Ventromedial-Frontopolar Prefrontal Cortex Atrophy Correlates with Insight Loss in Frontotemporal Dementia and Alzheimer's Disease
Ventromedial-Frontopolar Prefrontal Cortex Atrophy Correlates with Insight Loss in Frontotemporal Dementia and Alzheimer's Disease
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DOI：
10.1002/hbm.22200
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发表时间：
2014-02-01
影响因子：
4.8
通讯作者：
Hodges, John R.
中科院分区：
文献类型：
--
作者：
Hornberger, Michael;Yew, Belinda;Hodges, John R.
洞察力丧失是额颞叶痴呆 (FTD) 的一个主要特征，但相关研究相对较少。更重要的是，人们对洞察力丧失的神经基础仍然知之甚少。当前的研究调查了一大群神经退行性疾病患者 (n = 81) 的洞察力缺陷概况，其中包括 FTD 和阿尔茨海默病 (AD) 患者。我们采用了一种新颖的洞察力调查问卷，它利用了不同领域的变化：社交互动、情感、诊断/治疗、语言和动机。 FTD 亚型对于洞察力丧失的影响差异很大，行为变体最严重，渐进性非流利变体受影响最小。所有其他亚型和 AD 均表现出较轻微但一致的洞察力丧失。基于体素的形态测量分析显示，总体洞察力丧失与腹内侧和额极前额叶萎缩相关，但社交互动和情绪洞察力丧失除外，这还分别与外侧颞叶和杏仁核萎缩相关。我们的结果表明，患有神经退行性疾病的患者表现出不同程度的洞察力丧失，腹内侧和额极皮层区域似乎对洞察力特别重要。 Hum Brain Mapp 35:616-626, 2014。(c) 2012 Wiley periodicals, Inc.
Loss in insight is a major feature of frontotemporal dementia (FTD) but has been investigated relatively little. More importantly, the neural basis of insight loss is still poorly understood. The current study investigated insight deficit profiles across a large cohort of neurodegenerative patients (n = 81), including FTD and Alzheimer's disease (AD) patients. We employed a novel insight questionnaire, which tapped into changes across different domains: social interaction, emotion, diagnosis/treatment, language, and motivation. FTD subtypes varied considerably for insight loss, with the behavioral variant worst and the progressive non-fluent variant least affected. All other subtypes and AD showed milder but consistent insight loss. Voxel-based morphometry analysis revealed that overall insight loss correlated with ventromedial and frontopolar prefrontal atrophy, with exception of social interaction and emotion insight loss, which additionally correlated with lateral temporal and amygdala atrophy, respectively. Our results show that patients with neurodegenerative conditions show variable loss of insight, with ventromedial and frontopolar cortex regions appearing to be particularly important for insight. Hum Brain Mapp 35:616-626, 2014. (c) 2012 Wiley Periodicals, Inc.