Funktionelle Bildgebung bei der Amyotrophen Lateralsklerose: Analyse der Ruheaktivität

Zusammenfassung

Die vorliegende Studie untersucht die Frage, ob die Analyse der Ruheaktivität der BOLD (Blood Oxygen Level Dependency)-fMRT mithilfe der Unabhängigkeitsanalyse (Independent-Component-Analyse, ICA) bei der Amyotrophen Lateralsklerose (ALS) Veränderungen in distinkten Netzwerken von Hirnarealen im Vergleich zu Kontrollpersonen darstellen lässt. Es wurden 20 ALS-Patienten und ebenso viele Kontrollen untersucht. Die ICA zeigte fünf verschiedene Netzwerke, die sich reliabel für Patienten und Kontrollen finden ließen. Zwei dieser Netzwerke zeigten deutliche Veränderungen in der Patienten-Gruppe. Das sogenannte Default Mode Netzwerk (DMN) zeigte bei den ALS-Patienten eine signifikant geringere Konnektivität. Dies spiegelt wahrscheinlich die mittlerweile gut dokumentierte extramotorische Beteiligung bei dieser Erkrankung wider. Das sensomotorische Netzwerk, das sich aus Hirnarealen zusammensetzt, die bei motorischen Aktionen involviert sind, zeigte im Bereich der prämotorischen Regionen ebenfalls eine erniedrigte Konnektivität bei den ALS-Patienten. Da die Resultate unabhängig von spezifischen Aufgaben sind und daher auch kompensatorische Prozesse, die durch die für Patienten höhere Aufgabenschwierigkeit erklärbar wären, bei der Interpretation nicht berücksichtigt werden müssen, erlauben diese Ergebnisse direkte Rückschlüsse auf pathophysiologische Veränderungen bei der ALS.

Abstract

This study investigates the question whether the analysis of resting state BOLD (blood oxygen level dependency) fMRI using independent component analysis (ICA) allows us to assess pathological changes in distinct networks of brain areas in amyotrophic lateral sclerosis (ALS). Twenty patients and a similar number of matched controls were investigated. ICA revealed five different brain networks that could be reliably identified on the single subject level in both ALS patients and controls. Two of these networks showed marked changes in the patient group. The so-called default mode network (DMN) showed a significantly diminished connectivity in the patient group. This is likely related to the well-documented extramotor involvement in ALS patients. Moreover, the sensorimotor network which comprises brain areas that are involved in motor processes was similarly compromised in ALS. Because these results are independent of specific tasks and thus are not confounded by problems of differential task difficulty, they allow the direct assessment of pathological changes of different brain networks in ALS.

Schlüsselwörter

ALS - Ruheaktivität - Default Mode Netzwerk - funktionelle Bildgebung

Key words

ALS - resting activity - default mode network - functional imaging

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