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Neuroimage Clin. 2017 Jan 24;14:269-276. doi: 10.1016/j.nicl.2017.01.024. eCollection 2017.

Longitudinal evaluation of cerebral and spinal cord damage in Amyotrophic Lateral Sclerosis.

Author information

1
Department of Neurology and Neuroimaging Laboratory, School of Medical Sciences, University of Campinas - UNICAMP Rua Tessália Vieira de Camargo, 126, Cidade Universitaria "Zeferino Vaz" Campinas, SP 13083-887, Brazil.

Abstract

OBJECTIVE:

To evaluate MRI-based parameters as biomarkers of Amyotrophic Lateral Sclerosis (ALS) progression.

METHODS:

Twenty-seven patients and 27 controls performed two clinical and MRI acquisitions 8 months apart. ALSFRS-R scale was used to quantify disease severity at both time points. Multimodal analyses of MRI included cortical thickness measurements (FreeSurfer software), analysis of white matter integrity using diffusion-tensor imaging (tract-based spatial statistics-TBSS) and measurement of cervical spinal cord cross-sectional area (SpineSeg software). All analyses were corrected for multiple comparisons. The standardized response mean (SRM = mean score change / standard deviation of score change) was calculated for all methods herein employed and used for comparison purposes.

RESULTS:

There were 18 men and mean age at first examination was 51.9 years. Mean ALSFRS-R scores at baseline and follow-up were 34.0 and 29.0, respectively. There was no region with progressive cortical thinning, but there was significant brainstem volumetric reduction (p = 0.001). TBSS analyses revealed progressive increase of AD (axial diffusivity) and MD (mean diffusivity) at the corpus callosum (p < 0.05), whereas SpineSeg showed progressive cord area reduction (p = 0.002). Cervical spinal cord cross-sectional area reduction was the only MRI parameter that correlated with ALSFRS-R change (r = 0.309, p = 0.038). SRM for ALSFRS-R was 0.95, for cord area 0.95, for corpus callosum AD 0.62 and MD 0.65, and for brainstem volume 0.002.

CONCLUSIONS:

Structural MRI is able to detect short term longitudinal changes in ALS. Cervical spinal cord morphometry is a promising neuroimaging marker to assess ALS course.

KEYWORDS:

Amyotrophic Lateral Sclerosis; Cortical thickness; MRI; Spinal cord; TBSS

PMID:
28203530
PMCID:
PMC5294732
DOI:
10.1016/j.nicl.2017.01.024
[Indexed for MEDLINE]
Free PMC Article

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