Focal temporal pole atrophy and network degeneration in semantic variant primary progressive aphasia
Focal temporal pole atrophy and network degeneration in semantic variant primary progressive aphasia
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DOI：
10.1093/brain/aww313
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发表时间：
2017-02-01
期刊：
影响因子：
14.5
通讯作者：
Dickerson, Bradford C.
中科院分区：
文献类型：
--
作者：
Collins, Jessica A.;Montal, Victor;Dickerson, Bradford C.
关于语义变异型原发性进行性失语症（svPPA）神经变性的起源和进展有相互矛盾的数据。柯林斯等人在两个患者队列中发现了左颞极区持续萎缩。健康成年人大脑皮层的连通性可以预测svPPA中分布性萎缩的位置和程度。大量的神经影像学研究表明，语义变异型原发性进行性失语与分布性皮质萎缩有关，其中以左前颞叶皮质最为突出;然而，关于前颞叶皮层内哪个区域受损最严重，这可能表明神经变性的假定起源。在这项研究中，我们本地化的最突出的和一致的区域萎缩语义变异原发性进行性失语症使用皮质厚度分析在两个独立的患者样本（n = 16和28，分别）相对于年龄匹配的对照组（n = 30）。在两个样本中，最大萎缩点位于左颞极的同一区域。在两个语义变异型原发性进行性失语症样本中，同一区域是100%个体患者的最大萎缩点。在健康的年轻人（n = 89）使用静息状态的功能连接，我们发现，来自语义变异原发性进行性失语症分析的种子区与语义变异原发性进行性失语症的分布萎缩模式非常相似的大规模网络密切相关。在这两个患者样本中，脑区域内萎缩的程度是通过该区域与健康成人颞极种子区域的功能连接强度来预测的。这些研究结果表明，语义变异型原发性进行性失语症的皮质萎缩可能遵循一个大规模的网络，在颞极收敛的连接途径。
There are conflicting data on the origin and progression of neurodegeneration in semantic variant primary progressive aphasia (svPPA). Collins et al. identify a left temporal pole region with consistent atrophy in two patient cohorts. The region's connectivity in healthy adults predicts the localization and magnitude of distributed atrophy in svPPA.A wealth of neuroimaging research has associated semantic variant primary progressive aphasia with distributed cortical atrophy that is most prominent in the left anterior temporal cortex; however, there is little consensus regarding which region within the anterior temporal cortex is most prominently damaged, which may indicate the putative origin of neurodegeneration. In this study, we localized the most prominent and consistent region of atrophy in semantic variant primary progressive aphasia using cortical thickness analysis in two independent patient samples (n = 16 and 28, respectively) relative to age-matched controls (n = 30). Across both samples the point of maximal atrophy was located in the same region of the left temporal pole. This same region was the point of maximal atrophy in 100% of individual patients in both semantic variant primary progressive aphasia samples. Using resting state functional connectivity in healthy young adults (n = 89), we showed that the seed region derived from the semantic variant primary progressive aphasia analysis was strongly connected with a large-scale network that closely resembled the distributed atrophy pattern in semantic variant primary progressive aphasia. In both patient samples, the magnitude of atrophy within a brain region was predicted by that region's strength of functional connectivity to the temporopolar seed region in healthy adults. These findings suggest that cortical atrophy in semantic variant primary progressive aphasia may follow connectional pathways within a large-scale network that converges on the temporal pole.