Damage to the Frontal Aslant Tract Accounts for Visuo-Constructive Deficits in Alzheimer’s Disease
Article type: Research Article
Authors: Serra, Lauraa; * | Gabrielli, Giulia Bechia | Tuzzi, Elisaa | Spanò, Barbaraa | Giulietti, Giovannia | Failoni, Virginiaa | Marra, Camillob | Caltagirone, Carloc; d | Koch, Giacomoc; d | Cercignani, Maraa; e | Bozzali, Marcoa; e
Affiliations:
[a] Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
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[b] Institute of Neurology, Catholic University, Rome, Italy
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[c] Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
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[d] Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome, Italy
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[e] Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
Correspondence:
[*]
Correspondence to: Dr. Laura Serra, Via Ardeatina 306, 00179 Rome, Italy. Tel.: +39 06 5150 1493; Fax: +39 06 5150 1213; E-mail: [email protected].
Abstract: The frontal aslant tract (FAT) has been described as a bundle connecting the Broca’s area to the supplementary motor area (SMA) and the pre-SMA in both hemispheres. The functional properties of this tract and its role in degenerative dementia, such as Alzheimer’s disease (AD), still need to be fully clarified. The aim of this study was to explore the microstructural integrity of the FAT in patients with AD and its potential relationship with cognitive functioning. Twenty-three patients with AD and 25 healthy subjects (HS) were enrolled. All subjects underwent cognitive and MRI examination. MRI, including diffusion sequences, was used for probabilistic tractography analysis. We reconstructed individual FATs bilaterally and assessed their microstructural integrity using fractional anisotropy (FA), computed as both mean tract value and voxel-wise using SPM-8. Mean FA values were then used to test for correlations with cognitive measures. Mean tract FA and voxel-wise analyses revealed that patients with AD, compared to HS, had decreased FA in the FAT bilaterally. In addition, positive associations were found between FA in the FATs and patients’ performance at tests for constructional praxis and visuospatial logical reasoning. The present results reveal a bilateral damage of FAT in AD patients. The association between FATs’ microscopic abnormalities and constructive abilities fits well with the knowledge of a functional involvement of SMA and pre-SMA in movement sequences when executing constructive praxis tasks. The FAT is an associative bundle critically involved in the network sub-serving constructional praxis in patients with AD.
Keywords: Alzheimer’s disease, disconnection, frontal aslant tract, tractography, visuo-spatial abilities
DOI: 10.3233/JAD-170638
Journal: Journal of Alzheimer's Disease, vol. 60, no. 3, pp. 1015-1024, 2017
Accepted 31 July 2017
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Published: 3 October 2017
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