Intrahemispheric and Interhemispheric Structural Network Abnormalities in PLS and ALS
Intrahemispheric and Interhemispheric Structural Network Abnormalities in PLS and ALS
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DOI：
10.1002/hbm.22286
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发表时间：
2014-04-01
影响因子：
4.8
通讯作者：
Filippi, Massimo
中科院分区：
文献类型：
--
作者：
Agosta, Federica;Galantucci, Sebastiano;Filippi, Massimo
使用弥散张量 (DT) 磁共振成像 (MRI)，对 26 名散发性原发性侧索硬化症 (PLS) 患者、28 名具有类似残疾的散发性肌萎缩侧索硬化症 (ALS) 患者和 35 名健康对照者的大脑半球内和半球间连接损伤进行了评估。测试了 DT MRI 区分两种运动神经元疾病 (MND) 变异的诊断准确性。 PLS 和 ALS 患者表现出运动系统异常的分布模式，包括皮质脊髓束和胼胝体 (CC)。与 ALS 患者相比，PLS 患者的运动 CC 纤维和初级运动皮质下方的皮质下白质 (WM) 受到更严重的损伤。两组患者均出现运动外损伤，其中 PLS 损伤更为严重。这似乎并不是由于 PLS 病程较长所致。在 PLS 患者中，CC 中体损伤与上运动神经元临床负担的严重程度相关。 CC 分数各向异性值在区分 PLS 与对照和 ALS 方面具有最高的准确度。 PLS 和 ALS 具有 WM 异常的重叠模式。这强调指出，尽管 PLS 具有独特的临床表型和较长的生存期，但仍属于更广泛的 MND 谱系。 CC 扩散率是否可能是一种新的标志物，可以提高 PLS 与 ALS 早期诊断分离的信心，仍需研究。 Hum Brain Mapp 35:1710-1722, 2014。(c) 2013 Wiley-Periodicals, Inc.
Using diffusion tensor (DT) magnetic resonance imaging (MRI), damage to brain intrahemispheric and interhemispheric connections was assessed in 26 sporadic primary lateral sclerosis (PLS) patients compared with 28 sporadic amyotrophic lateral sclerosis (ALS) patients with similar disability and 35 healthy controls. DT MRI diagnostic accuracy in distinguishing the two motor neuron disease (MND) variants was tested. PLS and ALS patients showed a distributed pattern of abnormalities of the motor system, including the corticospinal tracts and corpus callosum (CC). PLS versus ALS patients showed a more severe damage to the motor CC fibers and subcortical white matter (WM) underlying the primary motor cortices. Both patient groups showed an extra-motor damage, which was more severe in PLS. This did not appear to be driven by longer disease duration in PLS. In PLS patients, damage to the CC mid-body correlated with the severity of upper motor neuron clinical burden. CC fractional anisotropy values had the highest accuracy in distinguishing PLS from controls and ALS. PLS and ALS share an overlapped pattern of WM abnormalities. This underscores that PLS, despite its distinct clinical phenotype and long survival, still lies within the wider MND spectrum. Whether CC diffusivity may be a novel marker to increase confidence in an early diagnostic separation of PLS from ALS still needs to be investigated. Hum Brain Mapp 35:1710-1722, 2014. (c) 2013 Wiley-Periodicals, Inc.