What wires together dies together: Verbs, actions and neurodegeneration in motor neuron disease
What wires together dies together: Verbs, actions and neurodegeneration in motor neuron disease
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DOI：
10.1016/j.cortex.2011.07.008
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发表时间：
2012-07-01
期刊：
影响因子：
3.6
通讯作者：
Chandran, Siddharthan
中科院分区：
文献类型：
--
作者：
Bak, Thomas H.;Chandran, Siddharthan
一个多世纪以来，运动神经元疾病（MND）的研究一直被一种紧张关系所主导，一种是选择性的、纯粹的运动退行性变的概念，另一种是越来越多的人认识到认知症状的高频率和重要性，这些症状最终会导致痴呆症。本文旨在整合这两个，看似相互排斥的疾病的解释。有人提出，MND的认知和运动症状是由于相同的选择性神经退行性过程，沿着神经系统的功能连接线传播。因此，认知功能受损最严重的部分是那些与运动系统功能联系最密切的部分，这一模式解释了这种疾病中动词和动作处理的不成比例的损害。与MND相关的痴呆可以被解释为MND的第五大临床表现，分别是球、胸、上肢和下肢表现。它遵循与其他表现相同的疾病进展规则，连续地从一个区域扩散到另一个区域，主要是尾端方向。因此，痴呆往往先于其他表现，并常伴有球症状。我们相信所提出的模型有助于更准确的MND概念，在同一疾病机制中整合认知和运动特征。同时，它强调了MND对认知神经科学的重要性，特别是对具身认知理论的重要性。(C) 2011 Elsevier Srl。版权所有。
For more than a century the research on Motor Neuron Disease (MND) has been dominated by a tension between the concept of a selective, purely motor degeneration and a growing realisation of the high frequency and importance of cognitive symptoms that can culminate in dementia.The present paper aims at integrating these two, seemingly mutually exclusive interpretations of the disease. It is proposed that the cognitive and motor symptoms in MND are due to the same selective neurodegenerative process, spreading along the lines of functional connections in the nervous system. Accordingly, the most impaired aspects of cognitive function are those with the closest functional links to the motor system, a pattern explaining a disproportionate impairment of verb and action processing in this disease.The dementia associated with MND can be interpreted as the fifth major clinical presentation of MND, alongside bulbar, thoracic, upper and lower limb presentation. It follows the same rules of disease progression as other presentations, spreading contiguously from region to region, with a predominantly caudal direction. Accordingly, dementia tends to precede other presentations and is often followed by bulbar symptoms.We believe that the presented model contributes to a more accurate concept of MND, integrating cognitive and motor features within the same disease mechanism. At the same time it highlights the importance of MND for cognitive neuroscience and, in particular, for theories of embodied cognition. (C) 2011 Elsevier Srl. All rights reserved.