Spinal Cord Gray Matter Atrophy in Amyotrophic Lateral Sclerosis

Area of Science:

• Neurology
• Radiology
• Biomarker Discovery

Background:

• Amyotrophic lateral sclerosis (ALS) requires better biomarkers for clinical phenotyping and progression prediction.
• Current methods lack sufficient sensitivity for early detection and monitoring.

Purpose of the Study:

• To quantify cervical spinal gray matter atrophy in ALS patients.
• To investigate the association of this atrophy with clinical disability at baseline and after one year.
• To assess its potential as a predictive biomarker for ALS progression.

Main Methods:

• 3T MR imaging was used for 29 ALS patients and 22 healthy controls.
• Spinal cord, gray matter, and white matter cross-sectional areas were automatically measured.
• Correlations between atrophy and clinical scores at baseline and 1-year follow-up were analyzed.

Main Results:

• Gray matter atrophy was more sensitive than spinal cord atrophy in distinguishing ALS patients (P = .004 vs P = .02).
• Both gray matter and spinal cord areas correlated well with clinical scores at baseline (R = 0.56 and R = 0.55, respectively).
• Predictive accuracy for 1-year clinical scores improved from R² = 0.54 to R² = 0.74 when including gray and white matter areas.

Conclusions:

• Cervical spinal gray matter cross-sectional area shows potential as an MRI biomarker for ALS.
• This measure may aid in monitoring disease evolution and patient stratification.
• While modest improvements, it offers a valuable structural biomarker for ALS research.