Patterns of brain regional functional coherence in cognitive impaired ALS

Background: The aim of the study is to reveal the brain regional functional coherence alterations in the early-stage amyotrophic lateral sclerosis (ALS) patients with cognitive impairments.Methods: Resting state functional MRI (fMRI) was performed to characterize the amplitude of regional homogeneity (ReHo). Twenty-one ALS patients with cognitive impairments (ALSci), 21 ALS patients without cognitive impairments (ALSnci) and 21 healthy controls (HCs) were enrolled.Result: Compared with HCs, the ALSci subgroup showed increased ReHo in bilateral inferior parietal lobules (IPLs), precuneus and inferior cerebellar areas, and the ALSnci subgroup had increased ReHo in the left IPL and left inferior cerebellar area. The ALSci subgroup also had increased ReHo in the right IPL and right inferior cerebellar area relative to the ALSnci subgroup. Meantime, compared with HCs, both ALS subgroups showed decreased ReHo in bilateral sensorimotor cortices. The ReHo values in the right cerebellar area were negatively correlated with the Chinese version of Addenbrooke Cognitive Examination-revised (ACE-R) total scores in all ALS patients. In addition, the grey matter (GM) volume revealed no significant difference among three groups, which indicated that the altered ReHo was not caused by the anatomic change.Conclusion: The altered regional functional coherence might indicate the underlying deficits of ALS with and without cognitive impairments. Our findings support that ALS is a multisystem disease and provide the evidence that alterations of ReHo in the right inferior cerebellar area might be a special marker of ALS with cognitive impairment. Our results are preliminary and further investigations are needed.