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Ryan M, Doherty MA, Al Khleifat A, Costello E, Hengeveld JC, Heverin M, Al-Chalabi A, Mclaughlin RL, Hardiman O. C9orf72 Repeat Expansion Discordance in 6 Multigenerational Kindreds. Neurol Genet 2024; 10:e200112. [PMID: 38149039 PMCID: PMC10751011 DOI: 10.1212/nxg.0000000000200112] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/02/2023] [Indexed: 12/28/2023]
Abstract
Background and Objectives A hexanucleotide repeat expansion in the noncoding region of the C9orf72 gene is the most common genetically identifiable cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia in populations of European ancestry. Pedigrees associated with this expansion exhibit phenotypic heterogeneity and incomplete disease penetrance, the basis of which is poorly understood. Relatives of those carrying the C9orf72 repeat expansion exhibit a characteristic cognitive endophenotype independent of carrier status. To examine whether additional shared genetic or environmental risks within kindreds could compel this observation, we have conducted a detailed cross-sectional study of the inheritance within multigenerational Irish kindreds carrying the C9orf72 repeat expansion. Methods One hundred thirty-one familial ALS pedigrees, 59 of which carried the C9orf72 repeat expansion (45.0% [95% CI 36.7-53.5]), were identified through the Irish population-based ALS register. C9orf72 genotyping was performed using repeat-primed PCR with amplicon fragment length analysis. Pedigrees were further investigated using SNP, targeted sequencing data, whole-exome sequencing, and whole-genome sequencing. Results We identified 21 kindreds where at least 1 family member with ALS carried the C9orf72 repeat expansion and from whom DNA was available from multiple affected family members. Of these, 6 kindreds (28.6% [95% CI 11.8-48.3]) exhibited discordant segregation. The C9orf72 haplotype was studied in 2 families and was found to segregate with the C9orf72-positive affected relative but not the C9orf72-negative affected relative. No other ALS pathogenic variants were identified within these discordant kindreds. Discussion Family members of kindreds associated with the C9orf72 repeat expansion may carry an increased risk of developing ALS independent of their observed carrier status. This has implications for assessment and counseling of asymptomatic individuals regarding their genetic risk.
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Affiliation(s)
- Marie Ryan
- From the Academic Unit of Neurology (M.R., E.C., M.H., O.H.) and Smurfit Institute of Genetics (M.A.D., J.C.H., R.L.M.), Trinity College Dublin, Ireland; Department of Basic and Clinical Neuroscience (A.A., A.A.-C.), Maurice Wohl Clinical Neuroscience Institute, King's College London, United Kingdom; Department of Psychology (E.C.), Beaumont Hospital, Dublin, Ireland; King's College Hospital (A.A.-C.), London, United Kingdom; and Department of Neurology (O.H.), Beaumont Hospital, Dublin, Ireland
| | - Mark A Doherty
- From the Academic Unit of Neurology (M.R., E.C., M.H., O.H.) and Smurfit Institute of Genetics (M.A.D., J.C.H., R.L.M.), Trinity College Dublin, Ireland; Department of Basic and Clinical Neuroscience (A.A., A.A.-C.), Maurice Wohl Clinical Neuroscience Institute, King's College London, United Kingdom; Department of Psychology (E.C.), Beaumont Hospital, Dublin, Ireland; King's College Hospital (A.A.-C.), London, United Kingdom; and Department of Neurology (O.H.), Beaumont Hospital, Dublin, Ireland
| | - Ahmad Al Khleifat
- From the Academic Unit of Neurology (M.R., E.C., M.H., O.H.) and Smurfit Institute of Genetics (M.A.D., J.C.H., R.L.M.), Trinity College Dublin, Ireland; Department of Basic and Clinical Neuroscience (A.A., A.A.-C.), Maurice Wohl Clinical Neuroscience Institute, King's College London, United Kingdom; Department of Psychology (E.C.), Beaumont Hospital, Dublin, Ireland; King's College Hospital (A.A.-C.), London, United Kingdom; and Department of Neurology (O.H.), Beaumont Hospital, Dublin, Ireland
| | - Emmet Costello
- From the Academic Unit of Neurology (M.R., E.C., M.H., O.H.) and Smurfit Institute of Genetics (M.A.D., J.C.H., R.L.M.), Trinity College Dublin, Ireland; Department of Basic and Clinical Neuroscience (A.A., A.A.-C.), Maurice Wohl Clinical Neuroscience Institute, King's College London, United Kingdom; Department of Psychology (E.C.), Beaumont Hospital, Dublin, Ireland; King's College Hospital (A.A.-C.), London, United Kingdom; and Department of Neurology (O.H.), Beaumont Hospital, Dublin, Ireland
| | - Jennifer C Hengeveld
- From the Academic Unit of Neurology (M.R., E.C., M.H., O.H.) and Smurfit Institute of Genetics (M.A.D., J.C.H., R.L.M.), Trinity College Dublin, Ireland; Department of Basic and Clinical Neuroscience (A.A., A.A.-C.), Maurice Wohl Clinical Neuroscience Institute, King's College London, United Kingdom; Department of Psychology (E.C.), Beaumont Hospital, Dublin, Ireland; King's College Hospital (A.A.-C.), London, United Kingdom; and Department of Neurology (O.H.), Beaumont Hospital, Dublin, Ireland
| | - Mark Heverin
- From the Academic Unit of Neurology (M.R., E.C., M.H., O.H.) and Smurfit Institute of Genetics (M.A.D., J.C.H., R.L.M.), Trinity College Dublin, Ireland; Department of Basic and Clinical Neuroscience (A.A., A.A.-C.), Maurice Wohl Clinical Neuroscience Institute, King's College London, United Kingdom; Department of Psychology (E.C.), Beaumont Hospital, Dublin, Ireland; King's College Hospital (A.A.-C.), London, United Kingdom; and Department of Neurology (O.H.), Beaumont Hospital, Dublin, Ireland
| | - Ammar Al-Chalabi
- From the Academic Unit of Neurology (M.R., E.C., M.H., O.H.) and Smurfit Institute of Genetics (M.A.D., J.C.H., R.L.M.), Trinity College Dublin, Ireland; Department of Basic and Clinical Neuroscience (A.A., A.A.-C.), Maurice Wohl Clinical Neuroscience Institute, King's College London, United Kingdom; Department of Psychology (E.C.), Beaumont Hospital, Dublin, Ireland; King's College Hospital (A.A.-C.), London, United Kingdom; and Department of Neurology (O.H.), Beaumont Hospital, Dublin, Ireland
| | - Russell L Mclaughlin
- From the Academic Unit of Neurology (M.R., E.C., M.H., O.H.) and Smurfit Institute of Genetics (M.A.D., J.C.H., R.L.M.), Trinity College Dublin, Ireland; Department of Basic and Clinical Neuroscience (A.A., A.A.-C.), Maurice Wohl Clinical Neuroscience Institute, King's College London, United Kingdom; Department of Psychology (E.C.), Beaumont Hospital, Dublin, Ireland; King's College Hospital (A.A.-C.), London, United Kingdom; and Department of Neurology (O.H.), Beaumont Hospital, Dublin, Ireland
| | - Orla Hardiman
- From the Academic Unit of Neurology (M.R., E.C., M.H., O.H.) and Smurfit Institute of Genetics (M.A.D., J.C.H., R.L.M.), Trinity College Dublin, Ireland; Department of Basic and Clinical Neuroscience (A.A., A.A.-C.), Maurice Wohl Clinical Neuroscience Institute, King's College London, United Kingdom; Department of Psychology (E.C.), Beaumont Hospital, Dublin, Ireland; King's College Hospital (A.A.-C.), London, United Kingdom; and Department of Neurology (O.H.), Beaumont Hospital, Dublin, Ireland
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Metzger M, Dukic S, McMackin R, Giglia E, Mitchell M, Bista S, Costello E, Peelo C, Tadjine Y, Sirenko V, Plaitano S, Coffey A, McManus L, Farnell Sharp A, Mehra P, Heverin M, Bede P, Muthuraman M, Pender N, Hardiman O, Nasseroleslami B. Functional network dynamics revealed by EEG microstates reflect cognitive decline in amyotrophic lateral sclerosis. Hum Brain Mapp 2024; 45:e26536. [PMID: 38087950 PMCID: PMC10789208 DOI: 10.1002/hbm.26536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/26/2023] [Accepted: 10/31/2023] [Indexed: 01/16/2024] Open
Abstract
Recent electroencephalography (EEG) studies have shown that patterns of brain activity can be used to differentiate amyotrophic lateral sclerosis (ALS) and control groups. These differences can be interrogated by examining EEG microstates, which are distinct, reoccurring topographies of the scalp's electrical potentials. Quantifying the temporal properties of the four canonical microstates can elucidate how the dynamics of functional brain networks are altered in neurological conditions. Here we have analysed the properties of microstates to detect and quantify signal-based abnormality in ALS. High-density resting-state EEG data from 129 people with ALS and 78 HC were recorded longitudinally over a 24-month period. EEG topographies were extracted at instances of peak global field power to identify four microstate classes (labelled A-D) using K-means clustering. Each EEG topography was retrospectively associated with a microstate class based on global map dissimilarity. Changes in microstate properties over the course of the disease were assessed in people with ALS and compared with changes in clinical scores. The topographies of microstate classes remained consistent across participants and conditions. Differences were observed in coverage, occurrence, duration, and transition probabilities between ALS and control groups. The duration of microstate class B and coverage of microstate class C correlated with lower limb functional decline. The transition probabilities A to D, C to B and C to B also correlated with cognitive decline (total ECAS) in those with cognitive and behavioural impairments. Microstate characteristics also significantly changed over the course of the disease. Examining the temporal dependencies in the sequences of microstates revealed that the symmetry and stationarity of transition matrices were increased in people with late-stage ALS. These alterations in the properties of EEG microstates in ALS may reflect abnormalities within the sensory network and higher-order networks. Microstate properties could also prospectively predict symptom progression in those with cognitive impairments.
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Affiliation(s)
- Marjorie Metzger
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Stefan Dukic
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
- Department of Neurology, University Medical Centre Utrecht Brain CentreUtrecht UniversityUtrechtThe Netherlands
| | - Roisin McMackin
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
- Discipline of Physiology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Eileen Giglia
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Matthew Mitchell
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Saroj Bista
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Emmet Costello
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Colm Peelo
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Yasmine Tadjine
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Vladyslav Sirenko
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Serena Plaitano
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Amina Coffey
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Lara McManus
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Adelais Farnell Sharp
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Prabhav Mehra
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Mark Heverin
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Peter Bede
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
| | - Muthuraman Muthuraman
- Neural Engineering with Signal Analytics and Artificial Intelligence, Department of NeurologyUniversity of WürzburgWürzburgGermany
| | - Niall Pender
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
- Department of PsychologyBeaumont HospitalDublinIreland
| | - Orla Hardiman
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
- Department of NeurologyBeaumont HospitalDublinIreland
| | - Bahman Nasseroleslami
- Academic Unit of Neurology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College DublinUniversity of DublinDublinIreland
- FutureNeuro ‐ SFI Research Centre for Chronic and Rare Neurological DiseasesRoyal College of SurgeonsDublinIreland
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Costello E, Ryan M, Donohoe B, Kavanagh C, Pinto-Grau M, Doherty M, McLaughlin RL, McHutchison C, Abrahams S, Heverin M, Hardiman O, Pender N. Cognitive and neuropsychiatric endophenotypes in amyotrophic lateral sclerosis. Brain Commun 2023; 5:fcad166. [PMID: 37288312 PMCID: PMC10243911 DOI: 10.1093/braincomms/fcad166] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/06/2023] [Accepted: 05/18/2023] [Indexed: 06/09/2023] Open
Abstract
First- and second-degree relatives of people with amyotrophic lateral sclerosis report higher rates of neuropsychiatric disorders, indicating that risk genes may be pleiotropic, causing multiple phenotypes within kindreds. Such phenotypes may constitute a disease endophenotype that associates with disease liability. We have directly investigated cognitive functioning and neuropsychiatric traits among relatives of people with amyotrophic lateral sclerosis to identify potential endophenotypes of the disease. In a family-based, cross-sectional study design, first- and second-degree relatives of people with amyotrophic lateral sclerosis (n = 149) were compared to controls (n = 60) using an in-depth neuropsychological and neuropsychiatric assessment. Subgroup analyses examined the effect of family history and C9orf72 repeat expansion status (n = 16 positive carriers). Relatives of people with amyotrophic lateral sclerosis had lower scores on executive functioning, language and memory tasks compared to controls, with large effect sizes observed on object naming (d = 0.91, P = 0.00001) and phonemic verbal fluency (d = 0.81, P = 0.0003). Relatives also had higher autism quotient attention to detail traits (d = -0.52, P = 0.005), lower conscientiousness (d = 0.57, P = 0.003) and lower openness to experience personality traits (d = 0.54, P = 0.01) than controls. These effects were typically larger in relatives of people with familial, rather than sporadic, amyotrophic lateral sclerosis and were present in both gene carrier and non-carrier relatives of probands with a C9orf72 repeat expansion. Poorer phonemic fluency and object naming, along with autism and personality traits, are more frequent in relatives of people with amyotrophic lateral sclerosis. Among kindreds carrying the C9orf72 repeat expansion, these traits were identified in relatives regardless of their carrier status, suggesting the presence of a disease-associated endophenotype that is not exclusively mediated by the C9orf72 expansion.
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Affiliation(s)
- Emmet Costello
- Correspondence to: Emmet Costello Academic Unit of Neurology, Trinity Biomedical Science Institute Pearse Street, Dublin D02 R590, Ireland E-mail:
| | | | - Bronagh Donohoe
- Academic Unit of Neurology, Trinity Biomedical Science Institute, Dublin D02 R590, Ireland
| | - Caoimhe Kavanagh
- Academic Unit of Neurology, Trinity Biomedical Science Institute, Dublin D02 R590, Ireland
| | - Marta Pinto-Grau
- Academic Unit of Neurology, Trinity Biomedical Science Institute, Dublin D02 R590, Ireland
- Psychology Department, Beaumont Hospital, Dublin D09 V2N0, Ireland
| | - Mark Doherty
- Academic Unit of Neurology, Trinity Biomedical Science Institute, Dublin D02 R590, Ireland
| | | | - Caroline McHutchison
- Human Cognitive Neurosciences–Psychology, School of Philosophy, Psychology, Language Sciences, The University of Edinburgh, Edinburgh EH8 9AD, UK
- Euan MacDonald Centre for Motor Neuron Disease Research, The University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Sharon Abrahams
- Human Cognitive Neurosciences–Psychology, School of Philosophy, Psychology, Language Sciences, The University of Edinburgh, Edinburgh EH8 9AD, UK
- Euan MacDonald Centre for Motor Neuron Disease Research, The University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Mark Heverin
- Academic Unit of Neurology, Trinity Biomedical Science Institute, Dublin D02 R590, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Science Institute, Dublin D02 R590, Ireland
| | - Niall Pender
- Psychology Department, Beaumont Hospital, Dublin D09 V2N0, Ireland
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Pinto-Grau M, Donohoe B, O'Connor S, Murphy L, Costello E, Heverin M, Vajda A, Hardiman O, Pender N. Patterns of Language Impairment in Early Amyotrophic Lateral Sclerosis. Neurol Clin Pract 2021; 11:e634-e644. [PMID: 34840877 DOI: 10.1212/cpj.0000000000001006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/07/2020] [Indexed: 11/15/2022]
Abstract
Objective To investigate the incidence and nature of language change and its relationship to executive dysfunction in a population-based incident amyotrophic lateral sclerosis (ALS) sample, with the hypothesis that patterns of frontotemporal involvement in early ALS extend beyond areas of executive control to regions associated with language processing. Methods One hundred seventeen population-based incident ALS cases without dementia and 100 controls matched by age, sex, and education were included in the study. A detailed assessment of language processing including lexical processing, word spelling, word reading, word naming, semantic processing, and syntactic/grammatical processing was undertaken. Executive domains of phonemic verbal fluency, working memory, problem-solving, cognitive flexibility, and social cognition were also evaluated. Results Language processing was impaired in this incident cohort of individuals with ALS, with deficits in the domains of word naming, orthographic processing, and syntactic/grammatical processing. Conversely, phonological lexical processing and semantic processing were spared. Although executive dysfunction accounted in part for impairments in grammatical and orthographic lexical processing, word spelling, reading, and naming, primary language deficits were also present. Conclusions Language impairment is characteristic of ALS at early stages of the disease and can develop independently of executive dysfunction, reflecting selective patterns of frontotemporal involvement at disease onset. Language change is therefore an important component of the frontotemporal syndrome associated with ALS.
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Affiliation(s)
- Marta Pinto-Grau
- Academic Unit of Neurology (MP-G, BD, SO, LM, EC, MH, AV, OH, NP), Trinity Biomedical Sciences Institute, Trinity College Dublin; and Department of Psychology (MP-G, BD, SO, LM, EC, NP), Beaumont Hospital, Dublin, Ireland
| | - Bronagh Donohoe
- Academic Unit of Neurology (MP-G, BD, SO, LM, EC, MH, AV, OH, NP), Trinity Biomedical Sciences Institute, Trinity College Dublin; and Department of Psychology (MP-G, BD, SO, LM, EC, NP), Beaumont Hospital, Dublin, Ireland
| | - Sarah O'Connor
- Academic Unit of Neurology (MP-G, BD, SO, LM, EC, MH, AV, OH, NP), Trinity Biomedical Sciences Institute, Trinity College Dublin; and Department of Psychology (MP-G, BD, SO, LM, EC, NP), Beaumont Hospital, Dublin, Ireland
| | - Lisa Murphy
- Academic Unit of Neurology (MP-G, BD, SO, LM, EC, MH, AV, OH, NP), Trinity Biomedical Sciences Institute, Trinity College Dublin; and Department of Psychology (MP-G, BD, SO, LM, EC, NP), Beaumont Hospital, Dublin, Ireland
| | - Emmet Costello
- Academic Unit of Neurology (MP-G, BD, SO, LM, EC, MH, AV, OH, NP), Trinity Biomedical Sciences Institute, Trinity College Dublin; and Department of Psychology (MP-G, BD, SO, LM, EC, NP), Beaumont Hospital, Dublin, Ireland
| | - Mark Heverin
- Academic Unit of Neurology (MP-G, BD, SO, LM, EC, MH, AV, OH, NP), Trinity Biomedical Sciences Institute, Trinity College Dublin; and Department of Psychology (MP-G, BD, SO, LM, EC, NP), Beaumont Hospital, Dublin, Ireland
| | - Alice Vajda
- Academic Unit of Neurology (MP-G, BD, SO, LM, EC, MH, AV, OH, NP), Trinity Biomedical Sciences Institute, Trinity College Dublin; and Department of Psychology (MP-G, BD, SO, LM, EC, NP), Beaumont Hospital, Dublin, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology (MP-G, BD, SO, LM, EC, MH, AV, OH, NP), Trinity Biomedical Sciences Institute, Trinity College Dublin; and Department of Psychology (MP-G, BD, SO, LM, EC, NP), Beaumont Hospital, Dublin, Ireland
| | - Niall Pender
- Academic Unit of Neurology (MP-G, BD, SO, LM, EC, MH, AV, OH, NP), Trinity Biomedical Sciences Institute, Trinity College Dublin; and Department of Psychology (MP-G, BD, SO, LM, EC, NP), Beaumont Hospital, Dublin, Ireland
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Dukic S, McMackin R, Costello E, Metzger M, Buxo T, Fasano A, Chipika R, Pinto-Grau M, Schuster C, Hammond M, Heverin M, Coffey A, Broderick M, Iyer PM, Mohr K, Gavin B, McLaughlin R, Pender N, Bede P, Muthuraman M, van den Berg L, Hardiman O, Nasseroleslami B. Resting-state EEG reveals four subphenotypes of amyotrophic lateral sclerosis. Brain 2021; 145:621-631. [PMID: 34791079 PMCID: PMC9014749 DOI: 10.1093/brain/awab322] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 03/29/2021] [Revised: 06/25/2021] [Accepted: 07/26/2021] [Indexed: 11/14/2022] Open
Abstract
Amyotrophic lateral sclerosis is a devastating disease characterized primarily by motor system degeneration, with clinical evidence of cognitive and behavioural change in up to 50% of cases. Amyotrophic lateral sclerosis is both clinically and biologically heterogeneous. Subgrouping is currently undertaken using clinical parameters, such as site of symptom onset (bulbar or spinal), burden of disease (based on the modified El Escorial Research Criteria) and genomics in those with familial disease. However, with the exception of genomics, these subcategories do not take into account underlying disease pathobiology, and are not fully predictive of disease course or prognosis. Recently, we have shown that resting-state EEG can reliably and quantitatively capture abnormal patterns of motor and cognitive network disruption in amyotrophic lateral sclerosis. These network disruptions have been identified across multiple frequency bands, and using measures of neural activity (spectral power) and connectivity (comodulation of activity by amplitude envelope correlation and synchrony by imaginary coherence) on source-localized brain oscillations from high-density EEG. Using data-driven methods (similarity network fusion and spectral clustering), we have now undertaken a clustering analysis to identify disease subphenotypes and to determine whether different patterns of disruption are predictive of disease outcome. We show that amyotrophic lateral sclerosis patients (n = 95) can be subgrouped into four phenotypes with distinct neurophysiological profiles. These clusters are characterized by varying degrees of disruption in the somatomotor (α-band synchrony), frontotemporal (β-band neural activity and γl-band synchrony) and frontoparietal (γl-band comodulation) networks, which reliably correlate with distinct clinical profiles and different disease trajectories. Using an in-depth stability analysis, we show that these clusters are statistically reproducible and robust, remain stable after reassessment using a follow-up EEG session, and continue to predict the clinical trajectory and disease outcome. Our data demonstrate that novel phenotyping using neuroelectric signal analysis can distinguish disease subtypes based exclusively on different patterns of network disturbances. These patterns may reflect underlying disease neurobiology. The identification of amyotrophic lateral sclerosis subtypes based on profiles of differential impairment in neuronal networks has clear potential in future stratification for clinical trials. Advanced network profiling in amyotrophic lateral sclerosis can also underpin new therapeutic strategies that are based on principles of neurobiology and designed to modulate network disruption.
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Affiliation(s)
- Stefan Dukic
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland.,Department of Neurology, University Medical Centre Utrecht Brain Centre, Utrecht University, Utrecht, The Netherlands
| | - Roisin McMackin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Emmet Costello
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Marjorie Metzger
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Teresa Buxo
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Antonio Fasano
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Rangariroyashe Chipika
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Marta Pinto-Grau
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Christina Schuster
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Michaela Hammond
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Amina Coffey
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Michael Broderick
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Parameswaran M Iyer
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Kieran Mohr
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Brighid Gavin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Russell McLaughlin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Niall Pender
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
| | - Muthuraman Muthuraman
- Movement disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Johannes-Gutenberg-University Hospital, Mainz, Germany
| | - Leonard van den Berg
- Department of Neurology, University Medical Centre Utrecht Brain Centre, Utrecht University, Utrecht, The Netherlands
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland.,Trinity College Institute of Neuroscience, Trinity College Dublin, University of Dublin, Ireland.,Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Bahman Nasseroleslami
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Ireland
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Rosato V, Gómez-Rubio P, Molina-Montes E, Márquez M, Löhr M, O'Rorke M, Michalski CW, Molero X, Farré A, Perea J, Kleeff J, Crnogorac-Jurcevic T, Greenhalf W, Ilzarbe L, Tardón A, Gress T, Barberá VM, Domínguez-Muñoz E, Muñoz-Bellvís L, Balsells J, Costello E, Iglesias M, Kong B, Mora J, O'Driscoll D, Poves I, Scarpa A, Ye W, Hidalgo M, Sharp L, Carrato A, Real FX, La Vecchia C, Malats N. Gallbladder disease and pancreatic cancer risk: a multicentric case-control European study. Eur J Cancer Prev 2021; 30:423-430. [PMID: 34545020 DOI: 10.1097/cej.0000000000000588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS The overall evidence on the association between gallbladder conditions (GBC: gallstones and cholecystectomy) and pancreatic cancer (PC) is inconsistent. To our knowledge, no previous investigations considered the role of tumour characteristics on this association. Thus, we aimed to assess the association between self-reported GBC and PC risk, by focussing on timing to PC diagnosis and tumour features (stage, location, and resection). METHODS Data derived from a European case-control study conducted between 2009 and 2014 including 1431 PC cases and 1090 controls. We used unconditional logistic regression models to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs) adjusted for recognized confounders. RESULTS Overall, 298 (20.8%) cases and 127 (11.6%) controls reported to have had GBC, corresponding to an OR of 1.70 (95% CI 1.33-2.16). The ORs were 4.84 (95% CI 2.96-7.89) for GBC diagnosed <3 years before PC and 1.06 (95% CI 0.79-1.41) for ≥3 years. The risk was slightly higher for stage I/II (OR = 1.71, 95% CI 1.15-2.55) vs. stage III/IV tumours (OR = 1.23, 95% CI 0.87-1.76); for tumours sited in the head of the pancreas (OR = 1.59, 95% CI 1.13-2.24) vs. tumours located at the body/tail (OR = 1.02, 95% CI 0.62-1.68); and for tumours surgically resected (OR = 1.69, 95% CI 1.14-2.51) vs. non-resected tumours (OR = 1.25, 95% CI 0.88-1.78). The corresponding ORs for GBC diagnosed ≥3 years prior PC were close to unity. CONCLUSION Our study supports the association between GBC and PC. Given the time-risk pattern observed, however, this relationship may be non-causal and, partly or largely, due to diagnostic attention and/or reverse causation.
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Affiliation(s)
- V Rosato
- Unit of Medical Statistics and Biometry, National Cancer Institute, IRCCS Foundation, Milan, Italy
| | - P Gómez-Rubio
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- CIBERONC, Spain
| | - E Molina-Montes
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- CIBERONC, Spain
| | - M Márquez
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- CIBERONC, Spain
| | - M Löhr
- Gastrocentrum, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - M O'Rorke
- Centre for Public Health, Belfast, Queen's University Belfast, Belfast, UK
| | - C W Michalski
- Department of Surgery, Technical University of Munich, Munich
- Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - X Molero
- Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Barcelona, Universitat Autònoma de Barcelona, Barcelona
- CIBEREHD
| | - A Farré
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona
| | - J Perea
- Department of Surgery, University Hospital 12 de Octubre
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J Kleeff
- Department of Surgery, Technical University of Munich, Munich
- Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - T Crnogorac-Jurcevic
- Barts Cancer Institute, Centre for Molecular Oncology, Queen Mary University of London, John Vane Science Centre, London
| | - W Greenhalf
- Department of Molecular and Clinical Cancer Medicine, The Royal Liverpool University Hospital, Liverpool, UK
| | - L Ilzarbe
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- Hospital del Mar-Parc de Salut Mar, Barcelona
| | - A Tardón
- Department of Medicine, Instituto Universitario de Oncología del Principado de Asturias, Oviedo
- CIBERESP, Spain
| | - T Gress
- Department of Gastroenterology, University Hospital of Giessen and Marburg, Marburg, Germany
| | - V M Barberá
- Molecular Genetics Laboratory, General University Hospital of Elche
| | - E Domínguez-Muñoz
- Department of Gastroenterology, University Clinical Hospital of Santiago de Compostela
| | - L Muñoz-Bellvís
- General and Digestive Surgery Department, Salamanca University Hospital, Elche, Santiago de Compostela, and Salamanca, Spain
| | - J Balsells
- Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Barcelona, Universitat Autònoma de Barcelona, Barcelona
- CIBEREHD
| | - E Costello
- Department of Molecular and Clinical Cancer Medicine, The Royal Liverpool University Hospital, Liverpool, UK
| | - M Iglesias
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- Hospital del Mar-Parc de Salut Mar, Barcelona
| | - Bo Kong
- Department of Surgery, Technical University of Munich, Munich
| | - J Mora
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona
| | - D O'Driscoll
- National Cancer Registry Ireland and HRB Clinical Research Facility, University College Cork, Cork, Ireland
| | - I Poves
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- Hospital del Mar-Parc de Salut Mar, Barcelona
| | - A Scarpa
- ARC-Net centre for Applied Research on Cancer and Department of Pathology and Diagnostics, University and Hospital trust of Verona, Verona, Italy
| | - W Ye
- Gastrocentrum, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - M Hidalgo
- Madrid-Norte-Sanchinarro Hospital, Madrid, Spain
| | - L Sharp
- National Cancer Registry Ireland and HRB Clinical Research Facility, University College Cork, Cork, Ireland
- Newcastle University, Institute of Health & Society, Newcastle, UK
| | - A Carrato
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- Department of Oncology, Ramón y Cajal University Hospital, IRYCIS, Alcala University
| | - F X Real
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- Epithelial Carcinogenesis Group
- Spanish National Cancer Research Centre (CNIO), Madrid
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - N Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- CIBERONC, Spain
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Goebel B, Salomon C, Abdulrahman M, Richter S, El Garhy M, Costello E, Lapp H, Lauten P. Echocardiographic predictors of the effectiveness of interventional edge-to-edge repair in tricuspid valve regurgitation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.083] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Percutaneous tricuspid valve edge-to-edge repair (pTVR) is a promising interventional technique for patients with tricuspid regurgitation (TR), but guidance regarding patient selection and echocardiographic screening is lacking. The aim of this study was to identify echocardiographic parameters which may predict pTVR success.
Methods
Before and after pTVR, echocardiographic data, including 3D full-volume datasets, were obtained and quantified. Right ventricular assessments included ejection fraction (RVEF3D) and diastolic (RVVd3D) and systolic (RVVs3D) volumes. Also evaluated were: right atrial (RA) volume, effective regurgitant orifice area by PISA method (EROAPISA), vena contracta area (VCA3D) by multiplanar reconstruction from a 3D colour Doppler loop (Figure 1a), maximal diastolic tricuspid annulus area from a 3D zoom image (Figure 1b), and tricuspid tenting area. TR severity was graded according to EROAPISA and VCA3D as grade 1+ to 5+.
Results
Patients (n=99, age 79±6 years, 48 male) with at least moderate to severe TR undergoing pTVR were consecutively included. The patients were divided into groups according to their post-pTVR TR grade. Group 1 had TR grade ≤2+, and group 2 had TR grade ≥3+.Echocardiographic parameters before pTVR for both groups are presented in Table 1. As expected, patients with TVR ≥3+ after pTVR had significantly worse pre-intervention echocardiographic measurements of TR severity, valve dimensions, and chamber volumes. ROC curves for the prediction of TR ≤2+ (mild to moderate) after pTVR (defined as VCA3D <0.75 cm2 and EROAPISA <0.4 cm2) were drawn for different echocardiographic features (Figure 2). VCA3D by 3D colour Doppler yielded the highest area under the ROC curve followed by TV anatomy measurements (Annulus area3D, Tenting area) and right atrial volume.
Conclusion
A thorough evaluation of TR and valve dimensions by 3D echocardiography, particularly the evaluation of VCA3D by 3D colour Doppler, aids in the prediction of the probability of pTVR success.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- B Goebel
- Heart Center of the Central Clinic Bad Berka, Cardiology Department, Bad Berka, Germany
| | - C Salomon
- Heart Center of the Central Clinic Bad Berka, Cardiology Department, Bad Berka, Germany
| | - M Abdulrahman
- Heart Center of the Central Clinic Bad Berka, Cardiology Department, Bad Berka, Germany
| | - S Richter
- Heart Center of the Central Clinic Bad Berka, Cardiology Department, Bad Berka, Germany
| | - M El Garhy
- Heart Center of the Central Clinic Bad Berka, Cardiology Department, Bad Berka, Germany
| | - E Costello
- Heart Center of the Central Clinic Bad Berka, Cardiology Department, Bad Berka, Germany
| | - H Lapp
- Heart Center of the Central Clinic Bad Berka, Cardiology Department, Bad Berka, Germany
| | - P Lauten
- Heart Center of the Central Clinic Bad Berka, Cardiology Department, Bad Berka, Germany
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8
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Costello E, Rooney J, Pinto-Grau M, Burke T, Elamin M, Bede P, McMackin R, Dukic S, Vajda A, Heverin M, Hardiman O, Pender N. Cognitive reserve in amyotrophic lateral sclerosis (ALS): a population-based longitudinal study. J Neurol Neurosurg Psychiatry 2021; 92:460-465. [PMID: 33563807 DOI: 10.1136/jnnp-2020-324992] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is often associated with cognitive and/or behavioural impairment. Cognitive reserve (CR) may play a protective role in offsetting cognitive impairment. This study examined the relationship between CR and longitudinal change in cognition in an Irish ALS cohort. METHODS Longitudinal neuropsychological assessment was carried out on 189 patients over 16 months using the Edinburgh cognitive and behavioural ALS screen (ECAS) and an additional battery of neuropsychological tests. CR was measured by combining education, occupation and physical activity data. Joint longitudinal and time-to-event models were fitted to investigate the associations between CR, performance at baseline and decline over time while controlling for non-random drop-out. RESULTS CR was a significant predictor of baseline neuropsychological performance, with high CR patients performing better than those with medium or low CR. Better cognitive performance in high CR individuals was maintained longitudinally for ECAS, social cognition, executive functioning and confrontational naming. Patients displayed little cognitive decline over the course of the study, despite controlling for non-random drop-out. CONCLUSIONS These findings suggest that CR plays a role in the presentation of cognitive impairment at diagnosis but is not protective against cognitive decline. However, further research is needed to examine the interaction between CR and other objective correlates of cognitive impairment in ALS.
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Affiliation(s)
- Emmet Costello
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland .,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - James Rooney
- Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,Institute and Clinic for Occupational, Social- and Environmental Medicine, University Hospital, Munich, Germany
| | - Marta Pinto-Grau
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland.,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Tom Burke
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland.,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Marwa Elamin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Peter Bede
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Roisin McMackin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Stefan Dukic
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland.,Department of Neurology, University Medical Centre Utrecht Brain Centre, Utrecht, The Netherlands
| | - Alice Vajda
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Niall Pender
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland.,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
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9
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McMackin R, Dukic S, Costello E, Pinto-Grau M, McManus L, Broderick M, Chipika R, Iyer PM, Heverin M, Bede P, Muthuraman M, Pender N, Hardiman O, Nasseroleslami B. Cognitive network hyperactivation and motor cortex decline correlate with ALS prognosis. Neurobiol Aging 2021; 104:57-70. [PMID: 33964609 DOI: 10.1016/j.neurobiolaging.2021.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023]
Abstract
We aimed to quantitatively characterize progressive brain network disruption in Amyotrophic Lateral Sclerosis (ALS) during cognition using the mismatch negativity (MMN), an electrophysiological index of attention switching. We measured the MMN using 128-channel EEG longitudinally (2-5 timepoints) in 60 ALS patients and cross-sectionally in 62 healthy controls. Using dipole fitting and linearly constrained minimum variance beamforming we investigated cortical source activity changes over time. In ALS, the inferior frontal gyri (IFG) show significantly lower baseline activity compared to controls. The right IFG and both superior temporal gyri (STG) become progressively hyperactive longitudinally. By contrast, the left motor and dorsolateral prefrontal cortices are initially hyperactive, declining progressively. Baseline motor hyperactivity correlates with cognitive disinhibition, and lower baseline IFG activities correlate with motor decline rate, while left dorsolateral prefrontal activity predicted cognitive and behavioural impairment. Shorter survival correlates with reduced baseline IFG and STG activity and later STG hyperactivation. Source-resolved EEG facilitates quantitative characterization of symptom-associated and symptom-preceding motor and cognitive-behavioral cortical network decline in ALS.
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Affiliation(s)
- Roisin McMackin
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland
| | - Stefan Dukic
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland
| | - Emmet Costello
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland
| | - Marta Pinto-Grau
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland; Department of Neurology, University Medical Centre Utrecht Brain Centre, Utrecht University, Utrecht, The Netherlands
| | - Lara McManus
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland
| | - Michael Broderick
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland; Trinity Centre for Bioengineering, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland
| | - Rangariroyashe Chipika
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland; Computational Neuroimaging Group, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland
| | - Parameswaran M Iyer
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland; Beaumont Hospital Dublin, Department of Neurology, Dublin 9, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland
| | - Peter Bede
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland; Computational Neuroimaging Group, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland
| | - Muthuraman Muthuraman
- Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Johannes-Gutenberg-University Hospital, Mainz, Germany
| | - Niall Pender
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland; Department of Neurology, University Medical Centre Utrecht Brain Centre, Utrecht University, Utrecht, The Netherlands; Beaumont Hospital Dublin, Department of Neurology, Dublin 9, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland; Beaumont Hospital Dublin, Department of Neurology, Dublin 9, Ireland.
| | - Bahman Nasseroleslami
- Academic Unit of Neurology, Trinity College Dublin, the University of Dublin, Dublin 2, Ireland
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10
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Goebel B, Salomon C, Awada H, Costello E, Sassenberg N, Lauten P, Lapp H. Vena contracta area size predicts effectiveness of interventional edge-to-edge repair in tricuspid valve regurgitation. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.219] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Percutaneous tricuspid valve edge-to-edge repair (pTVR) is a promising interventional technique for patients with tricuspid regurgitation (TR), but guidance regarding patient selection and echocardiographic screening is lacking. The aim of this study was to identify echocardiographic measurements which may predict pTVR success.
Methods
Before and after pTVR, echocardiographic data, including 3D full-volume datasets, were obtained and quantified. Right ventricular assessments included ejection fraction (RVEF3D) and diastolic (RVVd3D) and systolic (RVVs3D) volumes. Also evaluated were: right atrial (RA) volume, effective regurgitant orifice area by PISA method (EROAPISA), vena contracta area (VCA3D) by multiplanar reconstruction from a 3D colour Doppler loop (Figure 1a), maximal diastolic tricuspid annulus area from a 3D zoom image (Figure 1b), and tricuspid tenting area. TR severity was graded according to EROAPISA and VCA3D as grade 1+ to 5+.
Results
Patients (n= 44, age 72 ± 9 years, 20 male) with at least moderate to severe TR undergoing pTVR were consecutively included. The patients were divided into groups according to their post-pTVR TR grade. Group 1 had TR grade ≤2+, and group 2 had TR grade ≥3+.Echocardiographic parameters before pTVR for both groups are presented in Table 1. As expected, patients with TVR ≥3+ after pTVR had significantly worse pre-intervention echocardiographic measurements of TR severity, valve dimensions, and chamber volumes. ROC curves for the prediction of TR ≤2+ (mild to moderate) after pTVR (defined as VCA3D <0.75 cm² and EROAPISA <0.4 cm²) were drawn for different echocardiographic features (Figure 2). VCA3D by 3D colour Doppler yielded the highest area under the ROC curve followed by TV anatomy measurements (Annulus area3D, Tenting area) and right atrial volume.
Conclusion
A thorough evaluation of TR and valve dimensions by 3D echocardiography, particulary the evaluation of VCA3D by 3D colour Doppler, aids in the prediction of the probability of pTVR success.
Abstract Figure.
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Affiliation(s)
- B Goebel
- Central Clinic Bad Berka, Bad Berka, Germany
| | - C Salomon
- Central Clinic Bad Berka, Bad Berka, Germany
| | - H Awada
- Central Clinic Bad Berka, Bad Berka, Germany
| | - E Costello
- Central Clinic Bad Berka, Bad Berka, Germany
| | | | - P Lauten
- Central Clinic Bad Berka, Bad Berka, Germany
| | - H Lapp
- Central Clinic Bad Berka, Bad Berka, Germany
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11
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McMackin R, Dukic S, Costello E, Pinto-Grau M, Keenan O, Fasano A, Buxo T, Heverin M, Reilly RB, Pender N, Hardiman O, Nasseroleslami B. Sustained attention to response task-related beta oscillations relate to performance and provide a functional biomarker in ALS. J Neural Eng 2021; 18. [PMID: 33395671 DOI: 10.1088/1741-2552/abd829] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 01/04/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To characterize the cortical oscillations associated with performance of the sustained attention to response task (SART) and their disruptions in the neurodegenerative condition amyotrophic lateral sclerosis (ALS). APPROACH A randomised SART was undertaken by 24 ALS patients and 33 healthy controls during 128-channel electroencephalography. Complex Morlet wavelet transform was used to quantify non-phase-locked oscillatory activity in event-related spectral perturbations associated with performing the SART. We investigated the relationships between these perturbations and task performance, and associated motor and cognitive changes in ALS Main results: SART induced theta-band event-related synchronization (ERS) and alpha- and beta-band event-related desynchronization (ERD), followed by rebound beta ERS, in both Go and NoGo trials across the frontoparietal axis, with NoGo trials eliciting greater theta ERS and lesser beta ERS. Controls with greater Go trial beta ERS performed with greater speed and less accuracy. ALS patients exhibited increased anticipation compared to controls but similar reaction times and accuracy. Prefrontal (AUROC=0.8, Cohen's d=0.97) and parietal (AUROC=0.82, Cohen's d=1.12) beta-band ERD was significantly reduced in ALS but did not relate to performance, while patients with higher ECAS ALS-specific scores demonstrated greater ERS in beta (rho=0.72) upon successful withholding. SIGNIFICANCE EEG measurement of task-related oscillation changes reveals variation in cortical network engagement in relation to speed versus accuracy strategies. Such measures can also capture cognitive and motor network pathophysiology in the absence of task performance decline, which may facilitate development of more sensitive early neurodegenerative disease biomarkers.
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Affiliation(s)
- Roisin McMackin
- Academic Unit of Neurology, Trinity College Dublin Academic Unit of Neurology, Room 5.40, Trinity Biomedical Sciences Institute,, 152-160 Pearse St.,, Dublin, Dublin, 2, IRELAND
| | - Stefan Dukic
- Department of Neurology, University Medical Centre Utrecht Brain Centre, Utrecht University, Heidelberglaan 100, Utrecht, Utrecht, 3584 CX, NETHERLANDS
| | - Emmet Costello
- Academic Unit of Neurology, Trinity College Dublin Academic Unit of Neurology, 152-160 Pearse St., Dublin, D02 R590, IRELAND
| | - Marta Pinto-Grau
- Academic Unit of Neurology, Trinity College Dublin Academic Unit of Neurology, 152-160 Pearse St., Dublin, D02 R590, IRELAND
| | - Orla Keenan
- Academic Unit of Neurology, Trinity College Dublin Academic Unit of Neurology, 152-160 Pearse St., Dublin, D02 R590, IRELAND
| | - Antonio Fasano
- Academic Unit of Neurology, Trinity College Dublin Academic Unit of Neurology, 152-160 Pearse St., Dublin, D02 R590, IRELAND
| | - Teresa Buxo
- Academic Unit of Neurology, Trinity College Dublin Academic Unit of Neurology, 152-160 Pearse St., Dublin, D02 R590, IRELAND
| | - Mark Heverin
- Academic Unit of Neurology, Trinity College Dublin Academic Unit of Neurology, 152-160 Pearse St., Dublin, D02 R590, IRELAND
| | - Richard B Reilly
- Trinity Centre for Biomedical Engineering, University of Dublin Trinity College, Dublin 2, Dublin, 2, IRELAND
| | - Niall Pender
- Academic Unit of Neurology, Trinity College Dublin Academic Unit of Neurology, 152-160 Pearse St., Dublin, D02 R590, IRELAND
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity College Dublin Academic Unit of Neurology, 152-160 Pearse St., Dublin, D02 R590, IRELAND
| | - Bahman Nasseroleslami
- Academic Unit of Neurology, Trinity College Dublin Academic Unit of Neurology, 152-160 Pearse St., Dublin, D02 R590, IRELAND
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12
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McMackin R, Dukic S, Costello E, Pinto-Grau M, Fasano A, Buxo T, Heverin M, Reilly R, Muthuraman M, Pender N, Hardiman O, Nasseroleslami B. Corrigendum to: Localization of Brain Networks Engaged by the Sustained Attention to Response Task Provides Quantitative Markers of Executive Impairment in Amyotrophic Lateral Sclerosis. Cereb Cortex 2020; 30:4727. [PMID: 32436562 PMCID: PMC7325794 DOI: 10.1093/cercor/bhaa152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Roisin McMackin
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
| | - Stefan Dukic
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Emmet Costello
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
| | - Marta Pinto-Grau
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
- Beaumont Hospital Dublin, Department of Psychology, Dublin 9, Dublin, Ireland
| | - Antonio Fasano
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
| | - Teresa Buxo
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
| | - Richard Reilly
- Trinity College Institute of Neuroscience, Trinity College Dublin, The University of Dublin, Dublin 2, Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity College, The University of Dublin, Dublin 2, Dublin, Ireland
| | - Muthuraman Muthuraman
- Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Johannes-Gutenberg- University Hospital, D55131, Mainz, Germany
| | - Niall Pender
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
- Beaumont Hospital Dublin, Department of Psychology, Dublin 9, Dublin, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
- Department of Neurology, Beaumont Hospital Dublin, Dublin 9, Dublin, Ireland
| | - Bahman Nasseroleslami
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
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13
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Burke T, Pinto-Grau M, Costello E, Peelo C, Lonergan K, Heverin M, Hardiman O, Pender N. The reading the mind in the eyes test short form (A & B): validation and outcomes in an amyotrophic lateral sclerosis cohort. Amyotroph Lateral Scler Frontotemporal Degener 2020; 21:380-388. [PMID: 32501122 DOI: 10.1080/21678421.2020.1772824] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Deficits in social cognition are part of the cognitive phenotype of amyotrophic lateral sclerosis (ALS). This study investigated the psychometric properties and test-retest reliability of two short-form versions of the Reading the Mind in the Eyes Test. Method: Patients with ALS (n = 50), alongside age and IQ matched controls (n = 50) were recruited. The Reading the Mind in the Eyes Test (RMET) was apportioned according to previously published psychometric properties yielding two short forms. The internal consistency, test-retest reliability, item difficulty, and discrimination coefficient were computed to determine the utility of the short forms. Two one-sided t-test (TOST) assessed equivalency, and a ROC curve analysis determined a cutoff for impairment. Results: Cronbach's Alpha > 0.7 was observed for the RMET Short Form A and RMET Short Form B, indicating adequate internal consistency. Both RMET Short Forms had excellent psychometric properties when discriminating between ALS patients who performed well, compared to those who did not, with an overall medium difficulty coefficient observed. The TOST found the short forms to be equivalent. Conclusion: Social cognition is an important cognitive construct in ALS, as is its measurement. This study contributes not only to the psychometric knowledge of this measure, but also to the usability, efficacy, reliability, and repeatability of two short forms.
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Affiliation(s)
- Tom Burke
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland.,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Marta Pinto-Grau
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland.,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Emmet Costello
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland.,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Colm Peelo
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland.,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Katie Lonergan
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland.,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland.,Department of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Niall Pender
- Department of Psychology, Beaumont Hospital, Dublin 9, Ireland.,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland.,Department of Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
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14
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McMackin R, Dukic S, Costello E, Pinto-Grau M, Fasano A, Buxo T, Heverin M, Reilly R, Muthuraman M, Pender N, Hardiman O, Nasseroleslami B. Localization of Brain Networks Engaged by the Sustained Attention to Response Task Provides Quantitative Markers of Executive Impairment in Amyotrophic Lateral Sclerosis. Cereb Cortex 2020; 30:4834-4846. [PMID: 32318719 PMCID: PMC7391267 DOI: 10.1093/cercor/bhaa076] [Citation(s) in RCA: 4] [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: 01/17/2020] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 12/13/2022] Open
Abstract
Objective: To identify cortical regions engaged during the sustained attention to response task (SART) and characterize changes in their activity associated with the neurodegenerative condition amyotrophic lateral sclerosis (ALS). Methods: High-density electroencephalography (EEG) was recorded from 33 controls and 23 ALS patients during a SART paradigm. Differences in associated event-related potential peaks were measured for Go and NoGo trials. Sources active during these peaks were localized, and ALS-associated differences were quantified. Results: Go and NoGo N2 and P3 peak sources were localized to the left primary motor cortex, bilateral dorsolateral prefrontal cortex (DLPFC), and lateral posterior parietal cortex (PPC). NoGo trials evoked greater bilateral medial PPC activity during N2 and lesser left insular, PPC and DLPFC activity during P3. Widespread cortical hyperactivity was identified in ALS during P3. Changes in the inferior parietal lobule and insular activity provided very good discrimination (AUROC > 0.75) between patients and controls. Activation of the right precuneus during P3 related to greater executive function in ALS, indicative of a compensatory role. Interpretation: The SART engages numerous frontal and parietal cortical structures. SART–EEG measures correlate with specific cognitive impairments that can be localized to specific structures, aiding in differential diagnosis.
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Affiliation(s)
- Roisin McMackin
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
| | - Stefan Dukic
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland.,Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Emmet Costello
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
| | - Marta Pinto-Grau
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland.,Beaumont Hospital Dublin, Department of Psychology, Dublin 9, Dublin, Ireland
| | - Antonio Fasano
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
| | - Teresa Buxo
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
| | - Richard Reilly
- Trinity College Institute of Neuroscience, Trinity College Dublin, The University of Dublin, Dublin 2, Dublin, Ireland.,Trinity Centre for Biomedical Engineering, Trinity College, The University of Dublin, Dublin 2, Dublin, Ireland
| | - Muthuraman Muthuraman
- Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Johannes-Gutenberg- University Hospital, D55131, Mainz, Germany
| | - Niall Pender
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland.,Beaumont Hospital Dublin, Department of Psychology, Dublin 9, Dublin, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland.,Department of Neurology, Beaumont Hospital Dublin, Dublin 9, Dublin, Ireland
| | - Bahman Nasseroleslami
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Dublin, D02 R590, Ireland
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15
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Naing P, Playford D, Strange G, Abeyaratne A, Scalia G, Forrester D, Hall M, Costello E, Joseph S, Lee P, Falhammar H, Kangaharan N. 036 Top End Pulmonary Hypertension Study. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Costello E, Lonergan K, Madden C, O'Sullivan M, Mays I, Heverin M, Pinto-Grau M, Hardiman O, Pender N. Equivalency and practice effects of alternative versions of the Edinburgh Cognitive and Behavioral ALS Screen (ECAS). Amyotroph Lateral Scler Frontotemporal Degener 2019; 21:86-91. [PMID: 31833401 DOI: 10.1080/21678421.2019.1701681] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
To examine the equivalency of ECAS versions A, B, and C in an Irish cohort, and to examine potential practice effects, 236 healthy controls were recruited through the Irish ALS control database. One hundred and seventy-six (176) controls completed ECAS version A, B, or C. Separately, 60 controls completed all three versions (A-B-C), consecutively, four months apart. TOST analysis found that ECAS A was equivalent to ECAS B and C. ECAS B and C were not statistically equivalent, however the difference between them was minimal. Participants showed improvement in ECAS performance over time, indicative of practice effects. Significant improvement was observed from time 1 to 2, but not from time 2 to 3. We propose Irish specific reliable change index (RCI) scores that take into consideration practice effects and measurement error. These thresholds will help quantify clinically meaningful cognitive decline in ALS patients, leading to improved quality of care.
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Affiliation(s)
- Emmet Costello
- Academic Unit of Neurology, Trinity Biomedical Sciences Institutes, Trinity College Dublin, Dublin, Ireland and.,Department of Psychology, Beaumont Hospital Dublin, Dublin, Ireland
| | - Katie Lonergan
- Academic Unit of Neurology, Trinity Biomedical Sciences Institutes, Trinity College Dublin, Dublin, Ireland and.,Department of Psychology, Beaumont Hospital Dublin, Dublin, Ireland
| | - Caoifa Madden
- Academic Unit of Neurology, Trinity Biomedical Sciences Institutes, Trinity College Dublin, Dublin, Ireland and
| | - Meadhbh O'Sullivan
- Academic Unit of Neurology, Trinity Biomedical Sciences Institutes, Trinity College Dublin, Dublin, Ireland and
| | - Iain Mays
- Academic Unit of Neurology, Trinity Biomedical Sciences Institutes, Trinity College Dublin, Dublin, Ireland and
| | - Mark Heverin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institutes, Trinity College Dublin, Dublin, Ireland and
| | - Marta Pinto-Grau
- Academic Unit of Neurology, Trinity Biomedical Sciences Institutes, Trinity College Dublin, Dublin, Ireland and.,Department of Psychology, Beaumont Hospital Dublin, Dublin, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institutes, Trinity College Dublin, Dublin, Ireland and
| | - Niall Pender
- Academic Unit of Neurology, Trinity Biomedical Sciences Institutes, Trinity College Dublin, Dublin, Ireland and.,Department of Psychology, Beaumont Hospital Dublin, Dublin, Ireland
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17
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Dukic S, McMackin R, Buxo T, Fasano A, Chipika R, Pinto-Grau M, Costello E, Schuster C, Hammond M, Heverin M, Coffey A, Broderick M, Iyer PM, Mohr K, Gavin B, Pender N, Bede P, Muthuraman M, Lalor EC, Hardiman O, Nasseroleslami B. Patterned functional network disruption in amyotrophic lateral sclerosis. Hum Brain Mapp 2019; 40:4827-4842. [PMID: 31348605 PMCID: PMC6852475 DOI: 10.1002/hbm.24740] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [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: 03/26/2019] [Revised: 07/01/2019] [Accepted: 07/17/2019] [Indexed: 12/11/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease primarily affecting motor function, with additional evidence of extensive nonmotor involvement. Despite increasing recognition of the disease as a multisystem network disorder characterised by impaired connectivity, the precise neuroelectric characteristics of impaired cortical communication remain to be fully elucidated. Here, we characterise changes in functional connectivity using beamformer source analysis on resting‐state electroencephalography recordings from 74 ALS patients and 47 age‐matched healthy controls. Spatiospectral characteristics of network changes in the ALS patient group were quantified by spectral power, amplitude envelope correlation (co‐modulation) and imaginary coherence (synchrony). We show patterns of decreased spectral power in the occipital and temporal (δ‐ to β‐band), lateral/orbitofrontal (δ‐ to θ‐band) and sensorimotor (β‐band) regions of the brain in patients with ALS. Furthermore, we show increased co‐modulation of neural oscillations in the central and posterior (δ‐, θ‐ and γl‐band) and frontal (δ‐ and γl‐band) regions, as well as decreased synchrony in the temporal and frontal (δ‐ to β‐band) and sensorimotor (β‐band) regions. Factorisation of these complex connectivity patterns reveals a distinct disruption of both motor and nonmotor networks. The observed changes in connectivity correlated with structural MRI changes, functional motor scores and cognitive scores. Characteristic patterned changes of cortical function in ALS signify widespread disease‐associated network disruption, pointing to extensive dysfunction of both motor and cognitive networks. These statistically robust findings, that correlate with clinical scores, provide a strong rationale for further development as biomarkers of network disruption for future clinical trials.
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Affiliation(s)
- Stefan Dukic
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland.,Department of Neurology, University Medical Centre Utrecht Brain Centre, Utrecht University, Utrecht, The Netherlands
| | - Roisin McMackin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Teresa Buxo
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Antonio Fasano
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Rangariroyashe Chipika
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Marta Pinto-Grau
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Emmet Costello
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Christina Schuster
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Michaela Hammond
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Amina Coffey
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Michael Broderick
- Trinity Centre for Bioengineering, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Parameswaran M Iyer
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Kieran Mohr
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Brighid Gavin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Niall Pender
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Muthuraman Muthuraman
- Movement disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Johannes-Gutenberg-University Hospital, Mainz, Germany
| | - Edmund C Lalor
- Trinity Centre for Bioengineering, Trinity College Dublin, University of Dublin, Dublin, Ireland.,Trinity College Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland.,Department of Biomedical Engineering and Department of Neuroscience, University of Rochester, Rochester, New York
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland.,Trinity College Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland.,Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Bahman Nasseroleslami
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, University of Dublin, Dublin, Ireland
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18
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Sheel ARG, Harrison S, Sarantitis I, Nicholson JA, Hanna T, Grocock C, Raraty M, Ramesh J, Farooq A, Costello E, Jackson R, Chapman M, Smith A, Carter R, Mckay C, Hamady Z, Aithal GP, Mountford R, Ghaneh P, Hammel P, Lerch MM, Halloran C, Pereira SP, Greenhalf W. Identification of Cystic Lesions by Secondary Screening of Familial Pancreatic Cancer (FPC) Kindreds Is Not Associated with the Stratified Risk of Cancer. Am J Gastroenterol 2019; 114:155-164. [PMID: 30353057 DOI: 10.1038/s41395-018-0395-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Intraductal papillary mucinous neoplasms (IPMNs) are associated with risk of pancreatic ductal adenocarcinoma (PDAC). It is unclear if an IPMN in individuals at high risk of PDAC should be considered as a positive screening result or as an incidental finding. Stratified familial pancreatic cancer (FPC) populations were used to determine if IPMN risk is linked to familial risk of PDAC. METHODS This is a cohort study of 321 individuals from 258 kindreds suspected of being FPC and undergoing secondary screening for PDAC through the European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer (EUROPAC). Computerised tomography, endoscopic ultrasound of the pancreas and magnetic resonance imaging were used. The risk of being a carrier of a dominant mutation predisposing to pancreatic cancer was stratified into three even categories (low, medium and high) based on: Mendelian probability, the number of PDAC cases and the number of people at risk in a kindred. RESULTS There was a median (interquartile range (IQR)) follow-up of 2 (0-5) years and a median (IQR) number of investigations per participant of 4 (2-6). One PDAC, two low-grade neuroendocrine tumours and 41 cystic lesions were identified, including 23 IPMN (22 branch-duct (BD)). The PDAC case occurred in the top 10% of risk, and the BD-IPMN cases were evenly distributed amongst risk categories: low (6/107), medium (10/107) and high (6/107) (P = 0.63). CONCLUSIONS The risk of finding BD-IPMN was independent of genetic predisposition and so they should be managed according to guidelines for incidental finding of IPMN.
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Affiliation(s)
- A R G Sheel
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GA, UK
| | - S Harrison
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GA, UK
| | - I Sarantitis
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GA, UK
| | - J A Nicholson
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GA, UK
| | - T Hanna
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GA, UK
| | - C Grocock
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GA, UK
| | - M Raraty
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GA, UK
| | - J Ramesh
- Department of Gastroenterology, The Royal Liverpool University Hospital, London, UK
| | - A Farooq
- Department of Radiology, The Royal Liverpool University Hospital, London, UK
| | - E Costello
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GA, UK
| | - R Jackson
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GA, UK
| | - M Chapman
- Institute for Liver & Digestive Health, University College London, London, UK
| | - A Smith
- Department of Pancreatico-Biliary Surgery, Leeds Teaching Hospital Trust, Leeds, UK
| | - R Carter
- West of Scotland Pancreatic unit, Glasgow Royal Infirmary, Glasgow, UK
| | - C Mckay
- West of Scotland Pancreatic unit, Glasgow Royal Infirmary, Glasgow, UK
| | - Z Hamady
- Department of Hepatobiliary and Pancreatic Diseases, University Hospital Southampton, Southampton, UK
| | - G P Aithal
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, NG7 2UH, UK
| | - R Mountford
- Mersey Regional Molecular Genetics Laboratory, Liverpool Women's Hospital, Liverpool, UK
| | - P Ghaneh
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GA, UK
| | - P Hammel
- Service de Gastroentérologie-Pancréatologie, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon, 92118, Clichy Cedex, France
| | - M M Lerch
- Department of Medicine A, University Medicine Greifswald, Sauerbruch-Strasse, 17475, Greifswald, Germany
| | - C Halloran
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GA, UK
| | - S P Pereira
- Institute for Liver & Digestive Health, University College London, London, UK
| | - W Greenhalf
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3GA, UK
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19
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Elander NO, Aughton K, Ghaneh P, Neoptolemos JP, Palmer DH, Cox TF, Campbell F, Costello E, Halloran CM, Mackey JR, Scarfe AG, Valle JW, McDonald AC, Carter R, Tebbutt NC, Goldstein D, Shannon J, Dervenis C, Glimelius B, Deakin M, Charnley RM, Anthoney A, Lerch MM, Mayerle J, Oláh A, Büchler MW, Greenhalf W. Intratumoural expression of deoxycytidylate deaminase or ribonuceotide reductase subunit M1 expression are not related to survival in patients with resected pancreatic cancer given adjuvant chemotherapy. Br J Cancer 2018; 118:1084-1088. [PMID: 29523831 PMCID: PMC5931097 DOI: 10.1038/s41416-018-0005-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/04/2018] [Accepted: 01/04/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Deoxycytidylate deaminase (DCTD) and ribonucleotide reductase subunit M1 (RRM1) are potential prognostic and predictive biomarkers for pyrimidine-based chemotherapy in pancreatic adenocarcinoma. METHODS Immunohistochemical staining of DCTD and RRM1 was performed on tissue microarrays representing tumour samples from 303 patients in European Study Group for Pancreatic Cancer (ESPAC)-randomised adjuvant trials following pancreatic resection, 272 of whom had received gemcitabine or 5-fluorouracil with folinic acid in ESPAC-3(v2), and 31 patients from the combined ESPAC-3(v1) and ESPAC-1 post-operative pure observational groups. RESULTS Neither log-rank testing on dichotomised strata or Cox proportional hazard regression showed any relationship of DCTD or RRM1 expression levels to survival overall or by treatment group. CONCLUSIONS Expression of either DCTD or RRM1 was not prognostic or predictive in patients with pancreatic adenocarcinoma who had had post-operative chemotherapy with either gemcitabine or 5-fluorouracil with folinic acid.
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Affiliation(s)
- N O Elander
- Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - K Aughton
- Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - P Ghaneh
- Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - J P Neoptolemos
- Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - D H Palmer
- Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - T F Cox
- Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - F Campbell
- Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - E Costello
- Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - C M Halloran
- Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - J R Mackey
- Cross Cancer Institute and University of Alberta, Edmonton, Canada
| | - A G Scarfe
- Cross Cancer Institute and University of Alberta, Edmonton, Canada
| | - J W Valle
- University of Manchester/The Christie NHS Foundation Trust, Manchester, UK
| | - A C McDonald
- The Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - R Carter
- Glasgow Royal Infirmary, Glasgow, UK
| | | | - D Goldstein
- Prince of Wales hospital and Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - J Shannon
- Nepean Cancer Centre and University of Sydney, Camperdown, NSW, Australia
| | | | - B Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - M Deakin
- University Hospital, North Staffordshire, Staffordshire, UK
| | | | - A Anthoney
- St James's University Hospital, Leeds, UK
| | - M M Lerch
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - J Mayerle
- Department of Medicine II, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - A Oláh
- The Petz Aladar Hospital, Gyor, Hungary
| | - M W Büchler
- Department of Surgery, University of Heidelberg, Heidelberg, Germany
| | - W Greenhalf
- Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK.
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20
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Molina-Montes E, Gomez-Rubio P, Márquez M, Rava M, Löhr M, Michalski CW, Molero X, Farré A, Perea J, Greenhalf W, Ilzarbe L, O'Rorke M, Tardón A, Gress T, Barberà VM, Crnogorac-Jurcevic T, Domínguez-Muñoz E, Muñoz-Bellvís L, Balsells J, Costello E, Huang J, Iglesias M, Kleeff J, Kong B, Mora J, Murray L, O'Driscoll D, Poves I, Scarpa A, Ye W, Hidalgo M, Sharp L, Carrato A, Real FX, Malats N. Risk of pancreatic cancer associated with family history of cancer and other medical conditions by accounting for smoking among relatives. Int J Epidemiol 2018; 47:473-483. [PMID: 29329392 DOI: 10.1093/ije/dyx269] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2018] [Indexed: 12/16/2022] Open
Abstract
Background Family history (FH) of pancreatic cancer (PC) has been associated with an increased risk of PC, but little is known regarding the role of inherited/environmental factors or that of FH of other comorbidities in PC risk. We aimed to address these issues using multiple methodological approaches. Methods Case-control study including 1431 PC cases and 1090 controls and a reconstructed-cohort study (N = 16 747) made up of their first-degree relatives (FDR). Logistic regression was used to evaluate PC risk associated with FH of cancer, diabetes, allergies, asthma, cystic fibrosis and chronic pancreatitis by relative type and number of affected relatives, by smoking status and other potential effect modifiers, and by tumour stage and location. Familial aggregation of cancer was assessed within the cohort using Cox proportional hazard regression. Results FH of PC was associated with an increased PC risk [odds ratio (OR) = 2.68; 95% confidence interval (CI): 2.27-4.06] when compared with cancer-free FH, the risk being greater when ≥ 2 FDRs suffered PC (OR = 3.88; 95% CI: 2.96-9.73) and among current smokers (OR = 3.16; 95% CI: 2.56-5.78, interaction FHPC*smoking P-value = 0.04). PC cumulative risk by age 75 was 2.2% among FDRs of cases and 0.7% in those of controls [hazard ratio (HR) = 2.42; 95% CI: 2.16-2.71]. PC risk was significantly associated with FH of cancer (OR = 1.30; 95% CI: 1.13-1.54) and diabetes (OR = 1.24; 95% CI: 1.01-1.52), but not with FH of other diseases. Conclusions The concordant findings using both approaches strengthen the notion that FH of cancer, PC or diabetes confers a higher PC risk. Smoking notably increases PC risk associated with FH of PC. Further evaluation of these associations should be undertaken to guide PC prevention strategies.
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Affiliation(s)
- E Molina-Montes
- Spanish National Cancer Research Center (CNIO), Genetic and Molecular Epidemiology Group, Madrid, and CIBERONC, Spain
| | - P Gomez-Rubio
- Spanish National Cancer Research Center (CNIO), Genetic and Molecular Epidemiology Group, Madrid, and CIBERONC, Spain
| | - M Márquez
- Spanish National Cancer Research Center (CNIO), Genetic and Molecular Epidemiology Group, Madrid, and CIBERONC, Spain
| | - M Rava
- Spanish National Cancer Research Center (CNIO), Genetic and Molecular Epidemiology Group, Madrid, and CIBERONC, Spain
| | - M Löhr
- Karolinska Institutet and University Hospital, Gastrocentrum, Stockholm, Sweden
| | - C W Michalski
- Technical University of Munich, Department of Surgery, Munich, Germany
- University of Heidelberg, Department of Surgery, Heidelberg, Germany
| | - X Molero
- Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, and CIBEREHD, Spain
| | - A Farré
- Hospital de la Santa Creu i Sant Pau, Department of Gastroenterology, Barcelona, Spain
| | - J Perea
- University Hospital 12 de Octubre, Department of Surgery, Madrid, Spain
| | - W Greenhalf
- Royal Liverpool University Hospital, Department of Molecular and Clinical Cancer Medicine, Liverpool, UK
| | - L Ilzarbe
- Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - M O'Rorke
- Queen's University Belfast, Centre for Public Health, Belfast, UK
| | - A Tardón
- Instituto Universitario de Oncología del Principado de Asturias, Department of Medicine, Oviedo, and CIBERESP, Spain
| | - T Gress
- University Hospital of Giessen and Marburg, Department of Gastroenterology, Marburg, Germany
| | - V M Barberà
- General University Hospital of Elche, Molecular Genetics Laboratory, Elche, Spain
| | - T Crnogorac-Jurcevic
- Barts Cancer Institute, Centre for Molecular Oncology, Queen Mary University of London, London, UK
| | - E Domínguez-Muñoz
- University Clinical Hospital of Santiago de Compostela, Department of Gastroenterology, Santiago de Compostela, Spain
| | - L Muñoz-Bellvís
- Salamanca University Hospital, General and Digestive Surgery Department, Salamanca, Spain
| | - J Balsells
- Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, and CIBEREHD, Spain
| | - E Costello
- Royal Liverpool University Hospital, Department of Molecular and Clinical Cancer Medicine, Liverpool, UK
| | - J Huang
- Karolinska Institutet and University Hospital, Gastrocentrum, Stockholm, Sweden
| | - M Iglesias
- Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - J Kleeff
- Technical University of Munich, Department of Surgery, Munich, Germany
- Martin-Luther-University Halle-Wittenberg, Department of Visceral, Vascular and Endocrine Surgery, Halle (Saale), Germany
| | - Bo Kong
- Technical University of Munich, Department of Surgery, Munich, Germany
| | - J Mora
- Hospital de la Santa Creu i Sant Pau, Department of Gastroenterology, Barcelona, Spain
| | - L Murray
- Queen's University Belfast, Centre for Public Health, Belfast, UK
| | - D O'Driscoll
- National Cancer Registry Ireland and HRB Clinical Research Facility, University College Cork, Cork, Ireland
| | - I Poves
- Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - A Scarpa
- ARC-Net Centre for Applied Research on Cancer and Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - W Ye
- Karolinska Institutet and University Hospital, Gastrocentrum, Stockholm, Sweden
| | - M Hidalgo
- Madrid-Norte-Sanchinarro Hospital, Madrid, Spain
| | - L Sharp
- National Cancer Registry Ireland and HRB Clinical Research Facility, University College Cork, Cork, Ireland
- Newcastle University, Institute of Health and Society, Newcastle upon Tyne, UK
| | - A Carrato
- Ramón y Cajal University Hospital, Department of Oncology, IRYCIS, Alcala University, Madrid, and CIBERONC, Spain
| | - F X Real
- Spanish National Cancer Research Centre (CNIO), Epithelial Carcinogenesis Group, Madrid, Universitat Pompeu Fabra, Departament de Ciències Experimentals i de la Salut, Barcelona, and CIBERONC, Spain
| | - N Malats
- Spanish National Cancer Research Center (CNIO), Genetic and Molecular Epidemiology Group, Madrid, and CIBERONC, Spain
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Elander NO, Aughton K, Ghaneh P, Neoptolemos JP, Palmer DH, Cox TF, Campbell F, Costello E, Halloran CM, Mackey JR, Scarfe AG, Valle JW, McDonald AC, Carter R, Tebbutt NC, Goldstein D, Shannon J, Dervenis C, Glimelius B, Deakin M, Charnley RM, Anthoney A, Lerch MM, Mayerle J, Oláh A, Büchler MW, Greenhalf W. Expression of dihydropyrimidine dehydrogenase (DPD) and hENT1 predicts survival in pancreatic cancer. Br J Cancer 2018; 118:947-954. [PMID: 29515256 PMCID: PMC5931115 DOI: 10.1038/s41416-018-0004-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 12/21/2017] [Accepted: 01/04/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Dihydropyrimidine dehydrogenase (DPD) tumour expression may provide added value to human equilibrative nucleoside transporter-1 (hENT1) tumour expression in predicting survival following pyrimidine-based adjuvant chemotherapy. METHODS DPD and hENT1 immunohistochemistry and scoring was completed on tumour cores from 238 patients with pancreatic cancer in the ESPAC-3(v2) trial, randomised to either postoperative gemcitabine or 5-fluorouracil/folinic acid (5FU/FA). RESULTS DPD tumour expression was associated with reduced overall survival (hazard ratio, HR = 1.73 [95% confidence interval, CI = 1.21-2.49], p = 0.003). This was significant in the 5FU/FA arm (HR = 2.07 [95% CI = 1.22-3.53], p = 0.007), but not in the gemcitabine arm (HR = 1.47 [0.91-3.37], p = 0.119). High hENT1 tumour expression was associated with increased survival in gemcitabine treated (HR = 0.56 [0.38-0.82], p = 0.003) but not in 5FU/FA treated patients (HR = 1.19 [0.80-1.78], p = 0.390). In patients with low hENT1 tumour expression, high DPD tumour expression was associated with a worse median [95% CI] survival in the 5FU/FA arm (9.7 [5.3-30.4] vs 29.2 [19.5-41.9] months, p = 0.002) but not in the gemcitabine arm (14.0 [9.1-15.7] vs. 18.0 [7.6-15.3] months, p = 1.000). The interaction of treatment arm and DPD expression was not significant (p = 0.303), but the interaction of treatment arm and hENT1 expression was (p = 0.009). CONCLUSION DPD tumour expression was a negative prognostic biomarker. Together with tumour expression of hENT1, DPD tumour expression defined patient subgroups that might benefit from either postoperative 5FU/FA or gemcitabine.
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Affiliation(s)
- N O Elander
- From the Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - K Aughton
- From the Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - P Ghaneh
- From the Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - J P Neoptolemos
- The Department of Surgery, University of Heidelberg, Heidelberg, Germany
| | - D H Palmer
- From the Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - T F Cox
- From the Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - F Campbell
- From the Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - E Costello
- From the Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - C M Halloran
- From the Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK
| | - J R Mackey
- Cross Cancer Institute and University of Alberta, Alberta, Canada
| | - A G Scarfe
- Cross Cancer Institute and University of Alberta, Alberta, Canada
| | - J W Valle
- University of Manchester/The Christie NHS Foundation Trust, Manchester, UK
| | - A C McDonald
- The Beatson West of Scotland Cancer Centre, Glasgow, Scotland, UK
| | - R Carter
- Glasgow Royal Infirmary, Glasgow, Scotland, UK
| | | | - D Goldstein
- Prince of Wales hospital and Clinical School University of New South Wales, New South Wales, Australia
| | - J Shannon
- Nepean Cancer Centre and University of Sydney, Sydney, Australia
| | | | - B Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - M Deakin
- University Hospital, North Staffordshire, UK
| | | | | | - M M Lerch
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - J Mayerle
- Department of Medicine II, University Hospital of the Ludwig-Maximilians-University, Munich, Germany
| | - A Oláh
- The Petz Aladar Hospital, Gyor, Hungary
| | - M W Büchler
- The Department of Surgery, University of Heidelberg, Heidelberg, Germany
| | - W Greenhalf
- From the Cancer Research U.K. Liverpool Cancer Trials Unit, University of Liverpool, Liverpool, UK.
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22
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Crockford C, Newton J, Lonergan K, Madden C, Mays I, O'Sullivan M, Costello E, Pinto-Grau M, Vajda A, Heverin M, Pender N, Al-Chalabi A, Hardiman O, Abrahams S. Measuring reliable change in cognition using the Edinburgh Cognitive and Behavioural ALS Screen (ECAS). Amyotroph Lateral Scler Frontotemporal Degener 2017; 19:65-73. [PMID: 29214872 PMCID: PMC6510059 DOI: 10.1080/21678421.2017.1407794] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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] [Indexed: 12/11/2022]
Abstract
Background: Cognitive impairment affects approximately 50% of people with amyotrophic lateral sclerosis (ALS). Research has indicated that impairment may worsen with disease progression. The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) was designed to measure neuropsychological functioning in ALS, with its alternate forms (ECAS-A, B, and C) allowing for serial assessment over time. Objective: The aim of the present study was to establish reliable change scores for the alternate forms of the ECAS, and to explore practice effects and test-retest reliability of the ECAS’s alternate forms. Method: Eighty healthy participants were recruited, with 57 completing two and 51 completing three assessments. Participants were administered alternate versions of the ECAS serially (A-B-C) at four-month intervals. Intra-class correlation analysis was employed to explore test-retest reliability, while analysis of variance was used to examine the presence of practice effects. Reliable change indices (RCI) and regression-based methods were utilized to establish change scores for the ECAS alternate forms. Results: Test-retest reliability was excellent for ALS Specific, ALS Non-Specific, and ECAS Total scores of the combined ECAS A, B, and C (all > .90). No significant practice effects were observed over the three testing sessions. RCI and regression-based methods produced similar change scores. Conclusion: The alternate forms of the ECAS possess excellent test-retest reliability in a healthy control sample, with no significant practice effects. The use of conservative RCI scores is recommended. Therefore, a change of ≥8, ≥4, and ≥9 for ALS Specific, ALS Non-Specific, and ECAS Total score is required for reliable change.
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Affiliation(s)
- Christopher Crockford
- a Department of Psychology, Human Cognitive Neuroscience , University of Edinburgh , Edinburgh , UK.,b Euan MacDonald Centre for Motor Neurone Disease Research , Royal Infirmary of Edinburgh , Edinburgh , UK
| | - Judith Newton
- a Department of Psychology, Human Cognitive Neuroscience , University of Edinburgh , Edinburgh , UK.,c Anne Rowling Regenerative Neurology Clinic , Royal Infirmary of Edinburgh , Edinburgh , UK
| | - Katie Lonergan
- d Academic Unit of Neurology , Trinity College Dublin , Dublin , Ireland.,e Department of Psychology , Beaumont Hospital , Dublin , Ireland
| | - Caoifa Madden
- d Academic Unit of Neurology , Trinity College Dublin , Dublin , Ireland.,e Department of Psychology , Beaumont Hospital , Dublin , Ireland
| | - Iain Mays
- d Academic Unit of Neurology , Trinity College Dublin , Dublin , Ireland.,e Department of Psychology , Beaumont Hospital , Dublin , Ireland
| | - Meabhdh O'Sullivan
- d Academic Unit of Neurology , Trinity College Dublin , Dublin , Ireland
| | - Emmet Costello
- d Academic Unit of Neurology , Trinity College Dublin , Dublin , Ireland.,e Department of Psychology , Beaumont Hospital , Dublin , Ireland
| | - Marta Pinto-Grau
- d Academic Unit of Neurology , Trinity College Dublin , Dublin , Ireland.,e Department of Psychology , Beaumont Hospital , Dublin , Ireland
| | - Alice Vajda
- d Academic Unit of Neurology , Trinity College Dublin , Dublin , Ireland
| | - Mark Heverin
- d Academic Unit of Neurology , Trinity College Dublin , Dublin , Ireland
| | - Niall Pender
- e Department of Psychology , Beaumont Hospital , Dublin , Ireland
| | - Ammar Al-Chalabi
- f Department of Basic and Clinical Neuroscience , Maurice Wohl Clinical Neuroscience Institute, King's College London , London , UK , and
| | - Orla Hardiman
- d Academic Unit of Neurology , Trinity College Dublin , Dublin , Ireland.,g Department of Neurology , Beaumont Hospital , Dublin , Ireland
| | - Sharon Abrahams
- a Department of Psychology, Human Cognitive Neuroscience , University of Edinburgh , Edinburgh , UK.,b Euan MacDonald Centre for Motor Neurone Disease Research , Royal Infirmary of Edinburgh , Edinburgh , UK.,c Anne Rowling Regenerative Neurology Clinic , Royal Infirmary of Edinburgh , Edinburgh , UK
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23
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Gomez-Rubio P, Rosato V, Márquez M, Bosetti C, Molina-Montes E, Rava M, Piñero J, Michalski CW, Farré A, Molero X, Löhr M, Ilzarbe L, Perea J, Greenhalf W, O'Rorke M, Tardón A, Gress T, Barberá VM, Crnogorac-Jurcevic T, Muñoz-Bellvís L, Domínguez-Muñoz E, Gutiérrez-Sacristán A, Balsells J, Costello E, Guillén-Ponce C, Huang J, Iglesias M, Kleeff J, Kong B, Mora J, Murray L, O'Driscoll D, Peláez P, Poves I, Lawlor RT, Carrato A, Hidalgo M, Scarpa A, Sharp L, Furlong LI, Real FX, La Vecchia C, Malats N. A systems approach identifies time-dependent associations of multimorbidities with pancreatic cancer risk. Ann Oncol 2017; 28:1618-1624. [PMID: 28383714 DOI: 10.1093/annonc/mdx167] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma (PDAC) is usually diagnosed in late adulthood; therefore, many patients suffer or have suffered from other diseases. Identifying disease patterns associated with PDAC risk may enable a better characterization of high-risk patients. METHODS Multimorbidity patterns (MPs) were assessed from 17 self-reported conditions using hierarchical clustering, principal component, and factor analyses in 1705 PDAC cases and 1084 controls from a European population. Their association with PDAC was evaluated using adjusted logistic regression models. Time since diagnosis of morbidities to PDAC diagnosis/recruitment was stratified into recent (<3 years) and long term (≥3 years). The MPs and PDAC genetic networks were explored with DisGeNET bioinformatics-tool which focuses on gene-diseases associations available in curated databases. RESULTS Three MPs were observed: gastric (heartburn, acid regurgitation, Helicobacter pylori infection, and ulcer), metabolic syndrome (obesity, type-2 diabetes, hypercholesterolemia, and hypertension), and atopic (nasal allergies, skin allergies, and asthma). Strong associations with PDAC were observed for ≥2 recently diagnosed gastric conditions [odds ratio (OR), 6.13; 95% confidence interval CI 3.01-12.5)] and for ≥3 recently diagnosed metabolic syndrome conditions (OR, 1.61; 95% CI 1.11-2.35). Atopic conditions were negatively associated with PDAC (high adherence score OR for tertile III, 0.45; 95% CI, 0.36-0.55). Combining type-2 diabetes with gastric MP resulted in higher PDAC risk for recent (OR, 7.89; 95% CI 3.9-16.1) and long-term diagnosed conditions (OR, 1.86; 95% CI 1.29-2.67). A common genetic basis between MPs and PDAC was observed in the bioinformatics analysis. CONCLUSIONS Specific multimorbidities aggregate and associate with PDAC in a time-dependent manner. A better characterization of a high-risk population for PDAC may help in the early diagnosis of this cancer. The common genetic basis between MP and PDAC points to a mechanistic link between these conditions.
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Affiliation(s)
- P Gomez-Rubio
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, and CIBERONC, Spain
| | - V Rosato
- Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro," Department of Clinical Sciences and Community Health, University of Milan, Milan
- Unit of Medical Statistics, Biometry and Bioinformatics, National Cancer Institute, IRCCS Foundation, Milan
| | - M Márquez
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, and CIBERONC, Spain
| | - C Bosetti
- Department of Epidemiology, Mario Negri Institute for Pharmacological Research-IRCCS, Milan, Italy
| | - E Molina-Montes
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, and CIBERONC, Spain
| | - M Rava
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, and CIBERONC, Spain
| | - J Piñero
- Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute (IMIM), Pompeu Fabra Univeristy (UPF), Barcelona, Spain
| | - C W Michalski
- Department of Surgery, Technical University of Munich, Munich
- Department of Surgery, University of Heidelberg, Heidelberg, Germany
| | - A Farré
- Department of Gastroenterology, Santa Creu i Sant Pau Hospital, Barcelona
| | - X Molero
- Exocrine Pancreas Research Unit and Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Barcelona
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona
- Network of Biomedical Research Centres (CIBER), Hepatic and Digestive Diseases and Epidemiology and Public Health, Madrid, Spain
| | - M Löhr
- Gastrocentrum, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - L Ilzarbe
- Department of Gastroenterology, Parc de Salut Mar University Hospital, Barcelona
| | - J Perea
- Department of Surgery, 12 de Octubre University Hospital, Madrid, Spain
| | - W Greenhalf
- Department of Molecular and Clinical Cancer Medicine, The Royal Liverpool University Hospital, Liverpool
| | - M O'Rorke
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - A Tardón
- Network of Biomedical Research Centres (CIBER), Hepatic and Digestive Diseases and Epidemiology and Public Health, Madrid, Spain
- Department of Medicine, University Institute of Oncology of Asturias, Oviedo, Spain
| | - T Gress
- Department of Gastroenterology, University Hospital of Giessen and Marburg, Marburg, Germany
| | - V M Barberá
- Molecular Genetics Laboratory, General University Hospital of Elche, Elche, Spain
| | - T Crnogorac-Jurcevic
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, London, UK
| | - L Muñoz-Bellvís
- General and Digestive Surgery Department, Salamanca University Hospital, Salamanca
| | - E Domínguez-Muñoz
- Department of Gastroenterology, Clinical University Hospital of Santiago de Compostela, Santiago de Compostela
| | - A Gutiérrez-Sacristán
- Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute (IMIM), Pompeu Fabra Univeristy (UPF), Barcelona, Spain
| | - J Balsells
- Exocrine Pancreas Research Unit and Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Barcelona
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona
- Network of Biomedical Research Centres (CIBER), Hepatic and Digestive Diseases and Epidemiology and Public Health, Madrid, Spain
| | - E Costello
- Department of Molecular and Clinical Cancer Medicine, The Royal Liverpool University Hospital, Liverpool
| | - C Guillén-Ponce
- Department of Oncology, Ramón y Cajal Hospital, Madrid, and CIBERONC, Spain
| | - J Huang
- Gastrocentrum, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - M Iglesias
- Department of Gastroenterology, Parc de Salut Mar University Hospital, Barcelona
| | - J Kleeff
- Department of Surgery, Technical University of Munich, Munich
- Department of Molecular and Clinical Cancer Medicine, The Royal Liverpool University Hospital, Liverpool
| | - B Kong
- Department of Surgery, Technical University of Munich, Munich
| | - J Mora
- Department of Gastroenterology, Santa Creu i Sant Pau Hospital, Barcelona
| | - L Murray
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - D O'Driscoll
- Research Programme, National Cancer Registry Ireland
| | - P Peláez
- Department of Surgery, 12 de Octubre University Hospital, Madrid, Spain
| | - I Poves
- Department of Gastroenterology, Parc de Salut Mar University Hospital, Barcelona
| | - R T Lawlor
- ARC-Net Centre for Applied Research on Cancer and Department of Pathology and Diagnostics, University and Hospital trust of Verona, Verona, Italy
| | - A Carrato
- Department of Oncology, Ramón y Cajal Hospital, Madrid, and CIBERONC, Spain
| | - M Hidalgo
- Clara Campal Integrated Oncological Centre, Sanchinarro Hospital, Madrid, Spain
| | - A Scarpa
- ARC-Net Centre for Applied Research on Cancer and Department of Pathology and Diagnostics, University and Hospital trust of Verona, Verona, Italy
| | - L Sharp
- Research Programme, National Cancer Registry Ireland
- Institute of Health & Society, Newcastle University, UK
| | - L I Furlong
- Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute (IMIM), Pompeu Fabra Univeristy (UPF), Barcelona, Spain
| | - F X Real
- Epithelial Carcinogenesis Group, Spanish National Cancer Research Centre (CNIO), Madrid, and CIBERONC
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - C La Vecchia
- Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro," Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - N Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, and CIBERONC, Spain
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24
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Pinto-Grau M, Costello E, O’Connor S, Elamin M, Burke T, Heverin M, Pender N, Hardiman O. Assessing behavioural changes in ALS: cross-validation of ALS-specific measures. J Neurol 2017; 264:1397-1401. [DOI: 10.1007/s00415-017-8536-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 05/29/2017] [Accepted: 05/30/2017] [Indexed: 11/28/2022]
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25
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Burke T, Pinto-Grau M, Lonergan K, Elamin M, Bede P, Costello E, Hardiman O, Pender N. Measurement of Social Cognition in Amyotrophic Lateral Sclerosis: A Population Based Study. PLoS One 2016; 11:e0160850. [PMID: 27556398 PMCID: PMC4996502 DOI: 10.1371/journal.pone.0160850] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [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: 04/01/2016] [Accepted: 07/26/2016] [Indexed: 01/12/2023] Open
Abstract
Background: Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease. Executive dysfunction is common in patients with ALS, with up to 50% of patients performing within an impaired range. There is evidence that social cognitive deficits associated with ALS are a function of deficits in executive function. The ‘Reading the Mind in the Eyes’ Test is a recognized test of social cognitive function, although the reliability of this instrument remains to be established. Methodology: Patients with ALS (n = 106), and age and IQ matched controls (n = 50) were recruited and asked to perform the Reading the Mind in the Eyes Test as part of an on-going population-based study of cognitive function. ALS patients were sub-stratified based on the presence, and/or extent of executive dysfunction. Results: Cronbach’s Alpha of .73 was observed, indicating good reliability on this measure. Split-half reliability analysis further confirms these findings (p = 0.826). The Reading the Mind in the Eyes test had excellent psychometric properties when discriminating between ALS patients who are cognitively intact, and those who have executive impairment, with an overall medium difficulty. There was a large magnitude significant difference between patients and controls (p< 0.001; η2 = .19). Post-hoc analysis revealed that controls performed significantly higher than patients with executive impairment (p< 0.001), and patients with single executive deficits (p = 0.002). Conclusion: Executive dysfunction impacts on social cognitive performance. This study contributes not only to the psychometric knowledge of this measure, but also to the usability, efficacy, and reliability of social cognitive assessment in ALS. Using population-specific normative data, we confirm the Reading the Mind in the Eyes Test is a reliable measure of social cognitive processes in ALS.
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Affiliation(s)
- Tom Burke
- Department of Psychology, Beaumont Hospital, Dublin, 9, Ireland
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin, 2, Ireland
- * E-mail:
| | - Marta Pinto-Grau
- Department of Psychology, Beaumont Hospital, Dublin, 9, Ireland
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin, 2, Ireland
| | - Katie Lonergan
- Department of Psychology, Beaumont Hospital, Dublin, 9, Ireland
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin, 2, Ireland
| | - Marwa Elamin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin, 2, Ireland
| | - Peter Bede
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin, 2, Ireland
| | - Emmet Costello
- Department of Psychology, Beaumont Hospital, Dublin, 9, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin, 2, Ireland
- Department of Neurology, Beaumont Hospital, Dublin, 9, Ireland
| | - Niall Pender
- Department of Psychology, Beaumont Hospital, Dublin, 9, Ireland
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin, 2, Ireland
- Royal College of Surgeons in Ireland, Dublin, 2, Ireland
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26
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Costello E, Birkmeier M, Ruckert E, Lyons L, Cotton L. Use of computer assisted learning technology to enhance clinical decision making skills of physical therapist students in acute care settings. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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27
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Jenkinson C, Elliott V, Menon U, Apostolidou S, Fourkala OE, Gentry-Maharaj A, Pereira SP, Jacobs I, Cox TF, Greenhalf W, Timms JF, Sutton R, Neoptolemos JP, Costello E. Evaluation in pre-diagnosis samples discounts ICAM-1 and TIMP-1 as biomarkers for earlier diagnosis of pancreatic cancer. J Proteomics 2015; 113:400-2. [PMID: 25316052 DOI: 10.1016/j.jprot.2014.10.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 10/02/2014] [Indexed: 12/17/2022]
Abstract
Circulating intercellular adhesion molecule-1 (ICAM-1) and tissue inhibitor of metalloproteinases-1 (TIMP-1) have been widely proposed as potential diagnostic biomarkers for pancreatic ductal adenocarcinoma (PDAC). We report on serum protein levels prior to clinical presentation of pancreatic cancer. Serum ICAM-1 and TIMP-1 were measured by ELISA in two case–control sets: 1) samples from patients diagnosed with pancreatic cancer (n = 40), chronic pancreatitis (n = 20), benign jaundice due to gall stones (n = 20) and healthy subjects (n = 20); 2) a preclinical set from the UK Collaborative Trial of Ovarian Cancer Screening biobank of samples collected from 27 post-menopausal women 0–12 months prior to diagnosis of pancreatic cancer and controls matched for date of donation and centre. Levels of ICAM-1 and TIMP-1 were significantly elevated in set 1 in PDAC patients with jaundice compared to PDAC patients without jaundice and both proteins were elevated in patients with jaundice due to gall stones. Neither protein was elevated in samples taken 0–12 months prior to PDAC diagnosis compared to non-cancer control samples. In conclusion, evaluation in pre-diagnosis samples discounts ICAM-1 and TIMP-1 as biomarkers for earlier diagnosis of pancreatic cancer. Failure to account for obstructive jaundice may have contributed to the previous promise of these candidate biomarkers. BIOLOGICAL SIGNIFICANCE Pancreatic cancer is usually diagnosed when at an advanced stage which greatly limits therapeutic options. Biomarkers that could facilitate earlier diagnosis are urgently sought.
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Milne R, La Vecchia C, Van Steen K, Hahn S, Buchholz M, Costello E, Esposito I, Hoheisel JD, Lange B, Lopez-Bigas N, Michalski CW, Real FX, Brand A, Malats N. EU Pancreas: an integrated European platform for pancreas cancer research--from basic science to clinical and public health interventions for a rare disease. Public Health Genomics 2014; 16:305-12. [PMID: 24503591 DOI: 10.1159/000355937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Large-scale international collaboration is essential to decipher relevant information in the context of omics-scale interrogations in cancer research. This is even more important for rare and fatal diseases like pancreas cancer (PC). METHODS The COST Action BM1204 is a unique platform to facilitate the collaboration of a broad range of European and international PC multidisciplinary research groups in order to: (1) integrate knowledge and experience in a multidisciplinary way 'from cell to society', (2) promote the application of uniform study tools and protocols, (3) foster their optimal use by early-stage researchers, (4) enhance the mobility and training of researchers, and (5) disseminate the results produced to the broader society. RESULTS This Action will develop novel interdisciplinary tools for collaborative research to improve our understanding of PC and its prevention, diagnosis and treatment. It also aims to answer questions related to the etiology, early detection, evidence-based and personalized treatment, and health management for PC. Furthermore, the Action will contribute to new insights into PC personalized medicine and beyond as well as to the understanding of complex and rare diseases taking PC as a best practice example. The Action aims at attracting young scholars across a range of disciplines in collaboration with more experienced researchers and enhancing active European participation in the international scenario of PC research. CONCLUSION The ultimate aim is to foster PC research in Europe and to coordinate this effort with other international initiatives to reduce disease mortality.
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Affiliation(s)
- R Milne
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
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Shaw VE, Naisbitt DJ, Costello E, Greenhalf W, Park BK, Neoptolemos JP, Middleton GW. Current status of GV1001 and other telomerase vaccination strategies in the treatment of cancer. Expert Rev Vaccines 2014; 9:1007-16. [DOI: 10.1586/erv.10.92] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Allen AR, Dale J, McCormick C, Mallon TR, Costello E, Gordon SV, Hewinson RG, Skuce RA, Smith NH. The phylogeny and population structure of Mycobacterium bovis in the British Isles. Infect Genet Evol 2013; 20:8-15. [PMID: 23933404 DOI: 10.1016/j.meegid.2013.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 07/17/2013] [Accepted: 08/02/2013] [Indexed: 11/17/2022]
Abstract
To further understand the epidemic of bovine tuberculosis in Great Britain, Northern Ireland and the Republic of Ireland, we identified 16 mutations that are phylogenetically informative for Mycobacterium bovis strains from these regions. We determined the status of these mutations among a collection of 501 strains representing the molecular diversity found in these three regions of the British Isles. The resulting linear phylogenies from each region were concordant, showing that the same lineage of M. bovis was present. The dominance of this lineage is unique within Europe, and suggests that in the past the populations were homogenous. Comparison of approximately 500 strains isolated in 2005 from each region by spoligotype and 5 locus VNTR profiling, revealed distinct differences in the genotype frequencies and sub-lineage makeup between each region. We concluded that whilst each region shared the same major phylogenetic lineage of M. bovis, more recent evolution had resulted in the development of region-specific populations. Regional differences in the M. bovis populations suggest that it may be possible to identify the movement of strains from one region to another.
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Affiliation(s)
- A R Allen
- Agri-Food and Biosciences Institute, Stoney Road, Belfast, Northern Ireland BT4 3SD, UK.
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31
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Mirarchi FL, Costello E, Puller J, Cooney T, Kottkamp N, Markley MJ. NATIONAL ASSESSMENT OF LIVING WILLS AND DO NOT RESUSCITATE ORDERS. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000491.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tonack S, Jenkinson C, Cox T, Elliott V, Jenkins RE, Kitteringham NR, Greenhalf W, Shaw V, Michalski CW, Friess H, Neoptolemos JP, Costello E. iTRAQ reveals candidate pancreatic cancer serum biomarkers: influence of obstructive jaundice on their performance. Br J Cancer 2013; 108:1846-53. [PMID: 23579209 PMCID: PMC3658525 DOI: 10.1038/bjc.2013.150] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 01/09/2013] [Accepted: 03/14/2013] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The aims of our study were to identify serum biomarkers that distinguish pancreatic cancer (pancreatic ductal adenocarcinoma, PDAC) patients from benign pancreatic disease patients and healthy subjects, and to assess the effects of jaundice on biomarker performance. METHODS Isobaric tags for relative and absolute quantification were used to compare pooled serum and pancreatic juice samples from a test set of 59 and 25 subjects, respectively. Validation was undertaken in 113 independent subjects. RESULTS Candidate proteins Complement C5, inter-α-trypsin inhibitor heavy chain H3, α1-β glycoprotein and polymeric immunoglobulin receptor were elevated in cancer, as were the reference markers CA19-9 and Reg3A. Biliary obstruction had a significant effect on the performance of the markers, in particular within the PDAC group where the presence of jaundice was associated with a significant increase in the levels of all six proteins (P<0.01). Consequently, in the absence of jaundice, proteins showed reduced sensitivity for PDAC patients over benign subjects and healthy controls (HCs). Similarly, in the presence of jaundice, markers showed reduced specificity for PDAC patients over benign subjects with jaundice. Combining markers enabled improved sensitivity for non-jaundiced PDAC patients over HCs and improved specificity for jaundiced PDAC patients over jaundiced benign disease subjects. CONCLUSIONS The presence-absence of jaundice in the clinical scenario severely impacts the performance of biomarkers for PDAC diagnosis and has implications for their clinical translation.
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Affiliation(s)
- S Tonack
- Department of Molecular and Clinical Cancer Medicine, Liverpool Cancer Research-UK Centre, University of Liverpool, Liverpool, UK
| | - C Jenkinson
- Department of Molecular and Clinical Cancer Medicine, Liverpool Cancer Research-UK Centre, University of Liverpool, Liverpool, UK
| | - T Cox
- Department of Molecular and Clinical Cancer Medicine, Liverpool Cancer Research-UK Centre, University of Liverpool, Liverpool, UK
| | - V Elliott
- Department of Molecular and Clinical Cancer Medicine, Liverpool Cancer Research-UK Centre, University of Liverpool, Liverpool, UK
- National Institute for Health Research Liverpool Pancreatic Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - R E Jenkins
- Department of Pharmacology and Therapeutics, MRC Centre for Drug Safety Science, Liverpool, UK
| | - N R Kitteringham
- Department of Pharmacology and Therapeutics, MRC Centre for Drug Safety Science, Liverpool, UK
| | - W Greenhalf
- Department of Molecular and Clinical Cancer Medicine, Liverpool Cancer Research-UK Centre, University of Liverpool, Liverpool, UK
- National Institute for Health Research Liverpool Pancreatic Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - V Shaw
- Department of Molecular and Clinical Cancer Medicine, Liverpool Cancer Research-UK Centre, University of Liverpool, Liverpool, UK
| | - C W Michalski
- Department of General Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - H Friess
- Department of General Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - J P Neoptolemos
- Department of Molecular and Clinical Cancer Medicine, Liverpool Cancer Research-UK Centre, University of Liverpool, Liverpool, UK
- National Institute for Health Research Liverpool Pancreatic Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - E Costello
- Department of Molecular and Clinical Cancer Medicine, Liverpool Cancer Research-UK Centre, University of Liverpool, Liverpool, UK
- National Institute for Health Research Liverpool Pancreatic Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
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Abstract
Follow the guidelines on how to do this properly
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Affiliation(s)
- E Costello
- National Institute for Health Research Pancreas Biomedical Research Unit and Division of Surgery and Oncology, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool L69 3GA, UK
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Good M, Clegg TA, Costello E, More SJ. The comparative performance of the single intradermal test and the single intradermal comparative tuberculin test in Irish cattle, using tuberculin PPD combinations of differing potencies. Vet J 2011; 190:e60-e65. [PMID: 21420884 DOI: 10.1016/j.tvjl.2011.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 12/31/2010] [Accepted: 01/11/2011] [Indexed: 10/18/2022]
Abstract
In national bovine tuberculosis (BTB) control programmes, testing is generally conducted using a single source of bovine purified protein derivative (PPD) tuberculin. Alternative tuberculin sources should be identified as part of a broad risk management strategy as problems of supply or quality cannot be discounted. This study was conducted to compare the impact of different potencies of a single bovine PPD tuberculin on the field performance of the single intradermal comparative tuberculin test (SICTT) and single intradermal test (SIT). Three trial potencies of bovine PPD tuberculin, as assayed in naturally infected bovines, namely, low (1192IU/dose), normal (6184IU/dose) and high (12,554IU/dose) were used. Three SICTTs (using) were conducted on 2102 animals. Test results were compared based on reactor-status and changes in skin-thickness at the bovine tuberculin injection site. There was a significant difference in the number of reactors detected using the high and low potency tuberculins. In the SICTT, high and low potency tuberculin detected 40% more and 50% fewer reactors, respectively, than normal potency tuberculin. Furthermore, use of the low potency tuberculin in the SICTT failed to detect 20% of 35 animals with visible lesions, and in the SIT 11% of the visible lesion animals would have been classified as negative. Tuberculin potency is critical to the performance of both the SICTT and SIT. Tuberculin of different potencies will affect reactor disclosure rates, confounding between-year or between-country comparisons. Independent checks of tuberculin potency are an important aspect of quality control in national BTB control programmes.
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Affiliation(s)
- M Good
- Department of Agriculture Fisheries and Food, Kildare St., Dublin 2, Ireland.
| | - T A Clegg
- Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - E Costello
- Department of Agriculture Fisheries and Food, Central Veterinary Research Laboratory, Backweston Laboratory Complex, Celbridge, Co. Kildare, Ireland
| | - S J More
- Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
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35
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Murphy D, Gormley E, Collins DM, McGrath G, Sovsic E, Costello E, Corner LAL. Tuberculosis in cattle herds are sentinels for Mycobacterium bovis infection in European badgers (Meles meles): the Irish Greenfield Study. Vet Microbiol 2011; 151:120-5. [PMID: 21444162 DOI: 10.1016/j.vetmic.2011.02.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In Ireland badgers are removed in response to tuberculosis (TB) breakdowns in cattle herds (focal culling). Prevalence studies, conducted using a detailed post mortem and bacteriological examination, showed that 36-50% of badgers were infected with Mycobacterium bovis. Focal culling forms part of the medium term national strategy for the control of bovine TB in cattle and is based on the premise that badgers in areas with herd breakdowns have a higher prevalence of infection than the badger population at large. However, the hypothesis that cattle can be used as sentinels for infection in the badger population has never been formally tested. In this study we tested the hypothesis by determining the infection prevalence in badgers in areas where there had been historically, a consistently low prevalence of infection in cattle. Low cattle TB prevalence areas were defined as those herds with ≤ 2 standard reactors in the annual round of skin testing over the preceding 5 years (Greenfield sites). Using GIS, and adjusting for variation in land use, previous culling and cattle density, 198 Greenfield sites were identified and surveyed, and 138 areas with badger setts or signs of badger activity were identified. A single badger was removed from 87 sites and all were examined using detailed post mortem and bacteriological procedures. A prevalence of M. bovis infection of 14.9% was found in the Greenfield site badgers. This prevalence was significantly lower (P<0.001) than in badgers removed during focal culling (36.6%). The results validate the use of cattle as sentinels for TB in badgers and support the medium term national strategy for the control of bovine TB. The geographic variation in M. bovis infection prevalence in the Irish badger populations will be used when devising strategies for the incorporation of badger vaccination into the long term bovine TB control programme.
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Affiliation(s)
- D Murphy
- Veterinary Science Centre, School of Agriculture, Food Science & Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
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36
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Sharpe AE, Brady CP, Johnson A, Byrne W, Kenny K, Costello E. Concurrent outbreak of tuberculosis and caseous lymphadenitis in a goat herd. Vet Rec 2010; 166:591-2. [DOI: 10.1136/vr.b4825] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- A. E. Sharpe
- Central Veterinary Research Laboratory; Department of Agriculture, Fisheries and Food (DAFF), Backweston; Celbridge County Kildare Ireland
| | - C. P. Brady
- Central Veterinary Research Laboratory; Department of Agriculture, Fisheries and Food (DAFF), Backweston; Celbridge County Kildare Ireland
| | - A. Johnson
- DAFF Regional Veterinary Laboratory, Knockalisheen; Limerick Ireland
| | - W. Byrne
- Central Veterinary Research Laboratory; Department of Agriculture, Fisheries and Food (DAFF), Backweston; Celbridge County Kildare Ireland
| | - K. Kenny
- Central Veterinary Research Laboratory; Department of Agriculture, Fisheries and Food (DAFF), Backweston; Celbridge County Kildare Ireland
| | - E. Costello
- Central Veterinary Research Laboratory; Department of Agriculture, Fisheries and Food (DAFF), Backweston; Celbridge County Kildare Ireland
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37
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Murphy D, Gormley E, Costello E, O'Meara D, Corner LAL. Examining the true prevalence and transmission routes of TB in a badger population. Vet Rec 2010. [DOI: 10.1136/vr.c189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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38
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Doran P, Carson J, Costello E, More S. An outbreak of tuberculosis affecting cattle and people on an Irish dairy farm, following the consumption of raw milk. Ir Vet J 2009; 62:390-7. [PMID: 21851735 PMCID: PMC3113750 DOI: 10.1186/2046-0481-62-6-390] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Bovine tuberculosis is an ongoing problem in Ireland, and herd incidence has remained at approximately 5% for some years. Spillover of infection from cattle to people remains an ever-present possibility, given the ongoing pool of infection in the Irish cattle population. This paper describes an outbreak of tuberculosis affecting cattle and people on a dairy farm in southeastern Ireland following the consumption of milk from a seven-year-old cow with tuberculous mastitis. Twenty-five of 28 calves born during autumn 2004 and spring 2005 were subsequently identified as TB reactors, and five of six family members were positive on the Mantoux test. During 2005, milk from this cow had mainly been used to feed calves, and was added only occasionally to the bulk tank. Therefore, the calves each received infected milk on an almost continuous basis between birth and weaning. The family collected milk from the bulk milk tank, and consumed it without pasteurisation. This case highlights the risks associated with the consumption of raw milk. In this family, TB has had a very significant impact on the health of two young children. These risks are well recognised, and relevant information for farmers is available. It is of concern, therefore, that raw milk consumption remains prevalent on Irish farms. New strategies are needed, in partnership with industry, to address this important issue. Keywords: bovine tuberculosis, Ireland, mastitis, milk, Mycobacterium bovis, pasteurisation, TB, zoonosis
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Affiliation(s)
- P Doran
- District Veterinary Office, Enniscorthy, Co, Wexford, Ireland.
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39
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Corner L, Costello E, Lesellier S, O’Meara D, Gormley E. Experimental tuberculosis in the European badger (Meles meles) after endobronchial inoculation with Mycobacterium bovis: II. Progression of infection. Res Vet Sci 2008; 85:481-90. [DOI: 10.1016/j.rvsc.2008.03.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2007] [Revised: 03/11/2008] [Accepted: 03/13/2008] [Indexed: 10/22/2022]
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40
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Connolly D, Dwyer P, Fagan J, Hayes M, Ryan E, Costello E, Kilroy A, More S. Tuberculosis in alpaca (Lama pacos) on a farm in Ireland. 2. Results of an epidemiological investigation. Ir Vet J 2008; 61:533-7. [PMID: 21851720 PMCID: PMC3113878 DOI: 10.1186/2046-0481-61-8-533] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Tuberculosis (TB), due to infection with Mycobacterium bovis was diagnosed in a flock of alpaca in Ireland in 2004. An epidemiological investigation was conducted to identify the risk of TB for farmed alpaca where TB is endemic, the origin of the infection, the potential for alpaca-to-alpaca transmission and appropriate control measures. The investigation focused on the alpaca flock (including the farm, animal movements and breeding, feeding and flock health practice), the disease episode (including animal disease events and subsequent control measures) and TB infection risk in the locality. The TB risk to alpaca is high in areas where infection is endemic in cattle and badgers and where biosecurity is inadequate. It is most likely that the source of infection for the alpaca was a local strain of M. bovis, present in cattle in this area since at least 2001. Genotyping of isolates identified a single variable number tandem repeat (VNTR) profile in both cattle and alpaca in this region. Although a tuberculous badger was also removed from the vicinity, bacterial isolation was not attempted. On this farm, infection in alpaca was probably derived from a common source. Alpaca-to-alpaca transmission seems unlikely. Two broad control strategies were implemented, aimed at the rapid removal of infected (and potentially infectious) animals and the implementation of measures to limit transmission. Tests that proved useful in detecting potentially-infected animals included measurement of the albumin-to-globulin ratio and regular body condition scoring. Skin testing was time consuming and unproductive, and early detection of infected animals remains a challenge. The flock was managed as a series of separate groupings, based on perceived infection risk. No further TB cases have been detected.
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Abstract
This case report describes tuberculosis (TB) due to infection with Mycobacterium bovis (M. bovis) in alpaca (Lama pacos) on a farm in Ireland. Two severely debilitated alpaca were presented to the University Veterinary Hospital, University College Dublin in November 2004. Bloods were taken, and haematology and biochemistry results were indicative of chronic infection. Radiological examination showed evidence of diffuse granulomatous pneumonia suggestive of tuberculosis. On necropsy there were granulomatous lesions present throughout many body organs including lung, liver, kidney, intestine as well on peritoneum and mesentery. Culture of acid-fast bacilli from lesions led to a diagnosis of tuberculosis due to M. bovis. The use of intradermal skin testing proved inefficient and unreliable for ante mortem diagnosis of tuberculosis in alpaca. Infection due to M. bovis should be considered among the differential diagnoses of debilitating diseases in alpaca, particularly those farmed in areas known to be traditional black spots for tuberculosis in cattle.
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Affiliation(s)
- Eg Ryan
- Section of Herd and Veterinary Public Health, UCD School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
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42
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Olea-Popelka FJ, Costello E, White P, McGrath G, Collins JD, O'Keeffe J, Kelton DF, Berke O, More S, Martin SW. Risk factors for disclosure of additional tuberculous cattle in attested-clear herds that had one animal with a confirmed lesion of tuberculosis at slaughter during 2003 in Ireland. Prev Vet Med 2008; 85:81-91. [PMID: 18314209 DOI: 10.1016/j.prevetmed.2008.01.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2006] [Revised: 12/18/2007] [Accepted: 01/07/2008] [Indexed: 11/16/2022]
Abstract
All the Irish cattle herds considered "clear" of bovine tuberculosis (BTB) having a single animal with a tuberculous lesion at slaughter during 2003 were identified. We performed a descriptive and logistic regression analysis to investigate whether selected risk factors had an association with the result of the herd test immediately after the tuberculous lesion was found ("Factory Lesion Test", FLT). At the FLT, only 19.7% (n=338) of these 1713 herds had 1 or more standard reactors. The lesioned animal was home-bred in 46% of the "source" herds; these herds had an increased risk (23.4%) of having at least 1 standard reactor animal relative to herds with a purchased-lesioned animal (16.6%) (RR=1.41). Our logistic models identified a number of important risk factors; two that appeared most important in predicting the FLT outcome were the time spent (residency) by the lesioned animal in the "source" herd, and the presence, or not, of the lesioned animal in a previous BTB episode in either the "source" herd, or the seller's herd in the case the lesioned animal was purchased. Our models fit the data well based on the Hosmer-Lemeshow test, however their sensitivity and specificity were very low (57% and 61% respectively). Surveillance of the cattle population for BTB using lesions found at slaughter is an essential component of an overall control program. Nonetheless, due to the poor predictability of the variables we measured, complete herd investigations are needed to help explain the FLT outcome of a herd.
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Affiliation(s)
- F J Olea-Popelka
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Clinical Research Building, Guelph, Ont., Canada N1G 2W1.
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Corner LAL, Clegg TA, More SJ, Williams DH, O'Boyle I, Costello E, Sleeman DP, Griffin JM. The effect of varying levels of population control on the prevalence of tuberculosis in badgers in Ireland. Res Vet Sci 2008; 85:238-49. [PMID: 18191427 DOI: 10.1016/j.rvsc.2007.11.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Revised: 08/07/2007] [Accepted: 11/22/2007] [Indexed: 10/22/2022]
Abstract
We examined the effect of varying levels of badger population control on the prevalence of Mycobacterium bovis infection in badgers in four counties of Ireland. In the 'Removal' and 'Buffer' areas, proactive culling was conducted to substantially reduce and subsequently maintain badger populations at a low level for five years. In the 'Reference' areas, localised reactive culling was conducted in association with herd breakdowns. The infection status of badgers was determined using bacteriology. A total of 2696 badgers were recruited into the study, and 19.0% were found to be infected with M. bovis. The two population control strategies had differing effects on the subsequent prevalence of tuberculosis in badger populations. Proactive culling led to a long term decrease in the prevalence of tuberculosis in the re-emergent populations. Although there was an overall decline in the disease prevalence, no consistent trend in disease prevalence as a result of reactive culling was observed.
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Affiliation(s)
- L A L Corner
- Veterinary Sciences Centre, School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
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44
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Frankena K, White PW, O'Keeffe J, Costello E, Martin SW, van Grevenhof I, More SJ. Quantification of the relative efficiency of factory surveillance in the disclosure of tuberculosis lesions in attested Irish cattle. Vet Rec 2007; 161:679-84. [DOI: 10.1136/vr.161.20.679] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- K. Frankena
- Quantitative Veterinary Epidemiology Group; Wageningen Institute of Animal Sciences; PO Box 338 6700 AH Wageningen The Netherlands
| | - P. W. White
- Centre for Veterinary Epidemiology and Risk Analysis; School of Agriculture, Food Science and Veterinary Medicine; University College Dublin; Belfield Dublin 4 Ireland
| | - J. O'Keeffe
- Centre for Veterinary Epidemiology and Risk Analysis; School of Agriculture, Food Science and Veterinary Medicine; University College Dublin; Belfield Dublin 4 Ireland
| | - E. Costello
- Central Veterinary Research Laboratory; Department of Agriculture and Food; Backweston County Kildare Ireland
| | - S. W. Martin
- Department of Population Medicine; Ontario Veterinary College; University of Guelph; Guelph Ontario N1G 2W1 Canada
| | - I. van Grevenhof
- Quantitative Veterinary Epidemiology Group; Wageningen Institute of Animal Sciences; PO Box 338 6700 AH Wageningen The Netherlands
| | - S. J. More
- Centre for Veterinary Epidemiology and Risk Analysis; School of Agriculture, Food Science and Veterinary Medicine; University College Dublin; Belfield Dublin 4 Ireland
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45
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Saraga G, Mafficini A, Ghaneh P, Sorio C, Costello E. Both HIV- and EIAV-based lentiviral vectors mediate gene delivery to pancreatic cancer cells and human pancreatic primary patient xenografts. Cancer Gene Ther 2007; 14:781-90. [PMID: 17571071 DOI: 10.1038/sj.cgt.7701066] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Few effective treatments for pancreatic cancer exist, especially for patients with advanced disease. Gene therapy alone, or combined with current treatments, offers an alternative approach. Here we examined the potential of primate and nonprimate lentivectors to mediate gene delivery to this cancer type. VSV-G pseudotyped lentivectors based on human immunodeficiency type-1 virus (HIV-1) and equine infectious anemia virus (EIAV), containing the enhanced green fluorescent protein (EGFP) reporter gene were prepared and characterized for titer and RNA content. Vector-mediated gene delivery was examined in five pancreatic cancer cell lines in vitro, and in MiaPaCa-2 cells as well as in five human primary patient biopsies xenografted subcutaneously in nude mice. While individual cell lines showed differential sensitivities to transduction with lentivectors, all cell lines were successfully transduced with both vector types. Similarly, both vectors transduced MiaPaCa-2 and all of the human primary patient xenografts. We observed 6-29% transduction with HIV-based vectors (n=3 xenografts) and 1.8-30% with EIAV-based vectors (n=4 xenografts). Long-term EIAV-mediated gene expression was recorded in cell lines for up to 6 months. We conclude that these vectors have potential as mediators of clinical gene therapy for pancreatic cancer treatment. Moreover, they are useful laboratory research tools for pancreatic cancer research.
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Affiliation(s)
- G Saraga
- Division of Surgery and Oncology, Royal Liverpool University Hospital, University of Liverpool, Liverpool, Merseyside L68 3GA, UK
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Corner LAL, Costello E, Lesellier S, O'Meara D, Sleeman DP, Gormley E. Experimental tuberculosis in the European badger (Meles meles) after endobronchial inoculation of Mycobacterium bovis: I. Pathology and bacteriology. Res Vet Sci 2007; 83:53-62. [PMID: 17197004 DOI: 10.1016/j.rvsc.2006.10.016] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Revised: 10/06/2006] [Accepted: 10/26/2006] [Indexed: 11/29/2022]
Abstract
The aim was to develop an endobronchial infection procedure for the study of Mycobacterium bovis infection in badgers. The badgers were anaesthetised and a cannula was passed per os to the tracheal bifurcation. When in place 1 ml of M. bovis suspension was inoculated. Three concentrations of M. bovis suspension were used; <10 colony forming units (cfu), approximately 10(2) cfu and approximately 3 x 10(3) cfu. The badgers were examined at three weekly intervals for clinical signs of disease and a tracheal aspirate was collected at each examination. The badgers were euthanased 17 weeks post infection (pi) and at the post mortem examination a wide range of tissues were examined for gross and histopathological lesions of tuberculosis and cultured for M. bovis. A sample of bronchial alveolar lavage (BAL) fluid was collected at post mortem for culture. At post mortem examination 17 weeks after infection, gross and histopathological lesions of tuberculosis were observed in all badgers inoculated with the high and medium dose and 1/3 inoculated with the low dose. M. bovis was recovered from all inoculated badgers. Infection in the high dose group was more widely disseminated than in the other groups. The number of sites with gross and histopathological lesions increased with increasing dose of M. bovis. All tracheal aspirates were negative on culture and only one BAL, collected from a badger of the high dose group, was positive on culture. No clinical signs due to the experimental infection were observed. The endobronchial route of inoculation is an effective route for establishing experimental infection, and could be used for studies of tuberculosis pathogenesis, immunology of M. bovis infection in badgers and for challenging badgers in vaccine protection studies. Badgers appeared to be very susceptible to infection by this procedure even with a dose of < 10 cfu but appear to control and limit the resulting infection.
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Affiliation(s)
- L A L Corner
- Large Animal Clinical Studies, School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Stillorgan Road, Belfield, Dublin, Ireland.
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Thompson CC, Ashcroft FJ, Patel S, Saraga G, Vimalachandran D, Prime W, Campbell F, Dodson A, Jenkins RE, Lemoine NR, Crnogorac-Jurcevic T, Yin HL, Costello E. Pancreatic cancer cells overexpress gelsolin family-capping proteins, which contribute to their cell motility. Gut 2007; 56:95-106. [PMID: 16847067 PMCID: PMC1856675 DOI: 10.1136/gut.2005.083691] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previously, proteomic methods were applied to characterise differentially expressed proteins in microdissected pancreatic ductal adenocarcinoma cells. AIMS To report that CapG and a related protein, gelsolin, which have established roles in cell motility, are overexpressed in metastatic pancreatic cancer; and to describe their pattern of expression in pancreatic cancer tissue and their effect on cell motility in pancreatic cancer cell lines. METHODS CapG was identified by mass spectrometry and immunoblotting. CapG and gelsolin expression was assessed by immunohistochemical analysis on a pancreatic cancer tissue microarray and correlated with clinical and pathological parameters. CapG and gelsolin levels were reduced using RNA interface in Suit-2, Panc-1 and MiaPaCa-2 cells. Cell motility was assessed using modified Boyden chamber or wound-healing assays. RESULTS Multiple isoforms of CapG were detected in pancreatic cancer tissue and cell lines. Immunohistochemical analysis of benign (n = 44 patients) and malignant (n = 69) pancreatic ductal cells showed significantly higher CapG staining intensity in nuclear (p<0.001) and cytoplasmic (p<0.001) compartments of malignant cells. Similarly, gelsolin immunostaining of benign (n = 24 patients) and malignant (n = 68 patients) pancreatic ductal cells showed higher expression in both compartments (both p<0.001). High nuclear CapG was associated with increased tumour size (p = 0.001). High nuclear gelsolin was associated with reduced survival (p = 0.01). Reduction of CapG or gelsolin expression in cell lines by RNAi was accompanied by significantly impaired motility. CONCLUSIONS Up regulation of these actin-capping proteins in pancreatic cancer and their ability to modulate cell motility in vitro suggest their potentially important role in pancreatic cancer cell motility and consequently dissemination.
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Affiliation(s)
- C C Thompson
- Division of Surgery and Oncology, Royal Liverpool University Hospital, 5th Floor UCD Building, Daulby Street, University of Liverpool, Liverpool L68 3 GA, UK
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Costello E, Flynn O, Quigley F, O'Grady D, Griffin J, Clegg T, McGrath G. Genotyping of Mycobacterium bovis isolates from badgers in four areas of the Republic of Ireland by restriction fragment length polymorphism analysis. Vet Rec 2006; 159:619-23. [PMID: 17088296 DOI: 10.1136/vr.159.19.619] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
An analysis of the molecular epidemiology of Mycobacterium bovis in badgers was made in four selected areas of the Republic of Ireland in which an intensive badger removal programme was being carried out over a period of five years. Tissue samples from 2310 badgers were cultured. Restriction fragment length polymorphism (RFLP) analysis with IS6110, polymorphic GC-rich sequence (PGRS) and direct repeat sequence (DR) probes was applied to the isolates from 398 badgers, and 52 different rflp types were identified. Most of the isolates belonged to seven predominant types, and the other 45 types were represented by few isolates. An analysis suggests that some of these 45 types may have been introduced by the inward migration of badgers and others may have been the result of genetic changes to one of the prevalent types. The badgers were divided into groups on the basis of the sett at which they were captured, and RFLP typing was applied to isolates from two or more badgers from 85 groups. Multiple RFLP types were identified among isolates from 50 of these groups, suggesting that badgers probably moved frequently between group territories.
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Affiliation(s)
- E Costello
- Central Veterinary Research Laboratory, Abbotstown, Dublin 15, Republic of Ireland
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Abstract
INTRODUCTION The use of postoperative drains following total knee replacement (TKR) has recently been modified by the use of re-transfusion drains. The aim of our study was to investigate the optimal time for removal of re-transfusion drains following TKR. PATIENTS AND METHODS The medical records of 66 patients who had a TKR performed between October 2003 and October 2004 were reviewed; blood drained before 6 h and the total volume of blood drained was recorded. RESULTS A total of 56 patients had complete records of postoperative drainage. The mean volume of blood collected in the drain in the first 6 h was 442 ml. The mean total volume of blood in the drain was 595 ml. Therefore, of the blood drained, 78% was available for transfusion. CONCLUSION Re-transfusion drains should be removed after 6 h, when no further re-transfusion is permissible.
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Affiliation(s)
- M F Leeman
- Department of Orthopaedics & Trauma Surgery, Addenbrooke's NHS Trust, Cambridge, UK
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Olea-Popelka FJ, Flynn O, Costello E, McGrath G, Collins JD, O'keeffe J, Kelton DF, Berke O, Martin SW. Spatial relationship between Mycobacterium bovis strains in cattle and badgers in four areas in Ireland. Prev Vet Med 2005; 71:57-70. [PMID: 15993963 DOI: 10.1016/j.prevetmed.2005.05.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2004] [Revised: 05/11/2005] [Accepted: 05/23/2005] [Indexed: 11/18/2022]
Abstract
We investigated whether strains (restriction fragment length polymorphism, RFLP-types) of Mycobacterium bovis isolated from badgers and from cattle clustered among and within four areas in Ireland. The spatial scan test and nearest-neighbor analysis were used as the spatial cluster-detection techniques. In addition, for each of the major strains, associations between the distance to badger setts and the "centroid" of the cattle farm were assessed in a logistic model. Overall, between September 1997 and May 2000, 316 and 287 M. bovis samples, from badgers and cattle, respectively, were strain-typed. The distribution of strains in badgers, and separately in cattle, differed among areas. Within each of the four large areas, badgers and cattle tended to have similar strains; this is consistent with the sharing of M. bovis strains within an area. In more detailed within-area analyses, some spatial clusters of M. bovis strains were detected, separately, in both cattle and badgers. Almost half of the infected badger setts with a specific strain were located outside of the "detected" clusters. There was no association between the number of infected badgers with a specific M. bovis strain within 2 or 5 km distances to cattle herds, and the risk of the same strain in cattle. We speculate about the dynamic nature of badger movements, as an explanation for the absence of more clusters of most of the strains of M. bovis isolated from badgers, and its impact on trying to study transmission of M. bovis between cattle and badger.
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Affiliation(s)
- F J Olea-Popelka
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Clinical Research Building, Guelph, Ont., Canada N1G 2W1.
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