Patient-Tailored, Connectivity-Based Forecasts of Spreading Brain Atrophy

Publication date: Available online 14 October 2019Source: NeuronAuthor(s): Jesse A. Brown, Jersey Deng, John Neuhaus, Isabel J. Sible, Ana C. Sias, Suzee E. Lee, John Kornak, Gabe A. Marx, Anna M. Karydas, Salvatore Spina, Lea T. Grinberg, Giovanni Coppola, Dan H. Geschwind, Joel H. Kramer, Maria Luisa Gorno-Tempini, Bruce L. Miller, Howard J. Rosen, William W. SeeleySummaryNeurodegenerative diseases appear to progress by spreading via brain connections. Here we evaluated this transneuronal degeneration hypothesis by attempting to predict future atrophy in a longitudinal cohort of patients with behavioral variant frontotemporal dementia (bvFTD) and semantic variant primary progressive aphasia (svPPA). We determined patient-specific “epicenters” at baseline, located each patient’s epicenters in the healthy functional connectome, and derived two region-wise graph theoretical metrics to predict future atrophy: (1) shortest path length to the epicenter and (2) nodal hazard, the cumulative atrophy of a region’s first-degree neighbors. Using these predictors and baseline atrophy, we could accurately predict longitudinal atrophy in most patients. The regions most vulnerable to subsequent atrophy were functionally connected to the epicenter and had intermediate levels of baseline atrophy. These findings provide novel, longitudinal evidence that neurodegeneration progresses along connectional pathways and, further developed, could lead to network-based clinical...
Source: Neuron - Category: Neuroscience Source Type: research

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Conclusions In the current study, AQ underestimated the presence of PPA and WAB-R classification did not distinguish among PPA classification determined by consensus. Performance on individual subtests and relative performance across subtests demonstrated inconsistent alignment with PPA classification. We conclude the WAB-R in isolation is inadequate to detect or characterize PPA. We instead suggest utilizing the WAB-R as 1 component of a comprehensive language and motor speech assessment when PPA is suspected. PMID: 31639312 [PubMed - as supplied by publisher]
Source: American Journal of Speech-Language Pathology - Category: Speech-Language Pathology Authors: Tags: Am J Speech Lang Pathol Source Type: research
By KIP SULLIVAN The notion that hospital readmission rates are a “quality” measure reached the status of conventional wisdom by the late 2000s. In their 2007 and 2008 reports to Congress, the Medicare Payment Advisory Commission (MedPAC) recommended that Congress authorize a program that would punish hospitals for “excess readmissions” of Medicare fee-for-service (FFS) enrollees. In 2010, Congress accepted MedPAC’s recommendation and, in Section 3025 of the Affordable Care Act (ACA) (p. 328), ordered the Centers for Medicare and Medicaid Services (CMS) to start the Hospital Readmissions Red...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Policy Medicare ACA Affordable Care Act hospital readmissions Hospital Readmissions Reduction Program HRRP Kip Sullivan Medicaid MedPAC Source Type: blogs
AbstractThe utility of tau PET imaging in non-Alzheimer ’s disease (AD) tauopathies like behavioural frontotemporal dementia (bvFTD), which is mainly underlain by TDP-43 or tau pathology, remains debated. We aim to test the hypothesis that [18F]-AV-1451 tau PET using later than usual acquisition times, which have previously been shown in AD to allow to get closer to tracer equilibrium between the reference region and high-binding structures, and could be better suited to the lower affinity of this tracer for the straight tau filaments present in non-AD tauopathies, would allow to detect cortical tau pathology in a fr...
Source: Journal of Neurology - Category: Neurology Source Type: research
ConclusionSLTs fulfil an integral role in supporting both the diagnostic and post-diagnostic care pathways of people living with dementia and cognitive impairment attending memory services. SLTs have a unique role and skillset in identifying the specific nature of language difficulties for a person with dementia or cognitive impairment and in reducing the impact of the communication difficulties for the person and for their family members.
Source: Age and Ageing - Category: Geriatrics Source Type: research
DISCUSSION: The BEHAV and LANG domains enable the CDR® plus NACC FTLD to capture early symptomatology of FTLD. PMID: 31477517 [PubMed - as supplied by publisher]
Source: The Journal of Alzheimers Association - Category: Psychiatry Tags: Alzheimers Dement Source Type: research
DiscussionThe BEHAV and LANG domains enable the CDR® plus NACC FTLD to capture early symptomatology of FTLD.
Source: Alzheimer's and Dementia: The Journal of the Alzheimer's Association - Category: Geriatrics Source Type: research
The non-fluent / agrammatic variant of primary progressive aphasia (nfvPPA) and semantic variant (svPPA) of frontotemporal dementia (FTD) are neurodegenerative diseases. Previous works have shown alterations of fractional anisotropy (FA) and mean diffusivity (MD) from diffusion tensor images (DTIs). This manuscript is aimed at using DTI images to build a global tractography and to identify atrophy patterns of subcortical networks in each variant. Twenty patients with svPPA, 20 patients with nfvPPA, and 26 patients with behavioral variant of FTD (bvFTD) were included. An analysis based on the connectivity of structural netw...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
AbstractFrontotemporal dementia (FTD) is a neurodegenerative brain disorder primarily affecting the frontal and/or temporal lobes. Three main subtypes have been recognized: behavioural-variant FTD (bvFTD), semantic dementia (SD), and progressive nonfluent aphasia (PNFA), each of which has a distinct clinical and cognitive profile. Although the role of the cerebellum in cognition is increasingly accepted, knowledge of cerebellar changes across neuroimaging modalities and their contribution to behavioural and cognitive changes in FTD syndromes is currently scant. We conducted an anatomical/activation likelihood estimation (A...
Source: Neuropsychology Review - Category: Neuroscience Source Type: research
Authors: Nishida H, Hayashi Y, Ban Y, Kudo T, Harada N, Sakurai T Abstract A 61-year-old dextral woman was admitted to the hospital with difficulty finding words. Neurological examinations confirmed that her speech was affected by frequent pauses and occasional phonological paraphasia without cognitive deficits. We detected atrophy, hypoperfusion, and hypometabolism in the right perisylvian and parietal regions, expanding to the right anterior temporal lobes and right inferior frontal gyrus (opercular region) by magnetic resonance imaging, single-photon emission computed tomography, and fluorodexyglucose-positron e...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
CONCLUSIONS &IMPLICATIONS: This survey highlights the range of current PPA assessment and intervention practices in use by the respondents. Communication partner training is commonly used by the surveyed SLTs, despite the lack of research evidence examining its effectiveness for PPA. There is a need to develop evidence-based care pathways for people with PPA in order to advocate for further commissioning of clinical services. PMID: 31364253 [PubMed - as supplied by publisher]
Source: International Journal of Language and Communication Disorders - Category: Speech-Language Pathology Authors: Tags: Int J Lang Commun Disord Source Type: research
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