Can lesions to the motor cortex induce amyotrophic lateral sclerosis?

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• 作者：Angela Rosenbohm (1)
  Jan Kassubek (1)
  Patrick Weydt (1)
  Nicolai Marroquin (2)
  Alexander E. Volk (2)
  Christian Kubisch (2)
  Hans-Jürgen Huppertz (5)
  Markus Weber (3)
  Peter M. Andersen (1) (4)
  Jochen H. Weishaupt (1)
  Albert C. Ludolph (1)
  
• 关键词：Frontal lobe lesions ; Motor cortex lesions ; Amyotrophic lateral sclerosis ; Motor neuron disease
• 刊名：Journal of Neurology
• 出版年：2014
• 出版时间：February 2014
• 年：2014
• 卷：261
• 期：2
• 页码：283-290
• 全文大小：260 KB
• 作者单位：Angela Rosenbohm (1)
  Jan Kassubek (1)
  Patrick Weydt (1)
  Nicolai Marroquin (2)
  Alexander E. Volk (2)
  Christian Kubisch (2)
  Hans-Jürgen Huppertz (5)
  Markus Weber (3)
  Peter M. Andersen (1) (4)
  Jochen H. Weishaupt (1)
  Albert C. Ludolph (1)
  
  1. Department of Neurology, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany
  2. Institute of Human Genetics, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany
  5. Swiss Epilepsy Centre, Zürich, Switzerland
  3. Muskelzentrum/ALS Clinic, Kantonsspital St. Gallen, Greithstra?e 20, 9007, St. Gallen, Switzerland
  4. Department of Clinical Neuroscience, Ume? University, Ume?, Sweden
  
• ISSN：1432-1459

文摘

A recent staging effort for amyotrophic lateral sclerosis (ALS) has demonstrated that the TDP-43 neuropathology may initiate focally in the motor cortex in the majority of patients. We searched our data bank for patients with lesions of the motor cortex which preceded disease onset. We performed a search of our patient- and MRI-data bank and screened 1,835 patients with amyotrophic lateral sclerosis for frontal lobe/motor cortex lesions. We found 18 patients with definite ALS who had documented and defined lesions of the motor cortex, which preceded the initial ALS symptoms by 8-2?years. In the vast majority (15/18) of the patients, the onset of ALS was closely related to the focal lesion since it started in a body region reflecting the damaged cortical area. The findings suggest that initial lesions to the motor cortex may be a contributing initiating factor in some patients with ALS or determine the site of onset in individuals pre-disposed to ALS.