School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Neurology, Research Institute of Neuromuscular and Neurodegenerative Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Hum Brain Mapp. 2022 Dec 15;43(18):5421-5431. doi: 10.1002/hbm.26016. Epub 2022 Jul 22.
To examine selective atrophy patterns and resting-state functional connectivity (FC) alterations in the amygdala at different stages of amyotrophic lateral sclerosis (ALS), and to explore any correlations between amygdala abnormalities and neuropsychiatric symptoms. We used the King's clinical staging system for ALS to divide 83 consecutive patients with ALS into comparable subgroups at different disease stages. We explored the pattern of selective amygdala subnucleus atrophy and amygdala-based whole-brain FC alteration in these patients and 94 healthy controls (HCs). Cognitive and emotional functions were also evaluated using a neuropsychological test battery. There were no significant differences between ALS patients at King's stage 1 and HCs for any amygdala subnucleus volumes. Compared with HCs, ALS patients at King's stage 2 had significantly lower left accessory basal nucleus and cortico-amygdaloid transition volumes. Furthermore, ALS patients at King's stage 3 demonstrated significant reductions in most amygdala subnucleus volumes and global amygdala volumes compared with HCs. Notably, amygdala-cuneus FC was increased in ALS patients at King's stage 3. Specific subnucleus volumes were significantly associated with Mini-Mental State Examination scores and Hamilton Anxiety Rating Scale scores in ALS patients. In conclusions, our study provides a comprehensive profile of amygdala abnormalities in ALS patients. The pattern of amygdala abnormalities in ALS patients differed greatly across King's clinical disease stages, and amygdala abnormalities are an important feature of patients with ALS at relatively advanced stages. Moreover, our findings suggest that amygdala volume may play an important role in anxiety and cognitive dysfunction in ALS patients.
为了研究不同阶段肌萎缩侧索硬化症（ALS）患者杏仁核的选择性萎缩模式和静息状态功能连接（FC）改变，并探讨杏仁核异常与神经精神症状之间的相关性，我们使用 King 临床分期系统将 83 例连续 ALS 患者分为不同疾病阶段的可比亚组。我们研究了这些患者和 94 名健康对照（HCs）中杏仁核亚核选择性萎缩和基于杏仁核的全脑 FC 改变的模式。还使用神经心理学测试量表评估了认知和情绪功能。King 分期 1 的 ALS 患者与 HCs 之间任何杏仁核亚核体积均无显著差异。与 HCs 相比，King 分期 2 的 ALS 患者左侧辅助基底核和皮质杏仁核过渡区体积明显较小。此外，与 HCs 相比，King 分期 3 的 ALS 患者大多数杏仁核亚核体积和全杏仁核体积明显减小。值得注意的是，King 分期 3 的 ALS 患者杏仁核-楔前叶 FC 增加。特定亚核体积与 ALS 患者的简易精神状态检查评分和汉密尔顿焦虑量表评分显著相关。总之，我们的研究提供了 ALS 患者杏仁核异常的综合特征。ALS 患者杏仁核异常的模式在 King 临床疾病阶段有很大差异，杏仁核异常是 ALS 患者相对晚期的重要特征。此外，我们的研究结果表明，杏仁核体积可能在 ALS 患者的焦虑和认知功能障碍中起重要作用。
