Case Report: Cognitive Conversion in a Non-brazilian VAPB Mutation Carrier (ALS8)
Amyotrophic lateral sclerosis 8 (ALS8) is a predominantly lower motor neuron syndrome originally described in a Portuguese–Brazilian family, which originated from a common founder. ALS8 is caused by a VAPB mutation and extremely rare in Central Europe. We present a 51-year-old German man with ALS8 w...
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Frontiers Media S.A.
2021-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.668772/full |
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| author | Anna G. M. Temp Martin Dyrba Elisabeth Kasper Stefan Teipel Stefan Teipel Johannes Prudlo Johannes Prudlo |
| author_facet | Anna G. M. Temp Martin Dyrba Elisabeth Kasper Stefan Teipel Stefan Teipel Johannes Prudlo Johannes Prudlo |
| author_sort | Anna G. M. Temp |
| collection | DOAJ |
| description | Amyotrophic lateral sclerosis 8 (ALS8) is a predominantly lower motor neuron syndrome originally described in a Portuguese–Brazilian family, which originated from a common founder. ALS8 is caused by a VAPB mutation and extremely rare in Central Europe. We present a 51-year-old German man with ALS8 who had the P56S VAPB mutation independently of the founder effect. In the final 4 years of his life (disease duration 10 years), the patient had five MRI scans and four in-depth neuropsychological assessments. This paper addresses the course of the patient's cognitive status and relates cognitive performance to structural brain changes in order to determine whether this ALS8 case showed a different pattern of cognitive decline compared with sporadic ALS. The executive functions, verbal fluency, and memory of the patient and 17 age-, sex-, and education-matched controls were assessed on four different occasions. His cognitive performance and decline were investigated for abnormality using cross-sectional and longitudinal matched case–control analysis. We obtained five T1-weighted MRI, which we analyzed using voxel-wise non-parametric analysis with statistical non-parametric mapping in Matlab. Moreover, we conducted a single-subject correlation between cognitive performance and brain atrophy. The cognitive profile of the index patient featured executive dysfunction. Notably, his working memory and shifting ability declined from a healthy baseline to an impaired performance, leading to a transition from cognitively non-impaired (ALSni) to cognitively impaired (ALSci). The correlations we observed between cerebellar atrophy and verbal fluency in addition to fusiform gyrus atrophy and shifting are novel findings. We found that the conversion from ALSni to ALSci was associated with widespread cerebral atrophy, which extended beyond the primary motor and premotor cortex and affected, among others, the cerebellum and left fusiform gyrus. The index patients' cognitive profile resembles that of other ALS phenotypes, but the extensive atrophy beyond extra-motor areas has not yet been described. |
| first_indexed | 2024-12-17T07:53:00Z |
| format | Article |
| id | doaj.art-e0b7f0ffe7b74add86cbf3f8d0495e62 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-17T07:53:00Z |
| publishDate | 2021-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-e0b7f0ffe7b74add86cbf3f8d0495e622022-12-21T21:57:48ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-06-011210.3389/fneur.2021.668772668772Case Report: Cognitive Conversion in a Non-brazilian VAPB Mutation Carrier (ALS8)Anna G. M. Temp0Martin Dyrba1Elisabeth Kasper2Stefan Teipel3Stefan Teipel4Johannes Prudlo5Johannes Prudlo6German Center for Neurodegenerative Diseases (DZNE), Rostock, GermanyGerman Center for Neurodegenerative Diseases (DZNE), Rostock, GermanyDepartment of Neurology, Rostock University Medical Center, Rostock, GermanyGerman Center for Neurodegenerative Diseases (DZNE), Rostock, GermanyDepartment of Psychosomatic Medicine, Rostock University Medical Center, Rostock, GermanyGerman Center for Neurodegenerative Diseases (DZNE), Rostock, GermanyDepartment of Neurology, Rostock University Medical Center, Rostock, GermanyAmyotrophic lateral sclerosis 8 (ALS8) is a predominantly lower motor neuron syndrome originally described in a Portuguese–Brazilian family, which originated from a common founder. ALS8 is caused by a VAPB mutation and extremely rare in Central Europe. We present a 51-year-old German man with ALS8 who had the P56S VAPB mutation independently of the founder effect. In the final 4 years of his life (disease duration 10 years), the patient had five MRI scans and four in-depth neuropsychological assessments. This paper addresses the course of the patient's cognitive status and relates cognitive performance to structural brain changes in order to determine whether this ALS8 case showed a different pattern of cognitive decline compared with sporadic ALS. The executive functions, verbal fluency, and memory of the patient and 17 age-, sex-, and education-matched controls were assessed on four different occasions. His cognitive performance and decline were investigated for abnormality using cross-sectional and longitudinal matched case–control analysis. We obtained five T1-weighted MRI, which we analyzed using voxel-wise non-parametric analysis with statistical non-parametric mapping in Matlab. Moreover, we conducted a single-subject correlation between cognitive performance and brain atrophy. The cognitive profile of the index patient featured executive dysfunction. Notably, his working memory and shifting ability declined from a healthy baseline to an impaired performance, leading to a transition from cognitively non-impaired (ALSni) to cognitively impaired (ALSci). The correlations we observed between cerebellar atrophy and verbal fluency in addition to fusiform gyrus atrophy and shifting are novel findings. We found that the conversion from ALSni to ALSci was associated with widespread cerebral atrophy, which extended beyond the primary motor and premotor cortex and affected, among others, the cerebellum and left fusiform gyrus. The index patients' cognitive profile resembles that of other ALS phenotypes, but the extensive atrophy beyond extra-motor areas has not yet been described.https://www.frontiersin.org/articles/10.3389/fneur.2021.668772/fullALS8case reportcognitionMRIvolumetric change |
| spellingShingle | Anna G. M. Temp Martin Dyrba Elisabeth Kasper Stefan Teipel Stefan Teipel Johannes Prudlo Johannes Prudlo Case Report: Cognitive Conversion in a Non-brazilian VAPB Mutation Carrier (ALS8) Frontiers in Neurology ALS8 case report cognition MRI volumetric change |
| title | Case Report: Cognitive Conversion in a Non-brazilian VAPB Mutation Carrier (ALS8) |
| title_full | Case Report: Cognitive Conversion in a Non-brazilian VAPB Mutation Carrier (ALS8) |
| title_fullStr | Case Report: Cognitive Conversion in a Non-brazilian VAPB Mutation Carrier (ALS8) |
| title_full_unstemmed | Case Report: Cognitive Conversion in a Non-brazilian VAPB Mutation Carrier (ALS8) |
| title_short | Case Report: Cognitive Conversion in a Non-brazilian VAPB Mutation Carrier (ALS8) |
| title_sort | case report cognitive conversion in a non brazilian vapb mutation carrier als8 |
| topic | ALS8 case report cognition MRI volumetric change |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.668772/full |
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