Brain mechanisms underlying subtle cognitive changes in the premanifest stage of Huntington disease (prHD) are not understood due to a relative dearth of functional imaging studies. Preliminary evidence suggests that alterations in regional brain activation may be sensitive to very early changes in prHD. However, as cognition depends on communication among brain regions, functional connectivity of brain networks may be a more important intermediate phenotype of early pathology. The proposed longitudinal investigation of prHD will examine functional connectivity MRI (fcMRI) measured from a resting state. Resting state fcMRI correlates with cognitive abilities and has advantages as a biomarker for longitudinal studies, yet has received scant attention in prHD. The primary goal of this projec is to use fcMRI connectivity to identify the earliest changes in brain networks in prHD and to track them longitudinally. The proposed study will employ two different, but complimentary analytic approaches to study fcMRI, as some approaches may be more sensitive to disease-relevant changes. Connectivity strength in networks will be compared between a control group and prHD individuals who are stratified into three groups based on their genetic signature of disease progression. Participants will have been studied annually for three or four consecutive years.
Aim 1 will identify sensitive fcMRI markers of prHD using a region-of-interest (ROI) method. The selection of seed ROI will be informed by task-activated fMRI on tests that probe for functioning in different frontostriatal networks. The main hypothesis is that connectivity strength of seeds will be progressively weakened as prHD individuals approach diagnosis.
Aim 2 will identify sensitive fcMRI markers of prHD from complex network analysis, which characterizes organizational features and information- processing capabilities of whole-brain networks. The main hypothesis is that the organization, processing efficiency, and/or functional interactions between regions will progressively weaken as prHD individuals approach diagnosis.
Aim 3 will determine if fcMRI markers identified at baseline are sensitive to longitudinal decline across a three to four year period. The main hypothesis is that longitudinal changes in connectivity markers will emerge prior to changes in brain morphometry and cognitive functioning. The present proposal will also examine if fcMRI partially depends on the structural integrity of brain tissue.
Each aim will include a sub-aim wherein high angular diffusion weighted imaging and structural MRI will determine if a loss in fiber-tract connectivity and volume/thinning correlate with altered connectivity in specific networks at baseline. The relative sensitivity of fcMRI and structural markers of longitudinal change will be evaluated. We will also determine if fcMRI connectivity markers selectively correlate with cognitive abilities at baseline and longitudinal changes in cognition. Altogether, the proposed multipronged approach is expected to promote a new understanding of brain networks in prHD.

Public Health Relevance

Changes in the brain in Huntington disease (HD) begin long before a person is diagnosed, during a preclinical stage. To measure the effectiveness of potential treatments for HD, it is necessary to identify measurement tools that reliably detect changes in the brain during the preclinical stage where treatments are more likely to be successful. The primary goal of this project is to use a neuroimaging technique, namely functional connectivity MRI, to identify the earliest changes in brain connections in preclinical HD and to track these changes longitudinally.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01NS082083-03
Application #
8740575
Study Section
Special Emphasis Panel (ZNS1)
Program Officer
Sutherland, Margaret L
Project Start
2012-09-26
Project End
2015-08-31
Budget Start
2014-09-01
Budget End
2015-08-31
Support Year
3
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Cleveland Clinic Lerner
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
City
Cleveland
State
OH
Country
United States
Zip Code
44195
Espinoza, Flor A; Vergara, Victor M; Reyes, Daisy et al. (2018) Aberrant functional network connectivity in psychopathy from a large (N = 985) forensic sample. Hum Brain Mapp 39:2624-2634
Sakaie, Ken; Lowe, Mark (2017) Retrospective correction of bias in diffusion tensor imaging arising from coil combination mode. Magn Reson Imaging 37:203-208
Lourens, Spencer; Zhang, Ying; Long, Jeffrey D et al. (2017) Analysis of longitudinal censored semicontinuous data with application to the study of executive dysfunction: The Towers Task. Stat Methods Med Res 26:865-879
Long, Jeffrey D; Langbehn, Douglas R; Tabrizi, Sarah J et al. (2017) Validation of a prognostic index for Huntington's disease. Mov Disord 32:256-263
Harrington, Deborah L; Long, Jeffrey D; Durgerian, Sally et al. (2016) Cross-sectional and longitudinal multimodal structural imaging in prodromal Huntington's disease. Mov Disord 31:1664-1675
Lowe, Mark J; Sakaie, Ken E; Beall, Erik B et al. (2016) Modern Methods for Interrogating the Human Connectome. J Int Neuropsychol Soc 22:105-19
Harrington, Deborah L; Rubinov, Mikail; Durgerian, Sally et al. (2015) Network topology and functional connectivity disturbances precede the onset of Huntington's disease. Brain 138:2332-46
Williams, Janet K; Kim, Ji-In; Downing, Nancy et al. (2015) Everyday cognition in prodromal Huntington disease. Neuropsychology 29:255-67
Kim, Ji-In; Long, Jeffrey D; Mills, James A et al. (2015) Performance of the 12-item WHODAS 2.0 in prodromal Huntington disease. Eur J Hum Genet 23:1584-7
Musso, Mandi; Westervelt, Holly James; Long, Jeffrey D et al. (2015) Intra-individual Variability in Prodromal Huntington Disease and Its Relationship to Genetic Burden. J Int Neuropsychol Soc 21:8-21

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