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Foucher J, Öijerstedt L, Lovik A, Sun J, Ismail MAM, Sennfält S, Savitcheva I, Estenberg U, Pagani M, Fang F, Pereira JB, Ingre C. ECAS correlation with metabolic alterations on FDG-PET imaging in ALS. Amyotroph Lateral Scler Frontotemporal Degener 2024:1-9. [PMID: 38836336 DOI: 10.1080/21678421.2024.2361695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/17/2024] [Indexed: 06/06/2024]
Abstract
Background: Cognitive impairment is observed in up to 50% of patients with amyotrophic lateral sclerosis (ALS). The Edinburgh Cognitive and Behavioral ALS Screen (ECAS) is an ALS-specific multi-domain screening tool. Few studies have examined the relationship between ECAS scores and [18F]fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) findings. Objective: To assess the relationship between ECAS scores and glucose metabolism patterns on [18F]FDG -PET images in ALS. Methods: We collected [18F]FDG-PET images from 65 patients with ALS and 39 healthy controls. ECAS scores were collected on all patients and we calculated the correlation to [18F]FDG-PET in order to investigate the potential links between cognition and glucose metabolism. Results: We observed hypometabolism in the frontal cortex, insula, and limbic system, together with hypermetabolism in the cerebellum in patients with ALS compared to controls. A lower ECAS total score was associated with lower glucose metabolism in the right orbitofrontal gyrus and higher glucose metabolism in lateral occipital, medial occipital, and cerebellar regions, among patients with ALS. Similar results, although less widespread, were observed in the analyses of ECAS ALS-specific scores. Conclusions: The metabolic patterns in [18F]FDG -PET show that changes in the glucose metabolism of corresponding areas are related to cognitive dysfunction in ALS, and can be detected using the ECAS.
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Affiliation(s)
- Juliette Foucher
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, ME Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Linn Öijerstedt
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, ME Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Anikó Lovik
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Methodology and Statistics Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Jiawei Sun
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Muhammad-Al-Mustafa Ismail
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, ME Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Stefan Sennfält
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, ME Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Irina Savitcheva
- Medical Radiation Physics and Nuclear Medicine Imaging, Section for Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden, and
| | - Ulrika Estenberg
- Medical Radiation Physics and Nuclear Medicine Imaging, Section for Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden, and
| | - Marco Pagani
- Medical Radiation Physics and Nuclear Medicine Imaging, Section for Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden, and
- Institute of Cognitive Sciences and Technologies, Italian National Research Council, Rome, Italy
| | - Fang Fang
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Joana B Pereira
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Caroline Ingre
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, ME Neurology, Karolinska University Hospital, Stockholm, Sweden
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Cayir S, Volpi T, Toyonaga T, Gallezot JD, Yang Y, Sadabad FE, Mulnix T, Mecca AP, Fesharaki-Zadeh A, Matuskey D. Relationship between neuroimaging and cognition in frontotemporal dementia: An FDG-PET and structural MRI study. J Neuroimaging 2024. [PMID: 38676301 DOI: 10.1111/jon.13206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/14/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND AND PURPOSE Frontotemporal dementia (FTD) is a clinically and pathologically heterogeneous neurodegenerative condition with a prevalence comparable to Alzheimer's disease for patients under 65 years of age. Limited studies have examined the association between cognition and neuroimaging in FTD using different imaging modalities. METHODS We examined the association of cognition using Montreal Cognitive Assessment (MoCA) with both gray matter (GM) volume and glucose metabolism using magnetic resonance imaging and fluorodeoxyglucose (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 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 = 0.46, p = .04). The association between whole-cortex FDG SUVR and MoCA scores was not significant (r = 0.37, p = .09). GM volumes of the frontal cortex (r = 0.54, p = .01), caudate (r = 0.62, p<.01), and insula (r = 0.57, p<.01) were also significantly correlated with MoCA, as were SUVR values of the insula (r = 0.51, p = .02), thalamus (r = 0.48, p = .03), and posterior cingulate cortex (PCC) (r = 0.47, p = .03). CONCLUSIONS Whole-cortex atrophy is associated with cognitive dysfunction, and this association is larger than for whole-cortex hypometabolism as measured with FDG-PET. At the regional level, focal atrophy and/or hypometabolism in the frontal cortex, insula, PCC, thalamus, and caudate seem to be important 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.
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Affiliation(s)
- Salih Cayir
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Tommaso Volpi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Takuya Toyonaga
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jean-Dominique Gallezot
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Yanghong Yang
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Faranak Ebrahimian Sadabad
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Tim Mulnix
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Adam P Mecca
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Arman Fesharaki-Zadeh
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - David Matuskey
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
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3
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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. RESEARCH SQUARE 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] [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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Hypometabolic and hypermetabolic brain regions in patients with ALS-FTD show distinct patterns of grey and white matter degeneration: A pilot multimodal neuroimaging study. Eur J Radiol 2023; 158:110616. [PMID: 36493498 DOI: 10.1016/j.ejrad.2022.110616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/05/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Up to 50% of amyotrophic lateral sclerosis (ALS) patients develop some degree of cognitive dysfunction and a small proportion of these develop frontotemporal dementia (FTD). Non-invasive techniques of magnetic resonance imaging (MRI) and [18F]-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography (PET) have demonstrated structural and metabolic abnormalities, respectively, in the brains of such patients with ALS-FTD. Although initial 18F-FDG PET studies in ALS patients showed only hypometabolism of motor and extramotor brain regions, subsequent studies have demonstrated hypermetabolic changes as well. Such contrasting findings prompted us to hypothesize that hypo- and hypermetabolic brain regions in ALS-FTD patients are associated with divergent degeneration of structural grey matter (GM) and white matter (WM). METHODS Cerebral glucose metabolic rate (CMRglc), cortical thickness (CT), fractal dimension (FD), and graph theory WM network analyses were performed on clinical MRI and 18F-FDG PET images from 8 ALS-FTD patients and 14 neurologic controls to explore the relationship between GM-WM degeneration and hypo- and hypermetabolic brain regions. RESULTS CMRglc revealed significant hypometabolism in frontal and precentral gyrus brain regions, with hypermetabolism in temporal, occipital and cerebellar regions. Cortical thinning was noted in both hypo- and hypermetabolic brain areas. Unlike CT, FD did not reveal widespread GM degeneration in hypo- and hypermetabolic brain regions of ALS-FTD patients. Graph theory analysis showed severe WM degeneration in hypometabolic but not hypermetabolic areas, especially in the right hemisphere. CONCLUSION Our multimodal MRI-PET study provides insights into potentially differential pathophysiological mechanisms between hypo- and hypermetabolic brain regions of ALS-FTD patients.
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Aiello EN, Feroldi S, De Luca G, Guidotti L, Arrigoni E, Appollonio I, Solca F, Carelli L, Poletti B, Verde F, Silani V, Ticozzi N. Primary progressive aphasia and motor neuron disease: A review. Front Aging Neurosci 2022; 14:1003792. [PMID: 36158556 PMCID: PMC9492890 DOI: 10.3389/fnagi.2022.1003792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/24/2022] [Indexed: 11/30/2022] Open
Abstract
Background This study aims at reviewing, within the framework of motor neuron disease-frontotemporal degeneration (MND-FTD)-spectrum disorders, evidence on the co-occurrence between primary progressive aphasia (PPA) and MND in order to profile such a complex at pathological, genetic and clinical levels. Methods This review was pre-registered (osf.io/ds8m4) and performed in accordance with the 2020 PRISMA guidelines. Case reports/series and group studies were included if addressing (1) progressive non-fluent aphasia (PNFA) or semantic dementia (SD) with MND or (2) MND patients with co-morbid PNFA/SD. Results Out of 546 initial records, 56 studies were included. As to case reports/series (N = 35), which included 61 PPA-MND patients, the following findings yielded: (1) PNFA is more frequent than SD in PPA-MND; (2) in PPA-MND, the most prevalent motor phenotypes are amyotrophic lateral sclerosis and predominant-upper MND, with bulbar involvement being ubiquitous; (3) extrapyramidal features are moderately frequent in PPA-MND; (4) PPA-MND patients usually display frontotemporal, left-greater-than-right involvement; (5) TDP-43-B is the typical pathological substrate of PPA-MND; (6) TBK1 mutations represent the most frequent genetic risk factors for PPA-MND. As to group studies, including 121 patients, proportional meta-analytic procedures revealed that: (1) the lifetime prevalence of MND in PPA is 6%; (2) PPA occurs in 19% of patients with co-morbid MND and FTD; (3) MND is more frequent in PNFA (10%) than in SD patients (3%). Discussion Insights herewith delivered into the clinical, neuropathological and genetic features of PPA-MND patients prompt further investigations aimed at improving clinical practice within the MND-FTD spectrum.
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Affiliation(s)
- Edoardo Nicolò Aiello
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- *Correspondence: Edoardo Nicolò Aiello,
| | - Sarah Feroldi
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giulia De Luca
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Lucilla Guidotti
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Eleonora Arrigoni
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Ildebrando Appollonio
- Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Federica Solca
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Laura Carelli
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Federico Verde
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, Università degli Studi di Milano, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, Università degli Studi di Milano, Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, Università degli Studi di Milano, Milan, Italy
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Hinault T, Segobin S, Benbrika S, Carluer L, Doidy F, Eustache F, Viader F, Desgranges B. Longitudinal grey matter and metabolic contributions to cognitive changes in amyotrophic lateral sclerosis. Brain Commun 2022; 4:fcac228. [PMID: 36128222 PMCID: PMC9478152 DOI: 10.1093/braincomms/fcac228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/13/2022] [Accepted: 09/05/2022] [Indexed: 12/05/2022] Open
Abstract
Amyotrophic lateral sclerosis is characterized by rapidly evolving cognitive and brain impairments. While previous work revealed structural and functional alterations associated with cognitive decline in patients suffering from amyotrophic lateral sclerosis, the relationships between anatomo-functional changes and both disease's progression and the evolution of cognitive performance remain largely unexplored. Here, we took advantage of repeated multi-modal acquisitions in patients with amyotrophic lateral sclerosis over 1 year to assess the longitudinal sequence of grey matter atrophy, glucose metabolism and cognitive changes. Results revealed metabolic and structural changes over frontal, thalamic and temporal regions. Both cortical hypermetabolism and hypometabolism (right temporal gyrus and right angular gyrus, respectively) were associated with cognitive performance and thalamic hypometabolism during the follow-up testing session. Furthermore, the inferior frontal gyrus atrophy mediated the relation between early hypometabolism in this region and the subsequent decline of the theory of mind abilities. Marked volume loss was associated with larger hypometabolism and impaired cognitive performance. To our knowledge, this is the first study to longitudinally examine both grey matter volume and metabolic alteration patterns in patients with amyotrophic lateral sclerosis, over a mean follow-up time of 1 year. We identify how changes of the inferior frontal gyrus critically underly later cognitive performance, shedding new light on its high prognostic significance for amyotrophic lateral sclerosis-related changes. These results have important implications for our understanding of structural and functional changes associated with amyotrophic lateral sclerosis and how they underly cognitive impairments.
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Affiliation(s)
- Thomas Hinault
- Normandie University, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine (NIMH), Caen 14032, France
| | - Shailendra Segobin
- Normandie University, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine (NIMH), Caen 14032, France
| | - Soumia Benbrika
- Normandie University, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine (NIMH), Caen 14032, France
| | - Laurence Carluer
- Normandie University, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine (NIMH), Caen 14032, France
| | - Franck Doidy
- Normandie University, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine (NIMH), Caen 14032, France
| | - Francis Eustache
- Normandie University, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine (NIMH), Caen 14032, France
| | - Fausto Viader
- Normandie University, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine (NIMH), Caen 14032, France
| | - Béatrice Desgranges
- Normandie University, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine (NIMH), Caen 14032, France
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Ondaro J, Hernandez-Eguiazu H, Garciandia-Arcelus M, Loera-Valencia R, Rodriguez-Gómez L, Jiménez-Zúñiga A, Goikolea J, Rodriguez-Rodriguez P, Ruiz-Martinez J, Moreno F, Lopez de Munain A, Holt IJ, Gil-Bea FJ, Gereñu G. Defects of Nutrient Signaling and Autophagy in Neurodegeneration. Front Cell Dev Biol 2022; 10:836196. [PMID: 35419363 PMCID: PMC8996160 DOI: 10.3389/fcell.2022.836196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/21/2022] [Indexed: 12/27/2022] Open
Abstract
Neurons are post-mitotic cells that allocate huge amounts of energy to the synthesis of new organelles and molecules, neurotransmission and to the maintenance of redox homeostasis. In neurons, autophagy is not only crucial to ensure organelle renewal but it is also essential to balance nutritional needs through the mobilization of internal energy stores. A delicate crosstalk between the pathways that sense nutritional status of the cell and the autophagic processes to recycle organelles and macronutrients is fundamental to guarantee the proper functioning of the neuron in times of energy scarcity. This review provides a detailed overview of the pathways and processes involved in the balance of cellular energy mediated by autophagy, which when defective, precipitate the neurodegenerative cascade of Parkinson’s disease, frontotemporal dementia, amyotrophic lateral sclerosis or Alzheimer’s disease.
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Affiliation(s)
- Jon Ondaro
- Department of Neuroscience, Biodonostia Health Research Institute (IIS Biodonostia), San Sebastian, Spain.,Center for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Haizea Hernandez-Eguiazu
- Department of Neuroscience, Biodonostia Health Research Institute (IIS Biodonostia), San Sebastian, Spain.,Center for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Maddi Garciandia-Arcelus
- Department of Neuroscience, Biodonostia Health Research Institute (IIS Biodonostia), San Sebastian, Spain.,Center for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Raúl Loera-Valencia
- Department of Neurology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet (KI), Stockholm, Sweden
| | - Laura Rodriguez-Gómez
- Department of Neuroscience, Biodonostia Health Research Institute (IIS Biodonostia), San Sebastian, Spain.,Center for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Andrés Jiménez-Zúñiga
- Department of Neuroscience, Biodonostia Health Research Institute (IIS Biodonostia), San Sebastian, Spain.,Center for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Julen Goikolea
- Department of Neurology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet (KI), Stockholm, Sweden
| | - Patricia Rodriguez-Rodriguez
- Department of Neurology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet (KI), Stockholm, Sweden
| | - Javier Ruiz-Martinez
- Department of Neuroscience, Biodonostia Health Research Institute (IIS Biodonostia), San Sebastian, Spain.,Center for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Donostia University Hospital, San Sebastian, Spain
| | - Fermín Moreno
- Department of Neuroscience, Biodonostia Health Research Institute (IIS Biodonostia), San Sebastian, Spain.,Center for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Donostia University Hospital, San Sebastian, Spain
| | - Adolfo Lopez de Munain
- Department of Neuroscience, Biodonostia Health Research Institute (IIS Biodonostia), San Sebastian, Spain.,Center for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Donostia University Hospital, San Sebastian, Spain
| | - Ian James Holt
- Department of Neuroscience, Biodonostia Health Research Institute (IIS Biodonostia), San Sebastian, Spain.,Center for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom.,IKERBASQUE Basque Foundation for Science, Bilbao, Spain
| | - Francisco Javier Gil-Bea
- Department of Neuroscience, Biodonostia Health Research Institute (IIS Biodonostia), San Sebastian, Spain.,Center for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Gorka Gereñu
- Department of Neuroscience, Biodonostia Health Research Institute (IIS Biodonostia), San Sebastian, Spain.,Center for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Department of Physiology, Faculty of Medicine and Nursing, University of Basque Country (UPV-EHU), Leioa, Spain
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8
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Temp AGM, Naumann M, Hermann A, Glaß H. Applied Bayesian Approaches for Research in Motor Neuron Disease. Front Neurol 2022; 13:796777. [PMID: 35401404 PMCID: PMC8987707 DOI: 10.3389/fneur.2022.796777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
Statistical evaluation of empirical data is the basis of the modern scientific method. Available tools include various hypothesis tests for specific data structures, as well as methods that are used to quantify the uncertainty of an obtained result. Statistics are pivotal, but many misconceptions arise due to their complexity and difficult-to-acquire mathematical background. Even though most studies rely on a frequentist interpretation of statistical readouts, the application of Bayesian statistics has increased due to the availability of easy-to-use software suites and an increased outreach favouring this topic in the scientific community. Bayesian statistics take our prior knowledge together with the obtained data to express a degree of belief how likely a certain event is. Bayes factor hypothesis testing (BFHT) provides a straightforward method to evaluate multiple hypotheses at the same time and provides evidence that favors the null hypothesis or alternative hypothesis. In the present perspective, we show the merits of BFHT for three different use cases, including a clinical trial, basic research as well as a single case study. Here we show that Bayesian statistics is a viable addition of a scientist's statistical toolset, which can help to interpret data.
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Affiliation(s)
- Anna G. M. Temp
- Translational Neurodegeneration Section “Albrecht Kossel,” Department of Neurology, University Medical Centre, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
- Neurozentrum, Berufsgenossenschaftliches Klinikum Hamburg, Hamburg, Germany
- *Correspondence: Anna G. M. Temp ; orcid.org/0000-0003-0671-121X
| | - Marcel Naumann
- Translational Neurodegeneration Section “Albrecht Kossel,” Department of Neurology, University Medical Centre, Rostock, Germany
| | - Andreas Hermann
- Translational Neurodegeneration Section “Albrecht Kossel,” Department of Neurology, University Medical Centre, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
- Center for Transdisciplinary Neurosciences Rostock, University Medical Centre, Rostock, Germany
| | - Hannes Glaß
- Translational Neurodegeneration Section “Albrecht Kossel,” Department of Neurology, University Medical Centre, Rostock, Germany
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Whatley BP, Winston JS, Allen LA, Vos SB, Jha A, Scott CA, Smith AL, Chowdhury FA, Bomanji JB, Lhatoo SD, Harper RM, Diehl B. Distinct Patterns of Brain Metabolism in Patients at Risk of Sudden Unexpected Death in Epilepsy. Front Neurol 2021; 12:623358. [PMID: 34899550 PMCID: PMC8651549 DOI: 10.3389/fneur.2021.623358] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 10/25/2021] [Indexed: 12/21/2022] Open
Abstract
Objective: To characterize regional brain metabolic differences in patients at high risk of sudden unexpected death in epilepsy (SUDEP), using fluorine-18-fluorodeoxyglucose positron emission tomography (18FDG-PET). Methods: We studied patients with refractory focal epilepsy at high (n = 56) and low (n = 69) risk of SUDEP who underwent interictal 18FDG-PET as part of their pre-surgical evaluation. Binary SUDEP risk was ascertained by thresholding frequency of focal to bilateral tonic-clonic seizures (FBTCS). A whole brain analysis was employed to explore regional differences in interictal metabolic patterns. We contrasted these findings with regional brain metabolism more directly related to frequency of FBTCS. Results: Regions associated with cardiorespiratory and somatomotor regulation differed in interictal metabolism. In patients at relatively high risk of SUDEP, fluorodeoxyglucose (FDG) uptake was increased in the basal ganglia, ventral diencephalon, midbrain, pons, and deep cerebellar nuclei; uptake was decreased in the left planum temporale. These patterns were distinct from the effect of FBTCS frequency, where increasing frequency was associated with decreased uptake in bilateral medial superior frontal gyri, extending into the left dorsal anterior cingulate cortex. Significance: Regions critical to cardiorespiratory and somatomotor regulation and to recovery from vital challenges show altered interictal metabolic activity in patients with frequent FBTCS considered to be at relatively high-risk of SUDEP, and shed light on the processes that may predispose patients to SUDEP.
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Affiliation(s)
- Benjamin P Whatley
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom.,Division of Neurology, Dalhousie University, Halifax, NS, Canada
| | - Joel S Winston
- Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Wellcome Trust Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, United Kingdom.,Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Clinical Neurophysiology, King's College Hospital, London, United Kingdom
| | - Luke A Allen
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom.,Epilepsy Society MRI Unit, Chalfont St Peter, United Kingdom.,The Center for SUDEP Research, National Institutes of Neurological Disorders and Stroke, Bethesda, MD, United States
| | - Sjoerd B Vos
- Epilepsy Society MRI Unit, Chalfont St Peter, United Kingdom.,The Center for SUDEP Research, National Institutes of Neurological Disorders and Stroke, Bethesda, MD, United States.,Neuroradiological Academic Unit, Queen Square Institute of Neurology, University College London, London, United Kingdom.,Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Ashwani Jha
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Catherine A Scott
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom.,The Center for SUDEP Research, National Institutes of Neurological Disorders and Stroke, Bethesda, MD, United States
| | - April-Louise Smith
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Fahmida A Chowdhury
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Jamshed B Bomanji
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Samden D Lhatoo
- The Center for SUDEP Research, National Institutes of Neurological Disorders and Stroke, Bethesda, MD, United States.,Epilepsy Center, Neurological Institute, University Hospitals Case Medical Center, Cleveland, OH, United States.,Department of Neurology, University of Texas Health Sciences Center at Houston, Houston, TX, United States
| | - Ronald M Harper
- The Center for SUDEP Research, National Institutes of Neurological Disorders and Stroke, Bethesda, MD, United States.,Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Neurobiology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, United States
| | - Beate Diehl
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom.,Epilepsy Society MRI Unit, Chalfont St Peter, United Kingdom.,The Center for SUDEP Research, National Institutes of Neurological Disorders and Stroke, Bethesda, MD, United States
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10
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Ssali T, Anazodo UC, Narciso L, Liu L, Jesso S, Richardson L, Günther M, Konstandin S, Eickel K, Prato F, Finger E, St Lawrence K. Sensitivity of arterial Spin labeling for characterization of longitudinal perfusion changes in Frontotemporal dementia and related disorders. NEUROIMAGE-CLINICAL 2021; 35:102853. [PMID: 34697009 PMCID: PMC9421452 DOI: 10.1016/j.nicl.2021.102853] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/24/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
This study demonstrates the value of ASL for longitudinal monitoring of perfusion in FTD patients. Good agreement was found in repeat measures of CBF in patients and controls. Transit times were not a significant source of error for the selected post labeling delay (2 s).
Background Advances in the understanding of the pathophysiology of frontotemporal dementia (FTD) and related disorders, along with the development of novel candidate disease modifying treatments, have stimulated the need for tools to assess the efficacy of new therapies. While perfusion imaging by arterial spin labeling (ASL) is an attractive approach for longitudinal imaging biomarkers of neurodegeneration, sources of variability between sessions including arterial transit times (ATT) and fluctuations in resting perfusion can reduce its sensitivity. Establishing the magnitude of perfusion changes that can be reliably detected is necessary to delineate longitudinal perfusion changes related to disease processes from the effects of these sources of error. Purpose To assess the feasibility of ASL for longitudinal monitoring of patients with FTD by quantifying between-session variability of perfusion on a voxel-by-voxel basis. Methods and materials ASL data were collected in 13 healthy controls and 8 patients with FTD or progressive supra-nuclear palsy. Variability in cerebral blood flow (CBF) by single delay pseudo-continuous ASL (SD-pCASL) acquired one month apart were quantified by the coefficient of variation (CV) and intraclass correlation coefficient (ICC). Additionally, CBF by SD-pCASL and ATT by low-resolution multiple inversion time ASL (LowRes-pCASL) were compared to Hadamard encoded sequences which are able to simultaneously measure CBF and ATT with improved time-efficiency. Results Agreement of grey-matter perfusion between sessions was found for both patients and controls (CV = 10.8% and 8.3% respectively) with good reliability for both groups (ICC > 0.6). Intensity normalization to remove day-to-day fluctuations in resting perfusion reduced the CV by 28%. Less than 5% of voxels had ATTs above the chosen post labelling delay (2 s), indicating that the ATT was not a significant source of error. Hadamard-encoded perfusion imaging yielded systematically higher CBF compared to SD-pCASL, but produced similar transit-time measurements. Power analysis revealed that SD-pCASL has the sensitivity to detect longitudinal changes as low as 10% with as few as 10 patient participants. Conclusion With the appropriate labeling parameters, SD-pCASL is a promising approach for assessing longitudinal changes in CBF associated with FTD.
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Affiliation(s)
- Tracy Ssali
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada.
| | - Udunna C Anazodo
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Lucas Narciso
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Linshan Liu
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Sarah Jesso
- Lawson Health Research Institute, London, Canada; St. Joseph's Health Care, London, Canada
| | - Lauryn Richardson
- Lawson Health Research Institute, London, Canada; St. Joseph's Health Care, London, Canada
| | - Matthias Günther
- Fraunhofer Institute for Medical Image Computing MEVIS, Bremen, Germany; University Bremen, Bremen, Germany
| | - Simon Konstandin
- Fraunhofer Institute for Medical Image Computing MEVIS, Bremen, Germany; Mediri GmbH, Heidelberg, Germany
| | | | - Frank Prato
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Elizabeth Finger
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada; Department of Clinical Neurological Sciences, Western University, London, Canada
| | - Keith St Lawrence
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
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11
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Ford JN, Sweeney EM, Skafida M, Glynn S, Amoashiy M, Lange DJ, Lin E, Chiang GC, Osborne JR, Pahlajani S, de Leon MJ, Ivanidze J. Heuristic scoring method utilizing FDG-PET statistical parametric mapping in the evaluation of suspected Alzheimer disease and frontotemporal lobar degeneration. AMERICAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2021; 11:313-326. [PMID: 34513285 PMCID: PMC8414399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
Distinguishing frontotemporal lobar degeneration (FTLD) and Alzheimer Disease (AD) on FDG-PET based on qualitative review alone can pose a diagnostic challenge. SPM has been shown to improve diagnostic performance in research settings, but translation to clinical practice has been lacking. Our purpose was to create a heuristic scoring method based on statistical parametric mapping z-scores. We aimed to compare the performance of the scoring method to the initial qualitative read and a machine learning (ML)-based method as benchmarks. FDG-PET/CT or PET/MRI of 65 patients with suspected dementia were processed using SPM software, yielding z-scores from either whole brain (W) or cerebellar (C) normalization relative to a healthy cohort. A non-ML, heuristic scoring system was applied using region counts below a preset z-score cutoff. W z-scores, C z-scores, or WC z-scores (z-scores from both W and C normalization) served as features to build random forest models. The neurological diagnosis was used as the gold standard. The sensitivity of the non-ML scoring system and the random forest models to detect AD was higher than the initial qualitative read of the standard FDG-PET [0.89-1.00 vs. 0.22 (95% CI, 0-0.33)]. A categorical random forest model to distinguish AD, FTLD, and normal cases had similar accuracy than the non-ML scoring model (0.63 vs. 0.61). Our non-ML-based scoring system of SPM z-scores approximated the diagnostic performance of a ML-based method and demonstrated higher sensitivity in the detection of AD compared to qualitative reads. This approach may improve the diagnostic performance.
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Affiliation(s)
- Jeremy N Ford
- Department of Radiology, Massachusetts General HospitalBoston, MA, United States
| | - Elizabeth M Sweeney
- Department of Population Health Sciences, Division of Biostatistics and Epidemiology, Weill Cornell Medical CollegeNew York, NY, United States
| | - Myrto Skafida
- Department of Radiology, Weill Cornell Medical CollegeNew York, NY, United States
| | - Shannon Glynn
- Department of Radiology, Weill Cornell Medical CollegeNew York, NY, United States
| | - Michael Amoashiy
- Department of Neurology, Weill Cornell Medical CollegeNew York, NY, United States
| | - Dale J Lange
- Department of Neurology, Hospital for Special SurgeryNew York, NY, United States
| | - Eaton Lin
- Department of Radiology, Weill Cornell Medical CollegeNew York, NY, United States
| | - Gloria C Chiang
- Department of Radiology, Weill Cornell Medical CollegeNew York, NY, United States
| | - Joseph R Osborne
- Department of Radiology, Weill Cornell Medical CollegeNew York, NY, United States
| | - Silky Pahlajani
- Department of Neurology, Weill Cornell Medical CollegeNew York, NY, United States
| | - Mony J de Leon
- Department of Radiology, Weill Cornell Medical CollegeNew York, NY, United States
| | - Jana Ivanidze
- Department of Radiology, Weill Cornell Medical CollegeNew York, NY, United States
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12
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Rajagopalan V, Pioro EP. Degeneration of gray and white matter differs between hypometabolic and hypermetabolic brain regions in a patient with ALS-FTD: a longitudinal MRI - PET multimodal study. Amyotroph Lateral Scler Frontotemporal Degener 2021; 22:127-132. [PMID: 32924608 DOI: 10.1080/21678421.2020.1818784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 08/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE [18F]-fluoro-2-deoxy-d-glucose positron emission tomography (18F-FDG PET) imaging and magnetic resonance imaging (MRI) of brain in ALS patients with frontotemporal lobe dementia (ALS-FTD) reveal hypometabolism and hypermetabolism, as well as gray matter (GM) and white matter (WM) abnormalities in different brain regions, respectively. Hypometabolism arising from neuronal dysfunction or loss is the most recognized pathophysiologic change in neurodegeneration, whereas mechanisms underlying hypermetabolism remain unclear. We hypothesize that hypometabolic and hypermetabolic brain regions in ALS-FTD represent differential degeneration of GM and WM structures, as revealed by co-registered MRI in a two time-point longitudinal multimodal study. Methods: A 69-year-old female with ALS-FTD underwent 18F-FDG PET, diffusion tensor imaging (DTI), and T1-weighted MRI at baseline (15 months after symptom onset), and 20.4 months later. Cerebral glucose metabolism rate, cortical thickness, cortical area, and WM network changes were measured longitudinally. Results and conclusion: The patient had symptoms and signs of bulbar-onset upper motor neuron (UMN)-predominant ALS with language and behavioral dysfunction. Evaluation at baseline showed bulbar dysfunction, and impaired language and executive function. At follow-up, worsened bulbar and other motor functions, and prominent FTD both reflected significant progression. Cortical thickness and surface area showed differential involvement in the hypometabolic and hypermetabolic regions. WM connections from frontal regions to other brain regions were completely absent by graph theory-based network analysis when compared to temporal regions indicating prominent frontal lobe degeneration. Structural neuroimaging reveals different patterns of GM and WM involvement in the hypometabolic and hypermetabolic brain regions in a patient with ALS-FTD.
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Affiliation(s)
- Venkateswaran Rajagopalan
- Department of Electrical and Electronics Engineering, Birla Institute of Technology and Science Pilani, Hyderabad, India
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Erik P Pioro
- Department of Neurology, Cleveland Clinic, Cleveland, OH, USA, and
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
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13
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Tefera TW, Steyn FJ, Ngo ST, Borges K. CNS glucose metabolism in Amyotrophic Lateral Sclerosis: a therapeutic target? Cell Biosci 2021; 11:14. [PMID: 33431046 PMCID: PMC7798275 DOI: 10.1186/s13578-020-00511-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/04/2020] [Indexed: 12/11/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal progressive neurodegenerative disorder primarily characterized by selective degeneration of both the upper motor neurons in the brain and lower motor neurons in the brain stem and the spinal cord. The exact mechanism for the selective death of neurons is unknown. A growing body of evidence demonstrates abnormalities in energy metabolism at the cellular and whole-body level in animal models and in people living with ALS. Many patients with ALS exhibit metabolic changes such as hypermetabolism and body weight loss. Despite these whole-body metabolic changes being observed in patients with ALS, the origin of metabolic dysregulation remains to be fully elucidated. A number of pre-clinical studies indicate that underlying bioenergetic impairments at the cellular level may contribute to metabolic dysfunctions in ALS. In particular, defects in CNS glucose transport and metabolism appear to lead to reduced mitochondrial energy generation and increased oxidative stress, which seem to contribute to disease progression in ALS. Here, we review the current knowledge and understanding regarding dysfunctions in CNS glucose metabolism in ALS focusing on metabolic impairments in glucose transport, glycolysis, pentose phosphate pathway, TCA cycle and oxidative phosphorylation. We also summarize disturbances found in glycogen metabolism and neuroglial metabolic interactions. Finally, we discuss options for future investigations into how metabolic impairments can be modified to slow disease progression in ALS. These investigations are imperative for understanding the underlying causes of metabolic dysfunction and subsequent neurodegeneration, and to also reveal new therapeutic strategies in ALS.
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Affiliation(s)
- Tesfaye Wolde Tefera
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD, 4072, Australia.
| | - Frederik J Steyn
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.,Center for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Shyuan T Ngo
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD, 4072, Australia.,Center for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Karin Borges
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
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14
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Kang K, Han J, Lee SW, Jeong SY, Lim YH, Lee JM, Yoon U. Abnormal cortical thickening and thinning in idiopathic normal-pressure hydrocephalus. Sci Rep 2020; 10:21213. [PMID: 33273614 PMCID: PMC7712876 DOI: 10.1038/s41598-020-78067-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 11/02/2020] [Indexed: 12/16/2022] Open
Abstract
We investigated differences in cortical thickness between idiopathic normal-pressure hydrocephalus (INPH) patients and healthy controls. We also explored whether a relationship exists between cortical thinning and gait disturbance in INPH patients. Forty-nine INPH patients and 26 healthy controls were imaged with MRI, including 3-dimensional volumetric images, for automated surface-based cortical thickness analysis across the entire brain. Compared with age- and gender-matched healthy controls, unexpectedly, INPH patients showed statistically significant cortical thickening mainly in areas located in the high convexity of the frontal, parietal, and occipital regions. Additionally, cortical thinning mainly in temporal and orbitofrontal regions was observed in the INPH group relative to the control group. The Gait Status Scale (GSS) scores were negatively correlated with cortical thickness in the medial orbital part of the superior frontal gyrus, gyrus rectus, superior temporal gyrus, temporal pole, and insula. A distinctive pattern of cortical thickness changes was found in INPH patients. We cautiously suggest that cortical thickening in INPH can result from reactive gliosis. Further, our results support the hypothesis that cortical thinning in INPH can result from neuronal degeneration. In addition, cortical thinning can play an important role in gait disturbances in INPH patients.
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Affiliation(s)
- Kyunghun Kang
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea.,Department of Neurology, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Jaehwan Han
- Department of Biomedical Engineering, Daegu Catholic University, Gyeongsan-si, South Korea
| | - Sang-Woo Lee
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Shin Young Jeong
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Yong-Hyun Lim
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, South Korea.,Center of Self-Organizing Software-Platform, Kyungpook National University, Daegu, South Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea.
| | - Uicheul Yoon
- Department of Biomedical Engineering, Daegu Catholic University, Gyeongsan-si, South Korea.
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15
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Canosa A, Moglia C, Manera U, Vasta R, Torrieri MC, Arena V, D'Ovidio F, Palumbo F, Zucchetti JP, Iazzolino B, Peotta L, Calvo A, Pagani M, Chiò A. Metabolic brain changes across different levels of cognitive impairment in ALS: a 18F-FDG-PET study. J Neurol Neurosurg Psychiatry 2020; 92:jnnp-2020-323876. [PMID: 33229451 DOI: 10.1136/jnnp-2020-323876] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/17/2020] [Accepted: 10/26/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To identify the metabolic changes related to the various levels of cognitive deficits in amyotrophic lateral sclerosis (ALS) using 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) imaging. METHODS 274 ALS patients underwent neuropsychological assessment and brain 18F-FDG-PET at diagnosis. According to the criteria published in 2017, cognitive status was classified as ALS with normal cognition (ALS-Cn, n=132), ALS with behavioural impairment (ALS-Bi, n=66), ALS with cognitive impairment (ALS-Ci, n=30), ALS with cognitive and behavioural impairment (ALS-Cbi, n=26), ALS with frontotemporal dementia (ALS-FTD, n=20). We compared each group displaying some degree of cognitive and/or behavioural impairment to ALS-Cn patients, including age at PET, sex and ALS Functional Rating Scale-Revised as covariates. RESULTS We identified frontal lobe relative hypometabolism in cognitively impaired patients that resulted more extensive and significant across the continuum from ALS-Ci, through ALS-Cbi, to ALS-FTD. ALS-FTD patients also showed cerebellar relative hypermetabolism. ALS-Bi patients did not show any difference compared with ALS-Cn. CONCLUSIONS These data support the concept that patients with cognitive impairment have a more widespread neurodegenerative process compared with patients with a pure motor disease: the more severe the cognitive impairment, the more diffuse the metabolic changes. Otherwise, metabolic changes related to pure behavioural impairment need further characterisation.
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Affiliation(s)
- Antonio Canosa
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
- SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Cristina Moglia
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
- SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Umberto Manera
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Rosario Vasta
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Maria Claudia Torrieri
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Vincenzo Arena
- Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A, Turin, Italy
| | - Fabrizio D'Ovidio
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Francesca Palumbo
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Jean Pierre Zucchetti
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Barbara Iazzolino
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Laura Peotta
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
| | - Andrea Calvo
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
- SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
- Neuroscience Institute of Turin (NIT), Turin, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, C.N.R, Rome, Italy
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Adriano Chiò
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, ALS Centre, Turin, Italy
- SC Neurologia 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
- Neuroscience Institute of Turin (NIT), Turin, Italy
- Institute of Cognitive Sciences and Technologies, C.N.R, Rome, Italy
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16
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Rajagopalan V, Pioro EP. 2-Deoxy-2-[ 18 F]fluoro-d-glucose positron emission tomography, cortical thickness and white matter graph network abnormalities in brains of patients with amyotrophic lateral sclerosis and frontotemporal dementia suggest early neuronopathy rather than axonopathy. Eur J Neurol 2020; 27:1904-1912. [PMID: 32432818 DOI: 10.1111/ene.14332] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 05/13/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Amyotrophic lateral sclerosis (ALS) is a motor neuron disorder, although extra-motor degeneration is well recognized, especially in frontotemporal regions manifested as ALS with frontotemporal dementia (ALS-FTD). Previous neuroimaging studies of the brains of ALS-FTD patients have measured abnormalities of either grey matter (GM) or white matter (WM) structures but not of both together. Therefore, the aim was to evaluate both GM and WM in the same ALS-FTD patient using functional and structural neuroimaging. By doing so, insights could be gained into whether neurodegeneration in ALS-FTD is primarily a neuronopathy or axonopathy. METHODS After high-resolution brain 2-deoxy-2-[18 F]fluoro-D-glucose (18 F-FDG) positron emission tomography (PET) and magnetic resonance imaging (MRI) scans were obtained in ALS-FTD patients and in age- and sex-matched neurological controls, changes in metabolic rate, cortical thickness (CT) and WM network analysis using graph theory were analyzed. RESULTS Significant reductions in 18 F-FDG PET metabolism, CT and WM connections were observed in motor and extra-motor brain regions of ALS-FTD patients compared to controls. Both CT and underlying WM networks were abnormal in frontal, temporal, parietal and occipital lobes of ALS-FTD patients with 86 of 90 brain regions showing reductions of CT. CONCLUSION Abnormalities in significantly fewer WM networks underlying the affected cortical regions suggest that neurodegeneration in brains of ALS-FTD patients is primarily a 'neuronopathy' rather than an 'axonopathy.'
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Affiliation(s)
- V Rajagopalan
- Department of Electrical and Electronics Engineering, Birla Institute of Technology and Science Pilani, Hyderabad Campus, Hyderabad, India.,Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - E P Pioro
- Neuromuscular Center, Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.,Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
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