Bartels Claudia, Mertens Nina, Hofer Sabine, Merboldt Klaus-Dietmar, Dietrich Jeannine, Frahm Jens, Ehrenreich Hannelore
Division of Clinical Neuroscience, Max-Planck-Institute of Experimental Medicine, Hermann-Rein-Str.3, 37075 Göttingen, Germany.
Neuromuscul Disord. 2008 May;18(5):398-407. doi: 10.1016/j.nmd.2008.02.005. Epub 2008 May 5.
We investigated the frequency and functional relevance of corpus callosum degeneration in amyotrophic lateral sclerosis (ALS). A total of 22 ALS patients and 29 healthy controls performed the newly developed Contralateral Co-Movement Test as indicator of callosal dysfunction. Diffusion tensor imaging was applied to determine fractional anisotropy values in the callosal area containing the crossing motor fibers and in the pyramidal tracts in 13 subjects of each group. ALS patients had more than twice the amount of co-movements as compared to healthy subjects. Contralateral co-movements correlated with fractional anisotropy values of the corpus callosum motor region as did ALS Functional Rating Scale as measure of disease progression. In both groups, contralateral co-movements correlated with the central motor index (ratio of the mean of fractional anisotropy values of both pyramidal tracts and corpus callosum motor region). Neuropsychological test results failed to show correlations with functional or morphological parameters. Combining Contralateral Co-Movement Test and diffusion tensor imaging in ALS revealed the close relation between functional and morphological impairment in the degenerating central motor-neuronal network. The Contralateral Co-Movement Test delivers simple means of symptom quantification, independent of ALS Functional Rating Scale, for future neuroprotective trials.
我们研究了肌萎缩侧索硬化症（ALS）中胼胝体变性的频率及其功能相关性。共有22例ALS患者和29名健康对照者进行了新开发的对侧协同运动测试，以此作为胼胝体功能障碍的指标。应用扩散张量成像来测定每组13名受试者中包含交叉运动纤维的胼胝体区域以及锥体束中的分数各向异性值。与健康受试者相比，ALS患者的协同运动量多出两倍以上。对侧协同运动与胼胝体运动区域的分数各向异性值相关，作为疾病进展衡量指标的ALS功能评定量表也是如此。在两组中，对侧协同运动均与中枢运动指数（锥体束和胼胝体运动区域分数各向异性值均值之比）相关。神经心理学测试结果未能显示出与功能或形态学参数的相关性。在ALS中结合对侧协同运动测试和扩散张量成像揭示了退化的中枢运动神经元网络中功能和形态学损伤之间的密切关系。对侧协同运动测试为未来的神经保护试验提供了一种独立于ALS功能评定量表的简单症状量化方法。
