Divergent patterns of loss of interpersonal warmth in frontotemporal dementia syndromes are predicted by altered intrinsic network connectivity.
Divergent patterns of loss of interpersonal warmth in frontotemporal dementia syndromes are predicted by altered intrinsic network connectivity.
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额颞叶痴呆综合征中人际温暖丧失的不同模式是通过改变内在网络连接来预测的。
DOI：
10.1016/j.nicl.2019.101729
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Rankin,KatherineP
中科院分区：
文献类型：
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作者：
Toller,Gianina;Yang,WinsonFZ;Brown,JesseA;Ranasinghe,KamaliniG;Shdo,SuzanneM;Kramer,JoelH;Seeley,WilliamW;Miller,BruceL;Rankin,KatherineP
在群体水平上，行为变异型额颞叶痴呆（bvFTD）和语义变异型原发性进行性失语（svPPA）中有充分的记录，并且与显著性（SN）和语义评估（SAN）网络萎缩有关。然而，个体患者的临床观察显示出更大的异质性，因此测量这种临床变异性并识别潜在的神经机制是理解任何一个患者的症状特征的关键步骤。我们使用可靠的变化指数，结合发病前和当前基于信息的评估，描述了132例患者（21例bvFTD、19例svPPA、22例非流利变异型原发性进行性失语[nfvPPA]、37例阿尔茨海默病[AD]）和33例健康老年人的人际形容词量表（IAS）问卷温暖子量表的变化模式。我们研究了体温变化的个体差异是否反映在SN或SAN功能连接，或这两个网络中单个脑区的结构体积上。尽管一部分患者的体温明显下降到异常低的水平，（bvFTD：38%; svPPA：21%; nfvPPA：5%; AD：11%），第二个亚组显著下降，但仍在临床正常范围内（bvFTD：33%; svPPA：21%; nfvPPA：9%; AD：5%），第三个亚组未下降，保持在临床正常范围内（bvFTD：29%; svPPA：58%; nfvPPA：86%; AD：84%）。此外，SN功能连接对人际温暖评分有很强的预测作用（p <0.01），但SAN功能连接或这些网络中的结构体积对人际温暖评分没有预测作用。我们的研究结果通过显示bvFTD和svPPA中与疾病相关的人际温暖和SN功能连接减少程度的广泛个体差异，扩展了早期组水平的研究结果，并突出了揭示大脑连接如何预测个体患者水平行为的新方法。我们的研究结果表明，人际温暖度的测量可以提供有关潜在大脑网络变化的重要临床信息，并帮助临床医生和临床研究人员更好地识别哪些bvFTD和svPPA患者的人际关系破坏风险更大。
Loss of warmth is well-documented in behavioral variant frontotemporal dementia (bvFTD) and semantic variant primary progressive aphasia (svPPA) at a group level, and has been linked to salience (SN) and semantic-appraisal (SAN) network atrophy. However, clinical observations of individual patients show much greater heterogeneity, thus measuring this clinical variability and identifying the underlying neurologic mechanisms is a critical step for understanding the symptom profile of any one patient. We used reliable change indexes with premorbid and current informant-based evaluations to characterize patterns of change on the warmth subscale of the Interpersonal Adjective Scale (IAS) questionnaire in 132 patients (21 bvFTD, 19 svPPA, 22 nonfluent variant primary progressive aphasia [nfvPPA], 37 Alzheimer's disease [AD]) and 33 healthy older adults. We investigated whether individual differences in warmth change were reflected in SN or SAN functional connectivity, or structural volume of individual brain regions in these two networks. Though one subset of patients showed significant drop in warmth to abnormally low levels (bvFTD: 38%; svPPA: 21%; nfvPPA: 5%; AD: 11%), a second subset significantly dropped but remained within the clinically normal range (bvFTD: 33%; svPPA: 21%; nfvPPA: 9%; AD: 5%), and a third subset did not drop and stayed in the clinically normal range (bvFTD: 29%; svPPA: 58%; nfvPPA: 86%; AD: 84%). Furthermore, interpersonal warmth score was strongly predicted by SN functional connectivity (p < .01), but not by SAN functional connectivity or by structural volume in these networks. Our results extend earlier group-level findings by showing wide individual variability in degree of disease-related reduction of interpersonal warmth and SN functional connectivity in bvFTD and svPPA, and highlight new approaches to revealing how brain connectivity predicts behavior on an individual patient level. Our findings suggest that measures of interpersonal warmth can provide important clinical information about changes in underlying brain networks, and help clinicians and clinical researchers better identify which bvFTD and svPPA patients are at greater risk for interpersonal disruption.