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Cayir S, Volpi T, Toyonaga T, Gallezot JD, Yanghong Y, Sadabad FE, Mulnix T, Mecca AP, Fesharaki-Zadeh A, Matuskey D. Relationship between Neuroimaging and Cognition in Frontotemporal Dementia: A [18 F]FDG PET and Structural MRI Study. Res Sq 2024:rs.3.rs-3846125. [PMID: 38313264 PMCID: PMC10836106 DOI: 10.21203/rs.3.rs-3846125/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Background Frontotemporal dementia (FTD) is a clinically and pathologically heterogeneous condition with a prevalence comparable to Alzheimer's Disease for patients under sixty-five years of age. Gray matter (GM) atrophy and glucose hypometabolism are important biomarkers for the diagnosis and evaluation of disease progression in FTD. However, limited studies have systematically examined the association between cognition and neuroimaging in FTD using different imaging modalities in the same patient group. Methods We examined the association of cognition using Montreal Cognitive Assessment (MoCA) with both GM volume and glucose metabolism using structural magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography scanning ([18F]FDG PET) in 21 patients diagnosed with FTD. Standardized uptake value ratio (SUVR) using the brainstem as a reference region was the primary outcome measure for [18F]FDG PET. Partial volume correction was applied to PET data to account for disease-related atrophy. Results Significant positive associations were found between whole-cortex GM volume and MoCA scores (r = 0.461, p = 0.035). The association between whole-cortex [18F]FDG SUVR and MoCA scores was not Significant (r = 0.374, p = 0.094). GM volumes of the frontal cortex (r = 0.540, p = 0.011), caudate (r = 0.616, p = 0.002), and insula (r = 0.568, p = 0.007) were also Significantly correlated with MoCA, as were SUVR values of the insula (r = 0.508, p = 0.018), thalamus (r = 0.478, p = 0.028), and posterior cingulate cortex (PCC) (r = 0.472, p = 0.030). Discussion Whole-cortex atrophy is associated with cognitive dysfunction, and this effect is larger than for cortical hypometabolism as measured with [18F]FDG PET. At the regional level, focal atrophy and/or hypometabolism in the frontal lobe, insula, PCC, thalamus, and caudate seem to imply the importance of these regions for the decline of cognitive function in FTD. Furthermore, these results highlight how functional and structural changes may not overlap and might contribute to cognitive dysfunction in FTD in different ways. Our findings provide insight into the relationships between structural, metabolic, and cognitive changes due to FTD.
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Hattori T, Mitani N, Numasawa Y, Azuma R, Orimo S. Simultaneous Four Supratentorial Lesions Predict Tube Dependency Due to an Impaired Anticipatory Phase of Ingestion. Transl Stroke Res 2023:10.1007/s12975-023-01162-4. [PMID: 37249762 DOI: 10.1007/s12975-023-01162-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 04/23/2023] [Accepted: 05/22/2023] [Indexed: 05/31/2023]
Abstract
This study aimed to identify the neuroanatomical predictors of oropharyngeal dysphagia and tube dependency in patients with supratentorial or infratentorial ischemic strokes. Patients with acute ischemic stroke were enrolled and were classified into 3 groups: right supratentorial (n = 61), left supratentorial (n = 89), and infratentorial stroke (n = 50). Dysphagia was evaluated by a modified water swallowing test and the Food Intake LEVEL Scale to evaluate oropharyngeal dysphagia and tube dependency, respectively. As two dysphagia parameters, we evaluated the durations from onset of stroke to (1) success in the modified water swallowing test and to (2) rating 7 points or above on the Food Intake LEVEL Scale: patients regained sufficient oral intake and were not tube-dependent. Voxel-based lesion-symptom mapping analysis was performed for a spatially normalized lesion map of magnetic resonance imaging to explore the anatomies that are associated with the two dysphagia parameters for each stroke group. The right precentral gyrus and parts of the internal capsule are associated with oropharyngeal dysphagia. The four supratentorial areas are associated with tube dependency. The dorsal upper medulla is associated with both oropharyngeal dysphagia and tube dependency. These results suggest that supratentorial stroke patients can be tube-dependent due to an impaired anticipatory phase of ingestion. The simultaneous damage in the four supratentorial areas: the inferior part of the precentral gyrus, lenticular nucleus, caudate head, and anterior insular cortex, predicts tube dependency. In contrast, infratentorial stroke patients can be tube-dependent due to oropharyngeal dysphagia caused by lesions in the dorsal upper medulla, damaging the swallowing-related nucleus.
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Affiliation(s)
- Takaaki Hattori
- Department of Neurology and Neurological Science, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
| | - Naoko Mitani
- Division of Rehabilitation, Mitsui Memorial Hospital, Tokyo, Japan
| | - Yoshiyuki Numasawa
- Department of Neurology and Neurological Science, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Reo Azuma
- Department of Neurology, Kanto Central Hospital, Tokyo, Japan
| | - Satoshi Orimo
- Department of Neurology, Kanto Central Hospital, Tokyo, Japan
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Xiao Y, Wang J, Huang K, Gao L, Yao S. Progressive structural and covariance connectivity abnormalities in patients with Alzheimer's disease. Front Aging Neurosci 2023; 14:1064667. [PMID: 36688148 PMCID: PMC9853893 DOI: 10.3389/fnagi.2022.1064667] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023] Open
Abstract
Background Alzheimer's disease (AD) is one of most prevalent neurodegenerative diseases worldwide and characterized by cognitive decline and brain structure atrophy. While studies have reported substantial grey matter atrophy related to progression of AD, it remains unclear about brain regions with progressive grey matter atrophy, covariance connectivity, and the associations with cognitive decline in AD patients. Objective This study aims to investigate the grey matter atrophy, structural covariance connectivity abnormalities, and the correlations between grey matter atrophy and cognitive decline during AD progression. Materials We analyzed neuroimaging data of healthy controls (HC, n = 45) and AD patients (n = 40) at baseline (AD-T1) and one-year follow-up (AD-T2) obtained from the Alzheimer's Disease Neuroimaging Initiative. We investigated AD-related progressive changes of grey matter volume, covariance connectivity, and the clinical relevance to further understand the pathological progression of AD. Results The results showed clear patterns of grey matter atrophy in inferior frontal gyrus, prefrontal cortex, lateral temporal gyrus, posterior cingulate cortex, insula, hippocampus, caudate, and thalamus in AD patients. There was significant atrophy in bilateral superior temporal gyrus (STG) and left caudate in AD patients over a one-year period, and the grey matter volume decrease in right STG and left caudate was correlated with cognitive decline. Additionally, we found reduced structural covariance connectivity between right STG and left caudate in AD patients. Using AD-related grey matter atrophy as features, there was high discrimination accuracy of AD patients from HC, and AD patients at different time points.
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Affiliation(s)
- Yaqiong Xiao
- Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Jiaojian Wang
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China
| | - Kaiyu Huang
- Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Lei Gao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shun Yao
- Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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McKenna MC, Murad A, Huynh W, Lope J, Bede P. The changing landscape of neuroimaging in frontotemporal lobar degeneration: from group-level observations to single-subject data interpretation. Expert Rev Neurother 2022; 22:179-207. [PMID: 35227146 DOI: 10.1080/14737175.2022.2048648] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION While the imaging signatures of frontotemporal lobar degeneration (FTLD) phenotypes and genotypes are well-characterised based on group-level descriptive analyses, the meaningful interpretation of single MRI scans remains challenging. Single-subject MRI classification frameworks rely on complex computational models and large training datasets to categorise individual patients into diagnostic subgroups based on distinguishing imaging features. Reliable individual subject data interpretation is hugely important in the clinical setting to expedite the diagnosis and classify individuals into relevant prognostic categories. AREAS COVERED This article reviews (1) the neuroimaging studies that propose single-subject MRI classification strategies in symptomatic and pre-symptomatic FTLD, (2) potential practical implications and (3) the limitations of current single-subject data interpretation models. EXPERT OPINION Classification studies in FTLD have demonstrated the feasibility of categorising individual subjects into diagnostic groups based on multiparametric imaging data. Preliminary data indicate that pre-symptomatic FTLD mutation carriers may also be reliably distinguished from controls. Despite momentous advances in the field, significant further improvements are needed before these models can be developed into viable clinical applications.
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Affiliation(s)
| | - Aizuri Murad
- Computational Neuroimaging Group, Trinity College Dublin, Ireland
| | - William Huynh
- Brain and Mind Centre, University of Sydney, Australia
| | - Jasmin Lope
- Computational Neuroimaging Group, Trinity College Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Trinity College Dublin, Ireland.,Pitié-Salpêtrière University Hospital, Sorbonne University, France
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Bocchetta M, Malpetti M, Todd EG, Rowe JB, Rohrer JD. Looking beneath the surface: the importance of subcortical structures in frontotemporal dementia. Brain Commun 2021; 3:fcab158. [PMID: 34458729 PMCID: PMC8390477 DOI: 10.1093/braincomms/fcab158] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 12/15/2022] Open
Abstract
Whilst initial anatomical studies of frontotemporal dementia focussed on cortical involvement, the relevance of subcortical structures to the pathophysiology of frontotemporal dementia has been increasingly recognized over recent years. Key structures affected include the caudate, putamen, nucleus accumbens, and globus pallidus within the basal ganglia, the hippocampus and amygdala within the medial temporal lobe, the basal forebrain, and the diencephalon structures of the thalamus, hypothalamus and habenula. At the most posterior aspect of the brain, focal involvement of brainstem and cerebellum has recently also been shown in certain subtypes of frontotemporal dementia. Many of the neuroimaging studies on subcortical structures in frontotemporal dementia have been performed in clinically defined sporadic cases. However, investigations of genetically- and pathologically-confirmed forms of frontotemporal dementia are increasingly common and provide molecular specificity to the changes observed. Furthermore, detailed analyses of sub-nuclei and subregions within each subcortical structure are being added to the literature, allowing refinement of the patterns of subcortical involvement. This review focuses on the existing literature on structural imaging and neuropathological studies of subcortical anatomy across the spectrum of frontotemporal dementia, along with investigations of brain–behaviour correlates that examine the cognitive sequelae of specific subcortical involvement: it aims to ‘look beneath the surface’ and summarize the patterns of subcortical involvement have been described in frontotemporal dementia.
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Affiliation(s)
- Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Maura Malpetti
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
| | - Emily G Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - James B Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK.,Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
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Schneider TM, Ma J, Wagner P, Behl N, Nagel AM, Ladd ME, Heiland S, Bendszus M, Straub S. Multiparametric MRI for Characterization of the Basal Ganglia and the Midbrain. Front Neurosci 2021; 15:661504. [PMID: 34234639 PMCID: PMC8255625 DOI: 10.3389/fnins.2021.661504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/17/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives To characterize subcortical nuclei by multi-parametric quantitative magnetic resonance imaging. Materials and Methods: The following quantitative multiparametric MR data of five healthy volunteers were acquired on a 7T MRI system: 3D gradient echo (GRE) data for the calculation of quantitative susceptibility maps (QSM), GRE sequences with and without off-resonant magnetic transfer pulse for magnetization transfer ratio (MTR) calculation, a magnetization−prepared 2 rapid acquisition gradient echo sequence for T1 mapping, and (after a coil change) a density-adapted 3D radial pulse sequence for 23Na imaging. First, all data were co-registered to the GRE data, volumes of interest (VOIs) for 21 subcortical structures were drawn manually for each volunteer, and a combined voxel-wise analysis of the four MR contrasts (QSM, MTR, T1, 23Na) in each structure was conducted to assess the quantitative, MR value-based differentiability of structures. Second, a machine learning algorithm based on random forests was trained to automatically classify the groups of multi-parametric voxel values from each VOI according to their association to one of the 21 subcortical structures. Results The analysis of the integrated multimodal visualization of quantitative MR values in each structure yielded a successful classification among nuclei of the ascending reticular activation system (ARAS), the limbic system and the extrapyramidal system, while classification among (epi-)thalamic nuclei was less successful. The machine learning-based approach facilitated quantitative MR value-based structure classification especially in the group of extrapyramidal nuclei and reached an overall accuracy of 85% regarding all selected nuclei. Conclusion Multimodal quantitative MR enabled excellent differentiation of a wide spectrum of subcortical nuclei with reasonable accuracy and may thus enable sensitive detection of disease and nucleus-specific MR-based contrast alterations in the future.
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Affiliation(s)
- Till M Schneider
- Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany
| | - Jackie Ma
- Department of Artificial Intelligence, Fraunhofer Heinrich Hertz Institute, Berlin, Germany
| | - Patrick Wagner
- Department of Artificial Intelligence, Fraunhofer Heinrich Hertz Institute, Berlin, Germany
| | - Nicolas Behl
- Division of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Armin M Nagel
- Division of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany.,Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Mark E Ladd
- Division of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany.,Faculty of Physics and Astronomy and Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany
| | - Sina Straub
- Division of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
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7
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Esteves M, Moreira PS, Marques P, Castanho TC, Magalhães R, Amorim L, Portugal‐Nunes C, Soares JM, Coelho A, Almeida A, Santos NC, Sousa N, Leite‐Almeida H. Asymmetrical subcortical plasticity entails cognitive progression in older individuals. Aging Cell 2019; 18:e12857. [PMID: 30578611 PMCID: PMC6351824 DOI: 10.1111/acel.12857] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/05/2018] [Accepted: 09/15/2018] [Indexed: 01/05/2023] Open
Abstract
Structural brain asymmetries have been associated with cognition. However, it is not known to what extent neuropsychological parameters and structural laterality covary with aging. Seventy‐five subjects drawn from a larger normal aging cohort were evaluated in terms of MRI and neuropsychological parameters at two moments (M1 and M2), 18 months apart. In this time frame, asymmetry as measured by structural laterality index (ΔLI) was stable regarding both direction and magnitude in all areas. However, a significantly higher dispersion for this variation was observed in subcortical over cortical areas. Subjects with extreme increase in rightward lateralization of the caudate revealed increased M1 to M2 Stroop interference scores, but also a worsening of general cognition (MMSE). In contrast, subjects showing extreme increase in leftward lateralization of the thalamus presented higher increase in Stroop interference scores. In conclusion, while a decline in cognitive function was observed in the entire sample, regional brain asymmetries were relatively stable. Neuropsychological trajectories were associated with laterality changes in subcortical regions.
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Affiliation(s)
- Madalena Esteves
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
| | - Pedro S. Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
| | - Paulo Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
| | - Teresa C. Castanho
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
| | - Ricardo Magalhães
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
| | - Liliana Amorim
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
| | - Carlos Portugal‐Nunes
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
| | - José M. Soares
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
| | - Ana Coelho
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
| | - Armando Almeida
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
| | - Nadine C. Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
| | - Hugo Leite‐Almeida
- Life and Health Sciences Research Institute (ICVS), School of Medicine University of Minho Braga Portugal
- ICVS/3B’s ‐ PT Government Associate Laboratory Braga/Guimarães Portugal
- Clinical Academic Center – Braga Braga Portugal
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Possin KL, Kim H, Geschwind MD, Moskowitz T, Johnson ET, Sha SJ, Apple A, Xu D, Miller BL, Finkbeiner S, Hess CP, Kramer JH. Egocentric and allocentric visuospatial working memory in premotor Huntington's disease: A double dissociation with caudate and hippocampal volumes. Neuropsychologia 2017; 101:57-64. [PMID: 28427989 DOI: 10.1016/j.neuropsychologia.2017.04.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 03/21/2017] [Accepted: 04/15/2017] [Indexed: 12/13/2022]
Abstract
Our brains represent spatial information in egocentric (self-based) or allocentric (landmark-based) coordinates. Rodent studies have demonstrated a critical role for the caudate in egocentric navigation and the hippocampus in allocentric navigation. We administered tests of egocentric and allocentric working memory to individuals with premotor Huntington's disease (pmHD), which is associated with early caudate nucleus atrophy, and controls. Each test had 80 trials during which subjects were asked to remember 2 locations over 1-sec delays. The only difference between these otherwise identical tests was that locations could only be coded in self-based or landmark-based coordinates. We applied a multiatlas-based segmentation algorithm and computed point-wise Jacobian determinants to measure regional variations in caudate and hippocampal volumes from 3T MRI. As predicted, the pmHD patients were significantly more impaired on egocentric working memory. Only egocentric accuracy correlated with caudate volumes, specifically the dorsolateral caudate head, right more than left, a region that receives dense efferents from dorsolateral prefrontal cortex. In contrast, only allocentric accuracy correlated with hippocampal volumes, specifically intermediate and posterior regions that connect strongly with parahippocampal and posterior parietal cortices. These results indicate that the distinction between egocentric and allocentric navigation applies to working memory. The dorsolateral caudate is important for egocentric working memory, which can explain the disproportionate impairment in pmHD. Allocentric working memory, in contrast, relies on the hippocampus and is relatively spared in pmHD.
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Winton-Brown TT, Ting A, Mocellin R, Velakoulis D, Gaillard F, Gaillard F. Distinguishing Neuroimaging Features in Patients Presenting with Visual Hallucinations. AJNR Am J Neuroradiol 2016; 37:774-81. [PMID: 26744445 DOI: 10.3174/ajnr.a4636] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Visual hallucinations are relatively uncommon presentations in medical and psychiatric clinics, where they are generally regarded as a marker of possible underlying "organic" brain disease. Thus, patients with visual hallucinations are often referred for imaging of the brain. This article presents a pragmatic approach for the radiologist reviewing such imaging. Because conditions that can present with visual hallucinations are legion, a familiarity with the features of the hallucinations themselves, which can serve as clues to the underlying cause, can be helpful in interpreting such cases. We consider the nature of visual hallucinations and the mechanisms underlying their formation. We then provide a framework to guide the search for their cause, first in terms of focal lesions along the visual pathway and then global conditions affecting >1 region.
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Affiliation(s)
| | | | | | | | | | - F Gaillard
- Radiology (A.T., F.G.), Royal Melbourne Hospital, Parkville, Victoria, Australia
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10
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Bae JS, Ferguson M, Tan R, Mioshi E, Simon N, Burrell J, Vucic S, Hodges JR, Kiernan MC, Hornberger M. Dissociation of Structural and Functional Integrities of the Motor System in Amyotrophic Lateral Sclerosis and Behavioral-Variant Frontotemporal Dementia. J Clin Neurol 2016; 12:209-17. [PMID: 26932257 PMCID: PMC4828568 DOI: 10.3988/jcn.2016.12.2.209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 11/02/2015] [Accepted: 11/05/2015] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose This study investigated the structural and functional changes in the motor system in amyotrophic lateral sclerosis (ALS; n=25) and behavioral-variant fronto-temporal dementia (bvFTD; n=17) relative to healthy controls (n=37). Methods Structural changes were examined using a region-of-interest approach, applying voxel-based morphometry for gray-matter changes and diffusion tensor imaging for white-matter changes. Functional changes in the motor system were elucidated using threshold-tracking transcranial magnetic stimulation (TMS) measurements of upper motor-neuron excitability. Results The structural analyses showed that in ALS there were more white-matter changes in the corticospinal and motor-cortex regions and more gray-matter changes in the cerebellum in comparison to controls. bvFTD showed substantial gray- and white-matter changes across virtually all motor-system regions compared to controls, although the brainstem was affected less than the other regions. Direct comparisons across patient groups showed that the gray- and white-matter motor-system changes inclusive of the motor cortex were greater in bvFTD than in ALS. By contrast, the functional integrity of the motor system was more adversely affected in ALS than in bvFTD, with both patient groups showing increased excitability of upper motor neurons compared to controls. Conclusions Cross-correlation of structural and functional data further revealed a neural dissociation of different motor-system regions and tracts covarying with the TMS excitability across both patient groups. The structural and functional motor-system integrities appear to be dissociated between ALS and bvFTD, which represents useful information for the diagnosis of motor-system changes in these two disorders.
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Affiliation(s)
- Jong Seok Bae
- Department of Neurology, Hallym University College of Medicine, Seoul, Korea.,Neuroscience Research Australia, Sydney, Australia
| | - Michele Ferguson
- Neuroscience Research Australia, Sydney, Australia.,School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Rachel Tan
- Neuroscience Research Australia, Sydney, Australia
| | - Eneida Mioshi
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Neil Simon
- Neuroscience Research Australia, Sydney, Australia
| | | | - Steve Vucic
- Department of Neurology, Westmead Clinical School, University of Sydney, Westmead, Australia
| | - John R Hodges
- Neuroscience Research Australia, Sydney, Australia.,School of Medical Sciences, University of New South Wales, Sydney, Australia
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Abstract
Frontotemporal dementia (FTD) refers to a group of clinically and genetically heterogeneous neurodegenerative disorders that are a common cause of adult-onset behavioural and cognitive impairment. FTD often presents in combination with various hyperkinetic or hypokinetic movement disorders, and evidence suggests that various genetic mutations underlie these different presentations. Here, we review the known syndromatic-genetic correlations in FTD. Although no direct genotype-phenotype correlations have been identified, mutations in multiple genes have been associated with various presentations. Mutations in the genes that encode microtubule-associated protein tau (MAPT) and progranulin (PGRN) can manifest as symmetrical parkinsonism, including the phenotypes of Richardson syndrome and corticobasal syndrome (CBS). Expansions in the C9orf72 gene are most frequently associated with familial FTD, typically combined with motor neuron disease, but other manifestations, such as symmetrical parkinsonism, CBS and multiple system atrophy-like presentations, have been described in patients with these mutations. Less common gene mutations, such as those in TARDBP, CHMP2B, VCP, FUS and TREM2, can also present as atypical parkinsonism. The most common hyperkinetic movement disorders in FTD are motor and vocal stereotypies, which have been observed in up to 78% of patients with autopsy-proven FTD. Other hyperkinetic movements, such as chorea, orofacial dyskinesias, myoclonus and dystonia, are also observed in some patients with FTD.
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Möller C, Hafkemeijer A, Pijnenburg YA, Rombouts SA, van der Grond J, Dopper E, van Swieten J, Versteeg A, Pouwels PJ, Barkhof F, Scheltens P, Vrenken H, van der Flier WM. Joint assessment of white matter integrity, cortical and subcortical atrophy to distinguish AD from behavioral variant FTD: A two-center study. Neuroimage Clin 2015; 9:418-29. [PMID: 26594624 PMCID: PMC4600847 DOI: 10.1016/j.nicl.2015.08.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 08/25/2015] [Accepted: 08/31/2015] [Indexed: 12/03/2022]
Abstract
We investigated the ability of cortical and subcortical gray matter (GM) atrophy in combination with white matter (WM) integrity to distinguish behavioral variant frontotemporal dementia (bvFTD) from Alzheimer's disease (AD) and from controls using voxel-based morphometry, subcortical structure segmentation, and tract-based spatial statistics. To determine which combination of MR markers differentiated the three groups with the highest accuracy, we conducted discriminant function analyses. Adjusted for age, sex and center, both types of dementia had more GM atrophy, lower fractional anisotropy (FA) and higher mean (MD), axial (L1) and radial diffusivity (L23) values than controls. BvFTD patients had more GM atrophy in orbitofrontal and inferior frontal areas than AD patients. In addition, caudate nucleus and nucleus accumbens were smaller in bvFTD than in AD. FA values were lower; MD, L1 and L23 values were higher, especially in frontal areas of the brain for bvFTD compared to AD patients. The combination of cortical GM, hippocampal volume and WM integrity measurements, classified 97-100% of controls, 81-100% of AD and 67-75% of bvFTD patients correctly. Our results suggest that WM integrity measures add complementary information to measures of GM atrophy, thereby improving the classification between AD and bvFTD.
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Affiliation(s)
- Christiane Möller
- Department of Neurology & Alzheimer Center, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Anne Hafkemeijer
- Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Yolande A.L. Pijnenburg
- Department of Neurology & Alzheimer Center, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Serge A.R.B. Rombouts
- Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Elise Dopper
- Department of Neurology & Alzheimer Center, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Genetics, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - John van Swieten
- Department of Clinical Genetics, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Adriaan Versteeg
- Department of Radiology & Nuclear Medicine, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Petra J.W. Pouwels
- Department of Physics & Medical Technology, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology & Alzheimer Center, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Hugo Vrenken
- Department of Radiology & Nuclear Medicine, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
- Department of Physics & Medical Technology, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Wiesje M. van der Flier
- Department of Neurology & Alzheimer Center, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
- Department of Epidemiology & Biostatistics, Neuroscience Campus, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
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Bertoux M, O'Callaghan C, Flanagan E, Hodges JR, Hornberger M. Fronto-Striatal Atrophy in Behavioral Variant Frontotemporal Dementia and Alzheimer's Disease. Front Neurol 2015; 6:147. [PMID: 26191038 PMCID: PMC4486833 DOI: 10.3389/fneur.2015.00147] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/18/2015] [Indexed: 11/17/2022] Open
Abstract
Behavioral variant frontotemporal dementia (bvFTD) has only recently been associated with significant striatal atrophy, whereas the striatum appears to be relatively preserved in Alzheimer’s disease (AD). Considering the critical role the striatum has in cognition and behavior, striatal degeneration, together with frontal atrophy, could be responsible of some characteristic symptoms in bvFTD and emerges therefore as promising novel diagnostic biomarker to distinguish bvFTD and AD. Previous studies have, however, only taken either cortical or striatal atrophy into account when comparing the two diseases. In this study, we establish for the first time a profile of fronto-striatal atrophy in 23 bvFTD and 29 AD patients at presentation, based on the structural connectivity of striatal and cortical regions. Patients are compared to 50 healthy controls by using a novel probabilistic connectivity atlas, which defines striatal regions by their cortical white-matter connectivity, allowing us to explore the degeneration of the frontal and striatal regions that are functionally linked. Comparisons with controls revealed that bvFTD showed substantial fronto-striatal atrophy affecting the ventral as well as anterior and posterior dorso-lateral prefrontal cortices and the related striatal subregions. In contrast, AD showed few fronto-striatal atrophy, despite having significant posterior dorso-lateral prefrontal degeneration. Direct comparison between bvFTD and AD revealed significantly more atrophy in the ventral striatal–ventromedial prefrontal cortex regions in bvFTD. Consequently, deficits in ventral fronto-striatal regions emerge as promising novel and efficient diagnosis biomarker for bvFTD. Future investigations into the contributions of these fronto-striatal loops on bvFTD symptomology are needed to develop simple diagnostic and disease tracking algorithms.
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Affiliation(s)
- Maxime Bertoux
- Neurosciences Research Australia (NeuRA) , Randwick, NSW , Australia ; Department of Clinical Neurosciences, University of Cambridge , Cambridge , UK
| | - Claire O'Callaghan
- Neurosciences Research Australia (NeuRA) , Randwick, NSW , Australia ; School of Medical Sciences, University of New South Wales , Sydney, NSW , Australia
| | - Emma Flanagan
- Neurosciences Research Australia (NeuRA) , Randwick, NSW , Australia ; School of Medical Sciences, University of New South Wales , Sydney, NSW , Australia
| | - John R Hodges
- Neurosciences Research Australia (NeuRA) , Randwick, NSW , Australia
| | - Michael Hornberger
- Neurosciences Research Australia (NeuRA) , Randwick, NSW , Australia ; Department of Clinical Neurosciences, University of Cambridge , Cambridge , UK ; School of Medical Sciences, University of New South Wales , Sydney, NSW , Australia
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Macfarlane MD, Jakabek D, Walterfang M, Vestberg S, Velakoulis D, Wilkes FA, Nilsson C, van Westen D, Looi JC, Santillo AF. Striatal Atrophy in the Behavioural Variant of Frontotemporal Dementia: Correlation with Diagnosis, Negative Symptoms and Disease Severity. PLoS One 2015; 10:e0129692. [PMID: 26075893 DOI: 10.1371/journal.pone.0129692] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 05/12/2015] [Indexed: 11/19/2022] Open
Abstract
Introduction Behavioural variant frontotemporal dementia (bvFTD) is associated with changes in dorsal striatal parts of the basal ganglia (caudate nucleus and putamen), related to dysfunction in the cortico-striato-thalamic circuits which help mediate executive and motor functions. We aimed to determine whether the size and shape of striatal structures correlated with diagnosis of bvFTD, and measures of clinical severity, behaviour and cognition. Materials and Methods Magnetic resonance imaging scans from 28 patients with bvFTD and 26 healthy controls were manually traced using image analysis software (ITK-SNAP). The resulting 3-D objects underwent volumetric analysis and shape analysis, through spherical harmonic description with point distribution models (SPHARM-PDM). Correlations with size and shape were sought with clinical measures in the bvTFD group, including Frontal Behavioural Inventory, Clinical Dementia Rating for bvFTD, Color Word Interference, Hayling part B and Brixton tests, and Trail-Making Test. Results Caudate nuclei and putamina were significantly smaller in the bvFTD group compared to controls (left caudate 16% smaller, partial eta squared 0.173, p=0.003; right caudate 11% smaller, partial eta squared 0.103, p=0.023; left putamen 18% smaller, partial eta squared 0.179, p=0.002; right putamen 12% smaller, partial eta squared 0.081, p=0.045), with global shape deflation in the caudate bilaterally but no localised shape change in putamen. In the bvFTD group, shape deflations on the left, corresponding to afferent connections from dorsolateral prefrontal mediofrontal/anterior cingulate and orbitofrontal cortex, correlated with worsening disease severity. Global shape deflation in the putamen correlated with Frontal Behavioural Inventory scores—higher scoring on negative symptoms was associated with the left putamen, while positive symptoms were associated with the right. Other cognitive tests had poor completion rates. Conclusion Behavioural symptoms and severity of bvFTD are correlated with abnormalities in striatal size and shape. This adds to the promise of imaging the striatum as a biomarker in this disease.
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Walterfang M, Luders E, Looi JCL, Rajagopalan P, Velakoulis D, Thompson PM, Lindberg O, Ostberg P, Nordin LE, Svensson L, Wahlund LO. Shape analysis of the corpus callosum in Alzheimer's disease and frontotemporal lobar degeneration subtypes. J Alzheimers Dis 2015; 40:897-906. [PMID: 24531157 DOI: 10.3233/jad-131853] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Morphology of the corpus callosum is a useful biomarker of neuronal loss, as different patterns of cortical atrophy help to distinguish between dementias such as Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD). We used a sophisticated morphometric analysis of the corpus callosum in FTLD subtypes including frontotemporal dementia (FTD), semantic dementia (SD), and progressive non-fluent aphasia (PNFA), and compared them to AD patients and 27 matched controls. FTLD patient subgroups diverged in their callosal morphology profiles, with FTD patients showing marked widespread differences, PNFA patients with differences largely in the anterior half of the callosum, and SD patients differences in a small segment of the genu. AD patients showed differences in predominantly posterior callosal regions. This study is consistent with our previous findings showing significant cortical and subcortical regional atrophy across FTLD subtypes, and suggests that callosal atrophy patterns differentiate AD from FTLD, and FTLD subtypes.
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Affiliation(s)
- Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital and Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Eileen Luders
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA, USA
| | - Jeffrey C L Looi
- Research Centre for Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra, Australia Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Priya Rajagopalan
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA, USA
| | - Dennis Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital and Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Paul M Thompson
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA, USA Department of Neurology, Psychiatry, Radiology, Pediatrics, Engineering & Ophthalmology, University of Southern California, Los Angeles, CA, USA USC Imaging Genetics Center, Marina del Rey, CA, USA
| | - Olof Lindberg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Per Ostberg
- Division of Speech-Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, and Department of Speech-Language Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Love E Nordin
- Hospital Physics, Karolinska University Hospital, Hospital Physics and Radiology, Huddinge, Stockholm, Sweden
| | - Leif Svensson
- Hospital Physics, Karolinska University Hospital, Hospital Physics and Radiology, Huddinge, Stockholm, Sweden
| | - Lars-Olof Wahlund
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Macfarlane MD, Looi JC, Walterfang M, Spulber G, Velakoulis D, Styner M, Crisby M, Örndahl E, Erkinjuntti T, Waldemar G, Hennerici MG, Bäzner H, Blahak C, Wallin A, Wahlund LO. Shape abnormalities of the caudate nucleus correlate with poorer gait and balance: results from a subset of the LADIS study. Am J Geriatr Psychiatry 2015; 23:59-71.e1. [PMID: 23916546 PMCID: PMC4234689 DOI: 10.1016/j.jagp.2013.04.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 04/18/2013] [Accepted: 04/24/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Functional deficits seen in several neurodegenerative disorders have been linked with dysfunction in frontostriatal circuits and with associated shape alterations in striatal structures. The severity of visible white matter hyperintensities (WMHs) on magnetic resonance imaging has been found to correlate with poorer performance on measures of gait and balance. This study aimed to determine whether striatal volume and shape changes were correlated with gait dysfunction. METHODS Magnetic resonance imaging scans and clinical gait/balance data (scores from the Short Physical Performance Battery [SPPB]) were sourced from 66 subjects in the previously published LADIS trial, performed in nondisabled individuals older than age 65 years with WMHs at study entry. Data were obtained at study entry and at 3-year follow-up. Caudate nuclei and putamina were manually traced using a previously published method and volumes calculated. The relationships between volume and physical performance on the SPPB were investigated with shape analysis using the spherical harmonic shape description toolkit. RESULTS There was no correlation between the severity of WMHs and striatal volumes. Caudate nuclei volume correlated with performance on the SPPB at baseline but not at follow-up, with subsequent shape analysis showing left caudate changes occurred in areas corresponding to inputs of the dorsolateral prefrontal, premotor, and motor cortex. There was no correlation between putamen volumes and performance on the SPPB. CONCLUSION Disruption in frontostriatal circuits may play a role in mediating poorer physical performance in individuals with WMHs. Striatal volume and shape changes may be suitable biomarkers for functional changes in this population.
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Affiliation(s)
- Matthew D. Macfarlane
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychological and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia
| | - Jeffrey C.L. Looi
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychological and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia, Karolinska Institute, Department of Neurobiology, Care Science and Society, Division of Clinical Geriatrics, Stockholm, Sweden
| | - Mark Walterfang
- Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC, Australia
| | - Gabriela Spulber
- Karolinska Institute, Department of Neurobiology, Care Science and Society, Division of Clinical Geriatrics, Stockholm, Sweden
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC, Australia
| | - Martin Styner
- Neuroimaging Research and Analysis Laboratories, Carolina Institute of Developmental Disabilities, Departments of Psychiatry and Computer Science, University of North Carolina, Chapel Hill, NC
| | - Milita Crisby
- Karolinska Institute, Department of Neurobiology, Care Science and Society, Division of Clinical Geriatrics, Stockholm, Sweden
| | - Eva Örndahl
- Department of Clinical Science, Intervention and Technology at Karolinska Institute, Division of Medical Imaging and Technology, Stockholm, Sweden and Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Timo Erkinjuntti
- Department of Neurological Sciences, University of Helsinki, Finland and Department of Neurology, Helsinki University Central Hospital, Finland
| | - Gunhild Waldemar
- Memory Disorders Research Group, Dept. of Neurology, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - Michael G. Hennerici
- Department of Neurology, Universitäts Medizin Mannheim UMM, University of Heidelberg, Mannheim, Germany
| | - Hansjörg Bäzner
- Department of Neurology, Universitäts Medizin Mannheim UMM, University of Heidelberg, Mannheim, Germany
| | - Christian Blahak
- Department of Neurology, Universitäts Medizin Mannheim UMM, University of Heidelberg, Mannheim, Germany
| | - Anders Wallin
- Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars-Olof Wahlund
- Karolinska Institute, Department of Neurobiology, Care Science and Society, Division of Clinical Geriatrics, Stockholm, Sweden
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O'Callaghan C, Bertoux M, Hornberger M. Beyond and below the cortex: the contribution of striatal dysfunction to cognition and behaviour in neurodegeneration. J Neurol Neurosurg Psychiatry 2014; 85:371-8. [PMID: 23833269 DOI: 10.1136/jnnp-2012-304558] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Investigations of cognitive and behavioural changes in neurodegeneration have been mostly focussed on how cortical changes can explain these symptoms. In the proposed review, we will argue that the striatum has been overlooked as a critical nexus in understanding the generation of such symptoms. Although the striatum is historically more associated with motor dysfunction, there is increasing evidence from functional neuroimaging studies in the healthy that striatal regions modulate behaviour and cognition. This should not be surprising, as the striatum has strong anatomical connections to many cortical regions including the frontal, temporal and insula lobes, as well as some subcortical regions (amygdala, hippocampus). To date, however, it is largely unclear to what extent striatal regions are affected in many neurodegenerative conditions-and if so, how striatal dysfunction can potentially influence cognition and behaviour. The proposed review will examine the existing evidence of striatal changes across selected neurodegenerative conditions (Parkinson's disease, progressive supranuclear palsy, Huntington's disease, motor neuron disease, frontotemporal dementia and Alzheimer's disease), and will document their link with the cognitive and behavioural impairments observed. Thus, by reviewing the varying degrees of cortical and striatal changes in these conditions, we can start outlining the contributions of the striatal nexus to cognitive and behavioural symptoms. In turn, this knowledge will inform future studies investigating corticostriatal networks and also diagnostic strategies, disease management and future therapeutics of neurodegenerative conditions.
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18
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Frings L, Yew B, Flanagan E, Lam BYK, Hüll M, Huppertz HJ, Hodges JR, Hornberger M. Longitudinal grey and white matter changes in frontotemporal dementia and Alzheimer's disease. PLoS One 2014; 9:e90814. [PMID: 24595028 PMCID: PMC3940927 DOI: 10.1371/journal.pone.0090814] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 02/05/2014] [Indexed: 12/13/2022] Open
Abstract
Behavioural variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) dementia are characterised by progressive brain atrophy. Longitudinal MRI volumetry may help to characterise ongoing structural degeneration and support the differential diagnosis of dementia subtypes. Automated, observer-independent atlas-based MRI volumetry was applied to analyse 102 MRI data sets from 15 bvFTD, 14 AD, and 10 healthy elderly control participants with consecutive scans over at least 12 months. Anatomically defined targets were chosen a priori as brain structures of interest. Groups were compared regarding volumes at clinic presentation and annual change rates. Baseline volumes, especially of grey matter compartments, were significantly reduced in bvFTD and AD patients. Grey matter volumes of the caudate and the gyrus rectus were significantly smaller in bvFTD than AD. The bvFTD group could be separated from AD on the basis of caudate volume with high accuracy (79% cases correct). Annual volume decline was markedly larger in bvFTD and AD than controls, predominantly in white matter of temporal structures. Decline in grey matter volume of the lateral orbitofrontal gyrus separated bvFTD from AD and controls. Automated longitudinal MRI volumetry discriminates bvFTD from AD. In particular, greater reduction of orbitofrontal grey matter and temporal white matter structures after 12 months is indicative of bvFTD.
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Affiliation(s)
- Lars Frings
- Center of Geriatrics and Gerontology, University Medical Center, Freiburg, Germany
- Department of Nuclear Medicine, University Medical Center, Freiburg, Germany
| | - Belinda Yew
- Neuroscience Research Australia, Sydney, Australia
| | | | - Bonnie Y. K. Lam
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Michael Hüll
- Center of Geriatrics and Gerontology, University Medical Center, Freiburg, Germany
| | | | - John R. Hodges
- Neuroscience Research Australia, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Michael Hornberger
- Neuroscience Research Australia, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
- * E-mail:
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Macfarlane MD, Looi JC, Walterfang M, Spulber G, Velakoulis D, Crisby M, Orndahl E, Erkinjuntti T, Garde E, Waldemar G, Wallin A, Wahlund LO; LADIS Study Group. Executive dysfunction correlates with caudate nucleus atrophy in patients with white matter changes on MRI: a subset of LADIS. Psychiatry Res 2013; 214:16-23. [PMID: 23916538 DOI: 10.1016/j.pscychresns.2013.05.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 04/19/2013] [Accepted: 05/17/2013] [Indexed: 11/22/2022]
Abstract
White matter changes (WMC) are common magnetic resonance imaging (MRI) findings, particularly in the elderly. Recent studies such as the Leukoaraiosis and Disability Study (LADIS) have found that WMC relate to adverse outcomes including cognitive impairment, depression, disability, unsteadiness and falls in cross-sectional and follow-up studies. Frontostriatal (or frontosubcortical) brain circuits may serve many of these functions, with the caudate nuclei playing a role in convergence of cognitive functions. This study aimed to determine whether reduced caudate volume relates to cognitive functions (executive functions, memory functions and speed of processing) and WMC. We determined caudate nuclei volumes, through manual tracing, on a subgroup of the LADIS study (n=66) from four centres with baseline and 3-year follow-up MRI scans. Regression analysis was used to assess relationships between caudate volume, cognitive function and WMC. Severity of WMC did not relate to caudate volume. Smaller caudate volumes were significantly associated with poorer executive functioning at baseline and at 3 years, but were not associated with scores of memory or speed of processing. Thus, in patients with WMC, a surrogate of small vessel disease, caudate atrophy relates to the dysexecutive syndrome, supporting the role of caudate as an important part of the frontostriatal circuit.
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Choe MS, Ortiz-Mantilla S, Makris N, Gregas M, Bacic J, Haehn D, Kennedy D, Pienaar R, Caviness VS, Benasich AA, Grant PE. Regional infant brain development: an MRI-based morphometric analysis in 3 to 13 month olds. Cereb Cortex 2013; 23:2100-17. [PMID: 22772652 PMCID: PMC3729199 DOI: 10.1093/cercor/bhs197] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Elucidation of infant brain development is a critically important goal given the enduring impact of these early processes on various domains including later cognition and language. Although infants' whole-brain growth rates have long been available, regional growth rates have not been reported systematically. Accordingly, relatively less is known about the dynamics and organization of typically developing infant brains. Here we report global and regional volumetric growth of cerebrum, cerebellum, and brainstem with gender dimorphism, in 33 cross-sectional scans, over 3 to 13 months, using T1-weighted 3-dimensional spoiled gradient echo images and detailed semi-automated brain segmentation. Except for the midbrain and lateral ventricles, all absolute volumes of brain regions showed significant growth, with 6 different patterns of volumetric change. When normalized to the whole brain, the regional increase was characterized by 5 differential patterns. The putamen, cerebellar hemispheres, and total cerebellum were the only regions that showed positive growth in the normalized brain. Our results show region-specific patterns of volumetric change and contribute to the systematic understanding of infant brain development. This study greatly expands our knowledge of normal development and in future may provide a basis for identifying early deviation above and beyond normative variation that might signal higher risk for neurological disorders.
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Affiliation(s)
- Myong-sun Choe
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Children's HospitalBoston
- Division of Newborn Medicine, Department of Medicine, Children's Hospital Boston
- Department of Neurology, Center for Morphometric Analysis, Massachusetts General Hospital
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, and
| | - Silvia Ortiz-Mantilla
- Department of Neuroscience, Rutgers, Center for Molecular and Behavioral Neuroscience, The State University of New Jersey, Newark, NJ, USA and
| | - Nikos Makris
- Department of Neurology, Center for Morphometric Analysis, Massachusetts General Hospital
| | - Matt Gregas
- Clinical Research Program, Department of Neurology, Children's Hospital Boston
| | - Janine Bacic
- Clinical Research Program, Department of Neurology, Children's Hospital Boston
| | - Daniel Haehn
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Children's HospitalBoston
- Division of Neuroradiology, Department of Radiology, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA
| | - David Kennedy
- Department of Neurology, Center for Morphometric Analysis, Massachusetts General Hospital
- Child and Adolescent NeuroDevelopment Initiative (CANDI), Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Rudolph Pienaar
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Children's HospitalBoston
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, and
- Division of Neuroradiology, Department of Radiology, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA
| | - Verne S. Caviness
- Department of Neurology, Center for Morphometric Analysis, Massachusetts General Hospital
| | - April A. Benasich
- Department of Neuroscience, Rutgers, Center for Molecular and Behavioral Neuroscience, The State University of New Jersey, Newark, NJ, USA and
| | - P. Ellen Grant
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Children's HospitalBoston
- Division of Newborn Medicine, Department of Medicine, Children's Hospital Boston
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, and
- Division of Neuroradiology, Department of Radiology, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA
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Halabi C, Halabi A, Dean DL, Wang PN, Boxer AL, Trojanowski JQ, Dearmond SJ, Miller BL, Kramer JH, Seeley WW. Patterns of striatal degeneration in frontotemporal dementia. Alzheimer Dis Assoc Disord 2013; 27:74-83. [PMID: 22367382 DOI: 10.1097/WAD.0b013e31824a7df4] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Behavioral variant frontotemporal dementia and semantic dementia have been associated with striatal degeneration, but few studies have delineated striatal subregion volumes in vivo or related them to the clinical phenotype. We traced caudate, putamen, and nucleus accumbens on magnetic resonance images to quantify volumes of these structures in behavioral variant frontotemporal dementia, semantic dementia, Alzheimer disease, and healthy controls (n=12 per group). We further related these striatal volumes to clinical deficits and neuropathologic findings in a subset of patients. Behavioral variant frontotemporal dementia and semantic dementia showed significant overall striatal atrophy compared with controls. Moreover, behavioral variant frontotemporal dementia showed panstriatal degeneration, whereas semantic dementia featured a more focal pattern involving putamen and accumbens. Right-sided striatal atrophy, especially in the putamen, correlated with the overall behavioral symptom severity and with specific behavioral domains. At autopsy, patients with behavioral variant frontotemporal dementia and semantic dementia showed striking and severe tau or TAR DNA-binding protein of 43 kDa pathology, especially in ventral parts of the striatum. These results demonstrate that ventral striatum degeneration is a prominent shared feature in behavioral variant frontotemporal dementia and semantic dementia and may contribute to the social-emotional deficits common to both disorders.
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Niethammer M, Tang CC, Ma Y, Mattis PJ, Ko JH, Dhawan V, Eidelberg D. Parkinson's disease cognitive network correlates with caudate dopamine. Neuroimage 2013; 78:204-9. [PMID: 23578575 DOI: 10.1016/j.neuroimage.2013.03.070] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 03/20/2013] [Accepted: 03/27/2013] [Indexed: 11/27/2022] Open
Abstract
Prior evidence has suggested a link between caudate dopaminergic functioning and cognition in Parkinson's disease (PD). In this dual tracer study we analyzed the relationship between nigrostriatal dopaminergic dysfunction and the expression of the previously validated PD cognition-related metabolic pattern (PDCP). In this study, 17 non-demented PD patients underwent positron emission tomography (PET) imaging with [(18)F]-fluorodeoxyglucose to measure PDCP expression, and [(18)F]-fluoropropyl-β-CIT (FPCIT) to measure dopamine transporter (DAT) binding. Automated voxel-by-voxel searches of the FPCIT PET volumes were performed to identify regions in which DAT binding significantly correlated with PDCP expression values. The findings were validated using prespecified anatomical regions-of-interest (ROIs). Voxel-wise interrogation of the FPCIT PET scans revealed a single significant cluster in which DAT binding correlated with PDCP expression (p<0.05, corrected). This cluster was localized to the left caudate nucleus; an analogous correlation (r=-0.63, p<0.01) was also present in the "mirror" region of the right hemisphere. These findings were confirmed by the presence of a significant correlation (r=-0.67, p<0.005) between PDCP expression and DAT binding in caudate ROIs, which survived adjustment for age, disease duration, and clinical severity ratings. Correlation between caudate DAT binding and subject expression of the PD motor-related metabolic pattern was not significant (p>0.21). In summary, this study demonstrates a significant relationship between loss of dopaminergic input to the caudate nucleus and the expression of a cognition-related disease network in unmedicated PD patients. These baseline measures likely function in concert to determine the cognitive effects of dopaminergic therapy in PD.
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Affiliation(s)
- Martin Niethammer
- Center for Neurosciences, The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA.
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Yi DS, Bertoux M, Mioshi E, Hodges JR, Hornberger M. Fronto-striatal atrophy correlates of neuropsychiatric dysfunction in frontotemporal dementia (FTD) and Alzheimer's disease (AD). Dement Neuropsychol 2013; 7:75-82. [PMID: 29213823 PMCID: PMC5619548 DOI: 10.1590/s1980-57642013dn70100012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Behavioural disturbances in frontotemporal dementia (FTD) are thought to reflect mainly atrophy of cortical regions. Recent studies suggest that subcortical brain regions, in particular the striatum, are also significantly affected and this pathology might play a role in the generation of behavioural symptoms. OBJECTIVE To investigate prefrontal cortical and striatal atrophy contributions to behavioural symptoms in FTD. METHODS One hundred and eighty-two participants (87 FTD patients, 39 AD patients and 56 controls) were included. Behavioural profiles were established using the Cambridge Behavioural Inventory Revised (CBI-R) and Frontal System Behaviour Scale (FrSBe). Atrophy in prefrontal (VMPFC, DLPFC) and striatal (caudate, putamen) regions was established via a 5-point visual rating scale of the MRI scans. Behavioural scores were correlated with atrophy rating scores. RESULTS Behavioural and atrophy ratings demonstrated that patients were significantly impaired compared to controls, with bvFTD being most severely affected. Behavioural-anatomical correlations revealed that VMPFC atrophy was closely related to abnormal behaviour and motivation disturbances. Stereotypical behaviours were associated with both VMPFC and striatal atrophy. By contrast, disturbance of eating was found to be related to striatal atrophy only. CONCLUSION Frontal and striatal atrophy contributed to the behavioural disturbances seen in FTD, with some behaviours related to frontal, striatal or combined fronto-striatal pathology. Consideration of striatal contributions to the generation of behavioural disturbances should be taken into account when assessing patients with potential FTD.
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Affiliation(s)
- Dong Seok Yi
- Neuroscience Research Australia, Sydney, Australia
| | - Maxime Bertoux
- University Pierre and Marie Curie - Paris VI, Sorbonne Universités, Paris, France
| | - Eneida Mioshi
- Neuroscience Research Australia, Sydney, Australia. School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - John R Hodges
- Neuroscience Research Australia, Sydney, Australia. ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia. School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Michael Hornberger
- Neuroscience Research Australia, Sydney, Australia. ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia. School of Medical Sciences, University of New South Wales, Sydney, Australia
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Weickert TW, Leslie F, Rushby JA, Hodges JR, Hornberger M. Probabilistic association learning in frontotemporal dementia and schizophrenia. Cortex 2013; 49:101-6. [DOI: 10.1016/j.cortex.2011.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 09/05/2011] [Accepted: 09/28/2011] [Indexed: 11/17/2022]
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Nguyen T, Bertoux M, O’callaghan C, Ahmed S, Hodges J, Hornberger M. Grey and white matter brain network changes in frontotemporal dementia subtypes. Transl Neurosci 2013; 4. [DOI: 10.2478/s13380-013-0141-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
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Looi JC, Rajagopalan P, Walterfang M, Madsen SK, Thompson PM, Macfarlane MD, Ching C, Chua P, Velakoulis D. Differential putaminal morphology in Huntington's disease, Frontotemporal dementia and Alzheimer's disease. Aust N Z J Psychiatry 2012; 46:1145-58. [PMID: 22990433 PMCID: PMC4113021 DOI: 10.1177/0004867412457224] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Direct neuronal loss or deafferentation of the putamen, a critical hub in corticostriatal circuits, may result in diverse and distinct cognitive and motoric dysfunction in neurodegenerative disease. Differential putaminal morphology, as a quantitative measure of corticostriatal integrity, may thus be evident in Huntington's disease (HD), Alzheimer's disease (AD) and frontotemporal dementia (FTD), diseases with differential clinical dysfunction. METHODS HD (n = 17), FTD (n = 33) and AD (n = 13) patients were diagnosed according to international consensus criteria and, with healthy controls (n = 17), were scanned on the same MRI scanner. Patients underwent brief cognitive testing using the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG). Ten MRI scans from this dataset were manually segmented as a training set for the Adaboost algorithm, which automatically segmented all remaining scans for the putamen, yielding the following subset of the data: 9 left and 12 right putamen segmentations for AD; 25 left and 26 right putamina for FTD; 16 left and 15 right putamina for HD; 12 left and 12 right putamina for controls. Shape analysis was performed at each point on the surface of each structure using a multiple regression controlling for age and sex to compare radial distance across diagnostic groups. RESULTS Age, but not sex and intracranial volume (ICV), were significantly different in the segmentation subgroups by diagnosis. The AD group showed significantly poorer performance on cognitive testing than FTD. Mean putaminal volumes were HD < FTD < AD ≤ controls, controlling for age and ICV. The greatest putaminal shape deflation was evident in HD, followed by FTD, in regions corresponding to the interconnections to motoric cortex. CONCLUSIONS Differential patterns of putaminal atrophy in HD, FTD and AD, with relevance to corticostriatal circuits, suggest the putamen may be a suitable clinical biomarker in neurodegenerative disease.
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Affiliation(s)
- Jeffrey C.L. Looi
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychological and Addiction Medicine, Australian National University Medical School, Canberra, A.C.T., Australia,Correspondence: Associate Professor Jeffrey Looi, Research Centre for the Neurosciences of Ageing, Academic Unit of Psychological Medicine, ANU Medical School, Building 4, Level 2, Canberra Hospital, Garran A.C.T. 2605,
| | - Priya Rajagopalan
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA, USA
| | - Mark Walterfang
- Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, & University of Melbourne, Melbourne, VIC, Australia
| | - Sarah K. Madsen
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA, USA
| | - Paul M. Thompson
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA, USA
| | - Matthew D. Macfarlane
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychological and Addiction Medicine, Australian National University Medical School, Canberra, A.C.T., Australia
| | - Chris Ching
- Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA, USA
| | - Phyllis Chua
- School of Psychology and Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, & University of Melbourne, Melbourne, VIC, Australia
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Dalton MA, Weickert TW, Hodges JR, Piguet O, Hornberger M. Impaired acquisition rates of probabilistic associative learning in frontotemporal dementia is associated with fronto-striatal atrophy. Neuroimage Clin 2012; 2:56-62. [PMID: 24179759 PMCID: PMC3777677 DOI: 10.1016/j.nicl.2012.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 11/05/2012] [Accepted: 11/06/2012] [Indexed: 12/02/2022]
Abstract
Frontotemporal dementia (FTD) is classically considered to be a neurodegenerative disease with cortical changes. Recent structural imaging findings, however, highlight that subcortical and in particular striatal regions are also affected in the FTD syndrome. The influence of striatal pathology on cognitive and behavioural changes in FTD is virtually unexplored. In the current study we employ the Weather Prediction Task (WPT), a probabilistic learning task which taps into striatal dysfunction, in a group of FTD patients. We also regressed the patients' behavioural performance with their grey matter atrophy via voxel-based morphometry (VBM) to identify the grey matter contributions to WPT performance in FTD. Based on previous studies we expected to see striatal and frontal atrophy to be involved in impaired probabilistic learning. Our behavioural results show that patients performed on a similar level to controls overall, however, there was a large variability of patient performance in the first 30 trials of the task, which are critical in the acquisition of the probabilistic learning rules. A VBM analysis covarying the performance for the first 30 trials across participants showed that atrophy in striatal but also frontal brain regions correlated with WPT performance in these trials. Closer inspection of performance across the first 30 trials revealed a subgroup of FTD patients that performed significantly poorly than the remaining patients and controls on the WPT, despite achieving the same level of probabilistic learning as the other groups in later trials. Additional VBM analyses revealed that the subgroup of FTD patients with poor early probabilistic learning in the first 30 trials showed greater striatal atrophy compared to the remaining FTD patients and controls. These findings suggest that the integrity of fronto-striatal regions is important for probabilistic learning in FTD, with striatal integrity in particular, determining the acquisition learning rate. These findings will therefore have implications for developing an easily administered version of the probabilistic learning task which can be used by clinicians to assess striatal functioning in neurodegenerative syndromes.
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Affiliation(s)
- Marshall A. Dalton
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Thomas W. Weickert
- Neuroscience Research Australia, Sydney, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - John R. Hodges
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Olivier Piguet
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Michael Hornberger
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
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Ertekin T, Acer N, Içer S, Ilıca AT. Comparison of two methods for the estimation of subcortical volume and asymmetry using magnetic resonance imaging: a methodological study. Surg Radiol Anat 2012; 35:301-9. [DOI: 10.1007/s00276-012-1036-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Accepted: 10/25/2012] [Indexed: 01/18/2023]
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Lindberg O, Walterfang M, Looi JCL, Malykhin N, Ostberg P, Zandbelt B, Styner M, Paniagua B, Velakoulis D, Orndahl E, Wahlund LO. Hippocampal shape analysis in Alzheimer's disease and frontotemporal lobar degeneration subtypes. J Alzheimers Dis 2012; 30:355-65. [PMID: 22414571 DOI: 10.3233/jad-2012-112210] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hippocampal pathology is central to Alzheimer's disease (AD) and other forms of dementia such as frontotemporal lobar degeneration (FTLD). Autopsy studies have shown that certain hippocampal subfields are more vulnerable than others to AD and FTLD pathology, in particular the subiculum and cornu ammonis 1 (CA1). We conducted shape analysis of hippocampi segmented from structural T1 MRI images on clinically diagnosed dementia patients and controls. The subjects included 19 AD and 35 FTLD patients [13 frontotemporal dementia (FTD), 13 semantic dementia (SD), and 9 progressive nonfluent aphasia (PNFA)] and 21 controls. Compared to controls, SD displayed severe atrophy of the whole left hippocampus. PNFA and FTD also displayed atrophy on the left side, restricted to the hippocampal head in FTD. Finally, AD displayed most atrophy in left hippocampal body with relative sparing of the hippocampal head. Consistent with neuropathological studies, most atrophic deformation was found in CA1 and subiculum areas in FTLD and AD.
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Affiliation(s)
- Olof Lindberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
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Lindberg O, Manzouri A, Westman E, Wahlund LO. A comparison between volumetric data generated by voxel-based morphometry and manual parcellation of multimodal regions of the frontal lobe. AJNR Am J Neuroradiol 2012; 33:1957-63. [PMID: 22576892 DOI: 10.3174/ajnr.a3093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Volumetric measurements on structural MR images are an established method to investigate pathology-related volume changes in cortex. Manual volumetric methods have sometimes been referred to as the reference standard for quality control of automatic volumetric methods. While some automatic methods, like VBM, may rely on a template, manual methods use sulci as indirect landmarks for the subdivision of cortex. The purpose of this study was to compare volumetric data generated by MM and VBM on 4 multimodal regions in the frontal lobe. MATERIALS AND METHODS We investigated 4 multimodal frontocortical regions by MM and VBM in patients with frontotemporal lobar degeneration and Alzheimer disease and controls. RESULTS MM and VBM results were highly correlated for dorsolateral prefrontal cortex, orbitofrontal cortex, and hippocampus, but not for the dorsal and rostral anterior cingulate. VBM results were more consistent with results from previous studies on cingulate in frontotemporal lobar degeneration. Our results may potentially be explained by 2 factors. First, the volume of small cortical regions may be more affected by anatomic variability than large regions in the MM. Second, it has been shown that the location of multimodal cytoarchitectonic areas, such as the cingulate cortex, may be difficult to predict by the appearance of sulci and gyri. CONCLUSIONS While both VBM and the MM may do equally poorly in predicting cytoarchitecture, the MM may add additional unrelated variance caused by anatomic variability. Thus, paradoxically, the higher anatomic precision of the MM may potentially cause a weaker relation to cytoarchitecture.
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Affiliation(s)
- O Lindberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
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Looi JCL, Walterfang M, Velakoulis D, Macfarlane MD, Svensson LA, Wahlund LO. Frontotemporal dementia as a frontostriatal disorder: neostriatal morphology as a biomarker and structural basis for an endophenotype. Aust N Z J Psychiatry 2012; 46:422-34. [PMID: 22535292 DOI: 10.1177/0004867411432076] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This article reviews the evidence for a re-conceptualisation of a subtype of frontotemporal lobar degeneration (FTLD), frontotemporal dementia (FTD), as a frontostriatal disorder, working towards an endophenotype. METHOD We provide an overview of the role of frontostriatal circuits relevant to FTLD and FTD, as a subset of larger-scale distributed brain networks. We discuss the role of a strategic structure in these circuits, the neostriatum. Then we review the relationship of the clinical features of FTLD to frontostriatal circuits, correlating this with neuropsychological and neuropathological data. CONCLUSION The unique structure and linkages of the neostriatum make it an ideal structure for in vivo neuroimaging to understand the neuroanatomical basis of FTD. We develop a frontostriatal endophenotypic model for FTD as a platform for further investigation.
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Affiliation(s)
- Jeffrey C L Looi
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychological Medicine, Australian National University Medical School, Canberra Hospital, Canberra, Australia.
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Maltbie E, Bhatt K, Paniagua B, Smith RG, Graves MM, Mosconi MW, Peterson S, White S, Blocher J, El-Sayed M, Hazlett HC, Styner MA. Asymmetric bias in user guided segmentations of brain structures. Neuroimage 2012; 59:1315-23. [PMID: 21889995 PMCID: PMC3230681 DOI: 10.1016/j.neuroimage.2011.08.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 07/27/2011] [Accepted: 08/11/2011] [Indexed: 10/17/2022] Open
Abstract
Brain morphometric studies often incorporate comparative hemispheric asymmetry analyses of segmented brain structures. In this work, we present evidence that common user guided structural segmentation techniques exhibit strong left-right asymmetric biases and thus fundamentally influence any left-right asymmetry analyses. In this study, MRI scans from ten pediatric subjects were employed for studying segmentations of amygdala, globus pallidus, putamen, caudate, and lateral ventricle. Additionally, two pediatric and three adult scans were used for studying hippocampus segmentation. Segmentations of the sub-cortical structures were performed by skilled raters using standard manual and semi-automated methods. The left-right mirrored versions of each image were included in the data and segmented in a random order to assess potential left-right asymmetric bias. Using shape analysis we further assessed whether the asymmetric bias is consistent across subjects and raters with the focus on the hippocampus. The user guided segmentation techniques on the sub-cortical structures exhibited left-right asymmetric volume bias with the hippocampus displaying the most significant asymmetry values (p<<0.01). The hippocampal shape analysis revealed the bias to be strongest on the lateral side of the body and medial side of the head and tail. The origin of this asymmetric bias is considered to be based in laterality of visual perception; therefore segmentations with any degree of user interaction contain an asymmetric bias. The aim of our study is to raise awareness in the neuroimaging community regarding the presence of the asymmetric bias and its influence on any left-right hemispheric analyses. We also recommend reexamining previous research results in the light of this new finding.
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Affiliation(s)
- Eric Maltbie
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA.
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Looi JCL, Walterfang M, Styner M, Niethammer M, Svensson LA, Lindberg O, Ostberg P, Botes L, Orndahl E, Chua P, Velakoulis D, Wahlund LO. Shape analysis of the neostriatum in subtypes of frontotemporal lobar degeneration: neuroanatomically significant regional morphologic change. Psychiatry Res 2011; 191:98-111. [PMID: 21237621 DOI: 10.1016/j.pscychresns.2010.09.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Revised: 08/25/2010] [Accepted: 09/26/2010] [Indexed: 01/11/2023]
Abstract
Frontostriatal circuit mediated cognitive dysfunction has been implicated in frontotemporal lobar degeneration (FTLD) and may differ across subtypes of FTLD. We manually segmented the neostriatum (caudate nucleus and putamen) in FTLD subtypes: behavioral variant frontotemporal dementia, FTD, n=12; semantic dementia, SD, n=13; and progressive non-fluent aphasia, PNFA, n=9); in comparison with controls (n=27). Diagnoses were based on international consensus criteria. Manual bilateral segmentation of the caudate nucleus and putamen was conducted blind to diagnosis by a single analyst, on MRI scans using a standardized protocol. Intracranial volume was calculated via a stereological point counting technique and was used for normalizing the shape analysis. Segmented binaries were analyzed using the Spherical Harmonic (SPHARM) Shape Analysis tools (University of North Carolina) to perform comparisons between FTLD subtypes and controls for global shape difference, local significance maps and mean magnitude maps of shape displacement. Shape analysis revealed that there was significant shape difference between FTLD subtypes and controls, consistent with the predicted frontostriatal dysfunction and of significant magnitude, as measured by displacement maps. These differences were not significant for SD compared to controls; lesser for PNFA compared to controls; whilst FTD showed a more specific pattern in regions relaying fronto- and corticostriatal circuits. Shape analysis shows regional specificity of atrophy, manifest as shape deflation, with a differential between FTLD subtypes, compared to controls.
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Affiliation(s)
- Jeffrey Chee Leong Looi
- Research Centre for the Neurosciences of Ageing, Australian National University Medical School, Canberra Hospital, Canberra, Australia.
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Looi JCL, Walterfang M, Styner M, Svensson L, Lindberg O, Ostberg P, Botes L, Orndahl E, Chua P, Kumar R, Velakoulis D, Wahlund LO. Shape analysis of the neostriatum in frontotemporal lobar degeneration, Alzheimer's disease, and controls. Neuroimage 2010; 51:970-86. [PMID: 20156566 DOI: 10.1016/j.neuroimage.2010.02.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Revised: 01/07/2010] [Accepted: 02/08/2010] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND PURPOSE Frontostriatal circuit mediated cognitive dysfunction has been implicated in frontotemporal lobar degeneration (FTLD), but not Alzheimer's disease, or healthy aging. We measured the neostriatum (caudate nucleus and putamen) volume in FTLD (n=34), in comparison with controls (n=27) and Alzheimer's disease (AD, n=19) subjects. METHODS Diagnoses were based on international consensus criteria. Manual bilateral segmentation of the caudate nucleus and putamen was conducted blind to diagnosis by a single analyst, on MRI scans using a standardized protocol. Intra-cranial volume was calculated via a stereological point counting technique and was used for scaling the shape analysis. The manual segmentation binaries were analyzed using UNC Shape Analysis tools (University of North Carolina) to perform comparisons among FTLD, AD, and controls for global shape, local p-value significance maps, and mean magnitude of shape displacement. RESULTS Shape analysis revealed that there was significant shape difference between FTLD, AD, and controls, consistent with the predicted frontostriatal dysfunction and of significant magnitude, as measured by displacement maps. There was a lateralized difference in shape for the left caudate for FTLD compared to AD; non-specific global atrophy in AD compared to controls; while FTLD showed a more specific pattern in regions relaying fronto- and corticostriatal circuits. CONCLUSIONS Shape analysis shows regional specificity of atrophy, manifest as shape deflation, with implications for frontostriatal and corticostriatal motoric circuits, in FTLD, AD, and controls.
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Affiliation(s)
- Jeffrey Chee Leong Looi
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychological Medicine, Australian National University Medical School, Canberra Hospital, Canberra, Australia.
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Seelaar H, Klijnsma KY, de Koning I, van der Lugt A, Chiu WZ, Azmani A, Rozemuller AJM, van Swieten JC. Frequency of ubiquitin and FUS-positive, TDP-43-negative frontotemporal lobar degeneration. J Neurol 2009; 257:747-53. [PMID: 19946779 PMCID: PMC2864899 DOI: 10.1007/s00415-009-5404-z] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Revised: 10/23/2009] [Accepted: 11/16/2009] [Indexed: 01/04/2023]
Abstract
Frontotemporal lobar degeneration (FTLD) is a clinically, genetically and pathologically heterogeneous disorder. Within FTLD with ubiquitin-positive inclusions (FTLD-U), a new pathological subtype named FTLD-FUS was recently found with fused in sarcoma (FUS) positive, TDP-43-negative inclusions, and striking atrophy of the caudate nucleus. The aim of this study was to determine the frequency of FTLD-FUS in our pathological FTLD series, and to describe the clinical, neuroimaging and neuropathological features of FTLD-FUS, especially caudate atrophy. Demographic and clinical data collected prospectively from 387 patients with frontotemporal dementia (FTD) yielded 74 brain specimens. Immunostaining was carried out using a panel of antibodies, including AT-8, ubiquitin, p62, FUS, and TDP-43. Cortical and caudate atrophy on MRI (n = 136) was rated as normal, mild-moderate or severe. Of the 37 FTLD-U cases, 33 were reclassified as FTLD-TDP and four (0.11, 95%: 0.00-0.21) as FTLD-FUS, with ubiquitin and FUS-positive, p62 and TDP-43-negative neuronal intranuclear inclusions (NII). All four FTLD-FUS cases had a negative family history, behavioural variant FTD (bvFTD), and three had an age at onset <or=40 years. MRI revealed mild-moderate or severe caudate atrophy in all, with a mean duration from onset till MRI of 63 months (range 16-119 months). In our total clinical FTD cohort, we found 11 patients (0.03; 95% CI: 0.01-0.05) with bvFTD, negative family history, and age at onset <or=40 years. Caudate atrophy was present in 10 out of 136 MRIs, and included all four FUS-cases. The newly identified FTLD-FUS has a frequency of 11% in FTLD-U, and an estimated frequency of three percent in our clinical FTD cohort. The existence of this pathological subtype can be predicted with reasonable certainty by age at onset <or=40 years, negative family history, bvFTD and caudate atrophy on MRI.
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Affiliation(s)
- Harro Seelaar
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, Room Hs 611, s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
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Looi JCL, Tatham V, Kumar R, Maller JJ, Millard E, Wen W, Chen X, Brodaty H, Sachdev P. Caudate nucleus volumes in stroke and vascular dementia. Psychiatry Res 2009; 174:67-75. [PMID: 19796921 DOI: 10.1016/j.pscychresns.2009.04.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Revised: 01/19/2009] [Accepted: 04/15/2009] [Indexed: 11/30/2022]
Abstract
We aimed to assess the volume of the nucleus caudatus as a neuroanatomical substrate of fronto-subcortical circuits, in stroke patients with/without dementia, and the relationship to potential determinants of neural circuit integrity such as white matter hyperintensities (WMH) and stroke volume. Stroke only (Stroke) (n=19) and stroke with Vascular Dementia (VaD) (n=16) and healthy control (n=20) subjects, matched on demographic variables, underwent extensive neuropsychiatric assessments and manual MRI-based volumetric measurements for intracranial area (ICA), stroke volume, and bilateral caudate volume. WMH on MRI were quantified using an automated algorithm. Multivariate analysis of covariance (controlling for age and ICA), revealed that across the three groups, caudate volumes were significantly different. There was a significant difference in bilateral caudate nucleus volume between subjects by diagnosis (Stroke, VaD, control). The control group was largest in overall mean volume of the diagnostic groups, followed by the Stroke group (86% of controls), and finally, the VaD group (72%). There was a partial correlation between total caudate volume and the total volume of deep WMH including periventricular regions and brainstem, controlling for ICA; and for total stroke volume. Stroke patients with VaD have smaller caudate nuclei compared to those without dementia and healthy controls, with the stroke-only patients being intermediate in their caudate volume status. There was preliminary evidence of negative correlation of caudate volume with volume of deep WMH and total stroke volume, suggesting cerebrovascular disease contributes to caudate atrophy,which, in turn may disrupt fronto-subcortical circuits.
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Affiliation(s)
- Jeffrey Chee Leong Looi
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychological Medicine, Australian National University Medical School, Building 4, Level 2, The Canberra Hospital, P.O. Box 11, Woden Australian Capital Territory 2605, Australia.
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Kumar R, Ahdout R, Macey PM, Woo MA, Avedissian C, Thompson PM, Harper RM. Reduced caudate nuclei volumes in patients with congenital central hypoventilation syndrome. Neuroscience 2009; 163:1373-9. [PMID: 19632307 DOI: 10.1016/j.neuroscience.2009.07.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Revised: 07/16/2009] [Accepted: 07/18/2009] [Indexed: 10/20/2022]
Abstract
Congenital central hypoventilation syndrome (CCHS) children show cognitive and affective deficits, in addition to state-specific loss of respiratory drive. The caudate nuclei serve motor, cognitive, and affective roles, and show structural deficits in CCHS patients, based on gross voxel-based analytic procedures. However, the magnitude and regional sites of caudate injury in CCHS are unclear. We assessed global caudate nuclei volumes with manual volumetric procedures, and regional volume differences with three-dimensional surface morphometry in 14 CCHS (mean age+/-SD: 15.1+/-2.3 years; 8 male) and 31 control children (15.1+/-2.4 years; 17 male) using brain magnetic resonance imaging (MRI). Two high-resolution T1-weighted image series were collected using a 3.0 Tesla MRI scanner; images were averaged and reoriented (rigid-body transformation) to common space. Both left and right caudate nuclei were outlined in the reoriented images, and global volumes calculated; surface models were derived from manually-outlined caudate structures. Global caudate nuclei volume differences between groups were evaluated using a multivariate analysis of covariance (covariates: age, gender, and total intracranial volume). Both left and right caudate nuclei volumes were significantly reduced in CCHS over control subjects (left, 4293.45+/-549.05 vs. 4626.87+/-593.41 mm(3), P<0.006; right, 4376.29+/-565.42 vs. 4747.81+/-578.13 mm(3), P<0.004). Regional deficits in CCHS caudate volume appeared bilaterally, in the rostral head, ventrolateral mid, and caudal body. Damaged caudate nuclei may contribute to CCHS neuropsychological and motor deficits; hypoxic processes, or maldevelopment in the condition may underlie the injury.
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Affiliation(s)
- R Kumar
- Department of Neurobiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA
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Garibotto V, Borroni B, Agosti C, Premi E, Alberici A, Eickhoff SB, Brambati SM, Bellelli G, Gasparotti R, Perani D, Padovani A. Subcortical and deep cortical atrophy in Frontotemporal Lobar Degeneration. Neurobiol Aging 2011; 32:875-84. [PMID: 19501427 DOI: 10.1016/j.neurobiolaging.2009.05.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Revised: 02/20/2009] [Accepted: 05/04/2009] [Indexed: 11/21/2022]
Abstract
Though neuroimaging, pathology and pathophysiology suggest a subcortical and deep cortical involvement in Frontotemporal Lobar Degeneration (FTLD), no studies have comprehensively assessed the associated gray matter (GM) volume changes. We measured caudate, putamen, thalamus, and amygdala GM volume using probabilistic a-priori regions of interest (ROIs) in 53 early FTLD patients (38 behavioral variant FTD [bvFTD], 9 Semantic Dementia [SD], 6 Progressive Non-Fluent Aphasia [PNFA]), and 25 age-matched healthy controls (HC). ANOVA showed significant (P<0.001) main effect of diagnosis, and significant interactions for diagnosis and region, and diagnosis and hemisphere. Post-hoc comparisons with HC showed bilateral GM atrophy in the caudate, putamen and thalamus, in bvFTD; a left-confined GM reduction in the amygdala in SD; and bilateral GM atrophy in the caudate and thalamus, and left-sided GM reduction in the putamen and amygdala in PNFA. Correlation analyses suggested an association between GM volumes and language, psychomotor speed and behavioral disturbances. This study showed a widespread involvement of subcortical and deep cortical GM in early FTLD with patterns specific for clinical entity.
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Looi JCL, Svensson L, Lindberg O, Zandbelt BB, Ostberg P, Orndahl E, Wahlund LO. Putaminal volume in frontotemporal lobar degeneration and Alzheimer disease: differential volumes in dementia subtypes and controls. AJNR Am J Neuroradiol 2009; 30:1552-60. [PMID: 19497964 DOI: 10.3174/ajnr.a1640] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Frontostriatal (including the putamen) circuit-mediated cognitive dysfunction has been implicated in frontotemporal lobar degeneration (FTLD), but not in Alzheimer disease (AD) or healthy aging. We sought to assess putaminal volume as a measure of the structural basis of relative frontostriatal dysfunction in these groups. MATERIALS AND METHODS We measured putaminal volume in FTLD subtypes: frontotemporal dementia (FTD, n = 12), semantic dementia (SD, n = 13), and progressive nonfluent aphasia (PNFA, n = 9) in comparison with healthy controls (n = 25) and patients with AD (n = 18). Diagnoses were based on accepted clinical criteria. We conducted manual volume measurement of the putamen blinded to the diagnosis on T1 brain MR imaging by using a standardized protocol. RESULTS Paired t tests (P < .05) showed that the left putaminal volume was significantly larger than the right in all groups combined. Multivariate analysis of covariance with a Bonferroni correction was used to assess statistical significance among the subject groups (AD, FTD, SD, PNFA, and controls) as independent variables and right/left putaminal volumes as dependent variables (covariates, age and intracranial volume; P < .05). The right putamen in FTD was significantly smaller than in AD and controls; whereas in SD, it was smaller compared with controls with a trend toward being smaller than in AD. There was also a trend toward the putamen in the PNFA being smaller than that in controls and in patients with AD. Across the groups, there was a positive partial correlation between putaminal volume and Mini-Mental State Examination (MMSE). CONCLUSIONS Right putaminal volume was significantly smaller in FTD, the FTLD subtype with the greatest expected frontostriatal dysfunction; whereas in SD and PNFA, it showed a trend towards being smaller, consistent with expectation, compared to controls and AD; and in SD, compared with AD and controls. Putaminal volume weakly correlated with MMSE.
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Affiliation(s)
- J C L Looi
- Academic Unit of Psychological Medicine, Research Centre for the Neurosciences of Ageing, Australian National University Medical School, Canberra Hospital, Canberra, Australia.
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