Giovanna Zamboni

• MD, DPhil
• Professor (Associate) at University of Modena and Reggio Emilia

Posterior cortical atrophy is a neurodegenerative syndrome characterised by progressive disruption of visual and perceptual processing, associated with atrophy in the parieto-occipital cortex. Current diagnostic criteria describe relative sparing of episodic memory function, but recent findings suggest that anterograde memory is often impaired. Whe...

APOE-ε4 is best known as a risk factor for Alzheimer's disease (AD). Consequently, there is considerable research interest in understanding whether APOE-ε4 influences cognition in healthy adults. Despite a substantial literature reporting effects of APOE genotype on cognition, findings are inconsistent. In particular, it is challenging to separate...

Changes in functional connectivity (FC) measured using resting state fMRI within the basal ganglia network (BGN) have been observed in pathologies with altered neurotransmitter systems and conditions involving motor control and dopaminergic processes. However, less is known about non-disease factors affecting FC in the BGN. The aim of this study wa...

Background Little is known about factors influencing progression from mild cognitive impairment to Alzheimer’s dementia. A potential role of environmental chemicals and specifically of selenium, a trace element of nutritional and toxicological relevance, has been suggested. Epidemiologic studies of selenium are lacking, however, with the exception...

BACKGROUND: Combining PET amyloid-β (Aβ) and tau imaging may be critical for tracking disease progression in Alzheimer's disease (AD). OBJECTIVE: We sought to characterize the relationship between Aβ and tau ligands as well as with other measures of pathology. METHODS: We conducted a multi-center observational study in early AD (MMSE >20) participa...

Background Combining PET amyloid-β (Aβ) and tau imaging may be critical for tracking disease progression in Alzheimer’s disease (AD). Objective We sought to characterize the relationship between Aβ and tau ligands as well as with other measures of pathology. Methods We conducted a multi-center observational study in early AD (MMSE >20) participan...

Objective Posterior cortical atrophy (PCA) is a syndrome characterised by progressive disruption of visual processing and neurodegeneration in the parieto-occipital cortex. The most common underlying cause is Alzheimer’s pathology. Anterograde memory function and the medial temporal lobes (MTLs) are thought to be relatively preserved. Given that th...

Memory impairment in Posterior Cortical Atrophy is associated with dysfunction in the dorsal attention network

Background and purpose: Perivascular spaces (PVSs) are considered markers of small vessel disease. However, their long-term prognostic implications in transient ischemic attack/ischemic stroke patients are unknown. Ethnic differences in PVS prevalence are also unknown. Methods: Two independent prospective studies were conducted, 1 comprising pre...

Background and purpose: Among screening tools for cognitive impairment in large cohorts, the Montreal Cognitive Assessment (MoCA) seems to be more sensitive to early cognitive impairment than the Mini-Mental State Examination (MMSE), particularly after transient ischemic attack or minor stroke. We reasoned that if MoCA-detected early cognitive imp...

White matter hyperintensities (WMH) are frequently divided into periventricular (PWMH) and deep (DWMH), and the two classes have been associated with different cognitive, microstructural, and clinical correlates. However, although this distinction is widely used in visual ratings scales, how to best anatomically define the two classes is still disp...

Supplementary material

Background We have previously shown that increased resting-state functional magnetic resonance imaging (fMRI)-based functional connectivity (FC) within the frontal resting-state networks in Alzheimer's disease (AD) patients reflects residual, possibly compensatory, function. This suggests that symptomatic treatments should aim to enhance FC specifi...

Reliable quantification of white matter hyperintensities of presumed vascular origin (WMHs) is increasingly needed, given the presence of these MRI findings in patients with several neurological and vascular disorders, as well as in elderly healthy subjects. We present BIANCA (Brain Intensity AbNormality Classification Algorithm), a fully automated...

The introduction of MRI and positron emission tomography (PET) brain imaging has contributed significantly to the understanding of different dementia syndromes. Over the past 20 years these imaging techniques have been increasingly used for clinical characterisation and differential diagnosis, and to provide insight into the effects on functional c...

Tocilizumab is a humanized monoclonal antibody that targets the interleukin-6 receptor (IL-6-R). It is approved for use in moderate to severe refractory rheumatoid arthritis and more recently has been found to be effective in treating neuromyelitis optica.1 Common side effects include raised hepatic transaminases, gastroenteritis, infections, and h...

The Oxford Textbook of Cognitive Neurology and Dementia provides an accessible and authoritative resource for the busy clinician. It covers cognitive and dementia syndromes across a range of neurological disorders, spanning relevant fundamental neuroscience through to diagnosis and management of complex brain conditions. A key distinctive approach...

Supplementary materials

Resting state fMRI (rfMRI) is gaining in popularity, being easy to acquire and with promising clinical applications. However, rfMRI studies, especially those involving clinical groups, still lack reproducibility, largely due to the different analysis settings. This is particularly important for the development of imaging biomarkers. The aim of this...

Resting state functional MRI (rs-fMRI) has been previously shown to be a promising tool for the assessment of early Parkinson's disease (PD). In order to assess whether changes within the basal ganglia network (BGN) are disease specific or relate to neurodegeneration generally, BGN connectivity was assessed in 32 patients with early PD, 19 healthy...

Given the determinant role of ventromedial prefrontal cortex (vmPFC) in valuation, we examined whether vmPFC lesions also modulate how people scale political beliefs. Patients with penetrating traumatic brain injury (pTBI; N=102) and healthy controls (HC; N=31) were tested on the Political Belief Task, where they rated 75 statements expressing poli...

Given the determinant role of ventromedial prefrontal cortex (vmPFC) in valuation, we examined whether its lesions also modulate judgments of political beliefs. Patients with penetrating traumatic brain injury (pTBI; N=102) and healthy controls (HC; N=31) were tested on the Political Belief Task, where they rated 75 statements expressing political...

Background Resting state functional MRI (RS-fMRI) has been shown by our group to be a promising tool in investigation early PD. In this study, we aimed to investigate the use of a RS-fMRI in differentiating participants with an alpha-synucleinopathy from healthy controls and patients with Alzheimer's disease (AD). Methods RS-fMRI data were collecte...

Objective: To examine functional connectivity within the basal ganglia network (BGN) in a group of cognitively normal patients with early Parkinson disease (PD) on and off medication compared to age- and sex-matched healthy controls (HC), and to validate the findings in a separate cohort of participants with PD. Methods: Participants were scanne...

Mesial temporal lobe epilepsy (MTLE) can be associated with emotion recognition impairment that can be particularly severe in patients with early onset seizures (1–3). Whereas, there is growing evidence that memory and language can improve in seizure-free patients after anterior temporal lobectomy (ATL) (4), the effects of surgery on emotional proc...

In the healthy human brain, evidence for dissociable memory networks along the anterior-posterior axis of the hippocampus suggests that this structure may not function as a unitary entity. Failure to consider these functional divisions may explain diverging results among studies of memory adaptation in disease. Using task-based and resting function...

Functional MRI (fMRI) has great potential for unravelling mechanisms of functional decline in Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI), but task-fMRI studies have produced conflicting results, partly due to failure to account for underlying morphological changes, and to variations in ability to perform the tasks. Resting-fMRI is...

Background: Functional magnetic resonance imaging (fMRI) has great potential for measuring mechanisms of functional changes in Alzheimer's disease (AD) and mild cognitive impairment, but task fMRI studies have produced conflicting results, partly due to failure to account for underlying morphological changes and to variations in patients' ability...

Objective: To establish whether, in a cohort with normal cognition, severity of depressive symptoms at baseline was related to the time taken for conversion to mild cognitive impairment (MCI) and whether this interacted with other potential risk factors, including APOE ε4 status and demographic and cognitive variables. Methods: In a population-b...

Diffusion imaging is a promising marker of microstructural damage in neurodegenerative disorders, but interpretation of its relationship with underlying neuropathology can be complex. Here, we examined both volumetric and brain microstructure abnormalities in 13 amnestic patients with mild cognitive impairment (MCI), who progressed to probable Alzh...

Background: The Montreal Cognitive Assessment (MoCA) appears more sensitive to mild cognitive impairment (MCI) than the Mini-Mental State Examination (MMSE): over 50% of TIA and stroke patients with an MMSE score of ≥27 ('normal' cognitive function) at ≥6 months after index event, score <26 on the MoCA, a cutoff which has good sensitivity and spec...

Introduction: Patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) may be unaware of their cognitive impairment. The neuroanatomical mechanisms underlying this symptom, termed anosognosia or impaired self-awareness, are still poorly understood. In the present study we aimed to explore the functional correlates of self-awarene...

The comparative ability of the Montreal Cognitive Assessment (MoCA) and MMSE to detect mild cognitive difficulties was investigated in 107 older adults. The sensitivity of the MoCA to detect cognitive impairment with a cutoff score of <26 was investigated, as compared to the MMSE across all scores, and at a cutoff of ≥27. Performance on MoCA subtes...

Background: Impaired insight for cognitive and behavioural disturbances (also known as anosognosia) is common in Alzheimer's disease (AD) and amnestic mild cognitive impairment (a-MCI). However, it has not yet been determined clearly (i) whether anosognosia affects different cognitive domains to different degrees (Leicht et al, 2010), and (ii) whet...

To review studies investigating the brain correlates of unawareness of cognitive and behavioural symptoms in people with dementia. A detailed search of the literature was conducted to include all the peer-reviewed studies published in English aimed at identifying the structural or functional brain correspondents of unawareness in dementia patients....

Structural brain changes have been described in both mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, less is known about whether structural changes are detectable earlier, in the asymptomatic phase. Using voxel-based morphometry (VBM) and shape analyses of magnetic resonance imaging (MRI) data, we investigated structural brai...

The goal of this study was 2-fold, first, to compare decision making in behavioral variant frontotemporal dementia (bvFTD) patients and healthy adults using the Balloon Analog Risk Task (BART), and, second, to identify the regions of gray matter atrophy associated with bvFTD patients' BART performance. Stimulus-reinforcement learning is required to...

Studies on political participation have found that a person's interest in politics contributes to the likelihood that he or she will be involved in the political process. Here, we looked at whether or not interest in politics affects patterns of brain activity when individuals think about political matters. Using functional magnetic resonance imagi...

INTRODUCTION. The impairment of recent memory is a cardinal feature for diagnosis of Alzheimer’s Disease (Salmon & Bondi, 2009). Hamsher and Roberts (1985, 1990) devised the President Test, a brief battery for assessing different aspects of knowledge of the past six United States Presidents. Many patients manifested the so-called “tip-of-the-tongue...

Moral Cognition refers to judgements based on assessment of the adequacy of one’s own and others’ behaviours according to socially shaped ideas of right and wrong. To our knowledge, only a few studies directly examined the impact of neurodegenerative disorders, such as Alzheimer’s disease in early stage, on Moral Cognition. The present study invest...

Impaired insight for deficits (Anosognosia) is common in Alzheimer’s disease (AD). However, it has not yet been determined whether anosognosia affects different domains to different degrees (domain-specificity) and if it is present in pre-clinical stages of disease. Impaired insight was investigated in 13 subjects with amnestic Mild Cognitive Impai...

The relationship between cortical grey matter density and media violence exposure in healthy male adolescents was investigated using voxel-based morphometry and the Childrens' Report of Exposure to Violence. Adolescents with more frequent exposure have lower left lateral orbitofrontal cortex density--a possible risk factor for altered socioemotiona...

Patients with syndromes of the frontotemporal dementia spectrum are frequently unaware of their behavioral changes. Seventy patients with a clinical diagnosis of behavioral variant frontotemporal dementia (bv-FTD, n = 27), aphasic variant frontotemporal dementia (a-FTD, n = 12) and corticobasal syndrome (CBS, n = 31) participated in the study. Anos...

Emotional intelligence (EI) refers to a set of competencies that are essential features of human social life. Although the neural substrates of EI are virtually unknown, it is well established that the prefrontal cortex (PFC) plays a crucial role in human social-emotional behavior. We studied a unique sample of combat veterans from the Vietnam Head...

Politics is a manifestation of the uniquely human ability to debate, decide, and reach consensus on decisions affecting large groups over long durations of time. Recent neuroimaging studies on politics have focused on the association between brain regions and specific political behaviors by adopting party or ideological affiliation as a criterion t...

We propose an integrative cognitive neuroscience framework for understanding the cognitive and neural foundations of religious belief. Our analysis reveals 3 psychological dimensions of religious belief (God's perceived level of involvement, God's perceived emotion, and doctrinal/experiential religious knowledge), which functional MRI localizes wit...

To determine the pattern of executive dysfunction in frontotemporal dementia (FTD) and corticobasal syndrome (CBS) and to determine the brain areas associated with executive dysfunction in these illnesses. We administered the Delis-Kaplan Executive Function System (D-KEFS), a collection of standardized executive function tests, to 51 patients with...

Aberrant social behavior is a defining symptom of frontotemporal dementia (FTD) and may eventually occur in all syndromes composing the FTD spectrum. Two main behavioral abnormalities have been described: apathy and disinhibition, but their neuroanatomical correlates remain underspecified. Sixty-two patients with a clinical diagnosis of FTD partici...

To determine areas of atrophy in patients that are associated with caregiver burden. We measured caregiver burden, dementia and neuropsychiatric scores in 22 patients with corticobasal syndrome (CBS) and 25 with frontotemporal dementia (FTD), and in 14 healthy controls. We used voxel-based morphometry to correlate caregiver burden with gray matter...

Autoscopy is the experience of seeing an image of one's body in external space. We describe the case of a patient who reported longstanding autoscopic hallucinations following post-eclamptic brain damage. The MR scan demonstrated damage involving the occipital cortex and the basal ganglia bilaterally. We hypothesize that the image was the result of...

Lesion and neuroimaging studies have demonstrated that the mesial temporal lobe is crucial for recognizing emotions from facial expressions. In humans, bilateral amygdala damage is followed by impaired recognition of facial expressions of fear. To evaluate the influence of unilateral mesial temporal lobe damage we examined recognition of facial exp...