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October 2021; 7 (5) ArticleOpen Access

Revealing the Timeline of Structural MRI Changes in Premanifest to Manifest Huntington Disease

View ORCID ProfilePeter A. Wijeratne, View ORCID ProfileSara Garbarino, View ORCID ProfileSarah Gregory, View ORCID ProfileEileanoir B. Johnson, View ORCID ProfileRachael I. Scahill, View ORCID ProfileJane S. Paulsen, View ORCID ProfileSarah J. Tabrizi, View ORCID ProfileMarco Lorenzi, View ORCID ProfileDaniel C. Alexander; on behalf of the PREDICT-HD investigators and the TRACK-HD investigators.
First published October 12, 2021, DOI: https://doi.org/10.1212/NXG.0000000000000617
Peter A. Wijeratne
From the Centre for Medical Image Computing (P.A.W., D.C.A.), Department of Computer Science, University College London, Gower Street; Huntington's Disease Research Centre (P.A.W., S. Gregory, E.B.J., R.I.S., S.J.T.), Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom; Dipartimento di Matematica (S. Garbarino), UNIGE, DIMA, Genova, Italy; Departments of Neurology and Psychiatry (J.S.P.), Carver College of Medicine, University of Iowa; and Université Côte d’Azur (M.L.), Inria, Epione Research Project, Valbonne, France.
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Sara Garbarino
From the Centre for Medical Image Computing (P.A.W., D.C.A.), Department of Computer Science, University College London, Gower Street; Huntington's Disease Research Centre (P.A.W., S. Gregory, E.B.J., R.I.S., S.J.T.), Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom; Dipartimento di Matematica (S. Garbarino), UNIGE, DIMA, Genova, Italy; Departments of Neurology and Psychiatry (J.S.P.), Carver College of Medicine, University of Iowa; and Université Côte d’Azur (M.L.), Inria, Epione Research Project, Valbonne, France.
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  • For correspondence: garbarin@dima.unige.it
Sarah Gregory
From the Centre for Medical Image Computing (P.A.W., D.C.A.), Department of Computer Science, University College London, Gower Street; Huntington's Disease Research Centre (P.A.W., S. Gregory, E.B.J., R.I.S., S.J.T.), Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom; Dipartimento di Matematica (S. Garbarino), UNIGE, DIMA, Genova, Italy; Departments of Neurology and Psychiatry (J.S.P.), Carver College of Medicine, University of Iowa; and Université Côte d’Azur (M.L.), Inria, Epione Research Project, Valbonne, France.
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  • For correspondence: s.gregory@ucl.ac.uk
Eileanoir B. Johnson
From the Centre for Medical Image Computing (P.A.W., D.C.A.), Department of Computer Science, University College London, Gower Street; Huntington's Disease Research Centre (P.A.W., S. Gregory, E.B.J., R.I.S., S.J.T.), Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom; Dipartimento di Matematica (S. Garbarino), UNIGE, DIMA, Genova, Italy; Departments of Neurology and Psychiatry (J.S.P.), Carver College of Medicine, University of Iowa; and Université Côte d’Azur (M.L.), Inria, Epione Research Project, Valbonne, France.
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  • For correspondence: eileanoir.johnson@alumni.ucl.ac.uk
Rachael I. Scahill
From the Centre for Medical Image Computing (P.A.W., D.C.A.), Department of Computer Science, University College London, Gower Street; Huntington's Disease Research Centre (P.A.W., S. Gregory, E.B.J., R.I.S., S.J.T.), Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom; Dipartimento di Matematica (S. Garbarino), UNIGE, DIMA, Genova, Italy; Departments of Neurology and Psychiatry (J.S.P.), Carver College of Medicine, University of Iowa; and Université Côte d’Azur (M.L.), Inria, Epione Research Project, Valbonne, France.
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  • For correspondence: r.scahill@ucl.ac.uk
Jane S. Paulsen
From the Centre for Medical Image Computing (P.A.W., D.C.A.), Department of Computer Science, University College London, Gower Street; Huntington's Disease Research Centre (P.A.W., S. Gregory, E.B.J., R.I.S., S.J.T.), Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom; Dipartimento di Matematica (S. Garbarino), UNIGE, DIMA, Genova, Italy; Departments of Neurology and Psychiatry (J.S.P.), Carver College of Medicine, University of Iowa; and Université Côte d’Azur (M.L.), Inria, Epione Research Project, Valbonne, France.
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  • For correspondence: jane-paulsen@uiowa.edu
Sarah J. Tabrizi
From the Centre for Medical Image Computing (P.A.W., D.C.A.), Department of Computer Science, University College London, Gower Street; Huntington's Disease Research Centre (P.A.W., S. Gregory, E.B.J., R.I.S., S.J.T.), Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom; Dipartimento di Matematica (S. Garbarino), UNIGE, DIMA, Genova, Italy; Departments of Neurology and Psychiatry (J.S.P.), Carver College of Medicine, University of Iowa; and Université Côte d’Azur (M.L.), Inria, Epione Research Project, Valbonne, France.
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  • For correspondence: s.tabrizi@ucl.ac.uk
Marco Lorenzi
From the Centre for Medical Image Computing (P.A.W., D.C.A.), Department of Computer Science, University College London, Gower Street; Huntington's Disease Research Centre (P.A.W., S. Gregory, E.B.J., R.I.S., S.J.T.), Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom; Dipartimento di Matematica (S. Garbarino), UNIGE, DIMA, Genova, Italy; Departments of Neurology and Psychiatry (J.S.P.), Carver College of Medicine, University of Iowa; and Université Côte d’Azur (M.L.), Inria, Epione Research Project, Valbonne, France.
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  • For correspondence: marco.lorenzi@inria.fr
Daniel C. Alexander
From the Centre for Medical Image Computing (P.A.W., D.C.A.), Department of Computer Science, University College London, Gower Street; Huntington's Disease Research Centre (P.A.W., S. Gregory, E.B.J., R.I.S., S.J.T.), Department of Neurodegenerative Disease, University College London, Queen Square Institute of Neurology, London, United Kingdom; Dipartimento di Matematica (S. Garbarino), UNIGE, DIMA, Genova, Italy; Departments of Neurology and Psychiatry (J.S.P.), Carver College of Medicine, University of Iowa; and Université Côte d’Azur (M.L.), Inria, Epione Research Project, Valbonne, France.
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  • For correspondence: d.alexander@ucl.ac.uk
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Citation
Revealing the Timeline of Structural MRI Changes in Premanifest to Manifest Huntington Disease
Peter A. Wijeratne, Sara Garbarino, Sarah Gregory, Eileanoir B. Johnson, Rachael I. Scahill, Jane S. Paulsen, Sarah J. Tabrizi, Marco Lorenzi, Daniel C. Alexander
Neurol Genet Oct 2021, 7 (5) e617; DOI: 10.1212/NXG.0000000000000617

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    Figure 1 Regional Brain Volume Trajectories in the TRACK-HD Cohort

    Regional brain volume trajectories in the TRACK-HD cohort. (A-J) Individual regional volume trajectories, with PreHD individuals in solid orange lines, HD individuals in dashed red lines, GPPM average fit as a solid black line, and GPPM uncertainty as shaded red lines. (K) All regional volume trajectories overlaid. Standardized volumes (y-axis) are shown, and the time-scale (x-axis) is centered such that t = 0 when the fitted trajectory (black line) is equal to the mean value of the HD group. Uncertainty in the fit is shown as light shading about the mean and was estimated using 200 samples from the posterior. GPPM = Gaussian Process Progression Model; HD = manifest Huntington disease; PreHD = pre-manifest Huntington disease.

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    Figure 2 Time and Magnitude of Regional Brain Volume Trajectories in the TRACK-HD Cohort

    Time and magnitude of regional brain volume trajectories in the TRACK-HD cohort. (A) Predicted maximum change times for ten regional volumes from genotype-positive trajectories in TRACK-HD. Box-plots represent the mean, upper and lower bounds from 1,000 samples from the posterior. Extreme values are represented as black circles, while the green bars indicate the medians. (B) Average magnitude of change of each volume.

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    Figure 3 Selected Regional Brain Volume Trajectories by CAG Repeat Count in the TRACK-HD Cohort

    Selected regional brain volume trajectories inferred by GPPM from gene-positive (PreHD and HD) individuals from the TRACK-HD cohort, grouped by CAG repeat count. Standardized volumes (y-axis) are shown, and the time-scale (x-axis) is centered such that t = 0 when the fitted trajectory is equal to the mean value of the HD group. Uncertainty in the fit is shown as light shading about the mean and was estimated using 200 samples from the posterior. CAG = cytosine-adenine-guanine; GPPM = Gaussian Process Progression Model; HD = manifest Huntington disease; PreHD = pre-manifest Huntington disease.

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    Figure 4 Group-Level Staging Density in the TRACK-HD and PREDICT-HD Cohorts

    (A) TRACK-HD and (B) PREDICT-HD. Distributions were fit using a nonparametric density function (KDE: kernel density estimate). HD = manifest Huntington disease; PreHD = pre-manifest Huntington disease.

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    Figure 5 Predicted Time to Onset in the PREDICT-HD Cohort

    (A) Difference (residual) between actual and predicted time to onset for GPPM and SM, for PreHD individuals from PREDICT-HD. Boxplots show the median, first and third quartiles, and outliers. (B) Predicted and true time to onset for each model. Fits are from fixed effect linear models, with shaded bands corresponding to 95% confidence intervals. GPPM = Gaussian Process Progression Model; SM = survival model.

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