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A review of the flortaucipir literature for PET imaging of tau neurofibrillary tangles 用于陶氏神经纤维缠结 PET 成像的氟陶西泮文献综述
Pub Date : 2023-11-16 DOI: 10.1093/braincomms/fcad305
Samantha C. Burnham, L. Iaccarino, M. Pontecorvo, Adam S Fleisher, M. Lu, Emily C. Collins, Michael D Devous
Alzheimer’s disease is defined by the presence of β-amyloid plaques and neurofibrillary tau tangles potentially preceding clinical symptoms by many years. Previously only detectable postmortem, these pathological hallmarks are now identifiable using biomarkers, permitting an in vivo definitive diagnosis of Alzheimer’s disease. 18F-flortaucipir (previously known as 18F-T807; 18F-AV-1451) was the first tau positron emission tomography tracer to be introduced and is the only Food and Drug Administration approved tau positron emission tomography tracer (Tauvid™). It has been widely adopted and validated in a number of independent research and clinical settings. In this review, we present an overview of the published literature on flortaucipir for positron emission tomographyimaging of neurofibrillary tau tangles. We considered all accessible peer-reviewed literature pertaining to flortaucipir through April 30, 2022. We found 474 relevant peer-reviewed publications, which were organized into the following categories based on their primary focus: Typical Alzheimer’s disease, mild cognitive impairment, and pre-symptomatic populations; atypical Alzheimer’s disease; non- Alzheimer’s disease neurodegenerative conditions; head-to-head comparisons with other Tau positron emission tomography tracers; and technical considerations. The available flortaucipir literature provides substantial evidence for the use of this positron emission tomographytracer in assessing neurofibrillary tau tangles in Alzheimer’s disease and limited support for its use in other neurodegenerative disorders. Visual interpretation and quantitation approaches, although heterogeneous, mostly converge and demonstrate the high diagnostic and prognostic value of flortaucipir in Alzheimer’s disease.
阿尔茨海默病的定义是存在β-淀粉样蛋白斑块和神经纤维tau缠结,可能比临床症状出现早很多年。这些病理特征以前只能在死后检测到,现在可以利用生物标记物进行识别,从而可以在体内明确诊断阿尔茨海默病。18F-flortaucipir(以前称为 18F-T807;18F-AV-1451)是第一个推出的 tau 正电子发射断层扫描示踪剂,也是唯一获得美国食品药品管理局批准的 tau 正电子发射断层扫描示踪剂 (Tauvid™)。该示踪剂已被大量独立研究和临床机构广泛采用和验证。在本综述中,我们概述了已发表的有关氟替瑞匹用于神经纤维tau缠结正电子发射断层成像的文献。我们研究了截至 2022 年 4 月 30 日所有与氟替卡韦相关的同行评审文献。我们找到了 474 篇相关的同行评议出版物,根据其主要关注点分为以下几类:典型阿尔茨海默病、轻度认知障碍和症状前人群;非典型阿尔茨海默病;非阿尔茨海默病神经退行性疾病;与其他 Tau 正电子发射断层扫描示踪剂的头对头比较;以及技术考虑因素。现有的氟陶西泮文献提供了大量证据,证明这种正电子发射断层扫描示踪剂可用于评估阿尔茨海默病的神经纤维tau缠结,但对其在其他神经退行性疾病中的应用支持有限。目视解释和定量方法虽然不尽相同,但大多趋于一致,证明了氟替瑞匹在阿尔茨海默病中具有很高的诊断和预后价值。
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引用次数: 0
Probiotic treatment with bifidobacterium animalis subsp. lactis LKM512 + arginine improves cognitive flexibility in middle aged mice 动物双歧杆菌的益生菌治疗。乳酸LKM512 +精氨酸提高中年小鼠的认知灵活性
Pub Date : 2023-11-13 DOI: 10.1093/braincomms/fcad311
Daisuke Joho, Masahira Takahashi, Takeru Suzuki, Kayo Ikuta, Mitsuharu Matsumoto, Masaki Kakeyama
Abstract Cognitive flexibility, the ability of adapting to an everchanging environment, declines with aging and impaired in early stages of dementia. Although recent studies have indicated there is a relationship between the intestinal microbiota and cognitive function, few studies have shown relationships between intestinal microbiota and cognitive flexibility because of limited behavioral tasks in mice. We recently established a novel cognitive flexibility task for mice using a touchscreen operant apparatus and found that probiotic treatment with a mixture of Bifidobacterium animalis subsp. lactis LKM512 and arginine (LKM + Arg) improved cognitive flexibility in young adult mice. To confirm the effects of the probiotic treatment on cognitive flexibility and to determine whether it is effective even in older age, we here examined the effects of long-term treatment with LKM + Arg on cognitive flexibility in middle aged mice. From 8 to 15 months of age, mice received LKM + Arg or vehicle (controls) orally three times per week and were subjected to the cognitive flexibility task at 13–15 months old. In one of indices of cognitive flexibility, both LKM + Arg and vehicle treated mice showed progressively improved performance by repeating reversal tasks, with a small trend that LKM + Arg treated mice showed better learning performance through reversal phases. With respect to the other index of cognitive flexibility, LKM + Arg treated mice showed significantly fewer error choices than control mice at the reversal phase, i.e., LKM + Arg improved the performance of behavioral sequencing acquired in the previous phase, which allowed LKM + Arg treated mice to show an early onset of shift to reversal contingency. Taken together, long-term treatment with LKM + Arg was found to improve cognitive flexibility in middle aged mice, indicating that probiotic treatment might contribute to prevention of age-related cognitive decline.
认知灵活性,即适应不断变化的环境的能力,随着年龄的增长而下降,并在痴呆症的早期阶段受到损害。虽然最近的研究表明肠道微生物群与认知功能之间存在关系,但由于小鼠的行为任务有限,很少有研究表明肠道微生物群与认知灵活性之间存在关系。我们最近建立了一个新的认知灵活性任务小鼠使用触屏操作装置,并发现益生菌治疗与动物双歧杆菌亚种的混合物。乳酸LKM512和精氨酸(LKM + Arg)改善了年轻成年小鼠的认知灵活性。为了证实益生菌治疗对认知灵活性的影响,并确定它在老年是否有效,我们在这里研究了LKM + Arg长期治疗对中年小鼠认知灵活性的影响。从8 ~ 15月龄开始,小鼠每周口服3次LKM + Arg或对照物(对照组),并在13 ~ 15月龄时进行认知灵活性任务。在其中一项认知灵活性指标中,LKM + Arg组和大鼠组均表现出通过重复倒转任务逐步提高学习成绩的趋势,且LKM + Arg组在倒转阶段表现出更好的学习成绩。在认知灵活性的其他指标方面,LKM + Arg治疗小鼠在逆转阶段的错误选择明显少于对照组小鼠,即LKM + Arg改善了前一阶段获得的行为测序的表现,这使得LKM + Arg治疗小鼠表现出向逆转偶然性转变的早期开始。综上所述,长期使用LKM + Arg治疗可改善中年小鼠的认知灵活性,这表明益生菌治疗可能有助于预防与年龄相关的认知能力下降。
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引用次数: 0
Dorsal subthalamic nucleus targeting in deep brain stimulation: microelectrode recording versus 7-Tesla connectivity 脑深部刺激的丘脑下背核靶向:微电极记录与7-特斯拉连接
Pub Date : 2023-11-11 DOI: 10.1093/braincomms/fcad298
Naomi I Kremer, Mark J Roberts, Wouter V Potters, José Dilai, Varvara Mathiopoulou, Niels Rijks, Gea Drost, Teus van Laar, J Marc C van Dijk, Martijn Beudel, Rob M A de Bie, Pepijn van den Munckhof, Marcus L F Janssen, P Richard Schuurman, Maarten Bot
Abstract Connectivity-derived 7-Tesla MRI segmentation and intraoperative microelectrode recording can both assist subthalamic nucleus targeting for deep brain stimulation in Parkinson’s disease. It remains unclear if deep brain stimulation electrodes placed in the 7-Tesla MRI segmented subdivision with predominant projections to cortical motor areas (hyperdirect pathway) achieve superior motor improvement and whether microelectrode recording can accurately distinguish the motor subdivision. In 25 Parkinson’s disease patients, deep brain stimulation electrodes were evaluated for being inside or outside the predominantly motor-connected subthalamic nucleus (motor-connected subthalamic nucleus [mc-STN] or non-motor-connected subthalamic nucleus [nmc-STN], respectively) based on 7-Tesla MRI connectivity segmentation. Hemi-body motor improvement (Movement Disorder Society Unified Parkinson’s disease Rating Scale part III), and microelectrode recording characteristics multi- and single-unit activity were compared between groups. Deep brain stimulation electrodes placed in the motor-connected subthalamic nucleus resulted in higher hemi-body motor improvement, compared to electrodes placed in the non-motor-connected subthalamic nucleus (80% vs. 52%, P < 0.0001). Multi-unit activity was found slightly higher in the motor-connected subthalamic nucleus versus the non-motor-connected subthalamic nucleus (P < 0.001, receiver operating characteristic 0.63); single-unit activity did not differ between groups. Deep brain stimulation in the connectivity-derived 7T-MRI subthalamic nucleus motor-segment had superior clinical outcome, however, microelectrode recording did not accurately distinguish this subdivision within the subthalamic nucleus.
连接衍生的7-特斯拉MRI分割和术中微电极记录均可辅助帕金森病丘脑下核靶向深部脑刺激。目前尚不清楚,在7特斯拉MRI分段细分中,以皮层运动区(超直接通路)为主的脑深部刺激电极是否能获得更好的运动改善,以及微电极记录是否能准确区分运动细分。在25例帕金森病患者中,基于7-特斯拉MRI连通性分割,评估脑深部刺激电极在主要运动连接的丘脑下核(分别为运动连接的丘脑下核[mc-STN]或非运动连接的丘脑下核[nmc-STN])内或外。比较两组间半体运动改善(运动障碍学会统一帕金森病评定量表第III部分)和微电极记录特征的多单元和单单元活动。与放置在非运动连接的丘脑下核的电极相比,放置在运动连接的丘脑下核的深部脑刺激电极导致更高的半体运动改善(80%对52%,P <0.0001)。与非运动连接的丘脑下核相比,运动连接的丘脑下核的多单位活性略高(P <0.001,接受者工作特性0.63);单单位活动在两组之间没有差异。在连接性衍生的7T-MRI丘脑下核运动段的深部脑刺激具有优越的临床效果,然而,微电极记录并不能准确区分丘脑下核内的这一细分。
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引用次数: 0
Impaired discourse content in aphasia is associated with frontal white matter damage 失语症患者话语内容受损与额叶白质损伤有关
Pub Date : 2023-11-10 DOI: 10.1093/braincomms/fcad310
Junhua Ding, Erica L Middleton, Daniel Mirman
Abstract Aphasia is a common consequence of stroke with severe impacts on employability, social interactions, and quality of life. Producing discourse-relevant information in a real-world setting is the most important aspect of recovery because it is critical to successful communication. This study sought to identify the lesion correlates of impaired production of relevant information in spoken discourse in a large, unselected sample of participants with post-stroke aphasia. Spoken discourse (n=80) and structural brain scans (n=66) from participants with aphasia following left hemisphere stroke were analyzed. Each participant provided 10 samples of spoken discourse elicited in three different genres and “correct information unit” analysis was used to quantify the informativeness of speech samples. The lesion correlates were identified using multivariate lesion-symptom mapping, voxel-wise disconnection, and tract-wise analyses. Amount and speed of relevant information were highly correlated across different genres and with total lesion size. The analyses of lesion correlates converged on the same pattern: impaired production of relevant information was associated with damage to anterior dorsal white matter pathways, specifically the arcuate fasciculus, frontal aslant tract, and superior longitudinal fasciculus. Damage to these pathways may be a useful biomarker for impaired informative spoken discourse and informs development of neurorehabilitation strategies.
失语是中风的常见后果,严重影响就业能力、社会交往和生活质量。在现实世界中产生与话语相关的信息是康复中最重要的方面,因为它对成功的沟通至关重要。本研究试图在卒中后失语症患者的大量未选择样本中确定与口语话语中相关信息产生受损相关的病变。对左脑卒中后失语症患者的口头话语(n=80)和脑结构扫描(n=66)进行分析。每个参与者提供10个三种不同类型的口语话语样本,并使用“正确信息单元”分析来量化语音样本的信息量。病变相关因素通过多变量病变症状定位、体素型断连和导管型分析来确定。相关信息的数量和速度在不同类型和病变总大小之间高度相关。对病变相关因素的分析也得出了相同的结论:相关信息的产生受损与前背白质通路的损伤有关,特别是弓状束、额斜束和上纵束。这些通路的损伤可能是信息性话语受损的有用生物标志物,并为神经康复策略的发展提供信息。
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引用次数: 0
Congenital Myasthenic Syndromes: A Retrospective Natural History Study of Respiratory Outcomes in A Single Centre 先天性肌无力综合征:单一中心呼吸结果的回顾性自然史研究
Pub Date : 2023-11-09 DOI: 10.1093/braincomms/fcad299
J Poulos, M Samuels, J Palace, D Beeson, S Robb, S Ramdas, S Chan, P Munot
Abstract Respiratory problems are a major cause of morbidity and mortality in patients with congenital myasthenic syndromes (CMS), a rare heterogeneous group of neuromuscular disorders caused by genetic defects impacting the structure and function of the neuromuscular junction. Recurrent, life-threatening episodic apnoea in early infancy and childhood, as well as progressive respiratory failure requiring ventilation are features of certain genotypes of CMS. Robb et al published empirical guidance on respiratory management of the congenital myasthenic syndromes, but other than this workshop report, there is little published longitudinal natural history data on respiratory outcomes of these disorders. We report a retrospective, single-centre study on respiratory outcomes in a cohort of 40 well characterised genetically confirmed cases of CMS, including 10 distinct subtypes (DOK7, COLQ, RAPSN, CHAT, CHRNA1, CHRNG, COL13A1, CHRNE, CHRNE fast channel syndrome and CHRNA1 slow channel syndrome), with many followed up over 20 years in our centre. A quantitative and longitudinal analysis of key spirometry and sleep study parameters, as well as a description of historical hospital admissions for respiratory decompensation, provides a snapshot of the respiratory trajectory of CMS patients based on genotype.
先天性肌无力综合征(CMS)是一种罕见的异质神经肌肉疾病,由影响神经肌肉连接处结构和功能的遗传缺陷引起,呼吸系统疾病是其发病和死亡的主要原因。婴儿期和儿童期复发性、危及生命的发作性呼吸暂停,以及需要通气的进行性呼吸衰竭是某些基因型CMS的特征。Robb等人发表了先天性肌无力综合征呼吸系统管理的经验指导,但除了这篇研讨会报告外,很少有关于这些疾病呼吸结果的纵向自然历史数据发表。我们报告了一项回顾性的单中心研究,对40例遗传确诊的CMS病例的呼吸结果进行了研究,包括10种不同的亚型(DOK7、COLQ、RAPSN、CHAT、CHRNA1、CHRNG、COL13A1、CHRNE、CHRNE快通道综合征和CHRNA1慢通道综合征),其中许多人在我们的中心随访了20多年。对关键肺活量测定和睡眠研究参数的定量和纵向分析,以及对呼吸失代偿住院史的描述,提供了基于基因型的CMS患者呼吸轨迹的快照。
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引用次数: 0
Hippocampal subfield associations with memory depend on stimulus modality and retrieval mode 海马子区与记忆的关联依赖于刺激方式和检索方式
Pub Date : 2023-11-09 DOI: 10.1093/braincomms/fcad309
Etienne Aumont, Aurélie Bussy, Marc-André Bedard, Gleb Bezgin, Joseph Therriault, Melissa Savard, Jaime Fernandez Arias, Viviane Sziklas, Paolo Vitali, Nina Margherita Poltronetti, Vanessa Pallen, Emilie Thomas, Serge Gauthier, Eliane Kobayashi, Nesrine Rahmouni, Jenna Stevenson, Cecile Tissot, Mallar M Chakravarty, Pedro Rosa-Neto
Abstract Hippocampal atrophy is a well-known feature of age-related memory decline, and hippocampal subfields may contribute differently to this decline. In this cross-sectional study, we investigated the associations between hippocampal subfield volumes and performance in free recall and recognition memory tasks in both verbal and visual modalities in older adults without dementia. We collected MRIs from 97 (41 males) right-handed participants aged over 60. We segmented the right and left hippocampi into 1) dentate gyrus and cornu ammonis 4 (DG/CA4); 2) CA2 and CA3 (CA2/CA3); 3) CA1; 4) strata radiatum, lacunosum and moleculare (SRLM); and 5) subiculum. Memory was assessed with verbal free recall and recognition tasks, as well as visual free recall and recognition tasks. Amyloid-β and hippocampal tau positivity were assessed using [18F]AZD4694 and [18F]MK6240 PET tracers, respectively. The verbal free recall and verbal recognition performances were positively associated with CA1 and SRLM volumes. The verbal free recall and visual free recall were positively correlated with the right DG/CA4. The visual free recall, but not verbal free recall, was also associated with the right CA2/CA3. The visual recognition was not significantly associated with any subfield volume. Hippocampal tau positivity, but not amyloid-β positivity, was associated with reduced DG/CA4, CA2/CA3 and SRLM volumes. Our results suggest that memory performances are linked to specific subfields. CA1 appears to contribute to the verbal modality, irrespective of the free recall or recognition mode of retrieval. In contrast, DG/CA4 seems to be involved in the free recall mode, irrespective of verbal or visual modalities. These results are concordant with the view that DG/CA4 plays a primary role in encoding a stimulus’ distinctive attributes, and that CA2/CA3 could be instrumental in recollecting a visual memory from one of its fragments. Overall, we show that hippocampal subfield segmentation can be useful for detecting early volume changes and improve our understanding of the hippocampal subfields’ roles in memory.
海马萎缩是与年龄相关的记忆衰退的一个众所周知的特征,海马亚区可能对这种衰退有不同的贡献。在这项横断面研究中,我们调查了没有痴呆的老年人在语言和视觉模式下的自由回忆和识别记忆任务中的海马子区体积与表现之间的关系。我们收集了97名(41名男性)60岁以上的右撇子参与者的核磁共振成像。我们将左右海马体分割为1)齿状回和菊角4 (DG/CA4);2) CA2和CA3 (CA2/CA3);3) CA1;4)地层辐射、空隙和分子(SRLM);5)下骨。记忆力通过言语自由回忆和识别任务以及视觉自由回忆和识别任务进行评估。使用[18F]AZD4694和[18F]MK6240 PET示踪剂分别评估淀粉样蛋白-β和海马tau阳性。言语自由回忆和言语识别表现与CA1和SRLM量呈正相关。言语自由回忆和视觉自由回忆与右脑DG/CA4呈正相关。视觉自由回忆,而非言语自由回忆,也与右侧CA2/CA3有关。视觉识别与任何子场体积均无显著相关性。海马tau阳性而非淀粉样蛋白-β阳性与DG/CA4、CA2/CA3和SRLM体积降低相关。我们的研究结果表明,记忆表现与特定的子领域有关。CA1似乎与言语模态有关,与自由回忆或识别检索模式无关。相比之下,DG/CA4似乎与自由回忆模式有关,与语言或视觉模式无关。这些结果与DG/CA4在编码刺激的独特属性中起主要作用的观点一致,并且CA2/CA3可能有助于从其片段之一中回忆视觉记忆。总的来说,我们表明海马体子区分割可以用于检测早期体积变化,并提高我们对海马体子区在记忆中的作用的理解。
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引用次数: 0
The Brainbox - a tool to facilitate correlation of brain magnetic resonance imaging features to histopathology 脑盒-一种促进脑磁共振成像特征与组织病理学相关的工具
Pub Date : 2023-11-08 DOI: 10.1093/braincomms/fcad307
Wolfgang Faigle, Marco Piccirelli, Tibor Hortobágyi, Karl Frontzek, Amelia Elaine Cannon, Wolfgang Emanuel Zürrer, Tobias Granberg, Zsolt Kulcsar, Thomas Ludersdorfer, Katrin B M Frauenknecht, Regina Reimann, Benjamin Victor Ineichen
Abstract Magnetic resonance imaging (MRI) has limitations in identifying underlying tissue pathology, which is relevant for neurological diseases such as multiple sclerosis, stroke, or brain tumours. However, there are no standardized methods for correlating MRI features with histopathology. Thus, here we aimed to develop and validate a tool that can facilitate the correlation of brain MRI features to corresponding histopathology. For this, we designed the Brainbox, a waterproof and MRI-compatible 3D printed container with an integrated 3D coordinate system. We used the Brainbox to acquire post-mortem ex vivo MRI of eight human brains, fresh and formalin-fixed, and correlated focal imaging features to histopathology using the built-in 3D coordinate system. With its built-in 3D coordinate system, the Brainbox allowed correlation of MRI features to corresponding tissue substrates. The Brainbox was used to correlate different MR image features of interest to the respective tissue substrate, including normal anatomical structures such as the hippocampus or perivascular spaces, as well as a lacunar stroke. Brain volume decreased upon fixation by 7% (p = 0.01). The Brainbox enabled degassing of specimens prior to scanning, reducing susceptibility artifacts, and minimizing bulk motion during scanning. In conclusion, our proof-of-principle experiments demonstrate the usability of the Brainbox, which can contribute to improving the specificity of MRI and the standardization of the correlation between post-mortem ex vivo human brain MRI and histopathology. Brainboxes are available upon request from our institution.
磁共振成像(MRI)在识别潜在的组织病理方面有局限性,这与多发性硬化症、中风或脑肿瘤等神经系统疾病有关。然而,没有标准化的方法将MRI特征与组织病理学相关联。因此,在这里,我们的目的是开发和验证一种工具,可以促进脑MRI特征与相应组织病理学的相关性。为此,我们设计了Brainbox,这是一个防水的、与mri兼容的3D打印容器,带有集成的3D坐标系统。我们使用Brainbox获取了8个新鲜和福尔马林固定的人类大脑的死后离体MRI,并使用内置的3D坐标系统将病灶成像特征与组织病理学相关联。凭借其内置的3D坐标系统,Brainbox允许将MRI特征与相应的组织基质相关联。Brainbox被用来将不同的MR图像特征与相应的组织基质相关联,包括正常的解剖结构,如海马或血管周围空间,以及腔隙性中风。固定后脑容量减少7% (p = 0.01)。Brainbox能够在扫描前对标本进行脱气,减少敏感性伪影,并最大限度地减少扫描过程中的体积运动。总之,我们的原理验证实验证明了Brainbox的可用性,这有助于提高MRI的特异性,并有助于标准化死后离体人脑MRI与组织病理学之间的相关性。我们的机构可以根据要求提供脑力集训。
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引用次数: 0
Understanding ethnic diversity in open dementia neuroimaging datasets 了解开放痴呆神经影像学数据集的种族多样性
Pub Date : 2023-11-08 DOI: 10.1093/braincomms/fcad308
Nicholas Yew Wei Heng, Timothy Rittman
Abstract Ethnic differences in dementia are increasingly recognised in epidemiological measures and diagnostic biomarkers. Nonetheless, ethnic diversity remains limited in many study populations. Here we provide insights into ethnic diversity in open access neuroimaging dementia datasets. Datasets comprising dementia populations with available data on ethnicity were included. Statistical analyses of sample and effect sizes were based on the Cochrane Handbook. 19 databases were included, with 17 studies of healthy groups or combination of diagnostic groups if breakdown was unavailable, and 12 of MCI and dementia groups. Combining all studies on dementia patients, the largest ethnic group was Caucasian (20,547 participants) with the next most common being Afro-Caribbean (1958), followed by Asian (1211). The smallest effect size detectable within the Caucasian group was 0.03, compared to Afro-Caribbean (0.1) and Asian (0.13). Our findings quantify the lack of ethnic diversity in openly available dementia datasets. More representative data would facilitate the development and validation of biomarkers relevant across ethnicities.
痴呆症的种族差异越来越多地在流行病学测量和诊断生物标志物中得到认识。尽管如此,在许多研究人群中,种族多样性仍然有限。在这里,我们提供了对开放获取神经成像痴呆症数据集的种族多样性的见解。纳入了包含痴呆症人群的数据集,并提供了种族数据。样本和效应量的统计分析基于Cochrane手册,纳入了19个数据库,其中17个研究是健康组或诊断组的组合(如果无法分类),12个是轻度认知障碍和痴呆组。综合所有关于痴呆患者的研究,最多的种族是白种人(20,547名参与者),其次是非洲裔加勒比人(1958),其次是亚洲人(1211)。在白种人组中可检测到的最小效应大小为0.03,而非裔加勒比人(0.1)和亚洲人(0.13)。我们的研究结果量化了公开可用的痴呆症数据集中缺乏种族多样性。更具代表性的数据将促进跨种族相关生物标志物的开发和验证。
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引用次数: 0
A comparison of structural morphometry in children and adults with persistent developmental stuttering 儿童与成人持续性发育性口吃的结构形态学比较
Pub Date : 2023-11-06 DOI: 10.1093/braincomms/fcad301
Hilary E Miller, Emily O Garnett, Elizabeth S Heller Murray, Alfonso Nieto-Castañón, Jason A Tourville, Soo-Eun Chang, Frank H Guenther
Abstract This cross-sectional study aimed to differentiate earlier occurring neuroanatomical differences that may reflect core deficits in stuttering versus changes associated with a longer duration of stuttering by analyzing structural morphometry in a large sample of children and adults who stutter and age-matched controls. Whole-brain T1-weighted structural scans were obtained from 166 individuals who stutter (74 children, 92 adults; ages 3-58) and 191 controls (92 children, 99 adults; ages 3-53) from eight prior studies in our laboratories. Mean size and gyrification measures were extracted using FreeSurfer software for each cortical region of interest. FreeSurfer software was also used to generate subcortical volumes for regions in the automatic subcortical segmentation. For cortical analyses, separate ANOVA analyses of size (surface area, cortical thickness) and gyrification (local gyrification index) measures were conducted to test for a main effect of diagnosis (stuttering, control) and the interaction of diagnosis-group with age-group (children, adults) across cortical regions. Cortical analyses were first conducted across a set of regions that comprise the speech network and then in a second whole-brain analysis. Next, separate ANOVA analyses of volume were conducted across subcortical regions in each hemisphere. False discovery rate corrections were applied for all analyses. Additionally, we tested for correlations between structural morphometry and stuttering severity. Analyses revealed thinner cortex in children who stutter compared to controls in several key speech planning regions, with significant correlations between cortical thickness and stuttering severity. These differences in cortical size were not present in adults who stutter, who instead showed reduced gyrification in the right inferior frontal gyrus. Findings suggest that early cortical anomalies in key speech planning regions may be associated with stuttering onset. Persistent stuttering into adulthood may result from network-level dysfunction instead of focal differences in cortical morphometry. Adults who stutter may also have a more heterogeneous neural presentation than children who stutter due to their unique lived experiences.
本横断面研究旨在通过分析大样本口吃儿童和成人以及年龄匹配对照的结构形态学,区分早期发生的神经解剖学差异,这些差异可能反映口吃的核心缺陷,以及与更长口吃持续时间相关的变化。对166名口吃患者进行全脑t1加权结构扫描(74名儿童,92名成人;年龄3-58岁)和191名对照组(92名儿童,99名成人;年龄在3-53岁之间),来自我们实验室之前的8项研究。使用FreeSurfer软件提取每个感兴趣的皮质区域的平均尺寸和旋转测量值。使用FreeSurfer软件生成皮质下自动分割区域的皮质下体积。对于皮质分析,对大小(表面积、皮质厚度)和旋转(局部旋转指数)进行了单独的方差分析,以检验诊断(口吃、控制)的主要影响以及诊断组与年龄组(儿童、成人)在皮质区域的相互作用。皮层分析首先在一组构成语音网络的区域进行,然后进行第二次全脑分析。接下来,在每个半球的皮质下区域进行单独的体积方差分析。错误发现率校正应用于所有分析。此外,我们测试了结构形态与口吃严重程度之间的相关性。分析显示,与对照组相比,口吃儿童在几个关键的语言规划区域的皮层更薄,皮层厚度与口吃严重程度之间存在显著相关性。这些皮层大小的差异在口吃的成年人中并不存在,相反,他们表现出右侧额下回的回转减少。研究结果表明,早期关键言语规划区域的皮质异常可能与口吃的发生有关。持续口吃到成年可能是由于网络水平的功能障碍,而不是局部皮层形态的差异。由于他们独特的生活经历,口吃的成年人也可能比口吃的儿童有更异质的神经表现。
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引用次数: 0
Clinical course of pathologically confirmed corticobasal degeneration and corticobasal syndrome 病理证实的皮质基底变性和皮质基底综合征的临床病程
Pub Date : 2023-11-03 DOI: 10.1093/braincomms/fcad296
Ikuko Aiba, Yuichi Hayashi, Takayoshi Shimohata, Mari Yoshida, Yuko Saito, Koichi Wakabayashi, Takashi Komori, Masato Hasegawa, Takeshi Ikeuchi, Aya M Tokumaru, Keita Sakurai, Shigeo Murayama, Kazuko Hasegawa, Toshiki Uchihara, Yasuko Toyoshima, Yufuko Saito, Ichiro Yabe, Satoshi Tanikawa, Keizo Sugaya, Kentaro Hayashi, Terunori Sano, Masaki Takao, Motoko Sakai, Harutoshi Fujimura, Hiroshi Takigawa, Tadashi Adachi, Ritsuko Hanajima, Osamu Yokota, Tomoko Miki, Yasushi Iwasaki, Michio Kobayashi, Nobutaka Arai, Takuya Ohkubo, Takanori Yokota, Keiko Mori, Masumi Ito, Chiho Ishida, Masaharu Tanaka, Jiro Idezuka, Masato Kanazawa, Kenju Aoki, Masashi Aoki, Takafumi Hasegawa, Hirohisa Watanabe, Atsushi Hashizume, Hisayoshi Niwa, Keizo Yasui, Keita Ito, Yukihiko Washimi, Eiichiro Mukai, Akatsuki Kubota, Tatsushi Toda, Kenji Nakashima, Yuichi Hayashi, Takayoshi Shimohata, Mari Yoshida, Yuko Saito, Koichi Wakabayashi, Takashi Komori, Masato Hasegawa, Takeshi Ikeuchi, Aya M Tokumaru, Keita Sakurai, Shigeo Murayama, Kazuko Hasegawa, Toshiki Uchihara, Yasuko Toyoshima, Yufuko Saito, Ichiro Yabe, Satoshi Tanikawa, Keizo Sugaya, Kentaro Hayashi, Terunori Sano, Masaki Takao, Motoko Sakai, Harutoshi Fujimura, Hiroshi Takigawa, Tadashi Adachi, Ritsuko Hanajima, Osamu Yokota, Tomoko Miki, Yasushi Iwasaki, Michio Kobayashi, Nobutaka Arai, Takuya Ohkubo, Takanori Yokota, Keiko Mori, Masumi Ito, Chiho Ishida, Masaharu Tanaka, Jiro Idezuka, Masato Kanazawa, Kenju Aoki, Masashi Aoki, Takafumi Hasegawa, Hirohisa Watanabe, Atsushi Hashizume, Hisayoshi Niwa, Keizo Yasui, Keita Ito
Abstract The clinical presentation of corticobasal degeneration is diverse, while the background pathology of corticobasal syndrome is also heterogeneous. Therefore, predicting the pathological background of corticobasal syndrome is extremely difficult. Herein, we investigated the clinical findings and course in patients with pathologically, genetically, and biochemically verified corticobasal degeneration and corticobasal syndrome with background pathology to determine findings suggestive of background disorder. Thirty-two patients were identified as having corticobasal degeneration. The median intervals from the initial symptoms to the onset of key milestones were as follows: gait disturbance, 0.0 year; behavioural changes, 1.0 year; falls, 2.0 years; cognitive impairment, 2.0 years; speech impairment, 2.5 years; supranuclear gaze palsy, 3.0 years; urinary incontinence, 3.0 years; and dysphagia, 5.0 years. The median survival time was 7.0 years; 50% of corticobasal degeneration were diagnosed as corticobasal degeneration/corticobasal syndrome at the final presentation. Background pathologies of corticobasal syndrome (n = 48) included corticobasal degeneration (33.3%), progressive supranuclear palsy (29.2%), and Alzheimer's disease (12.5%). The common course of corticobasal syndrome was initial gait disturbance and early fall. Additionally, corticobasal degeneration-corticobasal syndrome manifested behavioural change (2.5 years) and cognitive impairment (3.0 years), as the patient with progressive supranuclear palsy-corticobasal syndrome developed speech impairment (1.0 years) and supranuclear gaze palsy (6.0 years). The Alzheimer's disease-corticobasal syndrome patients showed cognitive impairment (1.0 years). The frequency of frozen gait at onset was higher in the corticobasal degeneration-corticobasal syndrome group than in the progressive supranuclear palsy-corticobasal syndrome group (P = 0.005, odds ratio [95% confidence interval]: 31.67 [1.46-685.34]). Dysarthria at presentation was higher in progressive supranuclear palsy-corticobasal syndrome than in corticobasal degeneration-corticobasal syndrome (P = 0.047, 6.75 [1.16-39.20]). Pyramidal sign at presentation and personality change during entire course were higher in Alzheimer's disease-corticobasal syndrome than in progressive supranuclear palsy-corticobasal syndrome (P = 0.011, 27.44 [1.25-601.61], and P = 0.013, 40.00 [1.98-807.14], respectively). In corticobasal syndrome, decision tree analysis revealed that ‘freezing at onset’ or ‘no dysarthria at presentation and age at onset under 66 years in the case without freezing at onset’ predicted corticobasal degeneration pathology with a sensitivity of 81.3% and specificity of 84.4%. ‘Dysarthria at presentation and age at onset over 61 years’ suggested progressive supranuclear palsy pathology, and ‘pyramidal sign at presentation and personality change during the entire course’ implied Alzheimer's disease pathology. In conclusion, frozen
基底皮质变性的临床表现是多样的,而基底皮质综合征的背景病理也是异质性的。因此,预测基底皮质综合征的病理背景是非常困难的。在此,我们调查了经病理、遗传和生化证实的基底皮质变性和基底皮质综合征患者的临床表现和病程,以确定背景病理提示的结果。32例患者被确定为皮质基底变性。从最初症状到关键里程碑的中位时间间隔如下:步态障碍,0.0年;行为改变,1年;瀑布,2.0年;认知障碍,2.0岁;语言障碍,2.5岁;核上凝视性麻痹,3岁;尿失禁,3.0年;吞咽困难,5年。中位生存时间为7.0年;50%的基底皮质退行性变最终诊断为基底皮质退行性变/基底皮质综合征。皮质基底综合征(n = 48)的背景病理包括皮质基底变性(33.3%)、进行性核上性麻痹(29.2%)和阿尔茨海默病(12.5%)。皮质基底综合征的共同病程是最初的步态障碍和早期跌倒。此外,皮质基底变性-皮质基底综合征表现为行为改变(2.5年)和认知障碍(3.0年),进行性核上麻痹-皮质基底综合征患者出现语言障碍(1.0年)和核上凝视性麻痹(6.0年)。阿尔茨海默病-皮质基底综合征患者表现为认知障碍(1.0年)。基底皮质变性-基底皮质综合征组发病时冻结步态频率高于进行性核上性麻痹-基底皮质综合征组(P = 0.005,优势比[95%可信区间]:31.67[1.46-685.34])。进行性核上性麻痹-皮质基底综合征患者的构音障碍发生率高于皮质基底变性-皮质基底综合征患者(P = 0.047, 6.75[1.16-39.20])。阿尔茨海默病-皮质-基底综合征患者首发时的锥体征和整个病程中的人格改变高于进行性核上麻痹-皮质-基底综合征患者(P = 0.011, 27.44 [1.25-601.61], P = 0.013, 40.00[1.98-807.14])。在皮质基底综合征中,决策树分析显示,“起病时冻结”或“首发时无构音障碍,起病时年龄在66岁以下(起病时无冻结)”预测皮质基底变性病理的敏感性为81.3%,特异性为84.4%。“首发时构音障碍和发病年龄超过61岁”提示进行性核上性麻痹病理,“首发时锥体征和整个过程中的人格改变”提示阿尔茨海默病病理。总之,起病时的冻结步态、构音障碍、人格改变和锥体征象可能是预测皮质基底综合征背景病理的有用临床征象。
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Therefore, predicting the pathological background of corticobasal syndrome is extremely difficult. Herein, we investigated the clinical findings and course in patients with pathologically, genetically, and biochemically verified corticobasal degeneration and corticobasal syndrome with background pathology to determine findings suggestive of background disorder. Thirty-two patients were identified as having corticobasal degeneration. The median intervals from the initial symptoms to the onset of key milestones were as follows: gait disturbance, 0.0 year; behavioural changes, 1.0 year; falls, 2.0 years; cognitive impairment, 2.0 years; speech impairment, 2.5 years; supranuclear gaze palsy, 3.0 years; urinary incontinence, 3.0 years; and dysphagia, 5.0 years. The median survival time was 7.0 years; 50% of corticobasal degeneration were diagnosed as corticobasal degeneration/corticobasal syndrome at the final presentation. Background pathologies of corticobasal syndrome (n = 48) included corticobasal degeneration (33.3%), progressive supranuclear palsy (29.2%), and Alzheimer's disease (12.5%). The common course of corticobasal syndrome was initial gait disturbance and early fall. Additionally, corticobasal degeneration-corticobasal syndrome manifested behavioural change (2.5 years) and cognitive impairment (3.0 years), as the patient with progressive supranuclear palsy-corticobasal syndrome developed speech impairment (1.0 years) and supranuclear gaze palsy (6.0 years). The Alzheimer's disease-corticobasal syndrome patients showed cognitive impairment (1.0 years). The frequency of frozen gait at onset was higher in the corticobasal degeneration-corticobasal syndrome group than in the progressive supranuclear palsy-corticobasal syndrome group (P = 0.005, odds ratio [95% confidence interval]: 31.67 [1.46-685.34]). Dysarthria at presentation was higher in progressive supranuclear palsy-corticobasal syndrome than in corticobasal degeneration-corticobasal syndrome (P = 0.047, 6.75 [1.16-39.20]). Pyramidal sign at presentation and personality change during entire course were higher in Alzheimer's disease-corticobasal syndrome than in progressive supranuclear palsy-corticobasal syndrome (P = 0.011, 27.44 [1.25-601.61], and P = 0.013, 40.00 [1.98-807.14], respectively). In corticobasal syndrome, decision tree analysis revealed that ‘freezing at onset’ or ‘no dysarthria at presentation and age at onset under 66 years in the case without freezing at onset’ predicted corticobasal degeneration pathology with a sensitivity of 81.3% and specificity of 84.4%. ‘Dysarthria at presentation and age at onset over 61 years’ suggested progressive supranuclear palsy pathology, and ‘pyramidal sign at presentation and personality change during the entire course’ implied Alzheimer's disease pathology. In conclusion, frozen ","PeriodicalId":9318,"journal":{"name":"Brain Communications","volume":"36 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Brain Communications
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