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Sako W, Haji S, Abe T, Osaki Y, Matsumoto Y, Harada M, Izumi Y. M1/precuneus ratio as a surrogate marker of upper motor neuron sign in ALS. J Neurol Sci 2023; 445:120548. [PMID: 36640663 DOI: 10.1016/j.jns.2023.120548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate whether primary motor cortex (M1) volume measured with an automated approach in MRI reflects upper motor neuron dysfunction and whether it can serve as a potential diagnostic and/or disease-tracking biomarker for amyotrophic lateral sclerosis (ALS). METHODS In this retrospective study, we enrolled 95 subjects, including 33 possible or laboratory supported probable ALS, 26 probable or definite ALS (Prob/Def), 2 primary lateral sclerosis patients, 8 progressive muscular atrophy patients, 19 normal controls (NC) and 7 ALS patients having a second structural MRI scan. Some subjects also underwent functional MRI. We calculated M1, primary sensory cortex, precuneus volumes, and total gray matter volume (TGMV) with FreeSurfer. The sensorimotor network (SMN) was identified using independent component analysis. RESULTS The M1/precuneus ratio showed a significant difference between the NC and Prob/Def groups (p < 0.05). The diagnostic accuracy of the M1/precuneus ratio was moderate for distinguishing Prob/Def from NC (cutoff = 1.00, sensitivity = 0.42, specificity = 0.90). Two of eight cases without upper motor neuron dysfunction could be diagnosed with ALS using M1/precuneus ratio as a surrogate marker. A negative correlation between M1/precuneus ratio and functional activity was found in Brodmann area 6 in the SMN in all subjects. TGMV tended to decrease with disease progression (p = 0.04). INTERPRETATION The M1/precuneus volume ratio, associated with the SMN, may have potential as a surrogate biomarker of upper motor neuron dysfunction in ALS. Furthermore, TGMV may serve as an ALS disease-tracking biomarker.
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Affiliation(s)
- Wataru Sako
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan; Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
| | - Shotaro Haji
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takashi Abe
- Department of Radiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yusuke Osaki
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yuki Matsumoto
- Department of Radiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masafumi Harada
- Department of Radiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yuishin Izumi
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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Conte G, Sbaraini S, Morelli C, Casale S, Caschera L, Contarino VE, Scola E, Cinnante C, Trogu F, Triulzi F, Silani V. A susceptibility-weighted imaging qualitative score of the motor cortex may be a useful tool for distinguishing clinical phenotypes in amyotrophic lateral sclerosis. Eur Radiol 2020; 31:1281-1289. [PMID: 32886203 DOI: 10.1007/s00330-020-07239-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/21/2020] [Accepted: 08/27/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To distinguish amyotrophic lateral sclerosis (ALS) and its subtypes from ALS mimics and healthy controls based on the assessment of iron-related hypointensity of the primary motor cortex in susceptibility-weighted imaging (SWI). METHODS We enrolled 64 patients who had undergone magnetic resonance imaging studies with clinical suspicions of ALS. The ALS group included 48 patients; the ALS-mimicking disorder group had 16 patients. The ALS group was divided into three subgroups according to the prevalence of upper motor neuron (UMN) or lower motor neuron (LMN) impairment, with 12 subjects in the UMN-predominant ALS group (UMN-ALS), 16 in the LMN-predominant ALS group (LMN-ALS), and 20 with no prevalent impairment (C-ALS). The Motor Cortex Susceptibility (MCS) score was defined according to the hypointensity of the primary motor cortex in the SWI sequence. Its diagnostic accuracy in differentiating groups was evaluated. RESULTS The MCS was higher in the ALS group than in the healthy control and ALS-mimicking disorder groups (p < 0.001). Among ALS subgroups, the MCS was significantly higher in the UMN-ALS group than in the healthy control (p < 0.001), ALS-mimicking disorder (p = 0.002), and LMN-ALS groups (p = 0.002) and higher in the C-ALS group than in the healthy control group (p = 0.019). An MCS value ≥ 2 showed specificity and a positive predictive value of 100% in the detection of both UMN-ALS and C-ALS patients. CONCLUSIONS The assessment of MCS in the SWI sequence could be a useful tool in supporting diagnosis in patients suspicious for ALS with prevalent signs of UMN impairment or with no prevalence signs of UMN or LMN impairment. KEY POINTS • The hypointensity of the primary motor cortex in susceptibility-weighted imaging could support the diagnosis of ALS. • Our new qualitative score called MCS shows high specificity and positive predictive value in differentiating ALS patients with upper motor neuron impairment from patients with ALS-mimicking disorders and healthy controls.
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Affiliation(s)
- Giorgio Conte
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Sara Sbaraini
- Neuroradiology Unit, Department of Radiology, ASST Santi Paolo e Carlo, San Carlo Borromeo Hospital, via Pio II n. 3, Milan, Italy.
| | - Claudia Morelli
- Department of Neurology-Stroke Unit and Laboratory of Neuroscience, Istituto Auxologico Italiano IRCCS, piazzale Brescia 20, Milan, Italy
| | - Silvia Casale
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Luca Caschera
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Valeria Elisa Contarino
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Elisa Scola
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Claudia Cinnante
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Francesca Trogu
- Department of Neurology-Stroke Unit and Laboratory of Neuroscience, Istituto Auxologico Italiano IRCCS, piazzale Brescia 20, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy
| | - Fabio Triulzi
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology-Stroke Unit and Laboratory of Neuroscience, Istituto Auxologico Italiano IRCCS, piazzale Brescia 20, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy
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Barritt AW, Gabel MC, Cercignani M, Leigh PN. Emerging Magnetic Resonance Imaging Techniques and Analysis Methods in Amyotrophic Lateral Sclerosis. Front Neurol 2018; 9:1065. [PMID: 30564192 PMCID: PMC6288229 DOI: 10.3389/fneur.2018.01065] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 11/22/2018] [Indexed: 12/17/2022] Open
Abstract
Objective markers of disease sensitive to the clinical activity, symptomatic progression, and underlying substrates of neurodegeneration are highly coveted in amyotrophic lateral sclerosis in order to more eloquently stratify the highly heterogeneous phenotype and facilitate the discovery of effective disease modifying treatments for patients. Magnetic resonance imaging (MRI) is a promising, non-invasive biomarker candidate whose acquisition techniques and analysis methods are undergoing constant evolution in the pursuit of parameters which more closely represent biologically-applicable tissue changes. Neurite Orientation Dispersion and Density Imaging (NODDI; a form of diffusion imaging), and quantitative Magnetization Transfer Imaging (qMTi) are two such emerging modalities which have each broadened the understanding of other neurological disorders and have the potential to provide new insights into structural alterations initiated by the disease process in ALS. Furthermore, novel neuroimaging data analysis approaches such as Event-Based Modeling (EBM) may be able to circumvent the requirement for longitudinal scanning as a means to comprehend the dynamic stages of neurodegeneration in vivo. Combining these and other innovative imaging protocols with more sophisticated techniques to analyse ever-increasing datasets holds the exciting prospect of transforming understanding of the biological processes and temporal evolution of the ALS syndrome, and can only benefit from multicentre collaboration across the entire ALS research community.
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Affiliation(s)
- Andrew W Barritt
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Falmer, United Kingdom.,Hurstwood Park Neurological Centre Haywards Heath, West Sussex, United Kingdom
| | - Matt C Gabel
- Department of Neuroscience, Trafford Centre for Biomedical Research Brighton and Sussex Medical School, Falmer, United Kingdom
| | - Mara Cercignani
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Falmer, United Kingdom
| | - P Nigel Leigh
- Hurstwood Park Neurological Centre Haywards Heath, West Sussex, United Kingdom.,Department of Neuroscience, Trafford Centre for Biomedical Research Brighton and Sussex Medical School, Falmer, United Kingdom
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Wirth AM, Khomenko A, Baldaranov D, Kobor I, Hsam O, Grimm T, Johannesen S, Bruun TH, Schulte-Mattler W, Greenlee MW, Bogdahn U. Combinatory Biomarker Use of Cortical Thickness, MUNIX, and ALSFRS-R at Baseline and in Longitudinal Courses of Individual Patients With Amyotrophic Lateral Sclerosis. Front Neurol 2018; 9:614. [PMID: 30104996 PMCID: PMC6077217 DOI: 10.3389/fneur.2018.00614] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 07/09/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative process affecting upper and lower motor neurons as well as non-motor systems. In this study, precentral and postcentral cortical thinning detected by structural magnetic resonance imaging (MRI) were combined with clinical (ALS-specific functional rating scale revised, ALSFRS-R) and neurophysiological (motor unit number index, MUNIX) biomarkers in both cross-sectional and longitudinal analyses. Methods: The unicenter sample included 20 limb-onset classical ALS patients compared to 30 age-related healthy controls. ALS patients were treated with standard Riluzole and additional long-term G-CSF (Filgrastim) on a named patient basis after written informed consent. Combinatory biomarker use included cortical thickness of atlas-based dorsal and ventral subdivisions of the precentral and postcentral cortex, ALSFRS-R, and MUNIX for the musculus abductor digiti minimi (ADM) bilaterally. Individual cross-sectional analysis investigated individual cortical thinning in ALS patients compared to age-related healthy controls in the context of state of disease at initial MRI scan. Beyond correlation analysis of biomarkers at cross-sectional group level (n = 20), longitudinal monitoring in a subset of slow progressive ALS patients (n = 4) explored within-subject temporal dynamics of repeatedly assessed biomarkers in time courses over at least 18 months. Results: Cross-sectional analysis demonstrated individually variable states of cortical thinning, which was most pronounced in the ventral section of the precentral cortex. Correlations of ALSFRS-R with cortical thickness and MUNIX were detected. Individual longitudinal biomarker monitoring in four slow progressive ALS patients revealed evident differences in individual disease courses and temporal dynamics of the biomarkers. Conclusion: A combinatory use of structural MRI, neurophysiological and clinical biomarkers allows for an appropriate and detailed assessment of clinical state and course of disease of ALS.
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Affiliation(s)
- Anna M Wirth
- Department of Neurology, University Hospital of Regensburg, Regensburg, Germany.,Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - Andrei Khomenko
- Department of Neurology, University Hospital of Regensburg, Regensburg, Germany
| | - Dobri Baldaranov
- Department of Neurology, University Hospital of Regensburg, Regensburg, Germany
| | - Ines Kobor
- Department of Neurology, University Hospital of Regensburg, Regensburg, Germany
| | - Ohnmar Hsam
- Department of Neurology, University Hospital of Regensburg, Regensburg, Germany
| | - Thomas Grimm
- Department of Neurology, University Hospital of Regensburg, Regensburg, Germany
| | - Siw Johannesen
- Department of Neurology, University Hospital of Regensburg, Regensburg, Germany
| | - Tim-Henrik Bruun
- Department of Neurology, University Hospital of Regensburg, Regensburg, Germany
| | | | - Mark W Greenlee
- Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - Ulrich Bogdahn
- Department of Neurology, University Hospital of Regensburg, Regensburg, Germany
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Vázquez‐Costa JF, Mazón M, Carreres‐Polo J, Hervás D, Pérez‐Tur J, Martí‐Bonmatí L, Sevilla T. Brain signal intensity changes as biomarkers in amyotrophic lateral sclerosis. Acta Neurol Scand 2018; 137:262-271. [PMID: 29082510 DOI: 10.1111/ane.12863] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2017] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To evaluate the contribution of the demographical, clinical, analytical and genetic factors to brain signal intensity changes in T2-weighted MR images in amyotrophic lateral sclerosis (ALS) patients and controls. METHODS Susceptibility-weighted and FLAIR sequences were obtained in a 3T MR scanner. Iron-related hypointensities in the motor cortex (IRhMC) and hyperintensities of the corticospinal tract (HCT) were qualitatively scored. Age, gender, family history and clinical variables were recorded. Baseline levels of ferritin were measured. C9orf72 was tested in all patients and SOD1 only in familial ALS patients not carrying a C9orf72 expansion. Patients who carried a mutation were categorized as genetic. Associations of these variables with visual scores were assessed with multivariable analysis. RESULTS A total of 102 ALS patients (92 non-genetic and 10 genetic) and 48 controls (28 ALS mimics and 20 healthy controls) were recruited. In controls, IRhMC associated with age, but HCT did not. In ALS patients, both HTC and IRhMC strongly associated with clinical UMN impairment and bulbar onset. The intensity/extent of IRhMC in the different motor homunculus regions (lower limbs, upper limbs and bulbar) were linked to the symptoms onset site. Between genetic and sporadic patients, no difference in IRhMC and HCT was found. CONCLUSIONS IRhMC and HCT are reliable markers of UMN degeneration in ALS patients and are more frequent in bulbar onset patients, independently of the mutation status. Age should be considered when evaluating IRhMC. The regional measurement of IRhMC following the motor homunculus could be used as a measure of disease progression.
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Affiliation(s)
- Juan F. Vázquez‐Costa
- Neuromuscular Research Unit Instituto de Investigación Sanitaria la Fe Valencia Spain
- ALS Unit Department of Neurology Hospital Universitario y Politécnico La Fe Valencia Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) Valencia Spain
| | - Miguel Mazón
- Department of Radiology and Biomedical Imaging Research Group GIBI2 Hospital Universitario y Politécnico La Fe and Instituto de Investigación Sanitaria la Fe Valencia Spain
| | - Joan Carreres‐Polo
- Department of Radiology and Biomedical Imaging Research Group GIBI2 Hospital Universitario y Politécnico La Fe and Instituto de Investigación Sanitaria la Fe Valencia Spain
| | - David Hervás
- Biostatistics Unit Instituto de Investigación Sanitaria la Fe Valencia Spain
| | - Jordi Pérez‐Tur
- Laboratory of Molecular Genetics Institut de Biomedicina de València‐CSIC Valencia Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED) Valencia Spain
- Unidad mixta de Neurología y Genética Instituto de Investigación Sanitaria la Fe (IIS La Fe) Valencia Spain
| | - Luis Martí‐Bonmatí
- Department of Radiology and Biomedical Imaging Research Group GIBI2 Hospital Universitario y Politécnico La Fe and Instituto de Investigación Sanitaria la Fe Valencia Spain
| | - Teresa Sevilla
- Neuromuscular Research Unit Instituto de Investigación Sanitaria la Fe Valencia Spain
- ALS Unit Department of Neurology Hospital Universitario y Politécnico La Fe Valencia Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) Valencia Spain
- Department of Medicine University of Valencia Valencia Spain
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6
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Chen J, Kostenko V, Pioro EP, Trapp BD. MR Imaging-based Estimation of Upper Motor Neuron Density in Patients with Amyotrophic Lateral Sclerosis: A Feasibility Study. Radiology 2018; 287:955-964. [PMID: 29361242 DOI: 10.1148/radiol.2018162967] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To determine if magnetic resonance (MR) imaging metrics can estimate primary motor cortex (PMC) motor neuron (MN) density in patients with amyotrophic lateral sclerosis (ALS). Materials and Methods Between 2012 and 2014, in situ brain MR imaging was performed in 11 patients with ALS (age range, 35-81 years; seven women and four men) soon after death (mean, 5.5 hours after death; range, 3.2-9.6 hours). The brain was removed, right PMC (RPMC) was excised, and MN density was quantified. RPMC metrics (thickness, volume, and magnetization transfer ratio) were calculated from MR images. Regression modeling was used to estimate MN density by using RPMC and global MR imaging metrics (brain and tissue volumes); clinical variables were subsequently evaluated as additional estimators. Models were tested at in vivo MR imaging by using the same imaging protocol (six patients with ALS; age range, 54-66 years; three women and three men). Results RPMC mean MN density varied over a greater than threefold range across patients and was estimated by a linear function of normalized gray matter volume (adjusted R2 = 0.51; P = .008; <10% error in most patients). When considering only sporadic ALS, a linear function of normalized RPMC and white matter volumes estimated MN density (adjusted R2 = 0.98; P = .01; <10% error in all patients). In vivo data analyses detected decreases in MN density over time. Conclusion PMC mean MN density varies widely in end-stage ALS possibly because of disease heterogeneity. MN density can potentially be estimated by MR imaging metrics. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Jacqueline Chen
- From the Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195 (J.C., V.K., B.D.T.); and Department of Neurology, Neurologic Institute, Cleveland Clinic, Cleveland, Ohio (E.P.P.)
| | - Volodymyr Kostenko
- From the Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195 (J.C., V.K., B.D.T.); and Department of Neurology, Neurologic Institute, Cleveland Clinic, Cleveland, Ohio (E.P.P.)
| | - Erik P Pioro
- From the Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195 (J.C., V.K., B.D.T.); and Department of Neurology, Neurologic Institute, Cleveland Clinic, Cleveland, Ohio (E.P.P.)
| | - Bruce D Trapp
- From the Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195 (J.C., V.K., B.D.T.); and Department of Neurology, Neurologic Institute, Cleveland Clinic, Cleveland, Ohio (E.P.P.)
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7
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Xu J, Li H, Li C, Yao JC, Hu J, Wang J, Hu Q, Zhang Y, Zhang J. Abnormal cortical-basal ganglia network in amyotrophic lateral sclerosis: A voxel-wise network efficiency analysis. Behav Brain Res 2017; 333:123-128. [DOI: 10.1016/j.bbr.2017.06.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 12/28/2022]
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Terada T, Miyata J, Obi T, Kubota M, Yoshizumi M, Yamazaki K, Mizoguchi K, Murai T. Frontal assessment battery and frontal atrophy in amyotrophic lateral sclerosis. Brain Behav 2017. [PMID: 28638712 PMCID: PMC5474710 DOI: 10.1002/brb3.707] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To determine the potential utility of the frontal assessment battery (FAB) in assessing cognitive impairments in amyotrophic lateral sclerosis (ALS), we investigated the association between the FAB score and regional gray matter volume, and ascertained whether the regional brain alterations related to cognitive impairments occur in relatively mild stage of ALS. MATERIALS AND METHODS Twenty-four ALS patients with a Mini-Mental State Examination score of >23, a normal score on the Self-Rating Depression Scale, little or no disturbance in speech and handling utensils on the ALS Functional Rating Scale (ALSFRS), and normal measures on respiratory tests (respiratory function test and arterial blood gas analysis), and two age-matched normal control groups (one for FAB assessment and the other for brain morphometry) underwent FAB testing and structural magnetic resonance imaging. We applied voxel-based morphometry to investigate the relationship between the FAB score and regional brain alteration, and assessed the relationship between the altered regional brain volume and ALSFRS or respiratory tests. RESULTS Frontal assessment battery scores were significantly lower in ALS patients than in normal controls. Volume reduction in the right orbitofrontal gyrus in ALS was correlated with a lower FAB score. There was no correlation between the right orbitofrontal gyrus volume and ALSFRS or respiratory tests. CONCLUSIONS The results suggest that the FAB is an adequate tool for detecting cognitive impairments related to frontal lobe pathology in the relatively mild stage of ALS, independent of physical dysfunctions.
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Affiliation(s)
- Tatsuhiro Terada
- Department of Neurology Shizuoka Institute of Epilepsy and Neurological Disorders Aoi-ku Shizuoka Japan.,Department of Biofunctional Imaging Medical Photonics Research Centre Hamamatsu University School of Medicine Higashi-ku Hamamatsu Japan
| | - Jun Miyata
- Department of Psychiatry Graduate School of Medicine Kyoto University Sakyo-ku Kyoto Japan
| | - Tomokazu Obi
- Department of Neurology Shizuoka Institute of Epilepsy and Neurological Disorders Aoi-ku Shizuoka Japan
| | - Manabu Kubota
- Department of Psychiatry Graduate School of Medicine Kyoto University Sakyo-ku Kyoto Japan.,Brain Disorder Translational Research Team Department of Functional Brain Imaging Research National Institute of Radiological Sciences National Institutes for Quantum and Radiological Science and Technology Inage-ku Chiba Japan
| | - Miho Yoshizumi
- Department of Psychiatry Graduate School of Medicine Kyoto University Sakyo-ku Kyoto Japan
| | - Kinya Yamazaki
- Department of Neurology Shizuoka Institute of Epilepsy and Neurological Disorders Aoi-ku Shizuoka Japan
| | - Kouichi Mizoguchi
- Department of Neurology Shizuoka Institute of Epilepsy and Neurological Disorders Aoi-ku Shizuoka Japan
| | - Toshiya Murai
- Department of Psychiatry Graduate School of Medicine Kyoto University Sakyo-ku Kyoto Japan
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Kenkel D, Yamada Y, Weiger M, Jungraithmayr W, Wurnig MC, Boss A. Magnetization transfer as a potential tool for the early detection of acute graft rejection after lung transplantation in mice. J Magn Reson Imaging 2016; 44:1091-1098. [DOI: 10.1002/jmri.25266] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 03/25/2016] [Indexed: 12/14/2022] Open
Affiliation(s)
- David Kenkel
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| | - Yoshito Yamada
- Division of Thoracic Surgery; University Hospital Zurich; Switzerland
| | - Markus Weiger
- Institute for Biomedical Engineering, ETH Zurich and University of Zurich; Gloriastrasse 35 CH-8092 Zurich Switzerland
| | | | - Moritz C. Wurnig
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| | - Andreas Boss
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
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10
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Shen D, Cui L, Fang J, Cui B, Li D, Tai H. Voxel-Wise Meta-Analysis of Gray Matter Changes in Amyotrophic Lateral Sclerosis. Front Aging Neurosci 2016; 8:64. [PMID: 27065078 PMCID: PMC4811926 DOI: 10.3389/fnagi.2016.00064] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 03/14/2016] [Indexed: 12/11/2022] Open
Abstract
Background: Increasing neuroimaging studies have revealed gray matter (GM) anomalies of several brain regions by voxel-based morphometry (VBM) studies in patients with amyotrophic lateral sclerosis (ALS). A voxel-wise meta-analysis was conducted to integrate the reported studies to determine the consistent GM alterations in ALS based on VBM methods. Methods: Ovid Medline, Pubmed, Emabase, and BrainMap database were searched for relevant studies.Data were extracted by two independent researchers. Voxel-wise meta-analysis was performed using the effect-size signed differential mapping (ES-SDM) software. Results: Twenty-nine VBM studies comprising 638 subjects with ALS and 622 healthy controls (HCs) met inclusion criteria.The global GM volumes of ALS patients were significantly decreased compared with those of HCs. GM reductions in patients were mainly located in the right precentral gyrus, the left Rolandic operculum, the left lenticular nucleus and the right anterior cingulate/paracingulate gyri. The right precentral gyrus and the left inferior frontal gyrus might be potential anatomical biomarkers to evaluate the severity of the disease, and longer disease duration was associated with more GM atrophy in the left frontal aslant tract and the right precentral gyrus in ALS patients. Conclusion: The results support that ALS is a complex degenerative disease involving multisystems besides the motor system.The mechanism of asymmetric atrophy of the motor cortex and the implication of Rolandic operculum involvement in ALS need to be further elucidated in future studies.
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Affiliation(s)
- Dongchao Shen
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesBeijing, China; Neuroscience Center, Chinese Academy of Medical SciencesBeijing, China
| | - Jia Fang
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing, China
| | - Bo Cui
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing, China
| | - Dawei Li
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing, China
| | - Hongfei Tai
- Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences Beijing, China
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Cosottini M, Donatelli G, Costagli M, Caldarazzo Ienco E, Frosini D, Pesaresi I, Biagi L, Siciliano G, Tosetti M. High-Resolution 7T MR Imaging of the Motor Cortex in Amyotrophic Lateral Sclerosis. AJNR Am J Neuroradiol 2016; 37:455-61. [PMID: 26680464 DOI: 10.3174/ajnr.a4562] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/12/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE Amyotrophic lateral sclerosis is a progressive motor neuron disorder that involves degeneration of both upper and lower motor neurons. In patients with amyotrophic lateral sclerosis, pathologic studies and ex vivo high-resolution MR imaging at ultra-high field strength revealed the co-localization of iron and activated microglia distributed in the deep layers of the primary motor cortex. The aims of the study were to measure the cortical thickness and evaluate the distribution of iron-related signal changes in the primary motor cortex of patients with amyotrophic lateral sclerosis as possible in vivo biomarkers of upper motor neuron impairment. MATERIALS AND METHODS Twenty-two patients with definite amyotrophic lateral sclerosis and 14 healthy subjects underwent a high-resolution 2D multiecho gradient-recalled sequence targeted on the primary motor cortex by using a 7T scanner. Image analysis consisted of the visual evaluation and quantitative measurement of signal intensity and cortical thickness of the primary motor cortex in patients and controls. Qualitative and quantitative MR imaging parameters were correlated with electrophysiologic and laboratory data and with clinical scores. RESULTS Ultra-high field MR imaging revealed atrophy and signal hypointensity in the deep layers of the primary motor cortex of patients with amyotrophic lateral sclerosis with a diagnostic accuracy of 71%. Signal hypointensity of the deep layers of the primary motor cortex correlated with upper motor neuron impairment (r = -0.47; P < .001) and with disease progression rate (r = -0.60; P = .009). CONCLUSIONS The combined high spatial resolution and sensitivity to paramagnetic substances of 7T MR imaging demonstrate in vivo signal changes of the cerebral motor cortex that resemble the distribution of activated microglia within the cortex of patients with amyotrophic lateral sclerosis. Cortical thinning and signal hypointensity of the deep layers of the primary motor cortex could constitute a marker of upper motor neuron impairment in patients with amyotrophic lateral sclerosis.
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Affiliation(s)
- M Cosottini
- From the Department of Translational Research and New Technologies in Medicine and Surgery (M.Cosottini) and Neurology Unit
| | - G Donatelli
- Neuroradiology Unit (G.D., I.P.), Department of Diagnostic and Interventional Radiology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - M Costagli
- IMAGO7 Foundation (M.Costagli), Pisa, Italy
| | - E Caldarazzo Ienco
- Department of Clinical and Experimental Medicine (E.C.I., D.F., G.S.), University of Pisa, Pisa, Italy
| | - D Frosini
- Department of Clinical and Experimental Medicine (E.C.I., D.F., G.S.), University of Pisa, Pisa, Italy
| | - I Pesaresi
- Neuroradiology Unit (G.D., I.P.), Department of Diagnostic and Interventional Radiology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - L Biagi
- IRCCS Stella Maris (L.B., M.T.), Pisa, Italy
| | - G Siciliano
- Department of Clinical and Experimental Medicine (E.C.I., D.F., G.S.), University of Pisa, Pisa, Italy
| | - M Tosetti
- IRCCS Stella Maris (L.B., M.T.), Pisa, Italy
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12
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Motor and extra-motor gray matter atrophy in amyotrophic lateral sclerosis: quantitative meta-analyses of voxel-based morphometry studies. Neurobiol Aging 2015; 36:3288-3299. [PMID: 26362941 DOI: 10.1016/j.neurobiolaging.2015.08.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 08/11/2015] [Accepted: 08/14/2015] [Indexed: 02/05/2023]
Abstract
Considerable evidence from previous voxel-based morphometry studies indicates widespread but heterogeneous gray matter (GM) deficits in amyotrophic lateral sclerosis (ALS). Here, we aimed to investigate the concurrence across voxel-based morphometry studies to help clarify the spatial pattern of GM abnormalities that underlie this condition. Comprehensive meta-analyses to assess regional GM anomalies in ALS were conducted with the Anisotropic Effect Size version of Signed Differential Mapping software package. Twenty studies, which reported 22 comparisons and were composed of 454 ALS patients and 426 healthy controls, were included in the meta-analyses. Regional GM atrophy in ALS was consistently found in the frontal, temporal, and somatosensory areas. Meta-regression demonstrated that the disease duration, disease severity, and age were significantly related to GM deficits in ALS patients. The present meta-analysis provides convergent evidence that ALS is a multisystem degenerative disorder that is accompanied by a unique and widespread pattern of robust cortical GM atrophy. Future studies should investigate whether this atrophy pattern is a diagnostic and prognostic marker.
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13
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The "Motor Band Sign:" Susceptibility-Weighted Imaging in Amyotrophic Lateral Sclerosis. Can J Neurol Sci 2015; 42:260-3. [PMID: 25971894 DOI: 10.1017/cjn.2015.40] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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14
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de Munck E, Muñoz-Sáez E, Miguel BG, Solas MT, Martínez A, Arahuetes RM. Morphometric and neurochemical alterations found in l-BMAA treated rats. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2015; 39:1232-45. [PMID: 26002186 DOI: 10.1016/j.etap.2015.04.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 04/30/2015] [Indexed: 05/03/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive muscle paralysis that reflects the motoneurons' degeneration. Several studies support the relationship between β-N-methylamino-l-alanine (l-BMAA), a neurotoxic amino acid produced by cyanobacteria and diatoms, and the sporadic occurrence of ALS and other neurodegenerative diseases. Therefore, the study of its neurotoxicity mechanisms has assumed great relevance in recent years. Recently, our research team has proposed a sporadic ALS animal model by l-BMAA administration in rats, which displays many pathophysiological features of human ALS. In this paper, we deepen the characterization of this model corroborating the occurrence of alterations present in ALS patients such as decreased muscle volume, thinning of the motor cortex, enlarged brain's lateral ventricles, and alteration of both bulbar nuclei and neurotransmitters' levels. Therefore, we conclude that l-BMAA treated rats could be a good model which mimics degenerative features that ALS causes in humans.
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Affiliation(s)
- Estefanía de Munck
- Departamento de Biología Animal II, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Emma Muñoz-Sáez
- Departamento de Bioquímica y Biología Molecular I, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Begoña G Miguel
- Departamento de Bioquímica y Biología Molecular I, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - M Teresa Solas
- Departamento de Biología Celular (Morfología Microscópica), Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Ana Martínez
- Centro de Investigaciones Biológicas, Consejo Superior de Investigaciones Científicas, 28040 Madrid, Spain.
| | - Rosa M Arahuetes
- Departamento de Biología Animal II, Universidad Complutense de Madrid, 28040 Madrid, Spain.
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15
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Mohammadi B, Kollewe K, Cole DM, Fellbrich A, Heldmann M, Samii A, Dengler R, Petri S, Münte TF, Krämer UM. Amyotrophic lateral sclerosis affects cortical and subcortical activity underlying motor inhibition and action monitoring. Hum Brain Mapp 2015; 36:2878-89. [PMID: 25913637 DOI: 10.1002/hbm.22814] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 04/01/2015] [Accepted: 04/06/2015] [Indexed: 12/11/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by muscular atrophy, spasticity, and bulbar signs caused by loss of upper and lower motor neurons. Evidence suggests that ALS additionally affects other brain areas including premotor cortex and supplementary motor area. Here, we studied movement execution and inhibition in ALS patients using a stop-signal paradigm and functional magnetic resonance imaging. Seventeen ALS patients and 17 age-matched healthy controls performed a stop-signal task that required responding with a button press to a right- or left-pointing black arrow (go-stimuli). In stop-trials, a red arrow (stop-stimulus) was presented shortly after the black arrow indicating to withhold the prepared movement. Patients had by trend higher reaction times in go-trials but did not differ significantly in their inhibition performance. Patients showed stronger inhibition-related activity in inferior, superior, and middle frontal gyri as well as in putamen and pallidum. Error-related activity, conversely, was found to be stronger in healthy controls, particularly in the insula bilaterally. Patients also showed increased activity in the motor cortex during button presses. The results provide evidence for altered prefrontal and subcortical networks underlying motor execution, motor inhibition, and error monitoring in ALS.
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Affiliation(s)
- Bahram Mohammadi
- Department of Neurology, University Lübeck, Lübeck, Germany
- CNS-LAB, International Neuroscience Institute, Hannover, Germany
| | - Katja Kollewe
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - David M Cole
- Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
| | - Anja Fellbrich
- Department of Neurology, University Lübeck, Lübeck, Germany
| | | | - Amir Samii
- CNS-LAB, International Neuroscience Institute, Hannover, Germany
| | - Reinhard Dengler
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Thomas F Münte
- Department of Neurology, University Lübeck, Lübeck, Germany
- Institute of Psychology II, University Lübeck, Germany
| | - Ulrike M Krämer
- Department of Neurology, University Lübeck, Lübeck, Germany
- Institute of Psychology II, University Lübeck, Germany
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16
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Goveas J, O'Dwyer L, Mascalchi M, Cosottini M, Diciotti S, De Santis S, Passamonti L, Tessa C, Toschi N, Giannelli M. Diffusion-MRI in neurodegenerative disorders. Magn Reson Imaging 2015; 33:853-76. [PMID: 25917917 DOI: 10.1016/j.mri.2015.04.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 04/18/2015] [Accepted: 04/19/2015] [Indexed: 12/11/2022]
Abstract
The ability to image the whole brain through ever more subtle and specific methods/contrasts has come to play a key role in understanding the basis of brain abnormalities in several diseases. In magnetic resonance imaging (MRI), "diffusion" (i.e. the random, thermally-induced displacements of water molecules over time) represents an extraordinarily sensitive contrast mechanism, and the exquisite structural detail it affords has proven useful in a vast number of clinical as well as research applications. Since diffusion-MRI is a truly quantitative imaging technique, the indices it provides can serve as potential imaging biomarkers which could allow early detection of pathological alterations as well as tracking and possibly predicting subtle changes in follow-up examinations and clinical trials. Accordingly, diffusion-MRI has proven useful in obtaining information to better understand the microstructural changes and neurophysiological mechanisms underlying various neurodegenerative disorders. In this review article, we summarize and explore the main applications, findings, perspectives as well as challenges and future research of diffusion-MRI in various neurodegenerative disorders including Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, Huntington's disease and degenerative ataxias.
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Affiliation(s)
- Joseph Goveas
- Department of Psychiatry and Behavioral Medicine, and Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Laurence O'Dwyer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Mario Mascalchi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy; Quantitative and Functional Neuroradiology Research Program at Meyer Children and Careggi Hospitals of Florence, Florence, Italy
| | - Mirco Cosottini
- Department of Translational Research and New Surgical and Medical Technologies, University of Pisa, Pisa, Italy; Unit of Neuroradiology, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy
| | - Stefano Diciotti
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Italy
| | - Silvia De Santis
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, Italy; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Carlo Tessa
- Division of Radiology, "Versilia" Hospital, AUSL 12 Viareggio, Lido di Camaiore, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, Medical Physics Section, University of Rome "Tor Vergata", Rome, Italy; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Marco Giannelli
- Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy.
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17
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Meadowcroft MD, Mutic NJ, Bigler DC, Wang JL, Simmons Z, Connor JR, Yang QX. Histological-MRI correlation in the primary motor cortex of patients with amyotrophic lateral sclerosis. J Magn Reson Imaging 2015; 41:665-75. [PMID: 24615949 PMCID: PMC4145061 DOI: 10.1002/jmri.24582] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 01/10/2014] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To establish the relationship between ALS histopathology and quantitative MRI metrics. MATERIALS AND METHODS ALS patients (N = 8) in advanced stages of the disease were enrolled and, immediately after death, the brain of each patient was removed. Freshly excised ALS tissue was imaged at 3.0 Tesla with T1 and T2 mapping protocols and subsequently stained with astrocyte, myelin, and neuronal markers. Measures of ALS histological stains were compared with the internal control (primary visual cortex) and longitudinal parametric maps. RESULTS Post-mortem T1 -weighted images demonstrate diminished contrast between gray and white matter and alterations in T1 relaxation within the primary motor cortex. An increase in astrocyte number and reactivity as well as evident neuronal loss, a decrease in axonal density, and unraveling of the myelin sheaths in subcortical white matter were found in the ALS primary motor cortex exhibiting significant T1 relaxation and contrast changes. CONCLUSION This study provides a histopathological basis for differences in MR T1 contrast and relaxation seen in the ALS brain.
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Affiliation(s)
- Mark D. Meadowcroft
- Department of Neurosurgery, The Pennsylvania State University – College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
- Department of Radiology (Center for NMR Research), The Pennsylvania State University – College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Nathan J. Mutic
- Department of Radiology (Center for NMR Research), The Pennsylvania State University – College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Don C. Bigler
- Department of Radiology (Center for NMR Research), The Pennsylvania State University – College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Jian-li Wang
- Department of Radiology (Center for NMR Research), The Pennsylvania State University – College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Zachary Simmons
- Department of Neurology, The Pennsylvania State University – College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - James R. Connor
- Department of Neurosurgery, The Pennsylvania State University – College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Qing X. Yang
- Department of Radiology (Center for NMR Research), The Pennsylvania State University – College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
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18
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Tavazzi E, Laganà MM, Bergsland N, Tortorella P, Pinardi G, Lunetta C, Corbo M, Rovaris M. Grey matter damage in progressive multiple sclerosis versus amyotrophic lateral sclerosis: a voxel-based morphometry MRI study. Neurol Sci 2014; 36:371-7. [PMID: 25228014 DOI: 10.1007/s10072-014-1954-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 09/12/2014] [Indexed: 12/13/2022]
Abstract
Primary progressive multiple sclerosis (PPMS) and amyotrophic lateral sclerosis (ALS) seem to share some clinical and pathological features. MRI studies revealed the presence of grey matter (GM) atrophy in both diseases, but no comparative data are available. The objective was to compare the regional patterns of GM tissue loss in PPMS and ALS with voxel-based morphometry (VBM). Eighteen PPMS patients, 20 ALS patients, and 31 healthy controls (HC) were studied with a 1.5 Tesla scanner. VBM was performed to assess volumetric GM differences with age and sex as covariates. Threshold-free cluster enhancement analysis was used to obtain significant clusters. Group comparisons were tested with family-wise error correction for multiple comparisons (p < 0.05) except for HC versus MND which was tested at a level of p < 0.001 uncorrected and a cluster threshold of 20 contiguous voxels. Compared to HC, ALS patients showed GM tissue reduction in selected frontal and temporal areas, while PPMS patients showed a widespread bilateral GM volume decrease, involving both deep and cortical regions. Compared to ALS, PPMS patients showed tissue volume reductions in both deep and cortical GM areas. This preliminary study confirms that PPMS is characterized by a more diffuse cortical and subcortical GM atrophy than ALS and that, in the latter condition, brain damage is present outside the motor system. These results suggest that PPMS and ALS may share pathological features leading to GM tissue loss.
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Affiliation(s)
- Eleonora Tavazzi
- Unit of Motor Neurorehabilitation, Multiple Sclerosis Center, Scientific Institute Santa Maria Nascente, Fondazione Don Gnocchi, via Capecelatro 66, 20148, Milan, Italy
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19
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Stoppel CM, Vielhaber S, Eckart C, Machts J, Kaufmann J, Heinze HJ, Kollewe K, Petri S, Dengler R, Hopf JM, Schoenfeld MA. Structural and functional hallmarks of amyotrophic lateral sclerosis progression in motor- and memory-related brain regions. NEUROIMAGE-CLINICAL 2014; 5:277-90. [PMID: 25161894 PMCID: PMC4141983 DOI: 10.1016/j.nicl.2014.07.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 07/03/2014] [Accepted: 07/17/2014] [Indexed: 11/19/2022]
Abstract
Previous studies have shown that in amyotrophic lateral sclerosis (ALS) multiple motor and extra-motor regions display structural and functional alterations. However, their temporal dynamics during disease-progression are unknown. To address this question we employed a longitudinal design assessing motor- and novelty-related brain activity in two fMRI sessions separated by a 3-month interval. In each session, patients and controls executed a Go/NoGo-task, in which additional presentation of novel stimuli served to elicit hippocampal activity. We observed a decline in the patients' movement-related activity during the 3-month interval. Importantly, in comparison to controls, the patients' motor activations were higher during the initial measurement. Thus, the relative decrease seems to reflect a breakdown of compensatory mechanisms due to progressive neural loss within the motor-system. In contrast, the patients' novelty-evoked hippocampal activity increased across 3 months, most likely reflecting the build-up of compensatory processes typically observed at the beginning of lesions. Consistent with a stage-dependent emergence of hippocampal and motor-system lesions, we observed a positive correlation between the ALSFRS-R or MRC-Megascores and the decline in motor activity, but a negative one with the hippocampal activation-increase. Finally, to determine whether the observed functional changes co-occur with structural alterations, we performed voxel-based volumetric analyses on magnetization transfer images in a separate patient cohort studied cross-sectionally at another scanning site. Therein, we observed a close overlap between the structural changes in this cohort, and the functional alterations in the other. Thus, our results provide important insights into the temporal dynamics of functional alterations during disease-progression, and provide support for an anatomical relationship between functional and structural cerebral changes in ALS.
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Affiliation(s)
- Christian Michael Stoppel
- Department of Neurology, Otto-von-Guericke-University, Leipziger Str. 44, Magdeburg 39120, Germany
- Corresponding author.
| | - Stefan Vielhaber
- Department of Neurology, Otto-von-Guericke-University, Leipziger Str. 44, Magdeburg 39120, Germany
- DZNE — German Centre for Neurodegenerative Diseases, Leipziger Str. 44, Magdeburg 39120, Germany
- Corresponding author.
| | - Cindy Eckart
- Department of Neurology, Otto-von-Guericke-University, Leipziger Str. 44, Magdeburg 39120, Germany
- Institute for Systemic Neurosciences, University Clinic, Martinistr. 52, Hamburg 20246, Germany
| | - Judith Machts
- Department of Neurology, Otto-von-Guericke-University, Leipziger Str. 44, Magdeburg 39120, Germany
| | - Jörn Kaufmann
- Department of Neurology, Otto-von-Guericke-University, Leipziger Str. 44, Magdeburg 39120, Germany
| | - Hans-Jochen Heinze
- Department of Neurology, Otto-von-Guericke-University, Leipziger Str. 44, Magdeburg 39120, Germany
- Leibniz-Institute for Neurobiology, Brennecke Str. 6, Magdeburg 39118, Germany
| | - Katja Kollewe
- Department of Neurology, Medical School Hannover, Carl-Neuberg-str. 1, Hannover 30625, Germany
| | - Susanne Petri
- Department of Neurology, Medical School Hannover, Carl-Neuberg-str. 1, Hannover 30625, Germany
| | - Reinhard Dengler
- Department of Neurology, Medical School Hannover, Carl-Neuberg-str. 1, Hannover 30625, Germany
| | - Jens-Max Hopf
- Department of Neurology, Otto-von-Guericke-University, Leipziger Str. 44, Magdeburg 39120, Germany
- Leibniz-Institute for Neurobiology, Brennecke Str. 6, Magdeburg 39118, Germany
| | - Mircea Ariel Schoenfeld
- Department of Neurology, Otto-von-Guericke-University, Leipziger Str. 44, Magdeburg 39120, Germany
- Leibniz-Institute for Neurobiology, Brennecke Str. 6, Magdeburg 39118, Germany
- Kliniken Schmieder, Zum Tafelholz 8, Allensbach 78476, Germany
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20
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Mascalchi M, Toschi N, Ginestroni A, Giannelli M, Nicolai E, Aiello M, Soricelli A, Diciotti S. Gender, age-related, and regional differences of the magnetization transfer ratio of the cortical and subcortical brain gray matter. J Magn Reson Imaging 2013; 40:360-6. [PMID: 24923993 DOI: 10.1002/jmri.24355] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 07/29/2013] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To explore gender, age-related, and regional differences of magnetization transfer ratio (MTR) of brain cortical and subcortical gray matter (GM). MATERIALS AND METHODS In all, 102 healthy subjects (51 women and 51 men; range 25-84 years) were examined with 3-mm thick MT images. We assessed MTR in automatically segmented GM structures including frontal, parietal-insular, temporal, and occipital cortex, caudate, pallidus and putamen, and cerebellar cortex. A general linear model analysis was conducted to ascertain the linear and quadratic relationship among the MTR and gender, age, and anatomical structure. RESULTS The effect of gender was borderline (P = 0.07) in all GM structures (with higher MTR values in men), whereas age showed a significant linear as well as quadratic effect in all cortical and subcortical GM structures (P ≤ 0.001). Quadratic age-related decrease in MTR began at about 40 years of age. Mean and standard deviation (SD) of MTR had the following decreasing order: thalamus (58.3 + 0.8), pallidus (56.8 ± 1.3), caudate (55.5 ± 1.6) and putamen (54.6 ± 1.1); temporal (56.8 ± 0.9), parietal-insular (56.8 ± 1.1), frontal (56.5 ± 1.1), occipital (55.4 ± 1.0) and cerebellar (53.2 ± 1.0) cortex. In post-hoc testing, all regional pairwise differences were statistically significant except pallidus vs. temporal or parietal-insular cortex, caudate vs. occipital cortex, frontal vs. parietal-insular or temporal cortex. CONCLUSION MTR of the cortical and subcortical brain GM structures decreases quadratically after midlife and shows significant regional differences.
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Affiliation(s)
- Mario Mascalchi
- Quantitative and Functional Neuroradiology Program at Meyer Children's Hospital and Careggi Hospital of Florence, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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