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Maltby CJ, Krans A, Grudzien SJ, Palacios Y, Muiños J, Suárez A, Asher M, Khurana V, Barmada SJ, Dijkstra AA, Todd PK. AAGGG repeat expansions trigger RFC1-independent synaptic dysregulation in human CANVAS Neurons. bioRxiv 2023:2023.12.13.571345. [PMID: 38168171 PMCID: PMC10760133 DOI: 10.1101/2023.12.13.571345] [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] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS) is a late onset, recessively inherited neurodegenerative disorder caused by biallelic, non-reference pentameric AAGGG(CCCTT) repeat expansions within the second intron of replication factor complex subunit 1 (RFC1). To investigate how these repeats cause disease, we generated CANVAS patient induced pluripotent stem cell (iPSC) derived neurons (iNeurons) and utilized calcium imaging and transcriptomic analysis to define repeat-elicited gain-of-function and loss-of-function contributions to neuronal toxicity. AAGGG repeat expansions do not alter neuronal RFC1 splicing, expression, or DNA repair pathway functions. In reporter assays, AAGGG repeats are translated into pentapeptide repeat proteins that selectively accumulate in CANVAS patient brains. However, neither these proteins nor repeat RNA foci were detected in iNeurons, and overexpression of these repeats in isolation did not induce neuronal toxicity. CANVAS iNeurons exhibit defects in neuronal development and diminished synaptic connectivity that is rescued by CRISPR deletion of a single expanded allele. These phenotypic deficits were not replicated by knockdown of RFC1 in control neurons and were not rescued by ectopic expression of RFC1. These findings support a repeat-dependent but RFC1-independent cause of neuronal dysfunction in CANVAS, with important implications for therapeutic development in this currently untreatable condition.
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Affiliation(s)
- Connor J. Maltby
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Amy Krans
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Ann Arbor Veterans Administration Healthcare, Ann Arbor, MI, USA
| | - Samantha J. Grudzien
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Yomira Palacios
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Postbaccalaureate Research Education Program, University of Michigan, Ann Arbor, MI, USA
| | - Jessica Muiños
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- UM SMART Undergraduate Summer Program, University of Michigan, Ann Arbor, MI, USA
| | - Andrea Suárez
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Postbaccalaureate Research Education Program, University of Michigan, Ann Arbor, MI, USA
| | - Melissa Asher
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Vikram Khurana
- Department of Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Sami J. Barmada
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Anke A. Dijkstra
- Department of Pathology, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter K. Todd
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Ann Arbor Veterans Administration Healthcare, Ann Arbor, MI, USA
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Loef D, Tendolkar I, van Eijndhoven PFP, Hoozemans JJM, Oudega ML, Rozemuller AJM, Lucassen PJ, Dols A, Dijkstra AA. Electroconvulsive therapy is associated with increased immunoreactivity of neuroplasticity markers in the hippocampus of depressed patients. Transl Psychiatry 2023; 13:355. [PMID: 37981649 PMCID: PMC10658169 DOI: 10.1038/s41398-023-02658-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/23/2023] [Accepted: 11/07/2023] [Indexed: 11/21/2023] Open
Abstract
Electroconvulsive therapy (ECT) is an effective therapy for depression, but its cellular effects on the human brain remain elusive. In rodents, electroconvulsive shocks increase proliferation and the expression of plasticity markers in the hippocampal dentate gyrus (DG), suggesting increased neurogenesis. Furthermore, MRI studies in depressed patients have demonstrated increases in DG volume after ECT, that were notably paralleled by a decrease in depressive mood scores. Whether ECT also triggers cellular plasticity, inflammation or possibly injury in the human hippocampus, was unknown. We here performed a first explorative, anatomical study on the human post-mortem hippocampus of a unique, well-documented cohort of bipolar or unipolar depressed patients, who had received ECT in the 5 years prior to their death. They were compared to age-matched patients with a depressive disorder who had not received ECT and to matched healthy controls. Upon histopathological examination, no indications were observed for major hippocampal cell loss, overt cytoarchitectural changes or classic neuropathology in these 3 groups, nor were obvious differences present in inflammatory markers for astrocytes or microglia. Whereas the numbers of proliferating cells expressing Ki-67 was not different, we found a significantly higher percentage of cells positive for Doublecortin, a marker commonly used for young neurons and cellular plasticity, in the subgranular zone and CA4 / hilus of the hippocampus of ECT patients. Also, the percentage of positive Stathmin 1 cells was significantly higher in the subgranular zone of ECT patients, indicating neuroplasticity. These first post-mortem observations suggest that ECT has no damaging effects but may rather have induced neuroplasticity in the DG of depressed patients.
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Affiliation(s)
- Dore Loef
- Amsterdam UMC, location VUmc, Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands.
- GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands.
| | - Indira Tendolkar
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
- Department of Psychiatry and Psychotherapy, University Hospital Essen, Essen, Germany
| | - Philip F P van Eijndhoven
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - Mardien L Oudega
- Amsterdam UMC, location VUmc, Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands
| | - Annemieke J M Rozemuller
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - Paul J Lucassen
- Brain Plasticity Group, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Annemiek Dols
- Amsterdam UMC, location VUmc, Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands
| | - Anke A Dijkstra
- Molecular Neuroscience Group, Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Amsterdam, the Netherlands
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3
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Dijkstra AA, Morrema THJ, Hart de Ruyter FJ, Gami-Patel P, Verbraak FD, de Boer JF, Bouwman FH, Pijnenburg YAL, den Haan J, Rozemuller AJ, Hoozemans JJM. TDP-43 pathology in the retina of patients with frontotemporal lobar degeneration. Acta Neuropathol 2023; 146:767-770. [PMID: 37597044 PMCID: PMC10564657 DOI: 10.1007/s00401-023-02623-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023]
Affiliation(s)
- Anke A Dijkstra
- Department of Pathology, Amsterdam UMC, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands.
- Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands.
| | - Tjado H J Morrema
- Department of Pathology, Amsterdam UMC, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Frederique J Hart de Ruyter
- Department of Pathology, Amsterdam UMC, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Location VUmc, Alzheimer Center, Neurology, Amsterdam, The Netherlands
| | - Priya Gami-Patel
- Department of Pathology, Amsterdam UMC, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Frank D Verbraak
- Ophthalmology Department, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Johannes F de Boer
- Department of Physics, Bio Laser Lab, VU University, Amsterdam, The Netherlands
| | - Femke H Bouwman
- Amsterdam UMC, Location VUmc, Alzheimer Center, Neurology, Amsterdam, The Netherlands
| | | | - Jurre den Haan
- Amsterdam UMC, Location VUmc, Alzheimer Center, Neurology, Amsterdam, The Netherlands
| | - Annemieke J Rozemuller
- Department of Pathology, Amsterdam UMC, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam UMC, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands
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4
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Wang C, Terrigno M, Li J, Distler T, Pandya NJ, Ebeling M, Tyanova S, Hoozemans JJM, Dijkstra AA, Fuchs L, Xiang S, Bonni A, Grüninger F, Jagasia R. Increased G3BP2-Tau interaction in tauopathies is a natural defense against Tau aggregation. Neuron 2023; 111:2660-2674.e9. [PMID: 37385246 DOI: 10.1016/j.neuron.2023.05.033] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 02/21/2023] [Accepted: 05/31/2023] [Indexed: 07/01/2023]
Abstract
Many RNA-binding proteins (RBPs), particularly those associated with RNA granules, promote pathological protein aggregation in neurodegenerative diseases. Here, we demonstrate that G3BP2, a core component of stress granules, directly interacts with Tau and inhibits Tau aggregation. In the human brain, the interaction of G3BP2 and Tau is dramatically increased in multiple tauopathies, and it is independent of neurofibrillary tangle (NFT) formation in Alzheimer's disease (AD). Surprisingly, Tau pathology is significantly elevated upon loss of G3BP2 in human neurons and brain organoids. Moreover, we found that G3BP2 masks the microtubule-binding region (MTBR) of Tau, thereby inhibiting Tau aggregation. Our study defines a novel role for RBPs as a line of defense against Tau aggregation in tauopathies.
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Affiliation(s)
- Congwei Wang
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland.
| | - Marco Terrigno
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Juan Li
- School of Life Sciences, University of Science and Technology of China, 230026 Anhui, China
| | - Tania Distler
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Nikhil J Pandya
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Martin Ebeling
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Stefka Tyanova
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centers, 1081 HV Amsterdam, the Netherlands
| | - Anke A Dijkstra
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centers, 1081 HV Amsterdam, the Netherlands
| | - Luisa Fuchs
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Shengqi Xiang
- School of Life Sciences, University of Science and Technology of China, 230026 Anhui, China
| | - Azad Bonni
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Fiona Grüninger
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Ravi Jagasia
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland.
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5
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Fiondella L, Gami-Patel P, Blok CA, Rozemuller AJM, Hoozemans JJM, Pijnenburg YAL, Scarioni M, Dijkstra AA. Movement disorders are linked to TDP-43 burden in the substantia nigra of FTLD-TDP brain donors. Acta Neuropathol Commun 2023; 11:63. [PMID: 37046309 PMCID: PMC10091586 DOI: 10.1186/s40478-023-01560-7] [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] [Received: 12/09/2022] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
Movement disorders (MD) have been linked to degeneration of the substantia nigra (SN) in Parkinson's disease and include bradykinesia, rigidity, and tremor. They are also present in frontotemporal dementia (FTD), where MD have been linked to frontotemporal lobar degeneration with tau pathology (FTLD-tau). Although MD can also occur in FTLD with TDP-43 pathology (FTLD-TDP), the local pathology in the SN of FTLD-TDP patients with MD is currently unexplored. The aims of this study are to characterize the frequency and the nature of MD in a cohort of FTLD-TDP brain donors and to investigate the relationship between the presence of MD, the nigral neuronal loss, and the TDP-43 burden in the SN. From our cohort of FTLD-TDP patients (n = 53), we included 13 donors who presented with MD (FTLD-MD+), and nine age-sex matched donors without MD (FTLD-MD-) for whom the SN was available. In these donors, the TDP-43 burden and the neuronal density in the SN were assessed with ImageJ and Qupath software. The results were compared between the two groups using T-test. We found that the TDP-43 burden in the SN was higher in FTLD-MD+ (mean 3,43%, SD ± 2,7) compared to FTLD-MD- (mean 1,21%, SD ± 0,67) (p = 0,04), while no significant difference in nigral neuronal density was found between the groups (p = 0,09). 17% of FTLD-TDP patients developed MD, which present as symmetric akinetic-rigid parkinsonism or CBS. Given the absence of a significant nigral neuronal cell loss, TDP-43 induced neuronal dysfunction could be sufficient to cause MD.
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Affiliation(s)
- Luigi Fiondella
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands.
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | - Priya Gami-Patel
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Christian A Blok
- Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Annemieke J M Rozemuller
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Marta Scarioni
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Anke A Dijkstra
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands
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6
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Hok-A-Hin YS, Dijkstra AA, Rábano A, Hoozemans JJ, Castillo L, Seelaar H, van Swieten JC, Pijnenburg YAL, Teunissen CE, Del Campo M. Apolipoprotein L1 is increased in frontotemporal lobar degeneration post-mortem brain but not in ante-mortem cerebrospinal fluid. Neurobiol Dis 2022; 172:105813. [PMID: 35820647 DOI: 10.1016/j.nbd.2022.105813] [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] [Received: 01/31/2022] [Revised: 06/27/2022] [Accepted: 07/06/2022] [Indexed: 10/17/2022] Open
Abstract
AIMS Frontotemporal Dementia (FTD) is caused by frontal-temporal lobar degeneration (FTLD), characterized mainly by brain protein aggregates of tau (FTLD-Tau) or TDP-43 (FTLD-TDP). The clinicopathological heterogeneity makes ante-mortem diagnosis of these pathological subtypes challenging. Our proteomics study showed increased Apolipoprotein L1 (APOL1) levels in CSF from FTD patients, which was prominently expressed in FTLD-Tau. We aimed to understand APOL1 expression in FTLD post-mortem brain tissue and to validate its potential as a CSF biomarker for FTD and its pathological subtypes. METHODS APOL1 levels were analyzed in the frontal cortex of FTLD (including FTLD-Tau and FTLD-TDP) and non-demented controls by immunohistochemistry (FTLD total = 18 (12 FTLD-Tau and 6 FTLD-TDP); controls = 9), western blot (WB), and a novel prototype ELISA (FTLD total = 44 (21 FTLD-Tau and 23 FTLD-TDP); controls = 9). The association of APOL1 immunoreactivity with phosphorylated Tau (pTau) and TDP-43 (pTDP-43) immunoreactivity was assessed. CSF APOL1 was analyzed in confirmed FTD patients (n = 27, including 12 FTLD-Tau and 15 FTLD-TDP) and controls (n = 15) using the same ELISA. RESULTS APOL1 levels were significantly increased in FTLD post-mortem tissue compared to controls as measured by immunohistochemistry, WB, and ELISA. However, no differences between the pathological subtypes were observed. APOL1 immunoreactivity was present in neuronal and glial cells but did not co-localize with pTau or pTDP-43. CSF APOL1 levels were comparable between FTD patients and controls and between pathological subtypes. CONCLUSION APOL1 is upregulated in FTLD pathology irrespective of the subtypes, indicating a role of this novel protein in FTD pathophysiology. The APOL1 levels detected in brain tissue were not mirrored in the CSF, limiting its potential as a specific FTD biofluid-based biomarker using our current immunoassay.
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Affiliation(s)
- Yanaika S Hok-A-Hin
- Neurochemistry Laboratory, Clinical Chemistry Department, Amsterdam Neuroscience, VU University Medical Centers, the Netherlands.
| | - Anke A Dijkstra
- Department of Pathology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, the Netherlands
| | - Alberto Rábano
- CIEN Tissue Bank, Alzheimer's Centre Reina Sofía-CIEN Foundation, Madrid, Spain
| | - Jeroen J Hoozemans
- Department of Pathology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, the Netherlands
| | - Lucía Castillo
- Neurochemistry Laboratory, Clinical Chemistry Department, Amsterdam Neuroscience, VU University Medical Centers, the Netherlands
| | - Harro Seelaar
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - John C van Swieten
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Centre Amsterdam and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, the Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Clinical Chemistry Department, Amsterdam Neuroscience, VU University Medical Centers, the Netherlands
| | - Marta Del Campo
- Neurochemistry Laboratory, Clinical Chemistry Department, Amsterdam Neuroscience, VU University Medical Centers, the Netherlands; Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo- CEU, CEU Universities, Madrid, Spain
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7
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Gami‐Patel P, Scarioni M, Bouwman FH, Boon BDC, Swieten JC, Rozemuller AJM, Smit AB, Pijnenburg YAL, Hoozemans JJM, Dijkstra AA. The severity of behavioural symptoms in FTD is linked to the loss of GABRQ‐expressing VENs and pyramidal neurons. Neuropathol Appl Neurobiol 2022; 48:e12798. [PMID: 35152451 PMCID: PMC9306948 DOI: 10.1111/nan.12798] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/27/2021] [Accepted: 02/05/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Priya Gami‐Patel
- Department of Pathology, Amsterdam Neuroscience Amsterdam University Medical Centre, location VUmc Amsterdam The Netherlands
| | - Marta Scarioni
- Department of Pathology, Amsterdam Neuroscience Amsterdam University Medical Centre, location VUmc Amsterdam The Netherlands
- Department of Neurology, Alzheimer Centre, Amsterdam Neuroscience Amsterdam University Medical, location VUmc Centre Amsterdam The Netherlands
| | - Femke H. Bouwman
- Department of Neurology, Alzheimer Centre, Amsterdam Neuroscience Amsterdam University Medical, location VUmc Centre Amsterdam The Netherlands
| | - Baayla D. C. Boon
- Department of Pathology, Amsterdam Neuroscience Amsterdam University Medical Centre, location VUmc Amsterdam The Netherlands
- Department of Neurology, Alzheimer Centre, Amsterdam Neuroscience Amsterdam University Medical, location VUmc Centre Amsterdam The Netherlands
| | - John C. Swieten
- Department of Neurology, Alzheimer Centre, Erasmus MC Rotterdam The Netherlands
| | - Annemieke J. M. Rozemuller
- Department of Pathology, Amsterdam Neuroscience Amsterdam University Medical Centre, location VUmc Amsterdam The Netherlands
| | - August B. Smit
- Department of Molecular and Cellular Neurobiology, Centre for Neurogenomics and Cognitive Research, Amsterdam Neuroscience VU University Amsterdam Amsterdam The Netherlands
| | - Yolande A. L. Pijnenburg
- Department of Neurology, Alzheimer Centre, Amsterdam Neuroscience Amsterdam University Medical, location VUmc Centre Amsterdam The Netherlands
| | - Jeroen J. M. Hoozemans
- Department of Pathology, Amsterdam Neuroscience Amsterdam University Medical Centre, location VUmc Amsterdam The Netherlands
| | - Anke A. Dijkstra
- Department of Pathology, Amsterdam Neuroscience Amsterdam University Medical Centre, location VUmc Amsterdam The Netherlands
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8
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Scarioni M, Gami-Patel P, Peeters CFW, de Koning F, Seelaar H, Mol MO, van Swieten JC, Rozemuller AJM, Hoozemans JJM, Pijnenburg YAL, Dijkstra AA. Psychiatric symptoms of frontotemporal dementia and subcortical (co-)pathology burden: new insights. Brain 2022; 146:307-320. [PMID: 35136978 PMCID: PMC9825544 DOI: 10.1093/brain/awac043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/09/2021] [Accepted: 12/19/2021] [Indexed: 01/12/2023] Open
Abstract
Three subtypes of distinct pathological proteins accumulate throughout multiple brain regions and shape the heterogeneous clinical presentation of frontotemporal lobar degeneration (FTLD). Besides the main pathological subtypes, co-occurring pathologies are common in FTLD brain donors. The objective of this study was to investigate how the location and burden of (co-)pathology correlate to early psychiatric and behavioural symptoms of FTLD. Eighty-seven brain donors from The Netherlands Brain Bank cohort (2008-2017) diagnosed with FTLD were included: 46 FTLD-TAR DNA-binding protein 43 (FTLD-TDP), 34 FTLD-tau, and seven FTLD-fused-in-sarcoma (FTLD-FUS). Post-mortem brain tissue was dissected into 20 standard regions and stained for phosphorylated TDP-43, phosphorylated tau, FUS, amyloid-β, and α-synuclein. The burden of each pathological protein in each brain region was assessed with a semi-quantitative score. Clinical records were reviewed for early psychiatric and behavioural symptoms. Whole-brain clinico-pathological partial correlations were calculated (local false discovery rate threshold = 0.01). Elaborating on the results, we validated one finding using a quantitative assessment of TDP-43 pathology in the granular layer of the hippocampus in FTLD-TDP brain donors with (n = 15) and without (n = 15) hallucinations. In subcortical regions, the presence of psychiatric symptoms showed positive correlations with increased hippocampal pathology burden: hallucinations with TDP-43 in the granular layer (R = 0.33), mania with TDP-43 in CA1 (R = 0.35), depression with TDP-43 in CA3 and with parahippocampal tau (R = 0.30 and R = 0.23), and delusions with CA3 tau (R = 0.26) and subicular amyloid-β (R = 0.25). Behavioural disinhibition showed positive correlations with tau burden in the thalamus (R = 0.29) and with both TDP-43 and amyloid-β burden in the subthalamus (R = 0.23 and R = 0.24). In the brainstem, the presence of α-synuclein co-pathology in the substantia nigra correlated with disinhibition (R = 0.24), tau pathology in the substantia nigra correlated with depression (R = 0.25) and in the locus coeruleus with both depression and perseverative/compulsive behaviour (R = 0.26 and R = 0.32). The quantitative assessment of TDP-43 in the granular layer validated the higher burden of TDP-43 pathology in brain donors with hallucinations compared to those without hallucinations (P = 0.007). Our results show that psychiatric symptoms of FTLD are linked to subcortical pathology burden in the hippocampus, and hallucinations are linked to a higher burden of TDP-43 in the granular layer. Co-occurring non-FTLD pathologies in subcortical regions could contribute to configuring the clinical phenotype of FTLD.
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Affiliation(s)
- Marta Scarioni
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Priya Gami-Patel
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Carel F W Peeters
- Division of Mathematical and Statistical Methods—Biometris, Wageningen University and Research, Wageningen, The Netherlands,Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, The Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Florianne de Koning
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands,Department of Pathology, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Harro Seelaar
- Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Merel O Mol
- Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Annemieke J M Rozemuller
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Anke A Dijkstra
- Correspondence to: Anke A. Dijkstra De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands E-mail:
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Ossenkoppele R, Singleton EH, Groot C, Dijkstra AA, Eikelboom WS, Seeley WW, Miller B, Laforce RJ, Scheltens P, Papma JM, Rabinovici GD, Pijnenburg YAL. Research Criteria for the Behavioral Variant of Alzheimer Disease: A Systematic Review and Meta-analysis. JAMA Neurol 2021; 79:48-60. [PMID: 34870696 PMCID: PMC8649917 DOI: 10.1001/jamaneurol.2021.4417] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance The behavioral variant of Alzheimer disease (bvAD) is characterized by early and predominant behavioral deficits caused by AD pathology. This AD phenotype is insufficiently understood and lacks standardized clinical criteria, limiting reliability and reproducibility of diagnosis and scientific reporting. Objective To perform a systematic review and meta-analysis of the bvAD literature and use the outcomes to propose research criteria for this syndrome. Data Sources A systematic literature search in PubMed/MEDLINE and Web of Science databases (from inception through April 7, 2021) was performed in duplicate. Study Selection Studies reporting on behavioral, neuropsychological, or neuroimaging features in bvAD and, when available, providing comparisons with typical amnestic-predominant AD (tAD) or behavioral variant frontotemporal dementia (bvFTD). Data Extraction and Synthesis This analysis involved random-effects meta-analyses on group-level study results of clinical data and systematic review of the neuroimaging literature. The study was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Main Outcomes and Measures Behavioral symptoms (neuropsychiatric symptoms and bvFTD core clinical criteria), cognitive function (global cognition, episodic memory, and executive functioning), and neuroimaging features (structural magnetic resonance imaging, [18F]fluorodeoxyglucose-positron emission tomography, perfusion single-photon emission computed tomography, amyloid positron emission tomography, and tau positron emission tomography). Results The search led to the assessment of 83 studies, including 13 suitable for meta-analysis. Data were collected for 591 patients with bvAD. There was moderate to substantial heterogeneity and moderate risk of bias across studies. Cases with bvAD showed more severe behavioral symptoms than tAD (standardized mean difference [SMD], 1.16 [95% CI, 0.74-1.59]; P < .001) and a trend toward less severe behavioral symptoms compared with bvFTD (SMD, -0.22 [95% CI, -0.47 to 0.04]; P = .10). Meta-analyses of cognitive data indicated worse executive performance in bvAD vs tAD (SMD, -1.03 [95% CI, -1.74 to -0.32]; P = .008) but not compared with bvFTD (SMD, -0.61 [95% CI, -1.75 to 0.53]; P = .29). Cases with bvAD showed a nonsignificant difference of worse memory performance compared with bvFTD (SMD, -1.31 [95% CI, -2.75 to 0.14]; P = .08) but did not differ from tAD (SMD, 0.43 [95% CI, -0.46 to 1.33]; P = .34). The neuroimaging literature revealed 2 distinct bvAD neuroimaging phenotypes: an AD-like pattern with relative frontal sparing and a relatively more bvFTD-like pattern characterized by additional anterior involvement, with the AD-like pattern being more prevalent. Conclusions and Relevance These data indicate that bvAD is clinically most similar to bvFTD, while it shares most pathophysiological features with tAD. Based on these insights, we propose research criteria for bvAD aimed at improving the consistency and reliability of future research and aiding the clinical assessment of this AD phenotype.
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Affiliation(s)
- Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.,Lund University, Clinical Memory Research Unit, Lund, Sweden
| | - Ellen H Singleton
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Colin Groot
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Anke A Dijkstra
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Location VUMC, Amsterdam, the Netherlands
| | - Willem S Eikelboom
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Bruce Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Robert Jr Laforce
- Clinique Interdisciplinaire de Mémoire, Centre Hospitalier Universitaire de Québec, Québec, Canada
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Janne M Papma
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco.,Weill Institute for Neurosciences, University of California, San Francisco, San Francisco.,Associate Editor, JAMA Neurology
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
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10
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Dijkstra AA, Morrema T, Verbraak F, de Boer J, de Ruyter FJH, Pijnenburg YA, Rozemuller AJ, Bouwman FH, den Haan J, Hoozemans JJ. TDP‐43 proteinopathy in the retina of patients with frontotemporal lobar degeneration. Alzheimers Dement 2021. [DOI: 10.1002/alz.057489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Anke A. Dijkstra
- Amsterdam University Medical Centers, VUmc Amsterdam Netherlands
| | | | - Frank Verbraak
- Ophthalmology department VU University Medical Center Amsterdam Netherlands
| | - Johannes de Boer
- Department of Physics, VU University, Laser Lab Amsterdam Netherlands
| | | | | | | | | | - Jurre den Haan
- Alzheimer Center Amsterdam, Amsterdam UMC, VU Medical Center Amsterdam Netherlands
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11
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Scarioni M, Gami‐Patel P, Peeters CF, de Koning F, Seelaar H, van Swieten JC, Rozemuller AJ, Hoozemans JJ, Pijnenburg YA, Dijkstra AA. Neuroanatomy of FTD: Whole‐brain correlations between symptoms and pathologies. Alzheimers Dement 2021. [DOI: 10.1002/alz.056016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Marta Scarioni
- Amsterdam University Medical Centers, VUmc Amsterdam Netherlands
| | - Priya Gami‐Patel
- Amsterdam University Medical Centers, VUmc Amsterdam Netherlands
| | - Carel F.W. Peeters
- Amsterdam University Medical Centers, VUmc Amsterdam Netherlands
- Department of Mathematical & Statistical Methods – Biometris Wageningen University & Research Wageningen Netherlands
| | | | | | | | | | | | | | - Anke A. Dijkstra
- Amsterdam University Medical Centers, VUmc Amsterdam Netherlands
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12
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Hok‐A‐Hin YS, Dijkstra AA, Rabano A, Hoozemans JJ, Castillo L, Pijnenburg YA, Teunissen CE, Del Campo M. Apolipoprotein L1 is increased in frontotemporal lobar degeneration postmortem brain tissue but not in cerebrospinal fluid. Alzheimers Dement 2021. [DOI: 10.1002/alz.055154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Yanaika S. Hok‐A‐Hin
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Anke A. Dijkstra
- Department of Pathology, Amsterdam Neuroscience, Amsterdam UMC Amsterdam Netherlands
| | - Alberto Rabano
- CIEN Foundation/Queen Sofia Foundation Alzheimer Center Madrid Spain
| | - Jeroen J. Hoozemans
- Department of Pathology, Amsterdam Neuroscience, Amsterdam UMC Amsterdam Netherlands
| | - Lucia Castillo
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Yolande A.L. Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Marta Del Campo
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Pharmacology Lab, Department of Pharmaceutical and Health Sciences, University CEU San Pablo Madrid Spain
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13
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Zhao B, Louadi S, Dijkstra AA, Plotkin SS, Kaplan J, Cashman NR. Selective targeting of intracellular, misfolded, pathogenic TDP‐43 with rationally designed intrabodies. Alzheimers Dement 2021. [DOI: 10.1002/alz.055269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Beibei Zhao
- University of British Columbia Vancouver BC Canada
| | - Sarah Louadi
- University of British Columbia Vancouver BC Canada
| | - Anke A. Dijkstra
- Department of Pathology Amsterdam Neuroscience Amsterdam UMC Amsterdam Netherlands
| | | | | | - Neil R Cashman
- University of British Columbia Vancouver BC Canada
- ProMIS Neurosciences Toronto ON Canada
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14
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Ulugut H, Dijkstra AA, Scarioni M, Barkhof F, Scheltens P, Rozemuller AJM, Pijnenburg YAL. Right temporal variant frontotemporal dementia is pathologically heterogeneous: a case-series and a systematic review. Acta Neuropathol Commun 2021; 9:131. [PMID: 34344452 PMCID: PMC8330072 DOI: 10.1186/s40478-021-01229-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/12/2021] [Indexed: 12/11/2022] Open
Abstract
Although the right temporal variant frontotemporal dementia (rtvFTD) is characterised by distinct clinical and radiological features, its underlying histopathology remains elusive. Being considered a right-sided variant of semantic variant primary progressive aphasia (svPPA), TDP-43 type C pathology has been linked to the syndrome, but this has not been studied in detail in large cohorts. In this case report and systematic review, we report the autopsy results of five subjects diagnosed with rtvFTD from our cohort and 44 single rtvFTD subjects from the literature. Macroscopic pathological evaluation of the combined results revealed that rtvFTD demonstrated either a frontotemporal or temporal evolution, even if the degeneration started in the right temporal lobe initially. FTLD-TDP type C was the most common underlying pathology in rtvFTD, however, in 64% of rtvFTD, other underlying pathologies than FTLD-TDP type C were present, such as Tau-MAPT and FTLD-TDP type A and B. Additionally, accompanying motor neuron or corticospinal tract degeneration was observed in 28% of rtvFTD patients. Our results show that in contrast to the general assumption, rtvFTD might not be a pure FTLD-TDP type C disorder, unlike its left temporal counterpart svPPA. Large sample size pathological studies are warranted to understand the diverse pathologies of the right and left temporal variants of frontotemporal dementia.
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Boivin M, Deng J, Pfister V, Grandgirard E, Oulad-Abdelghani M, Morlet B, Ruffenach F, Negroni L, Koebel P, Jacob H, Riet F, Dijkstra AA, McFadden K, Clayton WA, Hong D, Miyahara H, Iwasaki Y, Sone J, Wang Z, Charlet-Berguerand N. Translation of GGC repeat expansions into a toxic polyglycine protein in NIID defines a novel class of human genetic disorders: The polyG diseases. Neuron 2021; 109:1825-1835.e5. [PMID: 33887199 PMCID: PMC8186563 DOI: 10.1016/j.neuron.2021.03.038] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 01/08/2021] [Accepted: 03/30/2021] [Indexed: 02/07/2023]
Abstract
Neuronal intranuclear inclusion disease (NIID) is a neurodegenerative disease characterized by the presence of intranuclear inclusions of unknown origin. NIID is caused by an expansion of GGC repeats in the 5′ UTR of the NOTCH2NLC (N2C) gene. We found that these repeats are embedded in a small upstream open reading frame (uORF) (uN2C), resulting in their translation into a polyglycine-containing protein, uN2CpolyG. This protein accumulates in intranuclear inclusions in cell and mouse models and in tissue samples of individuals with NIID. Furthermore, expression of uN2CpolyG in mice leads to locomotor alterations, neuronal cell loss, and premature death of the animals. These results suggest that translation of expanded GGC repeats into a novel and pathogenic polyglycine-containing protein underlies the presence of intranuclear inclusions and neurodegeneration in NIID. NIID is a neurodegenerative disease caused by expansion of GGC repeats in NOTCH2NLC These GGC repeats are translated into a polyglycine (polyG) protein The polyG protein is toxic and forms intranuclear inclusions in cells and animals Similarities between FXTAS and NIID define a new set of disorders: polyG diseases
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Affiliation(s)
- Manon Boivin
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, University of Strasbourg, 67404 Illkirch, France
| | - Jianwen Deng
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - Véronique Pfister
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, University of Strasbourg, 67404 Illkirch, France
| | - Erwan Grandgirard
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, University of Strasbourg, 67404 Illkirch, France
| | - Mustapha Oulad-Abdelghani
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, University of Strasbourg, 67404 Illkirch, France
| | - Bastien Morlet
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, University of Strasbourg, 67404 Illkirch, France
| | - Frank Ruffenach
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, University of Strasbourg, 67404 Illkirch, France
| | - Luc Negroni
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, University of Strasbourg, 67404 Illkirch, France
| | - Pascale Koebel
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, University of Strasbourg, 67404 Illkirch, France
| | - Hugues Jacob
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, University of Strasbourg, 67404 Illkirch, France
| | - Fabrice Riet
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, University of Strasbourg, 67404 Illkirch, France
| | - Anke A Dijkstra
- Department of Pathology, Amsterdam University Medical Centre, Amsterdam Neuroscience, VUmc, Amsterdam, the Netherlands
| | - Kathryn McFadden
- Department of Pathology, IWK Health Centre, Halifax, NS B3K 6R8, Canada
| | - Wiley A Clayton
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
| | - Daojun Hong
- Department of Neurology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hiroaki Miyahara
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Japan
| | - Yasushi Iwasaki
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Japan
| | - Jun Sone
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Japan; Department of Neurology, Suzuka National Hospital, Suzuka 513-8501, Japan
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - Nicolas Charlet-Berguerand
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, University of Strasbourg, 67404 Illkirch, France.
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16
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Singleton E, Hansson O, Pijnenburg YAL, La Joie R, Mantyh WG, Tideman P, Stomrud E, Leuzy A, Johansson M, Strandberg O, Smith R, Berendrecht E, Miller BL, Iaccarino L, Edwards L, Strom A, Wolters EE, Coomans E, Visser D, Golla SSV, Tuncel H, Bouwman F, Van Swieten JC, Papma JM, van Berckel B, Scheltens P, Dijkstra AA, Rabinovici GD, Ossenkoppele R. Heterogeneous distribution of tau pathology in the behavioural variant of Alzheimer's disease. J Neurol Neurosurg Psychiatry 2021; 92:jnnp-2020-325497. [PMID: 33850001 PMCID: PMC8292599 DOI: 10.1136/jnnp-2020-325497] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/16/2021] [Accepted: 03/10/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The clinical phenotype of the rare behavioural variant of Alzheimer's disease (bvAD) is insufficiently understood. Given the strong clinico-anatomical correlations of tau pathology in AD, we investigated the distribution of tau deposits in bvAD, in-vivo and ex-vivo, using positron emission tomography (PET) and postmortem examination. METHODS For the tau PET study, seven amyloid-β positive bvAD patients underwent [18F]flortaucipir or [18F]RO948 PET. We converted tau PET uptake values into standardised (W-)scores, adjusting for age, sex and mini mental state examination in a 'typical' memory-predominant AD (n=205) group. W-scores were computed within entorhinal, temporoparietal, medial and lateral prefrontal, insular and whole-brain regions-of-interest, frontal-to-entorhinal and frontal-to-parietal ratios and within intrinsic functional connectivity network templates. For the postmortem study, the percentage of AT8 (tau)-positive area in hippocampus CA1, temporal, parietal, frontal and insular cortices were compared between autopsy-confirmed patients with bvAD (n=8) and typical AD (tAD;n=7). RESULTS Individual regional W-scores ≥1.96 (corresponding to p<0.05) were observed in three cases, that is, case #5: medial prefrontal cortex (W=2.13) and anterior default mode network (W=3.79), case #2: lateral prefrontal cortex (W=2.79) and salience network (W=2.77), and case #7: frontal-to-entorhinal ratio (W=2.04). The remaining four cases fell within the normal distributions of the tAD group. Postmortem AT8 staining indicated no group-level regional differences in phosphorylated tau levels between bvAD and tAD (all p>0.05). CONCLUSIONS Both in-vivo and ex-vivo, patients with bvAD showed heterogeneous distributions of tau pathology. Since key regions involved in behavioural regulation were not consistently disproportionally affected by tau pathology, other factors are more likely driving the clinical phenotype in bvAD.
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Affiliation(s)
- Ellen Singleton
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - William G Mantyh
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Pontus Tideman
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital Lund, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital Lund, Lund, Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Maurits Johansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Evi Berendrecht
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Leonardo Iaccarino
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
- In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lauren Edwards
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Amelia Strom
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Emma E Wolters
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Emma Coomans
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Denise Visser
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Sandeep S V Golla
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Hayel Tuncel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Femke Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Janne M Papma
- Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bart van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Anke A Dijkstra
- Department of Pathology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
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17
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Dijkstra AA, Gami-Patel P, Rozemuller AJM, Bugiani M, Pijnenburg YAL, Smit GAB, Dols A, Hoozemans JJM. Reduction of GABA subunit theta-containing cortical neurons in schizophrenia. Schizophr Res 2021; 228:611-613. [PMID: 33243715 DOI: 10.1016/j.schres.2020.11.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 08/11/2020] [Accepted: 11/16/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Anke A Dijkstra
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centres, location VUmc, Amsterdam, the Netherlands.
| | - Priya Gami-Patel
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centres, location VUmc, Amsterdam, the Netherlands
| | - Annemieke J M Rozemuller
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centres, location VUmc, Amsterdam, the Netherlands
| | - Marianna Bugiani
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centres, location VUmc, Amsterdam, the Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centres, location VUmc, Amsterdam, the Netherlands
| | - Guus A B Smit
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, VU University, Amsterdam, the Netherlands
| | - Annemiek Dols
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centres, location VUmc, Amsterdam, the Netherlands; Department of Old Age Psychiatry, GGZinGeest and Amsterdam University Medical Centres, location VUmc, Amstelveenseweg 589, 1081 JC Amsterdam, the Netherlands
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centres, location VUmc, Amsterdam, the Netherlands
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18
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Dijkstra AA, Haify SN, Verwey NA, Prins ND, van der Toorn EC, Rozemuller AJM, Bugiani M, den Dunnen WFA, Todd PK, Charlet-Berguerand N, Willemsen R, Hukema RK, Hoozemans JJM. Neuropathology of FMR1-premutation carriers presenting with dementia and neuropsychiatric symptoms. Brain Commun 2021; 3:fcab007. [PMID: 33709078 PMCID: PMC7936660 DOI: 10.1093/braincomms/fcab007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 01/07/2023] Open
Abstract
CGG repeat expansions within the premutation range (55–200) of the FMR1 gene can lead to Fragile X-associated tremor/ataxia syndrome and Fragile X-associated neuropsychiatric disorders. These CGG repeats are translated into a toxic polyglycine-containing protein, FMRpolyG. Pathology of Fragile X-associated tremor/ataxia syndrome and Fragile X-associated neuropsychiatric disorders comprises FMRpolyG- and p62-positive intranuclear inclusions. Diagnosing a FMR1-premutation carrier remains challenging, as the clinical features overlap with other neurodegenerative diseases. Here, we describe two male cases with Fragile X-associated neuropsychiatric disorders-related symptoms and mild movement disturbances and novel pathological features that can attribute to the variable phenotype. Macroscopically, both donors did not show characteristic white matter lesions on MRI; however, vascular infarcts in cortical- and sub-cortical regions were identified. Immunohistochemistry analyses revealed a high number of FMRpolyG intranuclear inclusions throughout the brain, which were also positive for p62. Importantly, we identified a novel pathological vascular phenotype with inclusions present in pericytes and endothelial cells. Although these results need to be confirmed in more cases, we propose that these vascular lesions in the brain could contribute to the complex symptomology of FMR1-premutation carriers. Overall, our report suggests that Fragile X-associated tremor/ataxia syndrome and Fragile X-associated neuropsychiatric disorders may present diverse clinical involvements resembling other types of dementia, and in the absence of genetic testing, FMRpolyG can be used post-mortem to identify premutation carriers.
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Affiliation(s)
- Anke A Dijkstra
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Saif N Haify
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - Niek A Verwey
- Department of Neurology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands
| | - Niels D Prins
- Department of Neurology, Alzheimer Center, VU University Medical Center, Amsterdam Neuroscience, The Netherlands.,Brain Research Center, Amsterdam, The Netherlands
| | | | - Annemieke J M Rozemuller
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Marianna Bugiani
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Wilfred F A den Dunnen
- Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter K Todd
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA.,Department of Veterans Affairs, Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Nicolas Charlet-Berguerand
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U964, CNRS UMR7104, University of Strasbourg, 67400, Illkirch, France
| | - Rob Willemsen
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - Renate K Hukema
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands.,Department of Health Care Studies, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Amsterdam, The Netherlands
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19
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Cashman NR, Louadi S, Zhao B, Roman A, Gibbs E, Dijkstra AA, Plotkin SS, Kaplan J. Targeting of misfolded, pathogenic TDP‐43 with rationally designed antibodies. Alzheimers Dement 2020. [DOI: 10.1002/alz.045221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Neil R. Cashman
- University of British Columbia Vancouver BC Canada
- ProMIS Neurosciences Toronto ON Canada
| | - Sarah Louadi
- University of British Columbia Vancouver BC Canada
| | - Beibei Zhao
- University of British Columbia Vancouver BC Canada
| | - Andrei Roman
- University of British Columbia Vancouver BC Canada
| | - Ebrima Gibbs
- University of British Columbia Vancouver BC Canada
| | - Anke A. Dijkstra
- Department of Pathology Amsterdam Neuroscience Amsterdam University Medical Center Amsterdam Netherlands
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20
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Scarioni M, Gami‐Patel P, Timar Y, Seelaar H, van Swieten JC, Rozemuller AJ, Dols A, Scarpini E, Galimberti D, Bank NB, Hoozemans JJ, Pijnenburg YA, Dijkstra AA. Dissecting frontotemporal dementia: Correlations between neuropsychiatric symptoms and neuropathology. Alzheimers Dement 2020. [DOI: 10.1002/alz.038926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Marta Scarioni
- Amsterdam University Medical Centers VUmc Amsterdam Netherlands
- University of Milan, Fondazione Cà Granda, IRCCS Ospedale Policlinico Milan Italy
| | | | - Yannick Timar
- Amsterdam University Medical Centers VUmc Amsterdam Netherlands
| | | | | | | | - Annemiek Dols
- Amsterdam University Medical Centers VUmc Amsterdam Netherlands
- GGZInGeest/Amsterdam University Medical Centers Amsterdam Netherlands
| | - Elio Scarpini
- University of Milan, Fondazione Cà Granda, IRCCS Ospedale Policlinico Milan Italy
| | - Daniela Galimberti
- University of Milan, Fondazione Cà Granda, IRCCS Ospedale Policlinico Milan Italy
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21
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Singleton EH, Hansson O, Dijkstra AA, Joie R, Mantyh WG, Tideman P, Stomrud E, Leuzy A, Johansson M, Strandberg O, Smith R, van Swieten JC, Papma JM, Wolters EE, Coomans EM, Golla SS, Tuncel H, Berendrecht E, Blujdea RE, Van Berckel BN, Bouwman F, Scheltens P, Pijnenburg YA, Rabinovici GD, Ossenkoppele R. Heterogeneous distribution of pathology in behavioral variant Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.044830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ellen H. Singleton
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam University Medical Center Amsterdam Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Malmö Sweden
| | - Anke A. Dijkstra
- Department of Pathology Amsterdam Neuroscience Amsterdam University Medical Center Amsterdam Netherlands
| | - Renaud Joie
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - William G. Mantyh
- Department of Neurology Memory and Aging Center University of California San Francisco San Francisco CA USA
| | - Pontus Tideman
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Lund Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit Department of Clinical Sciences Malmö Lund University Malmö Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Maurits Johansson
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Lund Sweden
- Division of Clinical Sciences Department of Clinical Sciences Lund Lund University, Helsingborg Helsingborg Sweden
| | | | - Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - John C. van Swieten
- Alzheimer Center and Department of Neurology Erasmus University Medical Center Rotterdam Netherlands
- Erasmus MC Amsterdam Netherlands
| | - Janne M. Papma
- Erasmus Medical Centre Rotterdam Netherlands
- Department of Radiology Erasmus University Medical Center Rotterdam Netherlands
| | - Emma E. Wolters
- Department of Radiology & Nuclear Medicine Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam University Medical Center Amsterdam Netherlands
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Emma M. Coomans
- Department of Radiology & Nuclear Medicine Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Sandeep S.V. Golla
- Department of Radiology & Nuclear Medicine Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Hayel Tuncel
- Department of Radiology & Nuclear Medicine Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Evi Berendrecht
- Amsterdam Neuroscience Amsterdam University Medical Center Amsterdam Netherlands
| | - Raluca E. Blujdea
- Department of Pathology Amsterdam Neuroscience Amsterdam University Medical Center Amsterdam Netherlands
| | - Bart N.M. Van Berckel
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam University Medical Center Amsterdam Netherlands
| | - Femke Bouwman
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Netherlands
| | - Yolande A.L. Pijnenburg
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam University Medical Center Amsterdam Netherlands
| | - Gil D. Rabinovici
- Department of Neurology Memory and Aging Center University of California San Francisco San Francisco CA USA
- Department of Radiology and Biomedical Imaging University of California San Francisco San Francisco CA USA
- Molecular Biophysics and Integrated Bioimaging Division Lawrence Berkeley National Laboratory Berkeley CA USA
- Helen Wills Neuroscience Institute University of California Berkeley Berkeley CA USA
| | - Rik Ossenkoppele
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Lund Sweden
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
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22
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Dijkstra AA, Haify S, Verwey NA, Prins ND, van der Toorn E, Rozemuller AJ, Bugiani M, den Dunnen W, Todd PK, Charlet‐Berguerand N, Willemsen R, Hukema R, Hoozemans JJ. Neuropathology of FMR1‐premutation carriers presenting with dementia and neuropsychiatric symptoms. Alzheimers Dement 2020. [DOI: 10.1002/alz.044916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Anke A. Dijkstra
- Department of Pathology Amsterdam Neuroscience, Amsterdam University Medical Center Amsterdam Netherlands
| | - Saif Haify
- Erasmus Medical Center Rotterdam Netherlands
| | | | - Niels D. Prins
- Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
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23
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Berendrecht E, Gami‐Patel P, Blujdea RE, Singleton EH, Bouwman F, Pijnenburg YA, Scheltens P, van Swieten JC, Papma JM, Hoozemans JJ, Ossenkoppele R, Dijkstra AA. Assessment of cortical vulnerability of the anterior cingulate cortex in the behavioral variant of Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.045770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Evi Berendrecht
- Amsterdam Neuroscience Amsterdam University Medical Center Amsterdam Netherlands
| | - Priya Gami‐Patel
- Amsterdam University Medical Centers ‒ VUmc, Amsterdam Netherlands
| | - Raluca E. Blujdea
- Department of Pathology, Amsterdam Neuroscience Amsterdam University Medical Center Amsterdam Netherlands
| | - Ellen H. Singleton
- Alzheimer Center Amsterdam, Department of Neurology Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center Amsterdam Netherlands
| | - Femke Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Yolande A.L. Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center Amsterdam Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam Netherlands
| | | | | | | | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Anke A. Dijkstra
- Department of Pathology, Amsterdam Neuroscience Amsterdam University Medical Center Amsterdam Netherlands
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24
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Scarioni M, Arighi A, Fenoglio C, Sorrentino F, Serpente M, Rotondo E, Mercurio M, Marotta G, Dijkstra AA, Pijnenburg YAL, Scarpini E, Galimberti D. Late-onset presentation and phenotypic heterogeneity of the rare R377W PSEN1 mutation. Eur J Neurol 2020; 27:2630-2634. [PMID: 32894632 DOI: 10.1111/ene.14506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/31/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE Mutations in the PSEN1 gene are the most common cause of autosomal-dominant Alzheimer's disease and have been associated with the earliest disease onset. We describe an unusual presentation of the rare R377W PSEN1 mutation with a late age of onset, and we provide for the first time in vivo pathological evidence for this mutation. METHODS A 71-year-old female patient with progressive cognitive decline in the past 3 years and positive family history for dementia underwent neurological evaluation, neuropsychological testing, lumbar puncture, conventional brain imaging, amyloid-positron emission tomography (PET) and extensive genetic screening with a next-generation sequencing technique. RESULTS The diagnostic workup revealed mixed behavioural and amnestic disease features on neuropsychological tests, magnetic resonance imaging, and 18-fluorodeoxyglucose (FDG)-PET. Amyloid-PET detected amyloid deposition in the frontal areas, in the parietal lobes and the precunei. The genetic screening revealed the presence of the rare R377W mutation in the PSEN1 gene. CONCLUSIONS Extensive genetic screening is also advisable for late-onset presentations of Alzheimer's disease, especially in the presence of a positive family history or atypical clinical features.
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Affiliation(s)
- M Scarioni
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy.,Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Department of Neurology, Alzheimer Center, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - A Arighi
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - C Fenoglio
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - F Sorrentino
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - M Serpente
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - E Rotondo
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - M Mercurio
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - G Marotta
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy
| | - A A Dijkstra
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Y A L Pijnenburg
- Department of Neurology, Alzheimer Center, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - E Scarpini
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - D Galimberti
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
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25
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Gami-Patel P, van Dijken I, Meeter LH, Melhem S, Morrema THJ, Scheper W, van Swieten JC, Rozemuller AJM, Dijkstra AA, Hoozemans JJM. Unfolded protein response activation in C9orf72 frontotemporal dementia is associated with dipeptide pathology and granulovacuolar degeneration in granule cells. Brain Pathol 2020; 31:163-173. [PMID: 32865835 PMCID: PMC7891436 DOI: 10.1111/bpa.12894] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022] Open
Abstract
A repeat expansion in the C9orf72 gene is the most prevalent genetic cause of frontotemporal dementia (C9‐FTD). Several studies have indicated the involvement of the unfolded protein response (UPR) in C9‐FTD. In human neuropathology, UPR markers are strongly associated with granulovacuolar degeneration (GVD). In this study, we aim to assess the presence of UPR markers together with the presence of dipeptide pathology and GVD in post mortem brain tissue from C9‐FTD cases and neurologically healthy controls. Using immunohistochemistry we assessed the presence of phosphorylated PERK, IRE1α and eIF2α in the frontal cortex, hippocampus and cerebellum of C9‐FTD (n = 18) and control (n = 9) cases. The presence of UPR activation markers was compared with the occurrence of pTDP‐43, p62 and dipeptide repeat (DPR) proteins (poly(GA), ‐(GR) & ‐(GP)) as well as casein kinase 1 delta (CK1δ), a marker for GVD. Increased presence of UPR markers was observed in the hippocampus and cerebellum in C9‐FTD compared to control cases. In the hippocampus, overall levels of pPERK and peIF2α were higher in C9‐FTD, including in granule cells of the dentate gyrus (DG). UPR markers were also observed in granule cells of the cerebellum in C9‐FTD. In addition, increased levels of CK1δ were observed in granule cells in the DG of the hippocampus and granular layer of the cerebellum in C9‐FTD. Double‐labelling experiments indicate a strong association between UPR markers and the presence of dipeptide pathology as well as GVD. We conclude that UPR markers are increased in C9‐FTD and that their presence is associated with dipeptide pathology and GVD. Increased presence of UPR markers and CK1δ in granule cells in the cerebellum and hippocampus could be a unique feature of C9‐FTD.
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Affiliation(s)
- Priya Gami-Patel
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Irene van Dijken
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Lieke H Meeter
- Alzheimer Centre Rotterdam and Department of Neurology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Shamiram Melhem
- Alzheimer Centre Rotterdam and Department of Neurology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Tjado H J Morrema
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Wiep Scheper
- Department of Functional Genomics, Centre for Neurogenomics and Cognitive Research Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands.,Department of Clinical Genetics and Alzheimer Centre, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - John C van Swieten
- Alzheimer Centre Rotterdam and Department of Neurology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Annemieke J M Rozemuller
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands.,Dutch Surveillance Centre for Prion Diseases, Department of Pathology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Anke A Dijkstra
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
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26
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Cupidi C, Dijkstra AA, Melhem S, Vernooij MW, Severijnen LA, Hukema RK, Rozemuller AJM, Neumann M, van Swieten JC, Seelaar H. Refining the Spectrum of Neuronal Intranuclear Inclusion Disease: A Case Report. J Neuropathol Exp Neurol 2020; 78:665-670. [PMID: 31150092 DOI: 10.1093/jnen/nlz043] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Neuronal intranuclear inclusion disease (NIID) is a rare heterogeneous progressive neurodegenerative disease characterized by the presence of eosinophilic hyaline intranuclear inclusions in neuronal and glial cells of the CNS, peripheral cells of the autonomic nervous system, visceral organs and skin. The clinical presentation is broadly heterogeneous and includes limb weakness, dementia, seizures, ataxia, and parkinsonism. High-intensity signal in the corticomedullary junction on brain MRI is a characteristic finding in NIID. We describe a 65-year-old patient presenting with mild cognitive impairment, evolving in dementia with behavioral disturbances and parkinsonism. Brain MRI showed mild global cortical atrophy, more pronounced in the cingulate and temporal cortex and mild leukoaraiosis, but no high-intensity signal in corticomedullary junction on diffusion weighted imaging. Neuropathological examination showed p62- and optineurin-positive neuronal intranuclear inclusions in the hippocampus and in some subcortical structures. Glial cells did not present any intranuclear inclusions, and no spongiotic changes proximal to the U-fibers or diffuse myelin pallor were disclosed in the white matter. We report on a case with pathological features of NIID showing different neuroimaging and pathological findings. We noted an absence of typical MRI abnormalities, lack of intranuclear inclusions in glial cells, and prominent involvement of hippocampal neurons, refining the clinico-pathological spectrum of the disease.
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Affiliation(s)
- Chiara Cupidi
- Department of Neurology.,IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Anke A Dijkstra
- Department of Pathology, Amsterdam University Medical Centre, Amsterdam Neuroscience, VUmc, Amsterdam, The Netherlands
| | | | - Meike W Vernooij
- Department of Radiology and Nuclear Medicine.,Department of Epidemiology
| | - Lies-Anne Severijnen
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Renate K Hukema
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Annemieke J M Rozemuller
- Department of Pathology, Amsterdam University Medical Centre, Amsterdam Neuroscience, VUmc, Amsterdam, The Netherlands
| | - Manuela Neumann
- Department of Neuropathology, DZNE, German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
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27
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Scarioni M, Gami-Patel P, Timar Y, Seelaar H, van Swieten JC, Rozemuller AJM, Dols A, Scarpini E, Galimberti D, Hoozemans JJM, Pijnenburg YAL, Dijkstra AA. Frontotemporal Dementia: Correlations Between Psychiatric Symptoms and Pathology. Ann Neurol 2020; 87:950-961. [PMID: 32281118 PMCID: PMC7318614 DOI: 10.1002/ana.25739] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The pathology of frontotemporal dementia, termed frontotemporal lobar degeneration (FTLD), is characterized by distinct molecular classes of aggregated proteins, the most common being TAR DNA-binding protein-43 (TDP-43), tau, and fused in sarcoma (FUS). With a few exceptions, it is currently not possible to predict the underlying pathology based on the clinical syndrome. In this study, we set out to investigate the relationship between pathological and clinical presentation at single symptom level, including neuropsychiatric features. METHODS The presence or absence of symptoms from the current clinical guidelines, together with neuropsychiatric features, such as hallucinations and delusions, were scored and compared across pathological groups in a cohort of 150 brain donors. RESULTS Our cohort consisted of 68.6% FTLD donors (35.3% TDP-43, 28% tau, and 5.3% FUS) and 31.3% non-FTLD donors with a clinical diagnosis of frontotemporal dementia and a different pathological substrate, such as Alzheimer's disease (23%). The presence of hyperorality points to FTLD rather than non-FTLD pathology (p < 0.001). Within the FTLD group, hallucinations in the initial years of the disease were related to TDP-43 pathology (p = 0.02), including but not limited to chromosome 9 open reading frame 72 (C9orf72) repeat expansion carriers. The presence of perseverative or compulsive behavior was more common in the TDP-B and TDP-C histotypes (p = 0.002). INTERPRETATION Our findings indicate that neuropsychiatric features are common in FTLD and form an important indicator of underlying pathology. In order to allow better inclusion of patients in targeted molecular trials, the routine evaluation of patients with frontotemporal dementia should include the presence and nature of neuropsychiatric symptoms. ANN NEUROL 2020;87:950-961.
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Affiliation(s)
- Marta Scarioni
- Department of Pathology, Amsterdam University Medical Centers, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Department of Neurology, Amsterdam University Medical Centers, Location VUmc, Alzheimer Center, Amsterdam, The Netherlands.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - Priya Gami-Patel
- Department of Pathology, Amsterdam University Medical Centers, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Yannick Timar
- Department of Neurology, Amsterdam University Medical Centers, Location VUmc, Alzheimer Center, Amsterdam, The Netherlands
| | - Harro Seelaar
- Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - John C van Swieten
- Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Annemieke J M Rozemuller
- Department of Pathology, Amsterdam University Medical Centers, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Annemiek Dols
- Department of Neurology, Amsterdam University Medical Centers, Location VUmc, Alzheimer Center, Amsterdam, The Netherlands.,Department of Old Age Psychiatry, GGZinGeest/Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Elio Scarpini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - Daniela Galimberti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | -
- Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam University Medical Centers, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Department of Neurology, Amsterdam University Medical Centers, Location VUmc, Alzheimer Center, Amsterdam, The Netherlands
| | - Anke A Dijkstra
- Department of Pathology, Amsterdam University Medical Centers, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands
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Gami-Patel P, van Dijken I, van Swieten JC, Pijnenburg YAL, Rozemuller AJM, Hoozemans JJM, Dijkstra AA. Von Economo neurons are part of a larger neuronal population that are selectively vulnerable in C9orf72 frontotemporal dementia. Neuropathol Appl Neurobiol 2019; 45:671-680. [PMID: 31066065 PMCID: PMC6915913 DOI: 10.1111/nan.12558] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/16/2019] [Accepted: 04/17/2019] [Indexed: 12/12/2022]
Abstract
AIMS The behavioural variant of frontotemporal dementia with a C9orf72 expansion (C9-bvFTD) is characterised by early changes in social-emotional cognition that are linked to the loss of von Economo neurons (VENs). Together with a subset of neighbouring pyramidal neurons, VENs express the GABA receptor subunit theta (GABRQ). It is not known if the selective vulnerability of VENs in C9-bvFTD also includes this GABRQ-expressing population. METHODS We quantified VENs and GABRQ immunopositive neurons in the anterior cingulate cortex (ACC) in C9-bvFTD (n = 16), controls (n = 12) and Alzheimer's disease (AD) (n = 7). Second, we assessed VENs and GABRQ-expressing populations in relation to the clinicopathological profiles. RESULTS We found the number of VENs and GABRQ-expressing neurons and their ratio over the total layer 5 neuronal population was lower in C9-bvFTD compared to control and AD. C9-bvFTD donors with underlying TDP43 type A pathology in the ACC showed the highest loss of GABRQ-expressing neurons. C9-bvFTD donors that did not present with motor neuron disease (MND) symptoms in the first half of their disease course showed a prominent loss of GABRQ-expressing neurons compared to controls. C9-bvFTD donors with no symptoms of psychosis showed a higher loss compared to controls. Across all donors, the number of VENs correlated strongly with the number of GABRQ-expressing neurons. CONCLUSION We show that VENs, together with GABRQ-expressing neurons, are selectively vulnerable in C9-bvFTD but are both spared in AD. This suggests they are related and that this GABRQ-expressing population of VENs and pyramidal neurons, is a key modulator of social-emotional functioning.
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Affiliation(s)
- P Gami-Patel
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Location VUMC, Amsterdam, The Netherlands
| | - I van Dijken
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Location VUMC, Amsterdam, The Netherlands
| | - J C van Swieten
- Department of Neurology, Alzheimer Centre, Erasmus MC, Rotterdam, The Netherlands
| | - Y A L Pijnenburg
- Department of Neurology, Alzheimer Centre, Amsterdam Neuroscience, Amsterdam University Medical Centre, Location VUMC, Amsterdam, The Netherlands
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- Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - A J M Rozemuller
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Location VUMC, Amsterdam, The Netherlands
| | - J J M Hoozemans
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Location VUMC, Amsterdam, The Netherlands
| | - A A Dijkstra
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centre, Location VUMC, Amsterdam, The Netherlands
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Eikelboom WS, Singleton E, van den Berg E, Coesmans M, Mattace Raso F, van Bruchem RL, Goudzwaard JA, de Jong FJ, Koopmanschap M, den Heijer T, Driesen JJM, Vroegindeweij LJHM, Thomeer EC, Hoogers SE, Dijkstra AA, Zuidema SU, Pijnenburg YAL, Scheltens P, van Swieten JC, Ossenkoppele R, Papma JM. Early recognition and treatment of neuropsychiatric symptoms to improve quality of life in early Alzheimer's disease: protocol of the BEAT-IT study. Alzheimers Res Ther 2019; 11:48. [PMID: 31122267 PMCID: PMC6533693 DOI: 10.1186/s13195-019-0503-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 11/21/2018] [Accepted: 05/07/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are very common in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia and are associated with various disadvantageous clinical outcomes including a negative impact on quality of life, caregiver burden, and accelerated disease progression. Despite growing evidence of the efficacy of (non)pharmacological interventions to reduce these symptoms, NPS remain underrecognized and undertreated in memory clinics. The BEhavioural symptoms in Alzheimer's disease Towards early Identification and Treatment (BEAT-IT) study is developed to (1) investigate the neurobiological etiology of NPS in AD and (2) study the effectiveness of the Describe, Investigate, Create, Evaluate (DICE) approach to structure and standardize the current care of NPS in AD. By means of the DICE method, we aim to improve the quality of life of AD patients with NPS and their caregivers who visit the memory clinic. This paper describes the protocol for the intervention study that incorporates the latter aim. METHODS We aim to enroll a total of 150 community-dwelling patients with MCI or AD and their caregivers in two waves. First, we will recruit a control group who will receive care as usual. Next, the second wave of participants will undergo the DICE method. This approach consists of the following steps: (1) describe the context in which NPS occur, (2) investigate the possible causes, (3) create and implement a treatment plan, and (4) evaluate whether these interventions are effective. Primary outcomes are the quality of life of patients and their caregivers. Secondary outcomes include NPS change, caregiver burden, caregivers' confidence managing NPS, psychotropic medication use, the experiences of patients and caregivers who underwent the DICE method, and the cost-effectiveness of the intervention. CONCLUSIONS This paper describes the protocol of an intervention study that is part of the BEAT-IT study and aims to improve current recognition and treatment of NPS in AD by structuring and standardizing the detection and treatment of NPS in AD using the DICE approach. TRIAL REGISTRATION The trial was registered on the Netherlands Trial Registry ( NTR7459 ); registered 6 September 2018.
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Affiliation(s)
- Willem S. Eikelboom
- Department of Neurology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Ellen Singleton
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands
| | - Esther van den Berg
- Department of Neurology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Michiel Coesmans
- Department of Psychiatry, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Francesco Mattace Raso
- Department of Internal Medicine, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Rozemarijn L. van Bruchem
- Department of Internal Medicine, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Jeannette A. Goudzwaard
- Department of Internal Medicine, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Frank Jan de Jong
- Department of Neurology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Marc Koopmanschap
- Erasmus School of Health Policy & Management, Erasmus University, PO Box 1738, 3000 DR Rotterdam, the Netherlands
| | - Tom den Heijer
- Department of Neurology, Franciscus Gasthuis, PO Box 10900, 3004 BA Rotterdam, the Netherlands
| | - Jan J. M. Driesen
- Department of Neurology, Franciscus Vlietland, PO Box 215, 3100 AE Schiedam, the Netherlands
| | | | - Elsbeth C. Thomeer
- Department of Neurology, Maasstad Hospital, PO Box 9100, 3007 AC Rotterdam, the Netherlands
| | - Susanne E. Hoogers
- Department of Neurology, Spijkenisse Medical Center, PO Box 777, 3200 GA Spijkenisse, the Netherlands
| | - Anke A. Dijkstra
- Department of Anatomy and Neurosciences, Amsterdam University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands
| | - Sytse U. Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, PO Box 30,001, 9700 RB Groningen, the Netherlands
| | - Yolande A. L. Pijnenburg
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands
| | - John C. van Swieten
- Department of Neurology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Rik Ossenkoppele
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands
- Clinical Memory Research Unit, Lund University, Simrisbanvägen 14, 212 24 Malmö, Sweden
| | - Janne M. Papma
- Department of Neurology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
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Dijkstra AA, Gami-Patel P, Kochova E, Bouwman FH, Pijnenburg YA, Scheltens P, Papma JM, Swieten JC, Rozemuller AM, Ossenkoppele R, Hoozemans JJ. P2‐153: DIFFERENT CORTICAL NEURONAL VULNERABILITY IN DEMENTIA WITH AND WITHOUT PREDOMINANT BEHAVIOURAL SYMPTOMS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anke A. Dijkstra
- VU University Medical CenterAmsterdam NeuroscienceAmsterdamNetherlands
| | - Priya Gami-Patel
- VU University Medical CenterAmsterdam NeuroscienceAmsterdamNetherlands
| | - Elena Kochova
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Femke H. Bouwman
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - Yolande A.L. Pijnenburg
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | | | - Janne M. Papma
- Alzheimer Center and Department of NeurologyErasmus University Medical CenterRotterdamNetherlands
| | - John C. Swieten
- Department of NeurologyErasmus University Medical CenterRotterdamNetherlands
| | | | - Rik Ossenkoppele
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
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Dijkstra AA, Lin LC, Nana AL, Gaus SE, Seeley WW. Von Economo Neurons and Fork Cells: A Neurochemical Signature Linked to Monoaminergic Function. Cereb Cortex 2018; 28:131-144. [PMID: 27913432 PMCID: PMC6075576 DOI: 10.1093/cercor/bhw358] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 09/29/2016] [Indexed: 12/13/2022] Open
Abstract
The human anterior cingulate and frontoinsular cortices are distinguished by 2 unique Layer 5 neuronal morphotypes, the von Economo neurons (VENs) and fork cells, whose biological identity remains mysterious. Insights could impact research on diverse neuropsychiatric diseases to which these cells have been linked. Here, we leveraged the Allen Brain Atlas to evaluate mRNA expression of 176 neurotransmitter-related genes and identified vesicular monoamine transporter 2 (VMAT2), gamma-aminobutyric acid (GABA) receptor subunit θ (GABRQ), and adrenoreceptor α-1A (ADRA1A) expression in human VENs, fork cells, and a minority of neighboring Layer 5 neurons. We confirmed these results using immunohistochemistry or in situ hybridization. VMAT2 and GABRQ expression was absent in mouse cerebral cortex. Although VMAT2 is known to package monoamines into synaptic vesicles, in VENs and fork cells its expression occurs in the absence of monoamine-synthesizing enzymes or reuptake transporters. Thus, VENs and fork cells may possess a novel, uncharacterized mode of cortical monoaminergic function that distinguishes them from most other mammalian Layer 5 neurons.
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Affiliation(s)
- Anke A Dijkstra
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Li-Chun Lin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Alissa L Nana
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Stephanie E Gaus
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
- Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA
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Dijkstra AA, Ingrassia A, de Menezes RX, van Kesteren RE, Rozemuller AJM, Heutink P, van de Berg WDJ. Evidence for Immune Response, Axonal Dysfunction and Reduced Endocytosis in the Substantia Nigra in Early Stage Parkinson's Disease. PLoS One 2015; 10:e0128651. [PMID: 26087293 PMCID: PMC4472235 DOI: 10.1371/journal.pone.0128651] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [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: 11/25/2014] [Accepted: 04/29/2015] [Indexed: 11/24/2022] Open
Abstract
Subjects with incidental Lewy body disease (iLBD) may represent the premotor stage of Parkinson’s disease (PD). To elucidate molecular mechanisms underlying neuronal dysfunction and alpha-synuclein pathology in the premotor phase of PD, we investigated the transcriptome of the substantia nigra (SN) of well-characterized iLBD, PD donors and age-matched controls with Braak alpha-synuclein stage ranging from 0–6. In Braak alpha-synuclein stages 1 and 2, we observed deregulation of pathways linked to axonal degeneration, immune response and endocytosis, including axonal guidance signaling, mTOR signaling, EIF2 signaling and clathrin-mediated endocytosis in the SN. In Braak stages 3 and 4, we observed deregulation of pathways involved in protein translation and cell survival, including mTOR and EIF2 signaling. In Braak stages 5 and 6, we observed deregulation of dopaminergic signaling, axonal guidance signaling and thrombin signaling. Throughout the progression of PD pathology, we observed a deregulation of mTOR, EIF2 and regulation of eIF4 and p70S6K signaling in the SN. Our results indicate that molecular mechanisms related to axonal dysfunction, endocytosis and immune response are an early event in PD pathology, whereas mTOR and EIF2 signaling are impaired throughout disease progression. These pathways may hold the key to altering the disease progression in PD.
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Affiliation(s)
- Anke A. Dijkstra
- Department of Anatomy and Neurosciences, section Quantitative Morphology, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
- Department of Medical genomics, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - Angela Ingrassia
- Department of Anatomy and Neurosciences, section Quantitative Morphology, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Renee X. de Menezes
- Department of Epidemiology and Biostatistics, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Ronald E. van Kesteren
- Center for Neurogenomics and Cognitive Research, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Annemieke J. M. Rozemuller
- Department of Pathology, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Peter Heutink
- Department of Medical genomics, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
- German Center for Neurodegenerative diseases (DZNE), Tübingen, Germany
| | - Wilma D. J. van de Berg
- Department of Anatomy and Neurosciences, section Quantitative Morphology, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
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Dijkstra AA, Voorn P, Berendse HW, Groenewegen HJ, Rozemuller AJM, van de Berg WDJ. Stage-dependent nigral neuronal loss in incidental Lewy body and Parkinson's disease. Mov Disord 2014; 29:1244-51. [PMID: 24996051 DOI: 10.1002/mds.25952] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [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: 02/12/2013] [Revised: 05/19/2014] [Accepted: 06/02/2014] [Indexed: 11/07/2022] Open
Abstract
To gain a better understanding of the significance of α-synuclein pathological conditions during disease progression in Parkinson's disease, we investigated whether 1) nigral neuronal loss in incidental Lewy body disease and Parkinson's disease donors is associated with the local burden α-synuclein pathological conditions during progression of pathological conditions; 2) the burden and distribution of α-synuclein pathological conditions are related to clinical measures of disease progression. Post-mortem tissue and medical records of 24 Parkinson's disease patients, 20 incidental Lewy body disease donors, and 12 age-matched controls were obtained from the Netherlands Brain Bank for morphometric analysis. We observed a 20% decrease in nigral neuronal cell density in incidental Lewy body disease compared with controls. Nigral neuronal loss (12%) was already observed before the appearance α-synuclein aggregates. The progression from Braak α-synuclein stage 3 to 4 was associated with a significant decline in neuronal cell density (46%). Nigral neuronal loss increased with later Braak α-synuclein stages but did not vary across consecutive Braak α-synuclein stages. We observed a negative correlation between neuronal density and local α-synuclein burden in the substantia nigra of Parkinson's disease patients (ρ = -0.54), but no relationship with Hoehn & Yahr stage or disease duration. In conclusion, our findings cast doubt on the pathogenic role of α-synuclein aggregates in elderly, but do suggest that the severity of neurodegeneration and local burden of α-synuclein pathological conditions are closely coupled during disease progression in Parkinson's disease.
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Affiliation(s)
- Anke A Dijkstra
- Department of Anatomy and Neurosciences, section of Functional Neuroanatomy, VU University Medical Center, Amsterdam, the Netherlands
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van de Berg WD, Hepp DH, Dijkstra AA, Rozemuller JAM, Berendse HW, Foncke E. Patterns of alpha-synuclein pathology in incidental cases and clinical subtypes of Parkinson's disease. Parkinsonism Relat Disord 2012; 18 Suppl 1:S28-30. [DOI: 10.1016/s1353-8020(11)70011-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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van den Berge SA, van Strien ME, Korecka JA, Dijkstra AA, Sluijs JA, Kooijman L, Eggers R, De Filippis L, Vescovi AL, Verhaagen J, van de Berg WDJ, Hol EM. The proliferative capacity of the subventricular zone is maintained in the parkinsonian brain. Brain 2011; 134:3249-63. [DOI: 10.1093/brain/awr256] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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