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Vernooij, M. W., Pizzini, F. B., Schmidt, R., Smits, M., Yousry, T. A., Bargallo, N., . . . Barkhof, F. (2019). Dementia imaging in clinical practice: a European-wide survey of 193 centres and conclusions by the ESNR working group. Neuroradiology, 61(6), 633-642
Open this publication in new window or tab >>Dementia imaging in clinical practice: a European-wide survey of 193 centres and conclusions by the ESNR working group
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2019 (English)In: Neuroradiology, ISSN 0028-3940, E-ISSN 1432-1920, Vol. 61, no 6, p. 633-642Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Through a European-wide survey, we assessed the current clinical practice of imaging in the primary evaluation of dementia, with respect to standardised imaging, evaluation and reporting.

METHODS: An online questionnaire was emailed to all European Society of Neuroradiology (ESNR) members (n = 1662) and non-members who had expressed their interest in ESNR activities in the past (n = 6400). The questionnaire featured 42 individual items, divided into multiple choice, single best choice and free text answers. Information was gathered on the context of the practices, available and preferred imaging modalities, applied imaging protocols and standards for interpretation, reporting and communication.

RESULTS: A total of 193 unique (non-duplicate) entries from the European academic and non-academic institutions were received from a total of 28 countries. Of these, 75% were neuroradiologists, 12% general radiologists and 11% (neuro) radiologists in training. Of responding centres, 38% performed more than five scans/week for suspected dementia. MRI was primarily used in 72% of centres. Over 90% of centres acquired a combination of T2w, FLAIR, T1w, DWI and T2*w sequences. Visual rating scales were used in 75% of centres, most often the Fazekas and medial temporal atrophy scale; 32% of respondents lacked full confidence in their use. Only 23% of centres performed volumetric analysis. A minority of centres (28%) used structured reports.

CONCLUSIONS: Current practice in dementia imaging is fairly homogeneous across Europe, in terms of image acquisition and image interpretation. Hurdles identified include training on the use of visual rating scales, implementation of volumetric assessment and structured reporting.

Keywords
Dementia, Imaging, MRI, Survey
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-382952 (URN)10.1007/s00234-019-02188-y (DOI)000467659100002 ()30852630 (PubMedID)
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-06-19Bibliographically approved
Herrmann, F. R., Rodriguez, C., Haller, S., Garibotto, V., Montandon, M.-L. & Giannakopoulos, P. (2019). Gray Matter Densities in Limbic Areas and APOE4 Independently Predict Cognitive Decline in Normal Brain Aging. Frontiers in Aging Neuroscience, 11, Article ID 157.
Open this publication in new window or tab >>Gray Matter Densities in Limbic Areas and APOE4 Independently Predict Cognitive Decline in Normal Brain Aging
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2019 (English)In: Frontiers in Aging Neuroscience, ISSN 1663-4365, E-ISSN 1663-4365, Vol. 11, article id 157Article in journal (Refereed) Published
Abstract [en]

Cross-sectional magnetic resonance imaging (MRI) studies reported significant associations between gray matter (GM) density changes in various limbic and neocortical areas and worst cognitive performances in elderly controls. Longitudinal studies in this field remain scarce and led to conflicting data. We report a clinico-radiological investigation of 380 cognitively preserved individuals who undergo neuropsychological assessment at baseline and after 18 months. All cases were assessed using a continuous cognitive score taking into account the global evolution of neuropsychological performances. The vast majority of Mini Mental State Examination (MMSE) 29 and 30 cases showed equal or worst performance at follow-up due to a ceiling effect. GM densities, white matter hyperintensities and arterial spin labeling (ASL) values were assessed in the hippocampus, amygdala, mesial temporal and parietal cortex at inclusion using 3 Tesla MRI Scans. Florbetapir positron emission tomography (PET) amyloid was available in a representative subsample of 64 cases. Regional amyloid uptake ratios (SUVr), mean cortical SUVr values (mcSUVr) and corresponding z-scores were calculated. Linear regression models were built to explore the association between the continuous cognitive score and imaging variables. The presence of an APOE-epsilon 4 allele was negatively related to the continuous cognitive score. Among the areas studied, significant associations were found between GM densities in the hippocampus and amygdala but not mesial temporal and parietal areas and continuous cognitive score. Neither ASL values, Fazekas score nor mean and regional PET amyloid load was related to the cognitive score. In multivariate models, the presence of APOE-epsilon 4 allele and GM densities in the hippocampus and amygdala were independently associated with worst cognitive evolution at follow-up. Our data support the idea that early GM damage in the hippocampus and amygdala occur long before the emergence of the very first signs of cognitive failure in brain aging.

Keywords
amygdala, arterial spin labeling, cognition, gray matter density, hippocampus, longitudinal study, magnetic resonance imaging, white matter hyperintensity
National Category
Neurosciences
Identifiers
urn:nbn:se:uu:diva-390963 (URN)10.3389/fnagi.2019.00157 (DOI)000473279800001 ()31316372 (PubMedID)
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-08-16Bibliographically approved
Garibotto, V., Wissmeyer, M., Giavri, Z., Goldstein, R., Seimbille, Y., Seeck, M., . . . Picard, F. (2019). Nicotinic receptor abnormalities as a biomarker in idiopathic generalized epilepsy. European Journal of Nuclear Medicine and Molecular Imaging, 46(2), 385-395
Open this publication in new window or tab >>Nicotinic receptor abnormalities as a biomarker in idiopathic generalized epilepsy
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2019 (English)In: European Journal of Nuclear Medicine and Molecular Imaging, ISSN 1619-7070, E-ISSN 1619-7089, Vol. 46, no 2, p. 385-395Article in journal (Refereed) Published
Abstract [en]

Purpose: Mutations of cholinergic neuronal nicotinic receptors have been identified in the autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE), associated with changes on PET images using [18F]-F-85380-A (F-A-85380), an α4β2 nicotinic receptor ligand. The aim of the present study was to evaluate potential changes in nicotinic receptor availability in other types of epilepsy.

Methods: We included 34 male participants, 12 patients with idiopathic generalized epilepsy (IGE), 10 with non-lesional diurnal focal epilepsy, and 12 age-matched healthy controls. All patients underwent PET/CT using F-A-85380 and [18F]-fluorodeoxyglucose (FDG), 3D T1 MRI and diffusion tensor imaging (DTI). F-A-85380 and FDG images were compared with the control group using a voxel-wise (SPM12) and a volumes of interest (VOI) analysis.

Results: In the group of patients with IGE, the voxel-wise and VOI analyses showed a significant increase of F-A-85380 ratio index of binding potential (BPRI, corresponding to the receptor availability) in the anterior cingulate cortex (ACC), without structural changes on MRI. At an individual level, F-A-85380 BPRI increase in the ACC could distinguish IGE patients from controls and from patients with focal epilepsy with good accuracy.

Conclusions: We observed focal changes of density/availability of nicotinic receptors in IGE, namely an increase in the ACC. These data suggest that the modulation of α4β2 nicotinic receptors plays a role not only in ADNFLE, but also in other genetic epileptic syndromes such as IGE and could serve as a biomarker of epilepsy syndromes with a genetic background.

Keywords
F-A-85380, Focal epilepsy, Idiopathic generalized epilepsy, Nicotinic receptors, PET
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-362194 (URN)10.1007/s00259-018-4175-0 (DOI)000455817600014 ()30269157 (PubMedID)
Available from: 2018-10-02 Created: 2018-10-02 Last updated: 2019-02-05Bibliographically approved
van der Thiel, M., Rodriguez, C., Van De Ville, D., Giannakopoulos, P. & Haller, S. (2019). Regional Cerebral Perfusion and Cerebrovascular Reactivity in Elderly Controls With Subtle Cognitive Deficits. Frontiers in Aging Neuroscience, 11, Article ID 19.
Open this publication in new window or tab >>Regional Cerebral Perfusion and Cerebrovascular Reactivity in Elderly Controls With Subtle Cognitive Deficits
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2019 (English)In: Frontiers in Aging Neuroscience, ISSN 1663-4365, E-ISSN 1663-4365, Vol. 11, article id 19Article in journal (Refereed) Published
Abstract [en]

Background: Recent studies suggested that arterial spin labeling (ASL)-based measures of cerebral blood flow (CBF) as well as cerebral vasoreactivity to CO2 (CVR CO2) show significant alterations mainly in posterior neocortical areas both in mild cognitive impairment (MCI) and Alzheimer disease. It remains, however, unknown whether similar changes occur in at risk healthy elders without clinically overt symptoms. This longitudinal study investigated patterns of ASL perfusion and CVR CO2 as a function of the cognitive trajectories in asymptomatic elderly individuals.

Methods: Seventy-nine community-dwelling subjects (mean age: 78.7 years, 34 male) underwent three neuropsychological assessments during a subsequent 3-year period. Individuals were classified as stable-stable (SS), variable (V), or progressive-progressive (PP). Between-group comparisons were conducted for ASL CBF and transit-time delay maps and beta-maps of CO2 response. Spearman's rho maps assessed the correlation between ASL (respectively, CVR CO2 measures) and Shapes test for working memory, as well as Verbal fluency test for executive functions. Three group-with-continuous-covariate-interaction designs were implemented to investigate group-based differences on the association between neuropsychological scores and ASL or CO2 measures.

Results: Comparison of CBF maps demonstrates significantly lower perfusion in the V-group as to PP-cases predominantly in parietal regions, including the precuneus and, to a lesser degree, in temporal and frontal cortex. A stronger CVR CO2 response was found in the PP-group in left parietal areas compared to the V-group. V-cases showed a stronger ASL-Shape value relationship than V-group in right temporoparietal junction and superior parietal lobule. CO2-Shape value correlation was significantly higher in both SS and PP-groups compared to the V-group in right insular and superior perisylvian regions.

Conclusion: Our data indicate the presence of decreased ASL and CVR CO2 values mainly in parietal and fronto-temporal areas in cases with the first signs of cognitive instability (V-group). Importantly, the PP-group, at high risk for MCI transition, displays an increase of both parameters in the same areas. Clinicoradiologic correlations also indicate a clear distinction between the V-group and both PP and SS-cases. These data imply the presence of an inverted U-shape pattern of regional blood flow and CVR in old age that might predict subsequent cognitive fate.

Place, publisher, year, edition, pages
FRONTIERS MEDIA SA, 2019
Keywords
arterial spin labeling, asymptomatic controls, cerebrovascular reactivity, brain perfusion, clinicoradiologic correlations, CO2
National Category
Neurosciences
Identifiers
urn:nbn:se:uu:diva-378367 (URN)10.3389/fnagi.2019.00019 (DOI)000459127700001 ()
Available from: 2019-03-06 Created: 2019-03-06 Last updated: 2019-03-06Bibliographically approved
Rodriguez, C., Jagadish, A. K., Meskaldji, D.-E., Haller, S., Herrmann, F., Van De Ville, D. & Giannakopoulos, P. (2019). Structural Correlates of Personality Dimensions in Healthy Aging and MCI.. Frontiers in Psychology, 9, Article ID 2652.
Open this publication in new window or tab >>Structural Correlates of Personality Dimensions in Healthy Aging and MCI.
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2019 (English)In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 9, article id 2652Article in journal (Refereed) Published
Abstract [en]

The revised NEO Personality Inventory (NEOPI-R), popularly known as the five-factor model, defines five personality factors: Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. The structural correlates of these personality factors are still a matter of debate. In this work, we examine the impact of subtle cognitive deficits on structural substrates of personality in the elderly using DTI derived white matter (WM) integrity measure, Fractional Anisotropy (FA). We employed canonical correlation analysis (CCA) to study the relationship between personality factors of the NEOPI-R and FA measures in two population groups: healthy controls and MCI. Agreeableness was the only personality factor to be associated with FA patterns in both groups. Openness was significantly related to FA data in the MCI group and the inverse was true for Conscientiousness. Furthermore, we generated saliency maps using bootstrapping strategy which revealed a larger number of positive correlations in healthy aging in contrast to the MCI status. The MCI group was found to be associated with a predominance of negative correlations indicating that higher Agreeableness and Openness scores were mostly related to lower FA values in interhemispheric and cortico-spinal tracts and a limited number of higher FA values in cortico-cortical and cortico-subcortical connection. Altogether these findings support the idea that WM microstructure may represent a valid correlate of personality dimensions and also indicate that the presence of early cognitive deficits led to substantial changes in the associations between WM integrity and personality factors.

Keywords
NEO personality inventory, bootstrapping, canonical correlation analysis, diffusion tensor imaging, fractional anisotropy, mild cognitive impairment
National Category
Geriatrics
Identifiers
urn:nbn:se:uu:diva-375029 (URN)10.3389/fpsyg.2018.02652 (DOI)000455151400001 ()30670999 (PubMedID)
Available from: 2019-01-25 Created: 2019-01-25 Last updated: 2019-01-31Bibliographically approved
van der Thiel, M., Rodriguez, C., Giannakopoulos, P., Burke, M. X., Lebel, R. M., Gninenko, N., . . . Haller, S. (2018). Brain Perfusion Measurements Using Multidelay Arterial Spin-Labeling Are Systematically Biased by the Number of Delays.. American Journal of Neuroradiology, 39(8), 1432-1438
Open this publication in new window or tab >>Brain Perfusion Measurements Using Multidelay Arterial Spin-Labeling Are Systematically Biased by the Number of Delays.
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2018 (English)In: American Journal of Neuroradiology, ISSN 0195-6108, E-ISSN 1936-959X, Vol. 39, no 8, p. 1432-1438Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND PURPOSE: Multidelay arterial spin-labeling is a promising emerging method in clinical practice. The effect of imaging parameters in multidelay arterial spin-labeling on estimated cerebral blood flow measurements remains unknown. We directly compared 3-delay versus 7-delay sequences, assessing the difference in the estimated transit time and blood flow.

MATERIALS AND METHODS: This study included 87 cognitively healthy controls (78.7 ± 3.8 years of age; 49 women). We assessed delay and transit time-uncorrected and transit time-corrected CBF maps. Data analysis included voxelwise permutation-based between-sequence comparisons of 3-delay versus 7-delay, within-sequence comparison of transit time-uncorrected versus transit time-corrected maps, and average CBF calculations in regions that have been shown to differ.

RESULTS: The 7-delay sequence estimated a higher CBF value than the 3-delay for the transit time-uncorrected and transit time-corrected maps in regions corresponding to the watershed areas (transit time-uncorrected = 27.62 ± 12.23 versus 24.58 ± 11.70 mL/min/100 g, Cohen's d = 0.25; transit time-corrected = 33.48 ± 14.92 versus 30.16 ± 14.32 mL/min/100 g, Cohen's d = 0.23). In the peripheral regions of the brain, the estimated delay was found to be longer for the 3-delay sequence (1.52408 ± 0.25236 seconds versus 1.47755 ± 0.24242 seconds, Cohen's d = 0.19), while the inverse was found in the center of the brain (1.39388 ± 0.22056 seconds versus 1.42565 ± 0.21872 seconds, Cohen's d = 0.14). Moreover, 7-delay had lower hemispheric asymmetry.

CONCLUSIONS: The results of this study support the necessity of standardizing acquisition parameters in multidelay arterial spin-labeling and identifying basic parameters as a confounding factor in CBF quantification studies. Our findings conclude that multidelay arterial spin-labeling sequences with a high number of delays estimate higher CBF values than those with a lower number of delays.

National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-357433 (URN)10.3174/ajnr.A5717 (DOI)29976831 (PubMedID)
Available from: 2018-08-16 Created: 2018-08-16 Last updated: 2018-11-08Bibliographically approved
Haller, S., Vernooij, M. W., Kuijer, J. P., Larsson, E.-M., Jäger, H. R. & Barkhof, F. (2018). Cerebral Microbleeds: Imaging and Clinical Significance. Radiology, 287(1), 11-28
Open this publication in new window or tab >>Cerebral Microbleeds: Imaging and Clinical Significance
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2018 (English)In: Radiology, ISSN 0033-8419, E-ISSN 1527-1315, Vol. 287, no 1, p. 11-28Article, review/survey (Refereed) Published
Abstract [en]

Cerebral microbleeds (CMBs), also referred to as microhemorrhages, appear on magnetic resonance (MR) images as hypointense foci notably at T2*-weighted or susceptibility-weighted (SW) imaging. CMBs are detected with increasing frequency because of the more widespread use of high magnetic field strength and of newer dedicated MR imaging techniques such as three-dimensional gradient-echo T2*-weighted and SW imaging. The imaging appearance of CMBs is mainly because of changes in local magnetic susceptibility and reflects the pathologic iron accumulation, most often in perivascular macrophages, because of vasculopathy. CMBs are depicted with a true-positive rate of 48%–89% at 1.5 T or 3.0 T and T2*-weighted or SW imaging across a wide range of diseases. False-positive “mimics” of CMBs occur at a rate of 11%–24% and include microdissections, microaneurysms, and microcalcifications; the latter can be differentiated by using phase images. Compared with postmortem histopathologic analysis, at least half of CMBs are missed with premortem clinical MR imaging. In general, CMB detection rate increases with field strength, with the use of three-dimensional sequences, and with postprocessing methods that use local perturbations of the MR phase to enhance T2* contrast. Because of the more widespread availability of high-field-strength MR imaging systems and growing use of SW imaging, CMBs are increasingly recognized in normal aging, and are even more common in various disorders such as Alzheimer dementia, cerebral amyloid angiopathy, stroke, and trauma. Rare causes include endocarditis, cerebral autosomal dominant arteriopathy with subcortical infarcts, leukoencephalopathy, and radiation therapy. The presence of CMBs in patients with stroke is increasingly recognized as a marker of worse outcome. Finally, guidelines for adjustment of anticoagulant therapy in patients with CMBs are under development.

National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-346992 (URN)10.1148/radiol.2018170803 (DOI)000427992600003 ()29558307 (PubMedID)
Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2018-07-19Bibliographically approved
Haller, S., Montandon, M.-L., Rodriguez, C., Herrmann, F. R. & Giannakopoulos, P. (2018). Impact of Coffee, Wine, and Chocolate Consumption on Cognitive Outcome and MRI Parameters in Old Age. Nutrients, 10(10), Article ID 1391.
Open this publication in new window or tab >>Impact of Coffee, Wine, and Chocolate Consumption on Cognitive Outcome and MRI Parameters in Old Age
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2018 (English)In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 10, no 10, article id 1391Article in journal (Refereed) Published
Abstract [en]

Coffee, wine and chocolate are three frequently consumed substances with a significant impact on cognition. In order to define the structural and cerebral blood flow correlates of self-reported consumption of coffee, wine and chocolate in old age, we assessed cognition and brain MRI measures in 145 community-based elderly individuals with preserved cognition (69 to 86 years). Based on two neuropsychological assessments during a 3-year follow-up, individuals were classified into stable-stable (52 sCON), intermediate (61 iCON) and deteriorating-deteriorating (32 dCON). MR imaging included voxel-based morphometry (VBM), tract-based spatial statistics (TBSS) and arterial spin labelling (ASL). Concerning behavior, moderate consumption of caffeine was related to better cognitive outcome. In contrast, increased consumption of wine was related to an unfavorable cognitive evolution. Concerning MRI, we observed a negative correlation of wine and VBM in bilateral deep white matter (WM) regions across all individuals, indicating less WM lesions. Only in sCON individuals, we observed a similar yet weaker association with caffeine. Moreover, again only in sCON individuals, we observed a significant positive correlation between ASL and wine in overlapping left parietal WM indicating better baseline brain perfusion. In conclusion, the present observations demonstrate an inverse association of wine and coffee consumption with cognitive performances. Moreover, low consumption of wine but also moderate to heavy coffee drinking was associated with better WM preservation and cerebral blood-flow notably in cognitively stable elders.

Keywords
aging, caffeine, chocolate, cognition, wine
National Category
Radiology, Nuclear Medicine and Medical Imaging Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-362620 (URN)10.3390/nu10101391 (DOI)000448821300057 ()30275380 (PubMedID)
Available from: 2018-10-08 Created: 2018-10-08 Last updated: 2019-01-23Bibliographically approved
Haller, S., Burke, M. & Mueller, T. L. (2018). MR skin signal loss effect/artifact. Neuroradiology, 60(6), 661-662
Open this publication in new window or tab >>MR skin signal loss effect/artifact
2018 (English)In: Neuroradiology, ISSN 0028-3940, E-ISSN 1432-1920, Vol. 60, no 6, p. 661-662Article in journal, Editorial material (Refereed) Published
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-349496 (URN)10.1007/s00234-018-2025-1 (DOI)000432292400010 ()29682697 (PubMedID)
Available from: 2018-04-27 Created: 2018-04-27 Last updated: 2018-08-28Bibliographically approved
Haller, S. & Barkhof, F. (2018). Neuroimaging in Dementia: A Clinical Approach. In: Frederik Barkhof, Rolf Jager, Majda Thurnher, Alex Rovira Cañellas (Ed.), Clinical Neuroradiology: The ESNR Textbook. Springer
Open this publication in new window or tab >>Neuroimaging in Dementia: A Clinical Approach
2018 (English)In: Clinical Neuroradiology: The ESNR Textbook / [ed] Frederik Barkhof, Rolf Jager, Majda Thurnher, Alex Rovira Cañellas, Springer, 2018Chapter in book (Refereed)
Abstract [en]

Dementia is not a diagnosis or a specific disease entity but a syndrome that describes a wide range of symptoms leading to a decline in mental ability severe enough to interfere with daily life.

Neurodegenerative disorders including dementing disorders and movement disorders may present with overlapping clinical symptoms. Likewise, the underlying molecular and cellular pathology may be overlapping. Consequently, dementia syndromes and movement disorders may be considered as a spectrum of diseases, and symptoms may vary over time. Moreover, there is no direct link between clinical symptoms and imaging findings: the same degree of brain atrophy or metabolic abnormality may be associated to a variable degree of cognitive impairment, or from the other perspective, the same degree of cognitive impairment may be associated with variable level of brain atrophy or metabolic abnormality. Finally, it is not uncommon to have coexisting pathology, for example, Alzheimer type neurodegeneration and a vascular contribution.

In the first part, we review basic clinical presentations of dementia syndromes. In the second part, we review the radiological techniques and typical clinical neuroradiology findings of the various types of dementia, including Alzheimer dementia (hippocampal atrophy, hypometabolism/hypoperfusion in posterior cingulate and bilateral parietal areas), vascular dementia (small and large vessel disease), fronto-temporal lobar degeneration (fronto-temporal/peri-insular atrophy and hypometabolism/hypoperfusion), and dementia with Lewy Bodies (reduced dopamine uptake in striatum, abnormality of the nigrosome1). Additionally, we review unusual clinical presentations of dementia, including young-onset dementia and rapidly progressive dementia. Finally, we briefly discuss the overlapping clinical presentation and underlying pathology between dementia and movement disorders.

Place, publisher, year, edition, pages
Springer, 2018
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-382966 (URN)10.1007/978-3-319-61423-6_64-1 (DOI)978-3-319-61423-6 (ISBN)
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-09-13Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0001-7433-0203

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