Structural brain correlates of cognitive and behavioral impairment in MND

被引：92

作者：

Agosta, Federica ^{[1
]}

Ferraro, Pilar M. ^{[1
]}

Riva, Nilo ^{[2
]}

Spinelli, Edoardo G. ^{[1
,2
]}

Chio, Adriano ^{[3
]}

Canu, Elisa ^{[1
]}

Valsasina, Paola ^{[1
]}

Lunetta, Christian ^{[4
]}

Iannaccone, Sandro ^{[5
]}

Copetti, Massimiliano ^{[6
]}

Prudente, Evelina ^{[1
,7
,8
]}

Comi, Giancarlo ^{[2
]}

Falini, Andrea ^{[4
]}

Filippi, Massimo ^{[1
,2
]}

机构：

[1] Univ Vita Salute San Raffaele, Neuroimaging Res Unit, Inst Expt Neurol, San Raffaele Sci Inst,Div Neurosci, Via Olgettina 60, I-20132 Milan, Italy

[2] Univ Vita Salute San Raffaele, Dept Neurol, Inst Expt Neurol, Div Neurosci,San Raffaele Sci Inst, I-20132 Milan, Italy

[3] Univ Turin, ALS Ctr, Rita Levi Montalcini Dept Neurosci, Turin, Italy

[4] Serena Onlus Fdn, NEuroMuscular Omnictr, Milan, Italy

[5] Univ Vita Salute San Raffaele, San Raffaele Sci Inst, Dept Clin Neurosci, I-20132 Milan, Italy

[6] Osped Casa Sollievo Della Sofferenza, IRCCS, Biostat Unit, Foggia, Italy

[7] Univ Vita Salute San Raffaele, San Raffaele Sci Inst, Dept Neuroradiol, I-20132 Milan, Italy

[8] Univ Vita Salute San Raffaele, San Raffaele Sci Inst, CERMAC, I-20132 Milan, Italy

来源：

HUMAN BRAIN MAPPING | 2016年 / 37卷 / 04期

关键词：

motor neuron disease; amyotrophic lateral sclerosis; cognitive and behavioral impairment; cortical thinning; diffusion tensor MRI; AMYOTROPHIC-LATERAL-SCLEROSIS; HUMAN CEREBRAL-CORTEX; CARD SORTING TEST; CORTICAL THICKNESS; REPEAT EXPANSION; NORMATIVE DATA; ALS; MRI; INVOLVEMENT; DYSFUNCTION;

D O I：

10.1002/hbm.23124

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

ObjectiveTo assess the structural correlates of cognitive and behavioral impairment in motor neuron diseases (MND) using multimodal MRI. MethodsOne hundred one patients with sporadic MND (56 classic amyotrophic lateral sclerosis, 31 upper motor neuron phenotype, and 14 lower motor neuron phenotype) and 51 controls were enrolled. Patients were classified into MND with a pure motor syndrome (MND-motor) and with cognitive/behavioral symptoms (MND-plus). Cortical thickness measures and diffusion tensor (DT) metrics of white matter (WM) tracts were assessed. A random forest approach was used to explore the independent role of cortical and WM abnormalities in explaining major cognitive and behavioral symptoms. ResultsThere were 48 MND-motor and 53 MND-plus patients. Relative to controls, both patient groups showed a distributed cortical thinning of the bilateral precentral gyrus, insular and cingulate cortices, and frontotemporal regions. In all regions, there was a trend toward a more severe involvement in MND-plus cases, particularly in the temporal lobes. Both patient groups showed damage to the motor callosal fibers, which was more severe in MND-plus. MND-plus patients also showed a more severe involvement of the extra-motor WM tracts. The best predictors of executive and non-executive deficits and behavioral symptoms in MND were diffusivity abnormalities of the corpus callosum and frontotemporal tracts, including the uncinate, cingulum, and superior longitudinal fasciculi. ConclusionsCortical thinning and WM degeneration are highly associated with neuropsychological and behavioral symptoms in patients with MND. DT MRI metrics seem to be the most sensitive markers of extra-motor deficits within the MND spectrum. Hum Brain Mapp 37:1614-1626, 2016. (c) 2016 Wiley Periodicals, Inc.

引用

页码：1614 / 1626

页数：13