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Dash S, Park B, Kroenke CD, Rooney WD, Urbanski HF, Kohama SG. Brain volumetrics across the lifespan of the rhesus macaque. Neurobiol Aging 2023; 126:34-43. [PMID: 36917864 PMCID: PMC10106431 DOI: 10.1016/j.neurobiolaging.2023.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/22/2022] [Revised: 01/30/2023] [Accepted: 02/05/2023] [Indexed: 02/13/2023]
Abstract
The rhesus macaque is a long-lived nonhuman primate (NHP) with a brain structure similar to humans, which may represent a valuable translational animal model in which to study human brain aging. Previous magnetic resonance imaging (MRI) studies of age in rhesus macaque brains have been prone to low statistical power, unbalanced sex ratio and lack of a complete age range. To overcome these problems, the current study surveyed structural T1-weighted magnetic resonance imaging scans of 66 animals, 34 females (aged 6-31 years) and 32 males (aged 5-27 years). Differences observed in older animals, included enlargement of the lateral ventricles and a smaller volume in the frontal cortex, caudate, putamen, hypothalamus, and thalamus. Unexpected, greater volume, were measured in older animals in the hippocampus, amygdala, and globus pallidus. There were also numerous differences between males and females with respect to age in both white and gray matter regions. As an apparent model of normative human aging, the macaque is ideal for studying induction and mitigation of neurodegenerative disease.
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Affiliation(s)
- Steven Dash
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, USA
| | - Byung Park
- Biostatistics Shared Resource, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Christopher D Kroenke
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, USA; Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA; Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - William D Rooney
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA; Department of Neurology, Oregon Health & Science University, Portland, OR, USA; Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - Henryk F Urbanski
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, USA; Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - Steven G Kohama
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, USA; Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA.
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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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Gentreau M, Reynes C, Sabatier R, Maller JJ, Meslin C, Deverdun J, Le Bars E, Raymond M, Berticat C, Artero S. Glucometabolic Changes Are Associated with Structural Gray Matter Alterations in Prodromal Dementia. J Alzheimers Dis 2022; 89:1293-1302. [PMID: 36031896 DOI: 10.3233/jad-220490] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Glucometabolic changes, such as high glycemic load (GL) diet and insulin resistance (IR), are potential risk factor of Alzheimer's disease (AD). Yet, the effect of these factors on brain alterations that contribute to AD pathology has not been clearly demonstrated. OBJECTIVE We aimed to assess the relationship of GL and IR with gray matter volumes involved in prodromal dementia. METHODS GL and Triglyceride-Glucose (TyG) index, an IR surrogate marker, were calculated in 497 participants who underwent magnetic resonance imaging (MRI). The gray matter volumes most related to prodromal dementia/mild cognitive impairment (diagnosed in 18/158 participants during the 7-year follow-up) were identified using a data-driven machine learning algorithm. RESULTS Higher GL diet was associated with reduced amygdala volume. The TyG index was negatively associated with the hippocampus, amygdala, and putamen volumes. CONCLUSION These results suggest that GL and IR are associated with lower gray matter volumes in brain regions involved in AD pathology.
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Affiliation(s)
- Mélissa Gentreau
- IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
| | | | - Robert Sabatier
- IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Jerome J Maller
- Monash Alfred Psychiatry Research Centre, Melbourne, Victoria, Australia.,General Electric Healthcare, Richmond, Melbourne, Australia
| | - Chantal Meslin
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Jeremy Deverdun
- I2FH, Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France
| | - Emmanuelle Le Bars
- I2FH, Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France
| | - Michel Raymond
- ISEM, University of Montpellier, CNRS, EPHE, IRD, Montpellier, France
| | - Claire Berticat
- ISEM, University of Montpellier, CNRS, EPHE, IRD, Montpellier, France
| | - Sylvaine Artero
- IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
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Yang Z, Caldwell JZK, Cummings JL, Ritter A, Kinney JW, Cordes D. Sex Modulates the Pathological Aging Effect on Caudate Functional Connectivity in Mild Cognitive Impairment. Front Psychiatry 2022; 13:804168. [PMID: 35479489 PMCID: PMC9037326 DOI: 10.3389/fpsyt.2022.804168] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To assess the pathological aging effect on caudate functional connectivity among mild cognitive impairment (MCI) participants and examine whether and how sex and amyloid contribute to this process. Materials and Methods Two hundred and seventy-seven functional magnetic resonance imaging (fMRI) sessions from 163 cognitive normal (CN) older adults and 309 sessions from 139 participants with MCI were included as the main sample in our analysis. Pearson's correlation was used to characterize the functional connectivity (FC) between caudate nuclei and each brain region, then caudate nodal strength was computed to quantify the overall caudate FC strength. Association analysis between caudate nodal strength and age was carried out in MCI and CN separately using linear mixed effect (LME) model with covariates (education, handedness, sex, Apolipoprotein E4, and intra-subject effect). Analysis of covariance was conducted to investigate sex, amyloid status, and their interaction effects on aging with the fMRI data subset having amyloid status available. LME model was applied to women and men separately within MCI group to evaluate aging effects on caudate nodal strength and each region's connectivity with caudate nuclei. We then evaluated the roles of sex and amyloid status in the associations of neuropsychological scores with age or caudate nodal strength. An independent cohort was used to validate the sex-dependent aging effects in MCI. Results The MCI group had significantly stronger age-related increase of caudate nodal strength compared to the CN group. Analyzing women and men separately revealed that the aging effect on caudate nodal strength among MCI participants was significant only for women (left: P = 6.23 × 10-7, right: P = 3.37 × 10-8), but not for men (P > 0.3 for bilateral caudate nuclei). The aging effects on caudate nodal strength were not significantly mediated by brain amyloid burden. Caudate connectivity with ventral prefrontal cortex substantially contributed to the aging effect on caudate nodal strength in women with MCI. Higher caudate nodal strength is significantly related to worse cognitive performance in women but not in men with MCI. Conclusion Sex modulates the pathological aging effects on caudate nodal strength in MCI regardless of amyloid status. Caudate nodal strength may be a sensitive biomarker of pathological aging in women with MCI.
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Affiliation(s)
- Zhengshi Yang
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
- Department of Brain Health, University of Nevada Las Vegas, Las Vegas, NV, United States
| | | | - Jeffrey L. Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Aaron Ritter
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
| | - Jefferson W. Kinney
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Dietmar Cordes
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
- Department of Brain Health, University of Nevada Las Vegas, Las Vegas, NV, United States
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, United States
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Marterstock DC, Knott MFX, Hoelter P, Lang S, Oberstein T, Kornhuber J, Doerfler A, Schmidt MA. Pulsed Arterial Spin Labeling and Segmented Brain Volumetry in the Diagnostic Evaluation of Frontotemporal Dementia, Alzheimer’s Disease and Mild Cognitive Impairment. Tomography 2022; 8:229-244. [PMID: 35076603 PMCID: PMC8788517 DOI: 10.3390/tomography8010018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/16/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/21/2022] Open
Abstract
Background: Previous studies suggest that brain atrophy can not only be defined by its morphological extent, but also by the cerebral blood flow (CBF) within a certain area of the brain, including white and gray matter. The aim of this study is to investigate known atrophy patterns in different forms of dementia and to compare segmented brain volumetrics and pulsed arterial spin labeling (pASL) data to explore the correlation between brain maps with atrophy and this non-contrast-enhanced brain-perfusion method. Methods: Our study comprised 17 patients with diagnosed cognitive impairment (five Alzheimer’s disease = AD, five frontotemporal dementia = FTD, seven mild cognitive impairment = MCI) and 19 healthy control subjects (CO). All patients and controls underwent 4D-pASL brain-perfusion MR imaging and T1w MPRAGE. The data were assessed regarding relative brain volume on the basis of 286 brain regions, and absolute and relative cerebral blood flow (CBF/rCBF) were derived from pASL data in the corresponding brain regions. Mini-Mental State Examination (MMSE) was performed to assess cognitive functions. Results: FTD patients demonstrated significant brain atrophy in 43 brain regions compared to CO. Patients with MCI showed significant brain atrophy in 18 brain regions compared to CO, whereas AD patients only showed six brain regions with significant brain atrophy compared to CO. There was good correlation of brain atrophy and pASL perfusion data in five brain regions of patients with diagnosed FTD, especially in the superior temporal gyrus (r = 0.900, p = 0.037), the inferior frontal white matter (pars orbitalis; r = 0.968, p = 0.007) and the thalami (r = 0.810, p = 0.015). Patients with MCI demonstrated a correlation in one brain region (left inferior fronto-occipital fasciculus; r = 0.786, p = 0.036), whereas patients with diagnosed AD revealed no correlation. Conclusions: pASL can detect affected brain regions in cognitive impairment and corresponds with brain atrophy, especially for patients suffering from FTD and MCI. However, there was no correlation of perfusion alterations and brain atrophy in AD. pASL perfusion might thus represent a promising tool for noninvasive brain-perfusion evaluation in specific dementia subtypes as a complimentary imaging-based bio marker in addition to brain volumetry.
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Affiliation(s)
- Dominique Cornelius Marterstock
- Department of Neuroradiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Michael Franz Xaver Knott
- Department of Neuroradiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Philip Hoelter
- Department of Neuroradiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Stefan Lang
- Department of Neuroradiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Timo Oberstein
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Arnd Doerfler
- Department of Neuroradiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Manuel A Schmidt
- Department of Neuroradiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
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Heo YJ, Baek HJ, Skare S, Lee H, Kim D, Kim J, Yoon S. Automated Brain Volumetry in Patients With Memory Impairment: Comparison of Conventional and Ultrafast 3D T1-weighted MRI Sequences Using Two Software Packages. AJR Am J Roentgenol. [DOI: 10.2214/ajr.21.27043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Baik K, Yang JJ, Jung JH, Lee YH, Chung SJ, Yoo HS, Sohn YH, Lee PH, Lee JM, Ye BS. Structural connectivity networks in Alzheimer's disease and Lewy body disease. Brain Behav 2021; 11:e02112. [PMID: 33792194 PMCID: PMC8119831 DOI: 10.1002/brb3.2112] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 02/14/2021] [Accepted: 02/17/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE We evaluated disruption of the white matter (WM) network related with Alzheimer's disease (AD) and Lewy body disease (LBD), which includes Parkinson's disease and dementia with Lewy bodies. METHODS We consecutively recruited 37 controls and 77 patients with AD-related cognitive impairment (ADCI) and/or LBD-related cognitive impairment (LBCI). Diagnoses of ADCI and LBCI were supported by amyloid PET and dopamine transporter PET, respectively. There were 22 patients with ADCI, 19 patients with LBCI, and 36 patients with mixed ADCI/LBCI. We investigated the relationship between ADCI, LBCI, graph theory-based network measures on diffusion tensor images, and cognitive dysfunction using general linear models after controlling for age, sex, education, deep WM hyperintensities (WMH), periventricular WMH, and intracranial volume. RESULTS LBCI, especially mixed with ADCI, was associated with increased normalized path length and decreased normalized global efficiency. LBCI was related to the decreased nodal degree of left caudate, which was further associated with broad cognitive dysfunction. Decreased left caudate nodal degree was associated with decreased fractional anisotropy (FA) in the brain regions vulnerable to LBD. Compared with the control group, the LBCI group had an increased betweenness centrality in the occipital nodes, which was associated with decreased FA in the WM adjacent to the striatum and visuospatial dysfunction. CONCLUSION Concomitant ADCI and LBCI are associated with the accentuation of LBCI-related WM network disruption centered in the left caudate nucleus. The increase of occipital betweenness centrality could be a characteristic biologic change associated with visuospatial dysfunction in LBCI.
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Affiliation(s)
- Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Jin-Ju Yang
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Jin Ho Jung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
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Zhang J, Cheng J, Yang H. Effects of Rivastigmine on Brain Functional Networks in Patients With Alzheimer Disease Based on the Graph Theory. Clin Neuropharmacol 2021; 44:9-16. [PMID: 33337622 DOI: 10.1097/WNF.0000000000000427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to explore the effect of rivastigmine on brain function in Alzheimer disease (AD) by analyzing brain functional network based on the graph theory. METHODS We enrolled 9 patients with mild to moderate AD who received rivastigmine treatment and 9 healthy controls (HC). Subsequently, we used resting-state functional magnetic resonance imaging data to establish the whole-brain functional network using a graph theory-based analysis. Furthermore, we compared systemic and local network indicators between pre- and posttreatment. RESULTS Patients with AD exhibited a posttreatment increase in the Mini-Mental State Examination scores and a decrease in the Alzheimer's Disease Assessment Scale cognitive subscale scores and activities of daily living. The systemic network for HC and patients with AD had good pre- and posttreatment clustering coefficients. There was no change in the Cp, Lp, Gamma, Lambda, and Sigma in patients with AD. There were no significant between-group differences in the pre- and posttreatment systemic network measures. Regarding the regional network, patients with AD showed increased betweenness centrality in the bilateral caudate nucleus and right superior temporal pole after treatment with rivastigmine. However, there was no between-group difference in the pre- and posttreatment betweenness centrality of these regions. There were no significant correlations between regional network measure changes and clinical score alterations in patients with AD. CONCLUSIONS There are similar systemic network properties between patients with AD and HC. Rivastigmine cannot alter systemic network attributes in patients with AD. However, it improves the topological properties of regional networks and between-node information transmission in patients with AD.
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Udo N, Hashimoto N, Toyonaga T, Isoyama T, Oyanagi Y, Narita H, Shiga T, Nakagawa S, Kusumi I. Apathy in Alzheimer's Disease Correlates with the Dopamine Transporter Level in the Caudate Nuclei. Dement Geriatr Cogn Dis Extra 2020; 10:86-93. [PMID: 33082772 PMCID: PMC7548940 DOI: 10.1159/000509278] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Received: 05/27/2020] [Accepted: 06/06/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction Apathy is a common neuropsychiatric symptom in patients with Alzheimer's disease (AD). The striatal binding potential (BP) of 123I-FP-CIT (N-δ-fluoropropyl-2β-carbomethoxy-3β-[4-iodophenyl]tropane) single-photon emission computed tomography (SPECT) is correlated with the degree of apathy in patients with Parkinson's disease (PD) and dementia with Lewy bodies (DLB). This study aimed to determine if dopaminergic activity in the basal ganglia is associated with the development of apathy in AD. Methods Nineteen subjects with AD were included and underwent 123I-FP-CIT-SPECT. Patients with other types of dementia as a comorbidity, those taking antidepressants, and those with overt parkinsonism were excluded. Apathy was assessed using the Apathy Evaluation Scale Informant-Japanese version (AES-I-J). SPECT images were overlaid with images in striatal regions of interest (ROIs), and the SPECT values in these regions were counted. The relationship between BP values and AES-I-J scores was investigated using Spearman's rank correlation coefficient. Results Significant inverse correlations were observed between BP values and AES-I-J scores in the left caudate nucleus and there was a marginally significant inverse correlation in the right caudate nucleus. Conclusion The pathological basis of apathy might be the impairment of the dopaminergic nervous system. Further studies on more subjects with AD, healthy controls, and patients with PD and DLB are needed.
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Affiliation(s)
- Niki Udo
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takuya Toyonaga
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,PET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Tomoyuki Isoyama
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yuka Oyanagi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hisashi Narita
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tohru Shiga
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shin Nakagawa
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Yan T, Wang Y, Weng Z, Du W, Liu T, Chen D, Li X, Wu J, Han Y. Early-Stage Identification and Pathological Development of Alzheimer's Disease Using Multimodal MRI. J Alzheimers Dis 2020; 68:1013-1027. [PMID: 30958352 DOI: 10.3233/jad-181049] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [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: 01/04/2023]
Abstract
Alzheimer's disease (AD) is one of the most common progressive and irreversible neurodegenerative diseases. The study of the pathological mechanism of AD and early-stage diagnosis is essential and important. Subjective cognitive decline (SCD), the first at-risk stage of AD occurring prior to amnestic mild cognitive impairment (aMCI), is of great research value and has gained our interest. To investigate the entire pathological development of AD pathology efficiently, we proposed a machine learning classification method based on a multimodal support vector machine (SVM) to investigate the structural and functional connectivity patterns of the three stages of AD (SCD, aMCI, and AD). Our experiments achieved an accuracy of 98.58% in the AD group, 97.76% in the aMCI group, and 80.24% in the SCD group. Moreover, in our experiments, we identified the most discriminating brain regions, which were mainly located in the default mode network and subcortical structures (SCS). Notably, with the development of AD pathology, SCS regions have become increasingly important, and structural connectivity has shown more discriminative power than functional connectivity. The current study may shed new light on the pathological mechanism of AD and suggests that whole-brain connectivity may provide potential effective biomarkers for the early-stage diagnosis of AD.
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Affiliation(s)
- Tianyi Yan
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Yonghao Wang
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Zizheng Weng
- Daniel Felix Ritchie School of Engineering and Computer Science, University of Denver, Denver, CO, USA
| | - Wenying Du
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Tiantian Liu
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Duanduan Chen
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Xuesong Li
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, China
| | - Jinglong Wu
- Beijing Advanced Innovation Center for Intelligent Robots and Systems; Beijing Institute of Technology, Beijing, China
| | - Ying Han
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Institute of Geriatrics, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China
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Botzung A, Philippi N, Noblet V, Loureiro de Sousa P, Blanc F. Pay attention to the basal ganglia: a volumetric study in early dementia with Lewy bodies. Alzheimers Res Ther 2019; 11:108. [PMID: 31864422 PMCID: PMC6925479 DOI: 10.1186/s13195-019-0568-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/09/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cortical and subcortical cognitive impairments are usually found in dementia with Lewy bodies (DLB). Roughly, they comprise visuo-constructive/executive function and attention/processing speed impairments, whereas memory would remain relatively spared. In this study, we focused on the neuro-anatomical substrates of attention and processing speed, which is still poorly understood. For the purpose of the study, we examined the correlations between behavioral scores measuring the speed of processing and the degree of cerebral atrophy in patients with prodromal to moderate DLB. METHODS Ninety-three prodromal to moderate DLB patients (mean MMSE = 25.5) were selected to participate in the study as well as 28 healthy elderly subjects (mean MMSE = 28.9), matched in terms of age and educational level. The Trail Making Test A (TMTA) and the Digit Symbol Substitution Test (DSST) were used to assess attention and processing speed. Behavioral performances were compared between patients and healthy control subjects. Three-dimensional MRI images were acquired for all participants, and correlational analyses were performed in the patient group using voxel-based morphometry (VBM). RESULTS The behavioral results on both the TMTA (p = .026) and the DSST (p < .001) showed significantly impaired performances in patients in comparison with control subjects. In addition, correlational analyses using VBM revealed for the TMTA negative correlations in the caudate nucleus (left cluster peak significant at .05 FWE corrected), the putamen, the left thalamus, and the subthalamic nuclei (p < .05 FDR corrected). Some positive correlations associated with the DSST were found in the right inferior frontal gyrus, the left thalamus, and the left cerebellum (p < .001 uncorrected). CONCLUSIONS The behavioral results are in line with the literature on the DLB cognitive profile and confirm the existence of attention and processing speed impairment. Interestingly, VBM analysis revealed the involvement of the basal ganglia, in particular, the left caudate nucleus, which is part of the attention cerebral network, suggesting an important role of this structure for attentional processing speed. This also suggests the clinical implication of damage in this region relatively early in the course of the disease.
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Affiliation(s)
- Anne Botzung
- Geriatrics and Neurology Departments, Research and Resources Memory Center (CM2R), Strasbourg University Hospital, Strasbourg, France.
| | - Nathalie Philippi
- Geriatrics and Neurology Departments, Research and Resources Memory Center (CM2R), Strasbourg University Hospital, Strasbourg, France
- ICube laboratory (CNRS, UMR 7357) and FMTS (Fédération de Médecine Translationnelle de Strasbourg), University of Strasbourg, Strasbourg, France
| | - Vincent Noblet
- ICube laboratory (CNRS, UMR 7357) and FMTS (Fédération de Médecine Translationnelle de Strasbourg), University of Strasbourg, Strasbourg, France
| | - Paulo Loureiro de Sousa
- ICube laboratory (CNRS, UMR 7357) and FMTS (Fédération de Médecine Translationnelle de Strasbourg), University of Strasbourg, Strasbourg, France
| | - Frédéric Blanc
- Geriatrics and Neurology Departments, Research and Resources Memory Center (CM2R), Strasbourg University Hospital, Strasbourg, France
- ICube laboratory (CNRS, UMR 7357) and FMTS (Fédération de Médecine Translationnelle de Strasbourg), University of Strasbourg, Strasbourg, France
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12
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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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Abstract
BACKGROUND Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), which share many clinical, neurochemical, and morphological features, have been incorporated into DSM-5 as two separate entities of major neurocognitive disorders with Lewy bodies. Despite clinical overlap, their diagnosis is based on an arbitrary distinction concerning the time of onset of motor and cognitive symptoms, namely as early cognitive impairment in DLB and later onset following that of motor symptoms in PDD. Their morphological hallmarks - cortical and subcortical α-synuclein/Lewy body plus β-amyloid and tau pathologies - are similar, but clinical differences at onset suggest some dissimilar profiles. Based on recent publications, including the fourth consensus report of the DLB Consortium, a critical overview is provided herein. DISCUSSION The clinical constellations of DLB and PDD include cognitive impairment, parkinsonism, visual hallucinations, and fluctuating attention. Intravitam PET and postmortem studies have revealed a more pronounced cortical atrophy, elevated cortical and limbic Lewy body pathologies, higher Aβ and tau loads in cortex and striatum in DLB compared to PDD, and earlier cognitive defects in DLB. Conversely, multitracer PET studies have shown no differences in cortical and striatal cholinergic and dopaminergic deficits. Clinical management of both DLB and PDD includes cholinesterase inhibitors and other pharmacologic and non-drug strategies, yet with only mild symptomatic effects. Currently, no disease-modifying therapies are available. CONCLUSION DLB and PDD are important dementia syndromes that overlap in many clinical features, genetics, neuropathology, and management. They are currently considered as subtypes of an α-synuclein-associated disease spectrum (Lewy body diseases), from incidental Lewy body disease and non-demented Parkinson's disease to PDD, DLB, and DLB with Alzheimer's disease at the most severe end. Cognitive impairment in these disorders is induced not only by α-synuclein-related neurodegeneration but by multiple regional pathological scores. Both DLB and PDD show heterogeneous pathology and neurochemistry, suggesting that they share important common underlying molecular pathogenesis with Alzheimer's disease and other proteinopathies. While we prefer to view DLB and PDD as extremes on a continuum, there remains a pressing need to more clearly differentiate these syndromes and to understand the synucleinopathy processes leading to either one.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, A-1150, Vienna, Austria.
| | - Amos D Korczyn
- Tel-Aviv University, Sackler Faculty of Medicine, Ramat Aviv, Israel
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Persson K, Bohbot VD, Bogdanovic N, Selbæk G, Brækhus A, Engedal K. Finding of increased caudate nucleus in patients with Alzheimer's disease. Acta Neurol Scand 2018; 137:224-232. [PMID: 28741672 DOI: 10.1111/ane.12800] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVES A recently published study using an automated MRI volumetry method (NeuroQuant®) unexpectedly demonstrated larger caudate nucleus volume in patients with Alzheimer's disease dementia (AD) compared to patients with subjective and mild cognitive impairment (SCI and MCI). The aim of this study was to explore this finding. MATERIALS & METHODS The caudate nucleus and the hippocampus volumes were measured (both expressed as ratios of intracranial volume) in a total of 257 patients with SCI and MCI according to the Winblad criteria and AD according to ICD-10 criteria. Demographic data, cognitive measures, and APOE-ɛ4 status were collected. RESULTS Compared with non-dementia patients (SCI and MCI), AD patients were older, more of them were female, and they had a larger caudate nucleus volume and smaller hippocampus volume (P<.001). In multiple linear regression analysis, age and female sex were associated with larger caudate nucleus volume, but neither diagnosis nor memory function was. Age, gender, and memory function were associated with hippocampus volume, and age and memory function were associated with caudate nucleus/hippocampus ratio. CONCLUSIONS A larger caudate nucleus volume in AD patients was partly explained by older age and being female. These results are further discussed in the context of (1) the caudate nucleus possibly serving as a mechanism for temporary compensation; (2) methodological properties of automated volumetry of this brain region; and (3) neuropathological alterations. Further studies are needed to fully understand the role of the caudate nucleus in AD.
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Affiliation(s)
- K. Persson
- Norwegian National Advisory Unit on Ageing and Health Vestfold Hospital Trust Tønsberg Norway
- Department of Geriatric Medicine The Memory Clinic Oslo University Hospital Oslo Norway
| | - V. D. Bohbot
- Douglas Institute and Department of Psychiatry McGill University Montreal QC Canada
| | - N. Bogdanovic
- Department of Geriatric Medicine The Memory Clinic Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - G. Selbæk
- Norwegian National Advisory Unit on Ageing and Health Vestfold Hospital Trust Tønsberg Norway
- Centre for Old Age Psychiatric Research Innlandet Hospital Trust Ottestad Norway
- Institute of Health and Society University of Oslo Oslo Norway
| | - A. Brækhus
- Norwegian National Advisory Unit on Ageing and Health Vestfold Hospital Trust Tønsberg Norway
- Department of Geriatric Medicine The Memory Clinic Oslo University Hospital Oslo Norway
- Department of Neurology Oslo University Hospital Ullevaal Oslo Norway
| | - K. Engedal
- Norwegian National Advisory Unit on Ageing and Health Vestfold Hospital Trust Tønsberg Norway
- Department of Geriatric Medicine The Memory Clinic Oslo University Hospital Oslo Norway
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15
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Jellinger KA. Dementia with Lewy bodies and Parkinson's disease-dementia: current concepts and controversies. J Neural Transm (Vienna) 2017; 125:615-650. [PMID: 29222591 DOI: 10.1007/s00702-017-1821-9] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 11/28/2017] [Indexed: 12/15/2022]
Abstract
Dementia with Lewy bodies (DLB) and Parkinson's disease-dementia (PDD), although sharing many clinical, neurochemical and morphological features, according to DSM-5, are two entities of major neurocognitive disorders with Lewy bodies of unknown etiology. Despite considerable clinical overlap, their diagnosis is based on an arbitrary distinction between the time of onset of motor and cognitive symptoms: dementia often preceding parkinsonism in DLB and onset of cognitive impairment after onset of motor symptoms in PDD. Both are characterized morphologically by widespread cortical and subcortical α-synuclein/Lewy body plus β-amyloid and tau pathologies. Based on recent publications, including the fourth consensus report of the DLB Consortium, a critical overview is given. The clinical features of DLB and PDD include cognitive impairment, parkinsonism, visual hallucinations, and fluctuating attention. Intravitam PET and post-mortem studies revealed more pronounced cortical atrophy, elevated cortical and limbic Lewy pathologies (with APOE ε4), apart from higher prevalence of Alzheimer pathology in DLB than PDD. These changes may account for earlier onset and greater severity of cognitive defects in DLB, while multitracer PET studies showed no differences in cholinergic and dopaminergic deficits. DLB and PDD sharing genetic, neurochemical, and morphologic factors are likely to represent two subtypes of an α-synuclein-associated disease spectrum (Lewy body diseases), beginning with incidental Lewy body disease-PD-nondemented-PDD-DLB (no parkinsonism)-DLB with Alzheimer's disease (DLB-AD) at the most severe end, although DLB does not begin with PD/PDD and does not always progress to DLB-AD, while others consider them as the same disease. Both DLB and PDD show heterogeneous pathology and neurochemistry, suggesting that they share important common underlying molecular pathogenesis with AD and other proteinopathies. Cognitive impairment is not only induced by α-synuclein-caused neurodegeneration but by multiple regional pathological scores. Recent animal models and human post-mortem studies have provided important insights into the pathophysiology of DLB/PDD showing some differences, e.g., different spreading patterns of α-synuclein pathology, but the basic pathogenic mechanisms leading to the heterogeneity between both disorders deserve further elucidation. In view of the controversies about the nosology and pathogenesis of both syndromes, there remains a pressing need to differentiate them more clearly and to understand the processes leading these synucleinopathies to cause one disorder or the other. Clinical management of both disorders includes cholinesterase inhibitors, other pharmacologic and nonpharmacologic strategies, but these have only a mild symptomatic effect. Currently, no disease-modifying therapies are available.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
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16
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Morales S, Bernabeu-Sanz A, López-Mir F, González P, Luna L, Naranjo V. BRAIM: A computer-aided diagnosis system for neurodegenerative diseases and brain lesion monitoring from volumetric analyses. Comput Methods Programs Biomed 2017; 145:167-179. [PMID: 28552122 DOI: 10.1016/j.cmpb.2017.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 03/14/2017] [Accepted: 04/12/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND OBJECTIVE This paper presents BRAIM, a computer-aided diagnosis (CAD) system to help clinicians in diagnosing and treatment monitoring of brain diseases from magnetic resonance image processing. BRAIM can be used for early diagnosis of neurodegenerative diseases such as Parkinson, Alzheimer or Multiple Sclerosis and also for brain lesion diagnosis and monitoring. METHODS The developed CAD system includes different user-friendly tools for segmenting and determining whole brain and brain structure volumes in an easy and accurate way. Specifically, three types of measurements can be performed: (1) total volume of white, gray matter and cerebrospinal fluid; (2) brain structure volumes (volume of putamen, thalamus, hippocampus and caudate nucleus); and (3) brain lesion volumes. RESULTS As a proof of concept, some study cases were analyzed with the presented system achieving promising results. In addition to be used to quantify treatment effectiveness in patients with brain lesions, it was demonstrated that BRAIM is able to classify a subject according to the brain volume measurements using as reference a healthy control database created for this purpose. CONCLUSIONS The CAD system presented in this paper simplifies the daily work of clinicians and provides them with objective and quantitative volume data for prospective and retrospective analyses.
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Affiliation(s)
- Sandra Morales
- Instituto de Investigación e Innovación en Bioingeniería, I3B, Universitat Politècnica de València, Camino de Vera s/n, Valencia 46022, Spain.
| | | | - Fernando López-Mir
- Instituto de Investigación e Innovación en Bioingeniería, I3B, Universitat Politècnica de València, Camino de Vera s/n, Valencia 46022, Spain
| | - Pablo González
- Instituto de Investigación e Innovación en Bioingeniería, I3B, Universitat Politècnica de València, Camino de Vera s/n, Valencia 46022, Spain
| | - Luis Luna
- Inscanner S.L, Magnetic Resonance Department, Alicante, Spain
| | - Valery Naranjo
- Instituto de Investigación e Innovación en Bioingeniería, I3B, Universitat Politècnica de València, Camino de Vera s/n, Valencia 46022, Spain
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17
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Al-Shaikhli SDS, Yang MY, Rosenhahn B. Alzheimer's disease detection via automatic 3D caudate nucleus segmentation using coupled dictionary learning with level set formulation. Comput Methods Programs Biomed 2016; 137:329-339. [PMID: 28110736 DOI: 10.1016/j.cmpb.2016.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 08/07/2016] [Accepted: 09/09/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND OBJECTIVE This paper presents a novel method for Alzheimer's disease classification via an automatic 3D caudate nucleus segmentation. METHODS The proposed method consists of segmentation and classification steps. In the segmentation step, we propose a novel level set cost function. The proposed cost function is constrained by a sparse representation of local image features using a dictionary learning method. We present coupled dictionaries: a feature dictionary of a grayscale brain image and a label dictionary of a caudate nucleus label image. Using online dictionary learning, the coupled dictionaries are learned from the training data. The learned coupled dictionaries are embedded into a level set function. In the classification step, a region-based feature dictionary is built. The region-based feature dictionary is learned from shape features of the caudate nucleus in the training data. The classification is based on the measure of the similarity between the sparse representation of region-based shape features of the segmented caudate in the test image and the region-based feature dictionary. RESULTS The experimental results demonstrate the superiority of our method over the state-of-the-art methods by achieving a high segmentation (91.5%) and classification (92.5%) accuracy. CONCLUSIONS In this paper, we find that the study of the caudate nucleus atrophy gives an advantage over the study of whole brain structure atrophy to detect Alzheimer's disease.
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Affiliation(s)
- Saif Dawood Salman Al-Shaikhli
- School of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA; Institut für Informationsverarbeitung, Leibniz Universität Hannover, Appelstr. 9A, 30167 Hannover, Germany.
| | - Michael Ying Yang
- ITC - Faculty of Geo-Information Science and Earth Observation, Department of Earth Observation Science, University of Twente, Netherlands
| | - Bodo Rosenhahn
- Institut für Informationsverarbeitung, Leibniz Universität Hannover, Appelstr. 9A, 30167 Hannover, Germany
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18
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Yoo K, Lee P, Chung MK, Sohn WS, Chung SJ, Na DL, Ju D, Jeong Y. Degree-based statistic and center persistency for brain connectivity analysis. Hum Brain Mapp 2016; 38:165-181. [PMID: 27593391 DOI: 10.1002/hbm.23352] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 05/18/2016] [Accepted: 08/08/2016] [Indexed: 12/16/2022] Open
Abstract
Brain connectivity analyses have been widely performed to investigate the organization and functioning of the brain, or to observe changes in neurological or psychiatric conditions. However, connectivity analysis inevitably introduces the problem of mass-univariate hypothesis testing. Although, several cluster-wise correction methods have been suggested to address this problem and shown to provide high sensitivity, these approaches fundamentally have two drawbacks: the lack of spatial specificity (localization power) and the arbitrariness of an initial cluster-forming threshold. In this study, we propose a novel method, degree-based statistic (DBS), performing cluster-wise inference. DBS is designed to overcome the above-mentioned two shortcomings. From a network perspective, a few brain regions are of critical importance and considered to play pivotal roles in network integration. Regarding this notion, DBS defines a cluster as a set of edges of which one ending node is shared. This definition enables the efficient detection of clusters and their center nodes. Furthermore, a new measure of a cluster, center persistency (CP) was introduced. The efficiency of DBS with a known "ground truth" simulation was demonstrated. Then they applied DBS to two experimental datasets and showed that DBS successfully detects the persistent clusters. In conclusion, by adopting a graph theoretical concept of degrees and borrowing the concept of persistence from algebraic topology, DBS could sensitively identify clusters with centric nodes that would play pivotal roles in an effect of interest. DBS is potentially widely applicable to variable cognitive or clinical situations and allows us to obtain statistically reliable and easily interpretable results. Hum Brain Mapp 38:165-181, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Kwangsun Yoo
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea.,KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Peter Lee
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea.,KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Moo K Chung
- Department of Biostatistics and Medical Informatics and Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin, Madison, Wisconsin 53706
| | - William S Sohn
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Daheen Ju
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Yong Jeong
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea.,KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
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Abstract
Dementia with Lewy bodies (DLB) while common in older age can present a diagnostic challenge to clinicians and is often misdiagnosed as Alzheimer disease (AD). Imaging studies have improved our understanding of the neurobiological changes in DLB during life and how they differ from AD. This has led to significant advances in the development of new techniques, such as dopaminergic imaging, which can aid the clinical diagnosis. Other functional imaging methods also show promise in helping to assess the influence of differing pathologies in DLB, most notably, AD-related and vascular pathology during life. This article will provide an overview of the main imaging findings in DLB.
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Affiliation(s)
- Rosie Watson
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Sean J Colloby
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, The United Kingdom
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20
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Mirza SS, Ikram MA, Bos D, Mihaescu R, Hofman A, Tiemeier H. Mild cognitive impairment and risk of depression and anxiety: A population‐based study. Alzheimers Dement 2016; 13:130-139. [DOI: 10.1016/j.jalz.2016.06.2361] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 06/13/2016] [Accepted: 06/23/2016] [Indexed: 01/19/2023]
Affiliation(s)
- Saira Saeed Mirza
- Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands
| | - M. Arfan Ikram
- Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands
- Department of Neurology Erasmus Medical Center Rotterdam The Netherlands
- Department of Radiology Erasmus Medical Center Rotterdam The Netherlands
| | - Daniel Bos
- Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands
- Department of Radiology Erasmus Medical Center Rotterdam The Netherlands
| | - Raluca Mihaescu
- Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands
- Department of Psychiatry Erasmus Medical Center Rotterdam The Netherlands
| | - Albert Hofman
- Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands
| | - Henning Tiemeier
- Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands
- Department of Psychiatry Erasmus Medical Center Rotterdam The Netherlands
- Department of Child and Adolescent Psychiatry Erasmus Medical Center Rotterdam The Netherlands
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21
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Watson R, Colloby SJ, Blamire AM, O'Brien JT. Subcortical volume changes in dementia with Lewy bodies and Alzheimer's disease. A comparison with healthy aging. Int Psychogeriatr 2016; 28:529-36. [PMID: 26572170 DOI: 10.1017/S1041610215001805] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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] [Indexed: 12/11/2022]
Abstract
BACKGROUND Differentiating Alzheimer's disease (AD) and dementia with Lewy bodies (DLB), two of the commonest forms of dementia in older age, remains a diagnostic challenge. To assist with better understanding of the differences between the conditions during life, we assessed limbic and subcortical brain volumes in AD, DLB, and healthy older individuals using magnetic resonance imaging (MRI), with the hypothesis that when compared with controls, subcortical volumes would be reduced to a greater extent in DLB than in AD. METHODS One hundred participants (35 healthy controls, 32 AD, and 33 DLB) underwent 3 Tesla T1 weighted MR scanning. Volumes were automatically segmented for each participant using FreeSurfer, then expressed as a percentage of their total intracranial volumes. Group effects were assessed using multivariate analysis of covariance, controlling for age and gender. RESULTS Significant group effects were apparent among subcortical brain volumes (F 28,162 = 4.8, p < 0.001; Wilk's Λ = 0.30, partial η 2 = 0.45), while univariate tests showed differences in all volumetric measures (p AD, p < 0.008). CONCLUSIONS For similar levels of dementia severity, DLB appears to have greater involvement of subcortical brain atrophy than AD. Further investigation of the subcortical brain structures in DLB is warranted to fully understand their neurobiological role in this disease.
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Koikkalainen J, Rhodius-Meester H, Tolonen A, Barkhof F, Tijms B, Lemstra AW, Tong T, Guerrero R, Schuh A, Ledig C, Rueckert D, Soininen H, Remes AM, Waldemar G, Hasselbalch S, Mecocci P, van der Flier W, Lötjönen J. Differential diagnosis of neurodegenerative diseases using structural MRI data. Neuroimage Clin 2016; 11:435-449. [PMID: 27104138 PMCID: PMC4827727 DOI: 10.1016/j.nicl.2016.02.019] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 02/02/2016] [Accepted: 02/29/2016] [Indexed: 01/11/2023]
Abstract
Different neurodegenerative diseases can cause memory disorders and other cognitive impairments. The early detection and the stratification of patients according to the underlying disease are essential for an efficient approach to this healthcare challenge. This emphasizes the importance of differential diagnostics. Most studies compare patients and controls, or Alzheimer's disease with one other type of dementia. Such a bilateral comparison does not resemble clinical practice, where a clinician is faced with a number of different possible types of dementia. Here we studied which features in structural magnetic resonance imaging (MRI) scans could best distinguish four types of dementia, Alzheimer's disease, frontotemporal dementia, vascular dementia, and dementia with Lewy bodies, and control subjects. We extracted an extensive set of features quantifying volumetric and morphometric characteristics from T1 images, and vascular characteristics from FLAIR images. Classification was performed using a multi-class classifier based on Disease State Index methodology. The classifier provided continuous probability indices for each disease to support clinical decision making. A dataset of 504 individuals was used for evaluation. The cross-validated classification accuracy was 70.6% and balanced accuracy was 69.1% for the five disease groups using only automatically determined MRI features. Vascular dementia patients could be detected with high sensitivity (96%) using features from FLAIR images. Controls (sensitivity 82%) and Alzheimer's disease patients (sensitivity 74%) could be accurately classified using T1-based features, whereas the most difficult group was the dementia with Lewy bodies (sensitivity 32%). These results were notable better than the classification accuracies obtained with visual MRI ratings (accuracy 44.6%, balanced accuracy 51.6%). Different quantification methods provided complementary information, and consequently, the best results were obtained by utilizing several quantification methods. The results prove that automatic quantification methods and computerized decision support methods are feasible for clinical practice and provide comprehensive information that may help clinicians in the diagnosis making. Differential diagnostics of dementias was studied using structural MRI data. 504 patients with both T1 and FLAIR MRIs from five patient classes were evaluated. Different fully automatic quantification methods were compared and combined. Classification accuracy of 70.6% was obtained for 5-class classification problem. Combination of several quantification methods was needed for optimal accuracy.
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Affiliation(s)
- Juha Koikkalainen
- VTT Technical Research Centre of Finland, Tampere, Finland; Combinostics Ltd., Tampere, Finland.
| | - Hanneke Rhodius-Meester
- Alzheimer Center, Department of Neurology, VU University Medical Centre, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Antti Tolonen
- VTT Technical Research Centre of Finland, Tampere, Finland
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Centre, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Betty Tijms
- Alzheimer Center, Department of Neurology, VU University Medical Centre, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Afina W Lemstra
- Alzheimer Center, Department of Neurology, VU University Medical Centre, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Tong Tong
- Department of Computing, Imperial College London, London, UK
| | | | - Andreas Schuh
- Department of Computing, Imperial College London, London, UK
| | - Christian Ledig
- Department of Computing, Imperial College London, London, UK
| | - Daniel Rueckert
- Department of Computing, Imperial College London, London, UK
| | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Anne M Remes
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Gunhild Waldemar
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Steen Hasselbalch
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Patrizia Mecocci
- Section of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Wiesje van der Flier
- Alzheimer Center, Department of Neurology, VU University Medical Centre, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Centre, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Jyrki Lötjönen
- VTT Technical Research Centre of Finland, Tampere, Finland; Combinostics Ltd., Tampere, Finland
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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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Suri S, Topiwala A, Mackay CE, Ebmeier KP, Filippini N. Using structural and diffusion magnetic resonance imaging to differentiate the dementias. Curr Neurol Neurosci Rep 2015; 14:475. [PMID: 25030502 DOI: 10.1007/s11910-014-0475-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Dementia is one of the major causes of personal, societal and financial dependence in older people and in today's ageing society there is a pressing need for early and accurate markers of cognitive decline. There are several subtypes of dementia but the four most common are Alzheimer's disease, Lewy body dementia, vascular dementia and frontotemporal dementia. These disorders can only be diagnosed at autopsy, and ante-mortem assessments of "probable dementia (e.g. of Alzheimer type)" are traditionally driven by clinical symptoms of cognitive or behavioural deficits. However, owing to the overlapping nature of symptoms and age of onset, a significant proportion of dementia cases remain incorrectly diagnosed. Misdiagnosis can have an extensive impact, both at the level of the individual, who may not be offered the appropriate treatment, and on a wider scale, by influencing the entry of patients into relevant clinical trials. Magnetic resonance imaging (MRI) may help to improve diagnosis by providing non-invasive and detailed disease-specific markers of cognitive decline. MRI-derived measurements of grey and white matter structural integrity are potential surrogate markers of disease progression, and may also provide valuable diagnostic information. This review summarises the latest evidence on the use of structural and diffusion MRI in differentiating between the four major dementia subtypes.
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Affiliation(s)
- Sana Suri
- Department of Psychiatry, Warneford Hospital, Warneford Lane, University of Oxford, Oxford, OX3 7JX, UK
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25
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Dyrba M, Grothe M, Kirste T, Teipel SJ. Multimodal analysis of functional and structural disconnection in Alzheimer's disease using multiple kernel SVM. Hum Brain Mapp 2015; 36:2118-31. [PMID: 25664619 DOI: 10.1002/hbm.22759] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 01/30/2015] [Indexed: 01/13/2023] Open
Abstract
Alzheimer's disease (AD) patients exhibit alterations in the functional connectivity between spatially segregated brain regions which may be related to both local gray matter (GM) atrophy as well as a decline in the fiber integrity of the underlying white matter tracts. Machine learning algorithms are able to automatically detect the patterns of the disease in image data, and therefore, constitute a suitable basis for automated image diagnostic systems. The question of which magnetic resonance imaging (MRI) modalities are most useful in a clinical context is as yet unresolved. We examined multimodal MRI data acquired from 28 subjects with clinically probable AD and 25 healthy controls. Specifically, we used fiber tract integrity as measured by diffusion tensor imaging (DTI), GM volume derived from structural MRI, and the graph-theoretical measures 'local clustering coefficient' and 'shortest path length' derived from resting-state functional MRI (rs-fMRI) to evaluate the utility of the three imaging methods in automated multimodal image diagnostics, to assess their individual performance, and the level of concordance between them. We ran the support vector machine (SVM) algorithm and validated the results using leave-one-out cross-validation. For the single imaging modalities, we obtained an area under the curve (AUC) of 80% for rs-fMRI, 87% for DTI, and 86% for GM volume. When it came to the multimodal SVM, we obtained an AUC of 82% using all three modalities, and 89% using only DTI measures and GM volume. Combined multimodal imaging data did not significantly improve classification accuracy compared to the best single measures alone.
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Affiliation(s)
- Martin Dyrba
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Rostock, Germany
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26
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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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27
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Abstract
Parkinson's disease with dementia (PDD) and dementia with Lewy bodies (DLB) are pathological overlapping and important causes of dementia for which clinical trials are in their infancy. Cholinesterase inhibitors may be of benefit in DLB and PDD, as suggested by placebo-controlled clinical trials of rivastigmine and donepezil. The anti-psychotic agent clozapine has been of benefit in PD and PDD, but other agents, such as quetiapine, require adequate assessment. Barriers to trials include pathological overlap that can lead to inaccuracies in clinical diagnosis, unavailability of a consensus definition for PDD, unanswered questions regarding natural history and the paucity of validated outcome measures. Motor impairment must be considered in patients with PDD and DLB; conversely, cognitive impairment should be assessed in trials targeting motor impairment in advanced PD. Potential targets for treatment include onset of dementia, cognitive impairment, behavioral impairment, functional decline, falls, nursing home placement, mortality, quality of life and economic impact. Biomarkers including neuroimaging and cerebrospinal fluid markers are not currently established. At present PDD and DLB are distinct entities by definition. Future studies, including clinical trials and biomarker studies, will help to further define the clinical and therapeutic implications of this distinction.
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Shi CG, Yang YS, Li H, Zhang Y, Wang N, Wang SM, Wang JD, Zhang SC. Tanshinol protects hippocampus and attenuates vascular dementia development. J Asian Nat Prod Res 2014; 16:667-676. [PMID: 24957473 DOI: 10.1080/10286020.2014.930131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 05/28/2014] [Indexed: 06/03/2023]
Abstract
Tanshinol (3-(3',4'-dihydroxyphenyl)-(2R)-lactic acid, TSL) is widely used in traditional Chinese medicine for the treatment of cardiovascular and cerebrovascular diseases. Here, we assessed whether TSL protected hippocampus and attenuated vascular dementia (VD) development in rats. The behavioral analysis showed that TSL could decrease the distance and latency time, and increase the swim speed in water maze in rats subjected to VD. TSL remarkably increased acetylcholine level and decreased acetylcholinesterase activity in rats subjected to VD. Likewise, TSL remarkably decreased malondialdehyde and increased superoxide dismutase levels in rats subjected to VD. Furthermore, treatment with TSL reduced the level of dead neurons in dentate gyrus. In addition, TSL upregulated growth-associated protein 43 (GAP43) and vascular endothelial growth factor (VEGF) expression and downregulated phosphorylated Akt (p-AKt) and phosphorylated glycogen synthase kinase (p-GSK3β) expression in hippocampus in rats subjected to VD. These results suggest that TSL may be a potential compound in VD model.
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Affiliation(s)
- Cui-Ge Shi
- a Department of Cell Biology , National Research Institute of Family Planning , Beijing 100081 , China
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29
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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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30
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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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31
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Andrade-Moraes CH, Oliveira-Pinto AV, Castro-Fonseca E, da Silva CG, Guimarães DM, Szczupak D, Parente-Bruno DR, Carvalho LRB, Polichiso L, Gomes BV, Oliveira LM, Rodriguez RD, Leite REP, Ferretti-Rebustini REL, Jacob-Filho W, Pasqualucci CA, Grinberg LT, Lent R. Cell number changes in Alzheimer's disease relate to dementia, not to plaques and tangles. Brain 2013; 136:3738-52. [PMID: 24136825 DOI: 10.1093/brain/awt273] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [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: 12/25/2022] Open
Abstract
Alzheimer's disease is the commonest cause of dementia in the elderly, but its pathological determinants are still debated. Amyloid-β plaques and neurofibrillary tangles have been implicated either directly as disruptors of neural function, or indirectly by precipitating neuronal death and thus causing a reduction in neuronal number. Alternatively, the initial cognitive decline has been attributed to subtle intracellular events caused by amyloid-β oligomers, resulting in dementia after massive synaptic dysfunction followed by neuronal degeneration and death. To investigate whether Alzheimer's disease is associated with changes in the absolute cell numbers of ageing brains, we used the isotropic fractionator, a novel technique designed to determine the absolute cellular composition of brain regions. We investigated whether plaques and tangles are associated with neuronal loss, or whether it is dementia that relates to changes of absolute cell composition, by comparing cell numbers in brains of patients severely demented with those of asymptomatic individuals-both groups histopathologically diagnosed as Alzheimer's-and normal subjects with no pathological signs of the disease. We found a great reduction of neuronal numbers in the hippocampus and cerebral cortex of demented patients with Alzheimer's disease, but not in asymptomatic subjects with Alzheimer's disease. We concluded that neuronal loss is associated with dementia and not the presence of plaques and tangles, which may explain why subjects with histopathological features of Alzheimer's disease can be asymptomatic; and exclude amyloid-β deposits as causes for the reduction of neuronal numbers in the brain. We found an increase of non-neuronal cell numbers in the cerebral cortex and subcortical white matter of demented patients with Alzheimer's disease when compared with asymptomatic subjects with Alzheimer's disease and control subjects, suggesting a reactive glial cell response in the former that may be related to the symptoms they present.
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32
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Jiji S, Smitha KA, Gupta AK, Pillai VPM, Jayasree RS. Segmentation and volumetric analysis of the caudate nucleus in Alzheimer's disease. Eur J Radiol 2013; 82:1525-30. [DOI: 10.1016/j.ejrad.2013.03.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 03/15/2013] [Accepted: 03/21/2013] [Indexed: 11/29/2022]
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Pievani M, Bocchetta M, Boccardi M, Cavedo E, Bonetti M, Thompson PM, Frisoni GB. Striatal morphology in early-onset and late-onset Alzheimer's disease: a preliminary study. Neurobiol Aging 2013; 34:1728-39. [DOI: 10.1016/j.neurobiolaging.2013.01.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 01/10/2013] [Accepted: 01/22/2013] [Indexed: 11/28/2022]
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34
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Colloby SJ, McParland S, O'Brien JT, Attems J. Neuropathological correlates of dopaminergic imaging in Alzheimer's disease and Lewy body dementias. Brain 2012; 135:2798-808. [DOI: 10.1093/brain/aws211] [Citation(s) in RCA: 139] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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35
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Filippi M, Agosta F, Barkhof F, Dubois B, Fox NC, Frisoni GB, Jack CR, Johannsen P, Miller BL, Nestor PJ, Scheltens P, Sorbi S, Teipel S, Thompson PM, Wahlund LO. EFNS task force: the use of neuroimaging in the diagnosis of dementia. Eur J Neurol 2012; 19:e131-40, 1487-501. [DOI: 10.1111/j.1468-1331.2012.03859.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 07/18/2012] [Indexed: 01/18/2023]
Affiliation(s)
- M. Filippi
- Neuroimaging Research Unit; Division of Neuroscience; Institute of Experimental Neurology; San Raffaele Scientific Institute; Vita-Salute San Raffaele University; Milan Italy
| | - F. Agosta
- Neuroimaging Research Unit; Division of Neuroscience; Institute of Experimental Neurology; San Raffaele Scientific Institute; Vita-Salute San Raffaele University; Milan Italy
| | - F. Barkhof
- Department of Radiology; VU University Medical Center; Amsterdam The Netherlands
| | - B. Dubois
- Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière; Université Pierre et Marie Curie; Paris France
| | - N. C. Fox
- Dementia Research Centre; Institute of Neurology; University College London; London UK
| | - G. B. Frisoni
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli di Brescia; Brescia Italy
| | - C. R. Jack
- Department of Radiology; Mayo Clinic and Foundation; Rochester MN USA
| | - P. Johannsen
- Memory Clinic; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - B. L. Miller
- Memory and Aging Center; University of California; San Francisco CA USA
| | - P. J. Nestor
- Department of Clinical Neuroscience; University of Cambridge; Cambridge UK
| | - P. Scheltens
- Department of Neurology and Alzheimer Center; VU University Medical Center; Amsterdam The Netherlands
| | - S. Sorbi
- Department of Neurological and Psychiatric Sciences; Azienda Ospedaliero-Universitaria di Careggi; Florence Italy
| | - S. Teipel
- Department of Psychiatry; University of Rostock, and German Center for Neuro-degenerative Diseases (DZNE); Rostock Germany
| | - P. M. Thompson
- Department of Neurology; David Geffen School of Medicine at the University of California Los Angeles; Los Angeles CA USA
| | - L.-O. Wahlund
- Division of Clinical Geriatrics; Department of Neurobiology; Karolinska Institute; Stockholm Sweden
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36
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Abstract
SUMMARY Despite the characteristic clinical differences between dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD), a large degree of overlap exists. In particular, the clinical diagnostic criteria for DLB lack sensitivity so that many cases of DLB will be missed during life. MRI techniques offer a noninvasive method to assess the brain structure and function in more detail. In particular, advanced MRI methods such as diffusion-tensor imaging, functional MRI, arterial spin labeling (perfusion) and magnetic resonance spectroscopy may offer more sensitive methods to detect early and, possibly, preclinical change in dementia and contribute to our understanding of the differences between AD and DLB. This paper provides an overview of MRI changes in DLB and AD, the relationship to other imaging modalities such as single-photon emission computed tomography and PET, highlighting the differences between the conditions currently applicable to the clinical setting, as well as recent developments in MRI methods yet to be translated into large-scale clinical studies.
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Affiliation(s)
- Rosie Watson
- Institute for Ageing & Health, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - John T O’Brien
- Institute for Ageing & Health, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
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Abstract
Dementia with Lewy bodies (DLB) is a relative newcomer to the field of late-life dementia. Although a diversity of imaging methodologies is now available for the study of dementia, these have been applied most often to Alzheimer's disease (AD). Studies on DLB, although fewer, have yielded fascinating and important insights into the underlying pathophysiology of this condition and allowed clinical differentiation of DLB from other dementias. Imaging research on DLB has had significant ramifications in terms of raising the profile of DLB and helping define it as a distinctive and separate disease entity from AD.
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Affiliation(s)
- John-Paul Taylor
- Institute for Ageing and Health, Wolfson Research Centre, Campus for Aging and Vitality, Newcastle University, Newcastle Upon Tyne, NE4 5PL, UK.
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Abstract
BACKGROUND Dementia with Lewy bodies (DLB) shares common clinical, neuropsychological and pathological features with other dementia subtypes, such as Alzheimer's disease (AD), making it difficult to differentiate in clinical practice. Despite the development of consensus diagnostic criteria, many cases are missed, and biomarkers to assist with diagnosis would represent important advances. Our aim was to review the literature to identify potential biomarkers that may distinguish DLB from other dementia subtypes, especially AD. METHOD The literature search was performed using Medline up to October 2010 for imaging studies [single-photon emission computed tomography (SPECT), positron emission tomography (PET), magnetic resonance imaging (MRI) and amyloid imaging] and cerebrospinal fluid (CSF) markers in DLB. Individual articles were examined for additional references. The abstracts of the identified articles were read to determine the most relevant papers, which became the basis for this review. RESULTS The most robust evidence available was for striatal dopamine transporter activity visualised by (123) I-labelled N-(3-fluoropropyl)-2β-carbomethoxy-3β-(4-iodophenyl)nortropane ((123) I-FP-CIT) SPECT. Several other imaging techniques have also reported promising results, such as [(18) F]fluorodopa PET, which assesses nigrostriatal integrity; [(18) F]fluorodeoxyglucose PET, which assesses metabolic deficits; and meta-iodobenzylguanidine imaging, which assesses sympathetic cardiac denervation. Data from studies using CSF measures of amyloid and tau, occipital hypoperfusion on SPECT and preservation of medial temporal lobe structures on MRI suggest that they may offer less diagnostic discrimination. CONCLUSION Several potential biomarkers have shown good diagnostic accuracy for DLB, but apart from FP-CIT SPECT, there is now a need for larger clinical multi-site studies, as well as for studies with pathological verification of diagnosis, before their use could be recommended for routine clinical practice.
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Affiliation(s)
- Namrta Sinha
- Institute for Ageing and Health, Newcastle University, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK.
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Abstract
BACKGROUND Dementia with Lewy bodies (DLB) is a common form of dementia characterized by visual hallucinations, cognitive fluctuation and parkinsonism. We aimed to compare the patterns of gray matter atrophy in DLB with those in Alzheimer's disease (AD) and normal aging, and to investigate the relationship between atrophy and cognitive measures. METHODS We used voxel-based morphometry (VBM) to investigate gray matter (GM) loss in DLB (n = 35; mean age = 78.4; MMSE = 20.3), AD (n = 36; mean age = 78.3; MMSE = 19.5) and similar aged controls (n = 35; mean age = 76.7; MMSE = 29.1). T1 weighted MRI scans were acquired at 3 Tesla from all subjects and analyzed using VBM-DARTEL in SPM8. Cognitive function was assessed using the Cambridge Cognitive Examination (CAMCOG). RESULTS We found reduced gray matter in temporal, parietal, occipital, and subcortical structures in DLB when compared to normal controls. The degree of atrophy was less than that observed in AD. There was significantly more medial temporal lobe atrophy in the AD group when compared with DLB. We did not find a correlation between total CAMCOG score and atrophy, but the CAMCOG memory subscale score correlated with temporal lobe atrophy in both the DLB and combined DLB/AD group. CONCLUSIONS DLB is associated with less gray matter atrophy and relative preservation of the medial temporal lobe when compared to AD. Degree of medial temporal atrophy may be a useful imaging biomarker and our results provide support for its inclusion in the revised consensus criteria for DLB.
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Mavridis I, Boviatsis E, Anagnostopoulou S. The human nucleus accumbens suffers parkinsonism-related shrinkage: a novel finding. Surg Radiol Anat 2011; 33:595-9. [PMID: 21404044 DOI: 10.1007/s00276-011-0802-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Accepted: 03/03/2011] [Indexed: 12/30/2022]
Abstract
PURPOSE The human nucleus accumbens (NA) plays an important role in motivation and emotional processes and is involved in some of the most disabling neuropsychiatric disorders such as Parkinson's disease (PD). The purpose of our study was to check out the potential existence of a statistically significant difference in NA size between parkinsonian and non-parkinsonian individuals, through studying brain magnetic resonance images (MRIs). METHODS For our study we used 52 NAs from 26 cerebral MRIs from neurosurgical patients. Of these MRIs, 15 were preoperative from patients with advanced PD who underwent bilateral deep brain stimulation of the subthalamic nucleus. The group of non-parkinsonian MRIs came from the rest 11 individuals. We measured the absolute and relative NA maximum transverse diameter (D (max)), and absolute and relative NA width at a specific transverse plane. RESULTS We found a statistically significant difference of the mean value of the D (max) (absolute and relative) between the two groups. The mean percentage reduction of the NA size was 11.77% represented by the relative D (max). CONCLUSIONS To our knowledge, this is the first report of parkinsonism-related shrinkage of the human NA. Further research is needed to identify whether a respective shrinkage is also observed in patients with early PD and whether this atrophy is correlated with dopaminergic neuropsychiatric symptoms (perhaps mediated by a malfunctioning NA) that occur in PD.
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Affiliation(s)
- Ioannis Mavridis
- Department of Anatomy, University of Athens School of Medicine, Mikras Assias str. 75, Goudi, 11527, Athens, Greece.
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Skup M, Zhu H, Wang Y, Giovanello KS, Lin JA, Shen D, Shi F, Gao W, Lin W, Fan Y, Zhang H; Alzheimer's Disease Neuroimaging Initiative. Sex differences in grey matter atrophy patterns among AD and aMCI patients: results from ADNI. Neuroimage 2011; 56:890-906. [PMID: 21356315 DOI: 10.1016/j.neuroimage.2011.02.060] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 02/14/2011] [Accepted: 02/20/2011] [Indexed: 11/21/2022] Open
Abstract
We used longitudinal magnetic resonance imaging (MRI) data to determine whether there are any gender differences in grey matter atrophy patterns over time in 197 individuals with probable Alzheimer's disease (AD) and 266 with amnestic mild cognitive impairment (aMCI), compared with 224 healthy controls participating in the Alzheimer's Disease Neuroimaging Initiative (ADNI). While previous research has differentiated probable AD and aMCI groups from controls in brain atrophy, it is unclear whether and how sex plays a role in patterns of change over time. Using regional volumetric maps, we fit longitudinal models to the grey matter data collected at repeated occasions, seeking differences in patterns of volume change over time by sex and diagnostic group in a voxel-wise analysis. Additionally, using a region-of-interest approach, we fit longitudinal models to the global volumetric data of predetermined brain regions to determine whether this more conventional approach is sufficient for determining sex and group differences in atrophy. Our longitudinal analyses revealed that, of the various grey matter regions investigated, males and females in the AD group and the aMCI group showed different patterns of decline over time compared to controls in the bilateral precuneus, bilateral caudate nucleus, right entorhinal gyrus, bilateral thalamus, bilateral middle temporal gyrus, left insula, and right amygdala. As one of the first investigation to model more than two time points of structural MRI data over time, our findings add insight into how AD and aMCI males and females differ from controls and from each other over time.
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Abstract
Tracking progression in neurodegenerative diseases is hampered by the limitations of the clinical rating scales, which are seldom linear, suffer from floor and ceiling effects, lack the ability to distinguish symptomatic change from disease modification, and are limited by imperfect intra- and inter-rater reliability. The promise of an era of neuroprotective therapies renders urgent the search for reliable measures of progression. Biomarkers have the potential to enhance several aspects of both therapeutic trials and clinical practice. MRI-based measures of cerebral volume can provide a surrogate for neuronal loss and several techniques have been applied to elucidate disease processes, aid diagnosis, and enable monitoring of progression in a variety of Parkinsonian disorders, including Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy and Huntington's disease. We review the approaches to, and findings revealed by, serial volumetric MRI in these disorders.
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Affiliation(s)
- Edward J Wild
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology/National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
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Goto H, Ishii K, Uemura T, Miyamoto N, Yoshikawa T, Shimada K, Ohkawa S. Differential diagnosis of dementia with Lewy Bodies and Alzheimer Disease using combined MR imaging and brain perfusion single-photon emission tomography. AJNR Am J Neuroradiol 2010; 31:720-5. [PMID: 20075101 DOI: 10.3174/ajnr.a1926] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Diagnostic performance by MR imaging or by SPECT alone in discriminating DLB patients from AD patients has been estimated previously. However, the performance of a combination of MR imaging and SPECT has not yet been evaluated. Our aim was to evaluate the usefulness of combining MR imaging and SPECT to discriminate mild DLB from AD. MATERIALS AND METHODS Nineteen patients with mild DLB and 19 age- and cognitive decline-matched patients with mild AD underwent both SPECT and MR imaging. Hippocampal, occipital, and striatal volume and SPECT count ratios were compared. Linear discriminant and ROC analyses were performed by using the parameters of striatal volume and the occipital SPECT ratio. RESULTS The striatal volume ratio in the DLB group was significantly lower than that in the AD group. The occipital SPECT ratio in the DLB group was lower than that in the AD group. The mean area under the ROC curve from combined MR imaging and SPECT (AUC = 0.898) was higher than that from MR imaging (AUC = 0.679) or SPECT (AUC = 0.798) alone. CONCLUSIONS By combining MR imaging and SPECT, we were able to distinguish patients with mild DLB from those with AD with a high level of accuracy. Our findings suggest that combining MR imaging and SPECT modalities is a useful and practical approach for diagnostically differentiating DLB from AD.
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Affiliation(s)
- H Goto
- Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, Himeji, Japan
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Abstract
INTRODUCTION Anxiety disorders are less well studied in elderly people than other disorders such as depression. In particular the diagnosis of anxiety is more difficult in patients with Mild Cognitive Impairment (MCI) since the current definition of MCI does not mention neuropsychiatric symptoms. OBJECTIVES To validate the Italian version of Geriatric Anxiety Inventory (GAI), an instrument that measures dimensional anxiety in elderly people, and assess whether MCI subjects with anxiety symptoms show different neuropsychological profiles in comparison with MCI without anxiety symptoms. METHODS Fifty-seven outpatients with MCI were consecutively recruited. All patients were assessed using a complete neuropsychological battery to detect the cognitive impairment, and the GAI for the presence of anxiety symptoms. RESULTS Anxiety + patients (GAI >or= 10) show more behavioral and psychological disturbances than patients with Anxiety- (GAI < 10); in particular they had more agitation, anxiety, depression and more sleep disorders. Moreover, Anxiety + patients are more compromised on instrumental daily functions and on executive functions evaluated with Trail Making B test (TMB). Linear Regression analysis was completed to estimate the coefficients of the linear equation, involving neuropsychological, psychobehavioural and functional characteristics: the executive functions (TMB) are the only variable independently related to the presence of anxiety disturbances. CONCLUSIONS Executive functions are independently related to anxiety disorders in MCI patients. We hypothesized that the strict interaction between anxiety symptoms and executive functions could depend on specific pathological features at the level of caudate nucleus characterizing early phases of dementia.
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Affiliation(s)
- Luca Rozzini
- Department of Neurology, University of Brescia, Brescia, Italy.
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de Jong LW, van der Hiele K, Veer IM, Houwing JJ, Westendorp RGJ, Bollen ELEM, de Bruin PW, Middelkoop HAM, van Buchem MA, van der Grond J. Strongly reduced volumes of putamen and thalamus in Alzheimer's disease: an MRI study. Brain 2008; 131:3277-85. [PMID: 19022861 PMCID: PMC2639208 DOI: 10.1093/brain/awn278] [Citation(s) in RCA: 346] [Impact Index Per Article: 21.6] [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] [Indexed: 01/18/2023] Open
Abstract
Atrophy is regarded a sensitive marker of neurodegenerative pathology. In addition to confirming the well-known presence of decreased global grey matter and hippocampal volumes in Alzheimer's disease, this study investigated whether deep grey matter structure also suffer degeneration in Alzheimer's disease, and whether such degeneration is associated with cognitive deterioration. In this cross-sectional correlation study, two groups were compared on volumes of seven subcortical regions: 70 memory complainers (MCs) and 69 subjects diagnosed with probable Alzheimer's disease. Using 3T 3D T1 MR images, volumes of nucleus accumbens, amygdala, caudate nucleus, hippocampus, pallidum, putamen and thalamus were automatically calculated by the FMRIB's Integrated Registration and Segmentation Tool (FIRST)--algorithm FMRIB's Software Library (FSL). Subsequently, the volumes of the different regions were correlated with cognitive test results. In addition to finding the expected association between hippocampal atrophy and cognitive decline in Alzheimer's disease, volumes of putamen and thalamus were significantly reduced in patients diagnosed with probable Alzheimer's disease. We also found that the decrease in volume correlated linearly with impaired global cognitive performance. These findings strongly suggest that, beside neo-cortical atrophy, deep grey matter structures in Alzheimer's disease suffer atrophy as well and that degenerative processes in the putamen and thalamus, like the hippocampus, may contribute to cognitive decline in Alzheimer's disease.
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Affiliation(s)
- L W de Jong
- Department of Radiology, University Medical Center, Leiden, The Netherlands.
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Karas G, Scheltens P, Barkhof F. Feature extraction and strategy of analyzing structural neuroimaging in dementia. Handb Clin Neurol 2008; 89:75-86. [PMID: 18631732 DOI: 10.1016/S0072-9752(07)01206-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register]
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47
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Abstract
BACKGROUND - Idiopathic normal pressure hydrocephalus (iNPH) is a reversible dementia in which fronto-striatal cognitive deficits and apathy may be present. OBJECTIVES - The study investigated structural volumetric changes in iNPH, apart from ventriculomegaly. MATERIALS AND METHODS - A full-brain voxel-based morphometric analysis between 11 iNPH patients and 14 healthy controls identified regions of interest (ROIs) for manual volumetric analyses. RESULTS - Caudate and corpus callosum ROI measurements revealed diminished caudate nuclei volume in the iNPH group. CONCLUSIONS - The role of the caudate nucleus in cognitive and affective changes in iNPH should now be explored.
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Affiliation(s)
- E E DeVito
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Teipel SJ, Born C, Ewers M, Bokde ALW, Reiser MF, Möller HJ, Hampel H. Multivariate deformation-based analysis of brain atrophy to predict Alzheimer's disease in mild cognitive impairment. Neuroimage 2007; 38:13-24. [PMID: 17827035 DOI: 10.1016/j.neuroimage.2007.07.008] [Citation(s) in RCA: 151] [Impact Index Per Article: 8.9] [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: 01/18/2007] [Revised: 06/19/2007] [Accepted: 07/04/2007] [Indexed: 11/18/2022] Open
Abstract
Automated deformation-based analysis of MRI scans can be used to detect specific pattern of brain atrophy in Alzheimer's disease (AD), but it still lacks an established model to derive the individual risk of AD in at-risk subjects, such as patients with mild cognitive impairment (MCI). We applied principal component analysis to deformation maps derived from MRI scans of 32 AD patients, 18 elderly healthy controls and 24 MCI patients. Principal component scores were used to discriminate between AD patients and controls and between MCI converters and MCI non-converters. We found a significant regional pattern of atrophy (p<0.001) in medial temporal lobes, neocortical association areas, thalamus and basal ganglia and corresponding widening of cerebrospinal fluid (CSF) spaces (p<0.001) in AD patients compared to controls. Accuracy was 81% for CSF- and 83% for brain-based deformation maps to separate AD patients from controls. Nine out of 24 MCI patients converted to AD during clinical follow-up. Discrimination between MCI converters and non-converters reached 80% accuracy based on CSF maps and 73% accuracy based on brain maps. In a logistic regression model, principal component scores based on CSF maps predicted clinical outcome in MCI patients even after controlling for age, gender, MMSE score and time of follow-up. Our findings indicate that multivariate network analysis of deformation maps detects typical features of AD pathology and provides a powerful tool to predict conversion into AD in non-demented at risk patients.
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Affiliation(s)
- Stefan J Teipel
- Alzheimer Memorial Center, Dementia and Neuroimaging Section, Department of Psychiatry, Ludwig-Maximilian University, Nussbaumstr 7, 80336, Munich, Germany.
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Abstract
OBJECTIVES MRI assessments were correlated with serial Combined Mini-Mental Cognitive Capacity Screening Examinations (CMC). Vascular-MCI (VMCI), Neurodegenerative MCI (NMCI) and Parkinson-Lewy body MCI (PLB-MCI) were compared during conversions to dementia. Mild cognitive impairments (MCI) are identifiable prodromes for all dementia subtypes. MRI abnormalities are characterized among MCI subjects prodromal for dementia of Alzheimer's disease (DAT), vascular dementia (VaD) and Parkinson-Lewy body dementia (PLBD). METHODS Aging volunteers (n=166) were recruited from ongoing longitudinal studies of aging, stroke, cerebrovascular disease and dementia. Cognitively normal (CN, n=52), MCIs of neurodegenerative (N-MCI, n=30), vascular (V-MCI, n=35) and Parkinson-Lewy Body (PLB-MCI, n=8) subtypes, plus converted DAT (n=19), VaD (n=17) and PLBD (n=5) were all diagnosed according to established protocol recommendations. Cerebral MRI abnormalities were likewise intercorrelated utilizing quantitative volumetric measurements. RESULTS V-MCI and converted VaD showed extensive leukoaraiosis with more lacunar infarcts than subjects with N-MCI or PLB-MCI. N-MCI, prodromal for DAT, showed medial temporal atrophy, greater enlargement of temporal horns, and fewer vascular lesions. PLB-MCI, prodromal for PLBD, displayed third ventricular enlargement greater than N-MCI and V-MCI, with similar but less severe atrophy of medial temporal lobe than N-MCI and fewer vascular lesions than V-MCI. Cognitive Impairments due to PLB with vascular features (V-PLB-CI) showed more lacunar and microvascular lesions involving both white matter and basal ganglia with greater frontal horn enlargement. CONCLUSIONS This study confirms different MCI subtypes prior to conversion to different dementias listed, recognizable by specific MRI abnormalities.
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Affiliation(s)
- John Stirling Meyer
- Department of Neurology, Baylor College of Medicine, and Cerebrovascular Research Laboratories, Michael E. DeBakey Veterans Administration Medical Center, Houston, Texas 77098, USA.
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Whitwell JL, Weigand SD, Shiung MM, Boeve BF, Ferman TJ, Smith GE, Knopman DS, Petersen RC, Benarroch EE, Josephs KA, Jack CR. Focal atrophy in dementia with Lewy bodies on MRI: a distinct pattern from Alzheimer's disease. Brain 2007; 130:708-19. [PMID: 17267521 PMCID: PMC2730778 DOI: 10.1093/brain/awl388] [Citation(s) in RCA: 210] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Dementia with Lewy bodies (DLB) is the second most common cause of degenerative dementia after Alzheimer's disease. However, unlike the latter, the patterns of cerebral atrophy associated with DLB have not been well established. The aim of this study was to identify a signature pattern of cerebral atrophy in DLB and to compare it with the pattern found in Alzheimer's disease. Seventy-two patients that fulfilled clinical criteria for probable DLB were age- and gender-matched to 72 patients with probable Alzheimer's disease and 72 controls. Voxel-based morphometry (VBM) was used to assess patterns of grey matter (GM) atrophy in the two patient groups, relative to controls, after correction for multiple comparisons (P < 0.05). Study-specific templates and prior probability maps were used to avoid normalization and segmentation bias. Region-of-interest (ROI) analyses were also performed comparing loss of the midbrain, substantia innominata (SI), temporoparietal cortex and hippocampus between the groups. The DLB group showed very little cortical involvement on VBM with regional GM loss observed primarily in the dorsal midbrain, SI and hypothalamus. In comparison, the Alzheimer's disease group showed a widespread pattern of GM loss involving the temporoparietal association cortices and the medial temporal lobes. The SI and dorsal midbrain were involved in Alzheimer's disease; however, they were not identified as a cluster of loss discrete from uninvolved surrounding areas, as observed in the DLB group. On direct comparison between the two groups, the Alzheimer's disease group showed greater loss in the medial temporal lobe and inferior temporal regions than the DLB group. The ROI analysis showed reduced SI and midbrain GM in both patient groups, with a trend for more reduction of SI GM in Alzheimer's disease than DLB, and more reduction of midbrain in DLB than Alzheimer's disease. Significantly greater loss in the hippocampus and temporo-parietal cortex was observed in the Alzheimer's disease patients when the two patient groups were compared. A pattern of relatively focused atrophy of the midbrain, hypothalamus and SI, with a relative sparing of the hippocampus and temporoparietal cortex is, therefore, suggestive of DLB and this may aid in the differentiation of DLB from Alzheimer's disease. These findings support recent pathological studies showing an ascending pattern of Lewy body progression from brainstem to basal areas of the brain. Damage to this network of structures in DLB may affect a number of different neurotransmitter systems which in turn may contribute to a number of the core clinical features of DLB.
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