Christidi Foteini, Karavasilis Efstratios, Zalonis Ioannis, Ferentinos Panagiotis, Giavri Zoi, Wilde Elisabeth A, Xirou Sophia, Rentzos Michalis, Zouvelou Vasiliki, Velonakis George, Toulas Panagiotis, Efstathopoulos Efstathios, Poulou Loukia, Argyropoulos Georgios, Athanasakos Athanasios, Zambelis Thomas, Levin Harvey S, Karandreas Nikolaos, Kelekis Nikolaos, Evdokimidis Ioannis
First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Second Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Neurobiol Aging. 2017 Jan;49:69-78. doi: 10.1016/j.neurobiolaging.2016.09.014. Epub 2016 Sep 28.
We aimed to investigate structural changes in vivo in memory-related white matter tracts (i.e., perforant pathway zone [PPZ]; uncinate fasciculus [UF]; fornix) using diffusion tensor tractography and evaluate possible associations with memory performance in nondemented patients with amyotrophic lateral sclerosis (ALS). Forty-two ALS patients and 25 healthy controls (HCs) underwent a 30-directional diffusion-weighted imaging on a 3T MR scanner, followed by tractography of PPZ, UF, and fornix and analysis of fractional anisotropy (FA), axial diffusivity and radial diffusivity (Dr). Patients were administered neuropsychological measures of verbal (list learning via Rey Auditory Verbal Learning Test [RAVLT] and prose memory via Babcock Story Recall Test) and nonverbal (Rey's Complex Figure Test) episodic memory. After correcting for multiple comparisons, ALS patients showed increased Dr in the left PPZ compared to HC. We then fitted a multivariate general linear model within ALS patients with neuropsychological measures as dependent variables and age, age, gender, verbal IQ, and diffusion tensor tractography metrics with at least medium effect size differences between ALS and HC as independent variables. We found that (1) left PPZ FA, gender, and verbal IQ contributed to RAVLT-Total Learning; (2) left PPZ FA, left UF Dr, and gender contributed to RAVLT-Immediate Recall; and (3) left PPZ FA and left UF axial diffusivity contributed to Babcock Story Recall Test-Immediate and Delayed Recall. Advanced neuroimaging techniques verified in this study previously reported neuropathological findings regarding PPZ degeneration in ALS. We also detected a unique contribution of microstructural changes in hippocampal and frontotemporal white matter tracts on patients' memory profile.
我们旨在利用扩散张量纤维束成像技术研究与记忆相关的白质束（即穿通通路区[PPZ]；钩束[UF]；穹窿）在体内的结构变化，并评估其与非痴呆型肌萎缩侧索硬化症（ALS）患者记忆表现的可能关联。42例ALS患者和25名健康对照者（HCs）在3T磁共振成像扫描仪上接受了30方向扩散加权成像，随后对PPZ、UF和穹窿进行纤维束成像，并分析分数各向异性（FA）、轴向扩散率和径向扩散率（Dr）。对患者进行了言语（通过雷伊听觉言语学习测验[RAVLT]进行列表学习，通过巴布科克故事回忆测验进行散文记忆）和非言语（雷伊复杂图形测验）情景记忆的神经心理学测量。在进行多重比较校正后，与HC相比，ALS患者左侧PPZ的Dr增加。然后，我们在ALS患者中拟合了一个多元一般线性模型，将神经心理学测量作为因变量，将年龄、性别、言语智商以及ALS和HC之间至少有中等效应大小差异的扩散张量纤维束成像指标作为自变量。我们发现：（1）左侧PPZ FA、性别和言语智商对RAVLT总学习有贡献；（2）左侧PPZ FA、左侧UF Dr和性别对RAVLT即时回忆有贡献；（3）左侧PPZ FA和左侧UF轴向扩散率对巴布科克故事回忆测验的即时和延迟回忆有贡献。本研究中验证的先进神经成像技术证实了先前报道的关于ALS中PPZ变性的神经病理学发现。我们还检测到海马体和额颞叶白质束微观结构变化对患者记忆特征的独特贡献。
