Neuroimaging correlates of brain injury in Wilson's disease: a multimodal, whole-brain MRI study

Wilson's disease is an autosomal-recessive disorder of copper metabolism with neurological and hepatic presentations. Chelation therapy is used to 'de-copper' patients but neurological outcomes remain unpredictable. A range of neuroimaging abnormalities have been described and may provide insights into disease mechanisms, in addition to prognostic and monitoring biomarkers. Previous quantitative MRI analyses have focussed on specific sequences or regions of interest, often stratifying chronically-treated patients according to persisting symptoms as opposed to initial presentation. In this cross-sectional study, we performed a combination of unbiased, whole-brain analyses on T1-weighted, fluid-attenuated inversion recovery, diffusion-weighted and susceptibility-weighted imaging data from 40 prospectively-recruited patients with Wilson's disease (age range 16-68). We compared patients with neurological (n = 23) and hepatic (n = 17) presentations to determine the neuroradiological sequelae of the initial brain injury. We also subcategorized patients according to recent neurological status, classifying those with neurological presentations or deterioration in the preceding six months as having 'active' disease. This allowed us to compare patients with active (n = 5) and stable (n = 35) disease and identify imaging correlates for persistent neurological deficits and copper indices in chronically-treated, stable patients. Using a combination of voxel-based morphometry and region-of-interest volumetric analyses, we demonstrate that grey matter volumes are lower in the basal ganglia, thalamus, brainstem, cerebellum, anterior insula and orbitofrontal cortex when comparing patients with neurological and hepatic presentations. In chronically-treated, stable patients, the severity of neurological deficits correlated with grey matter volumes in similar, predominantly subcortical regions. In contrast, the severity of neurological deficits did not correlate with the volume of white matter hyperintensities, calculated using an automated lesion segmentation algorithm. Using tract-based spatial statistics, increasing neurological severity in chronically-treated patients was associated with decreasing axial diffusivity in white matter tracts whereas increasing serum non-caeruloplasmin-bound ('free') copper and active disease were associated with distinct patterns of increasing mean, axial and radial diffusivity. Whole-brain quantitative susceptibility mapping identified increased iron deposition in the putamen, cingulate and medial frontal cortices of patients with neurological presentations relative to those with hepatic presentations and neurological severity was associated with iron deposition in widespread cortical regions in chronically-treated patients. Our data indicate that composite measures of subcortical atrophy provide useful prognostic biomarkers, whereas abnormal mean, axial and radial diffusivity are promising monitoring biomarkers. Finally, deposition of brain iron in response to copper accumulation may directly contribute to neurodegeneration in Wilson's disease

Meaning in life in the Federal Republic of Germany: results of a representative survey with the Schedule for Meaning in Life Evaluation (SMiLE)

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Minimal Holographic Superconductors from Maximal Supergravity

We study a truncation of four-dimensional maximal gauged supergravity that provides a realization of the minimal model of a holographic superconductor. We find various flow solutions in this truncation at zero and finite temperature with a non-trivial profile for the charged scalar. Below a critical temperature we find holographic superconductor solutions that represent the thermodynamically preferred phase. Depending on the choice of boundary conditions, the superconducting phase transition is either first or second order. For vanishing temperature we find a flow with a condensing charged scalar that interpolates between two perturbatively stable AdS_4 vacua and is the zero-temperature ground state of the holographic superconductor.Comment: 25 pages, 9 figure

Vertical zonation of testate amoebae in the Elatia Mires, northern Greece : palaeoecological evidence for a wetland response to recent climate change or autogenic processes?

The Elatia Mires of northern Greece are unique ecosystems of high conservation value. The mires are climatically marginal and may be sensitive to changing hydroclimate, while northern Greece has experienced a significant increase in aridity since the late twentieth century. To investigate the impact of recent climatic change on the hydrology of the mires, the palaeoecological record was investigated from three near-surface monoliths extracted from two sites. Testate amoebae were analysed as sensitive indicators of hydrology. Results were interpreted using transfer function models to provide quantitative reconstructions of changing water table depth and pH. AMS radiocarbon dates and 210Pb suggest the peats were deposited within the last c. 50 years, but do not allow a secure chronology to be established. Results from all three profiles show a distinct shift towards a more xerophilic community particularly noted by increases in Euglypha species. Transfer function results infer a distinct lowering of water tables in this period. A hydrological response to recent climate change is a tenable hypothesis to explain this change; however other possible explanations include selective test decay, vertical zonation of living amoebae, ombrotrophication and local hydrological change. It is suggested that a peatland response to climatic change is the most probable hypothesis, showing the sensitivity of marginal peatlands to recent climatic change

Neuroimaging Correlates of Cognitive Deficits in Wilson's Disease

Data Availability Statement: Anonymised data are available on request to the corresponding author.Supporting Information: APPENDIX S1 available at: https://movementdisorders.onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Fmds.29123&file=mds29123-sup-0001-supinfo.pdf (PDF document, 3 MB).Copyright © 2022 The Authors. Background: Cognitive impairment is common in neurological presentations of Wilson's disease (WD). Various domains can be affected, and subclinical deficits have been reported in patients with hepatic presentations. Associations with imaging abnormalities have not been systematically tested. Objective: The aim was to determine the neuroanatomical basis for cognitive deficits in WD. Methods: We performed a 16-item neuropsychological test battery and magnetic resonance brain imaging in 40 patients with WD. The scores for each test were compared between patients with neurological and hepatic presentations and with normative data. Associations with Unified Wilson's Disease Rating Scale neurological examination subscores were examined. Quantitative, whole-brain, multimodal imaging analyses were used to identify associations with neuroimaging abnormalities in chronically treated stable patients. Results: Abstract reasoning, executive function, processing speed, calculation, and visuospatial function scores were lower in patients with neurological presentations than in those with hepatic presentations and correlated with neurological examination subscores. Deficits in abstract reasoning and phonemic fluency were associated with lower putamen volumes even after controlling for neurological severity. About half of patients with hepatic presentations had poor performance in memory for faces, cognitive flexibility, or associative learning relative to normative data. These deficits were associated with widespread cortical atrophy and/or white matter diffusion abnormalities. Conclusions: Subtle cognitive deficits in patients with seemingly hepatic presentations represent a distinct neurological phenotype associated with diffuse cortical and white matter pathology. This may precede the classical neurological phenotype characterized by movement disorders and executive dysfunction and be associated with basal ganglia damage. A binary phenotypic classification for WD may no longer be appropriate. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.Association of British Neurologists. Grant Number: N/A; Guarantors of Brain; Wilson's Disease Support Group UK; University College London Hospitals Biomedical Research Centre; Health Research; Open access funding enabled and organized by Projekt DEAL

Neuroimaging correlates of brain injury in Wilson's disease: a multimodal, whole-brain MRI study

Supplementary material: Supplementary material is available at Brain online at https://academic.oup.com/brain/article/145/1/263/6325019#supplementary-data .Copyright © The Author(s) (2021). Wilson’s disease is an autosomal-recessive disorder of copper metabolism with neurological and hepatic presentations. Chelation therapy is used to ‘de-copper’ patients but neurological outcomes remain unpredictable. A range of neuroimaging abnormalities have been described and may provide insights into disease mechanisms, in addition to prognostic and monitoring biomarkers. Previous quantitative MRI analyses have focused on specific sequences or regions of interest, often stratifying chronically treated patients according to persisting symptoms as opposed to initial presentation. In this cross-sectional study, we performed a combination of unbiased, whole-brain analyses on T1-weighted, fluid-attenuated inversion recovery, diffusion-weighted and susceptibility-weighted imaging data from 40 prospectively recruited patients with Wilson’s disease (age range 16–68). We compared patients with neurological (n = 23) and hepatic (n = 17) presentations to determine the neuroradiological sequelae of the initial brain injury. We also subcategorized patients according to recent neurological status, classifying those with neurological presentations or deterioration in the preceding 6 months as having ‘active’ disease. This allowed us to compare patients with active (n = 5) and stable (n = 35) disease and identify imaging correlates for persistent neurological deficits and copper indices in chronically treated, stable patients. Using a combination of voxel-based morphometry and region-of-interest volumetric analyses, we demonstrate that grey matter volumes are lower in the basal ganglia, thalamus, brainstem, cerebellum, anterior insula and orbitofrontal cortex when comparing patients with neurological and hepatic presentations. In chronically treated, stable patients, the severity of neurological deficits correlated with grey matter volumes in similar, predominantly subcortical regions. In contrast, the severity of neurological deficits did not correlate with the volume of white matter hyperintensities, calculated using an automated lesion segmentation algorithm. Using tract-based spatial statistics, increasing neurological severity in chronically treated patients was associated with decreasing axial diffusivity in white matter tracts whereas increasing serum non-caeruloplasmin-bound (‘free’) copper and active disease were associated with distinct patterns of increasing mean, axial and radial diffusivity. Whole-brain quantitative susceptibility mapping identified increased iron deposition in the putamen, cingulate and medial frontal cortices of patients with neurological presentations relative to those with hepatic presentations and neurological severity was associated with iron deposition in widespread cortical regions in chronically treated patients. Our data indicate that composite measures of subcortical atrophy provide useful prognostic biomarkers, whereas abnormal mean, axial and radial diffusivity are promising monitoring biomarkers. Finally, deposition of brain iron in response to copper accumulation may directly contribute to neurodegeneration in Wilson’s disease.The study was funded by a fellowship awarded to S.S. by the Guarantors of Brain and Association of British Neurologists. The Reta Lila Weston Institute and Wilson’s Disease Support Group UK provided additional financial support for MRI and participant-related costs, respectively. M.B. is supported by a Fellowship award from the Alzheimer’s Society (AS-JF-19a-004–517) and the UK Dementia Research Institute, which receives its funding from DRI Ltd, funded by the UK Medical Research Council, Alzheimer’s Society and Alzheimer’s Research UK. D.L.T. was supported by the UCL Leonard Wolfson Experimental Neurology Centre (PR/ylr/18575). J.D.R. is an MRC Clinician Scientist (MR/M008525/1) and has received funding from the NIHR Rare Diseases Translational Research Collaboration (BRC149/NS/MH), the Bluefield Project and the Association for Frontotemporal Degeneration

Supersymmetric Solutions in Six Dimensions: A Linear Structure

The equations underlying all supersymmetric solutions of six-dimensional minimal ungauged supergravity coupled to an anti-self-dual tensor multiplet have been known for quite a while, and their complicated non-linear form has hindered all attempts to systematically understand and construct BPS solutions. In this paper we show that, by suitably re-parameterizing these equations, one can find a structure that allows one to construct supersymmetric solutions by solving a sequence of linear equations. We then illustrate this method by constructing a new class of geometries describing several parallel spirals carrying D1, D5 and P charge and parameterized by four arbitrary functions of one variable. A similar linear structure is known to exist in five dimensions, where it underlies the black hole, black ring and corresponding microstate geometries. The unexpected generalization of this to six dimensions will have important applications to the construction of new, more general such geometries.Comment: v2: Eqs. (2.1), (2.39) corrected, references added. v3: minor correction

Black-hole entropy from supergravity superstrata states

This work of JdB was supported in part by the Foundation of Fundamental Research on Matter (FOM) and by an NWO Spinoza grant. The work of MS was supported in part by Grant-in-Aid for Young Scientists (B) 24740159 from the Japan Society for the Promotion of Science (JSPS)

Potential implications of differential preservation of testate amoeba shells for paleoenvironmental reconstruction in peatlands

Testate amoebae are now commonly used in paleoenvironmental studies but little is known of their taphonomy. There is some experimental evidence for differential preservation of some testate amoeba shell types over others, but it is unclear what, if any impact this has on palaeoenvironmental reconstruction. To investigate this issue we looked at palaeoecological evidence for the preservation of different shell types. We then investigated the possible impact of selective preservation on quantitative palaeoenvironmental inference. We first used existing palaeoecological data sets to assess the vertical patterns of relative abundance in four testate amoeba shell types: (1) shells made of secreted biosilica plates (idiosomes, e.g. Euglypha), (2) idiosomes with thick organic coating (Assulina), (3) proteinaceous shells (e.g. Hyalosphenia), (4) shells built from recycled organic or mineral particles (xenosomes) (e.g. Difflugia, Centropyxis). In three diagrams a clear pattern of decay was only observed for the idiosome type. In order to assess the implications of differential preservation of testate amoeba taxa for paleoenvironmental reconstruction we then carried out simulations using three existing transfer functions and a wide range of scenarios, downweighting different test categories to represent the impact of selective test decomposition. Simulation results showed that downweighting generally reduced overall model performance. However downweighting a shell type only produced a consistent directional bias in inferred water table depth where that shell type is both dominant and shows a clear preference along the ecological gradient. Applying a scenario derived from previous experimental work did not lead to significant difference in inferred water table. Our results show that differential shell preservation has little impact on paleohydrological reconstruction from Sphagnum-dominated peatlands. By contrast, for the minerotrophic peatlands data-set loss of idiosome tests leads to consistent underestimation of water table depth. However there are few studies from fens and it is possible that idiosome tests are not always dominant, and/or that differential decomposition is less marked than in Sphagnum peatlands. Further work is clearly needed to assess the potential of testate amoebae for paleoecological studies of minerotrophic peatlands

Widespread drying of European peatlands in recent centuries

This is the author accepted manuscript. The final version is available from Nature Research via the DOI in this record Climate warming and human impacts are thought to be causing peatlands to dry,potentially converting them from sinks to sources of carbon. However, it is unclear whether the hydrological status of peatlands has moved beyond their natural envelope. Here we show that European peatlands have undergone substantial, widespread drying during the last ~300 years. We analyse testate amoeba-derived hydrological reconstructions from 31 peatlands across Britain, Ireland, Scandinavia and continental Europe to examine changes in peatland surface wetness during the last 2000 years. 60% of our study sites were drier during the period CE 1800-2000 than they have been for the last 600 years; 40% of sites were drier than they have been for 1000 years; and 24% of sites were drier than they have been for 2000 years. This marked recent transition in the hydrology of European peatlands is concurrent with compound pressures including climatic drying, warming and direct human impacts on peatlands, although these factors vary between regions and individual sites. Our results suggest that the wetness of many European peatlands may now be moving away from natural baselines. Our findings highlight the need for effective management and restoration of European peatlands.Natural Environment Research Council (NERC