title: Memory-related white matter tract integrity in amyotrophic lateral sclerosis: an advanced neuroimaging and neuropsychological study.
abstract: We aimed to investigate structural changes in vivo in memory-related white matter tracts (i.e., perforant pathway zone [PPZ]; uncinate fasciculus [UF]; fornix) using diffusion tensor tractography and evaluate possible associations with memory performance in nondemented patients with amyotrophic lateral sclerosis (ALS). Forty-two ALS patients and 25 healthy controls (HCs) underwent a 30-directional diffusion-weighted imaging on a 3T MR scanner, followed by tractography of PPZ, UF, and fornix and analysis of fractional anisotropy (FA), axial diffusivity and radial diffusivity (Dr). Patients were administered neuropsychological measures of verbal (list learning via Rey Auditory Verbal Learning Test [RAVLT] and prose memory via Babcock Story Recall Test) and nonverbal (Rey's Complex Figure Test) episodic memory. After correcting for multiple comparisons, ALS patients showed increased Dr in the left PPZ compared to HC. We then fitted a multivariate general linear model within ALS patients with neuropsychological measures as dependent variables and age, age2, gender, verbal IQ, and diffusion tensor tractography metrics with at least medium effect size differences between ALS and HC as independent variables. We found that (1) left PPZ FA, gender, and verbal IQ contributed to RAVLT-Total Learning; (2) left PPZ FA, left UF Dr, and gender contributed to RAVLT-Immediate Recall; and (3) left PPZ FA and left UF axial diffusivity contributed to Babcock Story Recall Test-Immediate and Delayed Recall. Advanced neuroimaging techniques verified in this study previously reported neuropathological findings regarding PPZ degeneration in ALS. We also detected a unique contribution of microstructural changes in hippocampal and frontotemporal white matter tracts on patients' memory profile.
authors: First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: christidi.f.a@gmail.com.
authors: Foteini
authors: F
authors: Christidi
authors: Second Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Efstratios
authors: E
authors: Karavasilis
authors: First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Ioannis
authors: I
authors: Zalonis
authors: Second Department of Psychiatry, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Panagiotis
authors: P
authors: Ferentinos
authors: Department of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece.
authors: Zoi
authors: Z
authors: Giavri
authors: Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA; Department of Radiology, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
authors: Elisabeth A
authors: EA
authors: Wilde
authors: First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Sophia
authors: S
authors: Xirou
authors: First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Michalis
authors: M
authors: Rentzos
authors: First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Vasiliki
authors: V
authors: Zouvelou
authors: Second Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: George
authors: G
authors: Velonakis
authors: Second Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Panagiotis
authors: P
authors: Toulas
authors: Second Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Efstathios
authors: E
authors: Efstathopoulos
authors: Second Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Loukia
authors: L
authors: Poulou
authors: Second Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Georgios
authors: G
authors: Argyropoulos
authors: Second Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Athanasios
authors: A
authors: Athanasakos
authors: First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Thomas
authors: T
authors: Zambelis
authors: Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
authors: Harvey S
authors: HS
authors: Levin
authors: First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Nikolaos
authors: N
authors: Karandreas
authors: Second Department of Radiology, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Nikolaos
authors: N
authors: Kelekis
authors: First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors: Ioannis
authors: I
authors: Evdokimidis
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000473:pathology* / Q000523:psychology*; D016880:Anisotropy; D038524:Diffusion Magnetic Resonance Imaging; D056324:Diffusion Tensor Imaging; D005260:Female; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D061212:Memory, Episodic; D008875:Middle Aged; D059906:Neuroimaging; D009483:Neuropsychological Tests; D014706:Verbal Learning; D066127:White Matter / Q000000981:diagnostic imaging* / Q000473:pathology*
keywords: Amyotrophic lateral sclerosis; Diffusion tensor tractography; Fornix; Memory; Perforant pathway zone; Uncinate fasciculus