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  Unraveling corticobasal syndrome and alien limb syndrome with structural brain imaging

Albrecht, F., Mueller, K., Ballarini, T., Lampe, L., Diehl-Schmid, J., Fassbender, K., et al. (2019). Unraveling corticobasal syndrome and alien limb syndrome with structural brain imaging. Cortex, 117, 33-40. doi:10.1016/j.cortex.2019.02.015.

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Albrecht, Franziska1, Author           
Mueller, Karsten2, Author           
Ballarini, Tommaso1, Author           
Lampe, Leonie1, 3, Author           
Diehl-Schmid, Janine4, 5, Author
Fassbender, Klaus4, 6, Author
Fliessbach, Klaus 4, 7, Author
Jahn, Holger 4, 8, Author
Jech, Robert9, Author
Kassubek, Jan 4, 10, Author
Kornhuber, Johannes 4, 11, Author
Landwehrmeyer, Bernhard 10, Author
Lauer, Martin 4, 12, Author
Ludolph, Albert C. 10, Author
Lyros, Epameinondas4, 6, Author
Prudlo, Johannes 4, 13, Author
Schneider, Anja 4, 7, Author
Synofzik, Matthis 4, 14, 15, Author
Wiltfang, Jens 4, 16, Author
Danek, Adrian 4, 17, Author
Otto, Markus4, 10, AuthorFTLD-Consortium, Author              Schroeter, Matthias L.1, 3, 4, Author            more..
1Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_634549              
2Methods and Development Unit Nuclear Magnetic Resonance, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_634558              
3Clinic for Cognitive Neurology, University of Leipzig, Germany, ou_persistent22              
4German Consortium for Frontotemporal Lobar Degeneration (FTLD), Germany, ou_persistent22              
5Departments of Psychiatry and Psychotherapy, TU Munich, Germany, ou_persistent22              
6Clinic for Neurology, Saarland University, Saarbrücken, Germany, ou_persistent22              
7Department of Neurodegenerative Disease and Geriatric Psychiatry, University Hospital Bonn, Germany, ou_persistent22              
8Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany, ou_persistent22              
9Department of Neurology, First Faculty of Medicine, Charles University, Prague, Czech Republic, ou_persistent22              
10Department of Neurology, Ulm University, Germany, ou_persistent22              
11Department of Psychology and Psychotherapy, Friedrich Alexander University Erlangen, Germany, ou_persistent22              
12Clinic for Psychiatry, Psychosomatic Medicine and Psychotherapy, Julius Maximilian University, Würzburg, Germany, ou_persistent22              
13Department of Neurology, University Medicine Rostock, Germany, ou_persistent22              
14Hertie-Institute for Clinical Brain Research, Eberhard Karls University Tübingen, Germany, ou_persistent22              
15German Center for Neurodegenerative Diseases, Tübingen, Germany, ou_persistent22              
16University Medical Center, Göttingen, Germany, ou_persistent22              
17Department of Neurology, Ludwig Maximilians University Munich, Germany, ou_persistent22              


Free keywords: Alien limb syndrome; Anarchic limb syndrome; Corticobasal syndrome; Diagnosis prediction; Support vector machine
 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.


Language(s): eng - English
 Dates: 2018-12-032018-08-102019-02-152019-02-252019-08
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1016/j.cortex.2019.02.015
PMID: 30927559
Other: Epub ahead of print
 Degree: -



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Project name : German Consortium for Frontotemporal Lobar Degeneration
Grant ID : O1GI1007A
Funding program : -
Funding organization : German Federal Ministry of Education and Research (BMBF)
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Grant ID : PDF-IRG-1307
Funding program : -
Funding organization : Parkinson's Disease Foundation
Project name : -
Grant ID : 11362
Funding program : -
Funding organization : Michael Fox Foundation
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Grant ID : SCHR 774/5-1
Funding program : -
Funding organization : German Research Foundation
Project name : -
Grant ID : -
Funding program : -
Funding organization : Else Kröner-Fresenius-Stiftung
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Grant ID : -
Funding program : -
Funding organization : International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity (IMPRS NeuroCom)
Project name : -
Grant ID : 16-13323S
Funding program : -
Funding organization : Czech Science Foundation GAČR

Source 1

Title: Cortex
  Other : Cortex
Source Genre: Journal
Publ. Info: Milan [etc.] : Elsevier Masson SAS
Pages: - Volume / Issue: 117 Sequence Number: - Start / End Page: 33 - 40 Identifier: ISSN: 0010-9452
CoNE: https://pure.mpg.de/cone/journals/resource/954925393344