TY - JOUR
T1 - Brain Structure and Degeneration Staging in Friedreich Ataxia
T2 - Magnetic Resonance Imaging Volumetrics from the ENIGMA-Ataxia Working Group
AU - Harding, Ian H.
AU - Chopra, Sidhant
AU - Arrigoni, Filippo
AU - Boesch, Sylvia
AU - Brunetti, Arturo
AU - Cocozza, Sirio
AU - Corben, Louise A.
AU - Deistung, Andreas
AU - Delatycki, Martin
AU - Diciotti, Stefano
AU - Dogan, Imis
AU - Evangelisti, Stefania
AU - França, Marcondes C.
AU - Göricke, Sophia L.
AU - Georgiou-Karistianis, Nellie
AU - Gramegna, Laura L.
AU - Henry, Pierre Gilles
AU - Hernandez-Castillo, Carlos R.
AU - Hutter, Diane
AU - Jahanshad, Neda
AU - Joers, James M.
AU - Lenglet, Christophe
AU - Lodi, Raffaele
AU - Manners, David N.
AU - Martinez, Alberto R.M.
AU - Martinuzzi, Andrea
AU - Marzi, Chiara
AU - Mascalchi, Mario
AU - Nachbauer, Wolfgang
AU - Pane, Chiara
AU - Peruzzo, Denis
AU - Pisharady, Pramod K.
AU - Pontillo, Giuseppe
AU - Reetz, Kathrin
AU - Rezende, Thiago J.R.
AU - Romanzetti, Sandro
AU - Saccà, Francesco
AU - Scherfler, Christoph
AU - Schulz, Jörg B.
AU - Stefani, Ambra
AU - Testa, Claudia
AU - Thomopoulos, Sophia I.
AU - Timmann, Dagmar
AU - Tirelli, Stefania
AU - Tonon, Caterina
AU - Vavla, Marinela
AU - Egan, Gary F.
AU - Thompson, Paul M.
N1 - Publisher Copyright:
© 2021 The Authors. Annals of Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.
PY - 2021/10
Y1 - 2021/10
N2 - Objective: Friedreich ataxia (FRDA) is an inherited neurological disease defined by progressive movement incoordination. We undertook a comprehensive characterization of the spatial profile and progressive evolution of structural brain abnormalities in people with FRDA. Methods: A coordinated international analysis of regional brain volume using magnetic resonance imaging data charted the whole-brain profile, interindividual variability, and temporal staging of structural brain differences in 248 individuals with FRDA and 262 healthy controls. Results: The brainstem, dentate nucleus region, and superior and inferior cerebellar peduncles showed the greatest reductions in volume relative to controls (Cohen d = 1.5–2.6). Cerebellar gray matter alterations were most pronounced in lobules I–VI (d = 0.8), whereas cerebral differences occurred most prominently in precentral gyri (d = 0.6) and corticospinal tracts (d = 1.4). Earlier onset age predicted less volume in the motor cerebellum (rmax = 0.35) and peduncles (rmax = 0.36). Disease duration and severity correlated with volume deficits in the dentate nucleus region, brainstem, and superior/inferior cerebellar peduncles (rmax = −0.49); subgrouping showed these to be robust and early features of FRDA, and strong candidates for further biomarker validation. Cerebral white matter abnormalities, particularly in corticospinal pathways, emerge as intermediate disease features. Cerebellar and cerebral gray matter loss, principally targeting motor and sensory systems, preferentially manifests later in the disease course. Interpretation: FRDA is defined by an evolving spatial profile of neuroanatomical changes beyond primary pathology in the cerebellum and spinal cord, in line with its progressive clinical course. The design, interpretation, and generalization of research studies and clinical trials must consider neuroanatomical staging and associated interindividual variability in brain measures. ANN NEUROL 2021;90:570–583.
AB - Objective: Friedreich ataxia (FRDA) is an inherited neurological disease defined by progressive movement incoordination. We undertook a comprehensive characterization of the spatial profile and progressive evolution of structural brain abnormalities in people with FRDA. Methods: A coordinated international analysis of regional brain volume using magnetic resonance imaging data charted the whole-brain profile, interindividual variability, and temporal staging of structural brain differences in 248 individuals with FRDA and 262 healthy controls. Results: The brainstem, dentate nucleus region, and superior and inferior cerebellar peduncles showed the greatest reductions in volume relative to controls (Cohen d = 1.5–2.6). Cerebellar gray matter alterations were most pronounced in lobules I–VI (d = 0.8), whereas cerebral differences occurred most prominently in precentral gyri (d = 0.6) and corticospinal tracts (d = 1.4). Earlier onset age predicted less volume in the motor cerebellum (rmax = 0.35) and peduncles (rmax = 0.36). Disease duration and severity correlated with volume deficits in the dentate nucleus region, brainstem, and superior/inferior cerebellar peduncles (rmax = −0.49); subgrouping showed these to be robust and early features of FRDA, and strong candidates for further biomarker validation. Cerebral white matter abnormalities, particularly in corticospinal pathways, emerge as intermediate disease features. Cerebellar and cerebral gray matter loss, principally targeting motor and sensory systems, preferentially manifests later in the disease course. Interpretation: FRDA is defined by an evolving spatial profile of neuroanatomical changes beyond primary pathology in the cerebellum and spinal cord, in line with its progressive clinical course. The design, interpretation, and generalization of research studies and clinical trials must consider neuroanatomical staging and associated interindividual variability in brain measures. ANN NEUROL 2021;90:570–583.
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U2 - 10.1002/ana.26200
DO - 10.1002/ana.26200
M3 - Article
C2 - 34435700
AN - SCOPUS:85115260031
SN - 0364-5134
VL - 90
SP - 570
EP - 583
JO - Annals of Neurology
JF - Annals of Neurology
IS - 4
ER -