Background and purpose Considerable functional reorganization takes place in amyotrophic lateral sclerosis (ALS) in face of relentless structural degeneration. This study evaluates functional adaptation in ALS patients with lower motor neuron predominant (LMNp) and upper motor neuron predominant (UMNp) dysfunction. Methods Seventeen LMNp ALS patients, 14 UMNp ALS patients and 14 controls participated in a functional magnetic resonance imaging study. Study‐group‐specific activation patterns were evaluated during preparation for a motor task. Connectivity analyses were carried out using the supplementary motor area (SMA), cerebellum and striatum as seed regions and correlations were explored with clinical measures. Results Increased cerebellar, decreased dorsolateral prefrontal cortex and decreased SMA activation were detected in UMNp patients compared to controls. Increased cerebellar activation was also detected in UMNp patients compared to LMNp patients. UMNp patients exhibit increased effective connectivity between the cerebellum and caudate, and decreased connectivity between the SMA and caudate and between the SMA and cerebellum when performing self‐initiated movement. In UMNp patients, a positive correlation was detected between clinical variables and striato‐cerebellar connectivity. Conclusions Our findings indicate that, despite the dysfunction of SMA–striatal and SMA–cerebellar networks, cerebello‐striatal connectivity increases in ALS indicative of compensatory processes. The coexistence of circuits with decreased and increased connectivity suggests concomitant neurodegenerative and adaptive changes in ALS.

Our findings highlight that the ALS functional rating scale (ALSFRS-r) does not account for extrapyramidal deficits, which are major contributors to gait impairment in a subset of ALS patients. Basal ganglia degeneration in ALS does not only contribute to cognitive and behavioural deficits, but also adds to the heterogeneity of motor disability.

Background: Gait impairment is poorly characterized in amyotrophic lateral sclerosis (ALS), despite increasing evidence of extrapyramidal and cerebellar dysfunction. Gait impairment adds to the considerable motor disability of ALS patients and requires targeted multidisciplinary interventions. Purpose: To assess gait imagery-specific networks and functional adaptation in ALS. Study Type: Prospective. Population: Seventeen ALS patients with lower motor neuron predominant (LMNp) disability, 14 patients with upper motor neurons predominant (UMNp) disease, and 14 healthy controls were included. Field Strength/Sequences: 3T / gradient echo echo planar (GE-EPI). Assessment: Subjects performed a dual motor imagery task: normal and precision gait. The Movement Imagery Questionnaire-Revised Second Version (MIQ-rs) was used to appraise movement imagery in each participant. Study group-specific activation patterns were evaluated during motor imagery of gait. Additional generalized psychophysiological interaction analyses were carried out using the supplementary motor area, caudate, cerebellum, and superior parietal lobule as seed regions. Statistical Tests: Repeated-measures analysis of variance (ANOVA) was used to compare time imagery and MIQ-rs scores between groups. Size effects were also reported as partial eta squared (η2). One-way ANOVA was performed to explore differences in terms of connexions during motor imagery tasks. Results: A significant increase in imagery time in UMNp patients compared to controls (P < 0.05) and LMNp (P < 0.05) during imagined gait was demonstrated. UMNp patients exhibited altered supplementary motor area, precentral gyrus, superior parietal lobule, and dorsolateral prefrontal cortex activation and increased orbitofrontal (pFDR (False Discovery Rate) < 0.05), posterior parietal (pFDR < 0.05) caudate (pFDR < 0.05), and cerebellar (pFDR < 0.05) signal during imagined locomotion. Increased effective connectivity of the striato-cerebellar and parieto-cerebellar circuits was also demonstrated. Additional activation was detected in the insula and cingulate cortex. Data Conclusion: Enhanced striato-and parieto-cerebellar networks in UMNp ALS patients are likely to represent a compensatory response to impaired postural control. Level of Evidence: 2 Technical Efficacy Stage: 5

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The total concentration and the speciation of heavy metals (Pb, Cd, Cu, Zn, Ni, and Cr) in surface sediments of Rades-Hamam Lif coast were determined, with particular focus on the effect that urban and industrial waste in the Meliane river has on the estuary and coastal surface sediments of the Rades-Hamam Lif coast, off the Mediterranean Sea. Several geochemical indices were applied to assess the risk of contamination and the environmental risks of heavy metals on surface sediments. The total concentrations of these heavy metals are influenced by runoff, industrial, and urban wastewater. The Cd, Pb, Zn, and Ni are affected by anthropogenic sources, especially at the mouth of the Meliane river. The sequential extraction of Cd was presented dominantly in the exchangeable fraction and thus the high potential bioavailability. In contrast, Cr and Cu were mostly bound to the residual fraction indicating their low toxicity and bioavailability. The order of migration and transformation sequence was Cd > Pb > Ni > Zn > Cr > Cu, and the degree of pollution was Cd > Pb > Ni > Zn > Cr > Cu.