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Manifestations extra-motrices dans la sclérose latérale amyotrophique : quelles atteintes cliniques et cérébrales et quelles évolutions avec le temps ?

Abstract : Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with motor and non-motor manifestations. If non-motor manifestations are well recognized, questions remain around their evolution during the illness. The assessment of patients’ psychological state is surprising in that subjects present infrequently psychiatric disorders, which raises the question of specificity related to the disease. Anatomical lesions of the gray matter (GM) in ALS are well described, but their evolution as well as the links between these disorders and the clinical signs are less known. Through two original studies, we have focused on describing the profile of the extra-motor signs and the psychological state as well as their evolution in a group of patients. We searched for the links between cognitive, emotional and psychological manifestations. We were interested in looking for changes of GM as well as the evolution of those. Finally, we looked for potential correlations between extra-motor changes and GM volume and cortical thickness (CTH). While at diagnosis, alterations to executive functions were present in nearly 40% of patients, at follow-up there was no degradation of these functions except for the inhibition capabilities. Patients also exhibit alterations in affective theory of mind and recognition of their own emotions, which seem to protect them from a pathological affective reaction. Reduction of CTH at baseline concerns motor and extra-motor cererbral regions with decline overtime. Extra-motor disorders appear to be subtended by those of specific brain regions.
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Soumia Benbrika. Manifestations extra-motrices dans la sclérose latérale amyotrophique : quelles atteintes cliniques et cérébrales et quelles évolutions avec le temps ?. Psychologie. Normandie Université, 2019. Français. ⟨NNT : 2019NORMC041⟩. ⟨tel-02517623⟩

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