Integration of structural and functional magnetic resonance imaging in amyotrophic lateral sclerosis
Integration of structural and functional magnetic resonance imaging in amyotrophic lateral sclerosis
复制标题
DOI：
10.1093/brain/awr279
复制
发表时间：
2011-12-01
期刊：
影响因子：
14.5
通讯作者：
Turner, Martin R.
中科院分区：
文献类型：
--
作者：
Douaud, Gwenaelle;Filippini, Nicola;Turner, Martin R.
肌萎缩侧索硬化症作为一个系统故障是一个概念，支持一致的发现，运动外以及运动脑病理。使用先进的磁共振成像技术，如扩散张量成像和基于体素的形态测量检测到的结构变化的功能相关性尚未得到广泛的研究。一组25例肌萎缩侧索硬化症患者与健康对照受试者进行了比较，使用多模态神经成像方法，包括T-1加权，弥散加权和静息状态功能磁共振成像。使用概率纤维束成像，根据白色物质束空间统计学显示的皮质脊髓束和胼胝体受累，定义了一个灰质连接网络。肌萎缩侧索硬化症特异性网络包括运动、运动前和辅助运动皮质、盖部和与运动相关的丘脑核团。一种新的分析协议，使用这种疾病特异性灰质网络作为双回归分析的输入，然后用于评估与该网络直接相关的功能连接的变化。一个空间模式的增加功能连接跨越感觉运动，运动前区，前额叶和丘脑regions.A复合结构和功能磁共振成像措施也允许定性区分患者从控制。因此，一个综合的结构和功能连接的方法确定了明显的二分法的过程特征的肌萎缩侧索硬化症脑网络故障，其中有增加的功能连接的区域内的结构连接减少。疾病进展速度较慢的患者显示的连接性测量值更接近健康对照，这增加了功能连接性增加可能不仅仅代表对结构完整性降低的生理补偿的可能性。另一种可能性是，功能连接的增加反映了作为肌萎缩侧索硬化症发病机制的一部分的抑制性皮质影响的逐渐丧失，这可能与未来的治疗策略有关。
Amyotrophic lateral sclerosis as a system failure is a concept supported by the finding of consistent extramotor as well as motor cerebral pathology. The functional correlates of the structural changes detected using advanced magnetic resonance imaging techniques such as diffusion tensor imaging and voxel-based morphometry have not been extensively studied. A group of 25 patients with amyotrophic lateral sclerosis was compared to healthy control subjects using a multi-modal neuroimaging approach comprising T-1-weighted, diffusion-weighted and resting-state functional magnetic resonance imaging. Using probabilistic tractography, a grey matter connection network was defined based upon the prominent corticospinal tract and corpus callosum involvement demonstrated by white matter tract-based spatial statistics. This 'amyotrophic lateral sclerosis-specific' network included motor, premotor and supplementary motor cortices, pars opercularis and motor-related thalamic nuclei. A novel analysis protocol, using this disease-specific grey matter network as an input for a dual-regression analysis, was then used to assess changes in functional connectivity directly associated with this network. A spatial pattern of increased functional connectivity spanning sensorimotor, premotor, prefrontal and thalamic regions was found. A composite of structural and functional magnetic resonance imaging measures also allowed the qualitative discrimination of patients from controls. An integrated structural and functional connectivity approach therefore identified apparently dichotomous processes characterizing the amyotrophic lateral sclerosis cerebral network failure, in which there was increased functional connectivity within regions of decreased structural connectivity. Patients with slower rates of disease progression showed connectivity measures with values closer to healthy controls, raising the possibility that functional connectivity increases might not simply represent a physiological compensation to reduced structural integrity. One alternative possibility is that increased functional connectivity reflects a progressive loss of inhibitory cortical influence as part of amyotrophic lateral sclerosis pathogenesis, which might then have relevance to future therapeutic strategies.