High-Resolution 7T MR Imaging of the Motor Cortex in Amyotrophic Lateral Sclerosis

Cosottini, Mirco; Donatelli, Graziella; Costagli, Mauro; Ienco, Elena Caldarazzo; Frosini, Daniela; Pesaresi, Ilaria; Biagi, Laura; Siciliano, Gabriele; Tosetti, Michela

doi:10.3174/ajnr.a4562

Cited by 45 publications

(69 citation statements)

References 53 publications

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“…13 Our results agree with previous findings at ultra-high-field MR imaging 13 and confirm the link between the degree of focal cortical atrophy and hypointensity in the motor homunculus and the degree of signs of UMN degeneration in the corresponding limbs. Such results explain why neuroradiologists can correctly diagnose patients with ALS with moderate-to-severe UMN impairment, whereas patients with low or very low UMN burden are misdiagnosed.…”

Section: Results Of Visual Assessment Of 3t and 7t Imagessupporting

confidence: 83%

“…The gray-white matter junction in the M1 is sometimes hardly distinguishable in HS and in patients with mild UMN impairment because of the heavily myelinated deep layers of M1. 13 On the contrary, in patients with ALS with moderate-tosevere UMN impairment, the deep layers of the M1 appear mark- edly more hypointense than the underlying white matter (On-line Fig 1 and Fig 4).…”

Section: Sh/thk Changes In Patients With Als and Correlation With CLImentioning

confidence: 99%

“…They were clinically evaluated by an experienced neurologist on the day of enrollment, and the UMN impairment was quantified for each limb using a clinical composite semiquantitative arbitrary score of UMN burden (UMN score), according to that previously used by Cosottini et al 13 For each patient, the total UMN score (range, 0 -33) and the UMN score of each limb (range, 0 -8) were recorded; then, the average UMN score was calculated as the mean of UMN scores of both arms and legs. Clinical and demographic data of patients are reported in On-line Tables 1-3.…”

Section: Patients With Als and Healthy Subjectsmentioning

confidence: 99%

“…Images were labeled as "nonpathologic" if M1 deep layers were judged to be similar to those of other cortices or "pathologic" if they were markedly more hypointense and thin. 13 After 1 month from the first reading, the same neuroradiologists were asked to again assess the whole set of images.…”

Section: Visual Image Assessmentmentioning

confidence: 99%

“…12 The first attempt to move toward the radiologic diagnosis at the single-subject level was recently performed with an ultrahigh-field MR imaging system (7T). 13 Taking advantage of the very high sensitivity of ultra-high-field strength to the magnetic susceptibility of microglial ferritin, the authors localized pathologic cortical thinning and T2* hypointensity in the deep layers of M1, and they were shown to significantly correlate with the clinical UMN burden. In light of these results, the T2* hyopintensity of M1 was suggested as a possible marker of neuroinflammation and UMN impairment in patients with ALS rather than a marker of the disease.…”

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confidence: 99%

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Semiautomated Evaluation of the Primary Motor Cortex in Patients with Amyotrophic Lateral Sclerosis at 3T

Donatelli¹,

Retico

Ienco

et al. 2017

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Amyotrophic lateral sclerosis is a neurodegenerative disease involving the upper and lower motor neurons. In amyotrophic lateral sclerosis, pathologic changes in the primary motor cortex include Betz cell depletion and the presence of reactive iron-loaded microglia, detectable on 7T MR images as atrophy and T2*-hypointensity. Our purposes were the following: 1) to investigate the signal hypointensity-to-thickness ratio of the primary motor cortex as a radiologic marker of upper motor neuron involvement in amyotrophic lateral sclerosis with a semiautomated method at 3T, 2) to compare 3T and 7T results, and 3) to evaluate whether semiautomated measurement outperforms visual image assessment.

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Section: Results Of Visual Assessment Of 3t and 7t Imagessupporting

confidence: 83%

Section: Sh/thk Changes In Patients With Als and Correlation With CLImentioning

confidence: 99%

Section: Patients With Als and Healthy Subjectsmentioning

confidence: 99%

Section: Visual Image Assessmentmentioning

confidence: 99%

mentioning

confidence: 99%

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Semiautomated Evaluation of the Primary Motor Cortex in Patients with Amyotrophic Lateral Sclerosis at 3T

Donatelli¹,

Retico

Ienco

et al. 2017

AJNR Am J Neuroradiol

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Region‐specific atrophy of precentral gyrus in patients with amyotrophic lateral sclerosis

Qin

Zhang

Jiang

et al. 2017

Magnetic Resonance Imaging

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Purpose: To assess the region-specific atrophy of precentral gyrus (PrCG) and its correlation to clinical function score in amyotrophic lateral sclerosis (ALS). Materials and Methods: Twenty-eight patients with sporadic ALS and 28 healthy controls underwent high-resolution 3D T1-BRAVO magnetic resonance imaging at 3T. The bilateral PrCG segmentations were automatically obtained from a validated segmentation pipeline based on diffeomorphic multi-atlas likelihood fusion. Patients with ALS were further subclassified into early-stage (ALS-e, n 5 22) and late-stage (ALS-l, n 5 6) groups, with 12 months as a disease duration cutoff. Vertex-based shape analysis was performed to quantify the region-specific abnormalities of PrCG in ALS subgroups as compared to controls. In addition, we tested the statistical association between altered PrCG morphometry and clinical disability in ALS as evaluated by the revised ALS Functional Rating Scale (ALSFRS-r). Results: Compared to controls, vertex-wise analysis showed that both ALS-e and ALS-l had significant atrophy of the dorsal-lateral part of PrCG (P < 0.05, uncorrected). Importantly, atrophy in ALS-e was not as widespread as that in ALSl; while atrophy in ALS-e was mostly confined to the dorsal-lateral region (P < 0.05, uncorrected, surface areas exhibiting significant difference at a level of P 5 0.05: left 613.88 mm 2 , right 937.80 mm 2 ), atrophy in ALS-l occurred at the dorsalmedial and ventral region as well (P < 0.05, uncorrected, surface areas exhibiting significant difference at a level of P 5 0.05: left 1465.98 mm 2 , right 1253.89 mm 2 ). Partial correlation analysis showed that the significant surface area atrophy of PrCG in ALS, especially that of the dorsal-lateral portion, was found to link tightly with ALSFRS-r (P < 0.05, uncorrected, surface areas exhibiting significant correlation: left 723.08 mm 2 , right 474.24 mm 2 ). Conclusion: Our findings suggest that an altered PrCG morphometry, especially atrophy of the surface area in the dorsal-lateral portion, may be associated with the dysfunction that characterizes ALS. This study is an initial attempt to apply a validated statistical shape analysis pipeline to cortical gray matter structure like PrCG.

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The role of high‐field magnetic resonance imaging in parkinsonian disorders: Pushing the boundaries forward

et al. 2017

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Historically, magnetic resonance imaging (MRI) has contributed little to the study of Parkinson's disease (PD), but modern MRI approaches have unveiled several complementary markers that are useful for research and clinical applications. Iron‐ and neuromelanin‐sensitive MRI detect qualitative changes in the substantia nigra. Quantitative MRI markers can be derived from diffusion weighted and iron‐sensitive imaging or volumetry. Functional brain alterations at rest or during task performance have been captured with functional and arterial spin labeling perfusion MRI. These markers are useful for the diagnosis of PD and atypical parkinsonism, to track disease progression from the premotor stages of these diseases and to better understand the neurobiological basis of clinical deficits. A current research goal using MRI is to generate time‐dependent models of the evolution of PD biomarkers that can help understand neurodegeneration and provide reliable markers for therapeutic trials. This article reviews recent advances in MRI biomarker research at high‐field (3T) and ultra high field‐imaging (7T) in PD and atypical parkinsonism. © 2017 International Parkinson and Movement Disorder Society.

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High-Resolution 7T MR Imaging of the Motor Cortex in Amyotrophic Lateral Sclerosis

Cited by 45 publications

References 53 publications

Semiautomated Evaluation of the Primary Motor Cortex in Patients with Amyotrophic Lateral Sclerosis at 3T

Semiautomated Evaluation of the Primary Motor Cortex in Patients with Amyotrophic Lateral Sclerosis at 3T

Region‐specific atrophy of precentral gyrus in patients with amyotrophic lateral sclerosis

The role of high‐field magnetic resonance imaging in parkinsonian disorders: Pushing the boundaries forward

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