Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, 47 Boulevard de l'Hôpital, 75013, Paris, France.
INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, Paris, France.
Brain Struct Funct. 2022 Dec;227(9):2971-2989. doi: 10.1007/s00429-022-02519-5. Epub 2022 Jun 25.
We explored the resting state functional connectivity correlates of apathy assessed as a multidimensional construct, using behavioral metrics, in behavioral variant frontotemporal dementia (bvFTD). We recorded the behavior of 20 bvFTD patients and 16 healthy controls in a close-to-real-life situation including a free phase (FP-in which actions were self-initiated) and a guided phase (GP-in which initiation of actions was facilitated by external guidance). We investigated the activity time and walking episode features as quantifiers of apathy. We used the means ((FP + GP)/2) and the differences (FP-GP) calculated for these metrics as well as measures by questionnaires to extract apathy dimensions by factor analysis. We assessed two types of fMRI-based resting state connectivity measures (local activity and seed-based connectivity) and explored their relationship with extracted apathy dimensions. Apathy in bvFTD was associated with lower time spent in activity combined with walking episodes of higher frequency, lower acceleration and higher duration. Using these behavioral metrics and apathy measures by questionnaires, we disentangled two dimensions: the global reduction of goal-directed behaviors and the specific deficit of self-initiation. Global apathy was associated with lower resting state activity within prefrontal cortex and lower connectivity of salience network hubs while the decrease in self-initiation was related to increased connectivity of parietal default-mode network hubs. Through a novel dimensional approach, we dissociated the functional connectivity correlates of global apathy and self-initiation deficit. We discussed in particular the role of the modified connectivity of lateral parietal cortex in the volitional process.
我们使用行为学指标，探索了行为变异性额颞叶痴呆（bvFTD）患者中，作为多维结构评估的淡漠的静息态功能连接相关性。我们在接近现实生活的情况下记录了 20 名 bvFTD 患者和 16 名健康对照者的行为，包括自由阶段（FP-在此阶段中，行动是自主发起的）和引导阶段（GP-在此阶段中，行动的发起由外部指导辅助）。我们研究了活动时间和行走阶段特征作为淡漠的量化指标。我们使用这些指标的平均值（(FP+GP)/2）和差异（FP-GP）以及问卷测量值，通过因子分析提取淡漠维度。我们评估了两种基于 fMRI 的静息态连接测量方法（局部活动和种子连接），并探讨了它们与提取的淡漠维度的关系。bvFTD 中的淡漠与活动时间减少以及行走阶段频率更高、加速度更低、持续时间更长有关。使用这些行为学指标和问卷测量值，我们分解了两个维度：目标导向行为的整体减少和自我启动的特定缺陷。全局淡漠与前额叶皮层内静息状态活动降低以及突显网络枢纽连接降低有关，而自我启动减少与顶叶默认模式网络枢纽连接增加有关。通过一种新颖的维度方法，我们分离了全局淡漠和自我启动缺陷的功能连接相关性。我们特别讨论了外侧顶叶皮层连接改变在意志过程中的作用。
