Group leader:

Dr. Julia Schumacher

The research group Neuroimaging in Movement Disorders mainly works with neuroimaging and clinical data with the long-term goal of proposing a shift of the research focus on Lewy body disease (comprising dementia with Lewy bodies and Parkinson’s disease, LBD) which will be critical for achieving a better biological characterisation of the LBD spectrum, ultimately enabling individualised treatment and more targeted recruitment of patients into clinical trials.

Neurodegenerative diseases such as LBD are characterised by large heterogeneity across patients in terms of symptomatology and disease progression. The previous focus on the study of group average differences is likely to have slowed our understanding of pathophysiological mechanisms and impacted outcomes of clinical trials. The differential breakdown of different neurotransmitter systems in LBD leads to patient-specific patterns of brain neurotransmitter alterations that constitute an important biological driver of heterogeneity. A central aim of our ongoing work is the development and validation of robust neuroimaging biomarkers that assess the integrity of the dopaminergic, cholinergic, serotonergic, and noradrenergic systems in vivo and are derived from imaging data that are readily available in clinical practice to ensure widespread future applicability. While most previous work in this field has focused on studying the integrity of relevant source nuclei of the different neurotransmitter systems, we and others recently showed that an assessment of the ascending pathways that provide (cortical) cholinergic innervation can yield additional disease-relevant information. We aim to extend this approach to the other neurotransmitter systems and develop a reference atlas of neurotransmitter pathways which will also be of relevance for the study of other neurodegenerative diseases that show neurotransmitter changes, e.g. Alzheimer’s disease. Based on the developed neurotransmitter markers, the second aim is to identify subgroups of patients with similar patterns of neurotransmitter changes using data-driven subtyping and to characterise them with respect to symptomatology and longitudinal disease progression. Thirdly, we aim to study how the breakdown of different neurotransmitter systems relates to neuropathological changes, including the occurrence of Alzheimer’s disease co-pathology in LBD and how the interaction of neurotransmitter and pathological heterogeneity influences the clinical phenotype. This work aims to contribute to a better understanding of the neurotransmitter biology of LBD, leading to the definition of clinically relevant biological subtypes which will ultimately help to individualise treatment approaches, providing a first step towards precision neurology. The developed methods will be applicable beyond the field of LBD and will have value in the study of other neurodegenerative diseases and ageing.

Selected publications:

1. Schumacher, J., Teipel, S., Storch, A. Association of Alzheimer’s and Lewy body disease pathology with basal forebrain volume and cognitive impairment. Alzheimer’s Research & Therapy. 2025, doi: 10.1186/s13195-025-01678-x
2. Schumacher, J., Ray, N., Teipel, S., Storch, A. Associations of cholinergic system integrity with cognitive decline in GBA1 and LRRK2 mutation carriers. npj Parkinsons Dis. 2024, doi:10.1038/s41531-024-00743-w
3. Teipel, S., Hoffmann, H., Storch, A., Hermann, A., Dyrba, M., Schumacher, J. Brain age in genetic and idiopathic Parkinson's disease. Brain Communications 2024, doi:10.1093/braincomms/fcae382
4. Lehto, A., Schumacher, J., Kasper, E., Teipel, S., Hermann, A., Kurth, J., Krause, B.J., Prudlo, J. Cerebral glucose metabolic correlates of cognitive and behavioural impairments in amyotrophic lateral sclerosis. Journal of Neurology 2024, doi:10.1007/s00415-024-12388-z
5. Lehto, A., Schumacher, J., Kasper, E., Teipel, S., Hermann, A., Prudlo, J. Loss of the ipsilateral silent period in amyotrophic lateral sclerosis is associated with reduced white matter integrity in the motor section of the corpus callosum. Journal of the Neurological Sciences 2024, doi:10.1016/j.jns.2024.123267
6. Firbank, M.J., Collerton, D., daSilva Morgan, K., Schumacher, J., Donaghy, P.C., O'Brien, J.T., Thomas, A., Taylor, J.-P. Functional connectivity in Lewy body disease with visual hallucinations. European Journal of Neurology 2024, doi:10.1111/ene.16115
7. Schumacher, J., Kanel, P., Dyrba, M., Storch, A., Bohnen, N.I., Teipel, S., Grothe, M.J. Structural and molecular cholinergic imaging markers of cognitive decline in Parkinson’s disease. Brain 2023, doi: 10.1093/brain/awad226
8. Schumacher, J., Ray, N.J., Hamilton, C.A., Bergamino, M., Donaghy, P.C., Firbank, M., Watson, R., Roberts, G., Allan, L., Barnett, N., O'Brien, J.T., Thomas, A.J., Taylor, J.-P. Free water imaging of the cholinergic system in dementia with Lewy bodies and Alzheimer's disease. Alzheimer’s & Dementia 2023, doi:10.1002/alz.13034
9. Schumacher, J., Ray, N.J., Hamilton, C.A., Donaghy, P.C., Firbank, M., Roberts, G., Allan, L., Durcan, R., Barnett, N., O’Brien, J.T., Taylor, J.-P., Thomas, A.J. Cholinergic white matter pathways in dementia with Lewy bodies and Alzheimer’s disease. Brain 2022, doi:10.1093/brain/awab372
10. Schumacher, J., Taylor, J.-P., Hamilton, C.A., Firbank, M., Donaghy, P.C., Roberts, G., Allan, L., Durcan, R., Barnett, N., O’Brien, J.T., Thomas, A.J. Functional connectivity in mild cognitive impairment with Lewy bodies. Journal of Neurology 2021, doi:10.1007/s00415-021-10580-z
11. Schumacher, J., Gunter, J.L., Przybelski, S.A., Jones, D.T., Graff-Radford, J., Savica, R., Schwarz, C.G., Senjem, M.L., Jack, Jr, C.R., Lowe, V.J., Knopman, D.S., Fields, J.A., Kremers, W.K., Petersen, R.C., Graff-Radford, N.R., Ferman, T.J., Boeve, B.F., Thomas, A.J., Taylor, J.-P., Kantarci, K. Dementia with Lewy bodies: association of Alzheimer pathology with functional connectivity networks. Brain 2021, doi:10.1093/brain/awab218
12. Schumacher, J., Taylor, J.T., Hamilton, C.A., Firbank, M., Cromarty, R.A., Donaghy, P.C., Roberts, G., Allan, L., Lloyd, J., Durcan, R., Barnett, N., O'Brien, J.T., Thomas, A.J. In vivo nucleus basalis of Meynert degeneration in mild cognitive impairment with Lewy bodies. NeuroImage: Clinical 2021, doi:10.1016/j.nicl.2021.102604
13. Schumacher, J., Thomas, A.J., Peraza, L.R., Firbank, M., O’Brien, J.T., Taylor, J.-P. Functional connectivity of the nucleus basalis of Meynert in Lewy body dementia and Alzheimer’s disease. International Psychogeriatrics 2021, doi:10.1017/S1041610220003944
14. Schumacher, J., Thomas, A.J., Peraza, L.R., Firbank, M., Cromarty, R., Hamilton, C.A., Donaghy, P.C., O’Brien, J.T., Taylor, J.-P. EEG alpha reactivity and cholinergic system integrity in Lewy body dementia and Alzheimer’s disease. Alzheimer’s Research & Therapy 2020, doi:10.1186/s13195-020-00613-6
15. Schumacher, J., Taylor, J.-P., Hamilton, C.A., Firbank, M., Cromarty, R.A., Donaghy, P.C., Roberts, G., Allan, L., Lloyd, J., Durcan, R., Barnett, N., O’Brien, J.T., Thomas, A.J. Quantitative EEG as a biomarker in mild cognitive impairment with Lewy bodies. Alzheimer’s Research & Therapy 2020, doi:10.1186/s13195-020-00650-1
16. Schumacher, J., Peraza, L.R., Firbank, M., Thomas, A.J., Kaiser, M., Gallagher, P., O’Brien, J.T., Blamire, A.M., Taylor, J.-P. Dysfunctional brain dynamics and their origin in Lewy body dementia. Brain 2019, doi:10.1093/brain/awz069
17. O’Dowd, S., Schumacher, J., Burn, D.J., Bonanni, L., Onofrj, M., Thomas, A., Taylor, J.P. Fluctuating cognition in the Lewy body dementias. Brain 2019, doi:10.1093/brain/awz235
18. Schumacher, J., Peraza, L.R., Firbank, M., Thomas, A.J., Kaiser, M., Gallagher, P., O'Brien, J.T., Blamire, A.M., Taylor, J.-P. Dynamic functional connectivity changes in dementia with Lewy bodies and Alzheimer's disease. NeuroImage: Clinical 2019, doi:10.1016/j.nicl.2019.101812
19. Schumacher, J., Peraza, L.R., Firbank, M., Thomas, A.J., Kaiser, M., Gallagher, P., O'Brien, J.T., Blamire, A.M., Taylor, J.-P. Functional connectivity in dementia with Lewy bodies: A within‐and between‐network analysis. Human Brain Mapping 2018, doi:10.1002/hbm.23901

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