Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, 399 Bathurst St., Toronto, ON M5T2S8, Canada.
Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard Avenue, Toronto, ON M5T2S8, Canada.
Neuroimage Clin. 2017 Aug 26;16:447-454. doi: 10.1016/j.nicl.2017.08.020. eCollection 2017.
Non-cognitive features including personality changes are increasingly recognized in the three PPA variants (semantic-svPPA, non fluent-nfvPPA, and logopenic-lvPPA). However, differences in emotion processing among the PPA variants and its association with white matter tracts are unknown. We compared emotion detection across the three PPA variants and healthy controls (HC), and related them to white matter tract integrity and cortical degeneration. Personality traits in the PPA group were also examined in relation to white matter tracts. Thirty-three patients with svPPA, nfvPPA, lvPPA, and 32 HC underwent neuropsychological assessment, emotion evaluation task (EET), and MRI scan. Patients' study partners were interviewed on the Clinical Dementia Rating Scale (CDR) and completed an interpersonal traits assessment, the Interpersonal Adjective Scale (IAS). Diffusion tensor imaging of uncinate fasciculus (UF), superior longitudinal fasciculus (SLF) and inferior longitudinal fasciculus (ILF), and voxel-based morphometry to derive gray matter volumes for orbitofrontal cortex (OFC), anterior temporal lobe (ATL) regions were performed. In addition, gray matter volumes of white matter tract-associated regions were also calculated: inferior frontal gyrus (IFG), posterior temporal lobe (PTL), inferior parietal lobe (IPL) and occipital lobe (OL). ANCOVA was used to compare EET performance. Partial correlation and multivariate linear regression were conducted to examine association between EET and neuroanatomical regions affected in PPA. All three variants of PPA performed significantly worse than HC on EET, and the svPPA group was least accurate at recognizing emotions. Performance on EET was related to the right UF, SLF, and ILF integrity. Regression analysis revealed EET performance primarily relates to the right UF integrity. The IAS subdomain, cold-hearted, was also associated with right UF integrity. Disease-specific emotion recognition and personality changes occur in the three PPA variants and are likely associated with disease-specific neuroanatomical changes. Loss of white matter integrity contributes as significantly as focal atrophy in behavioral changes in PPA.
非认知特征，包括人格改变，在三种 PPA 变异型（语义性 svPPA、非流利性 nfvPPA 和失读性 lvPPA）中越来越受到重视。然而，PPA 变异型之间的情绪处理差异及其与白质束的关联尚不清楚。我们比较了三种 PPA 变异型和健康对照组（HC）之间的情绪检测，并将其与白质束完整性和皮质变性相关联。还检查了 PPA 组的人格特征与白质束的关系。33 名 svPPA、nfvPPA、lvPPA 患者和 32 名 HC 接受了神经心理学评估、情绪评估任务（EET）和 MRI 扫描。患者的研究伙伴接受了临床痴呆评定量表（CDR）访谈，并完成了人际特质评估，即人际形容词量表（IAS）。对钩束（UF）、上纵束（SLF）和下纵束（ILF）进行弥散张量成像，并进行基于体素的形态测量学，以获得眶额皮质（OFC）、前颞叶（ATL）区域的灰质体积。此外，还计算了与白质束相关区域的灰质体积：额下回（IFG）、颞后叶（PTL）、顶下小叶（IPL）和枕叶（OL）。采用方差分析比较 EET 表现。进行偏相关和多元线性回归分析，以检查 EET 与 PPA 受累神经解剖区域之间的关联。所有三种 PPA 变异型在 EET 上的表现均明显差于 HC，svPPA 组在识别情绪方面最不准确。EET 表现与右侧 UF、SLF 和 ILF 完整性相关。回归分析显示，EET 表现主要与右侧 UF 完整性相关。IAS 亚域，冷酷，也与右侧 UF 完整性相关。在三种 PPA 变异型中，存在特定疾病的情绪识别和人格改变，并且可能与特定疾病的神经解剖变化相关。在 PPA 中，白质完整性的丧失与局灶性萎缩一样，对行为变化有重要贡献。
