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Constantinides VC, Paraskevas GP, Velonakis G, Stefanis L, Kapaki E. Localizing apraxia in corticobasal syndrome: a morphometric MRI study. Cereb Cortex 2024; 34:bhae154. [PMID: 38629797 DOI: 10.1093/cercor/bhae154] [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: 12/08/2023] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/19/2024] Open
Abstract
Apraxia localization has relied on voxel-based, lesion-symptom mapping studies in left hemisphere stroke patients. Studies on the neural substrates of different manifestations of apraxia in neurodegenerative disorders are scarce. The primary aim of this study was to look into the neural substrates of different manifestations of apraxia in a cohort of corticobasal syndrome patients (CBS) by use of cortical thickness. Twenty-six CBS patients were included in this cross-sectional study. The Goldenberg apraxia test (GAT) was applied. 3D-T1-weighted images were analyzed via the automated recon-all Freesurfer version 6.0 pipeline. Vertex-based multivariate General Linear Model analysis was applied to correlate GAT scores with cortical thickness. Deficits in imitation of meaningless gestures correlated with bilateral superior parietal atrophy, extending to the angular and supramarginal gyri, particularly on the left. Finger imitation relied predominantly on superior parietal lobes, whereas the left angular and supramarginal gyri, in addition to superior parietal lobes, were critical for hand imitation. The widespread bilateral clusters of atrophy in CBS related to apraxia indicate different pathophysiological mechanisms mediating praxis in neurodegenerative disorders compared to vascular lesions, with implications both for our understanding of praxis and for the rehabilitation approaches of patients with apraxia.
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Affiliation(s)
- Vasilios C Constantinides
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 72 Vas. Sofias Avenue, Athens, P.C. 11528, Greece
| | - George P Paraskevas
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 72 Vas. Sofias Avenue, Athens, P.C. 11528, Greece
- Second Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, 1 Rimini Street, Athens, P.C. 12462, Greece
| | - Georgios Velonakis
- Second Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, 1 Rimini Street, Athens, P.C. 12462, Greece
| | - Leonidas Stefanis
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 72 Vas. Sofias Avenue, Athens, P.C. 11528, Greece
| | - Elisabeth Kapaki
- Second Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, 1 Rimini Street, Athens, P.C. 12462, Greece
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Pyrgelis ES, Paraskevas GP, Constantinides VC, Boufidou F, Papaioannou M, Stefanis L, Kapaki E. Alzheimer's Disease CSF Biomarkers as Possible Indicators of Tap-Test Response in Idiopathic Normal Pressure Hydrocephalus. Brain Sci 2023; 13:1593. [PMID: 38002553 PMCID: PMC10670082 DOI: 10.3390/brainsci13111593] [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: 08/30/2023] [Revised: 10/18/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
The aim of the present study is the evaluation of established Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers in patients with idiopathic normal-pressure hydrocephalus (iNPH), both individually and as a total profile, and the investigation of their use as potential predictors of Tap-test responsiveness. Fifty-three patients with iNPH participated in the study. Aβ42, Aβ40, total Tau and phospho-Tau proteins were measured in duplicate with double-sandwich ELISA assays. Clinical evaluation involved a 10 m timed walk test before an evacuative lumbar puncture (LP) and every 24 h for three consecutive days afterwards. Neuropsychological assessment involved a mini-mental state examination, frontal assessment battery, 5-word test and CLOX drawing test 1 and 2, which were also performed before and 48 h after LP. Response in the Tap-test was defined as a 20% improvement in gait and/or a 10% improvement in neuropsychological tests. The Aβ42/Aβ40 ratio was found to be significantly higher in Tap-test responders than non-responders. Total Tau and phospho-Tau CSF levels also differed significantly between these two groups, with Tap-test responders presenting with lower levels compared to non-responders. Regarding the AD CSF biomarker profile (decreased amyloid and increased Tau proteins levels), patients with a non-AD profile were more likely to have a positive response in the Tap-test than patients with an AD profile.
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Affiliation(s)
- Efstratios-Stylianos Pyrgelis
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece; (E.-S.P.); (V.C.C.); (L.S.)
- 1st Department of Neurology, Neurochemistry and Biological Markers Unit, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece; (G.P.P.); (F.B.); (M.P.)
| | - George P. Paraskevas
- 1st Department of Neurology, Neurochemistry and Biological Markers Unit, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece; (G.P.P.); (F.B.); (M.P.)
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” University General Hospital, Rimini 1, 12462 Athens, Greece
| | - Vasilios C. Constantinides
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece; (E.-S.P.); (V.C.C.); (L.S.)
- 1st Department of Neurology, Neurochemistry and Biological Markers Unit, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece; (G.P.P.); (F.B.); (M.P.)
| | - Fotini Boufidou
- 1st Department of Neurology, Neurochemistry and Biological Markers Unit, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece; (G.P.P.); (F.B.); (M.P.)
| | - Myrto Papaioannou
- 1st Department of Neurology, Neurochemistry and Biological Markers Unit, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece; (G.P.P.); (F.B.); (M.P.)
| | - Leonidas Stefanis
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece; (E.-S.P.); (V.C.C.); (L.S.)
| | - Elisabeth Kapaki
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece; (E.-S.P.); (V.C.C.); (L.S.)
- 1st Department of Neurology, Neurochemistry and Biological Markers Unit, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece; (G.P.P.); (F.B.); (M.P.)
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Pyrgelis ES, Velonakis G, Papageorgiou SG, Stefanis L, Kapaki E, Constantinides VC. Imaging Markers for Normal Pressure Hydrocephalus: An Overview. Biomedicines 2023; 11:biomedicines11051265. [PMID: 37238936 DOI: 10.3390/biomedicines11051265] [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: 03/28/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
Idiopathic bormal pressure hydrocephalus (iNPH) is a neurological syndrome that clinically presents with Hakim's triad, namely cognitive impairment, gait disturbances, and urinary incontinence. The fact that iNPH is potentially reversible makes its accurate and early diagnosis of paramount importance. Its main imaging characteristic is the dilation of the brain's ventricular system and the imaging parameters are also included in its diagnostic criteria along with clinical data. There is a variety of different modalities used and a great number of imaging markers that have been described while assessing iNPH patients. The present literature review attempts to describe the most important of these imaging markers and to shed some light on their role in diagnosis, differential diagnosis, and possibly prognosis of this potentially reversible neurological syndrome.
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Affiliation(s)
- Efstratios-Stylianos Pyrgelis
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
- Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Georgios Velonakis
- Research Unit of Radiology, 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Rimini 1, Chaidari, 12462 Athens, Greece
| | - Sokratis G Papageorgiou
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
- Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Vasilios C Constantinides
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
- Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
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Constantinides VC, Tentolouris-Piperas V, Paraskevas GP, Pyrgelis ES, Velonakis G, Karavasilis E, Toulas P, Boufidou F, Stefanis L, Kapaki E. Hippocampal subfield volumetry in corticobasal syndrome of diverse underlying pathologies. J Neurol 2023; 270:2059-2068. [PMID: 36565349 DOI: 10.1007/s00415-022-11538-5] [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: 11/13/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Multiple pathologies may underlie corticobasal syndrome (CBS), including Alzheimer's disease (AD). Typical amnestic AD is characterized by early selective hippocampal atrophy. The profile of hippocampal atrophy in AD patients presenting as CBS (CBS-AD), compared to CBS patients of non-AD pathologies (CBS-nAD) and amnestic AD patients, has not been studied. OBJECTIVES To compare hippocampal subfield atrophy patterns between CBS-AD, CBS-nAD, typical amnestic AD patients, and control subjects. METHODS Automated hippocampal subfield volumetry was performed via the hippocampal subfield segmentation pipeline of Freesurfer 6.0 on 3D T1-weighted images. CBS patients were classified as CBS-AD or CBS-nAD based on CSF AD biomarkers by applying the AT(N) classification system. Mean volumes of nine hippocampal subfields, head-body-tail segments, total hippocampus, and entorhinal and parahippocampal gyrus cortical thickness were measured. RESULTS Eighty-three subjects were included (CBS-AD: n = 14; CBS-nAD: n = 17; amnestic AD: n = 29; controls: n = 23). CBS-AD patients had greater whole hippocampal and hippocampal subfield atrophy compared to CBS-nAD. CBS-AD and amnestic AD patients did not differ in subfield volumes. CBS-nAD did not exhibit hippocampal atrophy compared to controls, with the exception of fimbria. (Cohen's d = 1.27; p = 0.038). Presubiculum (Cohen's d = 1.00; p = 0.002) and hippocampal body (Cohen's d = 0.95; p = 0.001) volumes exhibited the greatest differences between CBS-AD and CBS-nAD. Hippocampal subfield volume provided combined sensitivity and specificity < 80% for the discrimination of CBS-AD from CBS-nAD. CONCLUSION CBS-AD and amnestic AD patients exhibit comparable, and significantly greater hippocampal atrophy compared to CBS-nAD patients. Hippocampal subfield volumetry in CBS is indicative of an AD underlying pathology.
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Affiliation(s)
- Vasilios C Constantinides
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece.
| | - Vasileios Tentolouris-Piperas
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
| | - George P Paraskevas
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
- Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Attikon Hospital, Athens, Greece
| | - Efstratios-Stylianos Pyrgelis
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
| | - Georgios Velonakis
- Second Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Efstratios Karavasilis
- Second Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Panagiotis Toulas
- Second Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Fotini Boufidou
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
| | - Leonidas Stefanis
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
| | - Elisabeth Kapaki
- First Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
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Constantinides VC, Paraskevas GP, Boufidou F, Bourbouli M, Pyrgelis ES, Stefanis L, Kapaki E. CSF Aβ42 and Aβ42/Aβ40 Ratio in Alzheimer's Disease and Frontotemporal Dementias. Diagnostics (Basel) 2023; 13:diagnostics13040783. [PMID: 36832271 PMCID: PMC9955886 DOI: 10.3390/diagnostics13040783] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Alzheimer's disease dementia (ADD) may manifest with atypical phenotypes, resembling behavioral variant frontotemporal dementia (bvFTD) and corticobasal syndrome (CBS), phenotypes which typically have an underlying frontotemporal lobar degeneration with tau proteinopathy (FTLD-tau), such as Pick's disease, corticobasal degeneration (CBD), progressive supranuclear palsy (PSP), or FTLD with TDP-43 proteinopathy (FTLD-TDP). CSF biomarkers total and phosphorylated tau (τT and τP-181), and amyloid beta with 42 and 40 amino acids (Aβ42 and Aβ40) are biomarkers of AD pathology. The primary aim of this study was to compare the diagnostic accuracy of Aβ42 to Aβ42/Aβ40 ratio in: (a) differentiating ADD vs. frontotemporal dementias; (b) patients with AD pathology vs. non-AD pathologies; (c) compare biomarker ratios and composite markers to single CSF biomarkers in the differentiation of AD from FTD; Methods: In total, 263 subjects were included (ADD: n = 98; bvFTD: n = 49; PSP: n = 50; CBD: n = 45; controls: n = 21). CSF biomarkers were measured by commercially available ELISAs (EUROIMMUN). Multiple biomarker ratios (Aβ42/Aβ40; τT/τP-181; τT/Aβ42; τP-181/Aβ42) and composite markers (t-tau: τT/(Aβ42/Aβ40); p-tau: τP-181/(Aβ42/Aβ40) were calculated. ROC curve analysis was performed to compare AUCs of Aβ42 and Aβ42/Aβ40 ratio and relevant composite markers between ADD and FTD, as defined clinically. BIOMARKAPD/ABSI criteria (abnormal τT, τP-181 Aβ42, and Aβ42/Aβ40 ratio) were used to re-classify all patients into AD pathology vs. non-AD pathologies, and ROC curve analysis was repeated to compare Aβ42 and Aβ42/Aβ40; Results: Aβ42 did not differ from Aβ42/Aβ40 ratio in the differentiation of ADD from FTD (AUCs 0.752 and 0.788 respectively; p = 0.212). The τT/Aβ42 ratio provided maximal discrimination between ADD and FTD (AUC:0.893; sensitivity 88.8%, specificity 80%). BIOMARKAPD/ABSI criteria classified 60 patients as having AD pathology and 211 as non-AD. A total of 22 had discrepant results and were excluded. Aβ42/Aβ40 ratio was superior to Aβ42 in the differentiation of AD pathology from non-AD pathology (AUCs: 0.939 and 0.831, respectively; p < 0.001). In general, biomarker ratios and composite markers were superior to single CSF biomarkers in both analyses. CONCLUSIONS Aβ42/Aβ40 ratio is superior to Aβ42 in identifying AD pathology, irrespective of the clinical phenotype. CSF biomarker ratios and composite markers provide higher diagnostic accuracy compared to single CSF biomarkers.
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Affiliation(s)
- Vasilios C. Constantinides
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
- Neurochemistry and Biological Markers Unit, First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
- Correspondence: ; Tel.: +30-21-0728-9285
| | - George P. Paraskevas
- Neurochemistry and Biological Markers Unit, First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
- Second Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” University General Hospital, Rimini 1, 12462 Athens, Greece
| | - Fotini Boufidou
- Neurochemistry and Biological Markers Unit, First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Mara Bourbouli
- Neurochemistry and Biological Markers Unit, First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Efstratios-Stylianos Pyrgelis
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Leonidas Stefanis
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Elisabeth Kapaki
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
- Neurochemistry and Biological Markers Unit, First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
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Constantinides VC, Boufidou F, Bourbouli M, Pyrgelis ES, Ghika A, Koros C, Liakakis G, Papageorgiou S, Stefanis L, Paraskevas GP, Kapaki E. Application of the AT(N) and Other CSF Classification Systems in Behavioral Variant Frontotemporal Dementia. Diagnostics (Basel) 2023; 13:diagnostics13030332. [PMID: 36766437 PMCID: PMC9914032 DOI: 10.3390/diagnostics13030332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Patients with a frontotemporal lobar degeneration (FTLD) usually manifest with behavioral variant frontotemporal dementia (bvFTD). Alzheimer's disease (AD) may also manifest with a predominant behavioral-dysexecutive syndrome, similar to bvFTD. Cerebrospinal fluid (CSF) biomarkers, such as total tau (τT), phosphorylated tau (τP-181) and amyloid beta with 42 amino-acids (Aβ42), can predict AD pathology in vivo. The aim of this study was to compare the τT/Aβ42 and τP-181/Aβ42 ratios, the BIOMARKAPD/ABSI criteria and the AT(N) classification system in a cohort of bvFTD patients. METHODS A total of 105 bvFTD patients (21 possible bvFTD; 20%) with CSF data, examined from 2008 to 2022, were included. Seventy-eight AD patients and 62 control subjects were included. The CSF biomarkers were measured with Innotest (2008-2017 subcohort) and EUROIMMUN (2017-2022 subcohort) ELISAs. RESULTS Depending on the classification system, 7.6 to 28.6% of bvFTD had an AD biochemical profile. The τT/Aβ42 and τP-181/Aβ42 ratios classified more patients as AD compared to the BIOMARKAPD/ABSI and AT(N) systems. The patients with possible bvFTD had higher frequencies of AD compared to the probable bvFTD patients. CONCLUSIONS The four classification criteria of CSF AD biomarkers resulted in differences in AD allocation in this bvFTD cohort. A consensus on the optimal classification criteria of CSF AD biomarkers is pivotal.
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Affiliation(s)
- Vasilios C. Constantinides
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
- Neurochemistry and Biological Markers Unit, First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
- Correspondence: ; Tel.: +30-21-0728-9285
| | - Fotini Boufidou
- Neurochemistry and Biological Markers Unit, First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Mara Bourbouli
- Neurochemistry and Biological Markers Unit, First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Efstratios-Stylianos Pyrgelis
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
- Neurochemistry and Biological Markers Unit, First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Apostolia Ghika
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Christos Koros
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - George Liakakis
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Sokratis Papageorgiou
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - Leonidas Stefanis
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
| | - George P. Paraskevas
- Neurochemistry and Biological Markers Unit, First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
- Second Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” University General Hospital, Rimini 1, 12462 Athens, Greece
| | - Elisabeth Kapaki
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
- Neurochemistry and Biological Markers Unit, First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Vass. Sophias Ave. 74, 11528 Athens, Greece
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Koros C, Beratis I, Matsi S, Bougea A, Bonakis A, Papatriantafyllou I, Angelopoulou E, Kapaki E, Stefanis L, Papageorgiou SG. Prosopagnosia, Other Specific Cognitive Deficits, and Behavioral Symptoms: Comparison between Right Temporal and Behavioral Variant of Frontotemporal Dementia. Vision (Basel) 2022; 6:vision6040075. [PMID: 36548937 PMCID: PMC9781966 DOI: 10.3390/vision6040075] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/03/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
Right temporal variant of frontotemporal dementia (rtv-FTD) represents an uncommon and recently described frontotemporal dementia (FTD) entity presenting with symptoms in many ways comparable to those of the frontal or behavioral variant of FTD (bv-FTD). The aims of this study were to explore the timing of cognitive and behavioral symptoms of rtv-FTD, and to compare the distinct cognitive deficits including prosopagnosia and behavioral symptoms of rtv-FTD patients with those observed in bv-FTD patients. We reviewed the records of 105 patients clinically diagnosed with FTD. A total of 7 patients (5 men/2 women) with FTD and marked right temporal atrophy in magnetic resonance imaging (MRI) were detected. Clinical features were compared with those observed in a group of 22 age-matched patients (16 men/6 women) with FTD and predominant frontal lobe atrophy. The main presenting symptoms of rtv-FTD were prosopagnosia, apathy, and episodic memory impairment. In contrast, social awkwardness and compulsive behaviors were dominant in later stages of the disease together with disinhibition and loss of insight with a marked personality change. Although the cognitive and behavioral profiles of patients with right temporal or frontal lobes atrophy present substantial similarities, each subtype has a number of distinct characteristics. It appears that prosopagnosia, obsessive behaviors, and psychotic symptoms are more prominent in rtv-FTD patients.
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Affiliation(s)
- Christos Koros
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (C.K.); (I.B.); (S.M.); (A.B.); (I.P.); (E.K.); (L.S.); (S.G.P.)
| | - Ion Beratis
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (C.K.); (I.B.); (S.M.); (A.B.); (I.P.); (E.K.); (L.S.); (S.G.P.)
- Deree-The American College of Greece, 15342 Athens, Greece
| | - Stavroula Matsi
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (C.K.); (I.B.); (S.M.); (A.B.); (I.P.); (E.K.); (L.S.); (S.G.P.)
| | - Anastasia Bougea
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (C.K.); (I.B.); (S.M.); (A.B.); (I.P.); (E.K.); (L.S.); (S.G.P.)
| | - Anastasios Bonakis
- 2nd Department of Neurology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Ioannis Papatriantafyllou
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (C.K.); (I.B.); (S.M.); (A.B.); (I.P.); (E.K.); (L.S.); (S.G.P.)
| | - Efthalia Angelopoulou
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (C.K.); (I.B.); (S.M.); (A.B.); (I.P.); (E.K.); (L.S.); (S.G.P.)
- Correspondence:
| | - Elisabeth Kapaki
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (C.K.); (I.B.); (S.M.); (A.B.); (I.P.); (E.K.); (L.S.); (S.G.P.)
| | - Leonidas Stefanis
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (C.K.); (I.B.); (S.M.); (A.B.); (I.P.); (E.K.); (L.S.); (S.G.P.)
| | - Sokratis G. Papageorgiou
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (C.K.); (I.B.); (S.M.); (A.B.); (I.P.); (E.K.); (L.S.); (S.G.P.)
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8
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Kartanou C, Kontogeorgiou Z, Rentzos M, Potagas C, Aristeidou S, Kapaki E, Paraskevas GP, Constantinides VC, Stefanis L, Papageorgiou SG, Houlden H, Panas M, Koutsis G, Karadima G. Expanding the spectrum of C9ORF72-related neurodegenerative disorders in the Greek population. J Neurol Sci 2022; 442:120450. [PMID: 36252286 DOI: 10.1016/j.jns.2022.120450] [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: 07/15/2022] [Revised: 09/26/2022] [Accepted: 10/01/2022] [Indexed: 10/31/2022]
Abstract
The C9ORF72 hexanucleotide repeat expansion is an established cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) and has also been associated with Huntington disease (HD)-like syndromes and rarely with Parkinson's disease (PD) and Alzheimer's disease (AD). In the present study we aimed to investigate the genotypic and phenotypic profile of C9ORF72-related disorders in Greece. For this reason, 957 patients (467 with ALS, 53 with HD-like syndromes, 247 with dementia, 175 with PD and 15 with hereditary spastic paraplegia, HSP) and 321 controls were tested for the C9ORF72 repeat expansion. Forty-nine patients with ALS (10.5%), 2 with HD-like syndromes (3.8%), 13 with FTD (11.5%), 1 with AD (1.6%), and 2 with PD (1.1%) were expansion-positive. The expansion was not detected in the HSP or control groups. The results of this study provide an update on the spectrum of C9ORF72-related neurodegenerative diseases, emphasizing the importance of C9ORF72 genetic testing in Greek patients with familial and sporadic ALS and/or FTD and HD-like syndromes.
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Affiliation(s)
- Chrisoula Kartanou
- Neurogenetics Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Zoi Kontogeorgiou
- Neurogenetics Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Michail Rentzos
- 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantin Potagas
- Neuropsychology and Speech Pathology Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavroula Aristeidou
- Neurogenetics Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Kapaki
- Unit of Neurochemistry and Biological Markers, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Paraskevas
- Unit of Neurochemistry and Biological Markers, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasilios C Constantinides
- Unit of Neurochemistry and Biological Markers, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece; Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Greece
| | - Sokratis G Papageorgiou
- 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Henry Houlden
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Marios Panas
- Neurogenetics Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Koutsis
- Neurogenetics Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Karadima
- Neurogenetics Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
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9
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Potagas C, Nikitopoulou Z, Angelopoulou G, Kasselimis D, Laskaris N, Kourtidou E, Constantinides VC, Bougea A, Paraskevas GP, Papageorgiou G, Tsolakopoulos D, Papageorgiou SG, Kapaki E. Silent Pauses and Speech Indices as Biomarkers for Primary Progressive Aphasia. Medicina (B Aires) 2022; 58:medicina58101352. [PMID: 36295513 PMCID: PMC9611099 DOI: 10.3390/medicina58101352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 12/30/2022] Open
Abstract
Background and Objectives: Recent studies highlight the importance of investigating biomarkers for diagnosing and classifying patients with primary progressive aphasia (PPA). Even though there is ongoing research on pathophysiological indices in this field, the use of behavioral variables, and especially speech-derived factors, has drawn little attention in the relevant literature. The present study aims to investigate the possible utility of speech-derived indices, particularly silent pauses, as biomarkers for primary progressive aphasia (PPA). Materials and Methods: We recruited 22 PPA patients and 17 healthy controls, from whom we obtained speech samples based on two elicitation tasks, i.e., cookie theft picture description (CTP) and the patients’ personal narration of the disease onset and course. Results: Four main indices were derived from these speech samples: speech rate, articulation rate, pause frequency, and pause duration. In order to investigate whether these indices could be used to discriminate between the four groups of participants (healthy individuals and the three patient subgroups corresponding to the three variants of PPA), we conducted three sets of analyses: a series of ANOVAs, two principal component analyses (PCAs), and two hierarchical cluster analyses (HCAs). The ANOVAs revealed significant differences between the four subgroups for all four variables, with the CTP results being more robust. The subsequent PCAs and HCAs were in accordance with the initial statistical comparisons, revealing that the speech-derived indices for CTP provided a clearer classification and were especially useful for distinguishing the non-fluent variant from healthy participants as well as from the two other PPA taxonomic categories. Conclusions: In sum, we argue that speech-derived indices, and especially silent pauses, could be used as complementary biomarkers to efficiently discriminate between PPA and healthy speakers, as well as between the three variants of the disease.
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Affiliation(s)
- Constantin Potagas
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Correspondence:
| | - Zoi Nikitopoulou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Georgia Angelopoulou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Department of Speech and Language Therapy, School of Health Sciences, University of Peloponnese, 241 00 Kalamata, Greece
| | - Dimitrios Kasselimis
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Department of Psychology, Panteion University of Social and Political Sciences, 176 71 Athens, Greece
| | - Nikolaos Laskaris
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Department of Industrial Design and Production Engineering, School of Engineering, University of West Attica, 122 43 Athens, Greece
| | - Evie Kourtidou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Vasilios C. Constantinides
- 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Anastasia Bougea
- 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - George P. Paraskevas
- 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, 115 28 Athens, Greece
| | - Georgios Papageorgiou
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Dimitrios Tsolakopoulos
- Neuropsychology and Language Disorders Unit, 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Sokratis G. Papageorgiou
- 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, Eginitio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
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10
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Constantinides VC, Souvatzoglou M, Paraskevas GP, Chalioti M, Boufidou F, Stefanis L, Kapaki E. Dopamine transporter SPECT imaging in corticobasal syndrome: A peak into the underlying pathology? Acta Neurol Scand 2022; 145:762-769. [PMID: 35307816 DOI: 10.1111/ane.13614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Multiple pathologies may underlie corticobasal syndrome (CBS), including Alzheimer's disease (AD). Dopamine transporter density imaging with Ioflupane 123 I SPECT (DaTscan) may be normal in CBS. No studies to date have examined the relationship between DaTscan status and underlying pathology in CBS. OBJECTIVES The main objective of the study was to test whether a normal DaTscan in CBS patients is indicative of an underlying AD pathology, as determined by cerebrospinal fluid (CSF) biomarkers. METHODS Eighteen CBS patients were included. They were divided into patients with an AD and a non-AD disease pathology, based on their cerebrospinal fluid biochemical profile. A typical AD CSF profile was defined as an increase in total and phosphorylated at threonine 181 tau protein in addition to a decrease in amyloid-beta with 42 amino acids. DaTscan data were compared in these two groups. RESULTS Eight of the 18 CBS patients (44%) had a normal DaTscan. Seven of the 18 CBS patients (39%) had an AD cerebrospinal fluid biochemical profile. Two of seven CBS patients with AD biomarker profile had abnormal DaTscans. Three of 11 CBS patients with a non-AD biomarker profile had normal DaTscans. A normal DaTscan was indicative of AD pathology with suboptimal (~70%) sensitivity and specificity. Semi-quantitative DaTscan analysis did not differentiate between AD from non-AD CSF biomarker profile in CBS. CONCLUSION A normal DaTscan is indicative of AD in CBS, but the sensitivity and specificity of DaTscan as an in vivo marker of AD pathology is suboptimal.
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Affiliation(s)
- Vasilios C. Constantinides
- 1st Department of Neurology National and Kapodistrian University of Athens School of Medicine Eginition Hospital Athens Greece
| | - Michail Souvatzoglou
- Nuclear Medicine Division 1st Radiology Department National and Kapodistrian University of Athens Aretaieion Hospital Athens Greece
| | - George P. Paraskevas
- 1st Department of Neurology National and Kapodistrian University of Athens School of Medicine Eginition Hospital Athens Greece
- 2nd Department of Neurology National and Kapodistrian University of Athens School of Medicine Attikon Hospital Athens Greece
| | - Maria Chalioti
- Nuclear Medicine Division 1st Radiology Department National and Kapodistrian University of Athens Aretaieion Hospital Athens Greece
| | - Fotini Boufidou
- 1st Department of Neurology National and Kapodistrian University of Athens School of Medicine Eginition Hospital Athens Greece
| | - Leonidas Stefanis
- 1st Department of Neurology National and Kapodistrian University of Athens School of Medicine Eginition Hospital Athens Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology National and Kapodistrian University of Athens School of Medicine Eginition Hospital Athens Greece
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11
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Paraskevas GP, Stefanou MI, Constantinides VC, Bakola E, Chondrogianni M, Giannopoulos S, Kararizou E, Boufidou F, Zompola C, Tsantzali I, Theodorou A, Palaiodimou L, Vikelis M, Lachanis S, Papathanasiou M, Bakirtzis C, Koutroulou I, Karapanayiotides T, Xiromerisiou G, Kapaki E, Tsivgoulis G. CADASIL in Greece: Mutational spectrum and clinical characteristics based on a systematic review and pooled analysis of published cases. Eur J Neurol 2021; 29:810-819. [PMID: 34761493 DOI: 10.1111/ene.15180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/07/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Differences have been noted in the clinical presentation and mutational spectrum of CADASIL among various geographical areas. The aim of the present study was to investigate the mode of clinical presentation and genetic mutations reported in Greece. METHODS After a systematic literature search, we performed a pooled analysis of all published CADASIL cases from Greece. RESULTS We identified 14 studies that reported data from 14 families comprising 54 patients. Migraine with aura was reported in 39%, ischemic cerebrovascular diseases in 68%, behavioral-psychiatric symptoms in 47% and cognitive decline in 60% of the patients. The mean (±SD) age of onset for migraine with aura, ischemic cerebrovascular diseases, behavioral-psychiatric symptoms and cognitive decline was 26.2 ± 8.7, 49.3 ± 14.6, 47.9 ± 9.4 and 42.9 ± 10.3, respectively; the mean age at disease onset and death was 34.6 ± 12.1 and 60.2 ± 11.2 years. With respect to reported mutations, mutations in exon 4 were the most frequently reported (61.5% of all families), with the R169C mutation being the most common (30.8% of all families and 50% of exon 4 mutations), followed by R182C mutation (15.4% of all families and 25% of exon 4 mutations). CONCLUSIONS The clinical presentation of CADASIL in Greece is in accordance with the phenotype encountered in Caucasian populations, but differs from the Asian phenotype, which is characterized by a lower prevalence of migraine and psychiatric symptoms. The genotype of Greek CADASIL pedigrees is similar to that of British pedigrees, exhibiting a high prevalence of exon 4 mutations, but differs from Italian and Asian populations, where mutations in exon 11 are frequently encountered.
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Affiliation(s)
- George P Paraskevas
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Ioanna Stefanou
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasilios C Constantinides
- First Department of Neurology, School of Medicine, "Eginition" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Bakola
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Chondrogianni
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotirios Giannopoulos
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Kararizou
- First Department of Neurology, School of Medicine, "Eginition" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Fotini Boufidou
- First Department of Neurology, School of Medicine, "Eginition" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Zompola
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Tsantzali
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Theodorou
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Lina Palaiodimou
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Matilda Papathanasiou
- Second Department of Radiology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Bakirtzis
- Second Department of Neurology, School of Medicine, "AHEPA" University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioanna Koutroulou
- Second Department of Neurology, School of Medicine, "AHEPA" University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros Karapanayiotides
- Second Department of Neurology, School of Medicine, "AHEPA" University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Xiromerisiou
- Department of Neurology, School of Medicine, School of Health Sciences, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Elisabeth Kapaki
- First Department of Neurology, School of Medicine, "Eginition" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece.,Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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12
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Tsantzali I, Boufidou F, Sideri E, Mavromatos A, Papaioannou MG, Foska A, Tollos I, Paraskevas SG, Bonakis A, Voumvourakis KI, Tsivgoulis G, Kapaki E, Paraskevas GP. From Cerebrospinal Fluid Neurochemistry to Clinical Diagnosis of Alzheimer's Disease in the Era of Anti-Amyloid Treatments. Report of Four Patients. Biomedicines 2021; 9:biomedicines9101376. [PMID: 34680493 PMCID: PMC8533180 DOI: 10.3390/biomedicines9101376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/26/2021] [Accepted: 09/30/2021] [Indexed: 12/26/2022] Open
Abstract
Analysis of classical cerebrospinal fluid biomarkers, especially when incorporated in a classification/diagnostic system such as the AT(N), may offer a significant diagnostic tool allowing correct identification of Alzheimer’s disease during life. We describe four patients with more or less atypical or mixed clinical presentation, in which the classical cerebrospinal fluid biomarkers amyloid peptide with 42 and 40 amino acids (Aβ42 and Aβ40, respectively), phospho-tau (τP-181) and total tau (τΤ) were measured. Despite the unusual clinical presentation, the biomarker profile was compatible with Alzheimer’s disease in all four patients. The measurement of classical biomarkers in the cerebrospinal fluid may be a useful tool in identifying the biochemical fingerprints of Alzheimer’s disease, especially currently, due to the recent approval of the first disease-modifying treatment, allowing not only typical but also atypical cases to be enrolled in trials of such treatments.
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Affiliation(s)
- Ioanna Tsantzali
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece; (I.T.); (E.S.); (A.M.); (A.F.); (I.T.); (A.B.); (K.I.V.); (G.T.)
| | - Fotini Boufidou
- Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Eginition” Hospital, 11528 Athens, Greece; (F.B.); (M.G.P.); (S.G.P.); (E.K.)
| | - Eleni Sideri
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece; (I.T.); (E.S.); (A.M.); (A.F.); (I.T.); (A.B.); (K.I.V.); (G.T.)
| | - Antonis Mavromatos
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece; (I.T.); (E.S.); (A.M.); (A.F.); (I.T.); (A.B.); (K.I.V.); (G.T.)
| | - Myrto G. Papaioannou
- Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Eginition” Hospital, 11528 Athens, Greece; (F.B.); (M.G.P.); (S.G.P.); (E.K.)
| | - Aikaterini Foska
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece; (I.T.); (E.S.); (A.M.); (A.F.); (I.T.); (A.B.); (K.I.V.); (G.T.)
| | - Ioannis Tollos
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece; (I.T.); (E.S.); (A.M.); (A.F.); (I.T.); (A.B.); (K.I.V.); (G.T.)
| | - Sotirios G. Paraskevas
- Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Eginition” Hospital, 11528 Athens, Greece; (F.B.); (M.G.P.); (S.G.P.); (E.K.)
| | - Anastasios Bonakis
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece; (I.T.); (E.S.); (A.M.); (A.F.); (I.T.); (A.B.); (K.I.V.); (G.T.)
| | - Konstantinos I. Voumvourakis
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece; (I.T.); (E.S.); (A.M.); (A.F.); (I.T.); (A.B.); (K.I.V.); (G.T.)
| | - Georgios Tsivgoulis
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece; (I.T.); (E.S.); (A.M.); (A.F.); (I.T.); (A.B.); (K.I.V.); (G.T.)
| | - Elisabeth Kapaki
- Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Eginition” Hospital, 11528 Athens, Greece; (F.B.); (M.G.P.); (S.G.P.); (E.K.)
| | - George P. Paraskevas
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece; (I.T.); (E.S.); (A.M.); (A.F.); (I.T.); (A.B.); (K.I.V.); (G.T.)
- Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Eginition” Hospital, 11528 Athens, Greece; (F.B.); (M.G.P.); (S.G.P.); (E.K.)
- Correspondence: ; Tel.: +30-2105832466
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13
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Bourbouli M, Paraskevas GP, Rentzos M, Mathioudakis L, Zouvelou V, Bougea A, Tychalas A, Kimiskidis VK, Constantinides V, Zafeiris S, Tzagournissakis M, Papadimas G, Karadima G, Koutsis G, Kroupis C, Kartanou C, Kapaki E, Zaganas I. Genotyping and Plasma/Cerebrospinal Fluid Profiling of a Cohort of Frontotemporal Dementia-Amyotrophic Lateral Sclerosis Patients. Brain Sci 2021; 11:brainsci11091239. [PMID: 34573259 PMCID: PMC8472580 DOI: 10.3390/brainsci11091239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/05/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022] Open
Abstract
Frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) are part of the same pathophysiological spectrum and have common genetic and cerebrospinal fluid (CSF) biomarkers. Our aim here was to identify causative gene variants in a cohort of Greek patients with FTD, ALS and FTD-ALS, to measure levels of CSF biomarkers and to investigate genotype-phenotype/CSF biomarker associations. In this cohort of 130 patients (56 FTD, 58 ALS and 16 FTD-ALS), we performed C9orf72 hexanucleotide repeat expansion analysis, whole exome sequencing and measurement of “classical” (Aβ42, total tau and phospho-tau) and novel (TDP-43) CSF biomarkers and plasma progranulin. Through these analyses, we identified 14 patients with C9orf72 repeat expansion and 11 patients with causative variants in other genes (three in TARDBP, three in GRN, three in VCP, one in FUS, one in SOD1). In ALS patients, we found that levels of phospho-tau were lower in C9orf72 repeat expansion and MAPT c.855C>T (p.Asp285Asp) carriers compared to non-carriers. Additionally, carriers of rare C9orf72 and APP variants had lower levels of total tau and Aβ42, respectively. Plasma progranulin levels were decreased in patients carrying GRN pathogenic variants. This study expands the genotypic and phenotypic spectrum of FTD/ALS and offers insights in possible genotypic/CSF biomarker associations.
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Affiliation(s)
- Mara Bourbouli
- Neurogenetics Laboratory, Neurology Department, Medical School, University of Crete, 71003 Heraklion, Greece; (M.B.); (L.M.); (S.Z.); (M.T.)
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (G.P.P.); (M.R.); (V.Z.); (A.B.); (V.C.); (G.P.); (G.K.); (G.K.); (C.K.); (E.K.)
| | - George P. Paraskevas
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (G.P.P.); (M.R.); (V.Z.); (A.B.); (V.C.); (G.P.); (G.K.); (G.K.); (C.K.); (E.K.)
- 2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Attikon University General Hospital, 12462 Athens, Greece
| | - Mihail Rentzos
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (G.P.P.); (M.R.); (V.Z.); (A.B.); (V.C.); (G.P.); (G.K.); (G.K.); (C.K.); (E.K.)
| | - Lambros Mathioudakis
- Neurogenetics Laboratory, Neurology Department, Medical School, University of Crete, 71003 Heraklion, Greece; (M.B.); (L.M.); (S.Z.); (M.T.)
| | - Vasiliki Zouvelou
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (G.P.P.); (M.R.); (V.Z.); (A.B.); (V.C.); (G.P.); (G.K.); (G.K.); (C.K.); (E.K.)
| | - Anastasia Bougea
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (G.P.P.); (M.R.); (V.Z.); (A.B.); (V.C.); (G.P.); (G.K.); (G.K.); (C.K.); (E.K.)
| | - Athanasios Tychalas
- Department of Neurology, Papageorgiou General Hospital, 56403 Thessaloniki, Greece;
| | - Vasilios K. Kimiskidis
- 1st Department of Neurology, AHEPA Hospital, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece;
| | - Vasilios Constantinides
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (G.P.P.); (M.R.); (V.Z.); (A.B.); (V.C.); (G.P.); (G.K.); (G.K.); (C.K.); (E.K.)
| | - Spiros Zafeiris
- Neurogenetics Laboratory, Neurology Department, Medical School, University of Crete, 71003 Heraklion, Greece; (M.B.); (L.M.); (S.Z.); (M.T.)
| | - Minas Tzagournissakis
- Neurogenetics Laboratory, Neurology Department, Medical School, University of Crete, 71003 Heraklion, Greece; (M.B.); (L.M.); (S.Z.); (M.T.)
| | - Georgios Papadimas
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (G.P.P.); (M.R.); (V.Z.); (A.B.); (V.C.); (G.P.); (G.K.); (G.K.); (C.K.); (E.K.)
| | - Georgia Karadima
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (G.P.P.); (M.R.); (V.Z.); (A.B.); (V.C.); (G.P.); (G.K.); (G.K.); (C.K.); (E.K.)
| | - Georgios Koutsis
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (G.P.P.); (M.R.); (V.Z.); (A.B.); (V.C.); (G.P.); (G.K.); (G.K.); (C.K.); (E.K.)
| | - Christos Kroupis
- Department of Clinical Biochemistry, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Chrisoula Kartanou
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (G.P.P.); (M.R.); (V.Z.); (A.B.); (V.C.); (G.P.); (G.K.); (G.K.); (C.K.); (E.K.)
| | - Elisabeth Kapaki
- 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (G.P.P.); (M.R.); (V.Z.); (A.B.); (V.C.); (G.P.); (G.K.); (G.K.); (C.K.); (E.K.)
| | - Ioannis Zaganas
- Neurogenetics Laboratory, Neurology Department, Medical School, University of Crete, 71003 Heraklion, Greece; (M.B.); (L.M.); (S.Z.); (M.T.)
- Correspondence: ; Tel.: +30-2810-394643
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Ntymenou S, Tsantzali I, Kalamatianos T, Voumvourakis KI, Kapaki E, Tsivgoulis G, Stranjalis G, Paraskevas GP. Blood Biomarkers in Frontotemporal Dementia: Review and Meta-Analysis. Brain Sci 2021; 11:brainsci11020244. [PMID: 33672008 PMCID: PMC7919273 DOI: 10.3390/brainsci11020244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 12/12/2022] Open
Abstract
Biomarkers in cerebrospinal fluid (CSF) are useful in the differential diagnosis between frontotemporal dementia (FTD) and Alzheimer’s dementia (AD), but require lumbar puncture, which is a moderately invasive procedure that can cause anxiety to patients. Gradually, the measurement of blood biomarkers has been attracting great interest. Testing blood instead of CSF, in order to measure biomarkers, offers numerous advantages because it negates the need for lumbar puncture, it is widely available, and can be repeated, allowing the prediction of disease course. In this study, a systematic review of the existing literature was conducted, as well as meta-analysis with greater emphasis on the most studied biomarkers, p-tau and progranulin. The goal was to give prominence to evidence regarding the use of plasma biomarkers in clinical practice.
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Affiliation(s)
- Sofia Ntymenou
- Department of Neurology, Evangelismos Hospital, 10676 Athens, Greece
| | - Ioanna Tsantzali
- 2nd Department of Neurology, School of Medicine, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Theodosis Kalamatianos
- Department of Neurosurgery, School of Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Konstantinos I Voumvourakis
- 2nd Department of Neurology, School of Medicine, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Elisabeth Kapaki
- Ward of Cognitive and Movement Disorders, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
- Unit of Neurochemistry and Biological Markers, Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Georgios Tsivgoulis
- 2nd Department of Neurology, School of Medicine, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - George Stranjalis
- Department of Neurosurgery, School of Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - George P Paraskevas
- 2nd Department of Neurology, School of Medicine, "Attikon" University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
- Unit of Neurochemistry and Biological Markers, Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
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15
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Constantinides VC, Majbour NK, Paraskevas GP, Abdi I, Safieh-Garabedian B, Stefanis L, El-Agnaf OM, Kapaki E. Cerebrospinal Fluid α-Synuclein Species in Cognitive and Movements Disorders. Brain Sci 2021; 11:brainsci11010119. [PMID: 33477387 PMCID: PMC7830324 DOI: 10.3390/brainsci11010119] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 12/12/2022] Open
Abstract
Total CSF α-synuclein (t-α-syn), phosphorylated α-syn (pS129-α-syn) and α-syn oligomers (o-α-syn) have been studied as candidate biomarkers for synucleinopathies, with suboptimal specificity and sensitivity in the differentiation from healthy controls. Studies of α-syn species in patients with other underlying pathologies are lacking. The aim of this study was to investigate possible alterations in CSF α-syn species in a cohort of patients with diverse underlying pathologies. A total of 135 patients were included, comprising Parkinson's disease (PD; n = 13), multiple system atrophy (MSA; n = 9), progressive supranuclear palsy (PSP; n = 13), corticobasal degeneration (CBD; n = 9), Alzheimer's disease (AD; n = 51), frontotemporal degeneration (FTD; n = 26) and vascular dementia patients (VD; n = 14). PD patients exhibited higher pS129-α-syn/α-syn ratios compared to FTD (p = 0.045), after exclusion of samples with CSF blood contamination. When comparing movement disorders (i.e., MSA vs. PD vs. PSP vs. CBD), MSA patients had lower α-syn levels compared to CBD (p = 0.024). Patients with a synucleinopathy (PD and MSA) exhibited lower t-α-syn levels (p = 0.002; cut-off value: ≤865 pg/mL; sensitivity: 95%, specificity: 69%) and higher pS129-/t-α-syn ratios (p = 0.020; cut-off value: ≥0.122; sensitivity: 71%, specificity: 77%) compared to patients with tauopathies (PSP and CBD). There are no significant α-syn species alterations in non-synucleinopathies.
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Affiliation(s)
- Vasilios C. Constantinides
- Neurochemistry and Biomarkers Unit, 1st Department of Neurology, National and Kapodistrian University of Athens, 11528 Athens, Greece; (G.P.P.); (E.K.)
- Ward of Cognitive and movement Disorders, 1st Department of Neurology, National and Kapodistrian University of Athens, 11528 Athens, Greece;
- Correspondence: ; Tel.: +30-2107289285
| | - Nour K. Majbour
- Neurological Disorders Research Centre, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha 34110, Qatar; (N.K.M.); (I.A.); (O.M.E.-A.)
| | - George P. Paraskevas
- Neurochemistry and Biomarkers Unit, 1st Department of Neurology, National and Kapodistrian University of Athens, 11528 Athens, Greece; (G.P.P.); (E.K.)
| | - Ilham Abdi
- Neurological Disorders Research Centre, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha 34110, Qatar; (N.K.M.); (I.A.); (O.M.E.-A.)
| | | | - Leonidas Stefanis
- Ward of Cognitive and movement Disorders, 1st Department of Neurology, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Omar M. El-Agnaf
- Neurological Disorders Research Centre, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha 34110, Qatar; (N.K.M.); (I.A.); (O.M.E.-A.)
| | - Elisabeth Kapaki
- Neurochemistry and Biomarkers Unit, 1st Department of Neurology, National and Kapodistrian University of Athens, 11528 Athens, Greece; (G.P.P.); (E.K.)
- Ward of Cognitive and movement Disorders, 1st Department of Neurology, National and Kapodistrian University of Athens, 11528 Athens, Greece;
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Breza M, Kotsali-Peteinelli V, Tsantzali I, Mavromatos A, Strataki E, Bonakis A, Paraskevas GP, Constantinides VC, Stefanis L, Voumvourakis K, Boviatsis E, Tsivgoulis G, Kapaki E. Diffuse glioma manifesting as normal pressure hydrocephalus: A potential pitfall in diagnosis-a case report. Cerebral Circulation - Cognition and Behavior 2021; 2:100009. [PMID: 36324724 PMCID: PMC9616340 DOI: 10.1016/j.cccb.2021.100009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 11/21/2022]
Abstract
Hydrocephalus is rarely reported in patients with diffuse glioma. We describe a patient with a low-grade glioma presenting a complex phenotype initially masquerading as hydrocephalus of unknown etiology. The exact pathophysiological mechanism underlying hydrocephalus in the setting of diffuse glioma remains to be elucidated. Caution is advised regarding hydrocephalus of unknown etiology, reevaluation is necessary.
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Affiliation(s)
- Marianthi Breza
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki Kotsali-Peteinelli
- 2nd Department of Neurology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Tsantzali
- 2nd Department of Neurology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonis Mavromatos
- 2nd Department of Neurology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Strataki
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios Bonakis
- 2nd Department of Neurology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George P. Paraskevas
- 2nd Department of Neurology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasilios C. Constantinides
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Voumvourakis
- 2nd Department of Neurology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathios Boviatsis
- 2nd Department of Neurosurgery, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Tsivgoulis
- 2nd Department of Neurology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Corresponding author.
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Theodorou A, Tsantzali I, Kapaki E, Constantinides VC, Voumvourakis K, Tsivgoulis G, Paraskevas GP. Cerebrospinal fluid biomarkers and apolipoprotein E genotype in cerebral amyloid angiopathy. A narrative review. Cerebral Circulation - Cognition and Behavior 2021; 2:100010. [PMID: 36324707 PMCID: PMC9616386 DOI: 10.1016/j.cccb.2021.100010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/13/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Abstract
Lower Cerebrospinal Fluid Levels of Aβ40 and Aβ42 in Cerebral Amyloid Angiopathy compared with Alzheimer Disease and Healthy Controls. Cortical Superficial Siderosis-extent and lower levels of Aβ42 could be prognostic for the severity of Cerebral Amyloid Angiopathy. Apolipoprotein – E Genotype plays an important role in the pathophysiology of Cerebral Amyloid Angiopathy.
Sporadic cerebral amyloid angiopathy (CAA) is a cerebral small vessel disease, characterized by the deposition of β-amyloid within the cortical and leptomeningeal blood vessel walls. It has attracted interest concerning new therapeutic perspectives. However, there are scarce data regarding the cerebrospinal fluid biomarkers (CSF) and genetic factors in sporadic CAA. In this narrative review, we investigated the literature regarding the cerebrospinal fluid core biomarkers profile of patients with probable or possible CAA and its subtype, the CAA- related inflammation (CAA-ri), taking into account the clinical and radiological characteristics of the patients. We also analyzed the Apolipoprotein E (APOE) genotype differentiations among the different subtypes of cerebral amyloid angiopathy. Our results demonstrate specific CSF patterns of β-amyloid (Aβ42 and Aβ40) and tau-proteins (t-tau and p-tau) which may serve as molecular biomarkers for CAA/ CAA-ri and could prove helpful for novel therapeutic procedures. Specifically, decreased levels of Aβ40 and Aβ42 in both CAA and CAA-ri, mildly increased concentrations of tau protein in patients with CAA-ri and a strong association between APOE ε4/ε4 genotype and CAA-ri are the main findings.
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18
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Constantinides VC, Paraskevas GP, Velonakis G, Toulas P, Karavasilis E, Stefanis L, Kapaki E. The "hypointense substantia nigra" sign. A novel MRI marker of progressive supranuclear palsy. J Neurol Sci 2020; 421:117286. [PMID: 33360531 DOI: 10.1016/j.jns.2020.117286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/06/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Vasilios C Constantinides
- National and Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, 72 Vas. Sophias Ave., Athens, Greece.
| | - George P Paraskevas
- National and Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, 72 Vas. Sophias Ave., Athens, Greece
| | - Georgios Velonakis
- National and Kapodistrian University of Athens, School of Medicine, 2nd Department of Radiology, 19 Papadiamandopoulou Str., Athens, Greece
| | - Panagiotis Toulas
- National and Kapodistrian University of Athens, School of Medicine, 2nd Department of Radiology, 19 Papadiamandopoulou Str., Athens, Greece
| | - Efstratios Karavasilis
- National and Kapodistrian University of Athens, School of Medicine, 2nd Department of Radiology, 19 Papadiamandopoulou Str., Athens, Greece
| | - Leonidas Stefanis
- National and Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, 72 Vas. Sophias Ave., Athens, Greece.
| | - Elisabeth Kapaki
- National and Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, 72 Vas. Sophias Ave., Athens, Greece.
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Constantinides VC, Paraskevas GP, Boufidou F, Bourbouli M, Stefanis L, Kapaki E. Cerebrospinal fluid biomarker profiling in corticobasal degeneration: Application of the AT(N) and other classification systems. Parkinsonism Relat Disord 2020; 82:44-49. [PMID: 33246219 DOI: 10.1016/j.parkreldis.2020.11.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/09/2020] [Accepted: 11/15/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Total tau (τT), phosphorylated tau (τP-181) and amyloid beta (Aβ42) are cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD). There is no consensus on the interpretation criteria of these biomarkers. The aim of this study was to apply three different sets of criteria for CSF AD biomarker interpretation in a cohort of corticobasal degeneration (CBD) patients. METHOD SForty patients fulfilling diagnostic criteria for "probable CBD" were included. The AT(N), BIOMARKAPD/ABSI and the τP-181/Aβ42 ratio criteria were applied. RESULTS The AT(N) criteria categorized 50% of "probable CBD" patients as AD, and 62.5% as harboring amyloid pathology. The BIOMARKAPD/ABSI and τP- 181/Aβ42 criteria categorized ~40% of "probable CBD" patients as AD. DISCUSSION Use of different interpretation criteria for CSF AD biomarkers produces diverse results. AD pathology is common in patients fulfilling "probable" CBD criteria. CBD diagnostic criteria may have suboptimal positive predictive value. A consensus regarding interpretation criteria of CSF AD biomarkers is pivotal.
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Affiliation(s)
- Vasilios C Constantinides
- Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Neurochemistry and Biomarkers Unit, Greece; Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Division of Cognitive, Movement Disorders and Epilepsy, Greece.
| | - George P Paraskevas
- Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Neurochemistry and Biomarkers Unit, Greece; Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Attikon University General Hospital, Division of Cognitive and Movement Disorders, Greece
| | - Fotini Boufidou
- Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Neurochemistry and Biomarkers Unit, Greece
| | - Mara Bourbouli
- Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Neurochemistry and Biomarkers Unit, Greece
| | - Leonidas Stefanis
- Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Division of Cognitive, Movement Disorders and Epilepsy, Greece
| | - Elisabeth Kapaki
- Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Neurochemistry and Biomarkers Unit, Greece; Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Division of Cognitive, Movement Disorders and Epilepsy, Greece
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20
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Kormas C, Zalonis I, Evdokimidis I, Kapaki E, Potagas C. Face-Name Associative Memory Performance Among Cognitively Healthy Individuals, Individuals With Subjective Memory Complaints, and Patients With a Diagnosis of aMCI. Front Psychol 2020; 11:2173. [PMID: 33041886 PMCID: PMC7517892 DOI: 10.3389/fpsyg.2020.02173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/03/2020] [Indexed: 01/10/2023] Open
Affiliation(s)
- Constantinos Kormas
- First Department of Neurology, Faculty of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Zalonis
- First Department of Neurology, Faculty of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Evdokimidis
- First Department of Neurology, Faculty of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Kapaki
- First Department of Neurology, Faculty of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantin Potagas
- First Department of Neurology, Faculty of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
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21
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Vakrakou A, Constantinides V, Paraskevas GP, Kilidireas K, Stefanis L, Kapaki E. Area postrema involvement in chronic lymphocytic inflammation with pontine perivascular enhancement. Neurol Sci 2020; 42:361-364. [PMID: 32700227 DOI: 10.1007/s10072-020-04615-y] [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] [Received: 04/26/2020] [Accepted: 07/19/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Aigli Vakrakou
- 1st Department of Neurology, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, 72 Vas. Sofias Ave., 11528, Athens, Greece
| | - Vasilios Constantinides
- 1st Department of Neurology, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, 72 Vas. Sofias Ave., 11528, Athens, Greece.
| | - George P Paraskevas
- 1st Department of Neurology, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, 72 Vas. Sofias Ave., 11528, Athens, Greece
| | - Kostas Kilidireas
- 1st Department of Neurology, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, 72 Vas. Sofias Ave., 11528, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, 72 Vas. Sofias Ave., 11528, Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, 72 Vas. Sofias Ave., 11528, Athens, Greece
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22
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Constantinides VC, Paraskevas GP, Kalogera S, Yapijakis C, Kapaki E. Hot cross bun sign and prominent cerebellar peduncle involvement in a patient with oculodentodigital dysplasia. Neurol Sci 2020; 42:343-345. [PMID: 32676758 DOI: 10.1007/s10072-020-04569-1] [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] [Received: 04/24/2020] [Accepted: 07/02/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Vasilios C Constantinides
- 1st Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece.
| | - George P Paraskevas
- 1st Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
| | - Stefania Kalogera
- Department of Molecular Genetics, Cephalogenetics Diagnostic Center, Athens, Greece
| | - Christos Yapijakis
- Department of Molecular Genetics, Cephalogenetics Diagnostic Center, Athens, Greece.,1st Department of Pediatrics, National and Kapodistrian University of Athens, School of Medicine, Aghia Sophia Hospital, Athens, Greece.,Department of Oral & Maxillofacial Surgery, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave., 11528, Athens, Greece
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23
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Constantinides VC, Deligianni C, Dimitrakopoulos A, Paraskevas GP, Kapaki E. Lentiform fork sign in a patient with systemic lupus erythematosus. Neurol Sci 2020; 42:349-352. [DOI: 10.1007/s10072-020-04607-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/15/2020] [Indexed: 12/13/2022]
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Kormas C, Zalonis I, Evdokimidis I, Kapaki E, Potagas C. The severity of executive dysfunction among different PD-MCI subtypes. Appl Neuropsychol Adult 2020; 29:546-550. [PMID: 32633669 DOI: 10.1080/23279095.2020.1786832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Aim to examine the severity of executive dysfunction among different Parkinson's disease (PD)-mild cognitive impairment (MCI) subtypes in the early stages of the disease. The final sample consisted of 65 patients with mild PD progression. Based on neuropsychological measures, our sample was categorized into three PD-MCI subtypes: (1) PD-MCI executive group (n = 24), (2) PD-MCI executive plus memory group (n = 22), and (3) PD-MCI executive plus visuospatial group (n = 19). Patients' executive functions were evaluated with the Trail Making Test-Part B (TMT-B) and Stroop Neuropsychological Screening Test (SNST) for mental flexibility and inhibitory control, respectively. One-way ANOVA results indicated significant differences among the three subgroups on TMT-B and SNST performance. Post hoc Tukey honestly significant different (HSD) tests revealed that the PD-MCI executive plus visuospatial group had lower performances on both executive measures than the other two groups. Contrastingly, no significant differences were observed between the PD-MCI executive group and PD-MCI executive plus memory group. Our results indicated that the severity of executive dysfunction varies across different PD-MCI subtypes. These findings are discussed within the framework of the dual syndrome hypothesis and highlight the utility of determination of executive impairment severity for effective clinical management of patients with PD.
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Affiliation(s)
- Constantinos Kormas
- First Department of Neurology, National and Kapodistrian University of Athens, Aeginition Hospital, Athens, Greece
| | - Ioannis Zalonis
- First Department of Neurology, National and Kapodistrian University of Athens, Aeginition Hospital, Athens, Greece
| | - Ioannis Evdokimidis
- First Department of Neurology, National and Kapodistrian University of Athens, Aeginition Hospital, Athens, Greece
| | - Elisabeth Kapaki
- First Department of Neurology, National and Kapodistrian University of Athens, Aeginition Hospital, Athens, Greece
| | - Constantin Potagas
- First Department of Neurology, National and Kapodistrian University of Athens, Aeginition Hospital, Athens, Greece
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Vakrakou A, Constantinides VC, Velonakis G, Tzartos JS, Stefanis L, Kapaki E, Paraskevas GP. Paraneoplastic basal ganglia encephalitis associated with anti-CV2/CRMP-5 and anti-Yo antibodies in a patient with non-small-cell lung cancer. Neurol Sci 2020; 41:2649-2651. [PMID: 32307664 DOI: 10.1007/s10072-020-04399-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 04/06/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Aigli Vakrakou
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Medical School, 72 Vas. Sofias Ave, 11528, Athens, Greece
| | - Vasilios C Constantinides
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Medical School, 72 Vas. Sofias Ave, 11528, Athens, Greece.
| | - George Velonakis
- 2nd Department of Radiology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - John S Tzartos
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Medical School, 72 Vas. Sofias Ave, 11528, Athens, Greece.,Tzartos NeuroDiagnostics, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Medical School, 72 Vas. Sofias Ave, 11528, Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Medical School, 72 Vas. Sofias Ave, 11528, Athens, Greece
| | - George P Paraskevas
- 1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Medical School, 72 Vas. Sofias Ave, 11528, Athens, Greece
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26
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Constantinides VC, Paraskevas GP, Velonakis G, Toulas P, Stefanis L, Kapaki E. Midbrain morphology in idiopathic normal pressure hydrocephalus: A progressive supranuclear palsy mimic. Acta Neurol Scand 2020; 141:328-334. [PMID: 31856297 DOI: 10.1111/ane.13205] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/29/2019] [Accepted: 12/14/2019] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Various MRI markers have been applied to support the diagnosis of progressive supranuclear palsy (PSP), such as midbrain diameter and surface, superior cerebellar peduncle (SCP) width, midbrain to pons (m/p) diameter and surface ratio and the Magnetic Resonance Parkinsonism Index (MRPI). These markers provide excellent diagnostic accuracy in discriminating Richardson's syndrome from other causes of Parkinsonism. Idiopathic normal pressure hydrocephalus (iNPH) may mimic Richardson's syndrome, particularly in cases of subtle opthalmokinetic abnormalities. The aim of this study was to compare these MRI markers in PSP and iNPH and examine their diagnostic accuracy. MATERIALS AND METHODS Forty-three patients with probable PSP, 17 patients with iNPH, and 29 controls were included. Midbrain diameter and surface, SCP width, m/p diameter and surface ratio and the MRPI were recorded. The "hummingbird sign," "morning glory sign" and "mickey mouse sign" were also evaluated. Analysis of covariance, chi-squared test, and ROC curve analysis were used as appropriate. RESULTS All MRI measurements differed significantly among the three study groups. Comparison of PSP and iNPH patients produced the following significant differences: midbrain diameter (P < .0001), m/p diameter ratio (P < .0001), SCP width (P = .050), and MRPI (P = .049). None of these markers produced combined high (>80%) specificity and sensitivity. Qualitative MRI signs were specific, but lacked sensitivity. DISCUSSION Midbrain morphology in iNPH may resemble that of PSP. Established MRI markers of midbrain and SCP atrophy cannot confidently differentiate PSP from iNPH. MRI markers do not provide combined high sensitivity and specificity for the differential diagnosis of PSP from iNPH.
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Affiliation(s)
- Vasilios C. Constantinides
- 1st Department of Neurology School of Medicine National and Kapodistrian University of Athens Eginition Hospital Athens Greece
| | - George P. Paraskevas
- 1st Department of Neurology School of Medicine National and Kapodistrian University of Athens Eginition Hospital Athens Greece
| | - Georgios Velonakis
- 2nd Department of Radiology Research Unit of Radiology Medical School National and Kapodistrian University of Athens Athens Greece
| | - Panagiotis Toulas
- 2nd Department of Radiology Research Unit of Radiology Medical School National and Kapodistrian University of Athens Athens Greece
| | - Leonidas Stefanis
- 1st Department of Neurology School of Medicine National and Kapodistrian University of Athens Eginition Hospital Athens Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology School of Medicine National and Kapodistrian University of Athens Eginition Hospital Athens Greece
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Paraskevas GP, Bougea A, Constantinides VC, Bourbouli M, Petropoulou O, Kapaki E. In vivo Prevalence of Alzheimer Biomarkers in Dementia with Lewy Bodies. Dement Geriatr Cogn Disord 2020; 47:289-296. [PMID: 31311013 DOI: 10.1159/000500567] [Citation(s) in RCA: 6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 04/23/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Neuropathological studies indicate concomitant Alzheimer's disease (AD) pathology in patients with dementia with Lewy bodies (DLB). OBJECTIVES To measure cerebrospinal fluid (CSF) levels of β-amyloid peptide with 42 amino acids (Aβ42), total tau protein (τT), and tau phosphorylated at threonine 181 (τP-181) in 38 patients fulfilling the diagnostic criteria of probable DLB according to the most recent (4th consensus) report. METHODS Double-sandwich commercial ELISAs (Innotest; Fujirebio, Gent, Belgium) were used for measurements. RESULTS According to the current cutoff values of our laboratory, 4 biomarker profiles were noted: abnormal levels of Aβ42 only (44.7%), full AD profile (39.5%), abnormal levels of τT only (5.3%), and normal levels of all 3 biomarkers (10.5%). AD profile was associated with female sex, older age, lower education, and lower MMSE scores. CONCLUSIONS Reduction in Αβ42 in DLB may be more common (>80% of patients) than previously thought, and ∼40% may have the typical CSF AD biomarker profile. AD biochemistry in DLB may be an evolving process showing increasing frequency with disease progression.
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Affiliation(s)
- George P Paraskevas
- Unit of Neurochemistry and Biological Markers, First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece,
| | - Anastasia Bougea
- Unit of Neurochemistry and Biological Markers, First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasilios C Constantinides
- Unit of Neurochemistry and Biological Markers, First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Mara Bourbouli
- Unit of Neurochemistry and Biological Markers, First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Neurological Laboratory, Department of Neurology, School of Medicine, University of Crete, Iráklion, Greece
| | - Olga Petropoulou
- Unit of Neurochemistry and Biological Markers, First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Kapaki
- Unit of Neurochemistry and Biological Markers, First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Bougea A, Stefanis L, Emmanouilidou E, Vekrelis K, Kapaki E. High discriminatory ability of peripheral and CFSF biomarkers in Lewy body diseases. J Neural Transm (Vienna) 2020; 127:311-322. [PMID: 31912280 DOI: 10.1007/s00702-019-02137-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 12/27/2019] [Indexed: 11/30/2022]
Abstract
Differential diagnosis between Parkinson's disease (PD) Parkinson's disease dementia (PDD), dementia with Lewy bodies (DLB), namely spectrum of Lewy bodies disorders (LBDs), may be challenging, and their common underlying pathophysiology is debated. Our aim was to examine relationships among neurodegenerative biomarkers [alpha-synuclein (α-Syn), Alzheimer's Disease (AD)-related (beta-amyloid Aβ42, tau [total τΤ and phosphorylated τp-181]), dopaminergic imaging (DATSCAN-SPECT)] and spectrum of LBD. This is a cross-sectional prospective study in 30 PD, 18 PDD, 29 DLB patients and 30 healthy controls. We compared α-Syn in CSF, plasma and serum and CSF Aβ42, τΤ and τp-181 across these groups. Correlations between such biomarkers and motor, cognitive/neuropsychiatric tests, and striatal asymmetry indexes were examined. CSF α-Syn was higher in DLB versus PD/PDD/controls, and lower in PD and PDD patients compared to controls (all p < 0.001). Serum α-Syn levels were higher in all patient groups compared to controls. After excluding those DLB patients with CSF AD profile, plasma and serum Syn levels were higher in the LBD group as a whole compared to controls. The combination of CSF α-Syn, serum α-Syn and Aβ42 for comparison between PD and DLB [AUC = 0.96 (95% CI 0.90-1.00)] was significantly better when compared to serum α-Syn alone (p < 0.001). Correlation analyses of biomarkers with cognitive/neuropsychiatric scales revealed some associations, but no consistent, cohesive picture. Peripheral biomarkers such as serum α-Syn, and CSF α-Syn and Aβ42 may contribute as potential biomarkers to separate LBDs from controls and to differentiate DLB from the other LBDs with high sensitivity and specificity among study groups.
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Affiliation(s)
- Anastasia Bougea
- 1st Department of Neurology, Memory and Movement Disorder Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vassilisis Sophias Avenue 72-74, 11528, Athens, Greece. .,Department of Neuroscience, Center for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.
| | - Leonidas Stefanis
- 1st Department of Neurology, Memory and Movement Disorder Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vassilisis Sophias Avenue 72-74, 11528, Athens, Greece.,Department of Neuroscience, Center for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Evangelia Emmanouilidou
- Department of Neuroscience, Center for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Kostas Vekrelis
- Department of Neuroscience, Center for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, Memory and Movement Disorder Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vassilisis Sophias Avenue 72-74, 11528, Athens, Greece
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Ravanidis S, Bougea A, Papagiannakis N, Maniati M, Koros C, Simitsi AM, Bozi M, Pachi I, Stamelou M, Paraskevas GP, Kapaki E, Moraitou M, Michelakakis H, Stefanis L, Doxakis E. Circulating Brain-enriched MicroRNAs for detection and discrimination of idiopathic and genetic Parkinson's disease. Mov Disord 2019; 35:457-467. [PMID: 31799764 DOI: 10.1002/mds.27928] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [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: 06/18/2019] [Revised: 10/13/2019] [Accepted: 10/30/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND A minimally invasive test for early detection and monitoring of Parkinson's disease (PD) is a highly unmet need for drug development and planning of patient care. Blood plasma represents an attractive source of biomarkers. MicroRNAs (miRNAs) are conserved noncoding RNA molecules that serve as posttranscriptional regulators of gene expression. As opposed to ubiquitously expressed miRNAs that control house-keeping processes, brain-enriched miRNAs regulate diverse aspects of neuron development and function. These include neuron-subtype specification, axonal growth, dendritic morphogenesis, and spine density. Backed by a large number of studies, we now know that the differential expression of neuron-enriched miRNAs leads to brain dysfunction. OBJECTIVES The aim was to identify subsets of brain-enriched miRNAs with diagnostic potential for familial and idiopathic PD as well as specify the molecular pathways deregulated in PD. METHODS Initially, brain-enriched miRNAs were selected based on literature review and validation studies in human tissues. Subsequently, real-time reverse transcription polymerase chain reaction was performed in the plasma of 100 healthy controls and 99 idiopathic and 53 genetic (26 alpha-synucleinA53T and 27 glucocerebrosidase) patients. Statistical and bioinformatics analyses were carried out to pinpoint the diagnostic biomarkers and deregulated pathways, respectively. RESULTS An explicit molecular fingerprint for each of the 3 PD cohorts was generated. Although the idiopathic PD fingerprint was different from that of genetic PD, the molecular pathways deregulated converged between all PD subtypes. CONCLUSIONS The study provides a group of brain-enriched miRNAs that may be used for the detection and differentiation of PD subtypes. It has also identified the molecular pathways deregulated in PD. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Stylianos Ravanidis
- Center of Basic Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Anastasia Bougea
- Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece.,1st Department of Neurology, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Nikolaos Papagiannakis
- Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece.,1st Department of Neurology, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Matina Maniati
- Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Christos Koros
- 1st Department of Neurology, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece.,2nd Department of Neurology, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Athina-Maria Simitsi
- 1st Department of Neurology, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Maria Bozi
- 2nd Department of Neurology, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Ioanna Pachi
- 1st Department of Neurology, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Maria Stamelou
- 1st Department of Neurology, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece.,Parkinson's disease and Movement disorders department, HYGEIA Hospital, Athens, Greece
| | - George P Paraskevas
- 1st Department of Neurology, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Marina Moraitou
- Department of Enzymology and Cellular Function, Institute of Child Health, Athens, Greece
| | - Helen Michelakakis
- Department of Enzymology and Cellular Function, Institute of Child Health, Athens, Greece
| | - Leonidas Stefanis
- Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece.,1st Department of Neurology, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Epaminondas Doxakis
- Center of Basic Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
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Kormas C, Zalonis I, Evdokimidis I, Kapaki E, Potagas C. The Modality Effect on Delayed Free Recall in Non-demented Patients With Mild Parkinson's Disease Progression. Front Aging Neurosci 2019; 11:189. [PMID: 31396079 PMCID: PMC6664063 DOI: 10.3389/fnagi.2019.00189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 10/22/2018] [Accepted: 07/10/2019] [Indexed: 11/13/2022] Open
Abstract
Background: The modality effect plays the central role in learning and memory functions. Retrieval failure constitutes a common memory impairment that occurs among patients with Parkinson’s disease (PD). However, little knowledge exists about the relation between modality effect and delayed recall impairment in PD. The primary goal of this study was to compare delayed free recall performance between three different memory modalities (verbal, visual, and cross visual-verbal) in a sample of non-demented patients with mild PD progression. The secondary goal was to explore the frequency of deficient performance on the basis of normative comparisons on each of the three delayed free-recall measures. Method: A total of 71 non-demented patients with mild PD progression were recruited for the administration of the Montreal Cognitive Assessment (MoCA), the Rey Auditory Verbal Learning Test (RAVLT), the Rey Osterrieth Complex Figure Test (ROCFT), and the Greek Version of Face-Name Associative Memory Examination (GR-FNAME12). Results: The percentages of deficient-performances for the three delayed free recall measures were 45.1% (32/71), 39.4% (28/71) and 31% (22/71) for the GR-FNAME12, ROFCT and RAVLT, respectively. The results indicated no significant difference between performances of the GR-FNAME12 and ROCFT, both of which were significantly lower than performance on the RAVLT. Conclusions: In conclusion, delayed free recall appears to be more severely affected in the cross visual-verbal and visual memory modalities than in verbal-memory modalities in the early phase of PD progression.
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Affiliation(s)
- Constantinos Kormas
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Zalonis
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Evdokimidis
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Kapaki
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantin Potagas
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
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31
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Constantinides VC, Paraskevas GP, Efthymiopoulou E, Stefanis L, Kapaki E. Clinical, neuropsychological and imaging characteristics of Alzheimer's disease patients presenting as corticobasal syndrome. J Neurol Sci 2019; 398:142-147. [DOI: 10.1016/j.jns.2019.01.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/23/2019] [Accepted: 01/28/2019] [Indexed: 12/12/2022]
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Bougea A, Stefanis L, Paraskevas GP, Emmanouilidou E, Vekrelis K, Kapaki E. Plasma alpha-synuclein levels in patients with Parkinson's disease: a systematic review and meta-analysis. Neurol Sci 2019; 40:929-938. [PMID: 30715632 DOI: 10.1007/s10072-019-03738-1] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/23/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To date, there are no definitive biomarkers for diagnose Parkinson's disease (PD). The detection of α-synuclein (α-Syn) in plasma of PD patients has yielded promising but inconclusive results. To determine the performance of α-Syn as a diagnostic biomarker of PD, we used a meta-analysis. METHODS We identified 173 studies through a systematic literature review. From those, only studies reporting data on total α-Syn levels were included in the meta-analysis (10 publications, 1302 participants). Quality of studies was assessed by Newcastle-Ottawa scale. RESULTS The α-Syn levels were significantly higher in PD patients than healthy controls (standardized mean difference [SMD] = 0.778, 95% confidence interval = 0.284 to 1.272, p = 0.002). Similar results were found after omitting any individual study from meta-analysis, with SMD ranges from 0.318 (95% CI = 0.064 to 0.572, p = 0.014) to 0.914 (95% CI = 0.349 to 1.480, p = 0.002). According to meta-regression analysis, increased mean patients age (slope = - 0.232, 95% CI = - 0.456 to - 0.008, p = 0.042), increased total number of participants (slope = - 0.007, 95% CI = - 0.013 to - 0.0004, p = 0.038), and increased percentage of males (slope = - 6.444, 95% CI = - 10.841 to - 2.047, p = 0.004) were associated with decreased SMD of α-Syn levels across studies. We did not find any significant association between the SMD in α-Syn levels and disease duration, disease severity, and quality of studies. Most of studies applied ELISA assays. CONCLUSION Total plasma α-Syn levels were higher in PD patients than controls. Analytical factors were important limitations.
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Affiliation(s)
- Anastasia Bougea
- Neurochemistry laboratory, 1st Department of Neurology and Movement Disorders, Medical School, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74 Vasilissis Sofias Avenue, 11528, Athens, Greece.
- Neuroscience laboratory, Center for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.
| | - Leonidas Stefanis
- Neuroscience laboratory, Center for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - George P Paraskevas
- Neurochemistry laboratory, 1st Department of Neurology and Movement Disorders, Medical School, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74 Vasilissis Sofias Avenue, 11528, Athens, Greece
| | - Evangelia Emmanouilidou
- Neuroscience laboratory, Center for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Kostas Vekrelis
- Neuroscience laboratory, Center for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Elisabeth Kapaki
- Neurochemistry laboratory, 1st Department of Neurology and Movement Disorders, Medical School, Aeginition Hospital, National and Kapodistrian University of Athens, 72-74 Vasilissis Sofias Avenue, 11528, Athens, Greece
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Constantinides VC, Paraskevas GP, Potagas C, Stefanis L, Kapaki E. Quantifying apraxia and ophthalmokinetic abnormalities in patients with atypical Parkinsonism: A new way to differential diagnosis? Parkinsonism Relat Disord 2018; 61:39-44. [PMID: 30563744 DOI: 10.1016/j.parkreldis.2018.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/03/2018] [Accepted: 12/07/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Vasilios C Constantinides
- 1st Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave, 11528, Athens, Greece.
| | - George P Paraskevas
- 1st Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave, 11528, Athens, Greece.
| | - Constantinos Potagas
- 1st Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave, 11528, Athens, Greece.
| | - Leonidas Stefanis
- 1st Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave, 11528, Athens, Greece.
| | - Elisabeth Kapaki
- 1st Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas. Sophias Ave, 11528, Athens, Greece.
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34
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Bourbouli M, Rentzos M, Bougea A, Zouvelou V, Constantinides VC, Zaganas I, Evdokimidis I, Kapaki E, Paraskevas GP. Cerebrospinal Fluid TAR DNA-Binding Protein 43 Combined with Tau Proteins as a Candidate Biomarker for Amyotrophic Lateral Sclerosis and Frontotemporal Dementia Spectrum Disorders. Dement Geriatr Cogn Disord 2018; 44:144-152. [PMID: 28848086 DOI: 10.1159/000478979] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are nowadays recognized as spectrum disorders with a molecular link, the TAR DNA-binding protein 43 (TDP-43), rendering it a surrogate biomarker for these disorders. METHODS We measured cerebrospinal fluid (CSF) levels of TDP-43, beta-amyloid peptide with 42 amino acids (Aβ42), total tau protein (τT), and tau protein phosphorylated at threonine 181 (τP-181) in 32 patients with ALS, 51 patients with FTD, and 17 healthy controls. Double-sandwich commercial enzyme-linked immunosorbent assays were used for measurements. RESULTS Both ALS and FTD patients presented with higher TDP-43 and τT levels compared to the control group. The combination of biomarkers in the form of the TDP-43 × τT / τP-181 formula achieved the best discrimination between ALS or FTD and controls, with sensitivities and specificities >0.8. CONCLUSION Combined analysis of TDP-43, τT, and τP-181 in CSF may be useful for the antemortem diagnosis of ALS and FTD.
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Affiliation(s)
- Mara Bourbouli
- First Department of Neurology, Neurochemistry Unit, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
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Bougea A, Stefanis L, Paraskevas GP, Emmanouilidou E, Efthymiopoulou E, Vekrelis K, Kapaki E. Neuropsychiatric symptoms and α-Synuclein profile of patients with Parkinson’s disease dementia, dementia with Lewy bodies and Alzheimer’s disease. J Neurol 2018; 265:2295-2301. [DOI: 10.1007/s00415-018-8992-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 01/03/2023]
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Constantinides VC, Kasselimis DS, Paraskevas GP, Zacharopoulou M, Andreadou E, Evangelopoulos ME, Kapaki E, Kilidireas C, Stamboulis E, Potagas C. Anti-NMDA receptor encephalitis presenting as isolated aphasia in an adult. Neurocase 2018; 24:188-194. [PMID: 30293488 DOI: 10.1080/13554794.2018.1524915] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Anti-NMDA receptor (NMDA-r) encephalitis is a relatively rare cause of autoimmune encephalitis with divergent clinical presentations. We report a case of an adult patient with anti-NMDA-r encephalitis presenting with isolated, abrupt-onset aphasia. Her condition remained unaltered over a period of 6 months. The patients' electroencephalogram findings were typical for NMDA-r encephalitis; however, her magnetic resonance imaging and cerebrospinal fluid analysis were normal. She responded well to immunotherapy, and aphasia eventually resolved. The natural course of the present case contradicts the rapidly progressive nature of typical NMDA-r encephalitis. Furthermore, it broadens the clinical spectrum of anti-NMDA-r encephalitis, to incorporate isolated, nonprogressive aphasia.
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Affiliation(s)
- Vasilios C Constantinides
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Dimitrios S Kasselimis
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece.,b Department of Psychiatry , School of Medicine, University of Crete , Heraklion , Greece
| | - George P Paraskevas
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Maria Zacharopoulou
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Elisabeth Andreadou
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | | | - Elisabeth Kapaki
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Costas Kilidireas
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Eleftherios Stamboulis
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
| | - Constantin Potagas
- a 1st Department of Neurology , National and Kapodistrian University of Athens, Eginition Hospital , Athens , Greece
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Kormas C, Megalokonomou A, Zalonis I, Evdokimidis I, Kapaki E, Potagas C. Development of the Greek version of the Face Name Associative Memory Exam (GR-FNAME12) in cognitively normal elderly individuals. Clin Neuropsychol 2018; 32:152-163. [PMID: 29966491 DOI: 10.1080/13854046.2018.1495270] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The Face-Name Associative Memory Examination (FNAME) is a cross-modal associative memory test with a high sensitivity for detecting Alzheimer's disease-related subtle memory problems at an early preclinical stage. The present study examined the psychometric characteristics of a Greek version of the short form of FNAME (GR-FNAME12) to evaluate the contribution of demographic characteristics, report the range of performance within our sample, and estimate regression-based norms in cognitively normal elderly individuals. METHOD In all, 216 cognitively normal elderly individuals were recruited and were administered a version of the short form of the FNAME (GR-FNAME12) that was culture and language specific to Greek-speaking individuals and developed for this study. RESULTS The construct validity of GR-FNAME12 was determined using principal component analysis thereby revealing two factors: face-name and face-occupation. These match the original version of the test. A significant positive correlation between GR-FNAME12 and two traditional memory measures - the RAVLT and the ROCFT - supported convergent validity. Test-retest reliability was computed for 32 participants. Multiple regression analyses showed that only age and not education or gender significantly predicted performance on the GR-FNAME12. We also estimated regression-based norms for the GR-FNAME12 scales. CONCLUSION It was found that the Greek version of the FNAME12 had adequate psychometric properties, and could be administered to Greek-speaking individuals for clinical and research purposes.
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Affiliation(s)
- Constantinos Kormas
- a First Department of Neurology , National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece
| | - Anastasia Megalokonomou
- b Department of Psychology , Panteion University of Social and Political Sciences , Athens , Greece
| | - Ioannis Zalonis
- a First Department of Neurology , National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece
| | - Ioannis Evdokimidis
- a First Department of Neurology , National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece
| | - Elisabeth Kapaki
- a First Department of Neurology , National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece
| | - Constantin Potagas
- a First Department of Neurology , National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece
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Constantinides VC, Paraskevas GP, Velonakis G, Toulas P, Stamboulis E, Kapaki E. MRI Planimetry and Magnetic Resonance Parkinsonism Index in the Differential Diagnosis of Patients with Parkinsonism. AJNR Am J Neuroradiol 2018; 39:1047-1051. [PMID: 29622555 DOI: 10.3174/ajnr.a5618] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 02/07/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Differential diagnosis of multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration from Parkinson disease on clinical grounds is often difficult. MR imaging biomarkers could assist in a more accurate diagnosis. We examined the utility of MR imaging surface measurements (MR imaging planimetry) in the differential diagnosis of patients with parkinsonism. MATERIALS AND METHODS Fifty-two patients with Parkinson-plus (progressive supranuclear palsy, n = 24; corticobasal degeneration, n = 9; multiple system atrophy, n = 19), 18 patients with Parkinson disease, and 15 healthy controls were included. Corpus callosum, midbrain, and pons surfaces; relevant indices; and the Magnetic Resonance Parkinsonism Index were calculated. Corpus callosum subsection analysis was performed, and the corpus callosum posteroanterior gradient was introduced. RESULTS A Magnetic Resonance Parkinsonism Index value of >12.6 discriminated progressive supranuclear palsy from other causes of parkinsonism with a 91% sensitivity and 95% specificity. No planimetry measurement could accurately discriminate those with multiple system atrophy with parkinsonism from patients with Parkinson disease. A corpus callosum posteroanterior gradient value of ≤191 was highly specific (97%) and moderately sensitive (75%) for the diagnosis of corticobasal degeneration versus all other groups. A midbrain-to-corpus callosum posteroanterior gradient ratio of ≤0.45 was highly indicative of progressive supranuclear palsy over corticobasal degeneration (sensitivity 86%, specificity 88%). CONCLUSIONS MR imaging planimetry measurements are potent imaging markers of progressive supranuclear palsy and promising markers of corticobasal degeneration but do not seem to assist in the diagnosis of multiple system atrophy with parkinsonism.
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Affiliation(s)
- V C Constantinides
- From the 1st Department of Neurology (V.C.C., G.P.P., E.S., E.K.), National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - G P Paraskevas
- From the 1st Department of Neurology (V.C.C., G.P.P., E.S., E.K.), National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - G Velonakis
- Research Unit of Radiology (G.V., P.T.), 2nd Department of Radiology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - P Toulas
- Research Unit of Radiology (G.V., P.T.), 2nd Department of Radiology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - E Stamboulis
- From the 1st Department of Neurology (V.C.C., G.P.P., E.S., E.K.), National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - E Kapaki
- From the 1st Department of Neurology (V.C.C., G.P.P., E.S., E.K.), National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
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Bougea A, Kapaki E, Constantinides V, Yapijakis C, Paraskevas GP. An unusual phenocopy of the HANAC syndrome without genetic involvement of COL4A1/COL4A2. Acta Neurol Belg 2018; 118:135-136. [PMID: 29423873 DOI: 10.1007/s13760-018-0890-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 01/29/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Anastasia Bougea
- 1st Department of Neurology, Cognitive and Movement Disorders Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 72 Vas. Sophias Ave, 11528, Athens, Greece.
| | - Elisabeth Kapaki
- 1st Department of Neurology, Cognitive and Movement Disorders Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 72 Vas. Sophias Ave, 11528, Athens, Greece
| | - Vassilis Constantinides
- 1st Department of Neurology, Cognitive and Movement Disorders Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 72 Vas. Sophias Ave, 11528, Athens, Greece
| | - Christos Yapijakis
- 1st Department of Neurology, Cognitive and Movement Disorders Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 72 Vas. Sophias Ave, 11528, Athens, Greece
| | - George P Paraskevas
- 1st Department of Neurology, Cognitive and Movement Disorders Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 72 Vas. Sophias Ave, 11528, Athens, Greece
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Paraskevas GP, Kasselimis D, Kourtidou E, Constantinides V, Bougea A, Potagas C, Evdokimidis I, Kapaki E. Cerebrospinal Fluid Biomarkers as a Diagnostic Tool of the Underlying Pathology of Primary Progressive Aphasia. J Alzheimers Dis 2018; 55:1453-1461. [PMID: 27858708 DOI: 10.3233/jad-160494] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Primary progressive aphasia (PPA) may present with three main clinical variants, namely nonfluent agrammatic (nfaPPA), semantic (sPPA), and logopenic (lPPA) subtypes. Frontotemporal lobar degenerations (FTLD) or Alzheimer's disease (AD) are the most common etiologies. OBJECTIVE To study the potential of cerebrospinal fluid (CSF) biomarkers for identifying the underlying pathology in patients with PPA. METHODS CSF levels of total tau protein (τT), amyloid-β peptide (Aβ42), and tau phosphorylated at threonine-181 (τP - 181) were measured by double sandwich, enzyme-linked immunosorbent assay (ELISA) in 43 patients with PPA, 26 patients with AD, and 17 healthy controls. RESULTS All patients could be classified as compatible with the AD or non-AD biomarker profile, either with the three biomarkers (90.7%) or their ratios, especially the τP - 181/Aβ42 ratio (9.3%). An AD-compatible biomarker profile was present in 39.5% of all PPA patients, specifically 22.2%, 35.7%, and 75% of nfaPPA, sPPA, and lPPA, respectively. In PPA patients with a non-AD profile (presumably FTLD), two different clusters could be identified according to the τP - 181/τT ratio, possibly corresponding to the two major FTLD pathologies (tau and TDP-43). CONCLUSION CSF biomarkers may be a valuable tool for the discrimination between PPA patients with AD and non-AD pathophysiology and possibly between FTLD patients with tau and TDP-43 pathology.
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Wallin A, Román GC, Esiri M, Kettunen P, Svensson J, Paraskevas GP, Kapaki E. Update on Vascular Cognitive Impairment Associated with Subcortical Small-Vessel Disease. J Alzheimers Dis 2018; 62:1417-1441. [PMID: 29562536 PMCID: PMC5870030 DOI: 10.3233/jad-170803] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2017] [Indexed: 02/06/2023]
Abstract
Subcortical small-vessel disease (SSVD) is a disorder well characterized from the clinical, imaging, and neuropathological viewpoints. SSVD is considered the most prevalent ischemic brain disorder, increasing in frequency with age. Vascular risk factors include hypertension, diabetes, hyperlipidemia, elevated homocysteine, and obstructive sleep apnea. Ischemic white matter lesions are the hallmark of SSVD; other pathological lesions include arteriolosclerosis, dilatation of perivascular spaces, venous collagenosis, cerebral amyloid angiopathy, microbleeds, microinfarcts, lacunes, and large infarcts. The pathogenesis of SSVD is incompletely understood but includes endothelial changes and blood-brain barrier alterations involving metalloproteinases, vascular endothelial growth factors, angiotensin II, mindin/spondin, and the mammalian target of rapamycin pathway. Metabolic and genetic conditions may also play a role but hitherto there are few conclusive studies. Clinical diagnosis of SSVD includes early executive dysfunction manifested by impaired capacity to use complex information, to formulate strategies, and to exercise self-control. In comparison with Alzheimer's disease (AD), patients with SSVD show less pronounced episodic memory deficits. Brain imaging has advanced substantially the diagnostic tools for SSVD. With the exception of cortical microinfarcts, all other lesions are well visualized with MRI. Diagnostic biomarkers that separate AD from SSVD include reduction of cerebrospinal fluid amyloid-β (Aβ)42 and of the ratio Aβ42/Aβ40 often with increased total tau levels. However, better markers of small-vessel function of intracerebral blood vessels are needed. The treatment of SSVD remains unsatisfactory other than control of vascular risk factors. There is an urgent need of finding targets to slow down and potentially halt the progression of this prevalent, but often unrecognized, disorder.
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Affiliation(s)
- Anders Wallin
- Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg Sweden and Memory Clinic at Department of Neuropsychiatry, Sahlgrenska University, Hospital, Gothenburg, Sweden
| | - Gustavo C. Román
- Department of Neurology, Methodist Neurological Institute, Houston, TX, USA
- Weill Cornell Medical College, Cornell University, New York, NY, USA
| | - Margaret Esiri
- Neuropathology Department, West Wing, John Radcliffe Hospital, Oxford, UK
| | - Petronella Kettunen
- Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg Sweden and Memory Clinic at Department of Neuropsychiatry, Sahlgrenska University, Hospital, Gothenburg, Sweden
- Nuffield Department of Clinical Neurosciences, University of Oxford, West Wing, John Radcliffe Hospital, Oxford, UK
| | - Johan Svensson
- Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - George P. Paraskevas
- 1st Department of Neurology, Neurochemistry Unit, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, Neurochemistry Unit, National and Kapodistrian University of Athens, Athens, Greece
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Jansen WJ, Ossenkoppele R, Tijms BM, Fagan AM, Hansson O, Klunk WE, van der Flier WM, Villemagne VL, Frisoni GB, Fleisher AS, Lleó A, Mintun MA, Wallin A, Engelborghs S, Na DL, Chételat G, Molinuevo JL, Landau SM, Mattsson N, Kornhuber J, Sabri O, Rowe CC, Parnetti L, Popp J, Fladby T, Jagust WJ, Aalten P, Lee DY, Vandenberghe R, Resende de Oliveira C, Kapaki E, Froelich L, Ivanoiu A, Gabryelewicz T, Verbeek MM, Sanchez-Juan P, Hildebrandt H, Camus V, Zboch M, Brooks DJ, Drzezga A, Rinne JO, Newberg A, de Mendonça A, Sarazin M, Rabinovici GD, Madsen K, Kramberger MG, Nordberg A, Mok V, Mroczko B, Wolk DA, Meyer PT, Tsolaki M, Scheltens P, Verhey FRJ, Visser PJ, Aarsland D, Alcolea D, Alexander M, Almdahl IS, Arnold SE, Baldeiras I, Barthel H, van Berckel BNM, Blennow K, van Buchem MA, Cavedo E, Chen K, Chipi E, Cohen AD, Förster S, Fortea J, Frederiksen KS, Freund-Levi Y, Gkatzima O, Gordon MF, Grimmer T, Hampel H, Hausner L, Hellwig S, Herukka SK, Johannsen P, Klimkowicz-Mrowiec A, Köhler S, Koglin N, van Laere K, de Leon M, Lisetti V, Maier W, Marcusson J, Meulenbroek O, Møllergård HM, Morris JC, Nordlund A, Novak GP, Paraskevas GP, Perera G, Peters O, Ramakers IHGB, Rami L, Rodríguez-Rodríguez E, Roe CM, Rot U, Rüther E, Santana I, Schröder J, Seo SW, Soininen H, Spiru L, Stomrud E, Struyfs H, Teunissen CE, Vos SJB, van Waalwijk van Doorn LJC, Waldemar G, Wallin ÅK, Wiltfang J, Zetterberg H. Association of Cerebral Amyloid-β Aggregation With Cognitive Functioning in Persons Without Dementia. JAMA Psychiatry 2018; 75:84-95. [PMID: 29188296 PMCID: PMC5786156 DOI: 10.1001/jamapsychiatry.2017.3391] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Cerebral amyloid-β aggregation is an early event in Alzheimer disease (AD). Understanding the association between amyloid aggregation and cognitive manifestation in persons without dementia is important for a better understanding of the course of AD and for the design of prevention trials. OBJECTIVE To investigate whether amyloid-β aggregation is associated with cognitive functioning in persons without dementia. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included 2908 participants with normal cognition and 4133 with mild cognitive impairment (MCI) from 53 studies in the multicenter Amyloid Biomarker Study. Normal cognition was defined as having no cognitive concerns for which medical help was sought and scores within the normal range on cognitive tests. Mild cognitive impairment was diagnosed according to published criteria. Study inclusion began in 2013 and is ongoing. Data analysis was performed in January 2017. MAIN OUTCOMES AND MEASURES Global cognitive performance as assessed by the Mini-Mental State Examination (MMSE) and episodic memory performance as assessed by a verbal word learning test. Amyloid aggregation was measured with positron emission tomography or cerebrospinal fluid biomarkers and dichotomized as negative (normal) or positive (abnormal) according to study-specific cutoffs. Generalized estimating equations were used to examine the association between amyloid aggregation and low cognitive scores (MMSE score ≤27 or memory z score≤-1.28) and to assess whether this association was moderated by age, sex, educational level, or apolipoprotein E genotype. RESULTS Among 2908 persons with normal cognition (mean [SD] age, 67.4 [12.8] years), amyloid positivity was associated with low memory scores after age 70 years (mean difference in amyloid positive vs negative, 4% [95% CI, 0%-7%] at 72 years and 21% [95% CI, 10%-33%] at 90 years) but was not associated with low MMSE scores (mean difference, 3% [95% CI, -1% to 6%], P = .16). Among 4133 patients with MCI (mean [SD] age, 70.2 [8.5] years), amyloid positivity was associated with low memory (mean difference, 16% [95% CI, 12%-20%], P < .001) and low MMSE (mean difference, 14% [95% CI, 12%-17%], P < .001) scores, and this association decreased with age. Low cognitive scores had limited utility for screening of amyloid positivity in persons with normal cognition and those with MCI. In persons with normal cognition, the age-related increase in low memory score paralleled the age-related increase in amyloid positivity with an intervening period of 10 to 15 years. CONCLUSIONS AND RELEVANCE Although low memory scores are an early marker of amyloid positivity, their value as a screening measure for early AD among persons without dementia is limited.
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Affiliation(s)
- Willemijn J. Jansen
- Department of Psychiatry and Neuropsychology, School
for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University,
Maastricht, the Netherlands
| | - Rik Ossenkoppele
- Department of Neurology and Alzheimer Center, VU
University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands,Department of Radiology and Nuclear Medicine, VU
University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands,Department of Neurology, Memory and Aging Center,
University of California, San Francisco,Helen Wills Neuroscience Institute, University of
California, Berkeley
| | - Betty M. Tijms
- Department of Neurology and Alzheimer Center, VU
University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Anne M. Fagan
- Knight Alzheimer’s Disease Research Center,
Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Oskar Hansson
- Clinical Memory Research Unit, Clinical Sciences
Malmö, Lund University, Lund, Sweden
| | - William E. Klunk
- Department of Psychiatry, University of Pittsburgh
School of Medicine, Pittsburgh, Pennsylvania
| | - Wiesje M. van der Flier
- Department of Neurology and Alzheimer Center, VU
University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands,Department of Epidemiology and Biostatistics, VU
University Medical Center, Amsterdam, the Netherlands
| | - Victor L. Villemagne
- Department of Nuclear Medicine and Centre for PET,
Austin Health, Melbourne, Australia
| | - Giovanni B. Frisoni
- Laboratory of Alzheimer's Neuroimaging and
Epidemiology, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy,Memory Clinic and LANVIE–Laboratory of
Neuroimaging of Aging, University Hospitals, and University of Geneva, Geneva, Switzerland
| | - Adam S. Fleisher
- Banner Alzheimer’s Institute, Phoenix,
Arizona,Eli Lilly and Company, Indianapolis, Indiana,Department of Neurosciences, University of
California, San Diego
| | - Alberto Lleó
- Neurology Department, Hospital de Sant Pau,
Barcelona, Spain
| | | | - Anders Wallin
- Institute of Neuroscience and Physiology,
Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia
(BIODEM), University of Antwerp, Antwerp, Belgium
| | - Duk L. Na
- Department of Neurology, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gäel Chételat
- Institut National de la Santé et de la
Recherche Médicale (INSERM), CHU de Caen, Caen, France
| | - José Luis Molinuevo
- Alzheimer’s Disease and Other Cognitive
Disorders Unit, IDIBAPS, Clinic University Hospital, Barcelona, Spain
| | - Susan M. Landau
- Helen Wills Neuroscience Institute, University of
California, Berkeley
| | - Niklas Mattsson
- Clinical Memory Research Unit, Clinical Sciences
Malmö, Lund University, Lund, Sweden
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy,
Friedrich-Alexander University of Erlangen–Nuremberg, Erlangen, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of
Leipzig, Leipzig, Germany
| | - Christopher C. Rowe
- Knight Alzheimer’s Disease Research Center,
Department of Neurology, Washington University School of Medicine, St Louis, Missouri,Department of Nuclear Medicine and Centre for PET,
Austin Health, Melbourne, Australia
| | - Lucilla Parnetti
- Section of Neurology, Center for Memory
Disturbances, University of Perugia, Perugia, Italy
| | - Julius Popp
- Department of Psychiatry, Service of Old Age
Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Tormod Fladby
- Department of Neurology, Akershus University
Hospital, Lørenskog, Norway
| | - William J. Jagust
- Helen Wills Neuroscience Institute, University of
California, Berkeley
| | - Pauline Aalten
- Department of Psychiatry and Neuropsychology, School
for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University,
Maastricht, the Netherlands
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National
University, College of Medicine, Seoul, South Korea
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology and Alzheimer
Research Centre KU Leuven, Catholic University Leuven, Leuven, Belgium
| | - Catarina Resende de Oliveira
- Center for Neuroscience and Cell Biology, Faculty of
Medicine, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Elisabeth Kapaki
- First Department of Neurology, Eginition Hospital,
Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Lutz Froelich
- Department of Geriatric Psychiatry, Central
Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim,
Germany
| | - Adrian Ivanoiu
- Memory Clinic and Neurochemistry Laboratory, Saint
Luc University Hospital, Institute of Neuroscience, Université catholique de Louvain,
Brussels, Belgium
| | - Tomasz Gabryelewicz
- Department of Neurodegenerative Disorders,
Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | - Marcel M. Verbeek
- Departments of Neurology and Laboratory Medicine,
Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud
University Medical Center, Nijmegen, the Netherlands
| | - Páscual Sanchez-Juan
- Neurology Service, Universitary Hospital
Marqués de Valdecilla, IDIVAL, Santander, Spain
| | | | - Vincent Camus
- CHRU de Tours, CIC INSERM 1415, INSERM U930, and
Université François Rabelais de Tours, Tours, France
| | - Marzena Zboch
- Alzheimer Center, Wroclaw Medical University,
Scinawa, Poland
| | - David J. Brooks
- Division of Neuroscience, Medical Research Council
Clinical Sciences Centre, Imperial College London, London, England
| | - Alexander Drzezga
- Department of Nuclear Medicine, University of
Cologne, Cologne, Germany
| | - Juha O. Rinne
- Turku PET Centre and Division of Clinical
Neurosciences Turku, University of Turku and Turku University Hospital, Turku, Finland
| | - Andrew Newberg
- Myrna Brind Center of Integrative Medicine, Thomas
Jefferson University and Hospital, Philadelphia, Pennsylvania
| | - Alexandre de Mendonça
- Institute of Molecular Medicine and Faculty of
Medicine, University of Lisbon, Lisbon, Portugal
| | - Marie Sarazin
- Neurologie de la Mémoire et du Langage, Centre
Hospitalier Sainte-Anne, Université Paris 5, Paris, France
| | - Gil D. Rabinovici
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco
| | - Karine Madsen
- Neurobiology Research Unit, Copenhagen University
Hospital, Copenhagen, Denmark
| | - Milica G. Kramberger
- Center for Cognitive Impairments, University Medical
Centre Ljubljana, Ljubljana, Slovenia
| | - Agneta Nordberg
- Department NVS, Center for Alzheimer Research,
Translational Alzheimer Neurobiology, Karolinska Institutet, and Geriatric Medicine,
Karolinska University Hospital, Stockholm, Sweden
| | - Vincent Mok
- Lui Che Woo Institute of Innovative Medicine,
Department of Medicine and Therapeutics, Therese Pei Fong Chow Research Centre for
Prevention of Dementia, Hong Kong
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Leading
National Research Centre in Białystok (KNOW), Medical University of Białystok,
Białystok, Poland
| | - David A. Wolk
- Department of Neurology, University of Pennsylvania,
Philadelphia
| | - Philipp T. Meyer
- Department of Nuclear Medicine, University Hospital
Freiburg, Freiburg, Germany
| | - Magda Tsolaki
- Third Department of Neurology, Aristotle University
of Thessaloniki, Thessaloniki, Greece
| | | | - Philip Scheltens
- Department of Neurology and Alzheimer Center, VU
University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Frans R. J. Verhey
- Department of Psychiatry and Neuropsychology, School
for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University,
Maastricht, the Netherlands
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School
for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University,
Maastricht, the Netherlands,Department of Neurology and Alzheimer Center, VU
University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Dag Aarsland
- Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Daniel Alcolea
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | | | - Ina S Almdahl
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Steven E Arnold
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Inês Baldeiras
- Center for Neuroscience and Cell Biology, Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Enrica Cavedo
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Hôpital Pitié-Stijmsalpêtrière, Boulevard de l'hôpital, F-75013, Paris, France.,AXA Research Fund & UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie Paris 06, Inserm, CNRS, Institut du Cerveau et de la Moelle Épinière, Paris, France
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, Arizona
| | - Elena Chipi
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Ann D Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Stefan Förster
- Department of Nuclear Medicine, Technische Universitaet München, Munich, Germany
| | - Juan Fortea
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | - Kristian S Frederiksen
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Yvonne Freund-Levi
- Department of Geriatrics, Karolinska University Hospital Huddinge, Section of Clinical Geriatrics, Institution of NVS, Karolinska Institutet, Stockholm, Sweden
| | - Olymbia Gkatzima
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universitaet München, Munich, Germany
| | - Harald Hampel
- Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Hôpital Pitié-Stijmsalpêtrière, Boulevard de l'hôpital, F-75013, Paris, France.,AXA Research Fund & UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie Paris 06, Inserm, CNRS, Institut du Cerveau et de la Moelle Épinière, Paris, France.,Department of Psychiatry, Alzheimer Memorial Center and Geriatric Psychiatry Branch, Ludwig-Maximilian University, Munich, Germany
| | - Lucrezia Hausner
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sabine Hellwig
- Center of Geriatrics and Gerontology, University Hospital Freiburg, Freiburg, Germany
| | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Peter Johannsen
- Memory Clinic, Danish Dementia Research Center, Rigshospitalet, Copenhagen, Denmark
| | | | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | | | - Koen van Laere
- Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium
| | - Mony de Leon
- School of Medicine, Center for Brain Health, New York University, New York
| | - Viviana Lisetti
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Jan Marcusson
- Geriatric Medicine, Department of Clinical and Experimental Medicine, University of Linköping, Linköping, Sweden
| | - Olga Meulenbroek
- Department of Geriatric Medicine, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hanne M Møllergård
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - John C Morris
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Arto Nordlund
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Gerald P Novak
- Janssen Research and Development, Titusville, New Jersey
| | - George P Paraskevas
- First Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Gayan Perera
- Roche Products, Welwyn Garden City, United Kingdom.,Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, United Kingdom
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité Berlin, German Center for Neurodegenrative Diseases (DZNE), Berlin, Germany
| | - Inez H G B Ramakers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, IDIBAPS, Clinic University Hospital, Barcelona, Spain
| | | | - Catherine M Roe
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Uros Rot
- Center for Cognitive Impairments, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - Isabel Santana
- Center for Neuroscience and Cell Biology, Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Johannes Schröder
- Sektion Gerontopsychiatrie, Universität Heidelberg, Heidelberg, Germany
| | - Sang W Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Luiza Spiru
- Department of Geriatrics-Gerontology-Gerontopsychiatry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Erik Stomrud
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Hanne Struyfs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Stephanie J B Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Linda J C van Waalwijk van Doorn
- Departments of Neurology and Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gunhild Waldemar
- Department of Nuclear Medicine, Technische Universitaet München, Munich, Germany
| | - Åsa K Wallin
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,UCL Institute of Neurology, Queen Square, London, United Kingdom
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Breza M, Koutsis G, Karadima G, Potagas C, Kartanou C, Papageorgiou SG, Paraskevas GP, Kapaki E, Stefanis L, Panas M. The different faces of the p. A53T alpha-synuclein mutation: A screening of Greek patients with parkinsonism and/or dementia. Neurosci Lett 2017; 672:136-139. [PMID: 29233723 DOI: 10.1016/j.neulet.2017.12.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 11/18/2017] [Accepted: 12/06/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND The p. A53T mutation in the alpha-synuclein (SNCA) gene is a rare cause of autosomal dominant Parkinson's disease (PD). Although generally rare, it is particularly common in the Greek population due to a founder effect. A53T-positive PD patients often develop dementia during disease course and may very rarely present with dementia. METHODS We screened for the p. A53T SNCA mutation a total of 347 cases of Greek origin with parkinsonism and/or dementia, collected over 15 years at the Neurogenetics Unit, Eginition Hospital, University of Athens. Cases were classified into: "pure parkinsonism", "pure dementia" and "parkinsonism plus dementia". RESULTS In total, 4 p. A53T SNCA mutation carriers were identified. All had autosomal dominant family history and early onset. Screening of the "pure parkinsonism" category revealed 2 cases with typical PD. The other two mutation carriers were identified in the "parkinsonism plus dementia" category. One had a diagnosis of PD dementia and the other of behavioral variant frontotemporal dementia. Screening of patients with "pure dementia" failed to identify any further A53T-positive cases. CONCLUSIONS Our results confirm that the p. A53T SNCA mutation is relatively common in Greek patients with PD or PD plus dementia, particularly in cases with early onset and/or autosomal dominant family history.
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Affiliation(s)
- Marianthi Breza
- 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - Georgios Koutsis
- 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Karadima
- 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantin Potagas
- 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Chrisoula Kartanou
- 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sokratis G Papageorgiou
- 2nd Department of Neurology, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Paraskevas
- 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Marios Panas
- 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Constantinides VC, Paraskevas GP, Stamboulis E, Kapaki E. Simple linear brainstem MRI measurements in the differential diagnosis of progressive supranuclear palsy from the parkinsonian variant of multiple system atrophy. Neurol Sci 2017; 39:359-364. [DOI: 10.1007/s10072-017-3212-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/27/2017] [Indexed: 11/30/2022]
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45
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Kartanou C, Karadima G, Koutsis G, Breza M, Papageorgiou SG, Paraskevas GP, Kapaki E, Panas M. Screening for the C9ORF72 repeat expansion in a greek frontotemporal dementia cohort. Amyotroph Lateral Scler Frontotemporal Degener 2017; 19:152-154. [PMID: 29166782 DOI: 10.1080/21678421.2017.1400070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Chrisoula Kartanou
- Neurogenetics Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece,
| | - Georgia Karadima
- Neurogenetics Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece,
| | - Georgios Koutsis
- Neurogenetics Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece,
| | - Marianthi Breza
- Neurogenetics Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece,
| | - Sokratis G. Papageorgiou
- 2nd Department of Neurology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece, and
| | - George P. Paraskevas
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Marios Panas
- Neurogenetics Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece,
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46
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Constantinides VC, Paraskevas GP, Emmanouilidou E, Petropoulou O, Bougea A, Vekrellis K, Evdokimidis I, Stamboulis E, Kapaki E. CSF biomarkers β-amyloid, tau proteins and a-synuclein in the differential diagnosis of Parkinson-plus syndromes. J Neurol Sci 2017; 382:91-95. [DOI: 10.1016/j.jns.2017.09.039] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/01/2017] [Accepted: 09/26/2017] [Indexed: 10/18/2022]
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47
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Paraskevas GP, Yapijakis C, Bougea A, Constantinides V, Bourbouli M, Stamboulis E, Kapaki E. Novel PANK2 mutation in the first Greek compound heterozygote patient with pantothenate-kinase-associated neurodegeneration. SAGE Open Med Case Rep 2017; 5:2050313X17720101. [PMID: 28781879 PMCID: PMC5521331 DOI: 10.1177/2050313x17720101] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 06/05/2017] [Indexed: 11/16/2022] Open
Abstract
Pantothenate-kinase-associated neurodegeneration is the most common autosomal recessive form of neurodegeneration with brain iron accumulation. Less than 100 mutations in PANK2 gene (20p13) are responsible for classic and atypical cases. We report here the first Greek case of atypical pantothenate-kinase-associated neurodegeneration, confirmed by molecular analysis that revealed two trans-acting mutations. Our findings highlight the possible role of rare variants contributing to disease risk and possibly to variable clinical phenotype.
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Affiliation(s)
- George P Paraskevas
- First Department of Neurology, Cognitive and Movement Disorders Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Yapijakis
- First Department of Neurology, Cognitive and Movement Disorders Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Bougea
- First Department of Neurology, Cognitive and Movement Disorders Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasilios Constantinides
- First Department of Neurology, Cognitive and Movement Disorders Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Mara Bourbouli
- First Department of Neurology, Cognitive and Movement Disorders Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleftherios Stamboulis
- First Department of Neurology, Cognitive and Movement Disorders Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Kapaki
- First Department of Neurology, Cognitive and Movement Disorders Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Wallin A, Kapaki E, Boban M, Engelborghs S, Hermann DM, Huisa B, Jonsson M, Kramberger MG, Lossi L, Malojcic B, Mehrabian S, Merighi A, Mukaetova-Ladinska EB, Paraskevas GP, Popescu BO, Ravid R, Traykov L, Tsivgoulis G, Weinstein G, Korczyn A, Bjerke M, Rosenberg G. Biochemical markers in vascular cognitive impairment associated with subcortical small vessel disease - A consensus report. BMC Neurol 2017; 17:102. [PMID: 28535786 PMCID: PMC5442599 DOI: 10.1186/s12883-017-0877-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 05/09/2017] [Indexed: 12/17/2022] Open
Abstract
Background Vascular cognitive impairment (VCI) is a heterogeneous entity with multiple aetiologies, all linked to underlying vascular disease. Among these, VCI related to subcortical small vessel disease (SSVD) is emerging as a major homogeneous subtype. Its progressive course raises the need for biomarker identification and/or development for adequate therapeutic interventions to be tested. In order to shed light in the current status on biochemical markers for VCI-SSVD, experts in field reviewed the recent evidence and literature data. Method The group conducted a comprehensive search on Medline, PubMed and Embase databases for studies published until 15.01.2017. The proposal on current status of biochemical markers in VCI-SSVD was reviewed by all co-authors and the draft was repeatedly circulated and discussed before it was finalized. Results This review identifies a large number of biochemical markers derived from CSF and blood. There is a considerable overlap of VCI-SSVD clinical symptoms with those of Alzheimer’s disease (AD). Although most of the published studies are small and their findings remain to be replicated in larger cohorts, several biomarkers have shown promise in separating VCI-SSVD from AD. These promising biomarkers are closely linked to underlying SSVD pathophysiology, namely disruption of blood-CSF and blood–brain barriers (BCB-BBB) and breakdown of white matter myelinated fibres and extracellular matrix, as well as blood and brain inflammation. The leading biomarker candidates are: elevated CSF/blood albumin ratio, which reflects BCB/BBB disruption; altered CSF matrix metalloproteinases, reflecting extracellular matrix breakdown; CSF neurofilment as a marker of axonal damage, and possibly blood inflammatory cytokines and adhesion molecules. The suggested SSVD biomarker deviations contrasts the characteristic CSF profile in AD, i.e. depletion of amyloid beta peptide and increased phosphorylated and total tau. Conclusions Combining SSVD and AD biomarkers may provide a powerful tool to identify with greater precision appropriate patients for clinical trials of more homogeneous dementia populations. Thereby, biomarkers might promote therapeutic progress not only in VCI-SSVD, but also in AD.
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Affiliation(s)
- A Wallin
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden. .,Memory Clinic at Department of Neuropsychiatry, Sahlgrenska University Hospital, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Wallinsgatan 6, SE-431 41, Mölndal, Sweden.
| | - E Kapaki
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - M Boban
- Department of Neurology, University Hospital Centre Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - S Engelborghs
- Memory Clinic and Department of Neurology, Hospital Network Antwerp (ZNA) Middelheim and HogeBeuken, Antwerp, Belgium.,Reference Center for Biological Markers of Dementia, Department of Biomedical Sciences, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - D M Hermann
- Department of Neurology, University Hospital Essen, Essen, Germany
| | - B Huisa
- Department of Neurology, University of California, Irvine, California, USA
| | - M Jonsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - M G Kramberger
- Department of Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - L Lossi
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - B Malojcic
- Department of Neurology, University Hospital Centre Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - S Mehrabian
- Department of Neurology, University Hospital "Alexandrovska", Medical University, Sofia, Bulgaria
| | - A Merighi
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - E B Mukaetova-Ladinska
- Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - G P Paraskevas
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - B O Popescu
- Department of Neurology, Colentina Clinical Hospital, School of Medicine, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - R Ravid
- Brain Bank Consultants, Amsterdam, The Netherlands
| | - L Traykov
- Department of Neurology, University Hospital "Alexandrovska", Medical University, Sofia, Bulgaria
| | - G Tsivgoulis
- 2nd Department of Neurology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - G Weinstein
- School of Public Health, University of Haifa, Haifa, Israel
| | - A Korczyn
- Department of Neurology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Bjerke
- Reference Center for Biological Markers of Dementia, Department of Biomedical Sciences, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - G Rosenberg
- University of New Mexico Health Sciences Center, Albuquerque, NM, 87131, USA
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49
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Bougea A, Velonakis G, Spantideas N, Anagnostou E, Paraskevas G, Kapaki E, Kararizou E. The first Greek case of heterozygous cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy: An atypical clinico-radiological presentation. Neuroradiol J 2017; 30:583-585. [PMID: 28402226 DOI: 10.1177/1971400917700168] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) was previously considered a rare, early-onset recessive form of small-vessel disease (SVD) caused by biallelic mutations in the serine protease gene HTRA1 with subsequent loss of its activity. However, very recently, there is growing interest of research showing heterozygous HTRA1 mutations as causes of SVD with a dominant inheritance pattern. This first Greek heterozygous CARASIL case with unusual clinico-radiological presentation extends our very recent knowledge on how heterozygous CARASIL mutations may be associated with cerebral SVD. Our findings highlight heterozygous HTRA1 mutations as an important cause of familial SVD, and that screening of HTRA1 should be considered in all patients with a hereditary SVD of unknown aetiology.
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Affiliation(s)
- Anastasia Bougea
- 1 First Department of Neurology, National and Kapodistrian University of Athens Medical School, Aeginition Hospital, Greece
| | - George Velonakis
- 2 Research Unit of Radiology and Medical Imaging, Second Department of Radiology, National and Kapodistrian University of Athens Medical School, Aeginition Hospital, Greece
| | - Nikolaos Spantideas
- 1 First Department of Neurology, National and Kapodistrian University of Athens Medical School, Aeginition Hospital, Greece
| | - Evangelos Anagnostou
- 1 First Department of Neurology, National and Kapodistrian University of Athens Medical School, Aeginition Hospital, Greece
| | - George Paraskevas
- 1 First Department of Neurology, National and Kapodistrian University of Athens Medical School, Aeginition Hospital, Greece
| | - Elisabeth Kapaki
- 1 First Department of Neurology, National and Kapodistrian University of Athens Medical School, Aeginition Hospital, Greece
| | - Evangelia Kararizou
- 1 First Department of Neurology, National and Kapodistrian University of Athens Medical School, Aeginition Hospital, Greece
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50
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Bougea A, Koros C, Stamelou M, Simitsi A, Papagiannakis N, Antonelou R, Papadimitriou D, Breza M, Tasios K, Fragkiadaki S, Geronicola Trapali X, Bourbouli M, Koutsis G, Papageorgiou SG, Kapaki E, Paraskevas GP, Stefanis L. Frontotemporal dementia as the presenting phenotype of p.A53T mutation carriers in the alpha-synuclein gene. Parkinsonism Relat Disord 2016; 35:82-87. [PMID: 28012952 DOI: 10.1016/j.parkreldis.2016.12.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/14/2016] [Accepted: 12/03/2016] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The p.A53T point mutation in SNCA, the alpha-synuclein gene, has been linked to a rare dominant form of Parkinson's disease (PD). METHODS Here, we describe two apparently unrelated cases of p.A53T (G209A) SNCA mutation carriers with an atypical initial manifestation and disease course. Moreover, cerebrospinal fluid (CSF) levels of tau, p-tau and amyloid Aβ42 were measured in these patients and in an additional cohort of 5 symptomatic and 2 asymptomatic p.A53T carriers without an initial manifestation of dementia. RESULTS Both patients exhibited an early onset frontal-dysexecutive dysfunction with apathy and emotional blunting resembling frontotemporal dementia (FTD). Motor symptoms typical of Parkinson's disease appeared only later in the disease course and were less prominent than cognitive ones, which included language impairment. Autonomic dysfunction and myoclonus also emerged in a more advanced disease stage. In both patients, Brain Magnetic Resonance Imaging showed fronto-temporo-parietal atrophy, and CSF analysis showed elevated tau protein levels. In contrast, tau protein levels were normal in a cohort of 7 other p.A53T mutation carriers (5 symptomatic/2 asymptomatic). A screen of Greek patients presenting with frontotemporal dementia failed to identify any additional subjects with the p.A53T SNCA mutation. CONCLUSION Although cognitive decline has been recognized as a feature of the full-blown clinical picture of p.A53T related parkinsonism, a predominant frontotemporal dementia-like phenotype at presentation has not been previously described. This may represent a subtype of this disorder, with distinctive clinical, imaging and CSF biochemical characteristics, in which additional genetic or epigenetic factors may play a role.
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Affiliation(s)
- Anastasia Bougea
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Koros
- 2nd Department of Neurology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Stamelou
- 2nd Department of Neurology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Department of Neurology, Philipps University, Marburg, Germany
| | - Athina Simitsi
- 2nd Department of Neurology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papagiannakis
- 2nd Department of Neurology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Roubina Antonelou
- 2nd Department of Neurology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Marianthi Breza
- Neurogenetics Unit, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Tasios
- 2nd Department of Neurology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stella Fragkiadaki
- 2nd Department of Neurology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Xenia Geronicola Trapali
- Nuclear Medicine Unit, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Mara Bourbouli
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Koutsis
- Neurogenetics Unit, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sokratis G Papageorgiou
- 2nd Department of Neurology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Paraskevas
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Leonidas Stefanis
- 2nd Department of Neurology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.
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