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April 17-18, 2019 | Frankfurt, Germany
Parkinson’s, Huntington’s & Movement Disorders
International Conference on
Journal of Brain and Neurology | Volume 3
The use of multi-modal imaging to discover sensitive Neuroimaging biomarkers in
Huntington’s disease
Nellie Georgiou-Karistianis
Monash University, Australia
Aconsiderable effort has been underway
over the last decade to establish sensitive
biomarkers of disease onset and progression
in Huntington's disease (HD). In particular,
neuroimaging measures have been an important
area for biomarker development. For example,
large-scale multi-site studies (e.g., TRACK-
HD, PREDICT-HD) have used structural (MRI)
and microstructural (DTI) imaging methods
(along with clinical/cognitive/behavioural
measures) to document sensitivity of various
measures in tracking progressive changes.
The Melbourne based IMAGE-HD study is a
biomarker development study that adopted a
multi-modal approach with consideration of
MRI, DTI, functional MRI (fMRI) and susceptibility
weighted imaging (SWI). Importantly, across
all these studies, including other smaller scale
studies, volumetric changes have been shown
throughout the course of disease and are
observed many years prior to clinical onset. It
is now well recognised that caudate volume in
particular is the most sensitive marker of disease
progression, with white matter changes are also
seen very early on. Although there is evidence to
suggest that functional deficits in multiple cortical
and subcortical regions extend well beyond
the volumetric abnormalities, we are still some
way from understanding whether functional
changes reflect pathology or compensation, or in
determining the utility of functional markers for
clinical trials. This presentation will present multi-
modal data from the IMAGE-HD study, as well as
from other large multi-site studies, to showcase
sensitive markers of disease progression in HD
and will comment on the preparedness of imaging
markers for therapeutic trials.
Speaker Biography
Nellie Georgiou-Karistianis completed her PhD in 1997 at Monash
University, Australia. She is Professor of Psychology and currently heads
an independent research group at the Monash Institute of Cognitive
and Clinical Neurosciences. She leads efforts through IMAGE-HD and
IMAGE-FRDA to uncover sensitive imaging and cognitive biomarkers
of disease progression in rare disorders, such as Huntington’s disease
(HD) and Friedreich ataxia (FRDA). She also holds the position of
Associate Dean (Graduate Research) in the Faculty of Medicine, Nursing
and Health Sciences, Monash University, Australia, with a leadership
focus on excellence and quality in graduate research training. She has
over 190 peer-reviewed scientific publications, with a career total of
over $AUS12m in research funding. She is a member of the editorial
board for the Journal of Huntington's Disease and serves on a number
of international working groups/steering committees, including the
Huntington’s Disease Regulatory Science Consortium (HD-RSC), Critical
Path Institute, Arizona. .
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