Sanjana Shellikeri1,2, Matthew Myers2, Sandra E Black2,3,4,5, Agessandro Abrahao2,4, Lorne Zinman2,3,4, Yana Yunusova1,2,6. 1. a Department of Speech Language Pathology , University of Toronto , Ontario , Canada. 2. b Hurvitz Brain Sciences Program , Sunnybrook Research Institute , Ontario , Canada. 3. c L.C. Campbell Cognitive Neurology Research Unit , Sunnybrook Research Institute, University of Toronto , Toronto , Canada. 4. d Department of Medicine, Division of Neurology , Sunnybrook Health Sciences Centre , Toronto , Canada. 5. e Rotman Research Institute, Baycrest , Toronto , Canada , and. 6. f University Health Network, Toronto Rehabilitation Institute , Ontario , Canada.
Abstract
Objective: To examine gray (GM) and white matter (WM) structural changes in regions of the speech network (SpN) in ALS patients with varying degree of bulbar disease. Methods: T1 and DTI images were obtained for 19 ALS participants and 13 neurologically-intact controls. Surface-based, volumetric, and DTI metrics were obtained for 6 regions-of-interest (ROIs) including the primary motor cortex (PMC), pars triangularis (parsT), pars opercularis (ParsO), posterior superior temporal gyrus (pSTG), and transverse temporal (TT). Disease-effects and brain-behavioral correlates between neuroanatomy and clinical measures of bulbar, limb, and overall disability were examined using linear models. Results: Structural changes were observed in the right oral and limb PMC and left ParsT, TT, and pSTG in ALS. Bulbar motor dysfunction was associated with WM abnormalities in the right oral PMC and left pSTG, and GM changes in bilateral TT. In contrast, symptom progression rate predicted GM and WM changes in bilateral pars opercularis (part of Broca's area). Grip strength and disease duration models were non-significant. Conclusions: The findings suggested that regions of the left-dominant SpN may be implicated in ALS and degeneration of these areas are related to bulbar disease severity. Involvement of regions that overlap across multiple connectomes such as Broca's area, however, may be dependent on the rate of disease progression. The work contributes to our understanding of bulbar ALS subtype, which is crucial for predicting disease progression, delivering targeted clinical care, and appropriate recruitment into clinical trials.
Objective: To examine gray (GM) and white matter (WM) structural changes in regions of the speech network (SpN) in ALSpatients with varying degree of bulbar disease. Methods: T1 and DTI images were obtained for 19 ALSparticipants and 13 neurologically-intact controls. Surface-based, volumetric, and DTI metrics were obtained for 6 regions-of-interest (ROIs) including the primary motor cortex (PMC), pars triangularis (parsT), pars opercularis (ParsO), posterior superior temporal gyrus (pSTG), and transverse temporal (TT). Disease-effects and brain-behavioral correlates between neuroanatomy and clinical measures of bulbar, limb, and overall disability were examined using linear models. Results: Structural changes were observed in the right oral and limb PMC and left ParsT, TT, and pSTG in ALS. Bulbar motor dysfunction was associated with WM abnormalities in the right oral PMC and left pSTG, and GM changes in bilateral TT. In contrast, symptom progression rate predicted GM and WM changes in bilateral pars opercularis (part of Broca's area). Grip strength and disease duration models were non-significant. Conclusions: The findings suggested that regions of the left-dominant SpN may be implicated in ALS and degeneration of these areas are related to bulbar disease severity. Involvement of regions that overlap across multiple connectomes such as Broca's area, however, may be dependent on the rate of disease progression. The work contributes to our understanding of bulbar ALS subtype, which is crucial for predicting disease progression, delivering targeted clinical care, and appropriate recruitment into clinical trials.
Authors: Esther Verstraete; Jan H Veldink; Leonard H van den Berg; Martijn P van den Heuvel Journal: Hum Brain Mapp Date: 2013-03-01 Impact factor: 5.038
Authors: Sicong Tu; Ricarda A L Menke; Kevin Talbot; Matthew C Kiernan; Martin R Turner Journal: J Neurol Neurosurg Psychiatry Date: 2018-07-26 Impact factor: 10.154
Authors: Ricarda A L Menke; Sonja Körner; Nicola Filippini; Gwenaëlle Douaud; Steven Knight; Kevin Talbot; Martin R Turner Journal: Brain Date: 2014-06-20 Impact factor: 13.501
Authors: Sanjana Shellikeri; Reeman Marzouqah; Benjamin Rix Brooks; Lorne Zinman; Jordan R Green; Yana Yunusova Journal: J Speech Lang Hear Res Date: 2021-10-26 Impact factor: 2.674