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Dzialas V, Hoenig MC, Prange S, Bischof GN, Drzezga A, van Eimeren T. Structural underpinnings and long-term effects of resilience in Parkinson's disease. NPJ Parkinsons Dis 2024; 10:94. [PMID: 38697984 PMCID: PMC11066097 DOI: 10.1038/s41531-024-00699-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 04/02/2024] [Indexed: 05/05/2024] Open
Abstract
Resilience in neuroscience generally refers to an individual's capacity to counteract the adverse effects of a neuropathological condition. While resilience mechanisms in Alzheimer's disease are well-investigated, knowledge regarding its quantification, neurobiological underpinnings, network adaptations, and long-term effects in Parkinson's disease is limited. Our study involved 151 Parkinson's patients from the Parkinson's Progression Marker Initiative Database with available Magnetic Resonance Imaging, Dopamine Transporter Single-Photon Emission Computed Tomography scans, and clinical information. We used an improved prediction model linking neuropathology to symptom severity to estimate individual resilience levels. Higher resilience levels were associated with a more active lifestyle, increased grey matter volume in motor-associated regions, a distinct structural connectivity network and maintenance of relative motor functioning for up to a decade. Overall, the results indicate that relative maintenance of motor function in Parkinson's patients may be associated with greater neuronal substrate, allowing higher tolerance against neurodegenerative processes through dynamic network restructuring.
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Affiliation(s)
- Verena Dzialas
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, 50937, Cologne, Germany
- University of Cologne, Faculty of Mathematics and Natural Sciences, 50923, Cologne, Germany
| | - Merle C Hoenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, 50937, Cologne, Germany
- Molecular Organization of the Brain, Institute for Neuroscience and Medicine II, Research Center Juelich, 52428, Juelich, Germany
| | - Stéphane Prange
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, 50937, Cologne, Germany
- Université de Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR, 5229, Bron, France
| | - Gérard N Bischof
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, 50937, Cologne, Germany
- Molecular Organization of the Brain, Institute for Neuroscience and Medicine II, Research Center Juelich, 52428, Juelich, Germany
| | - Alexander Drzezga
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, 50937, Cologne, Germany
- Molecular Organization of the Brain, Institute for Neuroscience and Medicine II, Research Center Juelich, 52428, Juelich, Germany
- German Center for Neurodegenerative Diseases, 53127, Bonn, Germany
| | - Thilo van Eimeren
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, 50937, Cologne, Germany.
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, 50937, Cologne, Germany.
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2
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Theis H, Prange S, Bischof GN, Hoenig MC, Tittgemeyer M, Timmermann L, Fink GR, Drzezga A, Eggers C, van Eimeren T. Impulsive-compulsive behaviour in early Parkinson's disease is determined by apathy and dopamine receptor D3 polymorphism. NPJ Parkinsons Dis 2023; 9:154. [PMID: 37968562 PMCID: PMC10651866 DOI: 10.1038/s41531-023-00596-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 10/25/2023] [Indexed: 11/17/2023] Open
Abstract
Impulsive-compulsive behaviour (ICB) is a frequently observed non-motor symptom in early Parkinson's disease after initiating dopamine replacement therapy. At the opposite end of the motivated behaviour spectrum, apathy occurs in early Parkinson's disease even before dopamine replacement is started. The co-occurrence of these behavioural conditions in Parkinson's disease raises questions about their relationship and underlying pathophysiological determinants. In previous imaging or genetic studies, both conditions have been associated with the limbic dopaminergic system. The risk variant of the Ser9Gly polymorphism of the dopamine receptor D3 (DRD3) is linked to increased dopamine affinity in the limbic striatum. With this in mind, we investigated how ICB expression is explained by apathy and DRD3 polymorphisms and their effects on grey matter volume and dopamine synthesis capacity. Fifty-four patients with early Parkinson's disease took part in anatomical T1-weighted MRI. Forty of them also underwent dynamic PET imaging using [18F]DOPA to measure striatal dopamine synthesis capacity. Further, Ser9Gly (rs6280) gene polymorphism influencing the DRD3 dopamine-binding affinity was determined in all patients. The severity of impulsive-compulsive behaviour and apathy was assessed using the Questionnaire for Impulsive-Compulsive Disorders Rating Scale and the Apathy Evaluation Scale. ICB and the severity of apathy were indeed positively correlated. Apathy and the DRD3 polymorphism were interactive risk factors for ICB severity. Apathy was significantly linked to atrophy of the bilateral putamen. Patients with the DRD3 risk type had reduced dopamine synthesis capacity in the putamen and limbic striatum, apathy was associated with reduced dopamine synthesis capacity in the limbic striatum. The results of [18F]DOPA reached only trend significance. Apathy in drug-naïve PD patients might be a consequence of impaired striatal dopaminergic tone. This may represent a predisposing factor for the development of ICB after the initiation of dopamine replacement therapy. The risk type of DRD3 could further amplify this predisposition due to its higher affinity to dopamine.
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Affiliation(s)
- Hendrik Theis
- Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, 50937, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, 50937, Cologne, Germany
| | - Stéphane Prange
- Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, 50937, Cologne, Germany
- Université de Lyon, CNRS, UMR 5229, Institut des Sciences Cognitives Marc Jeannerod, Lyon, 69500, France
| | - Gérard N Bischof
- Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, 50937, Cologne, Germany
- Forschungszentrum Jülich, Institute for Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, 52428, Jülich, Germany
| | - Merle C Hoenig
- Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, 50937, Cologne, Germany
- Forschungszentrum Jülich, Institute for Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, 52428, Jülich, Germany
| | - Marc Tittgemeyer
- Max Planck Institute for Metabolism Research, 50931, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50931, Cologne, Germany
| | - Lars Timmermann
- Faculty of Medicine and University Hospital Marburg, Department of Neurology, University of Marburg, 35043, Marburg, Germany
| | - Gereon R Fink
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, 50937, Cologne, Germany
- Forschungszentrum Jülich, Institute of Neuroscience and Medicine (INM-3), Cognitive Neuroscience, 52428, Jülich, Germany
| | - Alexander Drzezga
- Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, 50937, Cologne, Germany
- Forschungszentrum Jülich, Institute for Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, 52428, Jülich, Germany
- German Center for Neurodegenerative Diseases (DZNE), 53127, Bonn-Cologne, Germany
| | - Carsten Eggers
- Department of Neurology, Knappschaftskrankenhaus Bottrop, 46242, Bottrop, Germany
| | - Thilo van Eimeren
- Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, 50937, Cologne, Germany.
- Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, 50937, Cologne, Germany.
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3
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Hoenig MC, Dzialas V, Banwinkler M, Asendorf A, Drzezga A, van Eimeren T. Educational level and its association with dopamine transporter loss in patients with Parkinson's disease. Parkinsonism Relat Disord 2023; 115:105844. [PMID: 37690218 DOI: 10.1016/j.parkreldis.2023.105844] [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] [Received: 05/12/2023] [Revised: 08/07/2023] [Accepted: 09/01/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND According to the cognitive-reserve concept, higher educated dementia patients tolerate more brain pathology than lower educated patients with similar impairment. Here, we examined whether higher education is associated with more severe dopamine terminal loss at the diagnosis of Parkinson's disease (PD). METHODS Dopamine transporter (DaT) SPECT information of 352 de novo PD patients and 172 healthy controls (HC) were retrieved from PPMI. Correlation analyses were performed between education years and regional DaT signal (i.e., putamen, caudate, striatum), correcting for UPDRS-III, age, sex and MoCA. Second, using a median split on education (Md = 16 yrs), high and low education groups were determined, which were matched for demographic and/or clinical scores and compared based on regional DaT signals. Finally, moderation analyses were conducted in the PD cohort, assessing the effect of education on the relation between putaminal DaT capacity and UPDRS-III. All analyses were performed across the entire cohorts and separately for three age ranges (sixth, seventh and eighth life decade). RESULTS Only PD patients in their eighth life decade presented a positive association between education and regional dopamine signalling. A significant moderation effect of education on the association between putaminal DaT signal loss and motor symptom severity was observed in this group (B=3.377, t=3.075, p = .003). The remaining analyses did not yield any significant results, neither in the PD nor HC cohort. CONCLUSION Higher education is not related with greater tolerance against dopamine loss in PD, but may nonetheless assert protective effects at more advanced age.
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Affiliation(s)
- Merle C Hoenig
- Research Center Juelich, Institute of Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany.
| | - Verena Dzialas
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany
| | - Magdalena Banwinkler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany
| | - Adrian Asendorf
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany
| | - Alexander Drzezga
- Research Center Juelich, Institute of Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany; German Center for Neurodegenerative Diseases, Bonn/Cologne, Germany
| | - Thilo van Eimeren
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany
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Hoenig MC, Drzezga A. Clear-headed into old age: Resilience and resistance against brain aging-A PET imaging perspective. J Neurochem 2023; 164:325-345. [PMID: 35226362 DOI: 10.1111/jnc.15598] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 11/28/2022]
Abstract
With the advances in modern medicine and the adaptation towards healthier lifestyles, the average life expectancy has doubled since the 1930s, with individuals born in the millennium years now carrying an estimated life expectancy of around 100 years. And even though many individuals around the globe manage to age successfully, the prevalence of aging-associated neurodegenerative diseases such as sporadic Alzheimer's disease has never been as high as nowadays. The prevalence of Alzheimer's disease is anticipated to triple by 2050, increasing the societal and economic burden tremendously. Despite all efforts, there is still no available treatment defeating the accelerated aging process as seen in this disease. Yet, given the advances in neuroimaging techniques that are discussed in the current Review article, such as in positron emission tomography (PET) or magnetic resonance imaging (MRI), pivotal insights into the heterogenous effects of aging-associated processes and the contribution of distinct lifestyle and risk factors already have and are still being gathered. In particular, the concepts of resilience (i.e. coping with brain pathology) and resistance (i.e. avoiding brain pathology) have more recently been discussed as they relate to mechanisms that are associated with the prolongation and/or even stop of the progressive brain aging process. Better understanding of the underlying mechanisms of resilience and resistance may one day, hopefully, support the identification of defeating mechanism against accelerating aging.
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Affiliation(s)
- Merle C Hoenig
- Research Center Juelich, Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany.,Department of Nuclear Medicine, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Alexander Drzezga
- Research Center Juelich, Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany.,Department of Nuclear Medicine, Faculty of Medicine, University Hospital Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases, Bonn/Cologne, Germany
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5
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Hoenig MC, Dzialas V, Drzezga A, van Eimeren T. The Concept of Motor Reserve in Parkinson's Disease: New Wine in Old Bottles? Mov Disord 2023; 38:16-20. [PMID: 36345092 DOI: 10.1002/mds.29266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/14/2022] [Accepted: 10/03/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Merle C Hoenig
- Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Research Center Juelich, Julich, Germany.,Department of Nuclear Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Verena Dzialas
- Department of Nuclear Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Faculty of Mathematics and Natural Sciences, University of Cologne, Cologne, Germany
| | - Alexander Drzezga
- Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Research Center Juelich, Julich, Germany.,Department of Nuclear Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany
| | - Thilo van Eimeren
- Department of Nuclear Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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6
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Banwinkler M, Dzialas V, Hoenig MC, van Eimeren T. Gray Matter Volume Loss in Proposed Brain-First and Body-First Parkinson's Disease Subtypes. Mov Disord 2022; 37:2066-2074. [PMID: 35943058 DOI: 10.1002/mds.29172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/24/2022] [Accepted: 07/10/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND α-Synuclein pathology is associated with neuronal degeneration in Parkinson's disease (PD) and considered to sequentially spread across the brain (Braak stages). According to a new hypothesis of distinct α-synuclein spreading directions based on the initial site of pathology, the "brain-first" spreading subtype would be associated with a more asymmetric cerebral and nigrostriatal pathology than the "body-first" subtype. OBJECTIVE Here, we tested if proposed markers of brain-first PD (ie, higher dopamine transporter [DaT] asymmetry; absence of rapid eye movement sleep behavior disorder [RBD]) are associated with a greater or more asymmetric reduction in gray matter volume (GMV) in comparison to body-first PD. METHODS Data of 255 de novo PD patients and 110 healthy controls (HCs) were retrieved from the Parkinson's Progression Markers Initiative. Structural magnetic resonance images were preprocessed, and GMVs and their hemispherical asymmetry were obtained for each of the neuropathologically defined Braak stages. Group and correlation comparisons were performed to assess differences in GMV and GMV asymmetry between PD subtypes. RESULTS PD patients demonstrated significantly smaller bilateral GMVs compared to HCs, in a pattern denoting stage-dependent disease-related brain atrophy. However, the degree of putaminal DaT asymmetry was not associated with reduced GMV or higher GMV asymmetry. Furthermore, RBD-negative and RBD-positive patients did not demonstrate a significant difference in GMV or GMV asymmetry. CONCLUSIONS Our findings suggest that putative brain-first and body-first patients do not present diverging brain atrophy patterns. Although certainly not disproving the brain-first/body-first spreading hypothesis, this study fails to provide evidence in support of it. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Magdalena Banwinkler
- Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - Verena Dzialas
- Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, University of Cologne, Cologne, Germany.,Faculty of Mathematics and Natural Sciences, University of Cologne, Cologne, Germany
| | | | - Merle C Hoenig
- Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, University of Cologne, Cologne, Germany.,Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Research Center Juelich, Juelich, Germany
| | - Thilo van Eimeren
- Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
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Doering E, Hoenig MC, Bischof GN, Bohn KP, Ellingsen LM, van Eimeren T, Drzezga A. Introducing a gatekeeping system for amyloid status assessment in mild cognitive impairment. Eur J Nucl Med Mol Imaging 2022; 49:4478-4489. [PMID: 35831715 PMCID: PMC9605923 DOI: 10.1007/s00259-022-05879-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 06/14/2022] [Indexed: 11/19/2022]
Abstract
Background In patients with mild cognitive impairment (MCI), enhanced cerebral amyloid-β plaque burden is a high-risk factor to develop dementia with Alzheimer’s disease (AD). Not all patients have immediate access to the assessment of amyloid status (A-status) via gold standard methods. It may therefore be of interest to find suitable biomarkers to preselect patients benefitting most from additional workup of the A-status. In this study, we propose a machine learning–based gatekeeping system for the prediction of A-status on the grounds of pre-existing information on APOE-genotype 18F-FDG PET, age, and sex. Methods Three hundred and forty-two MCI patients were used to train different machine learning classifiers to predict A-status majority classes among APOE-ε4 non-carriers (APOE4-nc; majority class: amyloid negative (Aβ-)) and carriers (APOE4-c; majority class: amyloid positive (Aβ +)) from 18F-FDG-PET, age, and sex. Classifiers were tested on two different datasets. Finally, frequencies of progression to dementia were compared between gold standard and predicted A-status. Results Aβ- in APOE4-nc and Aβ + in APOE4-c were predicted with a precision of 87% and a recall of 79% and 51%, respectively. Predicted A-status and gold standard A-status were at least equally indicative of risk of progression to dementia. Conclusion We developed an algorithm allowing approximation of A-status in MCI with good reliability using APOE-genotype, 18F-FDG PET, age, and sex information. The algorithm could enable better estimation of individual risk for developing AD based on existing biomarker information, and support efficient selection of patients who would benefit most from further etiological clarification. Further potential utility in clinical routine and clinical trials is discussed. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-022-05879-6.
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Affiliation(s)
- E Doering
- German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany. .,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Multimodal Neuroimaging Group, Cologne, Germany.
| | - M C Hoenig
- German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany.,Institute for Neuroscience and Medicine II-Molecular Organization of the Brain, Research Center Juelich, Jülich, Germany
| | - G N Bischof
- German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany.,Institute for Neuroscience and Medicine II-Molecular Organization of the Brain, Research Center Juelich, Jülich, Germany
| | - K P Bohn
- Klinikum Dritter Orden, Department of Radiology and Nuclear Medicine, Munich, Germany
| | - L M Ellingsen
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA.,Department of Electrical and Computer Engineering, University of Iceland, Reykjavik, Iceland
| | - T van Eimeren
- German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - A Drzezga
- German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Multimodal Neuroimaging Group, Cologne, Germany.,Institute for Neuroscience and Medicine II-Molecular Organization of the Brain, Research Center Juelich, Jülich, Germany
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Pfeil J, Hoenig MC, Doering E, van Eimeren T, Drzezga A, Bischof GN. Unique regional patterns of amyloid burden predict progression to prodromal and clinical stages of Alzheimer's disease. Neurobiol Aging 2021; 106:119-129. [PMID: 34284259 PMCID: PMC8461082 DOI: 10.1016/j.neurobiolaging.2021.06.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/22/2021] [Accepted: 06/15/2021] [Indexed: 01/21/2023]
Abstract
Although beta-amyloid (Aβ) positivity has shown to be associated with higher risk of progression to Alzheimer's disease (AD) in mild cognitive impairment (MCI), information on the time to conversion to manifest dementia cannot be readily deduced from this binary classification. Here, we assessed if regional patterns of Aβ deposition measured with 18F-florbetapir may serve as biomarker for progression risk in Aβ-positive cognitively normal (CN) and MCI patients, including clinical follow-up data and cerebrospinal fluid (CSF) biomarkers. Voxel-wise group comparisons between age and sex-matched Aβ-positive groups (i.e., CN-stables [n = 38] vs. CN-to-MCI/AD progressors [n = 38], MCI-stables [n = 104] versus MCI-to-AD progressors [n = 104]) revealed higher Aβ burden in precuneus, subcortical, and parietal regions in CN-to-MCI/AD progressors and cingulate, temporal, and frontal regions in MCI-to-AD progressors. Importantly, these regional patterns predicted progression to advanced stages on the AD spectrum in the short and the long-term beyond global Aβ burden and CSF biomarkers. These results suggest that distinct regional patterns of Aβ burden are a valuable biomarker for risk of disease progression in CN and MCI.
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Affiliation(s)
- Julia Pfeil
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, University Hospital of Cologne, Cologne, Germany.
| | - Merle C Hoenig
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, University Hospital of Cologne, Cologne, Germany; Research Center Juelich, Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany
| | - Elena Doering
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, University Hospital of Cologne, Cologne, Germany; German Center for Neurodegenerative Diseases, Bonn/Cologne, Germany
| | - Thilo van Eimeren
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, University Hospital of Cologne, Cologne, Germany; German Center for Neurodegenerative Diseases, Bonn/Cologne, Germany; University of Cologne, University Hospital of Cologne, Department of Neurology, Cologne, Germany
| | - Alexander Drzezga
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, University Hospital of Cologne, Cologne, Germany; Research Center Juelich, Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany; German Center for Neurodegenerative Diseases, Bonn/Cologne, Germany
| | - Gérard N Bischof
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, University of Cologne, University Hospital of Cologne, Cologne, Germany
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Abstract
This cross-sectional study examines positron emission tomography (PET) imaging to investigate the burden of tau tangles and amyloid β plaques in super agers, normal agers, and patients with mild cognitive impairment vs younger amyloid-negative controls.
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Affiliation(s)
- Merle C. Hoenig
- Research Center Juelich, Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Niclas Willscheid
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gérard N. Bischof
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Thilo van Eimeren
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Alexander Drzezga
- Research Center Juelich, Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
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10
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Hammes J, Theis H, Giehl K, Hoenig MC, Greuel A, Tittgemeyer M, Timmermann L, Fink GR, Drzezga A, Eggers C, van Eimeren T. Dopamine metabolism of the nucleus accumbens and fronto-striatal connectivity modulate impulse control. Brain 2020; 142:733-743. [PMID: 30753324 DOI: 10.1093/brain/awz007] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/23/2018] [Accepted: 11/28/2018] [Indexed: 12/14/2022] Open
Abstract
Impulsive-compulsive behaviours like pathological gambling or hypersexuality are a frequent side effect of dopamine replacement therapy in patients with Parkinson's disease. Multiple imaging studies suggest a significant reduction of presynaptic dopamine transporters in the nucleus accumbens to be a predisposing factor, reflecting either a reduction of mesolimbic projections or, alternatively, a lower presynaptic dopamine transporter expression per se. Here, we aimed to test the hypothesis of fewer mesolimbic projections as a risk factor by using dopamine synthesis capacity as a proxy of dopaminergic terminal density. Furthermore, previous studies have demonstrated a reduction of fronto-striatal connectivity to be associated with increased risk of impulsive-compulsive behaviour in Parkinson's disease. Therefore, another aim of this study was to investigate the relationship between severity of impulsive-compulsive behaviour, dopamine synthesis capacity and fronto-striatal connectivity. Eighty participants underwent resting state functional MRI and anatomical T1-weighted images [mean age: 68 ± 9.9 years, 67% male (patients)]. In 59 participants, 18F-DOPA-PET was obtained and voxel-wise Patlak slopes indicating dopamine synthesis capacity were calculated. All participants completed the QUIP-RS questionnaire, a well validated test to quantify severity of impulsive-compulsive behaviour in Parkinson's disease. A voxel-wise correlation analysis between dopamine synthesis capacity and QUIP-RS score was calculated for striatal regions. To investigate the relationship between symptom severity and functional connectivity, voxel-wise correlations were performed. A negative correlation was found between dopamine synthesis capacity and QUIP-RS score in the nucleus accumbens (r = -0.57, P = 0.001), a region functionally connected to the rostral anterior cingulate cortex. The connectivity strength was modulated by QUIP-RS, i.e. patients with more severe impulsive-compulsive behaviours had a weaker functional connectivity between rostral anterior cingulate cortex and the nucleus accumbens. In addition, cortical thickness and severity of impulsive-compulsive behaviour were positively correlated in the subgenual rostral anterior cingulate cortex. We found three factors to be associated with severity of impulsive-compulsive behaviour: (i) decreased dopamine synthesis capacity in the nucleus accumbens; (ii) decreased functional connectivity of the rostral anterior cingulate cortex with the nucleus accumbens; and (iii) increased cortical thickness of the subgenual rostral anterior cingulate cortex. Rather than a downregulation of dopamine transporters, a reduction of mesolimbic dopaminergic projections in conjunction with a dysfunctional rostral anterior cingulate cortex-a region known to play a key role in impulse control-could be the most crucial neurobiological risk factor for the development of impulsive-compulsive behaviours in patients with Parkinson's disease under dopamine replacement therapy.
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Affiliation(s)
- Jochen Hammes
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Hendrik Theis
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Kathrin Giehl
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Merle C Hoenig
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Andrea Greuel
- Department of Neurology, University Hospital of Marburg, Germany
| | - Marc Tittgemeyer
- Max Planck Institute for Metabolism Research, Cologne, Germany.,Cologne Cluster of Excellence in Cellular Stress and Aging-Associated Disease (CECAD), University of Cologne, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital of Marburg, Germany
| | - Gereon R Fink
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Germany
| | - Alexander Drzezga
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Germany
| | - Carsten Eggers
- Department of Neurology, University Hospital of Marburg, Germany
| | - Thilo van Eimeren
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.,Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Germany
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Hoenig MC, Bischof GN, Onur ÖA, Kukolja J, Jessen F, Fliessbach K, Neumaier B, Fink GR, Kalbe E, Drzezga A, van Eimeren T. Level of education mitigates the impact of tau pathology on neuronal function. Eur J Nucl Med Mol Imaging 2019; 46:1787-1795. [PMID: 31183635 DOI: 10.1007/s00259-019-04342-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/22/2019] [Indexed: 01/25/2023]
Abstract
PURPOSE Using PET imaging in a group of patients with Alzheimer's disease (AD), we investigated whether level of education, a proxy for resilience, mitigates the harmful impact of tau pathology on neuronal function. METHODS We included 38 patients with mild-to-moderate AD (mean age 67 ± 7 years, mean MMSE score 24 ± 4, mean years of education 14 ± 4; 20 men, 18 women) in whom a [18F]AV-1451 scan (a measure of tau pathology) and an [18F]FDG scan (a measure of neuronal function) were available. The preprocessed PET scans were z-transformed using templates for [18F]AV-1451 and [18F]FDG from healthy controls, and subsequently thresholded at a z-score of ≥3.0, representing an one-tailed p value of 0.001. Next, three volumes were computed in each patient: the tau-specific volume (tau pathology without neuronal dysfunction), the FDG-specific volume (neuronal dysfunction without tau pathology), and the overlap volume (tau pathology and neuronal dysfunction). Mean z-scores and volumes were extracted and used as dependent variables in regression analysis with years of education as predictor, and age and MMSE score as covariates. RESULTS Years of education were positively associated with tau-specific volume (β = 0.362, p = 0.022), suggesting a lower impact of tau pathology on neuronal function in patients with higher levels of education. Concomitantly, level of education was positively related to tau burden in the overlap volume (β = 0.303, p = 0.036) implying that with higher levels of education more tau pathology is necessary to induce neuronal dysfunction. CONCLUSION In patients with higher levels of education, tau pathology is less paralleled by regional and remote neuronal dysfunction. The data suggest that early life-time factors such as level of education support resilience mechanisms, which ameliorate AD-related effects later in life.
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Affiliation(s)
- Merle C Hoenig
- Multimodal Neuroimaging, Department of Nuclear Medicine, Medical Faculty and University Hospital, University Hospital Cologne, Cologne, Germany. .,Molecular Organization of the Brain, Institute of Neuroscience and Medicine (INM-2), Research Center Jülich, Jülich, Germany.
| | - Gérard N Bischof
- Multimodal Neuroimaging, Department of Nuclear Medicine, Medical Faculty and University Hospital, University Hospital Cologne, Cologne, Germany.,Faculty of Mathematics and Natural Sciences, University of Cologne, Cologne, Germany
| | - Özgür A Onur
- Department of Neurology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
| | - Juraj Kukolja
- Department of Neurology and Clinical Neurophysiology, Helios University Hospital Wuppertal, Wuppertal, Germany
| | - Frank Jessen
- Department of Psychiatry, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Bernd Neumaier
- Nuclear Chemistry, Institute of Neuroscience and Medicine (INM-5), Research Center Jülich, Jülich, Germany.,Institute of Radiochemistry and Experimental Molecular Imaging, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Gereon R Fink
- Department of Neurology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
| | - Elke Kalbe
- Department of Medical Psychology
- Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Alexander Drzezga
- Multimodal Neuroimaging, Department of Nuclear Medicine, Medical Faculty and University Hospital, University Hospital Cologne, Cologne, Germany.,Molecular Organization of the Brain, Institute of Neuroscience and Medicine (INM-2), Research Center Jülich, Jülich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany
| | - Thilo van Eimeren
- Multimodal Neuroimaging, Department of Nuclear Medicine, Medical Faculty and University Hospital, University Hospital Cologne, Cologne, Germany.,Department of Neurology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany
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Hoenig MC, Bischof GN, Seemiller J, Hammes J, Kukolja J, Onur ÖA, Jessen F, Fliessbach K, Neumaier B, Fink GR, van Eimeren T, Drzezga A. Networks of tau distribution in Alzheimer’s disease. Brain 2018; 141:568-581. [DOI: 10.1093/brain/awx353] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 11/08/2017] [Indexed: 12/13/2022] Open
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