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Structural explanation of poor prognosis of amyotrophic lateral sclerosis in the non-demented state

Title
Structural explanation of poor prognosis of amyotrophic lateral sclerosis in the non-demented state
Author
오기욱
Keywords
amyotrophic lateral sclerosis; atrophy; cognitive impairment; voxel-based morphometry
Issue Date
2017-01
Publisher
WILEY-BLACKWELL
Citation
EUROPEAN JOURNAL OF NEUROLOGY. v. 24, no. 1, page. 122-129
Abstract
Background and purpose: Amyotrophic lateral sclerosis (ALS), a motor neuron disease, is associated with various cortical symptoms including mild cognitive decline with behavior changes, suggesting the involvement of extra-motor areas in ALS. Our aim was to investigate the specific patterns of brain atrophy in sporadic, impaired ALS patients without commonly known genetic mutations using voxel-based morphometry.Materials and methods: Forty-seven patients with sporadic ALS and 28 agematched healthy controls were recruited. ALS participants were divided into three groups according to comprehensive neuropsychological testing: pure (ALS-pure), cognitive impairment (ALSci) and behavioral impairment (ALSbi). Quantitative comparison of brain atrophy patterns was performed amongst these three groups using voxel-based analysis. All analyses were adjusted for total intracranial volume, age, sex, disease duration and functional disability score.Results: The ALSci group exhibited decreased volume in the left cerebellum, fusiform gyrus, optic radiations and corticospinal tracts compared to healthy controls. ALSci patient imaging showed decreased brain volume in the bilateral cerebellum, right putamen gray matter and bilateral superior longitudinal fasciculi white matter compared to pure ALS patients (P < 0.001 uncorrected, corrected for the entire volume). Compared to healthy controls, ALS-pure and ALSbi groups did not show any significant volume changes in gray and white matter.Conclusions: These findings also support the hypothesis that ALS pathogenesis has a dual focality of onset (cortex and anterior horn) with contiguous spread outwards. Additionally, neuropsychological features may be an important predictor of progression and survival rates in ALS.
URI
https://onlinelibrary.wiley.com/doi/abs/10.1111/ene.13163https://repository.hanyang.ac.kr/handle/20.500.11754/112460
ISSN
1351-5101; 1468-1331
DOI
10.1111/ene.13163
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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