Behavioural subphenotypes and their anatomic correlates in neurodegenerative disease.
Behavioural subphenotypes and their anatomic correlates in neurodegenerative disease.
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DOI：
10.1093/braincomms/fcad038
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发表时间：
2023
影响因子：
4.8
通讯作者：
中科院分区：
文献类型：
--
作者：
患有神经退行性疾病的患者经历一系列神经精神症状。神经相关性已被探索为许多个别症状，如冷漠和去抑制。萎缩模式也与广泛认可的综合征有关，这些综合征将多种症状结合在一起，例如额颞叶痴呆的行为变体。有大量的异质性的症状，部分重叠的行为和受影响的神经解剖之间和痴呆亚型内。在神经退行性疾病中是否存在解剖学上不同的行为亚表型还没有很好地确定。本研究的目的是确定额颞叶痴呆谱系和阿尔茨海默病相关综合征的共同行为特征。此外，我们试图确定这些症状群的潜在神经相关性。281名被诊断患有七种不同痴呆综合征之一的患者，以及健康对照和轻度认知障碍的个体，完成了一项109项评估，捕获了一系列临床行为的严重程度。主成分分析捕捉相关行为的不同集群。基于体素的形态学分析用于识别与每个组件相关的体积损失区域。七个组成部分被确定和解释为捕捉以下行为：组件1-情感迟钝，2-情绪不稳定和抑制解除，3-神经质，4-刚性和不耐烦，5-不分青红皂白的消费，6-精神病和7-Geschwind综合征相关的行为。与结构脑容量的相关性揭示了与每个组成部分相关的不同神经解剖模式，包括在控制诊断后，这表明局部神经变性可导致各种痴呆综合征的行为症状群的发展。患有七种不同痴呆综合征之一的患者，轻度认知障碍或对照组（n = 281），完成了109项评估，捕获了一系列临床行为的严重程度。主成分分析确定了相关行为的七个组成部分。成像分析确定了与每个组件相关的体积损失区域。
Patients with neurodegenerative disorders experience a range of neuropsychiatric symptoms. The neural correlates have been explored for many individual symptoms, such as apathy and disinhibition. Atrophy patterns have also been associated with broadly recognized syndromes that bring together multiple symptoms, such as the behavioural variant of frontotemporal dementia. There is substantial heterogeneity of symptoms, with partial overlap of behaviour and affected neuroanatomy across and within dementia subtypes. It is not well established if there are anatomically distinct behavioural subphenotypes in neurodegenerative disease. The objective of this study was to identify shared behavioural profiles in frontotemporal dementia-spectrum and Alzheimer’s disease-related syndromes. Additionally, we sought to determine the underlying neural correlates of these symptom clusters. Two hundred and eighty-one patients diagnosed with one of seven different dementia syndromes, in addition to healthy controls and individuals with mild cognitive impairment, completed a 109-item assessment capturing the severity of a range of clinical behaviours. A principal component analysis captured distinct clusters of related behaviours. Voxel-based morphometry analyses were used to identify regions of volume loss associated with each component. Seven components were identified and interpreted as capturing the following behaviours: Component 1—emotional bluntness, 2—emotional lability and disinhibition, 3—neuroticism, 4—rigidity and impatience, 5—indiscriminate consumption, 6—psychosis and 7—Geschwind syndrome-related behaviours. Correlations with structural brain volume revealed distinct neuroanatomical patterns associated with each component, including after controlling for diagnosis, suggesting that localized neurodegeneration can lead to the development of behavioural symptom clusters across various dementia syndromes. Patients with one of seven different dementia syndromes, mild cognitive impairment, or controls (n = 281), completed a 109-item assessment capturing the severity of a range of clinical behaviours. A principal component analysis identified seven components of related behaviours. Imaging analyses identified regions of volume loss associated with each component.
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