These authors contributed equally to this work.
Distinct Brain Volume Changes Correlating with Clinical Stage, Disease Progression Rate, Mutation Size, and Age at Onset Prediction as Early Biomarkers of Brain Atrophy in Huntington's Disease
Version of Record online: 13 FEB 2009
© 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Ltd
CNS Neuroscience & Therapeutics
Volume 15, Issue 1, pages 1–11, Spring 2009
How to Cite
Squitieri, F., Cannella, M., Simonelli, M., Sassone, J., Martino, T., Venditti, E., Ciammola, A., Colonnese, C., Frati, L. and Ciarmiello, A. (2009), Distinct Brain Volume Changes Correlating with Clinical Stage, Disease Progression Rate, Mutation Size, and Age at Onset Prediction as Early Biomarkers of Brain Atrophy in Huntington's Disease. CNS Neuroscience & Therapeutics, 15: 1–11. doi: 10.1111/j.1755-5949.2008.00068.x
- Issue online: 13 FEB 2009
- Version of Record online: 13 FEB 2009
- Brain biomarkers;
- Magnetic resonance imaging;
- Peripheral markers;
- Progression rate and severity;
- Volumetric brain atrophy
Searching brain and peripheral biomarkers is a requisite to cure Huntington's disease (HD). To search for markers indicating the rate of brain neurodegenerative changes in the various disease stages, we quantified changes in brain atrophy in subjects with HD. We analyzed the cross-sectional and longitudinal rate of brain atrophy, quantitatively measured by fully-automated multiparametric magnetic resonance imaging, as fractional gray matter (GM, determining brain cortex volume), white matter (WM, measuring the volume of axonal fibers), and corresponding cerebral spinal fluid (CSF, a measure of global brain atrophy), in 94 gene-positive subjects with presymptomatic to advanced HD, and age-matched healthy controls. Each of the three brain compartments we studied (WM, GM, and CSF) had a diverse role and their time courses differed in the development of HD. GM volume decreased early in life. Its decrease was associated with decreased serum brain-derived-neurotrophic-factor and started even many years before onset symptoms, then decreased slowly in a nonlinear manner during the various symptomatic HD stages. WM volume loss also began in the presymptomatic stage of HD a few years before manifest symptoms appear, rapidly decreasing near to the zone-of-onset. Finally, the CSF volume increase began many years before age at onset. Its volume measured in presymptomatic subjects contributed to improve the CAG-based model of age at onset prediction. The progressive CSF increase depended on CAG mutation size and continued linearly until the last stages of HD, perhaps representing the best marker of progression rate and severity in HD (R2= 0.25, P < 0.0001).