbergGermany
| | - Johannes Levin
- Department of NeurologyLudwig‐Maximilians Universität MünchenMunichGermany
- Centre for Neurodegenerative Diseases (DZNE)MunichGermany
- Munich Cluster of Systems NeurologyMunichGermany
| | - Sandro Sorbi
- Department of NeurofarbaUniversity of FlorenceFirenzeItaly
- IRCCS Fondazione Don Carlo GnocchiFlorenceItaly
| | - Markus Otto
- Department of NeurologyUniversity of UlmUlmGermany
| | - Florence Pasquier
- University LilleLilleFrance
- Inserm 1172LilleFrance
- CHUCNR‐MAJLabex DistalzLiCEND LilleLilleFrance
| | - Simon Ducharme
- Douglas Mental Health University InstituteDepartment of PsychiatryMcGill UniversityMontrealCanada
- McConnell Brain Imaging CentreMontreal Neurological InstituteMcGill UniversityMontrealCanada
| | - Chris R. Butler
- Nuffield Department of Clinical NeurosciencesMedical Sciences DivisionUniversity of OxfordHeadley Way, HeadingtonOxfordUK
- Department of Brain SciencesImperial College LondonUK, Burlington DanesThe Hammersmith HospitalLondonUK
| | - Isabelle Le Ber
- Sorbonne UniversitéParis Brain Institute – Institut du Cerveau – ICM, Inserm U1127, CNRS UMR 7225, AP‐HP ‐ Hôpital Pitié‐SalpêtrièreParisFrance
- Reference Center for Rare or Early‐onset Dementias, IM2ADepartment of NeurologyAP‐HP ‐ Pitié‐Salpêtrière HospitalParisFrance
- Department of NeurologyAP‐HP ‐ Pitié‐Salpêtrière HospitalParisFrance
| | - Elizabeth Finger
- Department of Clinical Neurological SciencesUniversity of Western OntarioLondonCanada
| | - James B. Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of CambridgeDepartment of Clinical NeurosciencesCambridge Biomedical CampusCambridgeUK
| | - Matthis Synofzik
- Department of Neurodegenerative DiseasesHertie‐Institute for Clinical Brain Research & Centre of NeurologyUniversity of TübingenTübingenGermany
- Centre for Neurodegenerative Diseases (DZNE)TübingenGermany
| | - Fermin Moreno
- Cognitive Disorders UnitDepartment of NeurologyHospital Universitario DonostiaSan SebastianGipuzkoaSpain
- Neuroscience AreaBiodonostia Health Research InstituteSan SebastianGipuzkoaSpain
| | - Barbara Borroni
- Neurology UnitDepartment of Clinical and Experimental SciencesUniversity of BresciaPiazza del MercatoBresciaItaly
| | | | - Adam L. Boxer
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSandler Neurosciences Center, San FranciscoSan FranciscoUSA
| | - Howie J. Rosen
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSandler Neurosciences Center, San FranciscoSan FranciscoUSA
| | - Yolande A. L. Pijnenburg
- Alzheimer Center AmsterdamNeurologyVrije Universiteit AmsterdamAmsterdam UMC location VUmcAmsterdamAmsterdamthe Netherlands
| | - Jonathan D. Rohrer
- Dementia Research CentreDepartment of Neurodegenerative DiseaseUCL Institute of NeurologyQueen SquareLondonUK
| | - Maria Carmela Tartaglia
- Krembil Research InstituteUniversity Health NetworkTorontoCanada
- Tanz Centre for Research in Neurodegenerative DiseasesUniversity of TorontoTorontoCanada
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Kleinerova J, Tahedl M, McKenna MC, Garcia-Gallardo A, Hutchinson S, Hardiman O, Raoul C, Ango F, Schneider B, Pradat PF, Tan EL, Bede P. Cerebellar dysfunction in frontotemporal dementia: intra-cerebellar pathology and cerebellar network degeneration. J Neurol 2025; 272:289. [PMID: 40131525 PMCID: PMC11937067 DOI: 10.1007/s00415-025-13046-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2025] [Revised: 03/07/2025] [Accepted: 03/14/2025] [Indexed: 03/27/2025]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) share overlapping clinical, genetic, and neuroimaging features; a spectrum of conditions commonly referred to as the ALS-FTD continuum. The majority of imaging studies focus on supratentorial pathology, and phenotype-defining motor, cognitive, and behavioural profiles are often exclusively attributed to supratentorial degeneration overlooking the contribution of cerebellar pathology. METHODS A multimodal neuroimaging study was conducted to evaluate phenotype-associated cerebello-cerebral connectivity profiles in ALS-FTD, behavioural variant frontotemporal dementia (bvFTD), non-fluent variant (nfvPPA), and semantic variant primary progressive aphasia (svPPA). Structural connectivity, functional connectivity, and volumetric analyses were conducted. RESULTS Radial diffusivity analyses detected impaired bilateral cerebello-frontal, cerebello-parietal, and cerebello-temporal connectivity in all study groups along the ALS-FTD spectrum. Cerebello-occipital disconnection was captured in ALS-FTD and nfvPPA. Spinocerebellar disconnection was detected in C9orf72 negative ALS-FTD and nfvPPA. C9orf72 positive ALS-FTD patients exhibited both anterior and posterior lobe cerebellar volume loss, while bvFTD and nfvPPA patients showed posterior cerebellar atrophy. Flocculonodular degeneration was observed in nfvPPA and cerebellar crura atrophy in bvFTD. Bilateral corticospinal tract and corpus callosum degeneration was detected in ALS-FTD, bvFTD, and nfvPPA. Primary motor cortex volume reductions were captured in both ALS-FTD and nfvPPA. CONCLUSIONS Our analyses capture significant cerebro-cerebellar disconnection in frontotemporal dementia. Corticospinal tract and motor cortex degeneration can be readily detected in non-ALS phenotypes. Intra-cerebellar pathology, coupled with the degeneration of cerebellar projections and the ensuing dysfunction of cerebro-cerebellar networks likely contribute to phenotype-defining clinical profiles in frontotemporal dementia. Infratentorial disease burden and cerebellar network dysfunction should, therefore, be carefully considered in FTD, and phenotype-defining neuropsychological profiles should not be solely attributed to supratentorial degeneration.
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Affiliation(s)
- Jana Kleinerova
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, Room 5.43, Pearse Street, Dublin 2, Ireland
| | - Marlene Tahedl
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, Room 5.43, Pearse Street, Dublin 2, Ireland
| | - Mary Clare McKenna
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, Room 5.43, Pearse Street, Dublin 2, Ireland
| | | | | | - Orla Hardiman
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, Room 5.43, Pearse Street, Dublin 2, Ireland
| | - Cédric Raoul
- ALS Reference Centre, University of Montpellier, CHU Montpellier, Montpellier, France
- INM (Neuroscience Institute of Montpellier), University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Fabrice Ango
- INM (Neuroscience Institute of Montpellier), University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Bernard Schneider
- Bertarelli Platform for Gene Therapy, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Pierre-Francois Pradat
- Biomedical Imaging Laboratory, CNRS, INSERM, Sorbonne University, Paris, France
- Department of Neurology, Pitié-Salpêtrière University Hospital, Paris, France
| | - Ee Ling Tan
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, Room 5.43, Pearse Street, Dublin 2, Ireland
| | - Peter Bede
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, Room 5.43, Pearse Street, Dublin 2, Ireland.
- Department of Neurology, St James's Hospital, Dublin, Ireland.
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6
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Sharbafshaaer M, Siciliano M, Passaniti C, Sant'Elia V, Silvestro M, Russo A, Esposito S, Tedeschi G, Trojano L, Trojsi F. Screening of visuospatial abilities in amyotrophic lateral sclerosis (ALS): a pilot study using the battery for visuospatial abilities (BVA). Orphanet J Rare Dis 2025; 20:110. [PMID: 40057753 PMCID: PMC11890512 DOI: 10.1186/s13023-025-03645-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/02/2025] [Indexed: 05/13/2025] Open
Abstract
BACKGROUND Cognitive deficits related to frontotemporal dysfunction are common in Amyotrophic Lateral Sclerosis (ALS). Visuospatial deficits, related to posterior cerebral regions, are often underestimated in ALS, though they play a crucial role in attending daily living activities. Our pilot study aims at assessing visuospatial abilities using a domain-specific tool in ALS patients compared to healthy controls (HC). METHODS Twenty-three patients with early ALS and 23 age- and education-matched HC underwent the Battery for Visuospatial Abilities (BVA), including 4 visuo-perceptual and 4 visuo-representational subtests. RESULTS When compared to HC, ALS scored worse in 2 visuo-perceptual subtests (i.e., Line Length Judgment and Line Orientation Judgment) and 1 visuo-representational tasks (i.e., Hidden Figure Identification, HFI) (p < 0.01). No correlations arose between ALS clinical features and BVA performance. More than 80% of the ALS cohort obtained abnormal scores in the HFI subtest. CONCLUSIONS Our findings revealed that patients with ALS scored worse (compared to HC) on selective tests tapping "perceptual" and "representational" visuospatial abilities, since the early stages of disease. In clinical practice, our findings highlight the need for multi-domain neuropsychological assessment, for monitoring disease courses and properly organizing care management of patients with ALS.
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Affiliation(s)
- Minoo Sharbafshaaer
- Department of Advanced Medical and Surgical Sciences, MRI Research Center, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Mattia Siciliano
- Department of Advanced Medical and Surgical Sciences, MRI Research Center, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
- First Division of Neurology, AOU Università degli Studi della Campania "Luigi Vanvitelli", Naples, 80138, Italy
- Department of Psychology, Università degli Studi della Campania "Luigi Vanvitelli", Caserta, Italy
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Carla Passaniti
- First Division of Neurology, AOU Università degli Studi della Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Valeria Sant'Elia
- First Division of Neurology, AOU Università degli Studi della Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Marcello Silvestro
- Department of Advanced Medical and Surgical Sciences, MRI Research Center, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Russo
- Department of Advanced Medical and Surgical Sciences, MRI Research Center, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
- First Division of Neurology, AOU Università degli Studi della Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Sabrina Esposito
- First Division of Neurology, AOU Università degli Studi della Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, MRI Research Center, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
- First Division of Neurology, AOU Università degli Studi della Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Luigi Trojano
- Department of Psychology, Università degli Studi della Campania "Luigi Vanvitelli", Caserta, Italy
| | - Francesca Trojsi
- Department of Advanced Medical and Surgical Sciences, MRI Research Center, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.
- First Division of Neurology, AOU Università degli Studi della Campania "Luigi Vanvitelli", Naples, 80138, Italy.
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Pérez-Millan A, Lal-Trehan Estrada UM, Falgàs N, Guillén N, Borrego-Écija S, Juncà-Parella J, Bosch B, Tort-Merino A, Sarto J, Augé JM, Antonell A, Bargalló N, Ruiz-García R, Naranjo L, Balasa M, Lladó A, Sala-Llonch R, Sánchez-Valle R. The Cortical Asymmetry Index for subtyping dementia patients. Eur Radiol 2025:10.1007/s00330-025-11400-y. [PMID: 39934339 DOI: 10.1007/s00330-025-11400-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 12/19/2024] [Accepted: 01/02/2025] [Indexed: 02/13/2025]
Abstract
OBJECTIVES Frontotemporal dementia (FTD) usually shows more asymmetric atrophy patterns than Alzheimer's disease (AD). We aim to quantify this asymmetry to differentiate FTD, AD, and FTD subtypes. METHODS We studied T1-MRI scans, including FTD (different phenotypes), AD, and healthy controls (CTR). We defined the Cortical Asymmetry Index (CAI) using measures based on a metric derived from information theory with the cortical thickness measures. Some participants had additional follow-up MRIs, cerebrospinal fluid (CSF), or plasma measures. We analysed differences at cross-sectional and longitudinal levels. We then clustered FTD and AD participants based on the CAI values and studied the patients' fluid biomarker characteristics within each cluster. RESULTS A total of 101 FTD patients (64 ± 8 years, 53 men), 230 AD patients (65 ± 10 years, 84 men), and 173 CTR (59 ± 15 years, 67 men) were studied. CAI differentiated FTD, AD, and CTR. It also distinguished the semantic variant primary progressive aphasia (svPPA) from the other FTD phenotypes. In FTD, the CAI increased over time. The cluster analysis identified two subgroups within FTD, characterised by different neurofilament-light (NfL) levels, and two subgroups within AD, with different plasma glial fibrillary acidic protein (GFAP) levels. In AD, CAI correlated with GFAP and Mini-Mental State Examination (MMSE); in FTD, the CAI was associated with NfL levels. CONCLUSIONS The proposed method quantifies asymmetries previously described visually. The CAI could define clinically and biologically meaningful disease subgroups in the differential diagnosis of AD and FTD and its subtypes. CAI could also be of interest in tracking disease progression in FTD. KEY POINTS Question There is a need to find quantitative metrics from MRI that can identify disease subgroups, and that could be useful for diagnosis and tracking. Findings We propose a Cortical Asymmetry Index that differentiates Alzheimer's disease (AD) from Frontotemporal dementia (FTD), distinguishes FTD subtypes, correlates with NFL and GFAP levels, and monitors FTD progression. Clinical relevance Our proposed index holds the potential to support clinical applications for diagnosis and disease tracking in AD and FTD, using a quantitative summary metric from MRI data. It also contributes to the understanding of these diseases.
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Affiliation(s)
- Agnès Pérez-Millan
- Alzheimer's Disease and Other Cognitive Disorders Group, Service of Neurology, Hospital Clínic de Barcelona, Fundació Recerca Clínic Barcelona-IDIBAPS, 08036, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, 08036, Barcelona, Spain
- Department of Biomedicine, University of Barcelona, 08036, Barcelona, Spain
| | - Uma Maria Lal-Trehan Estrada
- Institut de Neurociències, University of Barcelona, 08036, Barcelona, Spain
- Department of Biomedicine, University of Barcelona, 08036, Barcelona, Spain
| | - Neus Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Group, Service of Neurology, Hospital Clínic de Barcelona, Fundació Recerca Clínic Barcelona-IDIBAPS, 08036, Barcelona, Spain
| | - Núria Guillén
- Alzheimer's Disease and Other Cognitive Disorders Group, Service of Neurology, Hospital Clínic de Barcelona, Fundació Recerca Clínic Barcelona-IDIBAPS, 08036, Barcelona, Spain
| | - Sergi Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders Group, Service of Neurology, Hospital Clínic de Barcelona, Fundació Recerca Clínic Barcelona-IDIBAPS, 08036, Barcelona, Spain
| | - Jordi Juncà-Parella
- Alzheimer's Disease and Other Cognitive Disorders Group, Service of Neurology, Hospital Clínic de Barcelona, Fundació Recerca Clínic Barcelona-IDIBAPS, 08036, Barcelona, Spain
| | - Beatriz Bosch
- Alzheimer's Disease and Other Cognitive Disorders Group, Service of Neurology, Hospital Clínic de Barcelona, Fundació Recerca Clínic Barcelona-IDIBAPS, 08036, Barcelona, Spain
| | - Adrià Tort-Merino
- Alzheimer's Disease and Other Cognitive Disorders Group, Service of Neurology, Hospital Clínic de Barcelona, Fundació Recerca Clínic Barcelona-IDIBAPS, 08036, Barcelona, Spain
| | - Jordi Sarto
- Alzheimer's Disease and Other Cognitive Disorders Group, Service of Neurology, Hospital Clínic de Barcelona, Fundació Recerca Clínic Barcelona-IDIBAPS, 08036, Barcelona, Spain
| | - Josep Maria Augé
- Biochemistry and Molecular Genetics Department, Hospital Clínic de Barcelona, 08036, Barcelona, Spain
| | - Anna Antonell
- Alzheimer's Disease and Other Cognitive Disorders Group, Service of Neurology, Hospital Clínic de Barcelona, Fundació Recerca Clínic Barcelona-IDIBAPS, 08036, Barcelona, Spain
| | - Núria Bargalló
- Image Diagnostic Centre, Hospital Clínic de Barcelona, Barcelona, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Magnetic Resonance Image Core Facility, IDIBAPS, 08036, Barcelona, Spain
| | - Raquel Ruiz-García
- Immunology Service, Biomedical Diagnostic Center, Hospital Clínic de Barcelona, 08036, Barcelona, Spain
| | - Laura Naranjo
- Immunology Service, Biomedical Diagnostic Center, Hospital Clínic de Barcelona, 08036, Barcelona, Spain
| | - Mircea Balasa
- Alzheimer's Disease and Other Cognitive Disorders Group, Service of Neurology, Hospital Clínic de Barcelona, Fundació Recerca Clínic Barcelona-IDIBAPS, 08036, Barcelona, Spain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Group, Service of Neurology, Hospital Clínic de Barcelona, Fundació Recerca Clínic Barcelona-IDIBAPS, 08036, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, 08036, Barcelona, Spain
| | - Roser Sala-Llonch
- Institut de Neurociències, University of Barcelona, 08036, Barcelona, Spain
- Department of Biomedicine, University of Barcelona, 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), 08036, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Group, Service of Neurology, Hospital Clínic de Barcelona, Fundació Recerca Clínic Barcelona-IDIBAPS, 08036, Barcelona, Spain.
- Institut de Neurociències, University of Barcelona, 08036, Barcelona, Spain.
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036, Barcelona, Spain.
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Shen T, Vogel JW, Van Deerlin VM, Suh E, Dratch L, Phillips JS, Massimo L, Lee EB, Irwin DJ, McMillan CT. Disparate and shared transcriptomic signatures associated with cortical atrophy in genetic behavioral variant frontotemporal degeneration. Mol Neurodegener 2025; 20:17. [PMID: 39920674 PMCID: PMC11806866 DOI: 10.1186/s13024-025-00806-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 01/23/2025] [Indexed: 02/09/2025] Open
Abstract
BACKGROUND Cortical atrophy is a common manifestation in behavioral variant frontotemporal degeneration (bvFTD), exhibiting spatial heterogeneity across various genetic subgroups, which may be driven by distinct biological mechanisms. METHODS We employed an integrative imaging transcriptomics approach to identify both disparate and shared transcriptomic signatures associated with cortical thickness in bvFTD with C9orf72 repeat expansions or pathogenic variants in GRN or MAPT. Functional enrichment analyses were conducted on each gene list significantly associated with cortical thickness. Additionally, we mapped neurotransmitter receptor/transporter density maps to the cortical thickness maps, to uncover different correlation patterns for each genetic form. Furthermore, we examined whether the identified genes were enriched for pathology-related genes by using previously identified genes linked to TDP-43 positive neurons and genes associated with tau pathology. RESULTS For each genetic form of bvFTD, we identified cortical thickness signatures and gene sets associated with them. The cortical thickness associated genes for GRN-bvFTD were significantly involved in neurotransmitter system and circadian entrainment. The different patterns of spatial correlations between synaptic density and cortical thinning, further confirmed the critical role of neurotransmission and synaptic signaling in shaping brain structure, especially in the GRN-bvFTD group. Furthermore, we observed significant overlap between genes linked to TDP-43 pathology and the gene sets associated with cortical thickness in C9orf72-bvFTD and GRN-bvFTD but not the MAPT-bvFTD group providing specificity for our associations. C9orf72-bvFTD and GRN-bvFTD also shared genes displaying consistent directionality, with those exhibiting either positive or negative correlations with cortical thickness in C9orf72-bvFTD showing the same direction (positive or negative) in GRN-bvFTD. MAPT-bvFTD displayed more pronounced differences in transcriptomic signatures compared to the other two genetic forms. The genes that exhibited significantly positive or negative correlations with cortical thickness in MAPT-bvFTD showed opposing directionality in C9orf72-bvFTD and GRN-bvFTD. CONCLUSIONS Overall, this integrative transcriptomic approach identified several new shared and disparate genes associated with regional vulnerability with increased biological interpretation including overlap with synaptic density maps and pathologically-specific gene expression. These findings illuminated the intricate molecular underpinnings contributing to the heterogeneous nature of disease distribution in bvFTD with distinct genetic backgrounds.
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Affiliation(s)
- Ting Shen
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, Richards 606B, Philadelphia, PA, 19104, USA
| | - Jacob W Vogel
- Department of Clinical Sciences Malmö, SciLifeLab, Lund University, Lund, Sweden
| | - Vivianna M Van Deerlin
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - EunRan Suh
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Laynie Dratch
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, Richards 606B, Philadelphia, PA, 19104, USA
| | - Jeffrey S Phillips
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, Richards 606B, Philadelphia, PA, 19104, USA
| | - Lauren Massimo
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, Richards 606B, Philadelphia, PA, 19104, USA
| | - Edward B Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David J Irwin
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, Richards 606B, Philadelphia, PA, 19104, USA
| | - Corey T McMillan
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3700 Hamilton Walk, Richards 606B, Philadelphia, PA, 19104, USA.
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Antonioni A, Raho EM, Granieri E, Koch G. Frontotemporal dementia. How to deal with its diagnostic complexity? Expert Rev Neurother 2025:1-35. [PMID: 39911129 DOI: 10.1080/14737175.2025.2461758] [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: 09/24/2024] [Revised: 01/27/2025] [Accepted: 01/29/2025] [Indexed: 02/07/2025]
Abstract
INTRODUCTION Frontotemporal dementia (FTD) encompasses a group of heterogeneous neurodegenerative disorders. Aside from genetic cases, its diagnosis is challenging, particularly in the early stages when symptoms are ambiguous, and structural neuroimaging does not reveal characteristic patterns. AREAS COVERED The authors performed a comprehensive literature search through MEDLINE, Scopus, and Web of Science databases to gather evidence to aid the diagnostic process for suspected FTD patients, particularly in early phases, even in sporadic cases, ranging from established to promising tools. Blood-based biomarkers might help identify very early neuropathological stages and guide further evaluations. Subsequently, neurophysiological measures reflecting functional changes in cortical excitatory/inhibitory circuits, along with functional neuroimaging assessing brain network, connectivity, metabolism, and perfusion alterations, could detect specific changes associated to FTD even decades before symptom onset. As the neuropathological process advances, cognitive-behavioral profiles and atrophy patterns emerge, distinguishing specific FTD subtypes. EXPERT OPINION Emerging disease-modifying therapies require early patient enrollment. Therefore, a diagnostic paradigm shift is needed - from relying on typical cognitive and neuroimaging profiles of advanced cases to widely applicable biomarkers, primarily fluid biomarkers, and, subsequently, neurophysiological and functional neuroimaging biomarkers where appropriate. Additionally, exploring subjective complaints and behavioral changes detected by home-based technologies might be crucial for early diagnosis.
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Affiliation(s)
- Annibale Antonioni
- Doctoral Program in Translational Neurosciences and Neurotechnologies, University of Ferrara, Ferrara, FE, Italy
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, FE, Italy
| | - Emanuela Maria Raho
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, FE, Italy
| | - Enrico Granieri
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, FE, Italy
| | - Giacomo Koch
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, FE, Italy
- Center for Translational Neurophysiology of Speech and Communication (CTNSC), Italian Institute of Technology (IIT), Ferrara, FE, Italy
- Non Invasive Brain Stimulation Unit, Istituto di Ricovero e Cura a Carattere Scientifico Santa Lucia, Roma, RM, Italy
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Jeon Y, Kim JJ, Yu S, Choi J, Han S. A fusion analytic framework for investigating functional brain connectivity differences using resting-state fMRI. Front Neurosci 2024; 18:1402657. [PMID: 39723421 PMCID: PMC11668745 DOI: 10.3389/fnins.2024.1402657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 11/19/2024] [Indexed: 12/28/2024] Open
Abstract
Introduction Functional magnetic resonance imaging (fMRI) data is highly complex and high-dimensional, capturing signals from regions of interest (ROIs) with intricate correlations. Analyzing such data is particularly challenging, especially in resting-state fMRI, where patterns are less identifiable without task-specific contexts. Nonetheless, interconnections among ROIs provide essential insights into brain activity and exhibit unique characteristics across groups. Methods To address these challenges, we propose an interpretable fusion analytic framework to identify and understand ROI connectivity differences between two groups, revealing their distinctive features. The framework involves three steps: first, constructing ROI-based Functional Connectivity Networks (FCNs) to manage resting-state fMRI data; second, employing a Self-Attention Deep Learning Model (Self-Attn) for binary classification to generate attention distributions encoding group-level differences; and third, utilizing a Latent Space Item-Response Model (LSIRM) to extract group-representative ROI features, visualized on group summary FCNs. Results We applied our framework to analyze four types of cognitive impairments, demonstrating their effectiveness in identifying significant ROIs that contribute to the differences between the two disease groups. The results reveal distinct connectivity patterns and unique ROI features, which differentiate cognitive impairments. Specifically, our framework highlighted group-specific differences in functional connectivity, validating its capability to capture meaningful insights from high-dimensional fMRI data. Discussion Our novel interpretable fusion analytic framework addresses the challenges of analyzing high-dimensional, resting-state fMRI data. By integrating FCNs, a Self-Attention Deep Learning Model, and LSIRM, the framework provides an innovative approach to discovering ROI connectivity disparities between groups. The attention distribution and group-representative ROI features offer interpretable insights into brain activity patterns and their variations among cognitive impairment groups. This methodology has significant potential to enhance our understanding of cognitive impairments, paving the way for more targeted therapeutic interventions.
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Affiliation(s)
- Yeseul Jeon
- Department of Statistics, Texas A&M University, College Station, TX, United States
| | - Jeong-Jae Kim
- Graduate Program in Cognitive Science, Yonsei University, Seoul, Republic of Korea
| | - SuMin Yu
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | - Junggu Choi
- Cancer Biology, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, United States
| | - Sanghoon Han
- Graduate Program in Cognitive Science, Yonsei University, Seoul, Republic of Korea
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
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11
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Qu JF, Liu XW, Wang MZ, Luo YS, Gao T, Shi L, Chen YK. Structural-informed functional MRI analysis of patients with empathy impairment following stroke. J Psychiatry Neurosci 2024; 49:E345-E356. [PMID: 39455087 PMCID: PMC11530265 DOI: 10.1503/jpn.240084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Revised: 08/27/2024] [Accepted: 09/03/2024] [Indexed: 10/28/2024] Open
Abstract
BACKGROUND The underlying functional alterations of brain structural changes among patients with empathy impairment following stroke remain unclear. We sought to investigate functional connectivity changes informed by brain structural abnormalities in multimodal magnetic resonance imaging (MRI) among patients with empathy impairment following stroke. METHODS We enrolled people who had experienced their first ischemic stroke, along with healthy controls. We assessed empathy 3 months after stroke using the Chinese version of the Empathy Quotient (EQ). During the acute phase, all patients underwent basic magnetic resonance imaging (MRI), followed by multimodal MRI during follow-up. Our MRI analyses encompassed acute infarction segmentation, volumetric brain measurements, regional quantification of diffusion parameters, and both region-of-interest-based and seed-based functional connectivity assessments. We grouped patients based on the severity of their empathy impairment for comparative analysis. RESULTS We included 84 patients who had stroke and 22 healthy controls. Patients had lower EQ scores than controls. Patients with low empathy had larger left cortical infarcts (odds ratio [OR] 4.082, 95% confidence interval [CI] 1.183-14.088), more pronounced atrophy in the right cingulate cortex (OR 1.248, 95% CI 1.038-1.502), and lower scores on the Montreal Cognitive Assessment (OR 0.873, 95% CI 0.74-0.947). In addition, the cingulate cortex served as the seed in the seed-based analysis, which showed heightened functional connectivity between the anterior cingulate gyrus and the right superior parietal lobule, specifically in the low-empathy group. LIMITATIONS We did not evaluate the relationship between specific network involvement and empathy impairment among patients following stroke. CONCLUSION Among patients with subacute ischemic stroke, reduced empathy was strongly associated with a more severe cognitive profile and atrophy of the right cingulate cortex. Our subsequent structural-informed functional MRI analysis suggests that the enhanced connectivity between the anterior cingulate gyrus and the superior parietal lobule may function as a compensatory mechanism for this atrophy.
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Affiliation(s)
- Jian-Feng Qu
- From the Department of Neurology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong Province, China (Qu, Liu, Wang, Chen); the Faculty of Neurology, Graduate School of Guangdong Medical University, Zhanjiang, Guangdong Province, China (Qu, Liu); the Faculty of Neurology, Graduate School of Southern Medical University, Guangzhou, Guangdong Province, China (Wang); the BrainNow Research Institute, Shenzhen, Guangdong Province, China (Luo, Shi); the School of Mathematics and Statistics, Huazhong University of Science and Technology, China (Gao); the Center for Mathematical Science, Huazhong University of Science and Technology, China (Gao); the Intelligent Brain Imaging and Brain Function Laboratory (Dongguan Key Laboratory), Dongguan People's Hospital, Dongguan, Guangdong, China (Qu, Chen); the Guangdong Provincial Key Laboratory of Mathematical and Neural Dynamical Systems, Great Bay University, Dongguan, Guangdong, China (Qu, Gao, Chen)
| | - Xiao-Wen Liu
- From the Department of Neurology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong Province, China (Qu, Liu, Wang, Chen); the Faculty of Neurology, Graduate School of Guangdong Medical University, Zhanjiang, Guangdong Province, China (Qu, Liu); the Faculty of Neurology, Graduate School of Southern Medical University, Guangzhou, Guangdong Province, China (Wang); the BrainNow Research Institute, Shenzhen, Guangdong Province, China (Luo, Shi); the School of Mathematics and Statistics, Huazhong University of Science and Technology, China (Gao); the Center for Mathematical Science, Huazhong University of Science and Technology, China (Gao); the Intelligent Brain Imaging and Brain Function Laboratory (Dongguan Key Laboratory), Dongguan People's Hospital, Dongguan, Guangdong, China (Qu, Chen); the Guangdong Provincial Key Laboratory of Mathematical and Neural Dynamical Systems, Great Bay University, Dongguan, Guangdong, China (Qu, Gao, Chen)
| | - Ming-Zi Wang
- From the Department of Neurology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong Province, China (Qu, Liu, Wang, Chen); the Faculty of Neurology, Graduate School of Guangdong Medical University, Zhanjiang, Guangdong Province, China (Qu, Liu); the Faculty of Neurology, Graduate School of Southern Medical University, Guangzhou, Guangdong Province, China (Wang); the BrainNow Research Institute, Shenzhen, Guangdong Province, China (Luo, Shi); the School of Mathematics and Statistics, Huazhong University of Science and Technology, China (Gao); the Center for Mathematical Science, Huazhong University of Science and Technology, China (Gao); the Intelligent Brain Imaging and Brain Function Laboratory (Dongguan Key Laboratory), Dongguan People's Hospital, Dongguan, Guangdong, China (Qu, Chen); the Guangdong Provincial Key Laboratory of Mathematical and Neural Dynamical Systems, Great Bay University, Dongguan, Guangdong, China (Qu, Gao, Chen)
| | - Yi-Shan Luo
- From the Department of Neurology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong Province, China (Qu, Liu, Wang, Chen); the Faculty of Neurology, Graduate School of Guangdong Medical University, Zhanjiang, Guangdong Province, China (Qu, Liu); the Faculty of Neurology, Graduate School of Southern Medical University, Guangzhou, Guangdong Province, China (Wang); the BrainNow Research Institute, Shenzhen, Guangdong Province, China (Luo, Shi); the School of Mathematics and Statistics, Huazhong University of Science and Technology, China (Gao); the Center for Mathematical Science, Huazhong University of Science and Technology, China (Gao); the Intelligent Brain Imaging and Brain Function Laboratory (Dongguan Key Laboratory), Dongguan People's Hospital, Dongguan, Guangdong, China (Qu, Chen); the Guangdong Provincial Key Laboratory of Mathematical and Neural Dynamical Systems, Great Bay University, Dongguan, Guangdong, China (Qu, Gao, Chen)
| | - Ting Gao
- From the Department of Neurology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong Province, China (Qu, Liu, Wang, Chen); the Faculty of Neurology, Graduate School of Guangdong Medical University, Zhanjiang, Guangdong Province, China (Qu, Liu); the Faculty of Neurology, Graduate School of Southern Medical University, Guangzhou, Guangdong Province, China (Wang); the BrainNow Research Institute, Shenzhen, Guangdong Province, China (Luo, Shi); the School of Mathematics and Statistics, Huazhong University of Science and Technology, China (Gao); the Center for Mathematical Science, Huazhong University of Science and Technology, China (Gao); the Intelligent Brain Imaging and Brain Function Laboratory (Dongguan Key Laboratory), Dongguan People's Hospital, Dongguan, Guangdong, China (Qu, Chen); the Guangdong Provincial Key Laboratory of Mathematical and Neural Dynamical Systems, Great Bay University, Dongguan, Guangdong, China (Qu, Gao, Chen)
| | - Lin Shi
- From the Department of Neurology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong Province, China (Qu, Liu, Wang, Chen); the Faculty of Neurology, Graduate School of Guangdong Medical University, Zhanjiang, Guangdong Province, China (Qu, Liu); the Faculty of Neurology, Graduate School of Southern Medical University, Guangzhou, Guangdong Province, China (Wang); the BrainNow Research Institute, Shenzhen, Guangdong Province, China (Luo, Shi); the School of Mathematics and Statistics, Huazhong University of Science and Technology, China (Gao); the Center for Mathematical Science, Huazhong University of Science and Technology, China (Gao); the Intelligent Brain Imaging and Brain Function Laboratory (Dongguan Key Laboratory), Dongguan People's Hospital, Dongguan, Guangdong, China (Qu, Chen); the Guangdong Provincial Key Laboratory of Mathematical and Neural Dynamical Systems, Great Bay University, Dongguan, Guangdong, China (Qu, Gao, Chen)
| | - Yang-Kun Chen
- From the Department of Neurology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong Province, China (Qu, Liu, Wang, Chen); the Faculty of Neurology, Graduate School of Guangdong Medical University, Zhanjiang, Guangdong Province, China (Qu, Liu); the Faculty of Neurology, Graduate School of Southern Medical University, Guangzhou, Guangdong Province, China (Wang); the BrainNow Research Institute, Shenzhen, Guangdong Province, China (Luo, Shi); the School of Mathematics and Statistics, Huazhong University of Science and Technology, China (Gao); the Center for Mathematical Science, Huazhong University of Science and Technology, China (Gao); the Intelligent Brain Imaging and Brain Function Laboratory (Dongguan Key Laboratory), Dongguan People's Hospital, Dongguan, Guangdong, China (Qu, Chen); the Guangdong Provincial Key Laboratory of Mathematical and Neural Dynamical Systems, Great Bay University, Dongguan, Guangdong, China (Qu, Gao, Chen)
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Selig M, Lee G, Lebowitz B, Franceschi D, Absar N. A Case of Personality and Behavioral Changes with Frontotemporal and Cerebellar Atrophy on MRI with Corresponding Hypometabolism on FDG-PET. Case Rep Psychiatry 2024; 2024:2863662. [PMID: 39188506 PMCID: PMC11347030 DOI: 10.1155/2024/2863662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 07/17/2024] [Accepted: 07/26/2024] [Indexed: 08/28/2024] Open
Abstract
Background The differential diagnosis of a patient with cognitive, behavioral, and motor symptoms is broad. There is much overlap between neurocognitive disorders due to frontotemporal dementia and other subcortical dementia. A less known diagnosis, cerebellar cognitive affective syndrome (CCAS), should also be considered. Case History. A 29-year-old female presented with ataxia and left-sided weakness. CSF showed oligoclonal bands, and MRI showed multiple white matter lesions with some atrophy. She was diagnosed with multiple sclerosis (MS). At age 35, she developed frontal lobe symptoms and executive dysfunction; she was diagnosed with MS with bipolar disorder. Neuropsychological evaluation at that time showed significant deficits in multiple cognitive domains. Subsequent MRI showed progressive frontotemporal atrophy, and FDG-PET uncovered hypometabolism in the frontotemporal lobes and cerebellum. At age 38, her behavior worsened with aggression, and she was started on olanzapine. She responded well with decreased agitation and improved motivation and attention. Compared with previous scans, most recent MRI and FDG-PET showed interval increase in cerebellar atrophy with increase in hypometabolism in the cerebellum, respectively. Conclusion Based on cerebellar, affective, and subcortical cognitive examination findings, our diagnosis is probable CCAS. The cerebellum should be considered as a possible etiology of frontal subcortical cognitive impairment.
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Affiliation(s)
- Megan Selig
- Department of NeuropsychiatryStony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Gloria Lee
- Department of NeuropsychiatryStony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Brian Lebowitz
- Department of NeuropsychiatryStony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Dinko Franceschi
- Department of NeuropsychiatryStony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Nicole Absar
- Neurocognitive ClinicMass General Brigham—Martha's Vineyard Hospital, Martha's Vineyard, MA, USA
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R K Roy A, Noohi F, Morris NA, Ljubenkov P, Heuer H, Fong J, Hall M, Lario Lago A, Rankin KP, Miller BL, Boxer AL, Rosen HJ, Seeley WW, Perry DC, Yokoyama JS, Lee SE, Sturm VE. Basal parasympathetic deficits in C9orf72 hexanucleotide repeat expansion carriers relate to smaller frontoinsula and thalamus volume and lower empathy. Neuroimage Clin 2024; 43:103649. [PMID: 39098187 PMCID: PMC11342757 DOI: 10.1016/j.nicl.2024.103649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 07/16/2024] [Accepted: 07/29/2024] [Indexed: 08/06/2024]
Abstract
Diminished basal parasympathetic nervous system activity is a feature of frontotemporal dementia that relates to left frontoinsula dysfunction and empathy impairment. Individuals with a pathogenic expansion of the hexanucleotide repeat in chromosome 9 open reading frame 72 (C9orf72), the most common genetic cause of frontotemporal dementia and amyotrophic lateral sclerosis, provide a unique opportunity to examine whether parasympathetic activity is disrupted in genetic forms of frontotemporal dementia and to investigate when parasympathetic deficits manifest in the pathophysiological cascade. We measured baseline respiratory sinus arrhythmia, a parasympathetic measure of heart rate variability, over two minutes in a sample of 102 participants that included 19 asymptomatic expansion carriers (C9+ asymp), 14 expansion carriers with mild cognitive impairment (C9+ MCI), 16 symptomatic expansion carriers with frontotemporal dementia (C9+ FTD), and 53 expansion-negative healthy controls (C9- HC) who also underwent structural magnetic resonance imaging. In follow-up analyses, we compared baseline respiratory sinus arrhythmia in the C9+ FTD group with an independent age-, sex-, and clinical severity-matched group of 26 people with sporadic behavioral variant frontotemporal dementia. The Frontotemporal Lobar Degeneration-modified Clinical Dementia Rating-Sum of Boxes score was used to quantify behavioral symptom severity, and informant ratings on the Interpersonal Reactivity Index provided measures of participants' current emotional (empathic concern) and cognitive (perspective-taking) empathy. Results indicated that the C9+ FTD group had lower baseline respiratory sinus arrhythmia than the C9+ MCI, C9+ asymp, and C9- HC groups, a deficit that was comparable to that of sporadic behavioral variant frontotemporal dementia. Linear regression analyses indicated that lower baseline respiratory sinus arrhythmia was associated with worse behavioral symptom severity and lower empathic concern and perspective-taking across the C9orf72 expansion carrier clinical spectrum. Whole-brain voxel-based morphometry analyses in participants with C9orf72 pathogenic expansions found that lower baseline respiratory sinus arrhythmia correlated with smaller gray matter volume in the left frontoinsula and bilateral thalamus, key structures that support parasympathetic function, and in the bilateral parietal lobes, occipital lobes, and cerebellum, regions that are also vulnerable in individuals with C9orf72 expansions. This study provides novel evidence that basal parasympathetic functioning is diminished in FTD due to C9orf72 expansions and suggests that baseline respiratory sinus arrhythmia may be a potential non-invasive biomarker that is sensitive to behavioral symptoms in the early stages of disease.
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Affiliation(s)
- Ashlin R K Roy
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Fate Noohi
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Nathaniel A Morris
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Peter Ljubenkov
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Hilary Heuer
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Jamie Fong
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Matthew Hall
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | | | - Katherine P Rankin
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Adam L Boxer
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Howard J Rosen
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - William W Seeley
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - David C Perry
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Jennifer S Yokoyama
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Suzee E Lee
- Department of Neurology, University of California, San Francisco, CA 94158, USA
| | - Virginia E Sturm
- Department of Neurology, University of California, San Francisco, CA 94158, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA 94143, USA.
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Shen T, Vogel JW, Van Deerlin VM, Suh E, Dratch L, Phillips JS, Massimo L, Lee EB, Irwin DJ, McMillan CT. Disparate and shared transcriptomic signatures associated with cortical atrophy in genetic bvFTD. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.25.24310894. [PMID: 39211858 PMCID: PMC11361203 DOI: 10.1101/2024.07.25.24310894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Cortical atrophy in behavioral variant frontotemporal degeneration (bvFTD) exhibits spatial heterogeneity across genetic subgroups, potentially driven by distinct biological mechanisms. Using an integrative imaging-transcriptomics approach, we identified disparate and shared transcriptomic signatures associated with cortical thickness in C9orf72 , GRN or MAPT -related bvFTD. Genes associated with cortical thinning in GRN -bvFTD were implicated in neurotransmission, further supported by mapping synaptic density maps to cortical thickness maps. Previously identified genes linked to TDP-43 positive neurons were significantly overlapped with genes associated with C9orf72 -bvFTD and GRN -bvFTD, but not MAPT -bvFTD providing specificity for our associations. C9orf72 -bvFTD and GRN -bvFTD shared genes displaying consistent directionality of correlations with cortical thickness, while MAPT -bvFTD displayed more pronounced differences in transcriptomic signatures with opposing directionality. Overall, we identified disparate and shared genes tied to regional vulnerability with increased biological interpretation including overlap with synaptic density maps and pathologically-specific gene expression, illuminating intricate molecular underpinnings contributing to heterogeneities in bvFTD.
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Christidi F, Kleinerova J, Tan EL, Delaney S, Tacheva A, Hengeveld JC, Doherty MA, McLaughlin RL, Hardiman O, Siah WF, Chang KM, Lope J, Bede P. Limbic Network and Papez Circuit Involvement in ALS: Imaging and Clinical Profiles in GGGGCC Hexanucleotide Carriers in C9orf72 and C9orf72-Negative Patients. BIOLOGY 2024; 13:504. [PMID: 39056697 PMCID: PMC11273537 DOI: 10.3390/biology13070504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/26/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
Background: While frontotemporal involvement is increasingly recognized in Amyotrophic lateral sclerosis (ALS), the degeneration of limbic networks remains poorly characterized, despite growing evidence of amnestic deficits, impaired emotional processing and deficits in social cognition. Methods: A prospective neuroimaging study was conducted with 204 individuals with ALS and 111 healthy controls. Patients were stratified for hexanucleotide expansion status in C9orf72. A deep-learning-based segmentation approach was implemented to segment the nucleus accumbens, hypothalamus, fornix, mammillary body, basal forebrain and septal nuclei. The cortical, subcortical and white matter components of the Papez circuit were also systematically evaluated. Results: Hexanucleotide repeat expansion carriers exhibited bilateral amygdala, hypothalamus and nucleus accumbens atrophy, and C9orf72 negative patients showed bilateral basal forebrain volume reductions compared to controls. Both patient groups showed left rostral anterior cingulate atrophy, left entorhinal cortex thinning and cingulum and fornix alterations, irrespective of the genotype. Fornix, cingulum, posterior cingulate, nucleus accumbens, amygdala and hypothalamus degeneration was more marked in C9orf72-positive ALS patients. Conclusions: Our results highlighted that mesial temporal and parasagittal subcortical degeneration is not unique to C9orf72 carriers. Our radiological findings were consistent with neuropsychological observations and highlighted the importance of comprehensive neuropsychological testing in ALS, irrespective of the underlying genotype.
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Affiliation(s)
- Foteini Christidi
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Jana Kleinerova
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Ee Ling Tan
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Siobhan Delaney
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Department of Neurology, St James’s Hospital, D08 KC95 Dublin, Ireland
| | - Asya Tacheva
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Department of Neurology, St James’s Hospital, D08 KC95 Dublin, Ireland
| | | | - Mark A. Doherty
- Smurfit Institute of Genetics, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | | | - Orla Hardiman
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - We Fong Siah
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Kai Ming Chang
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Jasmin Lope
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group (CNG), School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Department of Neurology, St James’s Hospital, D08 KC95 Dublin, Ireland
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Pasternak M, Mirza SS, Luciw N, Mutsaerts HJMM, Petr J, Thomas D, Cash D, Bocchetta M, Tartaglia MC, Mitchell SB, Black SE, Freedman M, Tang‐Wai D, Rogaeva E, Russell LL, Bouzigues A, van Swieten JC, Jiskoot LC, Seelaar H, Laforce R, Tiraboschi P, Borroni B, Galimberti D, Rowe JB, Graff C, Finger E, Sorbi S, de Mendonça A, Butler C, Gerhard A, Sanchez‐Valle R, Moreno F, Synofzik M, Vandenberghe R, Ducharme S, Levin J, Otto M, Santana I, Strafella AP, MacIntosh BJ, Rohrer JD, Masellis M. Longitudinal cerebral perfusion in presymptomatic genetic frontotemporal dementia: GENFI results. Alzheimers Dement 2024; 20:3525-3542. [PMID: 38623902 PMCID: PMC11095434 DOI: 10.1002/alz.13750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION Effective longitudinal biomarkers that track disease progression are needed to characterize the presymptomatic phase of genetic frontotemporal dementia (FTD). We investigate the utility of cerebral perfusion as one such biomarker in presymptomatic FTD mutation carriers. METHODS We investigated longitudinal profiles of cerebral perfusion using arterial spin labeling magnetic resonance imaging in 42 C9orf72, 70 GRN, and 31 MAPT presymptomatic carriers and 158 non-carrier controls. Linear mixed effects models assessed perfusion up to 5 years after baseline assessment. RESULTS Perfusion decline was evident in all three presymptomatic groups in global gray matter. Each group also featured its own regional pattern of hypoperfusion over time, with the left thalamus common to all groups. Frontal lobe regions featured lower perfusion in those who symptomatically converted versus asymptomatic carriers past their expected age of disease onset. DISCUSSION Cerebral perfusion is a potential biomarker for assessing genetic FTD and its genetic subgroups prior to symptom onset. HIGHLIGHTS Gray matter perfusion declines in at-risk genetic frontotemporal dementia (FTD). Regional perfusion decline differs between at-risk genetic FTD subgroups . Hypoperfusion in the left thalamus is common across all presymptomatic groups. Converters exhibit greater right frontal hypoperfusion than non-converters past their expected conversion date. Cerebral hypoperfusion is a potential early biomarker of genetic FTD.
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Cagnin A, Pigato G, Pettenuzzo I, Zorzi G, Roiter B, Anglani MG, Bussè C, Mozzetta S, Gabelli C, Campi C, Cecchin D. Data-driven analysis of regional brain metabolism in behavioral frontotemporal dementia and late-onset primary psychiatric diseases with frontal lobe syndrome: A PET/MRI study. Neurobiol Aging 2024; 137:47-54. [PMID: 38422798 DOI: 10.1016/j.neurobiolaging.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 01/10/2024] [Accepted: 01/30/2024] [Indexed: 03/02/2024]
Abstract
Late-onset primary psychiatric disease (PPD) and behavioral frontotemporal dementia (bvFTD) present with a similar frontal lobe syndrome. We compare brain glucose metabolism in bvFTD and late-onset PPD and investigate the metabolic correlates of cognitive and behavioral disturbances through FDG-PET/MRI. We studied 37 bvFTD and 20 late-onset PPD with a mean clinical follow-up of three years. At baseline evaluation, metabolism of the dorsolateral, ventrolateral, orbitofrontal regions and caudate could classify the patients with a diagnostic accuracy of 91% (95% CI: 0.81-0.98%). 45% of PPD showed low-grade hypometabolism in the anterior cingulate and/or parietal regions. Frontal lobe metabolism was normal in 32% of genetic bvFTD and bvFTD with motor neuron signs. Hypometabolism of the frontal and caudate regions could help in distinguishing bvFTD from PPD, except in cases with motor neuron signs and/or genetic bvFTD for which brain metabolism may be less informative.
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Affiliation(s)
- Annachiara Cagnin
- Neurology Unit, Department of Neuroscience (DNS) University of Padua, Padua, Italy; Padua Neuroscience Center, University of Padua, Padua, Italy.
| | - Giorgio Pigato
- Psychiatry Unit, Department of Neuroscience (DNS), University of Padua, Padua, Italy
| | - Ilaria Pettenuzzo
- Neurology Unit, Department of Neuroscience (DNS) University of Padua, Padua, Italy
| | - Giovanni Zorzi
- Neurology Unit, Department of Neuroscience (DNS) University of Padua, Padua, Italy; Padua Neuroscience Center, University of Padua, Padua, Italy; CRIC, Azienda Ospedale-Università of Padua, Italy
| | - Beatrice Roiter
- Psychiatry Unit, Department of Neuroscience (DNS), University of Padua, Padua, Italy
| | | | - Cinzia Bussè
- Neurology Unit, Department of Neuroscience (DNS) University of Padua, Padua, Italy
| | - Stefano Mozzetta
- Neurology Unit, Department of Neuroscience (DNS) University of Padua, Padua, Italy
| | | | - Cristina Campi
- Nuclear Medicine Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy; Department of Mathematics, University of Genoa and IRCCS Policlinico San Martino Hospital, Genoa
| | - Diego Cecchin
- Padua Neuroscience Center, University of Padua, Padua, Italy; Nuclear Medicine Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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18
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Sellier C, Corcia P, Vourc'h P, Dupuis L. C9ORF72 hexanucleotide repeat expansion: From ALS and FTD to a broader pathogenic role? Rev Neurol (Paris) 2024; 180:417-428. [PMID: 38609750 DOI: 10.1016/j.neurol.2024.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024]
Abstract
The major gene underlying monogenic forms of amyotrophic lateral sclerosis (ALS) and fronto-temporal dementia (FTD) is C9ORF72. The causative mutation in C9ORF72 is an abnormal hexanucleotide (G4C2) repeat expansion (HRE) located in the first intron of the gene. The aim of this review is to propose a comprehensive update on recent developments on clinical, biological and therapeutics aspects related to C9ORF72 in order to highlight the current understanding of genotype-phenotype correlations, and also on biological machinery leading to neuronal death. We will particularly focus on the broad phenotypic presentation of C9ORF72-related diseases, that goes well beyond the classical phenotypes observed in ALS and FTD patients. Last, we will comment the possible therapeutical hopes for patients carrying a C9ORF72 HRE.
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Affiliation(s)
- C Sellier
- Centre de recherches en biomédecine de Strasbourg, UMR-S1329, Inserm, université de Strasbourg, Strasbourg, France
| | - P Corcia
- UMR 1253 iBrain, Inserm, université de Tours, Tours, France; Centre constitutif de coordination SLA, CHU de Bretonneau, 2, boulevard Tonnelle, 37044 Tours cedex 1, France
| | - P Vourc'h
- UMR 1253 iBrain, Inserm, université de Tours, Tours, France; Service de biochimie et biologie moléculaire, CHU de Tours, Tours, France
| | - L Dupuis
- Centre de recherches en biomédecine de Strasbourg, UMR-S1329, Inserm, université de Strasbourg, Strasbourg, France.
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19
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Meade G, Whitwell JL, Dickson DW, Duffy JR, Clark HM, Ahlskog JE, Machulda MM, Josephs KA, Utianski RL. Primary Progressive Apraxia of Speech Caused by TDP-43: A Case Report. Neurol Genet 2024; 10:e200134. [PMID: 38515991 PMCID: PMC10955458 DOI: 10.1212/nxg.0000000000200134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/19/2024] [Indexed: 03/23/2024]
Abstract
Objectives To introduce the first case in which primary progressive apraxia of speech (PPAOS) is associated with TAR DNA-binding protein 43 (TDP-43) instead of 4-repeat tau. Methods This patient was identified through a postmortem autopsy. Following an initial diagnostic evaluation, he participated in 3 annual research visits during which speech, language, cognitive, and neurologic assessments were administered. Neuroimaging was also acquired. Results Apraxia of speech was diagnosed at his initial visit with a comprehensive neurologic examination further revealing subtle motor findings in the right hand. At subsequent visits, agrammatic aphasia and motor symptoms consistent with corticobasal syndrome were evident. Cognition and behavior remained relatively intact until advanced stages. FDG-PET revealed hypometabolism in the right temporoparietal cortex and left premotor and motor cortices. There was also low-level signal in the right temporoparietal cortex on tau-PET. A sequence variation in the progranulin gene was identified (GRN c.1A>C, p.Met1). Pathologic diagnosis was TDP-43 Type A with an atypical distribution of inclusions in premotor and motor cortices. Discussion This case report demonstrates that TDP-43 Type A inclusions in an atypical distribution can present clinically as PPAOS. The sequence variation in the progranulin gene and asymmetric temporoparietal cortex involvement were the strongest indications of the unusual neuropathophysiology prior to autopsy.
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Affiliation(s)
- Gabriela Meade
- From the Departments of Neurology (G.M., J.R.D., H.M.C., J.E.A., K.A.J., R.L.U.), Radiology (J.L.W.), and Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; and the Department of Neuroscience (D.W.D.), Mayo Clinic Jacksonville, FL
| | - Jennifer L Whitwell
- From the Departments of Neurology (G.M., J.R.D., H.M.C., J.E.A., K.A.J., R.L.U.), Radiology (J.L.W.), and Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; and the Department of Neuroscience (D.W.D.), Mayo Clinic Jacksonville, FL
| | - Dennis W Dickson
- From the Departments of Neurology (G.M., J.R.D., H.M.C., J.E.A., K.A.J., R.L.U.), Radiology (J.L.W.), and Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; and the Department of Neuroscience (D.W.D.), Mayo Clinic Jacksonville, FL
| | - Joseph R Duffy
- From the Departments of Neurology (G.M., J.R.D., H.M.C., J.E.A., K.A.J., R.L.U.), Radiology (J.L.W.), and Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; and the Department of Neuroscience (D.W.D.), Mayo Clinic Jacksonville, FL
| | - Heather M Clark
- From the Departments of Neurology (G.M., J.R.D., H.M.C., J.E.A., K.A.J., R.L.U.), Radiology (J.L.W.), and Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; and the Department of Neuroscience (D.W.D.), Mayo Clinic Jacksonville, FL
| | - J Eric Ahlskog
- From the Departments of Neurology (G.M., J.R.D., H.M.C., J.E.A., K.A.J., R.L.U.), Radiology (J.L.W.), and Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; and the Department of Neuroscience (D.W.D.), Mayo Clinic Jacksonville, FL
| | - Mary M Machulda
- From the Departments of Neurology (G.M., J.R.D., H.M.C., J.E.A., K.A.J., R.L.U.), Radiology (J.L.W.), and Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; and the Department of Neuroscience (D.W.D.), Mayo Clinic Jacksonville, FL
| | - Keith A Josephs
- From the Departments of Neurology (G.M., J.R.D., H.M.C., J.E.A., K.A.J., R.L.U.), Radiology (J.L.W.), and Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; and the Department of Neuroscience (D.W.D.), Mayo Clinic Jacksonville, FL
| | - Rene L Utianski
- From the Departments of Neurology (G.M., J.R.D., H.M.C., J.E.A., K.A.J., R.L.U.), Radiology (J.L.W.), and Psychiatry and Psychology (M.M.M.), Mayo Clinic, Rochester, MN; and the Department of Neuroscience (D.W.D.), Mayo Clinic Jacksonville, FL
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20
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Corriveau-Lecavalier N, Barnard LR, Przybelski SA, Gogineni V, Botha H, Graff-Radford J, Ramanan VK, Forsberg LK, Fields JA, Machulda MM, Rademakers R, Gavrilova RH, Lapid MI, Boeve BF, Knopman DS, Lowe VJ, Petersen RC, Jack CR, Kantarci K, Jones DT. Assessing network degeneration and phenotypic heterogeneity in genetic frontotemporal lobar degeneration by decoding FDG-PET. Neuroimage Clin 2023; 41:103559. [PMID: 38147792 PMCID: PMC10944211 DOI: 10.1016/j.nicl.2023.103559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 12/28/2023]
Abstract
Genetic mutations causative of frontotemporal lobar degeneration (FTLD) are highly predictive of a specific proteinopathy, but there exists substantial inter-individual variability in their patterns of network degeneration and clinical manifestations. We collected clinical and 18Fluorodeoxyglucose-positron emission tomography (FDG-PET) data from 39 patients with genetic FTLD, including 11 carrying the C9orf72 hexanucleotide expansion, 16 carrying a MAPT mutation and 12 carrying a GRN mutation. We performed a spectral covariance decomposition analysis between FDG-PET images to yield unbiased latent patterns reflective of whole brain patterns of metabolism ("eigenbrains" or EBs). We then conducted linear discriminant analyses (LDAs) to perform EB-based predictions of genetic mutation and predominant clinical phenotype (i.e., behavior/personality, language, asymptomatic). Five EBs were significant and explained 58.52 % of the covariance between FDG-PET images. EBs indicative of hypometabolism in left frontotemporal and temporo-parietal areas distinguished GRN mutation carriers from other genetic mutations and were associated with predominant language phenotypes. EBs indicative of hypometabolism in prefrontal and temporopolar areas with a right hemispheric predominance were mostly associated with predominant behavioral phenotypes and distinguished MAPT mutation carriers from other genetic mutations. The LDAs yielded accuracies of 79.5 % and 76.9 % in predicting genetic status and predominant clinical phenotype, respectively. A small number of EBs explained a high proportion of covariance in patterns of network degeneration across FTLD-related genetic mutations. These EBs contained biological information relevant to the variability in the pathophysiological and clinical aspects of genetic FTLD, and for offering valuable guidance in complex clinical decision-making, such as decisions related to genetic testing.
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Affiliation(s)
- Nick Corriveau-Lecavalier
- Department of Neurology, Mayo Clinic Rochester, USA; Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | | | | | | | - Hugo Botha
- Department of Neurology, Mayo Clinic Rochester, USA
| | | | | | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic Jacksonville, USA; VIB-UA Center for Molecular Neurology, VIB, University of Antwerp, Belgium
| | | | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | | | | | - Val J Lowe
- Department of Radiology, Mayo Clinic Rochester, USA
| | | | | | | | - David T Jones
- Department of Neurology, Mayo Clinic Rochester, USA; Department of Radiology, Mayo Clinic Rochester, USA.
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21
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Shen T, Vogel JW, Duda J, Phillips JS, Cook PA, Gee J, Elman L, Quinn C, Amado DA, Baer M, Massimo L, Grossman M, Irwin DJ, McMillan CT. Novel data-driven subtypes and stages of brain atrophy in the ALS-FTD spectrum. Transl Neurodegener 2023; 12:57. [PMID: 38062485 PMCID: PMC10701950 DOI: 10.1186/s40035-023-00389-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND TDP-43 proteinopathies represent a spectrum of neurological disorders, anchored clinically on either end by amyotrophic lateral sclerosis (ALS) and frontotemporal degeneration (FTD). The ALS-FTD spectrum exhibits a diverse range of clinical presentations with overlapping phenotypes, highlighting its heterogeneity. This study was aimed to use disease progression modeling to identify novel data-driven spatial and temporal subtypes of brain atrophy and its progression in the ALS-FTD spectrum. METHODS We used a data-driven procedure to identify 13 anatomic clusters of brain volume for 57 behavioral variant FTD (bvFTD; with either autopsy-confirmed TDP-43 or TDP-43 proteinopathy-associated genetic variants), 103 ALS, and 47 ALS-FTD patients with likely TDP-43. A Subtype and Stage Inference (SuStaIn) model was trained to identify subtypes of individuals along the ALS-FTD spectrum with distinct brain atrophy patterns, and we related subtypes and stages to clinical, genetic, and neuropathological features of disease. RESULTS SuStaIn identified three novel subtypes: two disease subtypes with predominant brain atrophy in either prefrontal/somatomotor regions or limbic-related regions, and a normal-appearing group without obvious brain atrophy. The limbic-predominant subtype tended to present with more impaired cognition, higher frequencies of pathogenic variants in TBK1 and TARDBP genes, and a higher proportion of TDP-43 types B, E and C. In contrast, the prefrontal/somatomotor-predominant subtype had higher frequencies of pathogenic variants in C9orf72 and GRN genes and higher proportion of TDP-43 type A. The normal-appearing brain group showed higher frequency of ALS relative to ALS-FTD and bvFTD patients, higher cognitive capacity, higher proportion of lower motor neuron onset, milder motor symptoms, and lower frequencies of genetic pathogenic variants. The overall SuStaIn stages also correlated with evidence for clinical progression including longer disease duration, higher King's stage, and cognitive decline. Additionally, SuStaIn stages differed across clinical phenotypes, genotypes and types of TDP-43 pathology. CONCLUSIONS Our findings suggest distinct neurodegenerative subtypes of disease along the ALS-FTD spectrum that can be identified in vivo, each with distinct brain atrophy, clinical, genetic and pathological patterns.
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Affiliation(s)
- Ting Shen
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jacob W Vogel
- Department of Clinical Sciences, SciLifeLab, Lund University, 222 42, Lund, Sweden
| | - Jeffrey Duda
- Penn Image Computing and Science Lab (PICSL), Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jeffrey S Phillips
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Philip A Cook
- Penn Image Computing and Science Lab (PICSL), Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - James Gee
- Penn Image Computing and Science Lab (PICSL), Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Lauren Elman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Colin Quinn
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Defne A Amado
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Michael Baer
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Lauren Massimo
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - David J Irwin
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Digital Neuropathology Laboratory, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Corey T McMillan
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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22
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Ortiz GG, Ramírez-Jirano J, Arizaga RL, Delgado-Lara DLC, Torres-Sánchez ED. Frontotemporal-TDP and LATE Neurocognitive Disorders: A Pathophysiological and Genetic Approach. Brain Sci 2023; 13:1474. [PMID: 37891841 PMCID: PMC10605418 DOI: 10.3390/brainsci13101474] [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: 09/15/2023] [Revised: 10/07/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Frontotemporal lobar degeneration (FTLD) belongs to a heterogeneous group of highly complex neurodegenerative diseases and represents the second cause of presenile dementia in individuals under 65. Frontotemporal-TDP is a subgroup of frontotemporal dementia characterized by the aggregation of abnormal protein deposits, predominantly transactive response DNA-binding protein 43 (TDP-43), in the frontal and temporal brain regions. These deposits lead to progressive degeneration of neurons resulting in cognitive and behavioral impairments. Limbic age-related encephalopathy (LATE) pertains to age-related cognitive decline primarily affecting the limbic system, which is crucial for memory, emotions, and learning. However, distinct, emerging research suggests a potential overlap in pathogenic processes, with some cases of limbic encephalopathy displaying TDP-43 pathology. Genetic factors play a pivotal role in both disorders. Mutations in various genes, such as progranulin (GRN) and chromosome 9 open reading frame 72 (C9orf72), have been identified as causative in frontotemporal-TDP. Similarly, specific genetic variants have been associated with an increased risk of developing LATE. Understanding these genetic links provides crucial insights into disease mechanisms and the potential for targeted therapies.
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Affiliation(s)
- Genaro Gabriel Ortiz
- Department of Philosophical and Methodological Disciplines, University Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico;
- Postgraduate Gerontology Program, University Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Javier Ramírez-Jirano
- Neurosciences Division, Western Biomedical Research Center, Mexican Social Security Institute, IMSS, Guadalajara 44340, Jalisco, Mexico;
| | - Raul L. Arizaga
- Public Health Department, School of Medicine, University of Buenos Aires, Buenos Aires C1121ABG, Argentina;
| | - Daniela L. C. Delgado-Lara
- Department of Philosophical and Methodological Disciplines, University Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico;
- Departamento Académico de Formación Universitaria, Ciencias de la Salud, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico
| | - Erandis D. Torres-Sánchez
- Department of Medical and Life Sciences, University Center of la Cienega, University of Guadalajara, Ocotlan 47820, Jalisco, Mexico
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23
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Zhang L, Flagan TM, Häkkinen S, Chu SA, Brown JA, Lee AJ, Pasquini L, Mandelli ML, Gorno-Tempini ML, Sturm VE, Yokoyama JS, Appleby BS, Cobigo Y, Dickerson BC, Domoto-Reilly K, Geschwind DH, Ghoshal N, Graff-Radford NR, Grossman M, Hsiung GYR, Huey ED, Kantarci K, Lago AL, Litvan I, Mackenzie IR, Mendez MF, Onyike CU, Ramos EM, Roberson ED, Tartaglia MC, Toga AW, Weintraub S, Wszolek ZK, Forsberg LK, Heuer HW, Boeve BF, Boxer AL, Rosen HJ, Miller BL, Seeley WW, Lee SE. Network Connectivity Alterations across the MAPT Mutation Clinical Spectrum. Ann Neurol 2023; 94:632-646. [PMID: 37431188 PMCID: PMC10727479 DOI: 10.1002/ana.26738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 06/05/2023] [Accepted: 06/28/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE Microtubule-associated protein tau (MAPT) mutations cause frontotemporal lobar degeneration, and novel biomarkers are urgently needed for early disease detection. We used task-free functional magnetic resonance imaging (fMRI) mapping, a promising biomarker, to analyze network connectivity in symptomatic and presymptomatic MAPT mutation carriers. METHODS We compared cross-sectional fMRI data between 17 symptomatic and 39 presymptomatic carriers and 81 controls with (1) seed-based analyses to examine connectivity within networks associated with the 4 most common MAPT-associated clinical syndromes (ie, salience, corticobasal syndrome, progressive supranuclear palsy syndrome, and default mode networks) and (2) whole-brain connectivity analyses. We applied K-means clustering to explore connectivity heterogeneity in presymptomatic carriers at baseline. Neuropsychological measures, plasma neurofilament light chain, and gray matter volume were compared at baseline and longitudinally between the presymptomatic subgroups defined by their baseline whole-brain connectivity profiles. RESULTS Symptomatic and presymptomatic carriers had connectivity disruptions within MAPT-syndromic networks. Compared to controls, presymptomatic carriers showed regions of connectivity alterations with age. Two presymptomatic subgroups were identified by clustering analysis, exhibiting predominantly either whole-brain hypoconnectivity or hyperconnectivity at baseline. At baseline, these two presymptomatic subgroups did not differ in neuropsychological measures, although the hypoconnectivity subgroup had greater plasma neurofilament light chain levels than controls. Longitudinally, both subgroups showed visual memory decline (vs controls), yet the subgroup with baseline hypoconnectivity also had worsening verbal memory and neuropsychiatric symptoms, and extensive bilateral mesial temporal gray matter decline. INTERPRETATION Network connectivity alterations arise as early as the presymptomatic phase. Future studies will determine whether presymptomatic carriers' baseline connectivity profiles predict symptomatic conversion. ANN NEUROL 2023;94:632-646.
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Affiliation(s)
- Liwen Zhang
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Taru M. Flagan
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Suvi Häkkinen
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Stephanie A. Chu
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Jesse A. Brown
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Alex J. Lee
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Lorenzo Pasquini
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Maria Luisa Mandelli
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Virginia E. Sturm
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Jennifer S. Yokoyama
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Brian S. Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Yann Cobigo
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | | | | | - Daniel H. Geschwind
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Nupur Ghoshal
- Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Murray Grossman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Edward D. Huey
- Departments of Psychiatry and Neurology, Columbia University, New York, New York, USA
| | | | - Argentina Lario Lago
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Irene Litvan
- University of California, San Diego, La Jolla, California, USA
| | - Ian R Mackenzie
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Mario F. Mendez
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Chiadi U. Onyike
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Eliana Marisa Ramos
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Erik D Roberson
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Arthur W. Toga
- University of Southern California, Laboratory of Neuroimaging (LONI), Los Angeles, California, USA
| | - Sandra Weintraub
- Department of Psychiatry and Behavioral Sciences; Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | | | | | - Hilary W. Heuer
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | | | - Adam L. Boxer
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Howard J. Rosen
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Bruce L. Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - William W. Seeley
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Suzee E. Lee
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
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24
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Ghirelli A, Spinelli EG, Canu E, Domi T, Basaia S, Castelnovo V, Pozzi L, Magnani G, Caso F, Caroppo P, Prioni S, Villa C, Riva N, Quattrini A, Carrera P, Filippi M, Agosta F. Case report: coexistence of C9orf72 expansion and progranulin mutation in a case of genetic frontotemporal dementia-clinical features and neuroimaging correlates. J Neurol 2023; 270:5102-5109. [PMID: 37382630 PMCID: PMC10511558 DOI: 10.1007/s00415-023-11839-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Alma Ghirelli
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Edoardo Gioele Spinelli
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Teuta Domi
- Experimental Neuropathology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Basaia
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Veronica Castelnovo
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Laura Pozzi
- Experimental Neuropathology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giuseppe Magnani
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Caso
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Caroppo
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5-Neuropathology, Milan, Italy
| | - Sara Prioni
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5-Neuropathology, Milan, Italy
| | - Cristina Villa
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Neurology 5-Neuropathology, Milan, Italy
| | - Nilo Riva
- Experimental Neuropathology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Angelo Quattrini
- Experimental Neuropathology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Carrera
- Laboratory of Clinical Molecular Biology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Vita-Salute San Raffaele University, Milan, Italy.
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25
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Samra K, MacDougall AM, Bouzigues A, Bocchetta M, Cash DM, Greaves CV, Convery RS, van Swieten JC, Jiskoot L, Seelaar H, Moreno F, Sanchez-Valle R, Laforce R, Graff C, Masellis M, Tartaglia MC, Rowe JB, Borroni B, Finger E, Synofzik M, Galimberti D, Vandenberghe R, de Mendonça A, Butler CR, Gerhard A, Ducharme S, Le Ber I, Tiraboschi P, Santana I, Pasquier F, Levin J, Otto M, Sorbi S, Rohrer JD, Russell LL. Prodromal language impairment in genetic frontotemporal dementia within the GENFI cohort. J Neurol Sci 2023; 451:120711. [PMID: 37348248 DOI: 10.1016/j.jns.2023.120711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To identify whether language impairment exists presymptomatically in genetic frontotemporal dementia (FTD), and if so, the key differences between the main genetic mutation groups. METHODS 682 participants from the international multicentre Genetic FTD Initiative (GENFI) study were recruited: 290 asymptomatic and 82 prodromal mutation carriers (with C9orf72, GRN, and MAPT mutations) as well as 310 mutation-negative controls. Language was assessed using items from the Progressive Aphasia Severity Scale, as well as the Boston Naming Test (BNT), modified Camel and Cactus Test (mCCT) and a category fluency task. Participants also underwent a 3 T volumetric T1-weighted MRI from which regional brain volumes within the language network were derived and compared between the groups. RESULTS 3% of asymptomatic (4% C9orf72, 4% GRN, 2% MAPT) and 48% of prodromal (46% C9orf72, 42% GRN, 64% MAPT) mutation carriers had impairment in at least one language symptom compared with 13% of controls. In prodromal mutation carriers significantly impaired word retrieval was seen in all three genetic groups whilst significantly impaired grammar/syntax and decreased fluency was seen only in C9orf72 and GRN mutation carriers, and impaired articulation only in the C9orf72 group. Prodromal MAPT mutation carriers had significant impairment on the category fluency task and the BNT whilst prodromal C9orf72 mutation carriers were impaired on the category fluency task only. Atrophy in the dominant perisylvian language regions differed between groups, with earlier, more widespread volume loss in C9orf72, and later focal atrophy in the temporal lobe in MAPT mutation carriers. CONCLUSIONS Language deficits exist in the prodromal but not asymptomatic stages of genetic FTD across all three genetic groups. Improved understanding of the language phenotype prior to phenoconversion to fully symptomatic FTD will help develop outcome measures for future presymptomatic trials.
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Affiliation(s)
- Kiran Samra
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Amy M MacDougall
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Arabella Bouzigues
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Caroline V Greaves
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Rhian S Convery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | | | - Lize Jiskoot
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Harro Seelaar
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Fermin Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia Universitary Hospital, San Sebastian, Spain; Neuroscience Area, Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain
| | - Raquel Sanchez-Valle
- Alzheimer's disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, and Faculté de Médecine, Université Laval, QC, Canada
| | - Caroline Graff
- Center for Alzheimer Research, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Bioclinicum, Karolinska Institutet, Solna, Sweden; Unit for Hereditary Dementias, Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany; Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Daniela Galimberti
- Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy; University of Milan, Centro Dino Ferrari, Milan, Italy
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium; Neurology Service, University Hospitals Leuven, Leuven, Belgium; Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Alexandre de Mendonça
- Laboratory of Neurosciences, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Chris R Butler
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford, UK; Department of Brain Sciences, Imperial College London, UK
| | - Alex Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK; Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg-Essen, Germany
| | - Simon Ducharme
- Department of Psychiatry, McGill University Health Centre, McGill University, Montreal, Québec, Canada; McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
| | - Isabelle Le Ber
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau - ICM, Inserm U1127, CNRS UMR 7225, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Centre de Référence des Démences rares ou Précoces, IM2A, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Reference Network for Rare Neurological Diseases (ERN-RND)
| | | | - Isabel Santana
- University Hospital of Coimbra (HUC), Neurology Service, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Florence Pasquier
- Univ Lille, France; Inserm 1172, Lille, France; CHU, CNR-MAJ, Labex Distalz, LiCEND Lille, France
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians Universität München, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Germany
| | - Sandro Sorbi
- Department of Neurofarba, University of Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK.
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26
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Shen T, Vogel JW, Duda J, Phillips JS, Cook PA, Gee J, Elman L, Quinn C, Amado DA, Baer M, Massimo L, Grossman M, Irwin DJ, McMillan CT. Novel data-driven subtypes and stages of brain atrophy in the ALS-FTD spectrum. RESEARCH SQUARE 2023:rs.3.rs-3183113. [PMID: 37609205 PMCID: PMC10441467 DOI: 10.21203/rs.3.rs-3183113/v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Background TDP-43 proteinopathies represents a spectrum of neurological disorders, anchored clinically on either end by amyotrophic lateral sclerosis (ALS) and frontotemporal degeneration (FTD). The ALS-FTD spectrum exhibits a diverse range of clinical presentations with overlapping phenotypes, highlighting its heterogeneity. This study aimed to use disease progression modeling to identify novel data-driven spatial and temporal subtypes of brain atrophy and its progression in the ALS-FTD spectrum. Methods We used a data-driven procedure to identify 13 anatomic clusters of brain volumes for 57 behavioral variant FTD (bvFTD; with either autopsy-confirmed TDP-43 or TDP-43 proteinopathy-associated genetic variants), 103 ALS, and 47 ALS-FTD patients with likely TDP-43. A Subtype and Stage Inference (SuStaIn) model was trained to identify subtypes of individuals along the ALS-FTD spectrum with distinct brain atrophy patterns, and we related subtypes and stages to clinical, genetic, and neuropathological features of disease. Results SuStaIn identified three novel subtypes: two disease subtypes with predominant brain atrophy either in prefrontal/somatomotor regions or limbic-related regions, and a normal-appearing group without obvious brain atrophy. The Limbic-predominant subtype tended to present with more impaired cognition, higher frequencies of pathogenic variants in TBK1 and TARDBP genes, and a higher proportion of TDP-43 type B, E and C. In contrast, the Prefrontal/Somatomotor-predominant subtype had higher frequencies of pathogenic variants in C9orf72 and GRN genes and higher proportion of TDP-43 type A. The normal-appearing brain group showed higher frequency of ALS relative to ALS-FTD and bvFTD patients, higher cognitive capacity, higher proportion of lower motor neuron onset, milder motor symptoms, and lower frequencies of genetic pathogenic variants. Overall SuStaIn stages also correlated with evidence for clinical progression including longer disease duration, higher King's stage, and cognitive decline. Additionally, SuStaIn stages differed across clinical phenotypes, genotypes and types of TDP-43 pathology. Conclusions Our findings suggest distinct neurodegenerative subtypes of disease along the ALS-FTD spectrum that can be identified in vivo, each with distinct brain atrophy, clinical, genetic and pathological patterns.
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Affiliation(s)
- Ting Shen
- University of Pennsylvania Perelman School of Medicine
| | | | - Jeffrey Duda
- University of Pennsylvania Perelman School of Medicine
| | | | - Philip A Cook
- University of Pennsylvania Perelman School of Medicine
| | - James Gee
- University of Pennsylvania Perelman School of Medicine
| | - Lauren Elman
- University of Pennsylvania Perelman School of Medicine
| | - Colin Quinn
- University of Pennsylvania Perelman School of Medicine
| | - Defne A Amado
- University of Pennsylvania Perelman School of Medicine
| | - Michael Baer
- University of Pennsylvania Perelman School of Medicine
| | | | | | - David J Irwin
- University of Pennsylvania Perelman School of Medicine
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27
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Chen M, Burke S, Olm CA, Irwin DJ, Massimo L, Lee EB, Trojanowski JQ, Gee JC, Grossman M. Antemortem network analysis of spreading pathology in autopsy-confirmed frontotemporal degeneration. Brain Commun 2023; 5:fcad147. [PMID: 37223129 PMCID: PMC10202556 DOI: 10.1093/braincomms/fcad147] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/15/2023] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
Despite well-articulated hypotheses of spreading pathology in animal models of neurodegenerative disease, the basis for spreading neurodegenerative pathology in humans has been difficult to ascertain. In this study, we used graph theoretic analyses of structural networks in antemortem, multimodal MRI from autopsy-confirmed cases to examine spreading pathology in sporadic frontotemporal lobar degeneration. We defined phases of progressive cortical atrophy on T1-weighted MRI using a published algorithm in autopsied frontotemporal lobar degeneration with tau inclusions or with transactional DNA binding protein of ∼43 kDa inclusions. We studied global and local indices of structural networks in each of these phases, focusing on the integrity of grey matter hubs and white matter edges projecting between hubs. We found that global network measures are compromised to an equal degree in patients with frontotemporal lobar degeneration with tau inclusions and frontotemporal lobar degeneration-transactional DNA binding protein of ∼43 kDa inclusions compared to healthy controls. While measures of local network integrity were compromised in both frontotemporal lobar degeneration with tau inclusions and frontotemporal lobar degeneration-transactional DNA binding protein of ∼43 kDa inclusions, we discovered several important characteristics that distinguished between these groups. Hubs identified in controls were degraded in both patient groups, but degraded hubs were associated with the earliest phase of cortical atrophy (i.e. epicentres) only in frontotemporal lobar degeneration with tau inclusions. Degraded edges were significantly more plentiful in frontotemporal lobar degeneration with tau inclusions than in frontotemporal lobar degeneration-transactional DNA binding protein of ∼43 kDa inclusions, suggesting that the spread of tau pathology involves more significant white matter degeneration. Weakened edges were associated with degraded hubs in frontotemporal lobar degeneration with tau inclusions more than in frontotemporal lobar degeneration-transactional DNA binding protein of ∼43 kDa inclusions, particularly in the earlier phases of the disease, and phase-to-phase transitions in frontotemporal lobar degeneration with tau inclusions were characterized by weakened edges in earlier phases projecting to diseased hubs in subsequent phases of the disease. When we examined the spread of pathology from a region diseased in an earlier phase to physically adjacent regions in subsequent phases, we found greater evidence of disease spreading to adjacent regions in frontotemporal lobar degeneration-transactional DNA binding protein of ∼43 kDa inclusions than in frontotemporal lobar degeneration with tau inclusions. We associated evidence of degraded grey matter hubs and weakened white matter edges with quantitative measures of digitized pathology from direct observations of patients' brain samples. We conclude from these observations that the spread of pathology from diseased regions to distant regions via weakened long-range edges may contribute to spreading disease in frontotemporal dementia-tau, while spread of pathology to physically adjacent regions via local neuronal connectivity may play a more prominent role in spreading disease in frontotemporal lobar degeneration-transactional DNA binding protein of ∼43 kDa inclusions.
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Affiliation(s)
- Min Chen
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sarah Burke
- Department of Neurology, Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christopher A Olm
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Neurology, Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Bioengineering, Bioengineering Graduate Group, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David J Irwin
- Department of Neurology, Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Neurology, Neuroscience Graduate Group, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Lauren Massimo
- Department of Neurology, Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Edward B Lee
- Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - James C Gee
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Bioengineering, Bioengineering Graduate Group, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Murray Grossman
- Department of Neurology, Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Bioengineering, Bioengineering Graduate Group, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Neurology, Neuroscience Graduate Group, University of Pennsylvania, Philadelphia, PA 19104, USA
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28
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Premi E, Pengo M, Mattioli I, Cantoni V, Dukart J, Gasparotti R, Buratti E, Padovani A, Bocchetta M, Todd EG, Bouzigues A, Cash DM, Convery RS, Russell LL, Foster P, Thomas DL, van Swieten JC, Jiskoot LC, Seelaar H, Galimberti D, Sanchez-Valle R, Laforce R, Moreno F, Synofzik M, Graff C, Masellis M, Tartaglia MC, Rowe JB, Tsvetanov KA, Vandenberghe R, Finger E, Tiraboschi P, de Mendonça A, Santana I, Butler CR, Ducharme S, Gerhard A, Levin J, Otto M, Sorbi S, Le Ber I, Pasquier F, Rohrer JD, Borroni B. Early neurotransmitters changes in prodromal frontotemporal dementia: A GENFI study. Neurobiol Dis 2023; 179:106068. [PMID: 36898614 DOI: 10.1016/j.nbd.2023.106068] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/01/2023] [Accepted: 03/04/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Neurotransmitters deficits in Frontotemporal Dementia (FTD) are still poorly understood. Better knowledge of neurotransmitters impairment, especially in prodromal disease stages, might tailor symptomatic treatment approaches. METHODS In the present study, we applied JuSpace toolbox, which allowed for cross-modal correlation of Magnetic Resonance Imaging (MRI)-based measures with nuclear imaging derived estimates covering various neurotransmitter systems including dopaminergic, serotonergic, noradrenergic, GABAergic and glutamatergic neurotransmission. We included 392 mutation carriers (157 GRN, 164 C9orf72, 71 MAPT), together with 276 non-carrier cognitively healthy controls (HC). We tested if the spatial patterns of grey matter volume (GMV) alterations in mutation carriers (relative to HC) are correlated with specific neurotransmitter systems in prodromal (CDR® plus NACC FTLD = 0.5) and in symptomatic (CDR® plus NACC FTLD≥1) FTD. RESULTS In prodromal stages of C9orf72 disease, voxel-based brain changes were significantly associated with spatial distribution of dopamine and acetylcholine pathways; in prodromal MAPT disease with dopamine and serotonin pathways, while in prodromal GRN disease no significant findings were reported (p < 0.05, Family Wise Error corrected). In symptomatic FTD, a widespread involvement of dopamine, serotonin, glutamate and acetylcholine pathways across all genetic subtypes was found. Social cognition scores, loss of empathy and poor response to emotional cues were found to correlate with the strength of GMV colocalization of dopamine and serotonin pathways (all p < 0.01). CONCLUSIONS This study, indirectly assessing neurotransmitter deficits in monogenic FTD, provides novel insight into disease mechanisms and might suggest potential therapeutic targets to counteract disease-related symptoms.
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Affiliation(s)
- Enrico Premi
- Neurology, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
| | - Marta Pengo
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy; Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Irene Mattioli
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Valentina Cantoni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Juergen Dukart
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research CentreJülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Roberto Gasparotti
- Neuroradiology Unit, Department of Medical and Surgical Specialties, University of Brescia, Brescia, Italy
| | | | - Alessandro Padovani
- Neurology, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy; Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Centre for Cognitive and Clinical Neuroscience, Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom
| | - Emily G Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Arabella Bouzigues
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Rhian S Convery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Phoebe Foster
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - David L Thomas
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - John C van Swieten
- Department of Neurology and Alzheimer center, Erasmus Medical Center Rotterdam, the Netherlands
| | - Lize C Jiskoot
- Department of Neurology and Alzheimer center, Erasmus Medical Center Rotterdam, the Netherlands
| | - Harro Seelaar
- Department of Neurology and Alzheimer center, Erasmus Medical Center Rotterdam, the Netherlands
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Raquel Sanchez-Valle
- Neurology Department, Hospital Clinic, Institut d'Investigacions Biomèdiques, Barcelona, Spain
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, Faculté de Médecine, Université Laval, Québec, Canada
| | - Fermin Moreno
- Hospital Universitario Donostia, San Sebastian, Spain
| | - Matthis Synofzik
- Division Translational Genomics of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Caroline Graff
- Karolinska Institutet, Department NVS, Division of Neurogeriatrics, Stockholm, Sweden; Unit for Hereditray Dementia, Theme Aging, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Mario Masellis
- Campbell Cognitive Neurology Research Unit, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Maria Carmela Tartaglia
- Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, Toronto, ON, Canada
| | - James B Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust and Medical Research Council Cognition and brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Kamen A Tsvetanov
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust and Medical Research Council Cognition and brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
| | - Pietro Tiraboschi
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Chris R Butler
- Department of Clinical Neurology, University of Oxford, Oxford, United Kingdom
| | - Simon Ducharme
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, United Kingdom; Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg-Essen, Germany
| | - Johannes Levin
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster of System Neurology, Munich, Germany
| | - Markus Otto
- Department of Neurology, University Hospital Halle, Halle, Germany
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Isabelle Le Ber
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau - ICM, Inserm U1127, CNRS UMR 7225, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Centre de référence des démences rares ou précoces, IM2A, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Reference Network for Rare Neurological Diseases (ERN-RND)
| | - Florence Pasquier
- University of Lille, France; Inserm 1172, Lille, France; CHU, CNR-MAJ, Labex Distalz, LiCEND Lille, France
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Barbara Borroni
- Neurology, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy; Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
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29
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Bocchetta M, Todd EG, Bouzigues A, Cash DM, Nicholas JM, Convery RS, Russell LL, Thomas DL, Malone IB, Iglesias JE, van Swieten JC, Jiskoot LC, Seelaar H, Borroni B, Galimberti D, Sanchez-Valle R, Laforce R, Moreno F, Synofzik M, Graff C, Masellis M, Tartaglia MC, Rowe JB, Vandenberghe R, Finger E, Tagliavini F, de Mendonça A, Santana I, Butler CR, Ducharme S, Gerhard A, Danek A, Levin J, Otto M, Sorbi S, Le Ber I, Pasquier F, Rohrer JD. Structural MRI predicts clinical progression in presymptomatic genetic frontotemporal dementia: findings from the GENetic Frontotemporal dementia Initiative cohort. Brain Commun 2023; 5:fcad061. [PMID: 36970046 PMCID: PMC10036293 DOI: 10.1093/braincomms/fcad061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/22/2022] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
Biomarkers that can predict disease progression in individuals with genetic frontotemporal dementia are urgently needed. We aimed to identify whether baseline MRI-based grey and white matter abnormalities are associated with different clinical progression profiles in presymptomatic mutation carriers in the GENetic Frontotemporal dementia Initiative. Three hundred eighty-seven mutation carriers were included (160 GRN, 160 C9orf72, 67 MAPT), together with 240 non-carrier cognitively normal controls. Cortical and subcortical grey matter volumes were generated using automated parcellation methods on volumetric 3T T1-weighted MRI scans, while white matter characteristics were estimated using diffusion tensor imaging. Mutation carriers were divided into two disease stages based on their global CDR®+NACC-FTLD score: presymptomatic (0 or 0.5) and fully symptomatic (1 or greater). The w-scores in each grey matter volumes and white matter diffusion measures were computed to quantify the degree of abnormality compared to controls for each presymptomatic carrier, adjusting for their age, sex, total intracranial volume, and scanner type. Presymptomatic carriers were classified as 'normal' or 'abnormal' based on whether their grey matter volume and white matter diffusion measure w-scores were above or below the cut point corresponding to the 10th percentile of the controls. We then compared the change in disease severity between baseline and one year later in both the 'normal' and 'abnormal' groups within each genetic subtype, as measured by the CDR®+NACC-FTLD sum-of-boxes score and revised Cambridge Behavioural Inventory total score. Overall, presymptomatic carriers with normal regional w-scores at baseline did not progress clinically as much as those with abnormal regional w-scores. Having abnormal grey or white matter measures at baseline was associated with a statistically significant increase in the CDR®+NACC-FTLD of up to 4 points in C9orf72 expansion carriers, and 5 points in the GRN group as well as a statistically significant increase in the revised Cambridge Behavioural Inventory of up to 11 points in MAPT, 10 points in GRN, and 8 points in C9orf72 mutation carriers. Baseline regional brain abnormalities on MRI in presymptomatic mutation carriers are associated with different profiles of clinical progression over time. These results may be helpful to inform stratification of participants in future trials.
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Affiliation(s)
- Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Centre for Cognitive and Clinical Neuroscience, Division of Psychology, Department of Life Sciences, Medicine and Life Sciences, College of Health, Brunel University London, London, United Kingdom
| | - Emily G Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Arabella Bouzigues
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Jennifer M Nicholas
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rhian S Convery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - David L Thomas
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Ian B Malone
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Juan Eugenio Iglesias
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - John C van Swieten
- Department of Neurology and Alzheimer center, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Lize C Jiskoot
- Department of Neurology and Alzheimer center, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Harro Seelaar
- Department of Neurology and Alzheimer center, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Raquel Sanchez-Valle
- Neurology Department, Hospital Clinic, Institut d’Investigacions Biomèdiques, Barcelona, Spain
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, Faculté de Médecine, Université Laval, Quebec City, QC, Canada
| | - Fermin Moreno
- Hospital Universitario Donostia, San Sebastian, Spain
| | - Matthis Synofzik
- Division Translational Genomics of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Caroline Graff
- Department NVS, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
- Unit for Hereditary Dementia, Theme Aging, Karolinska University Hospital-Solna Stockholm, Stockholm, Sweden
| | - Mario Masellis
- Campbell Cognitive Neurology Research Unit, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Maria Carmela Tartaglia
- Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease, Toronto, ON, Canada
| | - James B Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust and Medical Research Council Cognition and brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
| | - Fabrizio Tagliavini
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Chris R Butler
- Department of Clinical Neurology, University of Oxford, Oxford, United Kingdom
| | - Simon Ducharme
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, United Kingdom
- Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg-Essen, Essen, Germany
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Germany
| | - Johannes Levin
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Germany
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Munich Cluster of Systems Neurology, Munich, Germany
| | - Markus Otto
- Department of Neurology, University Hospital Ulm, Ulm, Germany
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Isabelle Le Ber
- Sorbonne Université, Paris Brain Institute—Institut du Cerveau– ICM, Inserm U1127, CNRS UMR 7225, AP-HP—Hôpital Pitié-Salpêtrière, Paris, France
- Centre deréférence des démences rares ou précoces, IM2A, Département de Neurologie, AP-HP—Hôpital Pitié-Salpêtrière, Paris, France
- Département de Neurologie, AP-HP—Hôpital Pitié-Salpêtrière, Paris, France
| | - Florence Pasquier
- University Lille, Lille, France
- Inserm 1172, Lille, France
- CHU, CNR-MAJ, Labex Distalz, LiCENDLille, Lille, France
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
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30
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Saracino D, Sellami L, Boniface H, Houot M, Pélégrini-Issac M, Funkiewiez A, Rinaldi D, Locatelli M, Azuar C, Causse-Lemercier V, Jaillard A, Pasquier F, Chastan M, Wallon D, Hitzel A, Pariente J, Pallardy A, Boutoleau-Bretonnière C, Guedj E, Didic M, Migliaccio R, Kas A, Habert MO, Le Ber I. Brain Metabolic Profile in Presymptomatic GRN Carriers Throughout a 5-Year Follow-up. Neurology 2023; 100:e396-e407. [PMID: 36257714 DOI: 10.1212/wnl.0000000000201439] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/06/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES GRN variants are a frequent cause of familial frontotemporal dementia (FTD). Monitoring disease progression in asymptomatic carriers of genetic variants is a major challenge in delivering preventative therapies before clinical onset. This study aimed to assess the usefulness of fluorodeoxyglucose (FDG)-PET in identifying metabolic changes in presymptomatic GRN carriers (PS-GRN+) and to trace their longitudinal progression. METHODS Participants were longitudinally evaluated over 5 years in a prospective cohort study focused on GRN disease (Predict-PGRN). They underwent cognitive/behavioral assessment, plasma neurofilament measurement, brain MRI, and FDG-PET. Voxel-wise comparisons of structural and metabolic imaging data between 2 groups were performed for each time point. Longitudinal PET changes were evaluated with voxel-wise comparisons and the metabolic percent annual changes method. The association of regional brain metabolism with plasma neurofilament and cognitive changes was analyzed. RESULTS Among the 80 individuals enrolled in the study, 58 (27 PS-GRN+ and 31 noncarriers) were included in the analyses. Cross-sectional comparisons between PS-GRN+ and controls found a significant hypometabolism in the left superior temporal sulcus (STS) region (encompassing the middle and superior temporal gyri), approximately 15 years before the expected disease onset, without significant cortical atrophy. The longitudinal metabolic decline over the following 5 years peaked around the right STS in carriers (p < 0.001), without significantly greater volume loss compared with that in controls. Their estimated annualized metabolic decrease (-1.37%) was higher than that in controls (-0.21%, p = 0.004). Lower glucose uptake was associated with higher neurofilament increase (p = 0.003) and lower frontal cognitive scores (p = 0.014) in PS-GRN+. DISCUSSION This study detected brain metabolic changes in the STS region, preceding structural and cognitive alterations, thus contributing to the characterization of the pathochronology of preclinical GRN disease. Owing to the STS involvement in the perception of facially communicated cues, it is likely that its dysfunction contributes to social cognition deficits characterizing FTD. Overall, our study highlights brain metabolic changes as an early disease-tracking biomarker and proposes annualized percent decrease as a metric to monitor therapeutic response in forthcoming trials.
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Affiliation(s)
- Dario Saracino
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Leila Sellami
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Hugo Boniface
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Marion Houot
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Mélanie Pélégrini-Issac
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Aurélie Funkiewiez
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Daisy Rinaldi
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Maxime Locatelli
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Carole Azuar
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Valérie Causse-Lemercier
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Alice Jaillard
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Florence Pasquier
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Mathieu Chastan
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - David Wallon
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Anne Hitzel
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Jérémie Pariente
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Amandine Pallardy
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Claire Boutoleau-Bretonnière
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Eric Guedj
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Mira Didic
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Raffaella Migliaccio
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Aurélie Kas
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Marie-Odile Habert
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France
| | - Isabelle Le Ber
- From the Sorbonne Université (D.S., L.S., M.H., A.F., D.R., M.L., R.M., I.L.B.), Paris Brain Institute-Institut du Cerveau-ICM, Inserm U1127, CNRS UMR 7225, Paris, France; IM2A (D.S., M.H., A.F., D.R., C.A., R.M., I.L.B.), Reference Centre for Rare or Early-Onset Dementias, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Aramis Project Team (D.S.), Inria Research Center of Paris, France; Sorbonne Université (H.B., M.P.-I., M.L., A.K., M.-O.H.), CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France; Centre d'Acquisition et de Traitement d'Images (CATI) (H.B., M.L., A.K., M.-O.H.), US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France; Université Paris-Saclay (H.B.), CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France; Centre of Excellence of Neurodegenerative Disease (CoEN) (M.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Médecine Nucléaire (V.C.-L., A.K., M.-O.H.), AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Nuclear Medicine Department (A.J.), CHU Lille, Lille, France; Univ Lille (F.P.), Inserm U1172, CHU Lille, DistAlz, LiCEND, CNR-MAJ, France; Department of Nuclear Medicine (M.C.), Centre Henri Becquerel, Rouen University Hospital, France; Normandie Univ (D.W.), UNIROUEN, Inserm U1245 and CHU Rouen, Department of Neurology, CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Rouen, France; Nuclear Medicine Department (A.H.), Toulouse Purpan University Hospital, France; Department of Neurology and ToNIC (J.P.), Toulouse NeuroImaging Centre, Inserm, UPS, Toulouse University Hospital, France; Nuclear Medicine Department (A.P.), University Hospital of Nantes, France; CHU Nantes (C.B.-B.), Inserm CIC04, Department of Neurology, Centre Mémoire de Ressources et Recherche, Nantes, France; Nuclear Medicine Department (E.G.), Aix-Marseille University, APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, France; APHM (M.D.), Timone, Service de Neurologie et Neuropsychologie, APHM-Hôpital Timone Adultes, Marseille, France; and Aix-Marseille Univ (M.D.), INSERM, INS Institut de Neurosciences des Systèmes, France.
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Chu M, Nan H, Jiang D, Liu L, Huang A, Wang Y, Wu L. Progranulin Gene Mutations in Chinese Patients with Frontotemporal Dementia: A Case Report and Literature Review. J Alzheimers Dis 2023; 93:225-234. [PMID: 36970912 DOI: 10.3233/jad-230052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Progranulin (GRN) mutations in frontotemporal dementia (FTD) have been less frequently reported in China than in Western countries. OBJECTIVE This study reports a novel GRN mutation and summarizes the genetic and clinical features of patients with GRN mutations in China. METHODS Comprehensive clinical, genetic, and neuroimaging examinations were conducted on a 58-year-old female patient diagnosed with semantic variant primary progressive aphasia. A literature review was also conducted and clinical and genetic features of patients with GRN mutations in China were summarized. RESULTS Neuroimaging revealed marked lateral atrophy and hypometabolism in the left frontal, temporal, and parietal lobes. The patient was negative for pathologic amyloid and tau deposition by positron emission tomography. A novel heterozygous 45-bp deletion (c.1414-14_1444delCCCTTCCCCGCCAGGCTGTGTGCTGCGAGGATCGCCAGCACTGCT) was detected by whole-exome sequencing of the patient's genomic DNA. Nonsense-mediated mRNA decay was presumed to be involved in the degradation of the mutant gene transcript. The mutation was deemed pathogenic according to American College of Medical Genetics and Genomics criteria. The patient had a reduced plasma GRN level. In the literature, there were reports of 13 Chinese patients - mostly female - with GRN mutations; the prevalence was 1.2% -2.6% and patients mostly had early disease onset. CONCLUSION Our findings expand the mutation profile of GRN in China, which can aid the diagnosis and treatment of FTD.
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Affiliation(s)
- Min Chu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Haitian Nan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Deming Jiang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Anqi Huang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yihao Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Liyong Wu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Lee H, Mackenzie IRA, Beg MF, Popuri K, Rademakers R, Wittenberg D, Hsiung GYR. White-matter abnormalities in presymptomatic GRN and C9orf72 mutation carriers. Brain Commun 2022; 5:fcac333. [PMID: 36632182 PMCID: PMC9825756 DOI: 10.1093/braincomms/fcac333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/26/2022] [Accepted: 12/18/2022] [Indexed: 12/23/2022] Open
Abstract
A large proportion of familial frontotemporal dementia is caused by TAR DNA-binding protein 43 (transactive response DNA-binding protein 43 kDa) proteinopathies. Accordingly, carriers of autosomal dominant mutations in the genes associated with TAR DNA-binding protein 43 aggregation, such as Chromosome 9 open reading frame 72 (C9orf72) or progranulin (GRN), are at risk of later developing frontotemporal dementia. Brain imaging abnormalities that develop before dementia onset in mutation carriers may serve as proxies for the presymptomatic stages of familial frontotemporal dementia due to a genetic cause. Our study objective was to investigate brain MRI-based white-matter changes in predementia participants carrying mutations in C9orf72 or GRN genes. We analysed mutation carriers and their family member controls (noncarriers) from the University of British Columbia familial frontotemporal dementia study. First, a total of 42 participants (8 GRN carriers; 11 C9orf72 carriers; 23 noncarriers) had longitudinal T1-weighted MRI over ∼2 years. White-matter signal hypointensities were segmented and volumes were calculated for each participant. General linear models were applied to compare the baseline burden and the annualized rate of accumulation of signal abnormalities among mutation carriers and noncarriers. Second, a total of 60 participants (9 GRN carriers; 17 C9orf72 carriers; 34 noncarriers) had cross-sectional diffusion tensor MRI available. For each participant, we calculated the average fractional anisotropy and mean, radial and axial diffusivity parameter values within the normal-appearing white-matter tissues. General linear models were applied to compare whether mutation carriers and noncarriers had different trends in diffusion tensor imaging parameter values as they neared the expected age of onset. Baseline volumes of white-matter signal abnormalities were not significantly different among mutation carriers and noncarriers. Longitudinally, GRN carriers had significantly higher annualized rates of accumulation (estimated mean: 15.87%/year) compared with C9orf72 carriers (3.69%/year) or noncarriers (2.64%/year). A significant relationship between diffusion tensor imaging parameter values and increasing expected age of onset was found in the periventricular normal-appearing white-matter region. Specifically, GRN carriers had a tendency of a faster increase of mean and radial diffusivity values and C9orf72 carriers had a tendency of a faster decline of fractional anisotropy values as they reached closer to the expected age of dementia onset. These findings suggest that white-matter changes may represent early markers of familial frontotemporal dementia due to genetic causes. However, GRN and C9orf72 mutation carriers may have different mechanisms leading to tissue abnormalities.
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Affiliation(s)
- Hyunwoo Lee
- Correspondence to: Hyunwoo Lee S154-2211 Wesbrook Mall Vancouver, B.C., Canada V6T 2B5 E-mail:
| | - Ian R A Mackenzie
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver V6T2B5, Canada
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby V5A1S6, Canada
| | - Karteek Popuri
- Department of Computer Science, Memorial University of Newfoundland, St John’s A1B3X5, Canada
| | - Rosa Rademakers
- Applied and Translational Neurogenomics, VIB Center for Molecular Neurology, VIB, Antwerp 2610, Belgium,Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium,Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Dana Wittenberg
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver V6T2B5, Canada
| | - Ging-Yuek Robin Hsiung
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver V6T2B5, Canada
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Olm CA, Burke SE, Peterson C, Lee EB, Trojanowski JQ, Massimo L, Irwin DJ, Grossman M, Gee JC. Event-based modeling of T1-weighted MRI is related to pathology in frontotemporal lobar degeneration due to tau and TDP. Neuroimage Clin 2022; 37:103285. [PMID: 36508888 PMCID: PMC9763503 DOI: 10.1016/j.nicl.2022.103285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND In previous studies of patients with frontotemporal lobar degeneration due to tau (FTLD-tau) and FTLD due to TDP (FTLD-TDP), cortical volumes derived from T1-weighted MRI have been used to identify a sequence of volume loss according to arbitrary volumetric criteria. Event-based modeling (EBM) is a probabilistic, generative machine learning model that determines the characteristic sequence of changes, or "events", occurring during disease progression. EBM also estimates an individual patient's disease "stage" by identifying which events have already occurred. In the present study, we use an EBM analysis to derive stages of regional anatomic atrophy in FTLD-tau and FTLD-TDP, and validated these stages against pathologic burden. METHODS Sporadic autopsy-confirmed patients with FTLD-tau (N = 42) and FTLD-TDP (N = 21), and 167 healthy controls with available T1-weighted images were identified. A subset of patients had quantitative digital histopathology of cortex performed at autopsy (FTLD-tau = 30, FTLD-TDP = 17). MRI images were processed, producing regional measures of cortical volumes. K-means clustering was used to find cortical regions with similar amounts of GM volume changes (n = 5 clusters). EBM was used to determine the characteristic sequence of cortical atrophy of identified clusters in autopsy-confirmed FTLD-tau and FTLD-TDP, and estimate each patient's disease stage by cortical volume biomarkers. Linear regressions related pathologic burden to EBM-estimated disease stages. RESULTS EBM for cortical volume biomarkers generated statistically robust characteristic sequences of cortical atrophy in each group of patients. Cortical volume-based EBM-estimated disease stage was associated with pathologic burden in FTLD-tau (R2 = 0.16, p = 0.017) and FTLD-TDP (R2 = 0.51, p = 0.0008). CONCLUSIONS We provide evidence that EBM can identify sequences of pathologically-confirmed cortical atrophy in sporadic FTLD-tau and FTLD-TDP.
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Affiliation(s)
- Christopher A Olm
- Penn Image Computing and Science Laboratory, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States; Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States.
| | - Sarah E Burke
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States.
| | - Claire Peterson
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States; Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States.
| | - Edward B Lee
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Lauren Massimo
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States.
| | - David J Irwin
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States; Digital Neuropathology Laboratory, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States.
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States.
| | - James C Gee
- Penn Image Computing and Science Laboratory, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States.
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Santamaría-García H, Ogonowsky N, Baez S, Palacio N, Reyes P, Schulte M, López A, Matallana D, Ibanez A. Neurocognitive patterns across genetic levels in behavioral variant frontotemporal dementia: a multiple single cases study. BMC Neurol 2022; 22:454. [PMID: 36474176 PMCID: PMC9724347 DOI: 10.1186/s12883-022-02954-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/06/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Behavioral variant frontotemporal dementia (bvFTD) has been related to different genetic factors. Identifying multimodal phenotypic heterogeneity triggered by various genetic influences is critical for improving diagnosis, prognosis, and treatments. However, the specific impact of different genetic levels (mutations vs. risk variants vs. sporadic presentations) on clinical and neurocognitive phenotypes is not entirely understood, specially in patites from underrepresented regions such as Colombia. METHODS Here, in a multiple single cases study, we provide systematic comparisons regarding cognitive, neuropsychiatric, brain atrophy, and gene expression-atrophy overlap in a novel cohort of FTD patients (n = 42) from Colombia with different genetic levels, including patients with known genetic influences (G-FTD) such as those with genetic mutations (GR1) in particular genes (MAPT, TARDBP, and TREM2); patients with risk variants (GR2) in genes associated with FTD (tau Haplotypes H1 and H2 and APOE variants including ε2, ε3, ε4); and sporadic FTD patients (S-FTD (GR3)). RESULTS We found that patients from GR1 and GR2 exhibited earlier disease onset, pervasive cognitive impairments (cognitive screening, executive functioning, ToM), and increased brain atrophy (prefrontal areas, cingulated cortices, basal ganglia, and inferior temporal gyrus) than S-FTD patients (GR3). No differences in disease duration were observed across groups. Additionally, significant neuropsychiatric symptoms were observed in the GR1. The GR1 also presented more clinical and neurocognitive compromise than GR2 patients; these groups, however, did not display differences in disease onset or duration. APOE and tau patients showed more neuropsychiatric symptoms and primary atrophy in parietal and temporal cortices than GR1 patients. The gene-atrophy overlap analysis revealed atrophy in regions with specific genetic overexpression in all G-FTD patients. A differential family presentation did not explain the results. CONCLUSIONS Our results support the existence of genetic levels affecting the clinical, neurocognitive, and, to a lesser extent, neuropsychiatric presentation of bvFTD in the present underrepresented sample. These results support tailored assessments characterization based on the parallels of genetic levels and neurocognitive profiles in bvFTD.
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Affiliation(s)
- Hernando Santamaría-García
- PhD program in Neuroscience, Pontificia Universidad Javeriana, Bogotá, Colombia.
- Memory and cognition Center, Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia.
- Department of Neurology, Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA.
| | - Natalia Ogonowsky
- CONICET & Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - Sandra Baez
- Faculty of Psychology, Universidad de los Andes, Bogotá, Colombia
| | - Nicole Palacio
- Integrated Program in Neuroscience, McGill University, Montreal, Canada
| | - Pablo Reyes
- PhD program in Neuroscience, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Michael Schulte
- CONICET & Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - Andrea López
- Pontificia Universidad Javeriana, Bogotá, Colombia
- Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Agustín Ibanez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago de Chile, Chile.
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, & National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
- Trinity Collegue of Dublin, Dublin, Irland.
- Global Brain Health Insititute, Universidad California San Francisco-Trinity College of Dublin, San Francisco, USA.
- Global Brain Health Insititute, Universidad California San Francisco-Trinity College of Dublin, Dublin, Irland.
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35
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Ferreira LK, Lindberg O, Santillo AF, Wahlund LO. Functional connectivity in behavioral variant frontotemporal dementia. Brain Behav 2022; 12:e2790. [PMID: 36306386 PMCID: PMC9759144 DOI: 10.1002/brb3.2790] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/13/2022] [Accepted: 09/24/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Functional connectivity (FC)-which reflects relationships between neural activity in different brain regions-has been used to explore the functional architecture of the brain in neurodegenerative disorders. Although an increasing number of studies have explored FC changes in behavioral variant frontotemporal dementia (bvFTD), there is no focused, in-depth review about FC in bvFTD. METHODS Comprehensive literature search and narrative review to summarize the current field of FC in bvFTD. RESULTS (1) Decreased FC within the salience network (SN) is the most consistent finding in bvFTD; (2) FC changes extend beyond the SN and affect the interplay between networks; (3) results within the Default Mode Network are mixed; (4) the brain as a network is less interconnected and less efficient in bvFTD; (5) symptoms, functional impairment, and cognition are associated with FC; and (6) the functional architecture resembles patterns of neuropathological spread. CONCLUSIONS FC has potential as a biomarker, and future studies are expected to advance the field with multicentric initiatives, longitudinal designs, and methodological advances.
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Affiliation(s)
- Luiz Kobuti Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden
| | - Olof Lindberg
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Alexander F Santillo
- Clinical Memory Research Unit and Psychiatry, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Lars-Olof Wahlund
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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36
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Giannini LAA, Ohm DT, Rozemuller AJM, Dratch L, Suh E, van Deerlin VM, Trojanowski JQ, Lee EB, van Swieten JC, Grossman M, Seelaar H, Irwin DJ. Isoform-specific patterns of tau burden and neuronal degeneration in MAPT-associated frontotemporal lobar degeneration. Acta Neuropathol 2022; 144:1065-1084. [PMID: 36066634 PMCID: PMC9995405 DOI: 10.1007/s00401-022-02487-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/18/2022] [Accepted: 08/26/2022] [Indexed: 01/26/2023]
Abstract
Frontotemporal lobar degeneration with MAPT pathogenic variants (FTLD-MAPT) has heterogeneous tau pathological inclusions postmortem, consisting of three-repeat (3R) or four-repeat (4R) tau isoforms, or a combination (3R + 4R). Here, we studied grey matter tau burden, its relation to neuronal degeneration, and regional patterns of pathology in different isoform groups of FTLD-MAPT. We included 38 FTLD-MAPT autopsy cases with 10 different MAPT pathogenic variants, grouped based on predominant tau isoform(s). In up to eleven regions (ten cortical and one striatal), we quantified grey matter tau burden using digital histopathological analysis and assigned semi-quantitative ratings for neuronal degeneration (i.e. 0-4) and separate burden of glial and neuronal tau inclusions (i.e. 0-3). We used mixed modelling to compare pathology measures (1) across the entire cohort and (2) within isoform groups. In the total cohort, tau burden and neuronal degeneration were positively associated and most severe in the anterior temporal, anterior cingulate and transentorhinal cortices. Isoform groups showed distinctive features of tau burden and neuronal degeneration. Across all regions, the 3R isoform group had lower tau burden compared to the 4R group (p = 0.008), while at the same time showing more severe neuronal degeneration than the 4R group (p = 0.002). The 3R + 4R group had an intermediate profile with relatively high tau burden along with relatively severe neuronal degeneration. Neuronal tau inclusions were most frequent in the 4R group (p < 0.001 vs. 3R), while cortical glial tau inclusions were most frequent in the 3R + 4R and 4R groups (p ≤ 0.009 vs. 3R). Regionally, neuronal degeneration was consistently most severe in the anterior temporal cortex within each isoform group. In contrast, the regions with the highest tau burden differed in isoform groups (3R: striatum; 3R + 4R: striatum, inferior parietal lobule, middle frontal cortex, anterior cingulate cortex; 4R: transentorhinal cortex, anterior temporal cortex, fusiform gyrus). We conclude that FTLD-MAPT isoform groups show distinctive features of overall neuronal degeneration and regional tau burden, but all share pronounced anterior temporal neuronal degeneration. These data suggest that distinct isoform-related mechanisms of genetic tauopathies, with slightly divergent tau distribution, may share similar regional vulnerability to neurodegeneration within the frontotemporal paralimbic networks.
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Affiliation(s)
- Lucia A A Giannini
- Alzheimer Center, Department of Neurology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Daniel T Ohm
- Digital Neuropathology Laboratory, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Frontotemporal Degeneration Center (FTDC), University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, 3600 Spruce Street, Philadelphia, PA, 19104, USA
| | - Annemieke J M Rozemuller
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, The Netherlands
| | - Laynie Dratch
- Frontotemporal Degeneration Center (FTDC), University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, 3600 Spruce Street, Philadelphia, PA, 19104, USA
| | - EunRan Suh
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Vivianna M van Deerlin
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - John Q Trojanowski
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Edward B Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Translational Neuropathology Research Laboratory, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - John C van Swieten
- Alzheimer Center, Department of Neurology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Murray Grossman
- Frontotemporal Degeneration Center (FTDC), University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, 3600 Spruce Street, Philadelphia, PA, 19104, USA
| | - Harro Seelaar
- Alzheimer Center, Department of Neurology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| | - David J Irwin
- Digital Neuropathology Laboratory, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Frontotemporal Degeneration Center (FTDC), University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, 3600 Spruce Street, Philadelphia, PA, 19104, USA.
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del Campo M, Zetterberg H, Gandy S, Onyike CU, Oliveira F, Udeh‐Momoh C, Lleó A, Teunissen CE, Pijnenburg Y. New developments of biofluid-based biomarkers for routine diagnosis and disease trajectories in frontotemporal dementia. Alzheimers Dement 2022; 18:2292-2307. [PMID: 35235699 PMCID: PMC9790674 DOI: 10.1002/alz.12643] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 02/04/2022] [Accepted: 02/04/2022] [Indexed: 01/31/2023]
Abstract
Frontotemporal dementia (FTD) covers a spectrum of neurodegenerative disorders with different phenotypes, genetic backgrounds, and pathological states. Its clinicopathological diversity challenges the diagnostic process and the execution of clinical trials, calling for specific diagnostic biomarkers of pathologic FTD types. There is also a need for biomarkers that facilitate disease staging, quantification of severity, monitoring in clinics and observational studies, and for evaluation of target engagement and treatment response in clinical trials. This review discusses current FTD biofluid-based biomarker knowledge taking into account the differing applications. The limitations, knowledge gaps, and challenges for the development and implementation of such markers are also examined. Strategies to overcome these hurdles are proposed, including the technologies available, patient cohorts, and collaborative research initiatives. Access to robust and reliable biomarkers that define the exact underlying pathophysiological FTD process will meet the needs for specific diagnosis, disease quantitation, clinical monitoring, and treatment development.
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Affiliation(s)
- Marta del Campo
- Departamento de Ciencias Farmacéuticas y de la SaludFacultad de FarmaciaUniversidad San Pablo‐CEUCEU UniversitiesMadridSpain
| | - Henrik Zetterberg
- Institute of Neuroscience and PhysiologyThe Sahlgrenska Academy at the University of GothenburgGothenburgSweden,Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden,UK Dementia Research Institute at UCLLondonUK,Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK,Hong Kong Center for Neurodegenerative DiseasesHong KongChina
| | - Sam Gandy
- Department of NeurologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Chiadi U Onyike
- Division of Geriatric Psychiatry and NeuropsychiatryThe Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Fabricio Oliveira
- Department of Neurology and NeurosurgeryEscola Paulista de MedicinaFederal University of São Paulo (UNIFESP)São PauloSão PauloBrazil
| | - Chi Udeh‐Momoh
- Ageing Epidemiology Research UnitSchool of Public HealthFaculty of MedicineImperial College LondonLondonUK,Translational Health SciencesFaculty of MedicineUniversity of BristolBristolUK
| | - Alberto Lleó
- Neurology DepartmentHospital de la Santa Creu I Sant PauBarcelonaSpain
| | - Charlotte E. Teunissen
- Neurochemistry LaboratoryDepartment of Clinical ChemistryAmsterdam NeuroscienceAmsterdam University Medical CentersVrije UniversiteitAmsterdamthe Netherlands
| | - Yolande Pijnenburg
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceVrije Universiteit AmsterdamAmsterdam UMCAmsterdamthe Netherlands
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38
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Snowden JS. Changing perspectives on frontotemporal dementia: A review. J Neuropsychol 2022. [DOI: 10.1111/jnp.12297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Julie S. Snowden
- Cerebral Function Unit, Manchester Centre for Neurosciences Salford Royal NHS Foundation Trust Salford UK
- Division of Neuroscience & Experimental Psychology School of Biological Sciences, University of Manchester Manchester UK
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39
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Beeraka NM, Nikolenko VN, Khaidarovich ZF, Valikovna OM, Aliagayevna RN, Arturovna ZL, Alexandrovich KA, Mikhaleva LM, Sinelnikov MY. Recent Investigations on the Functional Role of Cerebellar Neural Networks in Motor Functions & Nonmotor Functions -Neurodegeneration. Curr Neuropharmacol 2022; 20:1865-1878. [PMID: 35272590 PMCID: PMC9886798 DOI: 10.2174/1570159x20666220310121441] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/11/2022] [Accepted: 03/06/2022] [Indexed: 11/22/2022] Open
Abstract
The cerebellum is a well-established primary brain center in charge of controlling sensorimotor functions and non-motor functions. Recent reports depicted the significance of cerebellum in higher-order cognitive functions, including emotion-processing, language, reward-related behavior, working memory, and social behavior. As it can influence diverse behavioral patterns, any defects in cerebellar functions could invoke neuropsychiatric diseases as indicated by the incidence of alexithymia and induce alterations in emotional and behavioral patterns. Furthermore, its defects can trigger motor diseases, such as ataxia and Parkinson's disease (PD). In this review, we have extensively discussed the role of cerebellum in motor and non-motor functions and how the cerebellum malfunctions in relation to the neural circuit wiring as it could impact brain function and behavioral outcomes in patients with neuropsychiatric diseases. Relevant data regarding cerebellar non-motor functions have been vividly described, along with anatomy and physiology of these functions. In addition to the defects in basal ganglia, the lack of activity in motor related regions of the cerebellum could be associated with the severity of motor symptoms. All together, this review delineates the importance of cerebellar involvement in patients with PD and unravels a crucial link for various clinical aspects of PD with specific cerebellar sub-regions.
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Affiliation(s)
| | - Vladimir N. Nikolenko
- Address correspondence to these authors at the Department of Human Anatomy,I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia; Department of Human Anatomy, I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia; E-mail:
| | | | | | | | | | | | | | - Mikhail Y. Sinelnikov
- Address correspondence to these authors at the Department of Human Anatomy,I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia; Department of Human Anatomy, I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia; E-mail:
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40
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Singh NA, Graff-Radford J, Machulda MM, Schwarz CG, Baker MC, Rademakers R, Ertekin-Taner N, Lowe VJ, Josephs KA, Whitwell JL. Atypical Alzheimer's disease phenotypes with normal or borderline PET biomarker profiles. J Neurol 2022; 269:6613-6626. [PMID: 36001141 DOI: 10.1007/s00415-022-11330-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/05/2022] [Accepted: 08/07/2022] [Indexed: 01/01/2023]
Abstract
Posterior cortical atrophy (PCA) and logopenic progressive aphasia (LPA) are clinical syndromes that commonly have underlying Alzheimer's disease (AD), although non-AD pathologies have also been reported. PET imaging allows for identification of beta-amyloid (Aβ) and tau in AD, so we aimed to assess these in a large cohort to identify patients that do not have evidence for biomarker-defined AD. Eight-one patients, 47 PCA and 34 LPA, underwent extensive neurological and neuropsychological testing, [11C] Pittsburgh compound B, [18F] flortaucipir and [18F] fluorodeoxyglucose PETs. Global Aβ and tau-PET standardized uptake value ratios (SUVRs) were plotted for all patients and outliers, and patients with abnormally low SUVRs compared to the biomarker-classic cohort were identified. Six (7.4%) biomarker-outlier cases were identified, and three patterns were observed: (i) negative/borderline Aβ-PET and striking widespread tau-PET uptake (two LPA); (ii) negative/borderline Aβ-PET and low tau-PET uptake (three PCA) and (iii) elevated Aβ-PET uptake but mild focal tau-PET uptake (one LPA). Among the unusual patients in group ii, two patients showed no abnormal tau uptake suggesting non-AD pathology, with one developing features of cortico-basal syndrome and the other dementia with Lewy bodies. The remaining patient showed very mild focal tau uptake. This study demonstrates that a small minority (~ 8%) of PCA and LPA patients do not show the typical striking patterns of Aβ and tau PET uptake, with only 2% showing absence of both proteins. These findings will help inform the use of molecular PET in clinical treatment trials that include patients with atypical phenotypes of AD.
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Affiliation(s)
| | | | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Matthew C Baker
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | | | - Jennifer L Whitwell
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.
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41
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Perković R, Jerčić KG, Frančić M, Ozretić D, Borovečki F. Rare GRN mutation in a patient diagnosed with primary progressive aphasia and parkinsonism. Acta Neurol Belg 2022; 123:727-729. [PMID: 35980504 DOI: 10.1007/s13760-022-02064-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/10/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Romana Perković
- Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia.
| | - Kristina Gotovac Jerčić
- Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia.,Department of Functional Genomics, Center for Translational and Clinical Research, University of Zagreb School of Medicine, Zagreb, Croatia
| | | | - David Ozretić
- Department of Radiology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Fran Borovečki
- Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia.,Department of Functional Genomics, Center for Translational and Clinical Research, University of Zagreb School of Medicine, Zagreb, Croatia
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42
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Pickles S, Gendron TF, Koike Y, Yue M, Song Y, Kachergus JM, Shi J, DeTure M, Thompson EA, Oskarsson B, Graff-Radford NR, Boeve BF, Petersen RC, Wszolek ZK, Josephs KA, Dickson DW, Petrucelli L, Cook CN, Prudencio M. Evidence of cerebellar TDP-43 loss of function in FTLD-TDP. Acta Neuropathol Commun 2022; 10:107. [PMID: 35879741 PMCID: PMC9310392 DOI: 10.1186/s40478-022-01408-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/11/2022] [Indexed: 02/08/2023] Open
Abstract
Frontotemporal lobar degeneration with TDP-43 pathology (FTLD-TDP) is a neurodegenerative disease primarily affecting the frontal and/or temporal cortices. However, a growing body of evidence suggests that the cerebellum contributes to biochemical, cognitive, and behavioral changes in FTLD-TDP. To evaluate cerebellar TDP-43 expression and function in FTLD-TDP, we analyzed TDP-43 protein levels and the splicing of a TDP-43 target, STMN2, in the cerebellum of 95 FTLD-TDP cases and 25 non-neurological disease controls. Soluble TDP-43 was decreased in the cerebellum of FTLD-TDP cases but a concomitant increase in insoluble TDP-43 was not seen. Truncated STMN2 transcripts, an indicator of TDP-43 dysfunction, were elevated in the cerebellum of FTLD-TDP cases and inversely associated with TDP-43 levels. Additionally, lower cerebellar TDP-43 associated with a younger age at disease onset. We provide evidence of TDP-43 loss of function in the cerebellum in FTLD-TDP, supporting further investigation into this understudied brain region.
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Affiliation(s)
- Sarah Pickles
- Department of Neuroscience, Mayo Clinic, Mangurian Research Building, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Tania F Gendron
- Department of Neuroscience, Mayo Clinic, Mangurian Research Building, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Yuka Koike
- Department of Neuroscience, Mayo Clinic, Mangurian Research Building, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Mei Yue
- Department of Neuroscience, Mayo Clinic, Mangurian Research Building, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Yuping Song
- Department of Neuroscience, Mayo Clinic, Mangurian Research Building, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | | | - J Shi
- Department of Cancer Biology, Mayo Clinic, Jacksonville, FL, USA
| | - Michael DeTure
- Department of Neuroscience, Mayo Clinic, Mangurian Research Building, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | | | | | | | | | | | | | | | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Mangurian Research Building, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Leonard Petrucelli
- Department of Neuroscience, Mayo Clinic, Mangurian Research Building, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Casey N Cook
- Department of Neuroscience, Mayo Clinic, Mangurian Research Building, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA.
| | - Mercedes Prudencio
- Department of Neuroscience, Mayo Clinic, Mangurian Research Building, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA.
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McKenna MC, Tahedl M, Lope J, Chipika RH, Li Hi Shing S, Doherty MA, Hengeveld JC, Vajda A, McLaughlin RL, Hardiman O, Hutchinson S, Bede P. Mapping cortical disease-burden at individual-level in frontotemporal dementia: implications for clinical care and pharmacological trials. Brain Imaging Behav 2022; 16:1196-1207. [PMID: 34882275 PMCID: PMC9107414 DOI: 10.1007/s11682-021-00523-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 01/25/2023]
Abstract
Imaging studies of FTD typically present group-level statistics between large cohorts of genetically, molecularly or clinically stratified patients. Group-level statistics are indispensable to appraise unifying radiological traits and describe genotype-associated signatures in academic studies. However, in a clinical setting, the primary objective is the meaningful interpretation of imaging data from individual patients to assist diagnostic classification, inform prognosis, and enable the assessment of progressive changes compared to baseline scans. In an attempt to address the pragmatic demands of clinical imaging, a prospective computational neuroimaging study was undertaken in a cohort of patients across the spectrum of FTD phenotypes. Cortical changes were evaluated in a dual pipeline, using standard cortical thickness analyses and an individualised, z-score based approach to characterise subject-level disease burden. Phenotype-specific patterns of cortical atrophy were readily detected with both methodological approaches. Consistent with their clinical profiles, patients with bvFTD exhibited orbitofrontal, cingulate and dorsolateral prefrontal atrophy. Patients with ALS-FTD displayed precentral gyrus involvement, nfvPPA patients showed widespread cortical degeneration including insular and opercular regions and patients with svPPA exhibited relatively focal anterior temporal lobe atrophy. Cortical atrophy patterns were reliably detected in single individuals, and these maps were consistent with the clinical categorisation. Our preliminary data indicate that standard T1-weighted structural data from single patients may be utilised to generate maps of cortical atrophy. While the computational interpretation of single scans is challenging, it offers unrivalled insights compared to visual inspection. The quantitative evaluation of individual MRI data may aid diagnostic classification, clinical decision making, and assessing longitudinal changes.
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Affiliation(s)
- Mary Clare McKenna
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Marlene Tahedl
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Institute for Psychology, University of Regensburg, Regensburg, Germany
| | - Jasmin Lope
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Rangariroyashe H Chipika
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Stacey Li Hi Shing
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Mark A Doherty
- Complex Trait Genomics Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Jennifer C Hengeveld
- Complex Trait Genomics Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Alice Vajda
- Complex Trait Genomics Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Russell L McLaughlin
- Complex Trait Genomics Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Orla Hardiman
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | | | - Peter Bede
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.
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Recent Advances in Frontotemporal Dementia. Neurol Sci 2022:1-10. [DOI: 10.1017/cjn.2022.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Studart-Neto A, Coutinho AM. From clinical phenotype to proteinopathy: molecular neuroimaging in neurodegenerative dementias. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:24-35. [PMID: 35976328 PMCID: PMC9491407 DOI: 10.1590/0004-282x-anp-2022-s138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Neurodegenerative dementias are characterized by the abnormal accumulation of misfolded proteins. However, its diagnostic criteria are still based on the clinical phenotype. The development of biomarkers allowed in vivo detection of pathophysiological processes. This article aims to make a non-systematic review of the use of molecular neuroimaging as a biomarker. Molecular neuroimaging is based on the use of radiotracers for image acquisition. The radiotracer most used in PET is 18F-fluorodeoxyglucose (FDG), with which it is possible to study the regional brain glucose metabolism. The pattern of regional hypometabolism provides neuroanatomical information on the neurodegenerative process, which, in turn, has a good specificity for each type of proteinopathy. FDG is very useful in the differential diagnosis of neurodegenerative dementias through the regional pattern of involvement, including dementia with Lewy bodies and the spectrum of frontotemporal dementia. More recently, radiotracers with specific ligands to some of the pathological proteins have been developed. Pittsburgh compound B (PIB) labeled with 11C and the ligands that use 18F (florbetapir, florbetaben and flutemetamol) are the most used radiotracers for the detection of insoluble β-amyloid peptide in Alzheimer's disease (AD). A first generation of ligands for tau protein has been developed, but it has some affinity for other non-tau protein aggregates. A second generation has the advantage of having a higher affinity for hyperphosphorylated tau protein, including in primary tauopathies.
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Affiliation(s)
- Adalberto Studart-Neto
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo, SP, Brazil
| | - Artur Martins Coutinho
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Radiologia e Oncologia, Divisão e Laboratório de Medicina Nuclear (LIM 43), São Paulo, SP, Brazil
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Foster PH, Russell LL, Peakman G, Convery RS, Bouzigues A, Greaves CV, Bocchetta M, Cash DM, van Swieten JC, Jiskoot LC, Moreno F, Sanchez-Valle R, Laforce R, Graff C, Masellis M, Tartaglia C, Rowe JB, Borroni B, Finger E, Synofzik M, Galimberti D, Vandenberghe R, de Mendonça A, Butler CR, Gerhard A, Ducharme S, Le Ber I, Tagliavini F, Santana I, Pasquier F, Levin J, Danek A, Otto M, Sorbi S, Rohrer JD. Examining empathy deficits across familial forms of frontotemporal dementia within the GENFI cohort. Cortex 2022; 150:12-28. [PMID: 35325762 PMCID: PMC9067453 DOI: 10.1016/j.cortex.2022.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/14/2021] [Accepted: 01/09/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Reduced empathy is a common symptom in frontotemporal dementia (FTD). Although empathy deficits have been extensively researched in sporadic cases, few studies have explored the differences in familial forms of FTD. METHODS Empathy was examined using a modified version of the Interpersonal Reactivity Index (mIRI) in 676 participants from the Genetic FTD Initiative: 216 mutation-negative controls, 192 C9orf72 expansion carriers, 193 GRN mutation carriers and 75 MAPT mutation carriers. Using global scores from the CDR® plus NACC FTLD, mutation carriers were divided into three groups, asymptomatic (0), very mildly symptomatic/prodromal (.5), or fully symptomatic (1 or more). The mIRI Total score, as well as the subscores of Empathic Concern (EC) and Perspective Taking (PT) were assessed. Linear regression models with bootstrapping were used to assess empathy ratings across genetic groups, as well as across phenotypes in the symptomatic carriers. Neural correlates of empathy deficits were examined using a voxel-based morphometry (VBM) analysis. RESULTS All fully symptomatic groups scored lower on the mIRI Total, EC, and PT when compared to controls and their asymptomatic or prodromal counterparts (all p < .001). Prodromal C9orf72 expansion carriers also scored significantly lower than controls on the mIRI Total score (p = .046). In the phenotype analysis, all groups (behavioural variant FTD, primary progressive aphasia and FTD with amyotrophic lateral sclerosis) scored significantly lower than controls (all p < .007). VBM revealed an overlapping neural correlate of the mIRI Total score across genetic groups in the orbitofrontal lobe but with additional involvement in the temporal lobe, insula and basal ganglia in both the GRN and MAPT groups, and uniquely more posterior regions such as the parietal lobe and thalamus in the GRN group, and medial temporal structures in the MAPT group. CONCLUSIONS Significant empathy deficits present in genetic FTD, particularly in symptomatic individuals and those with a bvFTD phenotype, while prodromal deficits are only seen using the mIRI in C9orf72 expansion carriers.
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Affiliation(s)
- Phoebe H Foster
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Georgia Peakman
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Rhian S Convery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Arabella Bouzigues
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Caroline V Greaves
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK; Centre for Medical Image Computing, University College London, London, UK
| | | | - Lize C Jiskoot
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Fermin Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia Universitary Hospital, San Sebastian, Spain; Neuroscience Area, Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, and Faculté de Médecine, Université Laval, QC, Canada
| | - Caroline Graff
- Center for Alzheimer Research, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Bioclinicum, Karolinska Institutet, Solna, Sweden; Unit for Hereditary Dementias, Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - James B Rowe
- University of Cambridge Department of Clinical Neurosciences, and University of Cambridge Hospitals NHS Trust, University of Cambridge, UK
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany; Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Daniela Galimberti
- Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy; University of Milan, Centro Dino Ferrari, Milan, Italy
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium; Neurology Service, University Hospitals Leuven, Leuven, Belgium; Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | | | - Chris R Butler
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford, UK; Department of Brain Sciences, Imperial College London, UK
| | - Alex Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK; Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg-Essen, Germany
| | - Simon Ducharme
- Department of Psychiatry, McGill University Health Centre, McGill University, Montreal, Québec, Canada; McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
| | - Isabelle Le Ber
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau - ICM, Inserm U1127, CNRS UMR 7225, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Centre de référence des démences rares ou précoces, IM2A, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France; Reference Network for Rare Neurological Diseases (ERN-RND)
| | | | - Isabel Santana
- University Hospital of Coimbra (HUC), Neurology Service, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Florence Pasquier
- Univ Lille, France; Inserm 1172, Lille, France; CHU, CNR-MAJ, Labex Distalz, LiCEND Lille, France
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians Universität München, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians Universität München, Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Germany
| | - Sandro Sorbi
- Department of Neurofarba, University of Florence, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK.
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Zhang S, Shen L, Jiao B. Cognitive Dysfunction in Repeat Expansion Diseases: A Review. Front Aging Neurosci 2022; 14:841711. [PMID: 35478698 PMCID: PMC9036481 DOI: 10.3389/fnagi.2022.841711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/24/2022] [Indexed: 11/16/2022] Open
Abstract
With the development of the sequencing technique, more than 40 repeat expansion diseases (REDs) have been identified during the past two decades. Moreover, the clinical features of these diseases show some commonality, and the nervous system, especially the cognitive function was affected in part by these diseases. However, the specific cognitive domains impaired in different diseases were inconsistent. Here, we survey literature on the cognitive consequences of the following disorders presenting cognitive dysfunction and summarizing the pathogenic genes, epidemiology, and different domains affected by these diseases. We found that the cognitive domains affected in neuronal intranuclear inclusion disease (NIID) were widespread including the executive function, memory, information processing speed, attention, visuospatial function, and language. Patients with C9ORF72-frontotemporal dementia (FTD) showed impairment in executive function, memory, language, and visuospatial function. While in Huntington's disease (HD), the executive function, memory, and information processing speed were affected, in the fragile X-associated tremor/ataxia syndrome (FXTAS), executive function, memory, information processing speed, and attention were impaired. Moreover, the spinocerebellar ataxias showed broad damage in almost all the cognitive domains except for the relatively intact language ability. Some other diseases with relatively rare clinical data also indicated cognitive dysfunction, such as myotonic dystrophy type 1 (DM1), progressive myoclonus epilepsy (PME), Friedreich ataxia (FRDA), Huntington disease like-2 (HDL2), and cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS). We drew a cognitive function landscape of the related REDs that might provide an aspect for differential diagnosis through cognitive domains and effective non-specific interventions for these diseases.
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Affiliation(s)
- Sizhe Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Lu Shen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Bin Jiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- *Correspondence: Bin Jiao
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Thalamic and Cerebellar Regional Involvement across the ALS-FTD Spectrum and the Effect of C9orf72. Brain Sci 2022; 12:brainsci12030336. [PMID: 35326292 PMCID: PMC8945983 DOI: 10.3390/brainsci12030336] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/23/2022] [Accepted: 02/27/2022] [Indexed: 02/01/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are part of the same disease spectrum. While thalamic−cerebellar degeneration has been observed in C9orf72 expansion carriers, the exact subregions involved across the clinical phenotypes of the ALS−FTD spectrum remain unclear. Using MRIs from 58 bvFTD, 41 ALS−FTD and 52 ALS patients compared to 57 controls, we aimed to delineate thalamic and cerebellar subregional changes across the ALS−FTD spectrum and to contrast these profiles between cases with and without C9orf72 expansions. Thalamic involvement was evident across all ALS−FTD clinical phenotypes, with the laterodorsal nucleus commonly affected across all groups (values below the 2.5th control percentile). The mediodorsal nucleus was disproportionately affected in bvFTD and ALS−FTD but not in ALS. Cerebellar changes were only observed in bvFTD and ALS−FTD predominantly in the superior−posterior region. Comparison of genetic versus sporadic cases revealed significantly lower volumes exclusively in the pulvinar in C9orf72 expansion carriers compared to non-carriers, irrespective of clinical syndrome. Overall, bvFTD showed significant correlations between thalamic subregions, level of cognitive dysfunction and severity of behavioural symptoms. Notably, strong associations were evident between mediodorsal nucleus atrophy and severity of behavioural changes in C9orf72-bvFTD (r = −0.9, p < 0.0005). Our findings reveal distinct thalamic and cerebellar atrophy profiles across the ALS−FTD spectrum, with differential impacts on behaviour and cognition, and point to a unique contribution of C9orf72 expansions in the clinical profiles of these patients.
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Buciuc M, Martin PR, Tosakulwong N, Murray ME, Petrucelli L, Senjem ML, Spychalla AJ, Knopman DS, Boeve BF, Petersen RC, Parisi JE, Reichard RR, Dickson DW, Jack CR, Whitwell JL, Josephs KA. TDP-43-associated atrophy in brains with and without frontotemporal lobar degeneration. Neuroimage Clin 2022; 34:102954. [PMID: 35168140 PMCID: PMC8850800 DOI: 10.1016/j.nicl.2022.102954] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/21/2022] [Accepted: 02/01/2022] [Indexed: 11/29/2022]
Abstract
Transactive response DNA-binding protein of ∼43 kDa (TDP-43), a primary pathologic substrate in tau-negative frontotemporal lobar degeneration (FTLD), is also often found in the brains of elderly individuals without FTLD and is a key player in the process of neurodegeneration in brains with and without FTLD. It is unknown how rates and trajectories of TDP-43-associated brain atrophy compare between these two groups. Additionally, non-FTLD TDP-43 inclusions are not homogeneous and can be divided into two morphologic types: type-α and neurofibrillary tangle-associated type-β. Therefore, we explored whether neurodegeneration also varies due to the morphologic type. In this longitudinal retrospective study of 293 patients with 843 MRI scans spanning over ∼10 years, we used a Bayesian hierarchical linear model to quantify similarities and differences between the non-FTLD TDP-43 (type-α/type-β) and FTLD-TDP (n = 68) in both regional volume at various timepoints before death and annualized rate of atrophy. Since Alzheimer's disease (AD) is a frequent co-pathology in non-FTLD TDP-43, we further divided types α/β based on presence/absence of intermediate-high likelihood AD: AD-TDP type-β (n = 90), AD-TDP type-α (n = 104), and Pure-TDP (n = 31, all type-α). FTLD-TDP was associated with faster atrophy rates in the inferior temporal lobe and temporal pole compared to all non-FTLD TDP-43 groups. The atrophy rate in the frontal lobe was modulated by age with younger FTLD-TDP having the fastest rates. Older FTLD-TDP showed a limbic predominant pattern of neurodegeneration. AD-TDP type-α showed faster rates of hippocampal atrophy and smaller volumes of amygdala, temporal pole, and inferior temporal lobe compared to AD-TDP type-β. Pure-TDP was associated with slowest rates and less atrophy in all brain regions. The results suggest that there are differences and similarities in longitudinal brain volume loss between FTLD-TDP and non-FTLD TDP-43. Within FTLD-TDP age plays a role in which brain regions are the most affected. Additionally, brain atrophy regional rates also vary by non-FTLD TDP-43 type.
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Affiliation(s)
- Marina Buciuc
- Department of Neurology, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
| | - Peter R Martin
- Department of Quantitative Health Sciences, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
| | - Nirubol Tosakulwong
- Department of Quantitative Health Sciences, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
| | - Melissa E Murray
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL 32224, USA.
| | - Leonard Petrucelli
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL 32224, USA.
| | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
| | - Anthony J Spychalla
- Department of Radiology, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
| | - David S Knopman
- Department of Neurology, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
| | - Ronald C Petersen
- Department of Neurology, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
| | - Joseph E Parisi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
| | - R Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL 32224, USA.
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
| | - Jennifer L Whitwell
- Department of Radiology, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
| | - Keith A Josephs
- Department of Neurology, Mayo Clinic, 200 1(st) Street NW, Rochester, MN 55905, USA.
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50
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Chen Y, Landin-Romero R, Kumfor F, Irish M, Dobson-Stone C, Kwok JB, Halliday GM, Hodges JR, Piguet O. Cerebellar integrity and contributions to cognition in C9orf72-mediated frontotemporal dementia. Cortex 2022; 149:73-84. [DOI: 10.1016/j.cortex.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/07/2021] [Accepted: 12/22/2021] [Indexed: 11/03/2022]
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