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Buciuc M, Koga S, Pham NTT, Duffy JR, Knopman DS, Ali F, Boeve BF, Graff-Radford J, Botha H, Lowe VJ, Nguyen A, Reichard RR, Dickson DW, Petersen RC, Whitwell JL, Josephs KA. The many faces of globular glial tauopathy: A clinical and imaging study. Eur J Neurol 2023; 30:321-333. [PMID: 36256511 PMCID: PMC10141553 DOI: 10.1111/ene.15603] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 08/14/2022] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Globular glial tauopathy (GGT) has been associated with frontotemporal dementia syndromes; little is known about the clinical and imaging characteristics of GGT and how they differ from other non-globular glial 4-repeat tauopathies (N4GT) such as progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD). METHODS For this case-control study the Mayo Clinic brain banks were queried for all cases with an autopsy-confirmed diagnosis of GGT between 1 January 2011 and 31 October 2021. Fifty patients with N4GT (30 PSP, 20 CBD) were prospectively recruited and followed by the Neurodegenerative Research Group at Mayo Clinic, Minnesota. Magnetic resonance imaging was used to characterize patterns of gray/white matter atrophy, MR-parkinsonism index, midbrain volume, and white matter hyperintensities.18 F-Fluorodeoxyglucose-, 11 C Pittsburg compound-, and 18 F-flortaucipir-positron emission tomography scans were reviewed. RESULTS Twelve patients with GGT were identified: 83% were women compared to 42% in NG4T (p = 0.02) with median age at death 76.5 years (range: 55-87). The most frequent clinical features were eye movement abnormalities, parkinsonism, behavioral changes followed by pyramidal tract signs and motor speech abnormalities. Lower motor neuron involvement was present in 17% and distinguished GGT from NG4T (p = 0.035). Primary progressive apraxia of speech was the most frequent initial diagnosis (25%); 50% had a Parkinson-plus syndrome before death. Most GGT patients had asymmetric frontotemporal atrophy with matching hypometabolism. GGT patients had more gray matter atrophy in temporal lobes, normal MR-parkinsonism index, and larger midbrain volumes. CONCLUSIONS Female sex, lower motor neuron involvement in the context of a frontotemporal dementia syndrome, and asymmetric brain atrophy with preserved midbrain might be suggestive of underlying GGT.
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Affiliation(s)
- Marina Buciuc
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shunsuke Koga
- Department of Neurosciences, Mayo Clinic, Jacksonville, Florida, USA
| | | | - Joseph R Duffy
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Farwa Ali
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Aivi Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ross R Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Dennis W Dickson
- Department of Neurosciences, Mayo Clinic, Jacksonville, Florida, USA
| | | | | | - Keith A Josephs
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
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Cogswell PM, Murphy MC, Senjem ML, Botha H, Gunter JL, Elder BD, Graff-Radford J, Jones DT, Cutsforth-Gregory JK, Schwarz CG, Meyer FB, Huston J, Jack CR. Changes in Ventricular and Cortical Volumes following Shunt Placement in Patients with Idiopathic Normal Pressure Hydrocephalus. AJNR Am J Neuroradiol 2021; 42:2165-2171. [PMID: 34674997 DOI: 10.3174/ajnr.a7323] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 08/18/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE While changes in ventricular and extraventricular CSF spaces have been studied following shunt placement in patients with idiopathic normal pressure hydrocephalus, regional changes in cortical volumes have not. These changes are important to better inform disease pathophysiology and evaluation for copathology. The purpose of this work is to investigate changes in ventricular and cortical volumes in patients with idiopathic normal pressure hydrocephalus following ventriculoperitoneal shunt placement. MATERIALS AND METHODS This is a retrospective cohort study of patients with idiopathic normal pressure hydrocephalus who underwent 3D T1-weighted MR imaging before and after ventriculoperitoneal shunt placement. Images were analyzed using tensor-based morphometry with symmetric normalization to determine the percentage change in ventricular and regional cortical volumes. Ventricular volume changes were assessed using the Wilcoxon signed rank test, and cortical volume changes, using a linear mixed-effects model (P < .05). RESULTS The study included 22 patients (5 women/17 men; mean age, 73 [SD, 6] years). Ventricular volume decreased after shunt placement with a mean change of -15.4% (P < .001). Measured cortical volume across all participants and cortical ROIs showed a mean percentage increase of 1.4% (P < .001). ROIs near the vertex showed the greatest percentage increase in volume after shunt placement, with smaller decreases in volume in the medial temporal lobes. CONCLUSIONS Overall, cortical volumes mildly increased after shunt placement in patients with idiopathic normal pressure hydrocephalus with the greatest increases in regions near the vertex, indicating postshunt decompression of the cortex and sulci. Ventricular volumes showed an expected decrease after shunt placement.
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Affiliation(s)
- P M Cogswell
- From the Departments of Radiology (P.M.C., M.C.M., J.L.G., C.G.S., J.H., C.R.J.)
| | - M C Murphy
- From the Departments of Radiology (P.M.C., M.C.M., J.L.G., C.G.S., J.H., C.R.J.)
| | | | - H Botha
- Neurology (H.B., J.G.-R., D.T.J., J.K.C.-G.)
| | - J L Gunter
- From the Departments of Radiology (P.M.C., M.C.M., J.L.G., C.G.S., J.H., C.R.J.)
| | - B D Elder
- Neurosurgery (B.D.E., F.B.M.)
- Biomedical Engineering (B.D.E.), Mayo Clinic, Rochester, Minnesota
| | | | - D T Jones
- Neurology (H.B., J.G.-R., D.T.J., J.K.C.-G.)
| | | | - C G Schwarz
- From the Departments of Radiology (P.M.C., M.C.M., J.L.G., C.G.S., J.H., C.R.J.)
| | | | - J Huston
- From the Departments of Radiology (P.M.C., M.C.M., J.L.G., C.G.S., J.H., C.R.J.)
| | - C R Jack
- From the Departments of Radiology (P.M.C., M.C.M., J.L.G., C.G.S., J.H., C.R.J.)
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Knopman DS, Lundt ES, Therneau TM, Albertson SM, Gunter JL, Senjem ML, Schwarz CG, Mielke MM, Machulda MM, Boeve BF, Jones DT, Graff-Radford J, Vemuri P, Kantarci K, Lowe VJ, Petersen RC, Jack CR. Association of Initial β-Amyloid Levels With Subsequent Flortaucipir Positron Emission Tomography Changes in Persons Without Cognitive Impairment. JAMA Neurol 2021; 78:217-228. [PMID: 33074304 DOI: 10.1001/jamaneurol.2020.3921] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Importance Tau accumulation in Alzheimer disease (AD) is closely associated with cognitive impairment. Quantitating tau accumulation by positron emission tomography (PET) will be a useful outcome measure for future clinical trials in the AD spectrum. Objective To investigate the association of β-amyloid (Aβ) on PET with subsequent tau accumulation on PET in persons who were cognitively unimpaired (CU) to gain insight into temporal associations between Aβ and tau accumulation and inform clinical trial design. Design, Setting, and Participants This cohort study included individuals aged 65 to 85 years who were CU and had participated in the Mayo Clinic Study of Aging, with serial cognitive assessments, serial magnetic resonance imaging, 11C-Pittsburgh compound B (Aβ) PET scans, and 18F-flortaucipir PET scans, collected from May 2015 to March 2020. Persons were excluded if they lacked follow-up PET scans. A similarly evaluated CU group from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were also studied. These data were collected from September 2015 to March 2020. Exposures Participants were stratified by index Aβ levels on PET into low Aβ (≤8 centiloid [CL]), subthreshold Aβ (9-21 CL), suprathreshold Aβ (22-67 CL), and high Aβ (≥68 CL). Main Outcomes and Measures Changes over a mean of 2.7 (range, 1.1-4.1) years in flortaucipir PET in entorhinal, inferior temporal, and lateral parietal regions of interest and an AD meta-region of interest (ROI). Results A total of 167 people were included (mean age, 74 [range, 65-85] years; 75 women [44.9%]); 101 individuals were excluded lacking follow-up, and 114 individuals from the ADNI were also studied (mean [SD] age, 74.14 [5.29] years; 64 women [56.1%]). In the Mayo Clinic Study of Aging, longitudinal flortaucipir accumulation rates in the high Aβ group were greater than the suprathreshold, subthreshold, and low Aβ groups in the entorhinal ROI (suprathreshold, 0.025 [95% CI, 0.013-0.037] standardized uptake value ratio [SUVR] units; subthreshold, 0.026 [95% CI, 0.014-0.037] SUVR units; low Aβ, 0.034 [95% CI, 0.02-0.049] SUVR units), inferior temporal ROI (suprathreshold, 0.025 [95% CI, 0.014-0.035] SUVR units; subthreshold, 0.027 [95% CI, 0.017-0.037] SUVR units; low Aβ, 0.035 [95% CI, 0.022-0.047] SUVR units), and the AD meta-ROI (suprathreshold, 0.023 [95% CI, 0.013-0.032] SUVR units; subthreshold, 0.025 [95% CI, 0.016-0.034] SUVR units; low Aβ, 0.032 [95% CI, 0.021-0.043] SUVR units) (all P < .001). Flortaucipir accumulation rates in the subthreshold and suprathreshold Aβ groups in temporal regions were nonsignificantly elevated compared with the low Aβ group. In the ADNI cohort, the variance was larger than in the Mayo Clinic Study of Aging but point estimates for annualized flortaucipir accumulation in the inferior temporal ROI were very similar. An estimated 216 participants who were CU per group with PET Aβ of 68 CL or more would be needed to detect a 25% annualized reduction in flortaucipir accumulation rate in the AD meta-ROI with 80% power. Conclusions and Relevance Substantial flortaucipir accumulation in temporal regions is greatest in persons aged 65 to 85 years who were CU and had high initial Aβ PET levels, compared with those with lower Aβ levels. Recruiting persons who were CU and exhibiting Aβ of 68 CL or more on an index Aβ PET is a feasible strategy to recruit for clinical trials in which a change in tau PET signal is an outcome measure.
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Affiliation(s)
| | - Emily S Lundt
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Terry M Therneau
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | | | | | | | | | - Michelle M Mielke
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | | | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | | | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Ronald C Petersen
- Department of Neurology, Mayo Clinic, Rochester, Minnesota.,Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
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Whitwell JL, Tosakulwong N, Schwarz CC, Senjem ML, Spychalla AJ, Duffy JR, Graff-Radford J, Machulda MM, Boeve BF, Knopman DS, Petersen RC, Lowe VJ, Jack CR, Dickson DW, Parisi JE, Josephs KA. Longitudinal anatomic, functional, and molecular characterization of Pick disease phenotypes. Neurology 2020; 95:e3190-e3202. [PMID: 32989107 DOI: 10.1212/wnl.0000000000010948] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/30/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To characterize longitudinal MRI and PET abnormalities in autopsy-confirmed Pick disease (PiD) and determine how patterns of neurodegeneration differ with respect to clinical syndrome. METHODS Seventeen patients with PiD were identified who had antemortem MRI (8 with behavioral variant frontotemporal dementia [bvFTD-PiD], 6 with nonfluent/agrammatic primary progressive aphasia [naPPA-PiD], 1 with semantic primary progressive aphasia, 1 with unclassified primary progressive aphasia, and 1 with corticobasal syndrome). Thirteen patients had serial MRI for a total of 56 MRIs, 7 had [18F]fluorodeoxyglucose PET, 4 had Pittsburgh compound B (PiB) PET, and 1 patient had [18F]flortaucipir PET. Cross-sectional and longitudinal comparisons of gray matter volume and metabolism were performed between bvFTD-PiD, naPPA-PiD, and controls. Cortical PiB summaries were calculated to determine β-amyloid positivity. RESULTS The bvFTD-PiD and naPPA-PiD groups showed different foci of volume loss and hypometabolism early in the disease, with bvFTD-PiD involving bilateral prefrontal and anterior temporal cortices and naPPA-PiD involving left inferior frontal gyrus, insula, and orbitofrontal cortex. However, patterns merged over time, with progressive spread into prefrontal and anterior temporal lobe in naPPA-PiD, and eventual involvement of posterior temporal lobe, motor cortex, and parietal lobe in both groups. Rates of frontotemporal atrophy were faster in bvFTD-PiD than naPPA-PiD. One patient was β-amyloid-positive on PET with low Alzheimer neuropathologic changes at autopsy. Flortaucipir PET showed elevated uptake in frontotemporal white matter. CONCLUSION Patterns of atrophy and hypometabolism differ in PiD according to presenting syndrome, although patterns of neurodegeneration appear to converge over time.
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Affiliation(s)
- Jennifer L Whitwell
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL.
| | - Nirubol Tosakulwong
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Christopher C Schwarz
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Matthew L Senjem
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Anthony J Spychalla
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Joseph R Duffy
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Jon Graff-Radford
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Mary M Machulda
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Bradley F Boeve
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - David S Knopman
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Ronald C Petersen
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Val J Lowe
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Clifford R Jack
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Dennis W Dickson
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Joseph E Parisi
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
| | - Keith A Josephs
- From the Departments of Radiology (J.L.W., C.C.S., M.L.S., A.J.S., V.J.L., C.R.J.), Health Sciences Research (N.T.), Neurology (J.R.D., J.G.-R., B.F.B., D.S.K., R.C.P., K.A.J.), Psychiatry and Psychology (M.M.M.), and Neuropathology (J.E.P.), Mayo Clinic, Rochester, MN; and Department of Neuropathology (D.W.D.), Mayo Clinic, Jacksonville, FL
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5
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Heuer HW, Wang P, Rascovsky K, Wolf A, Appleby B, Bove J, Bordelon Y, Brannelly P, Brushaber DE, Caso C, Coppola G, Dickerson B, Dickinson S, Domoto-Reilly K, Faber K, Ferrall J, Fields J, Fishman A, Fong J, Foroud T, Forsberg LK, Gearhart D, Ghazanfari B, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford N, Grant I, Grossman M, Haley D, Hsiung GY, Huey E, Irwin D, Jones D, Kantarci K, Karydas A, Kaufer D, Kerwin D, Knopman D, Kornak J, Kramer JH, Kraft R, Kremers WK, Kukull W, Litvan I, Ljubenkov P, Mackenzie IR, Maldonado M, Manoochehri M, McGinnis S, McKinley E, Mendez MF, Miller BL, Onyike C, Pantelyat A, Pearlman R, Petrucelli L, Potter M, Rademakers R, Ramos EM, Rankin KP, Roberson ED, Rogalski E, Sengdy P, Shaw L, Syrjanen J, Tartaglia MC, Tatton N, Taylor J, Toga A, Trojanowski J, Weintraub S, Wong B, Wszolek Z, Boeve BF, Rosen HJ, Boxer AL. Comparison of sporadic and familial behavioral variant frontotemporal dementia (FTD) in a North American cohort. Alzheimers Dement 2020; 16:60-70. [PMID: 31914226 PMCID: PMC7192555 DOI: 10.1002/alz.12046] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Behavioral variant frontotemporal dementia (bvFTD) may present sporadically or due to an autosomal dominant mutation. Characterization of both forms will improve understanding of the generalizability of assessments and treatments. METHODS A total of 135 sporadic (s-bvFTD; mean age 63.3 years; 34% female) and 99 familial (f-bvFTD; mean age 59.9; 48% female) bvFTD participants were identified. f-bvFTD cases included 43 with known or presumed chromosome 9 open reading frame 72 (C9orf72) gene expansions, 28 with known or presumed microtubule-associated protein tau (MAPT) mutations, 14 with known progranulin (GRN) mutations, and 14 with a strong family history of FTD but no identified mutation. RESULTS Participants with f-bvFTD were younger and had earlier age at onset. s-bvFTD had higher total Neuropsychiatric Inventory Questionnaire (NPI-Q) scores due to more frequent endorsement of depression and irritability. DISCUSSION f-bvFTD and s-bvFTD cases are clinically similar, suggesting the generalizability of novel biomarkers, therapies, and clinical tools developed in either form to the other.
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Affiliation(s)
- Hilary W Heuer
- University of California, San Francisco, San Francisco, California
| | - P Wang
- University of California, San Francisco, San Francisco, California
| | - K Rascovsky
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - A Wolf
- University of California, San Francisco, San Francisco, California
| | - B Appleby
- Case Western Reserve University, Cleveland, Ohio
| | - J Bove
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - Y Bordelon
- University of California, Los Angeles, Los Angeles, California
| | - P Brannelly
- Tau Consortium, Rainwater Charitable Foundation, Fort Worth, Texas
| | | | - C Caso
- U Washington, Seattle, Washington
| | - G Coppola
- University of California, Los Angeles, Los Angeles, California
| | - B Dickerson
- Harvard University/MGH, Boston, Massachusetts
| | - S Dickinson
- Association for Frontotemporal Degeneration, Radnor, Pennsylvania
| | | | - K Faber
- National Centralized Repository for Alzheimer's Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, Indiana
| | - J Ferrall
- University of North Carolina, Chapel Hill, North Carolina
| | - J Fields
- Mayo Clinic, Rochester, Minnesota
| | - A Fishman
- Johns Hopkins University, Baltimore, Maryland
| | - J Fong
- University of California, San Francisco, San Francisco, California
| | - T Foroud
- National Centralized Repository for Alzheimer's Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, Indiana
| | | | | | | | - N Ghoshal
- Washington University, St. Louis, Missouri
| | - J Goldman
- Columbia University, New York, New York
| | | | | | - I Grant
- Northwestern University, Chicago, Illinois
| | - M Grossman
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - D Haley
- Mayo Clinic, Jacksonville, Florida
| | - G-Y Hsiung
- University of British Columbia, Vancouver, British Columbia, Canada
| | - E Huey
- Columbia University, New York, New York
| | - D Irwin
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - D Jones
- Mayo Clinic, Rochester, Minnesota
| | | | - A Karydas
- University of California, San Francisco, San Francisco, California
| | - D Kaufer
- University of North Carolina, Chapel Hill, North Carolina
| | - D Kerwin
- The University of Texas, Southwestern Medical Center at Dallas, Dallas, Texas
| | | | - J Kornak
- University of California, San Francisco, San Francisco, California
| | - J H Kramer
- University of California, San Francisco, San Francisco, California
| | - R Kraft
- Mayo Clinic, Rochester, Minnesota
| | | | - W Kukull
- National Alzheimer Coordinating Center (NACC), University of Washington, Seattle, Washington
| | - I Litvan
- University of California, San Diego, San Diego, California
| | - P Ljubenkov
- University of California, San Francisco, San Francisco, California
| | - I R Mackenzie
- University of British Columbia, Vancouver, British Columbia, Canada
| | - M Maldonado
- University of California, Los Angeles, Los Angeles, California
| | | | - S McGinnis
- Harvard University/MGH, Boston, Massachusetts
| | - E McKinley
- University of Alabama at Birmingham, Birmingham, Alabama
| | - M F Mendez
- University of California, Los Angeles, Los Angeles, California
| | - B L Miller
- University of California, San Francisco, San Francisco, California
| | - C Onyike
- Johns Hopkins University, Baltimore, Maryland
| | - A Pantelyat
- Johns Hopkins University, Baltimore, Maryland
| | - R Pearlman
- Bluefield Project, San Francisco, California
| | | | - M Potter
- National Centralized Repository for Alzheimer's Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, Indiana
| | | | - E M Ramos
- University of California, Los Angeles, Los Angeles, California
| | - K P Rankin
- University of California, San Francisco, San Francisco, California
| | - E D Roberson
- University of Alabama at Birmingham, Birmingham, Alabama
| | - E Rogalski
- Northwestern University, Chicago, Illinois
| | - P Sengdy
- University of British Columbia, Vancouver, British Columbia, Canada
| | - L Shaw
- University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | - N Tatton
- Association for Frontotemporal Degeneration, Radnor, Pennsylvania
| | - J Taylor
- University of California, San Francisco, San Francisco, California
| | - A Toga
- Laboratory of Neuroimaging (LONI), USC, Los Angeles, California
| | | | | | - B Wong
- Harvard University/MGH, Boston, Massachusetts
| | | | | | - H J Rosen
- University of California, San Francisco, San Francisco, California
| | - A L Boxer
- University of California, San Francisco, San Francisco, California
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6
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Boeve B, Ferman T, Graff-Radford N, Knopman D, Graff-Radford J, Savica R, Jones D, Drubach D, Fields J, Machulda M, Lucas J, Forsberg L, Miyagawa T, Allen L, Kantarci K, Murray M, Parisi J, Dickson D, Petersen R. Mild cognitive impairment associated with eventual Lewy body disease pathology: Clinical characterization of 75 patients. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.248] [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: 11/26/2022]
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7
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Knopman DS, Lundt ES, Therneau TM, Vemuri P, Lowe VJ, Kantarci K, Gunter JL, Senjem ML, Mielke MM, Machulda MM, Boeve BF, Jones DT, Graff-Radford J, Albertson SM, Schwarz CG, Petersen RC, Jack CR. Entorhinal cortex tau, amyloid-β, cortical thickness and memory performance in non-demented subjects. Brain 2019; 142:1148-1160. [PMID: 30759182 PMCID: PMC6439321 DOI: 10.1093/brain/awz025] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [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: 10/03/2018] [Revised: 12/03/2018] [Accepted: 12/15/2018] [Indexed: 01/13/2023] Open
Abstract
As more biomarkers for Alzheimer's disease and age-related brain conditions become available, more sophisticated analytic approaches are needed to take full advantage of the information they convey. Most work has been done using categorical approaches but the joint relationships of tau PET, amyloid PET and cortical thickness in their continuous distributions to cognition have been under-explored. We evaluated non-demented subjects over age 50 years in the Mayo Clinic Study of Aging, 2037 of whom had undergone 3 T MRI scan, 985 amyloid PET scan with 11C-Pittsburgh compound B (PIB) and MRI, and 577 PIB-PET, 18F-AV1451 flortaucipir PET and MRI. Participants received a nine-test cognitive battery. Three test scores (logical memory delayed recall, visual reproduction delayed recall and auditory verbal learning test delayed recall) were used to generate a memory composite z-score. We used Gradient Boosting Machine models to analyse the relationship between regional cortical thickness, flortaucipir PET signal, PIB-PET signal and memory z-scores. Age, education, sex and number of test exposures were included in the model as covariates. In this population-based study of non-demented subjects, most of the associations between biomarkers and memory z-scores accrued after 70 years of age. Entorhinal cortex exhibited the strongest associations between biomarkers and memory z-scores. Other temporal regions showed similar but attenuated associations, and non-temporal regions had negligible associations between memory z-scores and biomarkers. Entorhinal flortaucipir PET signal, PIB-PET signal and entorhinal cortical thickness were independently and additively associated with declining memory z-scores. In contrast to global PIB-PET signal where only very high amyloid-β levels were associated low memory z-scores, entorhinal flortaucipir PET signal just above background levels was associated with low memory z-scores. The lowest memory z-scores occurred with the confluence of elevated entorhinal flortaucipir PET signal and lower entorhinal cortical thickness.
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Affiliation(s)
| | - Emily S Lundt
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Terry M Therneau
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Michelle M Mielke
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
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8
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Graff-Radford J, Fugate JE, Klaas J, Flemming KD, Brown RD, Rabinstein AA. Distinguishing clinical and radiological features of non-traumatic convexal subarachnoid hemorrhage. Eur J Neurol 2016; 23:839-46. [PMID: 26910197 DOI: 10.1111/ene.12926] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/04/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE The full spectrum of causes of convexal subarachnoid hemorrhage (cSAH) requires further investigation. Therefore, our objective was to describe the spectrum of clinical and imaging features of patients with non-traumatic cSAH. METHODS A retrospective observational study of consecutive patients with non-traumatic cSAH was performed at a tertiary referral center. The underlying cause of cSAH was characterized and clinical and imaging features that predict a specific etiology were identified. The frequency of future cSAH or intracerebral hemorrhage (ICH) was determined. RESULTS In all, 88 patients [median age 64 years (range 25-85)] with non-traumatic cSAH were identified. The most common causes were reversible cerebral vasoconstriction syndrome (RCVS) (26, 29.5%), cerebral amyloid angiopathy (CAA) (23, 26.1%), indeterminate (14, 15.9%) and endocarditis (9, 10.2%). CAA patients commonly presented at an older age than RCVS patients (75 years versus 51 years, P < 0.0001). Thirteen patients (14.7%) had recurrent cSAH, and 12 patients (13.6%) had a subsequent ICH. However, the risk was high amongst those with CAA compared to those caused by RCVS, with recurrent cSAH in 39.1% and subsequent lobar ICH in 43.5% of CAA cases. CONCLUSIONS Our study demonstrates the clinical diversity of cSAH. Older age, sensorimotor dysfunction and stereotyped spells suggest CAA as the underlying cause. Younger age and thunderclap headache predict RCVS. Yet, various other causes also need to be considered in the differential diagnosis.
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Affiliation(s)
| | - J E Fugate
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - J Klaas
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - K D Flemming
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - R D Brown
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - A A Rabinstein
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
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Boeve B, Ferman T, Irfan M, Aakre J, Louis E, Silber M, Tippmann-Peikert M, Lipford M, Junna M, Graff-Radford J, Kantarci K, Lowe V. Clinical, neuropsychiatric, and ioflupane SPECT imaging findings in REM sleep behavior disorder. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.104] [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: 11/25/2022]
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Graff-Radford J, Duffy J, Strand E, Josephs K. Parkinsonism in the Agrammatic and Logopenic Variants of Primary Progressive Aphasia (P02.047). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p02.047] [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: 11/15/2022] Open
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Rubin M, Graff-Radford J, Boeve B, Josephs K, Aksamit A. The Alien Limb Phenomenon & Creutzfeldt-Jakob Disease (P03.257). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p03.257] [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: 11/15/2022] Open
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12
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Fugate J, Graff-Radford J, Wijdicks E, Rabinstein A. Extramedullary Tumors and Leukemia: A Diagnostic Pitfall for the Neurologist (P03.145). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p03.145] [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: 11/15/2022] Open
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Abstract
BACKGROUND AND PURPOSE Our objective was to document the clinical and imaging features of Othello's syndrome (delusional jealousy). METHODS The study design was a retrospective case series of 105 patients with Othello's syndrome that were identified using the Electronic Medical Record system of Mayo Clinic. RESULTS The average age at onset of Othello's syndrome was 68 (25-94) years with 61.9% of patients being male. Othello's syndrome was most commonly associated with a neurological disorder (73/105) compared with psychiatric disorders (32/105). Of the patients with a neurological disorder, 76.7% had a neurodegenerative disorder. Seven of eight patients with a structural lesion associated with Othello's syndrome had right frontal lobe pathology. Voxel-based morphometry showed greater gray matter loss predominantly in the dorsolateral frontal lobes in the neurodegenerative patients with Othello's compared to matched patients with neurodegenerative disorders without Othello's syndrome. Treatment success was notable for patients with dopamine agonist induced Othello's syndrome in which all six patients had improvement in symptoms following decrease in medication. CONCLUSIONS This study demonstrates that Othello's syndrome occurs most frequently with neurological disorders. This delusion appears to be associated with dysfunction of the frontal lobes, especially the right frontal lobe.
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Affiliation(s)
- J Graff-Radford
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
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Graff-Radford J, Foote KD, Mikos AE, Bowers D, Fernandez HH, Rosado CA, Rodriguez RL, Malaty IA, Haq IU, Jacobson CE, Okun MS. Mood and motor effects of thalamic deep brain stimulation surgery for essential tremor. Eur J Neurol 2010; 17:1040-6. [PMID: 20113336 DOI: 10.1111/j.1468-1331.2010.02958.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [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
PURPOSE The aim of this study was to evaluate the effects of unilateral and bilateral ventralis intermedius (Vim) deep brain stimulation (DBS) on mood and motor function. METHODS Thirty-one consecutive medication refractory patients with essential tremor who underwent unilateral or bilateral Vim DBS at University of Florida and returned for at least 6 -month follow-up completed the Visual Analog Mood (VAMS), the Beck Depression Inventory (BDI), and the Tremor Rating Scale (TRS) before and after surgery. We excluded all patients who were implanted at other institutions. RESULTS The tense subscale of the VAMS improved significantly in both the unilateral and bilateral DBS groups (P < 0.001). On the VAMS afraid subscale, only the bilateral group trended toward improvement (P = 0.075). There were no significant changes for either group for the happy, confused, sad, angry, energetic or tired VAMS scores. TRS subscale scores all improved after unilateral and bilateral Vim DBS surgery (P < 0.001). CONCLUSIONS Feelings of tenseness, tremor severity and ADLs improved following unilateral or bilateral Vim DBS for ET.
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Affiliation(s)
- J Graff-Radford
- Department of Neurology, University of Florida Movement Disorders Center, McKnight Brain Institute, Gainesville, FL 32610, USA
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