Measuring compensation in neurodegeneration using MRI.
Measuring compensation in neurodegeneration using MRI.
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DOI：
10.1097/wco.0000000000000469
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发表时间：
2017-08
影响因子：
4.8
通讯作者：
Rees G
中科院分区：
文献类型：
--
作者：
Gregory S;Long JD;Tabrizi SJ;Rees G
尽管有皮质和皮质下缺失的迹象，前驱期和早期神经退行性疾病患者的表现水平与正常人群相当。据推测，补偿过程的开始，即特定功能网络内的大脑激活或任务网络外区域的招募的变化，是维持正常表现的基础。然而，在迄今为止的大多数研究中，大脑活动的增加与病理和性能指标无关，似乎是补偿可能只是疾病的症状。MRI研究已经探索了神经退行性疾病的补偿，声称补偿在许多疾病中是明显的，包括阿尔茨海默病和帕金森病，但通常总是在早期阶段;在这一点之后，补偿通常不再能够在疾病病理的严重负担下运作。然而，这些研究都没有明确采用特定的补偿模式。因此，我们还讨论了我们最近尝试操作补偿的实证检验。在神经退行性疾病的早期阶段有明显的代偿过程的证据。然而，为了更全面地理解，这需要更明确的经验模型。
Despite signs of cortical and subcortical loss, patients with prodromal and early stage neurodegenerative disease are able to perform at a level comparable to the normal population. It is presumed that the onset of compensatory processes, that is, changes in brain activation within a function-specific network or in the recruitment of a region outside of the task-network underlies this maintenance of normal performance. However, in most studies to date increased brain activity is not correlated with indices of both pathology and performance and what appears to be compensation could simply be a symptom of the disease. MRI studies have explored compensation in neurodegenerative disease, claiming that compensation is evident across a number of disorders, including Alzheimer’s and Parkinson’s disease, but generally always in early stages; after this point compensation is generally no longer able to operate under the severe burden of disease pathology. However, none of these studies explicitly adopted a particular model of compensation. Thus, we also discuss our recent attempts to operationalise compensation for empirical testing. There is clear evidence of compensatory processes in the early stages of neurodegenerative disease. However, for a more complete understanding, this requires more explicit empirical modelling.