Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive loss of upper and lower motor neurons. Biomarkers are needed to improve diagnosis, gauge progression, and evaluate treatment. Diffusion tensor imaging (DTI) is a promising biomarker for detecting microstructural alterations in the white matter tracts. This study aimed to assess DTI metrics as biomarkers and to examine their relationship with clinical assessments in patients with ALS. Eleven patients with ALS and 21 healthy controls (HCs) underwent 3T MRI with DTI. DTI metrics, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD), were compared between key motor and extramotor tract groups. Group comparisons and correlations between DTI metrics also correlated with clinical scores of disability (ALSFRS-R), muscle strength (dynamometry), and motor unit loss (MUNIX). Widespread differences were found between patients with ALS and HCs in DTI metrics, including decreased FA and increased diffusivity metrics. However, MD and RD are more sensitive metrics for detecting white matter changes in patients with ALS. Significant interhemispheric correlations between the tract DTI metrics were also observed. DTI metrics showed symmetry between the hemispheres and correlated with the clinical assessments. MD, RD, and AD increases significantly correlated with lower ALSFRS-R and MUNIX scores and weaker dynamometry results. DTI reveals microstructural damage along the motor and extramotor regions in ALS patients. DTI metrics can serve as quantitative neuroimaging biomarkers for diagnosis, prognosis, monitoring of progression, and treatment. Combined analysis of imaging, electrodiagnostic, and functional biomarkers shows potential for characterizing disease pathophysiology and progression.
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive loss of upper and lower motor neurons. Biomarkers are needed to improve diagnosis, gauge progression, and evaluate treatment. Diffusion tensor imaging (DTI) is a promising biomarker for detecting microstructural alterations in the white matter tracts. This study aimed to assess DTI metrics as biomarkers and to examine their relationship with clinical assessments in patients with ALS. Eleven patients with ALS and 21 healthy controls (HCs) underwent 3T MRI with DTI. DTI metrics, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD), were compared between key motor and extramotor tract groups. Group comparisons and correlations between DTI metrics also correlated with clinical scores of disability (ALSFRS-R), muscle strength (dynamometry), and motor unit loss (MUNIX). Widespread differences were found between patients with ALS and HCs in DTI metrics, including decreased FA and increased diffusivity metrics. However, MD and RD are more sensitive metrics for detecting white matter changes in patients with ALS. Significant interhemispheric correlations between the tract DTI metrics were also observed. DTI metrics showed symmetry between the hemispheres and correlated with the clinical assessments. MD, RD, and AD increases significantly correlated with lower ALSFRS-R and MUNIX scores and weaker dynamometry results. DTI reveals microstructural damage along the motor and extramotor regions in ALS patients. DTI metrics can serve as quantitative neuroimaging biomarkers for diagnosis, prognosis, monitoring of progression, and treatment. Combined analysis of imaging, electrodiagnostic, and functional biomarkers shows potential for characterizing disease pathophysiology and progression.
Evidence has linked head trauma to increased risk factors for neuropathology, including acute mechanical deformation of the cortical sulcal fundus and, later, perivascular accumulation of hyperphosphorylated tau (p-tau) adjacent to these spaces related to chronic traumatic encephalopathy (CTE). Despite this, little is known about microstructural abnormalities and cellular dyshomeostasis at the acute stage of mild traumatic brain injury (mTBI) in humans, particularly in the cortex. To address this gap in the literature, we designed the first architectonically-motivated quantitative susceptibility mapping (QSM) study to assess regional patterns of positive (iron-related) and negative (myelin-, calcium-, and protein-related) magnetic susceptibility in cortical regions of interest (ROI) following mTBI. Depth- and curvature-specific positive and negative QSM values were compared between 25 males with acute (< 14 days) sports-related mTBI (sr-mTBI) and 25 age-matched male controls across 34 cortical ROIs. Bilateral between-group analyses were conducted on specific ROI curvature bins (crown, bank, and fundus) as well as a combined curvature measure, across 21 cortical depths, for each ROI. Correlations between positive and negative susceptibility were analysed for age, brain injury severity, and the number of days since injury. We observed significant group differences in magnetic susceptibility for depth, curvature, and ROIs. Our results suggest a trauma-induced pattern of iron deposition preferential to superficial, perivascular-adjacent spaces in the sulci of the parahippocampal gyrus. Co-localised decreases in diamagnetism in the same region suggest dual pathology of neural substrates, the biological mechanisms behind which remain speculative. Significant correlations were found between magnetic susceptibility and age, both in ROIs and cortical depths distinct from those showing sr-mTBI-related differences. Little to no relationship was observed between magnetic susceptibility and subjective markers of injury or injury latency. The coherence between our findings and pathognomonic patterns of misfolded proteins in trauma-related neurodegeneration is interesting, which may have implications for the role of brain iron in microstructural cortical tissue damage after a mild brain injury. Further longitudinal research is needed to elucidate the long-term implications of our findings.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.