Publications by authors named "Peggy Nopoulos"

Background: Previous studies suggest that early developmental delay is a common feature of Juvenile-Onset Huntington's disease (JOHD), with highest incidence in those with very high CAG repeats (> 80). However, all reports of developmental delay in JOHD are exclusively based on retrospective review of medical charts. Comprehensive assessment of birth history metrics may provide better insight into the question of early life development in JOHD.

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Objective: Huntington's disease (HD) is a neurodegenerative disease caused by a triplet repeat expansion within the gene huntingtin (HTT). Antagonistic pleiotropy is a theory of aging that posits that some genes, facilitating individual fitness early in life through adaptive evolutionary changes, also augment detrimental aging-related processes. Antagonistic pleiotropy theory may explain a positive evolutionary pressure toward functionally advantageous brain development that is vulnerable to rapid degeneration.

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Article Synopsis
  • - Juvenile Huntington's disease (JHD) features early motor symptoms like speech difficulties, rigidity, and dystonia in childhood, with cognitive decline typically evident through declining school performance.
  • - JHD can be misdiagnosed as autism spectrum disorder or ADHD due to overlapping behavioral symptoms, and specific JHD symptoms include epilepsy, ataxia, and faster disease progression compared to adult-onset forms.
  • - Diagnosis relies on clinical assessment, family history, and DNA analysis, with no current treatment guidelines available; future advancements may include better diagnostic markers like qualitative MRI and serum neurofilament light.
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The Cerebellar Cognitive Affective/Schmahmann Syndrome (CCAS) manifests as impaired executive control, linguistic processing, visual spatial function, and affect regulation. The CCAS has been described in the spinocerebellar ataxias (SCAs), but its prevalence is unknown. We analyzed results of the CCAS/Schmahmann Scale (CCAS-S), developed to detect and quantify CCAS, in two natural history studies of 309 individuals Symptomatic for SCA1, SCA2, SCA3, SCA6, SCA7, or SCA8, 26 individuals Pre-symptomatic for SCA1 or SCA3, and 37 Controls.

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  • Myotonic dystrophy type 1 (DM1) leads to neuromuscular degeneration, prompting a study to evaluate changes in white matter microstructure and cognitive/clinical abilities over three years in both DM1 patients and healthy adults.
  • Declines in white matter were observed in DM1 patients, affecting various functional outcomes such as motor skills and intelligence, with some cognitive functions remaining stable.
  • The research indicates that white matter health is crucial for understanding the progression of DM1, offering insights that could enhance the design of clinical trials aimed at treatment effectiveness.
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Background: Automated segmentation of individual calf muscle compartments in 3D MR images is gaining importance in diagnosing muscle disease, monitoring its progression, and prediction of the disease course. Although deep convolutional neural networks have ushered in a revolution in medical image segmentation, achieving clinically acceptable results is a challenging task and the availability of sufficiently large annotated datasets still limits their applicability.

Purpose: In this paper, we present a novel approach combing deep learning and graph optimization in the paradigm of assisted annotation for solving general segmentation problems in 3D, 4D, and generally n-D with limited annotation cost.

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Background: Juvenile-onset Huntington's disease (JOHD) is a rare form of Huntington's disease (HD) characterized by symptom onset before the age of 21 years. Observational data in this cohort is lacking.

Objectives: Quantify measures of disease progression for use in clinical trials of patients with JOHD.

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Spinocerebellar ataxias (SCAs) are progressive neurodegenerative disorders, but there is no metric that predicts disease severity over time. We hypothesized that by developing a new metric, the Severity Factor (S-Factor) using immutable disease parameters, it would be possible to capture disease severity independent of clinical rating scales. Extracting data from the CRC-SCA and READISCA natural history studies, we calculated the S-Factor for 438 participants with symptomatic SCA1, SCA2, SCA3, or SCA6, as follows: ((length of CAG repeat expansion - maximum normal repeat length) /maximum normal repeat length) × (current age - age at disease onset) × 10).

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Introduction: We compared neuropsychiatric symptoms between child and adolescent huntingtin gene-mutation carriers and noncarriers. Given previous evidence of atypical striatal development in carriers, we also assessed the relationship between neuropsychiatric traits and striatal development.

Methods: Participants between 6 and 18 years old were recruited from families affected by Huntington's disease and tested for the huntingtin gene expansion.

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Background: Juvenile-onset Huntington's disease (JOHD) is a rare and particularly devastating form of Huntington's disease (HD) for which clinical diagnosis is challenging and robust outcome measures are lacking. Neurofilament light protein (NfL) in plasma has emerged as a prognostic biomarker for adult-onset HD.

Methods: We performed a retrospective analysis of samples and data collected between 2009 and 2020 from the Kids-HD and Kids-JHD studies.

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Abnormalities of sleep are common in myotonic dystrophy type 1 (DM1), but few previous studies have combined polysomnography with detailed clinical measures and brain imaging. In the present study, domiciliary polysomnography, symptom questionnaires and cognitive evaluation were undertaken in 39 DM1-affected individuals. Structural brain MRI was completed in those without contra-indication (n = 32).

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Article Synopsis
  • * Using neuroimaging techniques, researchers categorized participants based on their gene status (gene expanded vs. gene non-expanded) and examined the thickness and surface area of the cortex.
  • * Findings reveal that cortical development appears normal in mHTT carriers, despite notable differences in development observed in another brain region (the striatum).
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Introduction: The present study had four aims. First, neuronal injury markers, including neurofilament light (NF-L), total tau, glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase (UCH-L1), were compared between individuals with and without adult-onset myotonic dystrophy type 1 (DM1). Second, the impact of age and CTG repeat on brain injury markers was evaluated.

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Objective: To investigate the associations between neurocognition and white matter integrity in children with chronic kidney disease (CKD).

Study Design: This cross-sectional study included 17 boys (age 6-16 years) with a diagnosis of mild to moderate (stages 1-3, nondialysis/nontransplant) CKD because of congenital anomalies of the kidney and urinary tract and 20 typically developing community controls. Participants underwent 3T neuroimaging and diffusion-weighted magnetic resonance imaging to assess white matter fractional anisotropy.

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Myotonic dystrophy type 1 is the most common form of muscular dystrophy in adults, and is primarily characterized by muscle weakness and myotonia, yet some of the most disabling symptoms of the disease are cognitive and behavioral. Here we evaluated several of these non-motor symptoms from a cross-sectional time-point in one of the largest longitudinal studies to date, including full-scale intelligence quotient, depression, anxiety, apathy, sleep, and cerebral white matter fractional anisotropy in a group of 39 adult-onset myotonic dystrophy type 1 participants (27 female) compared to 79 unaffected control participants (46 female). We show that intelligence quotient was significantly associated with depression ( < 0.

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Background: Neurofilament light-chain (NfL) protein is a blood-based marker of neuroaxonal injury. We sought to (1) compare plasma NfL levels in children with chronic kidney disease (CKD) and healthy peers, (2) characterize the relationship between NfL level and kidney function, and (3) evaluate NfL as a predictor of abnormal brain structure in CKD.

Methods: Sixteen children with CKD due to congenital kidney anomalies and 23 typically developing peers were included.

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Article Synopsis
  • The study aimed to explore brain and functional characteristics related to the premanifest phase of adult-onset myotonic dystrophy type 1 (PreDM1) among different groups, including healthy adults and those with manifest DM1.
  • Results showed that individuals with PreDM1 have intermediate white matter abnormalities, with lower fractional anisotropy compared to healthy controls but better than those with manifest DM1; they also demonstrated reduced finger-tapping performance and sleep issues.
  • These findings suggest notable central nervous system and functional deficits in the early stages of PreDM1, contributing to understanding the disease's progression.
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Background: The objective of this study was to determine sex-specific differences in inflammatory cytokine responses to red blood cell (RBC) transfusion in preterm infants in the neonatal period and their relationship to later neurocognitive status.

Methods: Infants with a birth weight <1000 g and gestational age 22-29 weeks were enrolled in the Transfusion of Prematures (TOP) trial. The total number of transfusions was used as a marker of transfusion status.

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Objective: To investigate the relationships between CAG repeat length in the huntingtin gene and cognitive performance in participants above and below the disease threshold for Huntington disease (HD), we performed a cross-sectional analysis of the Enroll-HD database.

Methods: We analyzed data from young, developing adults (≤30 years of age) without a history of depression, apathy, or cognitive deficits. We included participants with and without the gene expansion (CAG ≥36) for HD.

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Deficits in white matter (WM) integrity and motor symptoms are among the most robust and reproducible features of myotonic dystrophy type 1 (DM1). In the present study, we investigate whether WM integrity, obtained from diffusion-weighted MRI, corresponds to quantifiable motor outcomes (e.g.

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Objective: Myotonic dystrophy is a multisystem disorder caused by a trinucleotide repeat expansion on the myotonic dystrophy protein kinase () gene. To determine whether wildtype DMPK expression patterns vary as a function of age, we analyzed DMPK expression in the brain from 99 donors ranging from 5 postconceptional weeks to 80 years old.

Methods: We used the BrainSpan messenger RNA sequencing and the Yale Microarray data sets, which included brain tissue samples from 42 and 57 donors, respectively.

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  • The study assessed the effectiveness of quantitative muscle MRI in detecting early muscle issues and tracking disease progression in patients with adult-onset myotonic dystrophy type 1 (DM1).
  • The research involved 36 DM1 patients and 49 healthy adults, using advanced MRI techniques to measure muscle volume and fat content, revealing significant differences in muscle health between the two groups.
  • Results showed that even without noticeable symptoms, DM1 patients had reduced muscle volume and increased fat content, suggesting that muscle MRI could be an important tool for early diagnosis and monitoring of DM1.
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Spinocerebellar ataxia type 1 is a progressive neurodegenerative, movement disorder. With potential therapies on the horizon, it is critical to identify biomarkers that (i) differentiate between unaffected and spinocerebellar ataxia Type 1-affected individuals; (ii) track disease progression; and (iii) are directly related to clinical changes of the patient. Magnetic resonance imaging of volumetric changes in the brain may be a suitable source of biomarkers for spinocerebellar ataxia Type 1.

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  • The paper discusses the importance of accurately segmenting calf muscle compartments from 3D MR images to aid in tracking muscular disease progression.
  • The authors introduce a new fully convolutional network design that incorporates contextual information and edge-aware constraints to improve segmentation results.
  • Evaluation on a dataset of MR images shows the method achieves high accuracy, with DICE coefficients between 88.00% and 91.29% and minimal surface positioning errors.
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