Luo Chunyan, Hu Na, Xiao Yuan, Zhang Wenjing, Gong Qiyong, Lui Su
Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.
Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.
Front Aging Neurosci. 2020 Feb 11;12:14. doi: 10.3389/fnagi.2020.00014. eCollection 2020.
There is growing evidence supporting behavioral variant frontotemporal dementia (bvFTD) and amyotrophic lateral sclerosis (ALS) as extreme points of a disease spectrum. The aim of this study was to delineate the common and different patterns of gray matter atrophy associated with bvFTD and with ALS by pooling together the results of previous voxel-based morphometry (VBM) studies. We retrieved VBM studies that investigated gray matter atrophy in bvFTD patients vs. controls and in ALS patients vs. controls. Stereotactic data were extracted from those studies and subsequently tested for convergence and differences using activation likelihood estimation (ALE). A behavioral analysis using the BrainMap database was performed to assess the functional roles of the regions affected by bvFTD and/or ALS. Our study demonstrated a convergence of gray matter atrophy in the frontolimbic structures that involve the bilateral anterior insula and anterior cingulate cortex. Comparing the pattern of GM atrophy in bvFTD and ALS patients revealed greater atrophy in the frontomedial cortex, bilateral caudate, left anterior insula, and right thalamus in those with bvFTD and a higher degree of atrophy in the right motor cortex of those with ALS. Behavioral analysis revealed that the pattern of the affected regions contributed to the dysfunction of emotional and cognitive processing in bvFTD patients and the dysfunction of motor execution in ALS patients. Our results revealed a shared neural basis between bvFTD and ALS subjects, as well as a specific and distinct neural signature that underpinned the clinical manifestations of those two diseases. Those findings outlined the role of the frontomedial-caudate circuit in the development of bvFTD-like deficits in ALS patients.
越来越多的证据支持行为变异型额颞叶痴呆（bvFTD）和肌萎缩侧索硬化症（ALS）是疾病谱的两个极端点。本研究的目的是通过汇总先前基于体素的形态计量学（VBM）研究的结果，描绘与bvFTD和ALS相关的灰质萎缩的共同和不同模式。我们检索了研究bvFTD患者与对照以及ALS患者与对照之间灰质萎缩的VBM研究。从这些研究中提取立体定向数据，随后使用激活似然估计（ALE）测试其收敛性和差异。使用BrainMap数据库进行行为分析，以评估受bvFTD和/或ALS影响的区域的功能作用。我们的研究表明，涉及双侧前岛叶和前扣带回皮质的额边缘结构存在灰质萎缩的收敛。比较bvFTD和ALS患者的灰质萎缩模式发现，bvFTD患者的额内侧皮质、双侧尾状核、左侧前岛叶和右侧丘脑萎缩更严重，而ALS患者的右侧运动皮质萎缩程度更高。行为分析表明，受影响区域的模式导致bvFTD患者的情绪和认知加工功能障碍以及ALS患者的运动执行功能障碍。我们的结果揭示了bvFTD和ALS受试者之间共享的神经基础，以及支持这两种疾病临床表现的特定且独特的神经特征。这些发现概述了额内侧 - 尾状核回路在ALS患者中类似bvFTD缺陷发展中的作用。
