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Lee D, Jung YH, Kim S, Lee YI, Ku J, Yoon U, Choi SH. Alterations in cortical thickness of frontoparietal regions in patients with social anxiety disorder. Psychiatry Res Neuroimaging 2024; 340:111804. [PMID: 38460394 DOI: 10.1016/j.pscychresns.2024.111804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/26/2023] [Accepted: 02/20/2024] [Indexed: 03/11/2024]
Abstract
Although functional changes of the frontal and (para)limbic area for emotional hyper-reactivity and emotional dysregulation are well documented in social anxiety disorder (SAD), prior studies on structural changes have shown mixed results. This study aimed to identify differences in cortical thickness between SAD and healthy controls (CON). Thirty-five patients with SAD and forty-two matched CON underwent structural magnetic resonance imaging. A vertex-based whole brain and regional analyses were conducted for between-group comparison. The whole-brain analysis revealed increased cortical thickness in the left insula, left superior parietal lobule, left superior temporal gyrus, and left frontopolar cortex in patients with SAD compared to CON, as well as decreased thickness in the left superior/middle frontal gyrus and left fusiform gyrus in patients (after multiple-correction). The results from the ROI analysis did not align with these findings at the statistically significant level after multiple corrections. Changes in cortical thickness were not correlated with social anxiety symptoms. While consistent results were not obtained from different analysis methods, the results from the whole-brain analysis suggest that patients with SAD exhibit distinct neural deficits in areas involved in salience, attention, and socioemotional processing.
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Affiliation(s)
- Dasom Lee
- Department of Psychiatry, Seoul National University College of Medicine and Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ye-Ha Jung
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Suhyun Kim
- Department of Biomedical Engineering, Daegu Catholic University, Gyeongsan-si, Gyeongbuk, Republic of Korea
| | - Yoonji Irene Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeonghun Ku
- Department of Biomedical Engineering, Keimyung University, Gyeongsan-si, Gyeongbuk, Republic of Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, Daegu Catholic University, Gyeongsan-si, Gyeongbuk, Republic of Korea.
| | - Soo-Hee Choi
- Department of Psychiatry, Seoul National University College of Medicine and Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
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Park CH, Shin NY, Nam Y, Yoon U, Ahn K, Lee SK. Characteristics of perivascular space dilatation in normal aging. Hum Brain Mapp 2023; 44:3232-3240. [PMID: 36930038 PMCID: PMC10171536 DOI: 10.1002/hbm.26277] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/09/2023] [Accepted: 03/01/2023] [Indexed: 03/18/2023] Open
Abstract
The increased incidence of dilated perivascular spaces (dPVSs) visible on MRI has been observed with advancing age, but the relevance of PVS dilatation to normal aging across the lifespan has yet to be fully clarified. In the current study, we sought to find out the age dependence of dPVSs by exploring changes in different characteristics of PVS dilatation across a wide range of age. For 1220 healthy subjects aged between 18 and 100 years, PVSs were automatically segmented and characteristics of PVS dilatation were assessed in terms of the burden, location, and morphology of PVSs in the white matter (WM) and basal ganglia (BG). A machine learning model using the random forests method was constructed to estimate the subjects' age by employing the PVS features. The constructed machine learning model was able to estimate the age of the subjects with an error of 9.53 years on average (correlation = 0.875). The importance of the PVS features indicated the primary contribution of the burden of PVSs in the BG and the additional contribution of locational and morphological changes of PVSs, specifically peripheral extension and reduced linearity, in the WM to age estimation. Indeed, adding the PVS location or morphology features to the PVS burden features provided an improvement to the performance of age estimation. The age dependence of dPVSs in terms of such various characteristics of PVS dilatation in healthy subjects could provide a more comprehensive reference for detecting brain disease-related PVS dilatation.
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Affiliation(s)
- Chang-Hyun Park
- Division of Artificial Intelligence and Software, College of Engineering, Ewha Womans University, Seoul, South Korea
| | - Na-Young Shin
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, College of Medicine, Yonsei University, Seoul, South Korea
| | - Yoonho Nam
- Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Gyeonggi, South Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongsan, Gyeongbuk, South Korea
| | - Kookjin Ahn
- Department of Radiology, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Seung-Koo Lee
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, College of Medicine, Yonsei University, Seoul, South Korea
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Kim HG, Shin NY, Nam Y, Yun E, Yoon U, Lee HS, Ahn KJ. MRI-visible Dilated Perivascular Space in the Brain by Age: The Human Connectome Project. Radiology 2023; 306:e213254. [PMID: 36378031 DOI: 10.1148/radiol.213254] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Dilated perivascular spaces (dPVS) are associated with aging and various disorders; however, the effect of age on dPVS burden in young populations and normative data have not been fully evaluated. Purpose To investigate the dPVS burden and provide normative data according to age in a healthy population, including children. Materials and Methods In this retrospective study, three-dimensional T2-weighted brain MRI scans from the Human Connectome Project data sets were used for visual grading (grade 0, 1, 2, 3, 4 for 0, 1-10, 11-20, 21-40, and >40 dPVS on a single section of either hemispheric region) and automated volumetry of dPVS in basal ganglia (BGdPVS) and white matter (WMdPVS). Linear and nonlinear regression were performed to assess the association of dPVS volume with age. Optimal cutoff ages were determined with use of the maximized continuous-scale C-index. Participants were grouped by cutoff values. Linear regression was performed to assess the age-dPVS volume relationship in each age group. Normative data of dPVS visual grades were provided per age decade. Results A total of 1789 participants (mean age, 35 years; age range, 8-100 years; 1006 female participants) were evaluated. Age was related to dPVS volume in all regression models (R2 range, 0.41-0.55; P < .001). Age-dPVS volume relationships were altered at the mid-30s and age 55 years; BGdPVS and WMdPVS volumes negatively correlated with age until the mid-30s (β, -1.2 and -7.8), then positively until age 55 years (β, 3.3 and 54.1) and beyond (β, 3.9 and 42.8; P < .001). The 90th percentile for dPVS grades was grade 1 for age 49 years and younger, grade 2 for age 50-69 years, and grade 3 for age 70 years and older (overall, grade 2) for BGdPVS, and grade 3 for age 49 years and younger and grade 4 for age 50 years and older (overall, grade 3) for WMdPVS. Conclusion Dilated perivascular spaces (dPVS) showed a biphasic volume pattern with brain MRI, lower volumes until the mid-30s, then higher afterward. Grades of 3 or higher and 4 might be considered pathologic dPVS in basal ganglia and white matter, respectively. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Bapuraj and Chaudhary in this issue.
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Affiliation(s)
- Hyun Gi Kim
- From the Department of Radiology, Eunpyeong St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea (H.G.K.); Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea (N.Y.S., K.J.A.); Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.); Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Daegu, Republic of Korea (E.Y., U.Y.); and Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea (H.S.L.)
| | - Na-Young Shin
- From the Department of Radiology, Eunpyeong St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea (H.G.K.); Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea (N.Y.S., K.J.A.); Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.); Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Daegu, Republic of Korea (E.Y., U.Y.); and Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea (H.S.L.)
| | - Yoonho Nam
- From the Department of Radiology, Eunpyeong St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea (H.G.K.); Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea (N.Y.S., K.J.A.); Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.); Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Daegu, Republic of Korea (E.Y., U.Y.); and Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea (H.S.L.)
| | - Eunkyeong Yun
- From the Department of Radiology, Eunpyeong St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea (H.G.K.); Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea (N.Y.S., K.J.A.); Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.); Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Daegu, Republic of Korea (E.Y., U.Y.); and Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea (H.S.L.)
| | - Uicheul Yoon
- From the Department of Radiology, Eunpyeong St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea (H.G.K.); Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea (N.Y.S., K.J.A.); Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.); Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Daegu, Republic of Korea (E.Y., U.Y.); and Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea (H.S.L.)
| | - Hye Sun Lee
- From the Department of Radiology, Eunpyeong St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea (H.G.K.); Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea (N.Y.S., K.J.A.); Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.); Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Daegu, Republic of Korea (E.Y., U.Y.); and Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea (H.S.L.)
| | - Kook Jin Ahn
- From the Department of Radiology, Eunpyeong St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea (H.G.K.); Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea (N.Y.S., K.J.A.); Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.); Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Daegu, Republic of Korea (E.Y., U.Y.); and Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea (H.S.L.)
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Kang K, Jeong SY, Lee S, Yoon U. Distinct volumetric features of cerebrospinal fluid distribution in idiopathic normal‐pressure hydrocephalus and Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.065047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Kyunghun Kang
- School of Medicine, Kyungpook National University Daegu Republic of South Korea
| | - Shin Young Jeong
- School of Medicine, Kyungpook National University Daegu Republic of South Korea
| | - Sang‐Woo Lee
- School of Medicine, Kyungpook National University Daegu Republic of South Korea
| | - Uicheul Yoon
- Daegu Catholic University Gyeongsan‐si Republic of South Korea
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Kang K, Jeong SY, Park K, Hahm MH, Kim J, Lee H, Kim C, Yun E, Han J, Yoon U, Lee S. Distinct cerebral cortical perfusion patterns in idiopathic normal-pressure hydrocephalus. Hum Brain Mapp 2022; 44:269-279. [PMID: 36102811 PMCID: PMC9783416 DOI: 10.1002/hbm.25974] [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: 03/03/2022] [Revised: 04/29/2022] [Accepted: 05/12/2022] [Indexed: 02/05/2023] Open
Abstract
The aims of the study are to evaluate idiopathic normal-pressure hydrocephalus (INPH)-related cerebral blood flow (CBF) abnormalities and to investigate their relation to cortical thickness in INPH patients. We investigated cortical CBF utilizing surface-based early-phase 18 F-florbetaben (E-FBB) PET analysis in two groups: INPH patients and healthy controls. All 39 INPH patients and 20 healthy controls were imaged with MRI, including three-dimensional volumetric images, for automated surface-based cortical thickness analysis across the entire brain. A subgroup with 37 participants (22 INPH patients and 15 healthy controls) that also underwent 18 F-fluorodeoxyglucose (FDG) PET imaging was further analyzed. Compared with age- and gender-matched healthy controls, INPH patients showed statistically significant hyperperfusion in the high convexity of the frontal and parietal cortical regions. Importantly, within the INPH group, increased perfusion correlated with cortical thickening in these regions. Additionally, significant hypoperfusion mainly in the ventrolateral frontal cortex, supramarginal gyrus, and temporal cortical regions was observed in the INPH group relative to the control group. However, this hypoperfusion was not associated with cortical thinning. A subgroup analysis of participants that also underwent FDG PET imaging showed that increased (or decreased) cerebral perfusion was associated with increased (or decreased) glucose metabolism in INPH. A distinctive regional relationship between cerebral cortical perfusion and cortical thickness was shown in INPH patients. Our findings suggest distinct pathophysiologic mechanisms of hyperperfusion and hypoperfusion in INPH patients.
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Affiliation(s)
- Kyunghun Kang
- Department of Neurology, School of MedicineKyungpook National UniversityDaeguSouth Korea
| | - Shin Young Jeong
- Department of Nuclear Medicine, School of MedicineKyungpook National UniversityDaeguSouth Korea
| | - Ki‐Su Park
- Department of Neurosurgery, School of MedicineKyungpook National UniversityDaeguSouth Korea
| | - Myong Hun Hahm
- Department of Radiology, School of MedicineKyungpook National UniversityDaeguSouth Korea
| | - Jaeil Kim
- School of Computer Science and EngineeringKyungpook National UniversityDaeguSouth Korea
| | - Ho‐Won Lee
- Department of Neurology, School of MedicineKyungpook National UniversityDaeguSouth Korea,Brain Science and Engineering InstituteKyungpook National UniversityDaeguSouth Korea
| | - Chi‐Hun Kim
- Department of NeurologyHallym University Sacred Heart HospitalAnyangSouth Korea
| | - Eunkyeong Yun
- Department of Biomedical EngineeringDaegu Catholic UniversityGyeongsan‐siSouth Korea
| | - Jaehwan Han
- Department of Biomedical EngineeringDaegu Catholic UniversityGyeongsan‐siSouth Korea
| | - Uicheul Yoon
- Department of Biomedical EngineeringDaegu Catholic UniversityGyeongsan‐siSouth Korea
| | - Sang‐Woo Lee
- Department of Nuclear Medicine, School of MedicineKyungpook National UniversityDaeguSouth Korea
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Han J, Kim MN, Lee HW, Jeong SY, Lee SW, Yoon U, Kang K. Distinct volumetric features of cerebrospinal fluid distribution in idiopathic normal-pressure hydrocephalus and Alzheimer's disease. Fluids Barriers CNS 2022; 19:66. [PMID: 36045420 PMCID: PMC9434899 DOI: 10.1186/s12987-022-00362-8] [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: 03/04/2022] [Accepted: 07/13/2022] [Indexed: 12/04/2022] Open
Abstract
Objective The aims of the study were to measure the cerebrospinal fluid (CSF) volumes in the lateral ventricle, high-convexity subarachnoid space, and Sylvian fissure region in patients with idiopathic normal-pressure hydrocephalus (INPH) and Alzheimer’s disease (AD), and to evaluate differences in these volumes between INPH and AD groups and healthy controls. Methods Forty-nine INPH patients, 59 AD patients, and 26 healthy controls were imaged with automated three-dimensional volumetric MRI. Results INPH patients had larger lateral ventricles and CSF spaces of the Sylvian fissure region and smaller high-convexity subarachnoid spaces than other groups, and AD patients had larger lateral ventricles and CSF spaces of the Sylvian fissure region than the control group. The INPH group showed a negative correlation between lateral ventricle and high-convexity subarachnoid space volumes, while the AD group showed a positive correlation between lateral ventricle volume and volume for CSF spaces of the Sylvian fissure region. The ratio of lateral ventricle to high-convexity subarachnoid space volumes yielded an area under the curve of 0.990, differentiating INPH from AD. Conclusions Associations between CSF volumes suggest that there might be different mechanisms between INPH and AD to explain their respective lateral ventricular dilations. The ratio of lateral ventricle to high-convexity subarachnoid space volumes distinguishes INPH from AD with good diagnostic sensitivity and specificity. We propose to refer to this ratio as the VOSS (ventricle over subarachnoid space) index.
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Affiliation(s)
- Jaehwan Han
- Department of Biomedical Engineering, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Myoung Nam Kim
- Department of Biomedical Engineering, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Ho-Won Lee
- Department of Neurology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, South Korea.,Brain Science and Engineering Institute, Kyungpook National University, Daegu, South Korea
| | - Shin Young Jeong
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Sang-Woo Lee
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, Daegu Catholic University, 13-13 Hayang- ro, Hayang-eup, Gyeongsan, Gyeongbuk, 38430, South Korea.
| | - Kyunghun Kang
- Department of Neurology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, South Korea.
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Park CH, Shin NY, Yoo SW, Seo H, Yoon U, Yoo JY, Ahn K, Kim JS. Simulating the progression of brain structural alterations in Parkinson's disease. NPJ Parkinsons Dis 2022; 8:86. [PMID: 35764657 PMCID: PMC9240031 DOI: 10.1038/s41531-022-00349-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 06/10/2022] [Indexed: 12/01/2022] Open
Abstract
Considering brain structural alterations as neurodegenerative consequences of Parkinson's disease (PD), we sought to infer the progression of PD via the ordering of brain structural alterations from cross-sectional MRI observations. Having measured cortical thinning in gray matter (GM) regions and disintegrity in white matter (WM) regions as MRI markers of structural alterations for 130 patients with PD (69 ± 10 years, 72 men), stochastic simulation based on the probabilistic relationship between the brain regions was conducted to infer the ordering of structural alterations across all brain regions and the staging of structural alterations according to changes in clinical status. The ordering of structural alterations represented WM disintegrity tending to occur earlier than cortical thinning. The staging of structural alterations indicated structural alterations happening mostly before major disease complications such as postural instability and dementia. Later disease states predicted by the sequence of structural alterations were significantly related to more severe clinical symptoms. The relevance of the ordering of brain structural alterations to the severity of clinical symptoms suggests the clinical feasibility of predicting PD progression states.
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Affiliation(s)
- Chang-Hyun Park
- Department of Radiology, College of Medicine, Catholic University of Korea, Seoul, Korea.,Center for Neuroprosthetics and Brain Mind Institute, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Na-Young Shin
- Department of Radiology, College of Medicine, Catholic University of Korea, Seoul, Korea.
| | - Sang-Won Yoo
- Department of Neurology, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Haeseok Seo
- Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongsan, Gyeongbuk, Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongsan, Gyeongbuk, Korea
| | - Ji-Yeon Yoo
- Department of Neurology, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Kookjin Ahn
- Department of Radiology, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, Catholic University of Korea, Seoul, Korea
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Shin NY, Bang M, Yoo SW, Kim JS, Yun E, Yoon U, Han K, Ahn KJ, Lee SK. Cortical Thickness from MRI to Predict Conversion from Mild Cognitive Impairment to Dementia in Parkinson Disease: A Machine Learning-based Model. Radiology 2021; 300:390-399. [PMID: 34032515 DOI: 10.1148/radiol.2021203383] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Group comparison results associating cortical thinning and Parkinson disease (PD) dementia (PDD) are limited in their application to clinical settings. Purpose To investigate whether cortical thickness from MRI can help predict conversion from mild cognitive impairment (MCI) to dementia in PD at an individual level using a machine learning-based model. Materials and Methods In this retrospective study, patients with PD and MCI who underwent MRI from September 2008 to November 2016 were included. Features were selected from clinical and cortical thickness variables in 10 000 randomly generated training sets. Features selected 5000 times or more were used to train random forest and support vector machine models. Each model was trained and tested in 10 000 randomly resampled data sets, and a median of 10 000 areas under the receiver operating characteristic curve (AUCs) was calculated for each. Model performances were validated in an external test set. Results Forty-two patients progressed to PDD (converters) (mean age, 71 years ± 6 [standard deviation]; 22 women), and 75 patients did not progress to PDD (nonconverters) (mean age, 68 years ± 6; 40 women). Four PDD converters (mean age, 74 years ± 10; four men) and 20 nonconverters (mean age, 67 years ± 7; 11 women) were included in the external test set. Models trained with cortical thickness variables (AUC range, 0.75-0.83) showed fair to good performances similar to those trained with clinical variables (AUC range, 0.70-0.81). Model performances improved when models were trained with both variables (AUC range, 0.80-0.88). In pair-wise comparisons, models trained with both variables more frequently showed better performance than others in all model types. The models trained with both variables were successfully validated in the external test set (AUC range, 0.69-0.84). Conclusion Cortical thickness from MRI helped predict conversion from mild cognitive impairment to dementia in Parkinson disease at an individual level, with improved performance when integrated with clinical variables. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Port in this issue.
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Affiliation(s)
- Na-Young Shin
- From the Departments of Radiology (N.Y.S., M.B., K.J.A.) and Neurology (S.W.Y., J.S.K.), College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea (N.Y.S., K.H., S.K.L.); and Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongbuk, Korea (E.Y., U.Y.)
| | - Mirim Bang
- From the Departments of Radiology (N.Y.S., M.B., K.J.A.) and Neurology (S.W.Y., J.S.K.), College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea (N.Y.S., K.H., S.K.L.); and Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongbuk, Korea (E.Y., U.Y.)
| | - Sang-Won Yoo
- From the Departments of Radiology (N.Y.S., M.B., K.J.A.) and Neurology (S.W.Y., J.S.K.), College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea (N.Y.S., K.H., S.K.L.); and Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongbuk, Korea (E.Y., U.Y.)
| | - Joong-Seok Kim
- From the Departments of Radiology (N.Y.S., M.B., K.J.A.) and Neurology (S.W.Y., J.S.K.), College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea (N.Y.S., K.H., S.K.L.); and Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongbuk, Korea (E.Y., U.Y.)
| | - Eunkyeong Yun
- From the Departments of Radiology (N.Y.S., M.B., K.J.A.) and Neurology (S.W.Y., J.S.K.), College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea (N.Y.S., K.H., S.K.L.); and Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongbuk, Korea (E.Y., U.Y.)
| | - Uicheul Yoon
- From the Departments of Radiology (N.Y.S., M.B., K.J.A.) and Neurology (S.W.Y., J.S.K.), College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea (N.Y.S., K.H., S.K.L.); and Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongbuk, Korea (E.Y., U.Y.)
| | - Kyunghwa Han
- From the Departments of Radiology (N.Y.S., M.B., K.J.A.) and Neurology (S.W.Y., J.S.K.), College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea (N.Y.S., K.H., S.K.L.); and Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongbuk, Korea (E.Y., U.Y.)
| | - Kook Jin Ahn
- From the Departments of Radiology (N.Y.S., M.B., K.J.A.) and Neurology (S.W.Y., J.S.K.), College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea (N.Y.S., K.H., S.K.L.); and Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongbuk, Korea (E.Y., U.Y.)
| | - Seung-Koo Lee
- From the Departments of Radiology (N.Y.S., M.B., K.J.A.) and Neurology (S.W.Y., J.S.K.), College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Radiology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea (N.Y.S., K.H., S.K.L.); and Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongbuk, Korea (E.Y., U.Y.)
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9
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Yoo SW, Kim JS, Yoo JY, Yun E, Yoon U, Shin NY, Lee KS. Delayed orthostatic hypotension in Parkinson's disease. NPJ Parkinsons Dis 2021; 7:37. [PMID: 33854059 PMCID: PMC8047032 DOI: 10.1038/s41531-021-00181-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 02/26/2021] [Indexed: 12/19/2022]
Abstract
Orthostatic hypotension (OH) is relatively common in the early stage of Parkinson's disease (PD). It is divided into delayed OH and classical OH. Classical OH in PD has been investigated widely, however, the clinical implications of delayed OH in PD have seldom been studied. The purpose of this study is to characterize delayed OH in PD. A total of 285 patients with early drug-naïve PD were enrolled and divided into three groups according to orthostatic change: no-OH, delayed OH, and classical OH. The disease severity in terms of motor, non-motor, and cognitive functions was assessed. The cortical thickness of 82 patients was analyzed with brain magnetic resonance imaging. The differences among groups and linear tendency in the order of no-OH, delayed OH, and classical OH were investigated. Seventy-seven patients were re-evaluated. Initial and follow-up evaluations were explored to discern any temporal effects of orthostasis on disease severity. Sixty-four (22.5%) patients were defined as having delayed OH and 117 (41.1%) had classical OH. Between-group comparisons revealed that classical OH had the worst outcomes in motor, non-motor, cognitive, and cortical thickness, compared to the other groups. No-OH and delayed OH did not differ significantly. Linear trends across the pre-ordered OH subtypes found that clinical parameters worsened along with the orthostatic challenge. Clinical scales deteriorated and the linear gradient was maintained during the follow-up period. This study suggests that delayed OH is a mild form of classical OH in PD. PD with delayed OH has milder disease severity and progression.
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Affiliation(s)
- Sang-Won Yoo
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Ji-Yeon Yoo
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eunkyeong Yun
- Department of Biomedical Engineering, College of Health and Medical Science, Catholic University of Daegu, Gyeongbuk, Republic of Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, College of Health and Medical Science, Catholic University of Daegu, Gyeongbuk, Republic of Korea
| | - Na-Young Shin
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kwang-Soo Lee
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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10
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Kang K, Han J, Lee SW, Jeong SY, Lim YH, Lee JM, Yoon U. Abnormal cortical thickening and thinning in idiopathic normal-pressure hydrocephalus. Sci Rep 2020; 10:21213. [PMID: 33273614 PMCID: PMC7712876 DOI: 10.1038/s41598-020-78067-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 04/07/2020] [Accepted: 11/02/2020] [Indexed: 12/16/2022] Open
Abstract
We investigated differences in cortical thickness between idiopathic normal-pressure hydrocephalus (INPH) patients and healthy controls. We also explored whether a relationship exists between cortical thinning and gait disturbance in INPH patients. Forty-nine INPH patients and 26 healthy controls were imaged with MRI, including 3-dimensional volumetric images, for automated surface-based cortical thickness analysis across the entire brain. Compared with age- and gender-matched healthy controls, unexpectedly, INPH patients showed statistically significant cortical thickening mainly in areas located in the high convexity of the frontal, parietal, and occipital regions. Additionally, cortical thinning mainly in temporal and orbitofrontal regions was observed in the INPH group relative to the control group. The Gait Status Scale (GSS) scores were negatively correlated with cortical thickness in the medial orbital part of the superior frontal gyrus, gyrus rectus, superior temporal gyrus, temporal pole, and insula. A distinctive pattern of cortical thickness changes was found in INPH patients. We cautiously suggest that cortical thickening in INPH can result from reactive gliosis. Further, our results support the hypothesis that cortical thinning in INPH can result from neuronal degeneration. In addition, cortical thinning can play an important role in gait disturbances in INPH patients.
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Affiliation(s)
- Kyunghun Kang
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea.,Department of Neurology, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Jaehwan Han
- Department of Biomedical Engineering, Daegu Catholic University, Gyeongsan-si, South Korea
| | - Sang-Woo Lee
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Shin Young Jeong
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Yong-Hyun Lim
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, South Korea.,Center of Self-Organizing Software-Platform, Kyungpook National University, Daegu, South Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea.
| | - Uicheul Yoon
- Department of Biomedical Engineering, Daegu Catholic University, Gyeongsan-si, South Korea.
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11
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Jeong SY, Yoon U, Kang K, Lee S. Assessment of beta‐amyloid deposition using gray matter delineation by early‐phase F‐18 florbetaben PET in patients with brain atrophy. Alzheimers Dement 2020. [DOI: 10.1002/alz.038717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Shin Young Jeong
- School of Medicine Kyungpook National University Daegu South Korea
| | - Uicheul Yoon
- Daegu Catholic University Gyeongsan‐si South Korea
| | - Kyunghun Kang
- Department of Neurology School of Medicine Kyungpook National University Daegu South Korea
| | - Sang‐Woo Lee
- School of Medicine Kyungpook National University Daegu South Korea
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12
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Yoo SW, Yun E, Bang M, Yoon U, Yoo JY, Lee KS, Shin NY, Kim JS. Blood pressure lability is associated with subcortical atrophy in early Parkinson's disease. J Hypertens 2020; 38:2043-2049. [PMID: 32890281 DOI: 10.1097/hjh.0000000000002505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Increased cerebral white matter intensities associated with blood pressure (BP) lability were reported in patients with Parkinson's disease. However, this type of cardiovascular dysautonomia has seldom been associated with disruptions in deep gray matter structures in Parkinson's disease. In the present study, the associations between BP lability and subcortical deep gray matter structures in early Parkinson's disease were evaluated. METHODS The present study included 98 early nondemented Parkinson's disease patients. Supine and orthostatic BPs were measured using head-up tilt tests. BP variabilities, measured as standard deviations of 24-h daytime and nighttime BPs, were assessed using 24-h ambulatory BP monitoring. Every patient underwent brain MRI and measurement of deep gray matter volumes. The associations between BP lability and deep gray matter structures were analyzed. RESULTS Parkinson's disease patients with orthostatic hypotension had smaller volumes of striatum, particularly caudate, than patients without OH after adjusting for covariates of age, sex, disease duration, and Mini-Mental Status Examination score. Nocturnal BP variability was inversely associated with thalamus, hippocampus, and globus pallidus volumes. CONCLUSION The results from the present study showed that BP lability was adversely associated with structural changes in early Parkinson's disease. Different forms of BP fluctuations influenced distinct deep gray matter structures.
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Affiliation(s)
- Sang-Won Yoo
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul
| | - Eunkyeong Yun
- Department of Biomedical Engineering, College of Health and Medical Science, Catholic University of Daegu, Gyeongbuk
| | - Mirim Bang
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, College of Health and Medical Science, Catholic University of Daegu, Gyeongbuk
| | - Ji-Yeon Yoo
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul
| | - Kwang-Soo Lee
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul
| | - Na-Young Shin
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul
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13
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Shin NY, Kim BH, Yun E, Yoon U, Lee JM, Sung YH, Kim EY. Cortical thinning pattern according to differential nigrosome involvement in patients with Parkinson's disease. Neuroimage Clin 2020; 28:102382. [PMID: 32828029 PMCID: PMC7451416 DOI: 10.1016/j.nicl.2020.102382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 08/06/2020] [Accepted: 08/09/2020] [Indexed: 12/03/2022]
Abstract
The pathological hallmark of Parkinson's disease (PD) is the progressive degeneration of dopaminergic neurons in the substantia nigra pars compacta, where the dopaminergic neurons form five clusters called nigrosomes 1-5 (N1-N5). N1 is the largest and considered to be the most affected by PD, followed by N2, N4, N3, and N5. Recently, an MRI study suggested a sequential progression of loss from N1 to N4. As the extent of cortical thinning widens as PD progresses, we aimed to define cortical thinning patterns according to the differential involvement of N1 and N4 in PD patients. Cortical thickness was analyzed in 83 PD patients (29 with N1 loss on at least one side of the brain, but no N4 loss; and 54 with N4 loss on at least one side) and 35 healthy subjects with age, sex, disease duration, and intracranial volume as covariates. On patient-wise analysis, for areas with more cortical thinning than the controls, PD patients with N4 loss had wider cortical thinning involving more dorsolateral prefrontal cortex and temporal areas than PD patients with only N1 loss, but cortical thinning did not significantly differ between these two patient groups. However, cortical thinning was more apparent in hemisphere-level analysis with statistically significant clusters being found more in hemispheres with N4 loss than hemispheres with N1 loss in PD patients compared to normal hemispheres of the controls. Cortical thinning occurred in a similar propagation pattern to that seen with PD progression, supporting past hypotheses on the sequential progression of nigrosome loss from N1 to N4.
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Affiliation(s)
- Na-Young Shin
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Bo-Hyun Kim
- Department of Biomedical Engineering, Hanyang University, Seoul 04763, Republic of Korea
| | - Eunkyeong Yun
- Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongbuk 38430, Republic of Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongbuk 38430, Republic of Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul 04763, Republic of Korea
| | - Young Hee Sung
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Republic of Korea
| | - Eung Yeop Kim
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Republic of Korea.
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14
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Kang SY, Bang M, Hong JY, Oh J, Kim JS, Han YM, Chang SK, Lee SA, Yoon U, Shin NY. Neural and dopaminergic correlates of fatigue in Parkinson's disease. J Neural Transm (Vienna) 2020; 127:301-309. [PMID: 31894419 DOI: 10.1007/s00702-019-02130-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 12/19/2019] [Indexed: 11/25/2022]
Abstract
Fatigue is one of the most common non-motor symptoms in Parkinson's disease (PD). Despite its clinical importance, there are few studies on the cause or mechanism of fatigue. Our aim was to find brain areas related to fatigue and to explore the association between striatal dopaminergic dysfunction and fatigue. We consecutively screened forty-seven patients with de novo PD from 2012 to 2017 and enrolled 32 patients. The gray matter volumes, white matter tracts, and striatal dopaminergic activity between PD without fatigue and with fatigue were compared. The correlation between fatigue and striatal dopaminergic activity was also analyzed. Our data did not show any significant difference in gray matter volume between PD without fatigue and with fatigue (familywise error [FWE] corrected p > 0.05) but revealed significantly higher mean fractional anisotropy (FA) values for all analyzed white matter tracts in PD with fatigue (false discovery rate [FDR] corrected p < 0.05), except left cingulum-hippocampus (CH), right superior longitudinal fasciculus, and right longitudinal fasciculus temporal part (FDR corrected p > 0.06); lower mean diffusivity (MD) values for all analyzed white matter tracts in PD with fatigue (FDR corrected p < 0.05), except in the left CH and uncinate fasciculus (FDR corrected p > 0.05). The mean radial diffusivity (RD) values, except for the left CH (FDR corrected p = 0.0576), were also significantly lower (FDR corrected p < 0.05). There was no difference in dopaminergic deficits between PD without fatigue and PD with fatigue (p > 0.50). The alteration of the white matter tract may reflect the degree of fatigue in PD. This is not true of the gray matter and striatal dopaminergic activity. These results show the possibility that white matter changes can be used as a biomarker for fatigue.
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Affiliation(s)
- Suk Yun Kang
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong, Gyeonggi-do, 18450, Republic of Korea.
| | - Mirim Bang
- Department of Radiology, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Jing Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jungsu Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - You Mie Han
- Department of Nuclear Medicine, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong, Republic of Korea
| | - Suk Ki Chang
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
| | - Seun Ah Lee
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, College of Health and Medical Science, Catholic University of Daegu, Gyeongsan, Republic of Korea
| | - Na-Young Shin
- Department of Radiology, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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15
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Lee JS, Park YH, Park S, Yoon U, Choe Y, Cheon BK, Hahn A, Cho SH, Kim SJ, Kim JP, Jung YH, Park KC, Kim HJ, Jang H, Na DL, Seo SW. Distinct Brain Regions in Physiological and Pathological Brain Aging. Front Aging Neurosci 2019; 11:147. [PMID: 31275140 PMCID: PMC6591468 DOI: 10.3389/fnagi.2019.00147] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 03/28/2019] [Accepted: 06/04/2019] [Indexed: 12/17/2022] Open
Abstract
Background Studying structural brain aging is important to understand age-related pathologies, as well as to identify the early manifestations of the Alzheimer’s disease (AD) continuum. In this study, we investigated the long-term trajectory of physiological and pathological brain aging in a large number of participants ranging from the 50s to over 80 years of age. Objective To explore the distinct brain regions that distinguish pathological brain aging from physiological brain aging using sophisticated measurements of cortical thickness. Methods A total of 2,823 cognitively normal (CN) individuals and 2,675 patients with AD continuum [874 with subjective memory impairment (SMI), 954 with amnestic mild cognitive impairment (aMCI), and 847 with AD dementia] who underwent a high-resolution 3.0-tesla MRI were included in this study. To investigate pathological brain aging, we further classified patients with aMCI and AD according to the severity of cognitive impairment. Cortical thickness was measured using a surface-based method. Multiple linear regression analyses were performed to evaluate age, diagnostic groups, and cortical thickness. Results Aging extensively affected cortical thickness not only in CN individuals but also in AD continuum patients; however, the precuneus and inferior temporal regions were relatively preserved against age-related cortical thinning. Compared to CN individuals, AD continuum patients including those with SMI showed a decreased cortical thickness in the perisylvian region. However, widespread cortical thinning including the precuneus and inferior temporal regions were found from the late-stage aMCI to the moderate to severe AD. Unlike the other age groups, AD continuum patients aged over 80 years showed prominent cortical thinning in the medial temporal region with relative sparing of the precuneus. Conclusion Our findings suggested that the precuneus and inferior temporal regions are the key regions in distinguishing between physiological and pathological brain aging. Attempts to differentiate age-related pathology from physiological brain aging at a very early stage would be important in terms of establishing new strategies for preventing accelerated pathological brain aging.
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Affiliation(s)
- Jin San Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea.,Department of Neurology, Kyung Hee University Hospital, Seoul, South Korea
| | - Yu Hyun Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Seongbeom Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, Daegu Catholic University, Gyeongsan, South Korea
| | - Yeongsim Choe
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Bo Kyoung Cheon
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Alice Hahn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Soo Hyun Cho
- Department of Neurology, Chonnam National University Medical School, Gwangju, South Korea
| | - Seung Joo Kim
- Department of Neurology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Jun Pyo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Young Hee Jung
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Key-Chung Park
- Department of Neurology, Kyung Hee University Hospital, Seoul, South Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea.,Samsung Alzheimer Research Center, Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea.,Department of Health Sciences and Technology, Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
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16
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Kang K, Kwak K, Yoon U, Lee JM. Lateral Ventricle Enlargement and Cortical Thinning in Idiopathic Normal-pressure Hydrocephalus Patients. Sci Rep 2018; 8:13306. [PMID: 30190599 PMCID: PMC6127145 DOI: 10.1038/s41598-018-31399-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 04/30/2018] [Accepted: 08/14/2018] [Indexed: 01/26/2023] Open
Abstract
We utilized three-dimensional, surface-based, morphometric analysis to investigate ventricle shape between 2 groups: (1) idiopathic normal-pressure hydrocephalus (INPH) patients who had a positive response to the cerebrospinal fluid tap test (CSFTT) and (2) healthy controls. The aims were (1) to evaluate the location of INPH-related structural abnormalities of the lateral ventricles and (2) to investigate relationships between lateral ventricular enlargement and cortical thinning in INPH patients. Thirty-three INPH patients and 23 healthy controls were included in this study. We used sparse canonical correlation analysis to show correlated regions of ventricular surface expansion and cortical thinning. Significant surface expansion in the INPH group was observed mainly in clusters bilaterally located in the superior portion of the lateral ventricles, adjacent to the high convexity of the frontal and parietal regions. INPH patients showed a significant bilateral expansion of both the temporal horns of the lateral ventricles and the medial aspects of the frontal horns of the lateral ventricles to surrounding brain regions, including the medial frontal lobe. Ventricular surface expansion was associated with cortical thinning in the bilateral orbitofrontal cortex, bilateral rostral anterior cingulate cortex, left parahippocampal cortex, left temporal pole, right insula, right inferior temporal cortex, and right fusiform gyrus. These results suggest that patients with INPH have unique patterns of ventricular surface expansion. Our findings encourage future studies to elucidate the underlying mechanism of lateral ventricular morphometric abnormalities in INPH patients.
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Affiliation(s)
- Kyunghun Kang
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea.,Department of Neurology, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Kichang Kwak
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Uicheul Yoon
- Department of Biomedical Engineering, Daegu Catholic University, Gyeongsan-si, South Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea.
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17
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Kang K, Lee HW, Kwak K, Yoon U, Lee JM. P1‐397: LATERAL VENTRICLE ENLARGEMENT AND CORTICAL THINNING IN IDIOPATHIC NORMAL‐PRESSURE HYDROCEPHALUS PATIENTS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Kyunghun Kang
- Department of Neurology, School of MedicineKyungpook National UniversityDaeguRepublic of South Korea
| | - Ho-Won Lee
- Department of Neurology, School of MedicineKyungpook National UniversityDaeguRepublic of South Korea
| | - Kichang Kwak
- McGill Centre for Integrative Neuroscience, Montreal Neurological InstituteMcGill UniversityMontrealQCCanada
| | - Uicheul Yoon
- Department of Biomedical Engineering, College of Health and Medical ScienceCatholic University of DaeguGyeongsan‐siRepublic of South Korea
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18
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Mancini-Marïe A, Yoon U, Jiminez J, Fahim C, Potvin S, Grant JA, Laverdure-Dupont D, Dubé AA, Betrisey C, Rainville P, Evans AC, Stip E, Mendrek A. Sex, Age, Symptoms and Illness Duration and Their Relation with Gyrification Index in Schizophrenia. ACTA ACUST UNITED AC 2018. [DOI: 10.3371/csrp.mayo.070415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Kang K, Yoon U, Hong J, Jeong S, Ko PW, Lee SW, Lee HW. Amyloid Deposits and Idiopathic Normal-Pressure Hydrocephalus: An 18F-Florbetaben Study. Eur Neurol 2018; 79:192-199. [DOI: 10.1159/000487133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 01/23/2018] [Indexed: 01/21/2023]
Abstract
Background: The first aim of our study was to determine whether cortical 18F-florbetaben retention was different between healthy controls and idiopathic normal-pressure hydrocephalus (INPH) patients. Our second aim was to investigate whether there were any relationships between 18F-florbetaben retention and either hippocampal volume or clinical symptoms in INPH patients. Methods: Seventeen patients diagnosed with INPH and 8 healthy controls underwent studies with magnetic resonance imaging and 18F-florbetaben positron emission tomography imaging. Results: Automated region-of-interest analysis showed significant increases in 18F-florbetaben uptake in several brain regions in INPH patients compared to control subjects, with especially remarkable increases in the frontal (bilateral), parietal (bilateral), and occipital (bilateral) cortices. In the INPH group, right hippocampal volume was found to be negatively correlated with right frontal 18F-florbetaben retention. Korean-Mini Mental State Examination scores negatively correlated with right occipital 18F-florbetaben retention. Higher 18F-florbetaben retention correlated significantly with a higher Clinical Dementia Rating Scale score in the right occipital cortex. Conclusions: Our results indicate that INPH might be a disease exhibiting a characteristic pattern of cortical 18F-florbetaben retention. 18F-florbetaben retention in the frontal cortex may be related to hippocampal neuronal degeneration. Our findings may also help us understand the potential pathophysiology of cognitive impairments associated with INPH.
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Shin NY, Hong J, Choi JY, Lee SK, Lim SM, Yoon U. Retrosplenial cortical thinning as a possible major contributor for cognitive impairment in HIV patients. Eur Radiol 2017; 27:4721-4729. [PMID: 28409354 DOI: 10.1007/s00330-017-4836-6] [Citation(s) in RCA: 14] [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: 12/28/2016] [Revised: 03/06/2017] [Accepted: 03/24/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To identify brain cortical regions relevant to HIV-associated neurocognitive disorder (HAND) in HIV patients. METHODS HIV patients with HAND (n = 10), those with intact cognition (HIV-IC; n = 12), and age-matched, seronegative controls (n = 11) were recruited. All participants were male and underwent 3-dimensional T1-weighted imaging. Both vertex-wise and region of interest (ROI) analyses were performed to analyse cortical thickness. RESULTS Compared to controls, both HIV-IC and HAND showed decreased cortical thickness mainly in the bilateral primary sensorimotor areas, extending to the prefrontal and parietal cortices. When directly comparing HIV-IC and HAND, HAND showed cortical thinning in the left retrosplenial cortex, left dorsolateral prefrontal cortex, left inferior parietal lobule, bilateral superior medial prefrontal cortices, right temporoparietal junction and left hippocampus, and cortical thickening in the left middle occipital cortex. Left retrosplenial cortical thinning showed significant correlation with slower information processing, declined verbal memory and executive function, and impaired fine motor skills. CONCLUSIONS This study supports previous research suggesting the selective vulnerability of the primary sensorimotor cortices and associations between cortical thinning in the prefrontal and parietal cortices and cognitive impairment in HIV-infected patients. Furthermore, for the first time, we propose retrosplenial cortical thinning as a possible major contributor to HIV-associated cognitive impairment. KEY POINTS • Primary sensorimotor and supplementary motor cortices were selectively vulnerable to HIV infection • Prefrontal and parietal cortical thinning was associated with HIV-associated cognitive impairment • Retrosplenial cortical thinning might be a major contributor to HIV-associated cognitive impairment.
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Affiliation(s)
- Na-Young Shin
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jinwoo Hong
- Department of Biomedical Engineering, College of Health and Medical Science, Catholic University of Daegu, Hayang-Ro 13-13, Hayang-Eup, Gyeongsan-si, Gyeongbuk, Republic of Korea, 38430
| | - Jun Yong Choi
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Koo Lee
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Mee Lim
- Department of Radiology, Ewha Womans University, School of Medicine, Seoul, Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, College of Health and Medical Science, Catholic University of Daegu, Hayang-Ro 13-13, Hayang-Eup, Gyeongsan-si, Gyeongbuk, Republic of Korea, 38430.
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Kang K, Yoon U, Choi W, Lee HW. Diffusion tensor imaging of idiopathic normal-pressure hydrocephalus and the cerebrospinal fluid tap test. J Neurol Sci 2016; 364:90-6. [DOI: 10.1016/j.jns.2016.02.067] [Citation(s) in RCA: 9] [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: 11/19/2015] [Revised: 02/12/2016] [Accepted: 02/29/2016] [Indexed: 10/22/2022]
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Kang K, Choi W, Yoon U, Lee JM, Lee HW. Abnormal White Matter Integrity in Elderly Patients with Idiopathic Normal-Pressure Hydrocephalus: A Tract-Based Spatial Statistics Study. Eur Neurol 2016; 75:96-103. [PMID: 26882495 DOI: 10.1159/000443206] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 12/07/2015] [Indexed: 11/19/2022]
Abstract
We investigated white matter integrity utilizing diffusion tensor imaging in patients with idiopathic normal-pressure hydrocephalus (INPH) who had a positive response to the cerebrospinal fluid tap test and in age- and gender-matched Alzheimer's disease (AD) patients. We enrolled 28 patients with INPH, 28 patients with AD and 20 healthy controls. Tract-based spatial statistics demonstrated that INPH patients had lower fractional anisotropy (FA) in the anterior corona radiate (bilateral), corpus callosum, superior longitudinal fasciculus (bilateral), posterior thalamic radiation (bilateral), external capsule (bilateral) and middle cerebellar peduncle in comparison with the AD and control groups. Volume-of-interest analysis revealed that INPH patients, when compared to the AD and control groups, showed higher mean diffusivity in the anterior corona radiate (bilateral), corpus callosum, superior longitudinal fasciculus (bilateral), posterior thalamic radiation (left), external capsule (bilateral) and middle cerebellar peduncle. And gait dysfunction was significantly correlated with decreased FA in the splenium of the corpus callosum and right external capsule in INPH patients. Our findings may suggest a possibility for considering microstructural changes in white matter integrity in elderly patients as potential imaging markers for differentiation between INPH and AD and may help us understand the potential pathophysiology of gait disturbances associated with INPH.
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Affiliation(s)
- Kyunghun Kang
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, South Korea
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Kang K, Lee HW, Choi W, Yoon U, Lee JM. Abnormal white matter integrity in elderly patients with idiopathic normal-pressure hydrocephalus: A tract-based spatial statistics study. Parkinsonism Relat Disord 2016. [DOI: 10.1016/j.parkreldis.2015.10.378] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Shin NY, Shin YS, Lee PH, Yoon U, Han S, Kim DJ, Lee SK. Different Functional and Microstructural Changes Depending on Duration of Mild Cognitive Impairment in Parkinson Disease. AJNR Am J Neuroradiol 2015; 37:897-903. [PMID: 26705323 DOI: 10.3174/ajnr.a4626] [Citation(s) in RCA: 19] [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] [Received: 07/20/2015] [Accepted: 10/26/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The higher cortical burden of Lewy body and Alzheimer disease-type pathology has been reported to be associated with a faster onset of cognitive impairment of Parkinson disease. So far, there has been a few studies only about the changes of gray matter volume depending on duration of cognitive impairment in Parkinson disease. Therefore, our aim was to evaluate the different patterns of structural and functional changes in Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment. MATERIALS AND METHODS Fifty-nine patients with Parkinson disease with mild cognitive impairment were classified into 2 groups on the basis of shorter (<1 year, n = 16) and longer (≥1 year, n = 43) durations of parkinsonism before mild cognitive impairment. Fifteen drug-naïve patients with de novo Parkinson disease with intact cognition were included for comparison. Cortical thickness, Tract-Based Spatial Statistics, and seed-based resting-state functional connectivity analyses were performed. Age, sex, years of education, age at onset of parkinsonism, and levodopa-equivalent dose were included as covariates. RESULTS The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased fractional anisotropy and increased mean and radial diffusivity values in the frontal areas compared with the group with longer duration of parkinsonism before mild cognitive impairment (corrected P < .05). The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity in the default mode network area when the left or right posterior cingulate was used as a seed, and in the dorsolateral prefrontal areas when the left or right caudate was used as a seed (corrected P < .05). The group with longer duration of parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity mainly in the medial prefrontal cortex when the left or right posterior cingulate was used as a seed, and in the parieto-occipital areas when the left or right caudate was used as a seed (corrected P < .05). No differences in cortical thickness were found in all group contrasts. CONCLUSIONS Resting-state functional connectivity and WM alterations might be useful imaging biomarkers for identifying changes in patients with Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment. The functional and microstructural substrates may topographically differ depending on the rate of cognitive decline in these patients.
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Affiliation(s)
- N-Y Shin
- From the Department of Radiology (N.-Y.S.), Ewha Womans University School of Medicine, Seoul, Korea Radiology (N.-Y.S., D.J.K., S.-K.L.), Yonsei University College of Medicine, Seoul, Korea
| | - Y S Shin
- Department of Psychology (Y.S.S., S.H.), Yonsei University, Seoul, Korea
| | - P H Lee
- Departments of Neurology (P.H.L.)
| | - U Yoon
- Department of Biomedical Engineering (U.Y.), College of Health and Medical Science, Catholic University of Daegu, Gyeongsan-si, South Korea
| | - S Han
- Department of Psychology (Y.S.S., S.H.), Yonsei University, Seoul, Korea
| | - D J Kim
- Radiology (N.-Y.S., D.J.K., S.-K.L.), Yonsei University College of Medicine, Seoul, Korea
| | - S-K Lee
- Radiology (N.-Y.S., D.J.K., S.-K.L.), Yonsei University College of Medicine, Seoul, Korea
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Lee MJ, Shin JH, Seoung JK, Lee JH, Yoon U, Oh JH, Jung DS, Kim EJ. Cognitive impairments associated with morphological changes in cortical and subcortical structures in multiple system atrophy of the cerebellar type. Eur J Neurol 2015; 23:92-100. [DOI: 10.1111/ene.12796] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 06/15/2015] [Indexed: 01/15/2023]
Affiliation(s)
- M. J. Lee
- Department of Neurology; Pusan National University Hospital; Pusan National University School of Medicine and Biomedical Research Institute; Busan Korea
| | - J.-H. Shin
- Department of Bio-convergence Engineering; Korea University College of Health Science; Seoul Korea
| | - J.-K. Seoung
- Department of Biomedical Engineering; Korea University College of Health Science; Seoul Korea
| | - J.-H. Lee
- Department of Neurology; Pusan National University Yangsan Hospital; Pusan National University School of Medicine and Medical Research Institute; Yangsan Korea
| | - U. Yoon
- Department of Biomedical Engineering; Catholic University of Daegu; Gyeongsan Korea
| | - J.-H. Oh
- Department of Neurology; Pusan National University Hospital; Pusan National University School of Medicine and Biomedical Research Institute; Busan Korea
| | - D. S. Jung
- Department of Neurology; Pusan National University Hospital; Pusan National University School of Medicine and Biomedical Research Institute; Busan Korea
| | - E.-J. Kim
- Department of Neurology; Pusan National University Hospital; Pusan National University School of Medicine and Biomedical Research Institute; Busan Korea
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Kang K, Choi D, Ko PW, Lee HW, Yoon U. P1‐175: Diffusion tensor metrics as biomarkers in idiopathic normal‐pressure hydrocephalus. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Kyunghun Kang
- School of MedicineKyungpook National UniversityDaeguSouth Korea
| | - Dongho Choi
- School of MedicineKyungpook National UniversityDaeguSouth Korea
| | - Pan-Woo Ko
- School of MedicineKyungpook National UniversityDaeguSouth Korea
| | - Ho-Won Lee
- School of MedicineKyungpook National UniversityDaeguSouth Korea
| | - Uicheul Yoon
- College of Health and Medical ScienceCatholic University of DaeguGyeongsan-siSouth Korea
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Kim EJ, Shin JH, Lee JH, Kim JH, Na DL, Suh YL, Hwang SJ, Lee JH, Lee YM, Shin MJ, Lee MJ, Kim SJ, Yoon U, Park DY, Jung DS, Ahn JW, Sung S, Huh GY. Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia linked CSF1R mutation: Report of four Korean cases. J Neurol Sci 2014; 349:232-8. [PMID: 25563800 DOI: 10.1016/j.jns.2014.12.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 12/03/2014] [Accepted: 12/15/2014] [Indexed: 11/19/2022]
Abstract
We describe detailed clinical, biochemical, neuroimaging and neuropathological features in adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP), encompassing hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS) and pigmentary orthochromatic leukodystrophy (POLD), linked to colony-stimulating factor 1 receptor (CSF1R) mutations in four Korean cases. Clinical, biochemical, neuroimaging and neuropathological findings were obtained by direct evaluation and from previous medical records. The genetic analysis of the CSF1R gene was done in two autopsy-confirmed ALSP cases and two cases where ALSP was suspected based on the clinical and neuroimaging characteristics. We identified two known mutations: c.2342C>T (p.A781V) in one autopsy-proven HDLS and clinically ALSP-suspected case and c.2345G>A (p.R782H) in another autopsy-proven POLD case. We also found a novel mutation (c.2296A>G; p.M766V) in a patient presenting with hand tremor, stuttering and hesitant speech, and abnormal behavior whose father died from a possible diagnosis of spinocerebellar ataxia. To the best of our knowledge, this is the first documented ALSP-linked CSF1R mutation in Korea and supports the suggestion that HDLS and POLD, with pathological characteristics that are somewhat different but which are caused by CSF1R mutations, are the same spectrum of disease, ALSP.
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Affiliation(s)
- Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Jin-Hong Shin
- Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jeong Hee Lee
- Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jong Hun Kim
- Department of Neurology, Ilsan Hospital, National Health Insurance Corporation, Goyang-shi, South Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yeon-Lim Suh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sun Jae Hwang
- Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jae-Hyeok Lee
- Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Young Min Lee
- Department of Psychiatry, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Myung-Jun Shin
- Department of Rehabilitation medicine, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Myung Jun Lee
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Seong-Jang Kim
- Department of Nuclear Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, Catholic University of Daegu, Gyeongsan, South Korea
| | - Do Youn Park
- Department of Pathology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Dae Soo Jung
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Jae Woo Ahn
- Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Suk Sung
- Department of Anatomy, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Gi Yeong Huh
- Department of Forensic Medicine, Pusan National University School of Medicine and Medical Research Institute, South Korea.
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Kwon OD, Yoon U, Na DL. P1‐244: EFFECT OF ILLITERACY ON COGNITION AND CEREBRAL MORPHOLOGY IN LATER LIFE. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Oh Dae Kwon
- Daegu Catholic University Medical Center, Catholic University of DaeguDaeguSouth Korea
| | - Uicheul Yoon
- Department of Biomedical EngineeringCatholic University of DaeguHayangSouth Korea
| | - Duk L. Na
- Samsung Medical Center, Sungkyunkwan University School of MedicineSeoulSouth Korea
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Cha J, Jo HJ, Kim HJ, Seo SW, Kim HS, Yoon U, Park H, Na DL, Lee JM. Functional alteration patterns of default mode networks: comparisons of normal aging, amnestic mild cognitive impairment and Alzheimer's disease. Eur J Neurosci 2013; 37:1916-24. [PMID: 23773060 DOI: 10.1111/ejn.12177] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 01/21/2013] [Accepted: 01/30/2013] [Indexed: 11/27/2022]
Abstract
Most default mode network (DMN) studies in patients with amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD) are based on the comparison of only two groups, namely patients and controls. Information derived from comparing three groups, normal, aMCI and AD, simultaneously may lead us to better understand the progression of dementia. The purpose of this study was to evaluate functional connectivity of DMN in the continuum from normal through aMCI to AD. Differences in functional connectivity were compared between the three groups using independent component analysis. The relationship between functional connectivity and disease progression was investigated using multiple regression analysis with Mini-Mental State Examination (MMSE) scores. The results revealed differences throughout the left posterior cingulate cortex (PCC), left middle temporal gyrus (MTG), right middle frontal gyrus (MFG) and bilateral parahippocampal gyrus (PHG). Both patients with aMCI and those with AD showed decreased connectivity in the left PCC and left PHG compared with healthy subjects. Furthermore, patients with AD also showed decreased connectivity in the left MTG and right PHG. Increased functional connectivity was observed in the right MFG of patients with AD compared with other groups. MMSE scores exhibited significant positive and negative correlations with functional connectivity in PCC, MTG and MFG regions. Taken together, increased functional connectivity in the MFG for AD patients might compensate for the loss of function in the PCC and MTG via compensatory mechanisms in corticocortical connections.
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Affiliation(s)
- Jungho Cha
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
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Cho EB, Seo SW, Kim H, Lee JM, Yoon U, Im K, Kim GH, Noh Y, Cho H, Yoon CW, Kim HJ, Na DL. Effect of kidney dysfunction on cortical thinning in patients with probable Alzheimer's disease dementia. J Alzheimers Dis 2013; 33:961-8. [PMID: 23042210 DOI: 10.3233/jad-2012-121180] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There are some studies identifying the association between kidney dysfunction and cognitive impairment through various mechanisms including small vessel disease. However, results concerning the relationship between kidney dysfunction and cortical atrophy have been inconsistent. Thus, we aimed to evaluate the relationship among kidney dysfunction, small vessel disease, and cortical thinning in probable Alzheimer's disease (AD) dementia patients. Patients consisted of 162 subjects with probable AD dementia who underwent high-resolution T1-weighted volumetric magnetic resonance imaging (MRI) scans using the same scanner. The estimated glomerular filtration rate (GFR) was calculated and divided into the quartiles of patients for comparison. Volume of white matter hyperintensities (WMH) was automatically measured. Two neurologists counted the number of lacunes. Cortical thickness was measured using a surface-based method. GFR was not associated with WMH and the number of lacunes. However, the lowest quartile group of GFR (GFR 1) had cortical thinning in each lobe, compared to the highest quartile group of GFR (GFR 4). The topography of cortical thinning in the GFR 1 group was distributed predominantly in temporoparietal regions, compared to GFR 4. After further adjustment of small vessel disease MRI markers, the association between GFR and the cortical thinning remained. Our findings suggested that kidney dysfunction, represented by GFR, was related to temporoparietal thinning independent of small vessel disease in probable AD dementia patients.
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Affiliation(s)
- Eun Bin Cho
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
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Kwak K, Yoon U, Lee DK, Kim GH, Seo SW, Na DL, Shim HJ, Lee JM. Fully-automated approach to hippocampus segmentation using a graph-cuts algorithm combined with atlas-based segmentation and morphological opening. Magn Reson Imaging 2013; 31:1190-6. [DOI: 10.1016/j.mri.2013.04.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 02/12/2013] [Accepted: 04/13/2013] [Indexed: 10/26/2022]
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Kang K, Lee H, Yoon U. P4–350: Plasma levels of lipocalin 2 and chitinase 3‐like 1 protein in patients with amnestic mild cognitive impairment and Alzheimer's disease. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.08.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Kyunghun Kang
- Department of Neurology School of Medicine, Kyungpook National University Daegu South Korea
| | - Ho‐Won Lee
- Department of Neurology School of Medicine, Kyungpook National University Daegu South Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering Catholic University of Daegu Gyeongsan‐si South Korea
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Kim CH, Seo SW, Kim GH, Shin JS, Cho H, Noh Y, Kim SH, Kim MJ, Jeon S, Yoon U, Lee JM, Oh SJ, Kim JS, Kim ST, Lee JH, Na DL. Cortical thinning in subcortical vascular dementia with negative 11C-PiB PET. J Alzheimers Dis 2013; 31:315-23. [PMID: 22531413 DOI: 10.3233/jad-2012-111832] [Citation(s) in RCA: 31] [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] [Indexed: 11/15/2022]
Abstract
To determine the existence of cortical thinning in subcortical vascular dementia (SVaD) with a negative 11C-Pittsburgh compound B (PiB) positron emission tomography scan and to compare the topography of cortical thinning between PiB-negative SVaD and Alzheimer's disease (AD), we enrolled 24 patients with PiB(-) SVaD, 81 clinically probable AD individuals, and 72 normal cognitive controls. Compared with controls, cortical thinning in PiB(-) SVaD was most profound in the perisylvian area, medial prefrontal area, and posterior cingulate gyri, while the precuneus and medial temporal lobes were relatively spared. When the cortical thickness of AD and PiB(-) SVaD were directly compared, PiB(-) SVaD demonstrated significant cortical thinning in the bilateral inferior frontal, superior temporal gyri, and right medial frontal and orbitofrontal lobes, while AD showed significant cortical thinning in the right medial temporal region. SVaD without amyloid burden may lead to substantial cortical atrophy. Moreover, characteristic topography of cortical thinning in PiB(-) SVaD suggests different mechanisms of cortical thinning in PiB(-) SVaD and AD.
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Affiliation(s)
- Chi Hun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-ku, Seoul, South Korea
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Yang JJ, Yoon U, Yun HJ, Im K, Choi YY, Lee KH, Park H, Hough MG, Lee JM. Prediction for human intelligence using morphometric characteristics of cortical surface: partial least square analysis. Neuroscience 2013; 246:351-61. [PMID: 23643979 DOI: 10.1016/j.neuroscience.2013.04.051] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 04/18/2013] [Accepted: 04/22/2013] [Indexed: 11/17/2022]
Abstract
A number of imaging studies have reported neuroanatomical correlates of human intelligence with various morphological characteristics of the cerebral cortex. However, it is not yet clear whether these morphological properties of the cerebral cortex account for human intelligence. We assumed that the complex structure of the cerebral cortex could be explained effectively considering cortical thickness, surface area, sulcal depth and absolute mean curvature together. In 78 young healthy adults (age range: 17-27, male/female: 39/39), we used the full-scale intelligence quotient (FSIQ) and the cortical measurements calculated in native space from each subject to determine how much combining various cortical measures explained human intelligence. Since each cortical measure is thought to be not independent but highly inter-related, we applied partial least square (PLS) regression, which is one of the most promising multivariate analysis approaches, to overcome multicollinearity among cortical measures. Our results showed that 30% of FSIQ was explained by the first latent variable extracted from PLS regression analysis. Although it is difficult to relate the first derived latent variable with specific anatomy, we found that cortical thickness measures had a substantial impact on the PLS model supporting the most significant factor accounting for FSIQ. Our results presented here strongly suggest that the new predictor combining different morphometric properties of complex cortical structure is well suited for predicting human intelligence.
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Affiliation(s)
- J-J Yang
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
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Park JH, Seo SW, Kim C, Kim GH, Noh HJ, Kim ST, Kwak KC, Yoon U, Lee JM, Lee JW, Shin JS, Kim CH, Noh Y, Cho H, Kim HJ, Yoon CW, Oh SJ, Kim JS, Choe YS, Lee KH, Lee JH, Ewers M, Weiner MW, Werring DJ, Na DL. Pathogenesis of cerebral microbleeds: In vivo imaging of amyloid and subcortical ischemic small vessel disease in 226 individuals with cognitive impairment. Ann Neurol 2013; 73:584-93. [PMID: 23495089 DOI: 10.1002/ana.23845] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2012] [Revised: 11/18/2012] [Accepted: 11/30/2012] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Cerebral microbleeds (CMBs) are a neuroimaging marker of small vessel disease (SVD) with relevance for understanding disease mechanisms in cerebrovascular disease, cognitive impairment, and normal aging. It is hypothesized that lobar CMBs are due to cerebral amyloid angiopathy (CAA) and deep CMBs are due to subcortical ischemic SVD. We tested this hypothesis using structural magnetic resonance imaging (MRI) markers of subcortical SVD and in vivo imaging of amyloid in patients with cognitive impairment. METHODS We included 226 patients: 89 with Alzheimer disease-related cognitive impairment (ADCI) and 137 with subcortical vascular cognitive impairment (SVCI). All subjects underwent amyloid imaging with [(11) C] Pittsburgh compound B (PiB) positron emission tomography, and MRI to detect CMBs and markers of subcortical SVD, including the volume of white matter hyperintensities (WMH) and the number of lacunes. RESULTS Parietal and occipital lobar CMBs counts were higher in PiB(+) ADCI with moderate WMH than PiB(+) ADCI with minimal WMH, whereas PiB(-) patients with SVCI (ie, "pure" SVCI) showed both lobar and deep CMBs. In multivariate analyses of the whole cohort, WMH volume and lacuna counts were positively associated with both lobar and deep CMBs, whereas amyloid burden (PiB) was only associated with lobar CMBs. There was an interaction between lacuna burden and PiB retention on lobar (but not deep) CMBs (p<0.001). INTERPRETATION Our findings suggest that although deep CMBs are mainly linked to subcortical SVD, both subcortical SVD and amyloid-related pathologies (eg, CAA) contribute to the pathogenesis of lobar CMBs, at least in subjects with mixed lobar and deep CMBs. Furthermore, subcortical SVD and amyloid-related pathologies interact to increase the risk of lobar CMBs.
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Affiliation(s)
- Jae-Hyun Park
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
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Fahim C, Yoon U, Nashaat NH, Khalil AK, El-Belbesy M, Mancini-Marie A, Evans AC, Meguid N. Williams syndrome: a relationship between genetics, brain morphology and behaviour. J Intellect Disabil Res 2012; 56:879-894. [PMID: 22044458 DOI: 10.1111/j.1365-2788.2011.01490.x] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Genetically Williams syndrome (WS) promises to provide essential insight into the pathophysiology of cortical development because its ∼28 deleted genes are crucial for cortical neuronal migration and maturation. Phenotypically, WS is one of the most puzzling childhood neurodevelopmental disorders affecting most intellectual deficiencies (i.e. low-moderate intelligence quotient, visuospatial deficits) yet relatively preserving what is uniquely human (i.e. language and social-emotional cognition). Therefore, WS provides a privileged setting for investigating the relationship between genes, brain and the consequent complex human behaviour. METHODS We used in vivo anatomical magnetic resonance imaging analysing cortical surface-based morphometry, (i.e. surface area, cortical volume, cortical thickness, gyrification index) and cortical complexity, which is of particular relevance to the WS genotype-phenotype relationship in 22 children (2.27-14.6 years) to compare whole hemisphere and lobar surface-based morphometry between WS (n = 10) and gender/age matched normal controls healthy controls (n = 12). RESULTS Compared to healthy controls, WS children had a (1) relatively preserved Cth; (2) significantly reduced SA and CV; (3) significantly increased GI mostly in the parietal lobe; and (4) decreased CC specifically in the frontal and parietal lobes. CONCLUSION Our findings are then discussed with reference to the Rakic radial-unit hypothesis of cortical development, arguing that WS gene deletions may spare Cth yet affecting the number of founder cells/columns/radial units, hence decreasing the SA and CV. In essence, cortical brain structure in WS may be shaped by gene-dosage abnormalities.
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Affiliation(s)
- C Fahim
- Institute of Psychology, Faculty of Social Sciences and Politics, University of Lausanne, Lausanne, Switzerland.
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Yoon U, Perusse D, Evans AC. Mapping genetic and environmental influences on cortical surface area of pediatric twins. Neuroscience 2012; 220:169-78. [PMID: 22728098 DOI: 10.1016/j.neuroscience.2012.06.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 06/11/2012] [Accepted: 06/13/2012] [Indexed: 10/28/2022]
Abstract
Cortical surface area has been largely overlooked in genetic studies of human brain morphometry, even though phylogenetic differences in cortical surface area between individuals are known to be influenced by differences in genetic endowment. In this study, we examined the relative contribution of genetic and environmental influences on cortical surface areas in both the native and stereotaxic spaces for a cohort of homogeneously-aged healthy pediatric twins. Bilateral hemispheric surface and all lobar surface areas except the occipital lobes in native space showed high heritable estimates, while the common environmental effect on bilateral occipital lobes reached statistical significance. The proportion of genetic variance for cortical surface areas measured in stereotaxic space was lower than that measured in native space, whereas the unique environmental influences increased. This is reasonable since whole brain volume is also known to be heritable itself and so removing that component of areal variance due to overall brain size via stereotaxic transformation will reduce the genetic proportion. These findings further suggest that cortical surface areas involved in cognitive, attention and emotional processing, as well as in creating and retaining of long-term memories are likely to be more useful for examining the relationship between genotype and behavioral phenotypes.
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Affiliation(s)
- U Yoon
- Department of Biomedical Engineering, Catholic University of Daegu, 13-13 Hayang-ro, Hayang-eup, Gyeongsan-si, Gyeongsangbuk-do 712-702, South Korea.
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Yoon CW, Seo SW, Park JS, Kwak KC, Yoon U, Suh MK, Kim GH, Shin JS, Kim CH, Noh Y, Cho H, Kim MJ, Kim JH, Roh JH, Lee JM, Na DL. Cerebellar Atrophy in Patients with Subcortical-Type Vascular Cognitive Impairment. Cerebellum 2012; 12:35-42. [DOI: 10.1007/s12311-012-0388-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Cho E, Seo S, Yoon U, Kim GH, Shin J, Kim CH, Lee JM, Na D. Renal Dysfunction Cause Small Vessel Disease and Cortical Thinning in Cognitively Impaired Patients (P04.204). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.204] [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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Meguid NA, Fahim C, Sami R, Nashaat NH, Yoon U, Anwar M, El-Dessouky HM, Shahine EA, Ibrahim AS, Mancini-Marie A, Evans AC. Cognition and lobar morphology in full mutation boys with fragile X syndrome. Brain Cogn 2011; 78:74-84. [PMID: 22070923 DOI: 10.1016/j.bandc.2011.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 09/13/2011] [Accepted: 09/15/2011] [Indexed: 01/05/2023]
Abstract
The aims of the present study are twofold: (1) to examine cortical morphology (CM) associated with alterations in cognition in fragile X syndrome (FXS); (2) to characterize the CM profile of FXS versus FXS with an autism diagnosis (FXS+Aut) as a preliminary attempt to further elucidate the behavioral distinctions between the two sub-groups. We used anatomical magnetic resonance imaging surface-based morphometry in 21 male children (FXS N=11 and age [2.27-13.3] matched controls [C] N=10). We found (1) increased whole hemispheric and lobar cortical volume, cortical thickness and cortical complexity bilaterally, yet insignificant changes in hemispheric surface area and gyrification index in FXS compared to C; (2) linear regression analyses revealed significant negative correlations between CM and cognition; (3) significant CM differences between FXS and FXS+Aut associated with their distinctive behavioral phenotypes. These findings are critical in understanding the neuropathophysiology of one of the most common intellectual deficiency syndromes associated with altered cognition as they provide human in vivo information about genetic control of CM and cognition.
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Affiliation(s)
- Nagwa A Meguid
- Department of Research on Children with Special Needs, Medical Genetics Division, The National Research Centre, Cairo, Egypt
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Abstract
STUDY OBJECTIVES To investigate differences in cortical thickness in narcolepsy patients with cataplexy and control subjects. DESIGN Cortical thickness was measured using a 3-D surface-based method that enables more accurate measurement in deep sulci and localized regional mapping. SETTING University hospital. PATIENTS AND PARTICIPANTS We enrolled 28 patients with narcolepsy and cataplexy and 33 age-and sex-matched control subjects. INTERVENTIONS Cortical thickness was measured using a direct method for calculating the distance between corresponding vertices from inner and outer cortical surfaces. MEASUREMENTS AND RESULTS We normalized cortical surfaces using 2-D surface registration and performed diffusion smoothing to reduce the variability of folding patterns and to increase the power of the statistical analysis. Localized cortical thinning in narcolepsy patients with cataplexy was found in orbitofrontal gyri, dorsolateral and medial prefrontal cortexes, insula, cingulate gyri, middle and inferior temporal gyri, and inferior parietal lobule of the right and left hemispheres at the level of a false discovery rate P<0.05. No significant local increases in cortical thickness were observed in narcolepsy patients. A significant negative correlation was observed between the narcolepsy patients' scores on the Epworth Sleepiness Scale and the cortical thickness of the left supramarginal gyrus. CONCLUSIONS Cortical thinning in narcolepsy patients with cataplexy in localized anatomic brain regions may serve as a possible neuroanatomic mechanism of the disturbances in attention, memory, emotion, and sleepiness.
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Affiliation(s)
- Eun Yeon Joo
- Department of Neurology, Sungkyunkwan University School of Medicine, Seoul, Korea
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Seo EH, Lee DY, Park J, Yoon U, Lee J, Choo IH, Kim YK, Kim SG, Park SY, Woo JI. IC‐P‐174: Changes of functional brain network in mild cognitive impairment and Alzheimer's disease: Graph theoretical analysis of brain glucose metabolism. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Eun Hyun Seo
- Seoul National University HospitalSeoulSouth Korea
| | | | | | | | | | - Il Han Choo
- Seoul National University HospitalSeoulSouth Korea
| | - Yu Kyeong Kim
- Seoul National University Bundang HospitalSeongnamSouth Korea
| | - Shin Gyeom Kim
- Soonchunhyang University Bucheon HospitalBucheonSouth Korea
| | | | - Jong Inn Woo
- Seoul National University HospitalSeoulSouth Korea
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Fahim C, He Y, Yoon U, Chen J, Evans A, Pérusse D. Neuroanatomy of childhood disruptive behavior disorders. Aggress Behav 2011; 37:326-37. [PMID: 21538379 DOI: 10.1002/ab.20396] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [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] [Received: 04/09/2010] [Revised: 01/11/2011] [Accepted: 03/14/2011] [Indexed: 12/13/2022]
Abstract
Our aims were to (1) examine possible neuroanatomical abnormalities associated with the Disruptive Behavior Disorders (DBDs) as a group and (2) assess neuroanatomical anomalies specific to each DBD (i.e., conduct disorder [CD] and oppositional defiant disorder). Cortical thickness analysis and voxel-based morphometry were analyzed in 47 8-year-old boys (22 DBDs with and without CD and/or ODD and 25 healthy controls) from Magnetic Resonance Imaging brain scans. DBD symptoms were assessed using the Dominic-R. In DBD subjects relative to controls, we found (1) a decreased overall mean cortical thickness; (2) thinning of the cingulate, prefrontal and insular cortices; and (3) decreased gray matter density (GMd) in the same brain regions. We also found that scores on the Dominic-R were negatively correlated with GMd in the prefrontal and precuneus/superior temporal regions. There was a subdiagnostic main effect for CD, related to thinning of the middle/medial frontal, and for ODD in the left rectal/orbitofrontal. Findings suggest that thinning and decreased GMd of the insula disorganizes prefrontal circuits, diminishing the inhibitory influence of the prefrontal cortex on anger, aggression, cruelty, and impulsivity, and increasing a person's likelihood of aggressive behavior. These findings have implications for pathophysiologic models of the DBDs, their diagnostic classification system, and for designing more effective intervention programs.
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Affiliation(s)
- Cherine Fahim
- Institute of Psychology, Faculty of Social Sciences and Politics, University of Lausanne, Lausanne, Switzerland.
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Seo EH, Lee DY, Park J, Yoon U, Lee J, Choo ILH, Kim YK, Kim SG, Park SY, Woo JI. P4‐114: Changes of functional brain network in mild cognitive impairment and Alzheimer's disease: Graph theoretical analysis of brain glucose metabolism. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.2135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Eun Hyun Seo
- Seoul National Univeristy HospitalSeoulSouth Korea
| | | | | | | | | | - IL Han Choo
- Seoul National University HospitalSeoulSouth Korea
| | - Yu Kyeong Kim
- Seoul National University Bundang HospitalSeongnamSouth Korea
| | - Shin Gyeom Kim
- Soonchunhyang University Bucheon hospitalBucheonSouth Korea
| | | | - Jong Inn Woo
- Seoul National University HospitalSeoulSouth Korea
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Knobloch K, Yoon U. Quality of reporting of randomised controlled trials - an analysis of the world congress of sports injury prevention in 2005 and 2008. Br J Sports Med 2011. [DOI: 10.1136/bjsm.2011.084038.134] [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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Knobloch K, Yoon U. The fate of clinical sports injury prevention abstracts presented at the 1st world conference on sports injury prevention in oslo 2005. Br J Sports Med 2011. [DOI: 10.1136/bjsm.2011.084038.135] [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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Yoon U, Perusse D, Lee JM, Evans AC. Genetic and environmental influences on structural variability of the brain in pediatric twin: deformation based morphometry. Neurosci Lett 2011; 493:8-13. [PMID: 21296128 DOI: 10.1016/j.neulet.2011.01.070] [Citation(s) in RCA: 27] [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] [Received: 09/15/2010] [Revised: 01/28/2011] [Accepted: 01/28/2011] [Indexed: 10/18/2022]
Abstract
Twin studies are one of the most powerful study designs for estimating the relative contribution of genetic and environmental influences on phenotypic variation inhuman brain morphology. In this study, we applied deformation based morphometry, a technique that provides a voxel-wise index of local tissue growth or atrophy relative to a template brain, combined with univariate ACE model, to investigate the genetic and environmental effects on the human brain structural variations in a cohort of homogeneously aged healthy pediatric twins. In addition, anatomical regions of interest (ROIs) were defined in order to explore global and regional genetic effects. ROI results showed that the influence of genetic factors on cerebrum (h(2)=0.70), total gray matter (0.67), and total white matter (0.73) volumes were significant. In particular, structural variability of left-side lobar volumes showed a significant heritability. Several subcortical structures such as putamen (h(ROI)(2)=0.79/0.77(L/R),h(MAX)(2)=0.82/0.79) and globus pallidus (0.81/0.76, 0.88/0.82) were also significantly heritable in both voxel-wise and ROI-based results. In the voxel-wise results, lateral parts of right cerebellum (c(2)=0.68) and the posterior portion of the corpus callosum (0.63) were rather environmentally determined, but it failed to reach statistical significance. Pediatric twin studies are important because they can discriminate several influences on developmental brain trajectories and identify relationships between gene and behavior. Several brain structures showed significant genetic effects and might therefore serve as biological markers for inherited traits, or as targets for genetic linkage and association studies.
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Affiliation(s)
- Uicheul Yoon
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec H3A 2B4, Canada
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Park JS, Yoon U, Kwak KC, Seo SW, Kim SI, Na DL, Lee JM. The relationships between extent and microstructural properties of the midsagittal corpus callosum in human brain. Neuroimage 2011; 56:174-84. [PMID: 21281715 DOI: 10.1016/j.neuroimage.2011.01.065] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 01/19/2011] [Accepted: 01/24/2011] [Indexed: 11/26/2022] Open
Abstract
Recent quantitative analyses of the corpus callosum (CC) have tried to assess the interhemispheric connectivity. Based on histological results showing an expansion of callosal extent at the midsagittal plane, without fiber density alterations, callosal extent was interpreted as an index of interhemispheric connectivity. The microstructural properties of the CC have also been investigated extensively using diffusion tensor imaging, to assess interhemispheric connectivity. The relationships between axonal density and callosal extent need to be investigated to understand how these parameters reflect interhemispheric connectivity. We used a semi-automated CC segmentation scheme in T1-weighted magnetic resonance image and fractional anisotropy (FA) image, respectively. The parameterization method of the segmented CC was applied to 47 right-handed healthy adult subjects. The callosal extent and microstructural properties were measured using the callosal thickness and diffusion indices (FA, mean diffusivity, and axial and radial diffusivity), respectively. Our results revealed a correlation between callosal thickness and FA on the posterior body and isthmus of the CC, which suggests that these regions are more sensitive to fiber alterations than other regions. Based on this result, we suggest that both the extent of the CC and its microstructural properties should be considered together in the estimation of interhemispheric connectivity in healthy adult populations.
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Affiliation(s)
- Jun-Sung Park
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
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Abstract
OBJECTIVE Converging evidence suggests that abnormalities of brain development may play a role in the pathogenesis of temporal lobe epilepsy (TLE). As sulco-gyral patterns are thought to be a footprint of cortical development, we set out to quantitatively map folding complexity across the neocortex in TLE. Additionally, we tested whether there was a relationship between cortical complexity and features of hippocampal maldevelopment, commonly referred to as malrotation. METHODS To quantify folding complexity, we obtained whole-brain surface-based measures of absolute mean cortical curvature from MRI scans acquired in 43 drug-resistant patients with TLE with unilateral hippocampal atrophy, and 40 age- and sex-matched healthy controls. In patients, we correlated changes in cortical curvature with 3-dimensional measures of hippocampal positioning. RESULTS We found increased folding complexity in the temporolimbic cortices encompassing parahippocampal, temporopolar, insular, and fronto-opercular regions. Increased complexity was observed ipsilateral to the seizure focus in patients with left TLE (LTLE), whereas these changes were bilateral in patients with right TLE (RTLE). In both TLE groups, increased temporolimbic complexity was associated with increased hippocampal malrotation. We found tendencies for increased complexity in bilateral posterior temporal cortices in LTLE and contralateral parahippocampal cortices in RTLE to be predictive of unfavorable seizure outcome after surgery. CONCLUSION The anatomic distribution of increased cortical complexity overlapping with limbic seizure networks in TLE and its association with hippocampal maldevelopment further imply that neurodevelopmental factors may play a role in the epileptogenic process of TLE.
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Affiliation(s)
- N L Voets
- Department of Neurology and McConnell Brain Imaging Center, Montreal Neurological Institute (WB-322), 3801 University Street, Montreal, Quebec, Canada H3A 2B4
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Meguid N, Fahim C, Yoon U, Nashaat NH, Ibrahim AS, Mancini-Marie A, Brandner C, Evans AC. Brain morphology in autism and fragile X syndrome correlates with social IQ: first report from the Canadian-Swiss-Egyptian Neurodevelopmental Study. J Child Neurol 2010; 25:599-608. [PMID: 20110214 DOI: 10.1177/0883073809341670] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Fragile X syndrome shares most of the behavioral phenotypic similarities with autism. How are these similarities reflected in brain morphology? A total of 10 children with autism and 7 with fragile X underwent morphological (T1) 1.5-T magnetic resonance imaging (MRI). The authors found no significant difference in total brain volumes, regional volumes, gyrification index, sulcul depth, and cerebral cortical thickness. However, children with autism showed significant decrease in the medial prefrontal bilaterally and the left anterior cingulate cortices. Regression analysis revealed positive correlation between the medial prefrontal cortical thickness and the social IQ. The authors suggest that the difference between the 2 groups in the medial prefrontal and anterior cingulate cortices thickness may entail an altered social cognitive style. Functional MRI studies directly differentiating between social indifference (autism) and social avoidance (fragile X) are needed to further characterize the spectrum of social abnormalities between these 2 groups.
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Affiliation(s)
- Nagwa Meguid
- Department of Children with Special Needs, Medical Genetics Division, The National Research Centre, Cairo, Egypt
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