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Cope, T. E.

Publications and source records attributed to Cope, T. E..

4 recordsLinked to original sources

From group-level neurophysiological biomarkers to individual-level phenotyping to identify mechanisms of neurodegenerative disease

Precision medicine approaches require physiological effects to be informative when translated to the individual. Reliable group differences may have limited individual value when distributions overlap, mechanisms are heterogeneous, or patients differ in phenotype. A feature can differ between group means and still overlap heavily across individuals Moreover, combinations of physiological abnormalities may reveal subject-level structure that is not captured by any single marker at the group level. We evaluate the translation between group- and individual-level features derived from resting-state magnetoencephalography (MEG) using behavioural-variant frontotemporal dementia (bvFTD) and progressive supranuclear palsy (PSP) as demonstrator conditions. These illnesses have distinct molecular pathology but share the pressing need for therapeutic development and have partially overlapping clinical and physiological features. We combine clinical phenotype, power spectral density (PSD), and latent network mechanisms inferred by dynamic causal modelling (DCM) to compare groups and to access their individuals mapping translations. We used classification as an exploratory probe of how group-defined physiological features from 74 healthy controls, 45 participants with bvFTD and 55 participants with PSP support individual assignment. Clinical scores showed strong individual-level translation, consistent with clinical diagnostic definitions (e.g, controls-vs-PSP accuracy 0.94; bvFTD-vs-PSP accuracy 0.83). MEG spectra feature classified individuals weakly (accuracy ~0.6), despite group level re-organization (e.g., reduced beta-band and increased fronto-insular alpha-phase/beta-amplitude coupling in bvFTD). Inferred biophysical parameters gave intermediate performance (e.g. PSP-vs-control accuracy 0.70; bvFTD-vs-PSP accuracy 0.74) while retaining mechanistic interpretability. Using this approach, experimental medicine studies of neurological disease can formally trade between mechanistic insight and classification performance, in using biomarkers that can account for individual heterogeneity within and between diagnostic groups.

bioengineering↗

Immediate neural network impact after the loss of a semantic hub

The human brain extracts meaning from the world using an extensive neural system for semantic knowledge. Whether such broadly distributed systems1-3 crucially depend on or can compensate for the loss of one of their highly interconnected hubs4-6 is controversial4. The strongest level of causal evidence for the role of a brain hub is to evaluate its acute network-level impact following disconnection and any rapid functional compensation that ensues. We report rare neurophysiological data from two patients who underwent awake intracranial recordings during a speech prediction task immediately before and after neurosurgical treatment that required disconnection of the left anterior temporal lobe (ATL), a crucial hub for semantic knowledge4-6. Informed by a predictive coding framework, we tested three sets of hypotheses including diaschisis causing disruption in interconnected sites7 and incomplete or complete compensation by other language-critical and speech processing sites8-10. Immediately after ATL disconnection, we observed highly specific neurophysiological alterations in the recorded fronto-temporal network, including abnormally magnified high gamma responses to the speech sounds in auditory cortex. We also observed evidence for rapid compensation, seen as focal increases in effective connectivity involving language-critical sites in the inferior frontal gyrus and speech processing sites in auditory cortex. However, compensation was incomplete, in part because after ATL disconnection speech prediction signals were depleted in auditory cortex. This study provides direct causal evidence for a semantic hub in the human brain and shows striking neural impact and a rapid attempt at compensation in a neural network after the loss of one of its hubs.

neuroscience↗

GABA-ergic dynamics in human frontotemporal networks confirmed by pharmaco-magnetoencephalography.

To bridge the gap between preclinical cellular models of disease and in vivo imaging of human cognitive network dynamics, there is a pressing need for informative biophysical models. Here we assess dynamic causal models (DCM) of cortical network responses, inverted to magnetoencephalographic observations during an auditory oddball roving paradigm in healthy adults. This paradigm induces robust perturbations that permeate frontotemporal networks, including an evoked mismatch negativity response and transiently induced oscillations. Here, we probe GABAergic influences of the networks using double-blind placebo-controlled randomised-crossover administration of the GABA re-uptake inhibitor, tiagabine (oral, 10mg) in healthy older adults. We demonstrate the facility of conductance-based neural mass mean-field models, incorporating local synaptic connectivity, to investigate laminar-specific and GABAergic mechanisms of the auditory response. The neuronal model accurately recapitulated the observed magnetoencephalographic data. Using parametric empirical Bayes for optimal model inversion across both sessions, we identify the effect of tiagabine on GABAergic modulation of deep pyramidal and interneuronal cell populations. Moreover, in keeping with the hierarchical coding of beliefs and sensory evidence, we found a transition of the main GABAergic drug effects from auditory cortex in standard trials to prefrontal cortex in deviant trials. The successful integration of pharmaco-magnetoencephalography with dynamic causal models of frontotemporal networks provides a potential platform on which to evaluate the effects of disease and pharmacological interventions.\n\nSignificance StatementUnderstanding human brain function and developing new treatments require good models of brain function. We tested a detailed generative model of cortical microcircuits that accurately reproduced human magnetoencephalography, to quantify network dynamics and connectivity in frontotemporal cortex. This approach correctly identified the effect of a test drug (tiagabine) on neuronal function (GABA-ergic dynamics), opening the way for psychopharmacological studies in health and disease with the mechanistic precision afforded by generative models of the brain.

neuroscience↗

Neuroinflammation and protein aggregation co-localize across the frontotemporal dementia spectrum.

The clinical syndromes of frontotemporal dementia are clinically and neuropathologically heterogeneous, but processes such as neuroinflammation may be common across the disease spectrum. We investigated how neuroinflammation relates to the aggregation of Tau and TDP-43 in frontotemporal dementia, and to the heterogeneity of clinical disease. We used positron emission tomography in vivo with (a) [11C]PK-11195, a marker of activated microglia and a proxy index of neuroinflammation, and (b) [18F]AV-1451, a radioligand with increased binding to pathologically affected regions in tauopathies and diseases associated with TDP-43 protein aggregation, and which is used as a surrogate marker of non-{beta}-amyloid protein aggregation. We assessed 31 patients with frontotemporal dementia (10 with behavioural variant frontotemporal dementia, 11 with the semantic variant of primary progressive aphasia and 10 with the non-fluent variant of primary progressive aphasia), 28 of whom underwent both [18F]AV-1451 and [11C]PK-11195 PET, and matched controls (14 for [18F]AV-1451 and 15 for [11C]PK-11195). We used univariate region-of-interest analyses, and multivariate analysis of the distribution of binding that explicitly control for individual differences in ligand affinity for TDP-43 and different Tau isoforms. We found differences between patients and controls in frontotemporal regions for both neuroinflammation and protein aggregation, and a strong positive correlation between these two processes in all disease groups. Despite this regional co-localisation, the multivariate distribution of [11C]PK-11195 binding related better to clinical heterogeneity than did the distribution of [18F]AV-1451: distinct spatial modes of neuroinflammation were associated with different frontotemporal dementia syndromes and supported accurate group classification of participants. These in vivo findings indicate a close association between neuroinflammation and protein aggregation in frontotemporal dementia. The inflammatory component may be important in shaping the clinical and neuropathological patterns of the diverse clinical syndromes of frontotemporal dementia.

neuroscience↗