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Related Experiment Videos

Diffusion tensor MRI assesses corticospinal tract damage in ALS.

C M Ellis1, A Simmons, D K Jones

  • 1Department of Clinical Neurosciences, Institute of Psychiatry, and Guy's, King's and St. Thomas' School of Medicine, London, UK.

Neurology
|September 25, 1999
PubMed
Summary
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Diffusion tensor MRI detects upper motor neuron damage in amyotrophic lateral sclerosis (ALS) by showing changes in corticospinal tracts. These diffusion changes correlate with disease severity and duration, supporting MRI

Area of Science:

  • Neuroimaging
  • Neurology
  • Biophysics

Background:

  • Assessing upper motor neuron (UMN) damage in amyotrophic lateral sclerosis (ALS) has relied on various neurophysiologic and neuroimaging techniques.
  • Diffusion tensor MRI (DT-MRI) detects alterations in water molecule diffusion caused by changes in central nervous system (CNS) tissue structure.

Purpose of the Study:

  • To investigate if degeneration of motor fibers in ALS alters diffusion characteristics in the posterior limb of the internal capsule.
  • To determine if DT-MRI can detect these diffusion changes associated with ALS.

Main Methods:

  • Studied 22 ALS patients (limb and bulbar onset) and 20 healthy controls.
  • Assessed transcranial magnetic stimulation (TMS) parameters: central motor conduction time (CMCT), threshold to stimulation, and silent period.

Related Experiment Videos

  • Acquired DT-MRI data from the posterior limb of the internal capsule, generating maps of mean diffusivity and fractional anisotropy.

    • Main Results:

    • No significant differences in TMS measures (CMCT, threshold, silent period) between groups, though CMCT correlated with UMN involvement.
    • Significant increases in mean diffusivity and reductions in fractional anisotropy were observed along the corticospinal tracts in ALS patients compared to controls.
    • These diffusion changes were most pronounced in the bulbar-onset ALS group and correlated with disease severity, UMN involvement, and duration.

    Conclusions:

    • DT-MRI effectively detects pathology in the corticospinal tracts in ALS patients.
    • Diffusion characteristics, specifically mean diffusivity and fractional anisotropy, serve as sensitive biomarkers for UMN degeneration in ALS.