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脊髓小脑共济失调 7 型的运动和认知障碍及其与皮质体积的相关性。

Motor and cognitive impairments in spinocerebellar ataxia type 7 and its correlations with cortical volumes.

机构信息

Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México.

CONACYT - Instituto de Neuroetología, Universidad Veracruzana, Xalapa, México.

出版信息

Eur J Neurosci. 2018 Nov;48(10):3199-3211. doi: 10.1111/ejn.14148. Epub 2018 Sep 26.

Abstract

Spinocerebellar Ataxia Type 7 (SCA7) is a neurodegenerative disorder caused by cytosine-adenine-guanine (CAG) repeat expansion. It is clinically characterized by ataxia and visual loss. To date, little is known about SCA7 cognitive impairments and its relationship with grey matter volume (GMV) changes. The aim of this study was to explore SCA7 patients' performance in specific components of auditory-verbal neuropsychological tests and to correlate their scores with genetic mutation, severity of ataxia and GMV. We assessed verbal memory and verbal fluency proficiencies in 31 genetically confirmed SCA7 patients, and compared their results with 32 healthy matched volunteers; we also correlated CAG repeats and severity of motor symptoms with performance in the auditory-verbal tests. SCA7 patients exhibited deficiencies in several components of these cognitive tasks, which were independent of motor impairments and showed no relation to CAG repeats. Based on Resonance Images performed in 27 patients we found association between ataxia severity and GMV in "sensoriomotor" cerebellum, as well as correlations of impaired verbal memory and semantic fluency scores with GMV in association cortices, including the right parahippocampal gyrus. To our knowledge, this is the first report of deficits in the organization of semantic information and in the evocation of verbal material, as well as greater susceptibility to proactive interference in SCA7 patients. These findings bring novel information about specific cognitive abilities in SCA7 patients, particularly verbal memory and fluency, and their relation with GMV variations in circumscribed brain regions, including association cortices known to have functional relationships with the cerebellum.

摘要

脊髓小脑共济失调 7 型(SCA7)是一种由胞嘧啶-腺嘌呤-鸟嘌呤(CAG)重复扩展引起的神经退行性疾病。它的临床特征是共济失调和视力丧失。迄今为止,人们对 SCA7 的认知障碍及其与灰质体积(GMV)变化的关系知之甚少。本研究旨在探讨 SCA7 患者在听觉言语神经心理测试特定成分中的表现,并将其评分与基因突变、共济失调严重程度和 GMV 相关联。我们评估了 31 名经基因确认的 SCA7 患者的言语记忆和言语流畅性能力,并将他们的结果与 32 名健康匹配的志愿者进行比较;我们还将 CAG 重复和运动症状的严重程度与听觉言语测试中的表现相关联。SCA7 患者在这些认知任务的几个组成部分中表现出缺陷,这些缺陷与运动障碍无关,与 CAG 重复无关。基于对 27 名患者进行的共振成像,我们发现共济失调严重程度与“感觉运动”小脑的 GMV 之间存在关联,以及言语记忆和语义流畅性评分受损与包括右侧海马旁回在内的联合皮质 GMV 之间存在相关性。据我们所知,这是首次报道 SCA7 患者在语义信息组织和言语材料唤起方面存在缺陷,以及在 SCA7 患者中更容易出现前摄干扰。这些发现提供了有关 SCA7 患者特定认知能力的新信息,特别是言语记忆和流畅性,以及它们与小脑相关的特定脑区 GMV 变化的关系。

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