Neuroimaging of multimodal sensory stimulation in amyotrophic lateral sclerosis
Neuroimaging of multimodal sensory stimulation in amyotrophic lateral sclerosis
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DOI：
10.1136/jnnp.2009.192260
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发表时间：
2010-08-01
影响因子：
11
通讯作者：
Birbaumer, Niels
中科院分区：
文献类型：
--
作者：
Lule, Dorothee;Diekmann, Volker;Birbaumer, Niels
目的 结合结构和功能成像技术来研究肌萎缩侧索硬化症 (ALS) 的感觉系统功能。方法采用功能性 MRI (fMRI) 来研究 14 名 ALS 患者和 18 名对照受试者在视觉、听觉和体感刺激期间的皮质活动。对血氧水平依赖性反应的幅度、潜伏期和持续时间的变化进行建模。此外，弥散张量成像用于研究白质网络的变化。结果在视觉刺激过程中，功能磁共振成像显示 ALS 患者次级视觉区域的反应下降，可能与感觉神经纤维脱髓鞘有关。大脑关联皮层活动的增加与身体功能的下降有关，并且可能代表一种补偿过程。此外，投射到纹状外视觉皮层的纤维的白质功能明显降低。对于听觉刺激，在 ALS 患者中，次级听觉区域的延迟反应可能与神经传导时间延长以及涉及目标处理/检测的区域的皮质模式改变有关。观察初级和次级听觉皮层的结构性白质变化。对于体感刺激，观察到顶叶感觉整合区域的反应延长/减少，这可能与由于不动而导致的内脏流入减少有关。结论多参数 MRI 表明 ALS 的二级/高级感觉处理区域存在进行性功能缺陷，可能与由于进行性不动而导致的再传入信息流减少有关。所描述的变化也可能代表疾病过程本身的表达。发现了多模式关联皮质中补偿过程的证据。
Aim Structural and functional imaging techniques were combined to investigate sensory system function in amyotrophic lateral sclerosis (ALS).Methods Functional MRI (fMRI) was used to investigate cortical activity during visual, auditory and somatosensory stimulation in 14 ALS patients and 18 control subjects. Changes in amplitude, latency and duration of the blood oxygen level dependent response were modelled. Furthermore, diffusion tensor imaging was used to investigate changes in white matter networks.Results During visual stimulation, fMRI demonstrated a decreased response in secondary visual areas in ALS, possibly related to demyelination of sensory nerve fibres. Increasing brain activity in associative cortices was linked to a decrease in physical functioning and might represent a compensatory process. Additionally, reduced white matter functioning became evident for fibres projecting to the extrastriate visual cortex. For auditory stimulation, a delayed response in secondary auditory areas probably linked to prolonged nerve conductance time and an altered cortical pattern in areas involved in target processing/detection became evident in ALS patients. Structural white matter changes in the primary and secondary auditory cortices were observed. For somatosensory stimulation, a prolonged/reduced response in sensory integration areas of the parietal lobe was observed, perhaps linked to the reduced visceral inflow due to immobility.Conclusion Multiparametric MRI suggests a progressive functional deficit in secondary/higher order sensory processing areas in ALS, probably associated with reduction of re-afferent information flow due to progressive immobility. The changes described might also represent an expression of the disease process itself. Evidence for compensatory processes in multimodal associative cortices was found.