Pain and temperature processing in dementia: a clinical and neuroanatomical analysis
Phillip D. Fletcher,Laura E. Downey,Hannah L. Golden,Camilla N. Clark,Catherine F. Slattery,Ross W. Paterson,Jonathan D. Rohrer,Jonathan M. Schott,Martin N. Rossor,Jason D. Warren +9 more
TLDR
Using a semi-structured caregiver questionnaire and MRI voxel-based morphometry in patients with frontotemporal degeneration or Alzheimer’s disease, Fletcher et al. show that symptoms are underpinned by atrophy in a distributed thalamo-temporo-insular network implicated in somatosensory processing.Abstract:
Symptoms suggesting altered processing of pain and temperature have been described in dementia diseases and may contribute importantly to clinical phenotypes, particularly in the frontotemporal lobar degeneration spectrum, but the basis for these symptoms has not been characterized in detail. Here we analysed pain and temperature symptoms using a semi-structured caregiver questionnaire recording altered behavioural responsiveness to pain or temperature for a cohort of patients with frontotemporal lobar degeneration (n = 58, 25 female, aged 52-84 years, representing the major clinical syndromes and representative pathogenic mutations in the C9orf72 and MAPT genes) and a comparison cohort of patients with amnestic Alzheimer's disease (n = 20, eight female, aged 53-74 years). Neuroanatomical associations were assessed using blinded visual rating and voxel-based morphometry of patients' brain magnetic resonance images. Certain syndromic signatures were identified: pain and temperature symptoms were particularly prevalent in behavioural variant frontotemporal dementia (71% of cases) and semantic dementia (65% of cases) and in association with C9orf72 mutations (6/6 cases), but also developed in Alzheimer's disease (45% of cases) and progressive non-fluent aphasia (25% of cases). While altered temperature responsiveness was more common than altered pain responsiveness across syndromes, blunted responsiveness to pain and temperature was particularly associated with behavioural variant frontotemporal dementia (40% of symptomatic cases) and heightened responsiveness with semantic dementia (73% of symptomatic cases) and Alzheimer's disease (78% of symptomatic cases). In the voxel-based morphometry analysis of the frontotemporal lobar degeneration cohort, pain and temperature symptoms were associated with grey matter loss in a right-lateralized network including insula (P < 0.05 corrected for multiple voxel-wise comparisons within the prespecified anatomical region of interest) and anterior temporal cortex (P < 0.001 uncorrected over whole brain) previously implicated in processing homeostatic signals. Pain and temperature symptoms accompanying C9orf72 mutations were specifically associated with posterior thalamic atrophy (P < 0.05 corrected for multiple voxel-wise comparisons within the prespecified anatomical region of interest). Together the findings suggest candidate cognitive and neuroanatomical bases for these salient but under-appreciated phenotypic features of the dementias, with wider implications for the homeostatic pathophysiology and clinical management of neurodegenerative diseases.read more
Citations
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Editorial: Pathophysiologic Insights From Biomarker Studies in Neurological Disorders.
TL;DR: This work aims to demonstrate the efforts towards in-situ applicability of EMMARM, as to provide real-time information about the “physiological underpinnings” of multiple sclerosis.
Journal ArticleDOI
Somatic Symptom Disorder in Semantic Dementia: The Role of Alexisomia.
TL;DR: It is found that semantic dementia, a disorder of semantic knowledge, is associated with somatic symptom disorder from impaired identification of somatic sensations, or "alexisomia," which results in disproportionate and persistent concern about somatic sensation with consequent significant disability.
Journal ArticleDOI
Sleep symptoms in syndromes of frontotemporal dementia and Alzheimer’s disease: A proof-of-principle behavioural study
Tara Puspitarini Sani,Tara Puspitarini Sani,Rebecca L. Bond,Charles R. Marshall,Charles R. Marshall,Chris J.D. Hardy,Lucy L. Russell,Katrina M. Moore,Catherine F. Slattery,Ross W. Paterson,Ione O.C. Woollacott,Indra Putra Wendi,Sebastian J. Crutch,Jonathan M. Schott,Jonathan D. Rohrer,Sofia H Eriksson,Derk-Jan Dijk,Jason D. Warren +17 more
TL;DR: Sleep is a key concern in dementias but their sleep phenotypes are not well defined, so this issue was addressed in major FTD and AD syndromes versus healthy older controls and sleep symptoms were frequent.
Book ChapterDOI
Central neural substrates involved in temperature discrimination, thermal pain, thermal comfort, and thermoregulatory behavior.
TL;DR: A phylogenetically novel pathway that emerged with primate encephalization is described, which conveys high-fidelity cutaneous thermosensory activity in "labeled lines" to a somatotopic map in the dorsal posterior insular cortex.
Journal ArticleDOI
Neural correlates of changes in sexual function in frontotemporal dementia: implications for reward and physiological functioning.
Rebekah M. Ahmed,Rebekah M. Ahmed,Zoë-Lee Goldberg,Cassandra Kaizik,Cassandra Kaizik,Matthew C. Kiernan,Matthew C. Kiernan,John R. Hodges,Olivier Piguet,Muireann Irish +9 more
TL;DR: Counter to the prevailing view, younger-onset dementia syndromes predominantly display an attenuation in sexual drive, which likely reflects the degeneration of cortical and subcortical neural circuits implicated in reward, autonomic function, empathy, and emotional processing.
References
More filters
Journal ArticleDOI
An automated labeling system for subdividing the human cerebral cortex on MRI scans into gyral based regions of interest.
Rahul S. Desikan,Florent Ségonne,Bruce Fischl,Bruce Fischl,Brian T. Quinn,Bradford C. Dickerson,Deborah Blacker,Randy L. Buckner,Randy L. Buckner,Anders M. Dale,R. Paul Maguire,Bradley T. Hyman,Marilyn S. Albert,Ronald J. Killiany +13 more
TL;DR: An automated labeling system for subdividing the human cerebral cortex into standard gyral-based neuroanatomical regions is both anatomically valid and reliable and may be useful for both morphometric and functional studies of the cerebral cortex.
Journal ArticleDOI
A fast diffeomorphic image registration algorithm
TL;DR: DARTEL has been applied to intersubject registration of 471 whole brain images, and the resulting deformations were evaluated in terms of how well they encode the shape information necessary to separate male and female subjects and to predict the ages of the subjects.
Journal ArticleDOI
Dissociable Intrinsic Connectivity Networks for Salience Processing and Executive Control
William W. Seeley,Vinod Menon,Alan F. Schatzberg,Jennifer Keller,Gary H. Glover,Heather A. Kenna,Allan L. Reiss,Michael D. Greicius +7 more
TL;DR: Two distinct networks typically coactivated during functional MRI tasks are identified, anchored by dorsal anterior cingulate and orbital frontoinsular cortices with robust connectivity to subcortical and limbic structures, and an “executive-control network” that links dorsolateral frontal and parietal neocortices.
Journal ArticleDOI
How do you feel--now? The anterior insula and human awareness.
TL;DR: New findings suggest a fundamental role for the AIC (and the von Economo neurons it contains) in awareness, and thus it needs to be considered as a potential neural correlate of consciousness.
Journal ArticleDOI
How do you feel? Interoception: the sense of the physiological condition of the body.
TL;DR: Functional anatomical work has detailed an afferent neural system in primates and in humans that represents all aspects of the physiological condition of the physical body that might provide a foundation for subjective feelings, emotion and self-awareness.
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