Shuangwu Liu1,2, Qingguo Ren3, Gaolang Gong4, Yuan Sun5, Bing Zhao5, Xiaotian Ma6, Na Zhang2, Suyu Zhong3, Yan Lin2, Wenqing Wang2, Rui Zheng2, Xiaolin Yu7, Yan Yun8, Dong Zhang2, Kai Shao6, Pengfei Lin2, Ying Yuan9, Tingjun Dai2, Yongqing Zhang5, Ling Li5, Wei Li2, Yuying Zhao2, Peiyan Shan7, Xiangshui Meng3, Chuanzhu Yan10,11. 1. School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China. 2. Research Institute of Neuromuscular and Neurodegenerative Disease, Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, West Wenhua street No.107, Jinan, 250012, China. 3. Department of Radiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China. 4. State Key Laboratory of Cognitive Neuroscience and Learning &IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China. 5. Department of Neurology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China. 6. Department of Clinical Laboratory, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China. 7. Department of Gerontology, Qilu Hospital of Shandong University, Jinan, China. 8. Department of Radiology, Qilu Hospital of Shandong University, Jinan, China. 9. Sleep Medicine Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China. 10. Research Institute of Neuromuscular and Neurodegenerative Disease, Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, West Wenhua street No.107, Jinan, 250012, China. czyan@sdu.edu.cn. 11. Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong, China. czyan@sdu.edu.cn.
Abstract
OBJECTIVE: To investigate atrophy patterns in hypothalamic subunits at different stages of ALS and examine correlations between hypothalamic subunit volume and clinical information. METHODS: We used the King's clinical staging system to divide 91 consecutive ALS patients into the different disease stages. We investigated patterns of hypothalamic atrophy using a recently published automated segmentation method in ALS patients and in 97 healthy controls. We recorded all subjects' demographic and clinical information. RESULTS: Compared with healthy controls, we found significant atrophy in the bilateral anterior-superior subunit and the superior tubular subunit, as well as a reduction in global hypothalamic volume in ALS patients. When we used the King's clinical staging system to divide patients into the different disease stages, we found neither global nor specific subunit atrophy until King's stage 3 in the hypothalamus. Moreover, specific subunit volumes were significantly associated with body mass index. CONCLUSIONS: In a relatively large sample of Chinese patients with ALS, using a recently published automated segmentation method for the hypothalamus, we found the pattern of hypothalamic atrophy in ALS patients differed greatly across King's clinical disease stages. Moreover, specific hypothalamic subunit atrophy may play an important role in energy metabolism in ALS patients. Thus, our findings suggest that hypothalamic atrophy may have potential phenotypic associations, and improved energy metabolism may become an important component of individualised therapy for ALS.
OBJECTIVE: To investigate atrophy patterns in hypothalamic subunits at different stages of ALS and examine correlations between hypothalamic subunit volume and clinical information. METHODS: We used the King's clinical staging system to divide 91 consecutive ALS patients into the different disease stages. We investigated patterns of hypothalamic atrophy using a recently published automated segmentation method in ALS patients and in 97 healthy controls. We recorded all subjects' demographic and clinical information. RESULTS: Compared with healthy controls, we found significant atrophy in the bilateral anterior-superior subunit and the superior tubular subunit, as well as a reduction in global hypothalamic volume in ALS patients. When we used the King's clinical staging system to divide patients into the different disease stages, we found neither global nor specific subunit atrophy until King's stage 3 in the hypothalamus. Moreover, specific subunit volumes were significantly associated with body mass index. CONCLUSIONS: In a relatively large sample of Chinese patients with ALS, using a recently published automated segmentation method for the hypothalamus, we found the pattern of hypothalamic atrophy in ALS patients differed greatly across King's clinical disease stages. Moreover, specific hypothalamic subunit atrophy may play an important role in energy metabolism in ALS patients. Thus, our findings suggest that hypothalamic atrophy may have potential phenotypic associations, and improved energy metabolism may become an important component of individualised therapy for ALS.
Authors: David P Breen; Cristina Nombela; Romina Vuono; P Simon Jones; Kate Fisher; David J Burn; David J Brooks; Akhilesh B Reddy; James B Rowe; Roger A Barker Journal: Mov Disord Date: 2016-03-12 Impact factor: 10.338