Structural brain network imaging shows expanding disconnection of the motor system in amyotrophic lateral sclerosis.

Abstract:

:Amyotrophic lateral sclerosis (ALS) is a severe neurodegenerative disease, which primarily targets the motor system. The structural integrity of the motor network and the way it is embedded in the overall brain network is essential for motor functioning. We studied the longitudinal effects of ALS on the brain network using diffusion tensor imaging and questioned whether over time an increasing number of connections become involved or whether there is progressive impairment of a limited number of connections. The brain network was reconstructed based on "whole brain" diffusion tensor imaging data. We examined: (1) network integrity in 24 patients with ALS at baseline (T = 1) and at a more advanced stage of the disease (T = 2; interval 5.5 months) compared with a group of healthy controls and (2) progressive brain network impairment comparing patients at two time-points in a paired-analysis. These analyses demonstrated an expanding subnetwork of affected brain connections over time with a central role for the primary motor regions (P-values T = 1 0.003; T = 2 0.001). Loss of structural connectivity mainly propagated to frontal and parietal brain regions at T = 2 compared with T = 1. No progressive impairment of the initially affected (motor) connections could be detected. The main finding of this study is an increasing loss of network structure in patients with ALS. In contrast to the theory of ALS solely affecting a fixed set of primary motor connections, our findings show that the network of impaired connectivity is expanding over time. These results are in support of disease spread along structural brain connections.

journal_name

Hum Brain Mapp

journal_title

Human brain mapping

authors

Verstraete E,Veldink JH,van den Berg LH,van den Heuvel MP

doi

10.1002/hbm.22258

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

1351-61

issue

4

eissn

1065-9471

issn

1097-0193

journal_volume

35

pub_type

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