Adaptive functional reorganization in amyotrophic lateral sclerosis: coexisting degenerative and compensatory changes.
Adaptation, Physiological
Adult
Aged
Amyotrophic Lateral Sclerosis
/ diagnostic imaging
Cerebellum
/ diagnostic imaging
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Motor Cortex
/ diagnostic imaging
Motor Neurons
Movement
Neostriatum
/ diagnostic imaging
Neurodegenerative Diseases
/ diagnostic imaging
Prefrontal Cortex
/ diagnostic imaging
Young Adult
MRI
amyotrophic lateral sclerosis
fMRI
imaging
motor neuron disease
neuroplasticity
Journal
European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
22
03
2019
accepted:
10
07
2019
pubmed:
17
7
2019
medline:
29
12
2020
entrez:
17
7
2019
Statut:
ppublish
Résumé
Considerable functional reorganization takes place in amyotrophic lateral sclerosis (ALS) in face of relentless structural degeneration. This study evaluates functional adaptation in ALS patients with lower motor neuron predominant (LMNp) and upper motor neuron predominant (UMNp) dysfunction. Seventeen LMNp ALS patients, 14 UMNp ALS patients and 14 controls participated in a functional magnetic resonance imaging study. Study-group-specific activation patterns were evaluated during preparation for a motor task. Connectivity analyses were carried out using the supplementary motor area (SMA), cerebellum and striatum as seed regions and correlations were explored with clinical measures. Increased cerebellar, decreased dorsolateral prefrontal cortex and decreased SMA activation were detected in UMNp patients compared to controls. Increased cerebellar activation was also detected in UMNp patients compared to LMNp patients. UMNp patients exhibit increased effective connectivity between the cerebellum and caudate, and decreased connectivity between the SMA and caudate and between the SMA and cerebellum when performing self-initiated movement. In UMNp patients, a positive correlation was detected between clinical variables and striato-cerebellar connectivity. Our findings indicate that, despite the dysfunction of SMA-striatal and SMA-cerebellar networks, cerebello-striatal connectivity increases in ALS indicative of compensatory processes. The coexistence of circuits with decreased and increased connectivity suggests concomitant neurodegenerative and adaptive changes in ALS.
Sections du résumé
BACKGROUND AND PURPOSE
Considerable functional reorganization takes place in amyotrophic lateral sclerosis (ALS) in face of relentless structural degeneration. This study evaluates functional adaptation in ALS patients with lower motor neuron predominant (LMNp) and upper motor neuron predominant (UMNp) dysfunction.
METHODS
Seventeen LMNp ALS patients, 14 UMNp ALS patients and 14 controls participated in a functional magnetic resonance imaging study. Study-group-specific activation patterns were evaluated during preparation for a motor task. Connectivity analyses were carried out using the supplementary motor area (SMA), cerebellum and striatum as seed regions and correlations were explored with clinical measures.
RESULTS
Increased cerebellar, decreased dorsolateral prefrontal cortex and decreased SMA activation were detected in UMNp patients compared to controls. Increased cerebellar activation was also detected in UMNp patients compared to LMNp patients. UMNp patients exhibit increased effective connectivity between the cerebellum and caudate, and decreased connectivity between the SMA and caudate and between the SMA and cerebellum when performing self-initiated movement. In UMNp patients, a positive correlation was detected between clinical variables and striato-cerebellar connectivity.
CONCLUSIONS
Our findings indicate that, despite the dysfunction of SMA-striatal and SMA-cerebellar networks, cerebello-striatal connectivity increases in ALS indicative of compensatory processes. The coexistence of circuits with decreased and increased connectivity suggests concomitant neurodegenerative and adaptive changes in ALS.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
121-128Subventions
Organisme : Investissements d'avenir
Pays : International
Organisme : Institut National pour la Santé et la Recherche Médicale (INSERM)
Pays : International
Organisme : Association for Research on ALS (ARSLA)
Pays : International
Organisme : the Association for Research on ALS (ARSLA)
Pays : International
Informations de copyright
© European Academy of Neurology 2019.
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