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White matter connection's damage, not cortical activation, leading to language dysfunction of mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes
First author：Ye Na
Corresponding author：Zhang Yu-Mei
essential_information
2019-03-05
Published articles
Journal：Chinese Medical Journal
Publication type: Clinical Observation
IF(IF): 2.628
PMID: 30707182 Link To Pubmed Full text Download
Background And Purpose
Method
Mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes (MELAS) is a metabolic disorder characterized by hyperlactic acidemia and stroke-like symptoms.[1] The clinical symptoms of MELAS are complex and diverse, with an incidence of 39.47% of aphasia.[2] MELAS is often considered to be gray matter damage, little studies investigated its white matter changes. However, many studies have shown that for stroke patients, white matter played an important role in language dysfunction, especially in conductive aphasia.[3] Therefore, language function disorder is an ideal target for exploring white matter's role in MELAS. This study aimed to discover which damage caused the abnormal symptoms in a particular case. First, we measured grey and white matter sizes of the MELAS patient and controls. Second, we investigated the cortical activation's decrease (based on a Blood oxygenation level dependent functional magnetic resonance imaging [BOLD-fMRI], white matter connections’ damage (based on diffusion tensor imaging [DTI]) and proposed a hypothesis about which of them may be the most likely cause by comparing the two together. This was first done worldwide.
Conclusion
Mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes (MELAS) is a metabolic disorder characterized by hyperlactic acidemia and stroke-like symptoms.[1] The clinical symptoms of MELAS are complex and diverse, with an incidence of 39.47% of aphasia.[2] MELAS is often considered to be gray matter damage, little studies investigated its white matter changes. However, many studies have shown that for stroke patients, white matter played an important role in language dysfunction, especially in conductive aphasia.[3] Therefore, language function disorder is an ideal target for exploring white matter's role in MELAS. This study aimed to discover which damage caused the abnormal symptoms in a particular case. First, we measured grey and white matter sizes of the MELAS patient and controls. Second, we investigated the cortical activation's decrease (based on a Blood oxygenation level dependent functional magnetic resonance imaging [BOLD-fMRI], white matter connections’ damage (based on diffusion tensor imaging [DTI]) and proposed a hypothesis about which of them may be the most likely cause by comparing the two together. This was first done worldwide.