Hemispheric asymmetry in neurodegenerative diseases.

Q2 Medicine

Handbook of clinical neurology Pub Date : 2025-01-01 DOI:10.1016/B978-0-443-15646-5.00009-9

Stefano F Cappa

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Abstract

Hemispheric asymmetry in pathologic involvement is frequently observed in neurodegenerative disorders (NDD) and is responsible for differences in cognitive and motor clinical manifestations in individual patients. While asymmetry is modest in typical Alzheimer disease (AD), atypical AD presentations with prominent language impairment [logopenic/phonologic variant of primary progressive aphasia (L/Phv-PPA)] are associated with prevalent involvement of the language-dominant hemisphere. Similarly, in the frontotemporal dementia-amyotrophic lateral sclerosis (FTD-ALS) spectrum, the semantic (Sv) and nonfluent/agrammatic (Nf/Av) variants of PPA are due to asymmetric pathology involving the language-dominant hemisphere. A reversed (typically right-sided) pattern of asymmetry is often found in conditions associated with prominent disorders of behavior and social cognition (i.e., behavioral variant of frontotemporal degeneration-Bv FTD). Asymmetry is generally modest and less consistent in NDD with prevalent motor manifestations, such as Parkinson disease (PD). Overall, the pattern of hemispheric involvement reflects the network-specific selectivity of NDD and is compatible with the spreading of pathology along connection pathways.

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神经退行性疾病的半球不对称。

病理受累的半球不对称在神经退行性疾病（NDD）中经常观察到，并且是个体患者认知和运动临床表现差异的原因。虽然在典型的阿尔茨海默病（AD）中，不对称性是适度的，但伴有显著语言障碍的非典型AD表现[原发性进行性失语症（L/Phv-PPA）的语音缺失/语音变体]与语言主导半球的普遍受损伤有关。同样，在额颞叶痴呆-肌萎缩侧索硬化症（FTD-ALS）谱系中，PPA的语义（Sv）和非流畅/语法（Nf/Av）变异是由于涉及语言主导半球的不对称病理所致。相反的（典型的右侧）不对称模式经常出现在与显著的行为和社会认知障碍相关的疾病中（即额颞叶变性的行为变异- bv FTD）。不对称通常是适度的，不太一致的NDD与普遍的运动表现，如帕金森病（PD）。总的来说，半球受损伤的模式反映了NDD的网络特异性选择性，并且与病理沿连接通路的传播是相容的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Handbook of clinical neurology Medicine-Neurology (clinical)

CiteScore

4.10

自引率

0.00%

发文量

302

期刊介绍： The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.