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Brain atrophy in primary progressive aphasia involves the cholinergic basal forebrain and Ayala's nucleus

机译:原发性进行性失语的脑萎缩涉及胆碱能基底前脑和阿亚拉核

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摘要

Primary progressive aphasia (PPA) is characterized by left hemispheric frontotemporal cortical atrophy. Evidence from anatomical studies suggests that the nucleus subputaminalis (NSP), a subnucleus of the cholinergic basal forebrain, may be involved in the pathological process of PPA. Therefore, we studied the pattern of cortical and basal forebrain atrophy in 10 patients with a clinical diagnosis of PPA and 18 healthy age-matched controls using high-resolution magnetic resonance imaging (MRI). We determined the cholinergic basal forebrain nuclei according to Mesulam's nomenclature and the NSP in MRI reference space based on histological sections and the MRI scan of a post-mortem brain in cranio. Using voxel-based analysis, we found left hemispheric cortical atrophy in PPA patients compared with controls, including prefrontal, lateral temporal and medial temporal lobe areas. We detected cholinergic basal forebrain atrophy in left predominant localizations of Ch4p, Ch4am, Ch4al, Ch3 and NSP. For the first time, we have described the pattern of basal forebrain atrophy in PPA and confirmed the involvement of NSP that had been predicted based on theoretical considerations. Our findings may enhance understanding of the role of cholinergic degeneration for the regional specificity of the cortical destruction leading to the syndrome of PPA.
机译:原发性进行性失语症(PPA)的特征是左半球额颞叶皮质萎缩。解剖学研究的证据表明,胆碱能基底前脑的一个亚核的下丘脑核(NSP)可能与PPA的病理过程有关。因此,我们使用高分辨率磁共振成像(MRI)研究了10位临床诊断为PPA的患者和18位年龄匹配的健康对照者的皮质和基底前脑萎缩的模式。我们根据组织切片和颅内验尸后脑部的MRI扫描,根据Mesulam的命名法和MRI参考空间中的NSP确定了胆碱能性基底前脑核。使用基于体素的分析,我们发现PPA患者的左半球皮质萎缩与对照组相比,包括额叶前额叶,颞叶外侧和颞叶内侧区域。我们在Ch4p,Ch4am,Ch4al,Ch3和NSP的左主要位置检测到胆碱能性基底前脑萎缩。首次,我们描述了PPA中基底前脑萎缩的模式,并确认了基于理论考虑而预测的NSP的参与。我们的发现可能会加深对胆碱能变性在导致PPA综合征的皮质破坏的区域特异性中的作用的理解。

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