Disentangling the neural correlates of corticobasal syndrome and corticobasal degeneration with systematic and quantitative ALE meta-analyses.
Disentangling the neural correlates of corticobasal syndrome and corticobasal degeneration with systematic and quantitative ALE meta-analyses.
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DOI：
10.1038/s41531-017-0012-6
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Schroeter ML
中科院分区：
文献类型：
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作者：
Albrecht F;Bisenius S;Morales Schaack R;Neumann J;Schroeter ML
皮质基底节变性是一种罕见的神经退行性疾病，只能通过组织病理学检查才能确诊。据报道与多种临床综合征相关，其典型的临床表型是皮质基底节综合征。由于皮质基底节综合征/皮质基底节变性很少见，并且单个研究中纳入的患者数量较少，荟萃分析特别适合理清临床综合征和组织病理学的特征。利用 PubMed，我们确定了 11 项磁共振成像研究，测量了 22 个独立队列的萎缩情况，其中包括 200 名患者，与 318 名健康对照者进行对比。应用解剖可能性估计方法来揭示研究中受影响的大脑区域。皮质基底节综合征与基底节/丘脑、额叶、顶叶和颞叶的灰质损失有关。在皮质基底节变性患者中，发现丘脑、额叶、颞叶和枕叶萎缩。最后，在联合分析中，双侧丘脑、双侧后额正中皮质、后扣带回皮质和前运动区/辅助运动区，以及左后上回和额中回/中央前回被确定为与皮质基底节综合征和皮质基底节变性相关的区域。值得注意的是，根据解剖可能性估计方法荟萃分析，运动前区/辅助运动区和后中扣带回/额正中皮质的萎缩似乎是皮质基底节综合征/皮质基底节变性所特有的，而丘脑和左后上回和额中回/中央前回的萎缩也与其他神经退行性疾病相关。我们的研究创建了一个新的概念框架，通过强大的数据驱动荟萃分析方法来理解和区分临床特征（皮质基底节综合征）和组织病理学结果（皮质基底节变性）。此外，它提出将区域特异性萎缩作为诊断皮质基底节综合征/皮质基底节变性生前的成像生物标志物。脑成像可用于区分皮质基底节变性（CBD）和帕金森病（PD）患者。 CBD 是一种罕见的疾病，是由大脑中连接思维和运动的区域的脑细胞逐渐丧失引起的。 CBD 的临床特征被称为皮质基底综合征 (CBS)，与 PD 患者的临床特征相似，但进展情况不同。为了帮助更早、更准确的诊断，德国马克斯·普朗克人类认知和脑科学研究所的 Franziska Albrecht 及其同事回顾了 11 项磁共振成像研究，以找到 CBS/CBD 患者特别受影响的大脑区域。他们表明，运动区和额正皮质特定区域的细胞丢失是 CBS/CBD 的标志，而丘脑和部分额叶/中央前回的细胞丢失则与其他神经退行性疾病相关。
Corticobasal degeneration is a scarce neurodegenerative disease, which can only be confirmed by histopathological examination. Reported to be associated with various clinical syndromes, its classical clinical phenotype is corticobasal syndrome. Due to the rareness of corticobasal syndrome/corticobasal degeneration and low numbers of patients included in single studies, meta-analyses are particularly suited to disentangle features of the clinical syndrome and histopathology. Using PubMed, we identified 11 magnetic resonance imaging studies measuring atrophy in 22 independent cohorts with 200 patients contrasted to 318 healthy controls. The anatomic likelihood estimation method was applied to reveal affected brain regions across studies. Corticobasal syndrome was related to gray matter loss in the basal ganglia/thalamus, frontal, parietal, and temporal lobes. In corticobasal degeneration patients, atrophy in the thalamus, frontal, temporal, and occipital lobes were found. Finally, in a conjunction analysis, the bilateral thalamus, the bilateral posterior frontomedian cortex, posterior midcingulate cortex and premotor area/supplementary motor area, and the left posterior superior and middle frontal gyrus/precentral gyrus were identified as areas associated with both, corticobasal syndrome and corticobasal degeneration. Remarkably, atrophy in the premotor area/supplementary motor area and posterior midcingulate/frontomedian cortex seems to be specific for corticobasal syndrome/corticobasal degeneration, whereas atrophy in the thalamus and the left posterior superior and middle frontal gyrus/precentral gyrus are also associated with other neurodegenerative diseases according to anatomic likelihood estimation method meta-analyses. Our study creates a new conceptual framework to understand, and distinguish between clinical features (corticobasal syndrome) and histopathological findings (corticobasal degeneration) by powerful data-driven meta-analytic approaches. Furthermore, it proposes regional-specific atrophy as an imaging biomarker for diagnosis of corticobasal syndrome/corticobasal degeneration ante-mortem. Brain imaging could be used to distinguish between patients with corticobasal degeneration (CBD) and Parkinson's disease (PD). CBD is a rare condition caused by the gradual loss of brain cells in areas of the brain that link thinking to movement. The clinical features of CBD, referred to as corticobasal syndrome (CBS), are similar to those of patients with PD, but they progress differently. To aid earlier and more accurate diagnosis, Franziska Albrecht, at the Max Planck Institute for Human Cognitive and Brain Sciences, Germany, and colleagues reviewed 11 magnetic resonance imaging studies to find brain areas that are specifically affected in CBS/CBD patients. They show that cell loss in specific regions of the motor areas and frontomedian cortex is a hallmark of CBS/CBD, whereas cell loss in the thalamus and parts of the frontal/precentral gyrus were associated with other neurodegenerative diseases.