Neuropsychiatric effects of neurodegeneration of the medial versus lateral ventral prefrontal cortex in humans.
Neuropsychiatric effects of neurodegeneration of the medial versus lateral ventral prefrontal cortex in humans.
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人类内侧腹侧前额叶皮质与外侧腹侧前额皮质神经变性的神经精神影响。
DOI：
10.1016/j.cortex.2015.08.002
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Grafman,Jordan
中科院分区：
文献类型：
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作者：
Huey,EdwardD;Lee,Seonjoo;Brickman,AdamM;Manoochehri,Masood;Griffith,Erica;Devanand,DP;Stern,Yaakov;Grafman,Jordan
动物证据表明，涉及内侧和头侧腹侧前额叶皮层 (PFC) 的大脑网络是威胁反应和唤醒的核心，而涉及外侧和尾侧 PFC 的网络在奖励学习和行为控制中发挥着重要作用。在这项研究中，我们使用 MRI、神经精神量表 (NPI) 以及 Delis-Kaplan 执行功能系统 (D-KEFS) 的排序、塔、二十个问题和流畅性测试，比较了 43 名额颞叶痴呆 (FTD) 患者和 11 名皮质基底综合征 (CBS) 患者的内侧和外侧 PFC 退化对神经精神的影响。使用 FreeSurfer 确定了 86 名年龄匹配的健康对照受试者的 MRI 灰质体积偏差。使用多变量回归来确定哪些大脑区域与特定的神经精神和认知症状相关。右侧内侧腹侧 PFC 灰质体积减少与焦虑和冷漠增加相关，右侧腹侧 PFC 体积减少与冷漠和不适当的重复行为相关，左侧腹侧 PFC 体积减少与 FTD 和 CBS 患者在分类和二十个问题任务中表现不佳有关。与动物研究类似，内侧 OFC 的损伤似乎与唤醒中断有关，而外侧 OFC 的损伤似乎与试错学习和行为失调的缺陷有关。对人类大脑功能障碍的研究对于连接动物和人类神经精神病学研究很有价值。
Animal evidence suggests that a brain network involving the medial and rostral ventral prefrontal cortex (PFC) is central for threat response and arousal and a network involving the lateral and caudal PFC plays an important role in reward learning and behavioral control. In this study, we contrasted the neuropsychiatric effects of degeneration of the medial versus lateral PFC in 43 patients with Frontotemporal dementia (FTD) and 11 patients with Corticobasal Syndrome (CBS) using MRI, the Neuropsychiatric Inventory (NPI), and the Sorting, Tower, Twenty Questions, and Fluency tests of the Delis-Kaplan Executive Function System (D-KEFS). Deviations in MRI grey matter volume from 86 age-matched healthy control subjects were determined for the patients using FreeSurfer. Multivariate regression was used to determine which brain areas were associated with specific neuropsychiatric and cognitive symptoms. Decreased grey matter volume of the right medial ventral PFC was associated with increased anxiety and apathy, decreased volume of the right lateral ventral PFC with apathy and inappropriate repetitive behaviors, and of the left lateral ventral PFC with poor performance on the sorting and Twenty Questions task in patients with FTD and CBS. Similar to in animal studies, damage to the medial OFC appears to be associated with a disruption of arousal, and damage to the lateral OFC appears to be associated with deficits in trial-and-error learning and behavioral dysregulation. Studies of brain dysfunction in humans are valuable to bridge animal and human neuropsychiatric research.