Thalamic Involvement in Fluctuating Cognition in Dementia with Lewy Bodies: Magnetic Resonance Evidences

被引：73
作者：
Delli Pizzi, Stefano [1 ,2 ,3 ]
Franciotti, Raffaella [1 ,2 ,3 ]
Taylor, John-Paul [4 ]
Thomas, Astrid [1 ,2 ]
Tartaro, Armando [1 ,3 ]
Onofrj, Marco [1 ,2 ]
Bonanni, Laura [1 ,2 ]
机构：
[1] Univ G dAnnunzio, Dept Neurosci Imaging & Clin Sci, Chieti, Italy
[2] G dAnnunzio Univ Chieti Pescara, Aging Res Ctr, Ce S I, I-66100 Chieti, Italy
[3] G dAnnunzio Univ Chieti Pescara, Inst Adv Biomed Technol ITAB, I-66100 Chieti, Italy
[4] Newcastle Univ, Inst Ageing & Hlth, Newcastle Upon Tyne NE4 5PL, Tyne & Wear, England
来源：
CEREBRAL CORTEX | 2015年 / 25卷 / 10期
基金：
英国惠康基金;
关键词：
attention; choline; dementia with Lewy bodies; fluctuating cognition; thalamus; ALZHEIMERS-DISEASE; PARKINSONS-DISEASE; DIFFERENTIAL-DIAGNOSIS; VISUAL HALLUCINATIONS; N-ACETYLASPARTATE; EPISODIC MEMORY; BRAIN; SPECTROSCOPY; ATTENTION; CONSCIOUSNESS;
D O I：
10.1093/cercor/bhu220
中图分类号：
Q189 [神经科学];
学科分类号：
071006 ;
摘要：
Dementia with Lewy bodies (DLB) is characterized by fluctuation in cognition and attention. Thalamocortical connectivity and integrity of thalami are central to attentional function. We hypothesize that DLB patients with marked and frequent fluctuating cognition (flCog) have a loss of thalamocortical connectivity, an intrinsic disruption to thalamic structure and imbalances in thalamic neurotransmitter levels. To test this, magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) and proton MR spectroscopy on thalami were performed on 16 DLB, 16 Alzheimer's disease (AD) and 13 healthy subjects. MRI and DTI were combined to subdivide thalami according to their cortical connectivity and to investigate microstructural changes in connectivity-defined thalamic regions. Compared with controls, lower N-acetyl-aspartate/total creatine (NAA/tCr) and higher total choline/total creatine (tCho/tCr) values were observed within thalami of DLB patients. tCho/tCr increase was found within right thalamus of DLB patients as compared with AD. This increase correlated with severity and frequency of flCog. As compared with controls, DLB patients showed bilateral damage within thalamic regions projecting to prefrontal and parieto-occipital cortices, whereas AD patients showed bilateral alteration within thalamic region projecting to temporal cortex. We posit that microstructural thalamic damage and cholinergic imbalance may be central to the etiology of flCog in DLB.
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页码：3682 / 3689
页数：8
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