Objective

To evaluate the metabolic correlates of lifetime sport practice in ALS through brain ¹⁸F-FDG-PET.

Methods

131 patients completed a questionnaire about lifetime exposures, including physical activity related to sports, hobbies and occupations, and underwent brain ¹⁸F-FDG-PET. Exposure to sports was expressed as MET (Metabolic Equivalent of Task). We considered only regular practice (at least 2 h/week, for at least three months). We compared brain metabolism between two groups: subjects who did not report regular sport practice during life (N-group) and patients who did (Y-group). The resulting significant clusters were used in each group as seed regions in an interregional correlation analysis (IRCA) to evaluate the impact of lifetime sport practice on brain networks typically involved by the neurodegenerative process of ALS. Each group was compared to healthy controls (HC, n = 40).

Results

We found a significant, relative cerebellar hypermetabolism in the N-group compared to the Y-group. The metabolism of such cerebellar cluster resulted correlated to more significant and widespread metabolic changes in areas known to be affected by ALS (i.e. frontotemporal regions and corticospinal tracts) in the N-group as compared to the Y-group, despite the same level of disability as expressed by the ALS FRS-R. Such findings resulted independent of age, sex, site of onset (bulbar/spinal), presence/absence of C9ORF72 expansion, cognitive status and physical activity related to hobbies and occupations. When compared to HC, the N-group showed more widespread metabolic changes than the Y-group in cortical regions known to be relatively hypometabolic in ALS patients as compared to HC.

Conclusions

We hypothesize that patients of the N-group might cope better with the neurodegenerative process, since they show more widespread metabolic changes as compared to the Y-group, despite the same level of disability. Nevertheless, further studies are necessary to corroborate this hypothesis.

中文翻译：

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终生运动实践和肌萎缩性侧索硬化症的脑代谢。

目的

通过大脑¹⁸ F-FDG-PET评估ALS中终身运动实践的代谢相关性。

方法

131名患者完成了关于终生暴露的问卷，包括与运动，爱好和职业有关的体育锻炼，并接受了脑¹⁸ F-FDG-PET。运动暴露表示为MET（任务的代谢当量）。我们仅考虑常规练习（每周至少2小时，至少三个月）。我们比较了两组之间的脑代谢：一生中未报告常规运动习惯的受试者（N组）和进行过运动的患者（Y组）。产生的重要簇在每个组中用作区域间相关性分析（IRCA）中的种子区域评估终身体育锻炼对通常由ALS的神经退行性过程所涉及的大脑网络的影响。将每组与健康对照（HC，n = 40）进行比较。

结果

我们发现，与Y组相比，N组有明显的相对小脑代谢亢进。尽管有相同程度的残疾，但小脑簇的代谢与N组相比，与N组相比在已知受ALS（即额颞区和皮质脊髓束）影响的区域中与更显着和广泛的代谢变化相关。如ALS FRS-R所述。这些发现与年龄，性别，发病部位（球/脊柱），是否存在C9ORF72扩展，认知状态以及与嗜好和职业有关的体育活动无关。与HC相比，在ALS患者中，与HC相比，N组的代谢变化比Y组的分布更广泛，这在ALS患者中相对代谢较弱。

结论

我们假设N组患者可能更好地应对神经退行性病变，因为与Y组相比，尽管残疾水平相同，但他们表现出更广泛的代谢变化。然而，需要进一步的研究来证实这一假设。