Strategic lesions in the anterior thalamic radiation and apathy in early Alzheimer's disease.
<h4>Background</h4>Behavioural disorders and psychological symptoms of Dementia (BPSD) are commonly observed in Alzheimer's disease (AD), and strongly contribute to increasing patients' disability. Using voxel-lesion-symptom mapping (VLSM), we investigated the impact of white m...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2015-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0124998 |
| _version_ | 1819029031537868800 |
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| author | Mario Torso Laura Serra Giovanni Giulietti Barbara Spanò Elisa Tuzzi Giacomo Koch Carlo Caltagirone Mara Cercignani Marco Bozzali |
| author_facet | Mario Torso Laura Serra Giovanni Giulietti Barbara Spanò Elisa Tuzzi Giacomo Koch Carlo Caltagirone Mara Cercignani Marco Bozzali |
| author_sort | Mario Torso |
| collection | DOAJ |
| description | <h4>Background</h4>Behavioural disorders and psychological symptoms of Dementia (BPSD) are commonly observed in Alzheimer's disease (AD), and strongly contribute to increasing patients' disability. Using voxel-lesion-symptom mapping (VLSM), we investigated the impact of white matter lesions (WMLs) on the severity of BPSD in patients with amnestic mild cognitive impairment (a-MCI).<h4>Methods</h4>Thirty-one a-MCI patients (with a conversion rate to AD of 32% at 2 year follow-up) and 26 healthy controls underwent magnetic resonance imaging (MRI) examination at 3T, including T2-weighted and fluid-attenuated-inversion-recovery images, and T1-weighted volumes. In the patient group, BPSD was assessed using the Neuropsychiatric Inventory-12. After quantitative definition of WMLs, their distribution was investigated, without an a priori anatomical hypothesis, against patients' behavioural symptoms. Unbiased regional grey matter volumetrics was also used to assess the contribution of grey matter atrophy to BPSD.<h4>Results</h4>Apathy, irritability, depression/dysphoria, anxiety and agitation were shown to be the most common symptoms in the patient sample. Despite a more widespread anatomical distribution, a-MCI patients did not differ from controls in WML volumes. VLSM revealed a strict association between the presence of lesions in the anterior thalamic radiations (ATRs) and the severity of apathy. Regional grey matter atrophy did not account for any BPSD.<h4>Conclusions</h4>This study indicates that damage to the ATRs is strategic for the occurrence of apathy in patients with a-MCI. Disconnection between the prefrontal cortex and the mediodorsal and anterior thalamic nuclei might represent the pathophysiological substrate for apathy, which is one of the most common psychopathological symptoms observed in dementia. |
| first_indexed | 2024-12-21T06:07:48Z |
| format | Article |
| id | doaj.art-3354535e5b7240a1bdd67df8e80c4be7 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T06:07:48Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-3354535e5b7240a1bdd67df8e80c4be72022-12-21T19:13:35ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01105e012499810.1371/journal.pone.0124998Strategic lesions in the anterior thalamic radiation and apathy in early Alzheimer's disease.Mario TorsoLaura SerraGiovanni GiuliettiBarbara SpanòElisa TuzziGiacomo KochCarlo CaltagironeMara CercignaniMarco Bozzali<h4>Background</h4>Behavioural disorders and psychological symptoms of Dementia (BPSD) are commonly observed in Alzheimer's disease (AD), and strongly contribute to increasing patients' disability. Using voxel-lesion-symptom mapping (VLSM), we investigated the impact of white matter lesions (WMLs) on the severity of BPSD in patients with amnestic mild cognitive impairment (a-MCI).<h4>Methods</h4>Thirty-one a-MCI patients (with a conversion rate to AD of 32% at 2 year follow-up) and 26 healthy controls underwent magnetic resonance imaging (MRI) examination at 3T, including T2-weighted and fluid-attenuated-inversion-recovery images, and T1-weighted volumes. In the patient group, BPSD was assessed using the Neuropsychiatric Inventory-12. After quantitative definition of WMLs, their distribution was investigated, without an a priori anatomical hypothesis, against patients' behavioural symptoms. Unbiased regional grey matter volumetrics was also used to assess the contribution of grey matter atrophy to BPSD.<h4>Results</h4>Apathy, irritability, depression/dysphoria, anxiety and agitation were shown to be the most common symptoms in the patient sample. Despite a more widespread anatomical distribution, a-MCI patients did not differ from controls in WML volumes. VLSM revealed a strict association between the presence of lesions in the anterior thalamic radiations (ATRs) and the severity of apathy. Regional grey matter atrophy did not account for any BPSD.<h4>Conclusions</h4>This study indicates that damage to the ATRs is strategic for the occurrence of apathy in patients with a-MCI. Disconnection between the prefrontal cortex and the mediodorsal and anterior thalamic nuclei might represent the pathophysiological substrate for apathy, which is one of the most common psychopathological symptoms observed in dementia.https://doi.org/10.1371/journal.pone.0124998 |
| spellingShingle | Mario Torso Laura Serra Giovanni Giulietti Barbara Spanò Elisa Tuzzi Giacomo Koch Carlo Caltagirone Mara Cercignani Marco Bozzali Strategic lesions in the anterior thalamic radiation and apathy in early Alzheimer's disease. PLoS ONE |
| title | Strategic lesions in the anterior thalamic radiation and apathy in early Alzheimer's disease. |
| title_full | Strategic lesions in the anterior thalamic radiation and apathy in early Alzheimer's disease. |
| title_fullStr | Strategic lesions in the anterior thalamic radiation and apathy in early Alzheimer's disease. |
| title_full_unstemmed | Strategic lesions in the anterior thalamic radiation and apathy in early Alzheimer's disease. |
| title_short | Strategic lesions in the anterior thalamic radiation and apathy in early Alzheimer's disease. |
| title_sort | strategic lesions in the anterior thalamic radiation and apathy in early alzheimer s disease |
| url | https://doi.org/10.1371/journal.pone.0124998 |
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