White matter lesions associated with the reemergence of grasp reflexes in patients with idiopathic normal pressure hydrocephalus.

IF 6.2 1区医学 Q1 NEUROSCIENCES

Fluids and Barriers of the CNS Pub Date : 2025-10-27 DOI:10.1186/s12987-025-00718-w

Junyan Liu, Shigenori Kanno, Chifumi Iseki, Nobuko Kawakami, Kazuo Kakinuma, Kazuto Katsuse, Shiho Matsubara, Shoko Ota, Keiko Endo, Kentaro Takanami, Shin-Ichiro Osawa, Tomohiro Kawaguchi, Hidenori Endo, Shunji Mugikura, Kyoko Suzuki

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Abstract

Background: The white matter damage inducing the reemergence of grasp reflexes and their potential lateralization remains unstudied. Idiopathic normal pressure hydrocephalus (iNPH), a subcortical dementia, is an ideal model for these investigations. We aim to understand the contributions of white matter to the inhibition of grasp reflexes in patients with iNPH.

Methods: A total of 48 patients (mean age at admission: 77.8 ± 5.2 years; 56% male) with probable iNPH were retrospectively enrolled in this study. The intensity of grasp reflexes was assessed using a four-category classification. A voxel-based morphometric analysis of the fractional anisotropy (FA) maps was conducted to identify responsible regions related to the grasp reflex. The white matter fibers passing through these regions were tracked using fiber-tracking data from fifty age-/sex-matched healthy subjects from the Lifespan Human Connectome Project Aging Study. Fibers with an inter-subject overlap rate > 50% were defined as reliable tracts for further discussion.

Results: Positive grasp reflex was identified in 60% (29/48) of probable iNPH cases. The voxel-based multiple regression analysis revealed that the reflex intensity scores were negatively correlated with FA values in the right frontal subcortical white matter near the anterior horn of the right lateral ventricle. The white matter fibers project through this structure mainly to the posterior parts of the right superior, middle, and inferior frontal gyri; the bilateral presupplementary motor areas; the right dorsal anterior cingulate cortex; the ventral lateral nuclei of the bilateral thalami; the pulvinar inferior nucleus of the right thalamus; the lateral part of the right putamen; and the right subthalamic nucleus.

Conclusion: The inhibition of grasp reflexes is achieved via a right-lateralized prefrontal cortex-basal ganglia-thalamocortical 'stopping' network.

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特发性常压脑积水患者的抓握反射重现与白质病变相关。

背景：脑白质损伤诱导抓握反射的重新出现及其潜在的侧化仍未被研究。特发性常压脑积水（iNPH）是一种皮层下痴呆，是这些研究的理想模型。我们的目的是了解白质对iNPH患者抓握反射的抑制作用。方法：回顾性分析48例可能患有iNPH的患者（入院时平均年龄77.8±5.2岁，56%为男性）。用四类分类法评估抓握反射的强度。对分数各向异性（FA）图进行了基于体素的形态计量学分析，以确定与抓握反射相关的负责区域。通过对50名年龄/性别匹配的健康受试者的纤维追踪数据，研究人员对穿过这些区域的白质纤维进行了追踪。这些受试者来自“寿命人类连接组项目衰老研究”。受试者间重叠率为bbbb50 %的纤维被定义为可靠的束，供进一步讨论。结果：60%（29/48）的疑似iNPH病例出现抓握反射阳性。基于体素的多元回归分析显示，右侧侧脑室前角附近右侧额叶皮层下白质反射强度评分与FA值呈负相关。白质纤维主要通过该结构投射到右侧额上回、中回和额下回的后部；双侧辅助前运动区；右侧前扣带皮层背侧；双侧丘脑腹外侧核；右丘脑枕下核；右侧壳核外侧部分；右边的丘脑下核。结论：抓握反射的抑制是通过右侧前额叶皮层-基底神经节-丘脑皮质“停止”网络实现的。

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来源期刊

Fluids and Barriers of the CNS Neuroscience-Developmental Neuroscience

CiteScore

10.70

自引率

8.20%

发文量

审稿时长

14 weeks

期刊介绍： "Fluids and Barriers of the CNS" is a scholarly open access journal that specializes in the intricate world of the central nervous system's fluids and barriers, which are pivotal for the health and well-being of the human body. This journal is a peer-reviewed platform that welcomes research manuscripts exploring the full spectrum of CNS fluids and barriers, with a particular focus on their roles in both health and disease. At the heart of this journal's interest is the cerebrospinal fluid (CSF), a vital fluid that circulates within the brain and spinal cord, playing a multifaceted role in the normal functioning of the brain and in various neurological conditions. The journal delves into the composition, circulation, and absorption of CSF, as well as its relationship with the parenchymal interstitial fluid and the neurovascular unit at the blood-brain barrier (BBB).