Loss of functional connectivity is an early imaging marker in primary lateral sclerosis.
Loss of functional connectivity is an early imaging marker in primary lateral sclerosis.
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DOI：
10.1080/21678421.2018.1517180
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发表时间：
2018-11
影响因子：
2.8
通讯作者：
Floeter MK
中科院分区：
文献类型：
--
作者：
Clark MG;Smallwood Shoukry R;Huang CJ;Danielian LE;Bageac D;Floeter MK
只有在上运动神经元症状进展了几年而没有出现下运动神经元体征后，才能做出原发性侧索硬化的临床诊断。这项研究的目标是确定在临床诊断之前，原发性侧索硬化症早期发生的神经影像变化。对13名成人起病五年或以下的进行性痉挛患者进行了MRI扫描，并对他们进行了纵向追踪，以确认临床诊断为原发性侧索硬化症。获得静息状态功能磁共振成像、扩散张量成像和解剖图像。这些“前偏头痛”患者与18名长期确诊的原发性侧索硬化症患者和28名对照组进行了比较。与对照组和患有长期疾病的患者相比，Pre-PLS患者基于种子的静息状态运动网络连接性显著降低。与对照组相比，两组患者脑白质区域的各向异性分数减少的情况相似。长期患病的患者中央前回皮质变薄。在最初的Pre-PLS患者扫描中，发现右侧中央前回略有变薄。8例PLS期前患者在1-2年后的随访扫描显示，运动连接性增强，中央前回变薄，皮质脊髓束或穹隆运动区的弥散测量没有变化。运动功能连接性丧失是原发性侧索硬化症的早期影像指标。这与文献中对肌萎缩侧索硬化症的描述不同，需要进一步的研究来测试静息状态功能MRI是否能在疾病的早期阶段区分肌萎缩侧索硬化症和原发性侧索硬化症。
The clinical diagnosis of primary lateral sclerosis can only be made after upper motor neuron symptoms have progressed for several years without developing lower motor neuron signs. The goal of the study was to identify neuroimaging changes that occur early in primary lateral sclerosis, prior to clinical diagnosis. MRI scans were obtained on 13 patients with adult-onset progressive spasticity for five years or less who were followed longitudinally to confirm a clinical diagnosis of primary lateral sclerosis. Resting state functional MRI, diffusion tensor imaging, and anatomical images were obtained. These ‘pre-PLS’ patients were compared to 18 patients with longstanding, established primary lateral sclerosis and 28 controls. Pre-PLS patients had a marked reduction in seed-based resting-state motor network connectivity compared to controls and patients with longstanding disease. White matter regions with reduced fractional anisotropy were similar in the two patient groups compared to controls. Patients with longstanding disease had cortical thinning of the precentral gyrus. A slight thinning of right precentral gyrus was detected in initial pre-PLS patients’ scans. Follow-up scans in 8 pre-PLS patients 1-2 years later showed increasing motor connectivity, thinning of the precentral gyrus, and no change in diffusion measures of the corticospinal tract or callosal motor region. Loss of motor functional connectivity is an early imaging marker in primary lateral sclerosis. This differs from literature descriptions of amyotrophic lateral sclerosis, warranting further studies to test whether resting-state functional MRI can differentiate between amyotrophic lateral sclerosis and primary lateral sclerosis at early disease stages.
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影响因子：
5.7
作者：
Reuter, Martin;Schmansky, Nicholas J.;Rosas, H. Diana;Fischl, Bruce
通讯作者：
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作者：
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通讯作者：
Turner, Martin R.
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作者：
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