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Unraveling corticobasal syndrome and alien limb syndrome with structural brain imaging

MPS-Authors
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Albrecht,  Franziska
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Mueller,  Karsten
Methods and Development Unit Nuclear Magnetic Resonance, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Ballarini,  Tommaso
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Lampe,  Leonie
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;
Clinic for Cognitive Neurology, University of Leipzig, Germany;

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Schroeter,  Matthias L.
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;
Clinic for Cognitive Neurology, University of Leipzig, Germany;
German Consortium for Frontotemporal Lobar Degeneration (FTLD), Germany;

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Albrecht_Mueller_2019.pdf
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Citation

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.


Cite as: http://hdl.handle.net/21.11116/0000-0003-4D20-3
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.