Lorenzi, RM;
Palesi, F;
Castellazzi, G;
Vitali, P;
Anzalone, N;
Bernini, S;
Cotta Ramusino, M;
... Gandini Wheeler-Kingshott, CAM; + view all
(2020)
Unsuspected Involvement of Spinal Cord in Alzheimer Disease.
Frontiers in Cellular Neuroscience
, 14
, Article 6. 10.3389/fncel.2020.00006.
Preview |
Text
fncel-14-00006.pdf - Published Version Download (2MB) | Preview |
Abstract
OBJECTIVE: Brain atrophy is an established biomarker for dementia, yet spinal cord involvement has not been investigated to date. As the spinal cord is relaying sensorimotor control signals from the cortex to the peripheral nervous system and vice-versa, it is indeed a very interesting question to assess whether it is affected by atrophy due to a disease that is known for its involvement of cognitive domains first and foremost, with motor symptoms being clinically assessed too. We, therefore, hypothesize that in Alzheimer’s disease (AD), severe atrophy can affect the spinal cord too and that spinal cord atrophy is indeed an important in vivo imaging biomarker contributing to understanding neurodegeneration associated with dementia. METHODS: 3DT1 images of 31 AD and 35 healthy control (HC) subjects were processed to calculate volume of brain structures and cross-sectional area (CSA) and volume (CSV) of the cervical cord [per vertebra as well as the C2-C3 pair (CSA23 and CSV23)]. Correlated features (ρ > 0.7) were removed, and the best subset identified for patients’ classification with the Random Forest algorithm. General linear model regression was used to find significant differences between groups (p ≤ 0.05). Linear regression was implemented to assess the explained variance of the Mini-Mental State Examination (MMSE) score as a dependent variable with the best features as predictors. RESULTS: Spinal cord features were significantly reduced in AD, independently of brain volumes. Patients classification reached 76% accuracy when including CSA23 together with volumes of hippocampi, left amygdala, white and gray matter, with 74% sensitivity and 78% specificity. CSA23 alone explained 13% of MMSE variance. DISCUSSION: Our findings reveal that C2-C3 spinal cord atrophy contributes to discriminate AD from HC, together with more established features. The results show that CSA23, calculated from the same 3DT1 scan as all other brain volumes (including right and left hippocampi), has a considerable weight in classification tasks warranting further investigations. Together with recent studies revealing that AD atrophy is spread beyond the temporal lobes, our result adds the spinal cord to a number of unsuspected regions involved in the disease. Interestingly, spinal cord atrophy explains also cognitive scores, which could significantly impact how we model sensorimotor control in degenerative diseases with a primary cognitive domain involvement. Prospective studies should be purposely designed to understand the mechanisms of atrophy and the role of the spinal cord in AD.
| Type: | Article |
|---|---|
| Title: | Unsuspected Involvement of Spinal Cord in Alzheimer Disease |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3389/fncel.2020.00006 |
| Publisher version: | https://doi.org/10.3389/fncel.2020.00006 |
| Language: | English |
| Additional information: | This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Alzheimer’s disease, cross-sectional area (CSA), brain atrophy, spinal cord atrophy, spinal cord toolbox, Alzheimer’s diagnosis, dementia biomarker, sensorymotor function impairment |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neuroinflammation |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10092690 |
Loading...
Loading...Loading...| 1. |  China | 4 |
| 2. |  United States | 1 |
| 3. |  Japan | 1 |
| 4. |  Russian Federation | 1 |
| 5. |  Korea, Republic of | 1 |
| 6. |  India | 1 |
| 7. |  United Kingdom | 1 |
Archive Staff Only
 |
View Item |
