The two-year progression of structural and functional cerebral MRI in amyotrophic lateral sclerosis.
The two-year progression of structural and functional cerebral MRI in amyotrophic lateral sclerosis.
复制标题
DOI：
10.1016/j.nicl.2017.12.025
复制
发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Turner MR
中科院分区：
文献类型：
--
作者：
Menke RAL;Proudfoot M;Talbot K;Turner MR
MRI已成为神经退行性疾病肌萎缩侧索硬化症（ALS）的几个急需的候选疾病进展生物标志物之一，尤其是由于其独特的非侵入性评估结构和功能性大脑病理的能力。我们试图在更长的时间内确定大脑MRI指标的可检测变化程度。多模态MRI数据的分析是在一组16例患者（13例ALS和3例原发性侧索硬化症）中进行的，在这些患者中，有可能在两年内获得六个月的图像。使用基于体素的灰质形态测量和皮质下灰质结构的形状分析、针对白色物质纵向分析优化的弥散张量成像（DTI）度量的基于束的空间统计以及DTI度量的全脑体素统计来评估脑结构变化。静息状态功能性MRI（rs-fMRI）的变化进行了研究，通过独立成分和双重回归分析的功能连接（FC），控制灰质下降的混杂效应。研究了随时间的线性变化和与修订的ALS功能评定评分（ALSFRS-R）下降相关的脑变化。在中央前回和后扣带回皮质中观察到广泛和进行性灰质减少，以及丘脑、尾状核和双侧苍白球以及右侧壳核、海马和杏仁核的进行性局部萎缩。最突出的DTI束为基础的变化是在上级纵束和胼胝体。更广泛的DTI改变的区域包括丘脑和尾状核、海马回和海马旁回、岛叶皮质、前扣带回和后扣带回、额盖和小脑。FC减少之间的感觉运动静息状态网络和额极，网络之间包括丘脑和视觉皮层中的一个区域，从基线和ALSFRS-R下降的时间。两种统计方法均观察到左侧初级运动皮层和左侧额顶叶网络之间的FC增加。较长时间的随访，虽然必然涉及更多的缓慢进展的情况下，表现出广泛的变化，在灰色和白色物质的结构MRI测量。FC区域性减少和增加的混合图像与代偿性变化相容，应被视为以运动和额叶投射脑网络的大规模解体为特征的脑疾病。对ALS患者进行连续MRI数据分析（2年内6个月）。观察到广泛的渐进性脑结构和功能变化。在这一前所未有的研究期间，基底神经节区域发生了变化。结果揭示了新的纵向功能连接的见解。
MRI has emerged as one of several urgently needed candidate disease progression biomarkers for the neurodegenerative disorder amyotrophic lateral sclerosis (ALS), not least due to its unique ability to non-invasively assess structural and functional cerebral pathology. We sought to identify the extent of detectable change in cerebral MRI metrics over a more prolonged period. Analysis of multi-modal MRI data was performed in a cohort of sixteen patients (13 ALS and 3 with primary lateral sclerosis) in whom it was possible to acquire six-monthly images over two years. Structural brain changes were assessed using voxel-based morphometry of grey matter and shape analysis of sub-cortical grey matter structures, tract-based spatial statistics of diffusion tensor imaging (DTI) metrics optimized for longitudinal analysis in the white matter, as well as whole brain voxel-wise statistics of DTI metrics. Changes in resting state functional MRI (rs-fMRI) were investigated via independent component and dual regression analyses of functional connectivity (FC), controlled for confounding effects of grey matter decline. Both linear changes with time and brain changes correlated with revised ALS functional rating score (ALSFRS-R) decline were studied. Widespread and progressive reductions in grey matter were observed in the precentral gyri and posterior cingulate cortex, as well as progressive local atrophy of the thalamus, caudate, and pallidum bilaterally, and right putamen, hippocampus and amygdala. The most prominent DTI tract-based changes were in the superior longitudinal fasciculi and corpus callosum. More widespread areas of DTI changes included the thalami and caudate nuclei, hippocampi and parahippocampal gyri, insular cortices, anterior and posterior cingulate gyri, frontal operculum and cerebellum. FC decreases were noted between the sensorimotor resting state network and the frontal pole, between a network comprising both thalami and an area in the visual cortex, in relation to both time from baseline and ALSFRS-R decline. FC increases between the left primary motor cortex and left fronto-parietal network were seen for both statistical approaches. A longer period of follow-up, though necessarily involving more slowly-progressive cases, demonstrated widespread changes in both grey and white matter structural MRI measures. The mixed picture of regional decreases and increases in FC is compatible with compensatory change, in what should be viewed as a brain-based disease characterised by larger-scale disintegration of motor and frontal projection cerebral networks. Analysis of serial MRI data (6-monthly over 2 years) was performed in ALS patients. Widespread progressive structural and functional brain changes were observed. Changes during this unprecedented study period involved basal ganglia regions. The results revealed novel longitudinal functional connectivity insights.
登录
查看更多内容
影响因子：
5.7
作者：
Jenkinson, M;Bannister, P;Smith, S
通讯作者：
Smith, S
影响因子：
2.4
作者：
Keil C;Prell T;Peschel T;Hartung V;Dengler R;Grosskreutz J
通讯作者：
Grosskreutz J
影响因子：
3.7
作者：
Chenji S;Jha S;Lee D;Brown M;Seres P;Mah D;Kalra S
通讯作者：
Kalra S
DOI：
10.1093/brain/awu162
发表时间：
2014-09
期刊：
Brain : a journal of neurology
影响因子：
--
作者：
Menke RA;Körner S;Filippini N;Douaud G;Knight S;Talbot K;Turner MR
通讯作者：
Turner MR
影响因子：
4.2
作者：
Kwan, Justin Y.;Meoded, Avner;Floeter, Mary Kay
通讯作者：
Floeter, Mary Kay