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White matter cortico-striatal tracts predict apathy subtypes in Huntington's disease

White matter cortico-striatal tracts predict apathy subtypes in Huntington's disease

Authors :
Audrey E. De Paepe
Joanna Sierpowska
Clara Garcia-Gorro
Saül Martinez-Horta
Jesus Perez-Perez
Jaime Kulisevsky
Nadia Rodriguez-Dechicha
Irene Vaquer
Susana Subira
Matilde Calopa
Esteban Muñoz
Pilar Santacruz
Jesus Ruiz-Idiago
Celia Mareca
Ruth de Diego-Balaguer
Estela Camara
Source :
NeuroImage: Clinical, Vol 24, Iss , Pp - (2019)
Publication Year :
2019
Publisher :
Elsevier, 2019.

Abstract

Background: Apathy is the neuropsychiatric syndrome that correlates most highly with Huntington's disease progression, and, like early patterns of neurodegeneration, is associated with lesions to cortico-striatal connections. However, due to its multidimensional nature and elusive etiology, treatment options are limited. Objectives: To disentangle underlying white matter microstructural correlates across the apathy spectrum in Huntington's disease. Methods: Forty-six Huntington's disease individuals (premanifest (N = 22) and manifest (N = 24)) and 35 healthy controls were scanned at 3-tesla and underwent apathy evaluation using the short-Problem Behavior Assessment and short-Lille Apathy Rating Scale, with the latter being characterized into three apathy domains, namely emotional, cognitive, and auto-activation deficit. Diffusion tensor imaging was used to study whether individual differences in specific cortico-striatal tracts predicted global apathy and its subdomains. Results: We elucidate that apathy profiles may develop along differential timelines, with the auto-activation deficit domain manifesting prior to motor onset. Furthermore, diffusion tensor imaging revealed that inter-individual variability in the disruption of discrete cortico-striatal tracts might explain the heterogeneous severity of apathy profiles. Specifically, higher levels of auto-activation deficit symptoms significantly correlated with increased mean diffusivity in the right uncinate fasciculus. Conversely, those with severe cognitive apathy demonstrated increased mean diffusivity in the right frontostriatal tract and left dorsolateral prefrontal cortex to caudate nucleus tract. Conclusions: The current study provides evidence that white matter correlates associated with emotional, cognitive, and auto-activation subtypes may elucidate the heterogeneous nature of apathy in Huntington's disease, as such opening a door for individualized pharmacological management of apathy as a multidimensional syndrome in other neurodegenerative disorders. Keywords: Apathy, Diffusion MRI, Huntington's disease, Individual differences, Neurodegeneration, White matter microstructure

Details

Language :
English
ISSN :
22131582
Volume :
24
Issue :
-
Database :
Directory of Open Access Journals
Journal :
NeuroImage: Clinical
Publication Type :
Academic Journal
Accession number :
edsdoj.b537bf4973c44e07bb5e0b336fb1e8e4
Document Type :
article
Full Text :
https://doi.org/10.1016/j.nicl.2019.101965