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Abstract Details

Structural and Functional Brain Reorganization Related to Cognitive Impairment in Amyotrophic Lateral Sclerosis
Neuromuscular and Clinical Neurophysiology (EMG)
P5 - Poster Session 5 (8:00 AM-9:00 AM)
1-012

To evaluate the impact of cognitive impairment on structural and functional brain organization in patients with amyotrophic lateral sclerosis (ALS).
ALS is a disease characterized by motor system degeneration. Nevertheless, patients might also develop cognitive and/or behavioural symptoms.
74 ALS patients and 61 age- and sex-matched controls underwent clinical and cognitive evaluations, as well as diffusion tensor and resting-state functional magnetic resonance imaging. Neuropsychological testing was used to identify two subgroups of ALS patients: 54 ALS pure motor (ALS-pure) and 20 ALS with cognitive and/or behavioural impairment (ALS-plus). Graph analysis and connectomics assessed structural and functional topological network properties at global, lobar and connection-wise level. 
Both ALS-pure and ALS-plus showed a relatively preserved structural and functional architecture at the global level relative to controls. At the lobar level, both patient groups demonstrated lower structural clustering coefficient within the sensorimotor network relative to controls. In addition, ALS-plus patients showed higher functional mean nodal strength, local efficiency and clustering coefficient in the sensorimotor regions compared to controls. Regarding the connection-wise analysis, ALS-pure showed significant structural changes relative to controls involving connections within sensorimotor and basal ganglia regions. When comparing controls with ALS-plus patients, the latter showed a non-significant trend of structural alterations within the motor regions and significantly increased functional connectivity involving the connections within the sensorimotor, anterior frontal, temporal and parieto-occipital areas. 

While it is well-known that structural disruption of the sensorimotor network is a common signature of ALS, the occurrence of cognitive impairment is characterized by further functional connectivity changes involving motor and extra-motor brain areas. Graph analysis and connectomics turned out to be suitable tools to better characterize and identify patterns of ALS with cognitive impairment.
Authors/Disclosures
Massimo Filippi, MD, FÂ鶹´«Ã½Ó³»­ (Ospedale San Raffaele, Neuroimaging Research Unit)
PRESENTER 		Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Edoardo G. Spinelli, MD Dr. Spinelli has nothing to disclose.
Camilla Cividini, MSc (San Raffaele Scientific Institute, Vita-Salute San Raffaele University) Ms. Cividini has nothing to disclose.
Silvia Basaia Silvia Basaia has nothing to disclose.
Elisa Canu (Ospedale San Raffaele) The institution of Elisa Canu has received research support from Italian Ministry of Health .
Veronica Castelnovo, MSc (San Raffaele Scientific Institute, Vita-Salute San Raffaele University) Dr. Castelnovo has nothing to disclose.
No disclosure on file
Yuri Falzone Yuri Falzone has nothing to disclose.
Federica Agosta (San Raffaele Scientific Institute) Federica Agosta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Philips. Federica Agosta has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier INC.