Unraveling corticobasal syndrome and alien limb syndrome with structural brain imaging. (August 2019)

• Record Type: Journal Article
• Authors: Anderl-Straub, Sarah; Brüggen, Katharina; Fischer, Marie; Förstl, Hans; Hammer, Anke; Homola, György; Just, Walter; Levin, Johannes; Marroquin, Nicolai; Marschhauser, Anke; Nagl, Magdalena; Oberstein, Timo; Polyakova, Maryna; Pellkofer, Hannah; Richter-Schmidinger, Tanja; Rossmeier, Carola; Schuemberg, Katharina; Semler, Elisa; Spottke, Annika; Steinacker, Petra; Thöne-Otto, Angelika; Uttner, Ingo; Zech, Heike; Albrecht, Franziska; Mueller, Karsten; Ballarini, Tommaso; Lampe, Leonie; Diehl-Schmid, Janine; Fassbender, Klaus; Fliessbach, Klaus; Jahn, Holger; Jech, Robert; Kassubek, Jan; Kornhuber, Johannes; Landwehrmeyer, Bernhard; Lauer, Martin; Ludolph, Albert C.; Lyros, Epameinondas; Prudlo, Johannes; Schneider, Anja; Synofzik, Matthis; Wiltfang, Jens; Danek, Adrian; Otto, Markus; Schroeter, Matthias L.;
• Is Part Of: Cortex. Volume 117(2019)
• Page Start: 33
• Page End: 40
• Publication Date: 2019-08
• Subjects: Alien limb syndrome -- Anarchic limb syndrome -- Corticobasal syndrome -- Diagnosis prediction -- Support vector machine; Neuropsychology -- Periodicals; Nervous system -- Periodicals; Neurology -- Periodicals; Psychophysiology -- Periodicals; Behavior -- Periodicals; Neurology -- Periodicals; 612.825
• DOI: 10.1016/j.cortex.2019.02.015
• Languages: English
• ISSNs: 0010-9452

Abstract

Abstract: Alien limb phenomenon is a rare syndrome associated with a feeling of non-belonging and disowning toward one's limb. In contrast, anarchic limb phenomenon leads to involuntary but goal-directed movements. Alien/anarchic limb phenomena are frequent in corticobasal syndrome (CBS), an atypical parkinsonian syndrome characterized by rigidity, akinesia, dystonia, cortical sensory deficit, and apraxia. The structure–function relationship of alien/anarchic limb was investigated in multi-centric structural magnetic resonance imaging (MRI) data. Whole-group and single-subject comparisons were made in 25 CBS and eight CBS-alien/anarchic limb patients versus controls. Support vector machine was used to see if CBS with and without alien/anarchic limb could be distinguished by structural MRI patterns. Whole-group comparison of CBS versus controls revealed asymmetric frontotemporal atrophy. CBS with alien/anarchic limb syndrome versus controls showed frontoparietal atrophy including the supplementary motor area contralateral to the side of the affected limb. Exploratory analysis identified frontotemporal regions encompassing the pre-/and postcentral gyrus as compromised in CBS with alien limb syndrome. Classification of CBS patients yielded accuracies of 79%. CBS-alien/anarchic limb syndrome was differentiated from CBS patients with an accuracy of 81%. Predictive differences were found in the cingulate gyrus spreading to frontomedian cortex, postcentral gyrus, and temporoparietoocipital regions. We present the first MRI-based group analysis on CBS-alien/anarchic limb. Results pave the way for individual clinical syndrome prediction and allow understanding the underlying neurocognitive architecture.